Search results for: older adults

Authors: Tugba Sevinc Gamsiz, Emine Koroglu, Ozcan Keskin

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Aim: Nonalcoholic fatty liver disease (NAFLD) is considered the most common chronic liver disease in the general population. The higher mortality and morbidity among NAFLD patients and lack of symptoms makes early detection and management important. In our study, we aimed to evaluate the relationship between noninvasive imaging and biochemical markers in diabetic and nondiabetic patients diagnosed with NAFLD. Materials and Methods: The study was conducted from (September 2017) to (December 2017) on adults admitted to Internal Medicine and Gastroenterology outpatient clinics with hepatic steatosis reported on ultrasound or transient elastography within the last six months that exclude patients with other liver diseases or alcohol abuse. The data were collected and analyzed retrospectively. Number cruncher statistical system (NCSS) 2007 program was used for statistical analysis. Results: 116 patients were included in this study. Diabetic patients compared to nondiabetics had significantly higher Controlled Attenuation Parameter (CAP), Liver Stiffness Measurement (LSM) and fibrosis values. Also, hypertension, hepatomegaly, high BMI, hypertriglyceridemia, hyperglycemia, high A1c, and hyperuricemia were found to be risk factors for NAFLD progression to fibrosis. Advanced fibrosis (F3, F4) was present in 18,6 % of all our patients; 35,8 % of diabetic and 5,7 % of nondiabetic patients diagnosed with hepatic steatosis. Conclusion: Transient elastography is now used in daily clinical practice as an accurate noninvasive tool during follow-up of patients with fatty liver. Early diagnosis of the stage of liver fibrosis improves the monitoring and management of patients, especially in those with metabolic syndrome criteria.

Keywords: diabetes, elastography, fatty liver, fibrosis, metabolic syndrome

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Authors: Yamunah Devi Apalasamy, Sanjay Rampal, Tin Tin Su, Foong Ming Moy, Hazreen Abdul Majid, Awang Bulgiba, Zahurin Mohamed

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Obesity is a growing global health issue. Obesity results from a combination of environmental and genetics factors. Brain-derived neurotrophic factor (BDNF), a gene encodes the BDNF protein and the BDNF gene have been linked to regulation of body weight and appetite. Genome-wide association studies have identified the BDNF variants to be related to obesity among Caucasians, East Asians, and Filipinos. However, the role of BDNF in other ethnic groups remains inconclusive. This case control study aims to investigate the associations of BDNF gene polymorphisms with obesity and metabolic parameters in Malaysian Malays. BDNF rs4074134, BDNF rs10501087 and BDNF rs6265 were genotyped using Sequenom MassARRAY. Anthropometric, body fat, fasting lipids and glucose levels were measured. A total of 663 subjects (194 obese and 469 non-obese) were included in this study. There were no significant associations association between BDNF SNPs and obesity. The allelic and genotype frequencies of the BDNF SNPs were similar in the obese and non-obese groups. After adjustment for age and sex, the BDNF variants were not associated with obesity, body fat, fasting lipids and glucose levels. Haplotypes at the BDNF gene region, were not significantly associated with obesity. The BDNF rs4074134 was in strong LD with BDNF rs10501087 (D'=0.98) and BDNF rs6265 (D'=0.87). The BDNF rs10501087 was also in strong LD with BDNF rs6265 (D'=0.91). Our findings suggest that the BDNF variants and the haplotypes of BDNF gene were not associated with obesity and metabolic traits in this study population. Further research is needed to explore other BDNF variants with a larger sample size with gene-environment interactions in multi ethnic Malaysian population.

Keywords: genomics of obesity, SNP, BMI, haplotypes

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Authors: Daryl Clement Knutt, Neela Badrie, Marsha Singh

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Quality assurance and product labelling are vital in the food and drink industry, as a tactical tool in a competitive environment. The food label is a principal marketing tool which also serves as a regulatory mechanism in the safeguarding of consumer well –being. The objective of this study was to evaluate the level of consumers’ use and understanding of food labeling information and knowledge pertaining to food quality assurance systems. The study population consisted of Trinidadian adults, who were over the age of 18 (n=384). Data collection was conducted via a self-administered questionnaire, which contained 31 questions, comprising of four sections: I. socio demographic information; II. food quality and quality assurance; III. use of Labeling information; and IV. laws and regulations. Sampling was conducted at six supermarkets, in five major regions of the country over a period of three weeks in 2014. The demographic profile of the shoppers revealed that majority was female (63.6%). The gender factor and those who were concerned about the nutrient content of their food, were predictive indicators of those who read food labels. Most (93.1%) read food labels before purchase, 15.4% ‘always’; 32.5% ‘most times’ and 45.2% ‘sometimes’. Some (42%) were often satisfied with the information presented on food labels, whilst 35.7% of consumers were unsatisfied. When the respondents were questioned on their familiarity with terms ‘food quality’ and ‘food quality assurance’, 21.3% of consumers replied positively - ‘I have heard the terms and know a lot’ whilst 37% were only ‘somewhat familiar’. Consumers were mainly knowledgeable of the International Standard of Organization (ISO) (51.5%) and Good Agricultural Practices GAP (38%) as quality tools. Participants ranked ‘nutritional information’ as the number one labeling element that should be better presented, followed by ‘allergy notes’ and ‘best before date’. Females were more inclined to read labels being the household shoppers. The shoppers would like better presentation of the food labelling information so as to guide their decision to purchase a product.

Keywords: food labels, food quality, nutrition, marketing, Trinidad, Tobago

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Authors: M. E. Joret, F. Germeys, P. Van de Craen

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Background: Previous studies have shown that ‘full’ bilingualism seems to enhance the executive functions in children, young adults and elderly people. Executive functions refer to a complex cognitive system responsible for self-controlled and planned behavior and seem to predict academic achievement. The present study aimed at investigating whether similar effects could be found in children learning their second language at school in immersion education programs. Methods: In this study, 44 children involved in immersion education for 4 to 5 years were compared to 48 children in traditional schools. All children were between 9 and 11 years old. To assess executive functions, the Simon task was used, a neuropsychological measure assessing executive functions with reaction times and accuracy on congruent and incongruent trials. To control for background measures, all children underwent the Raven’s coloured progressive matrices, to measure non-verbal intelligence and the Echelle de Vocabulaire en Images Peabody (EVIP), assessing verbal intelligence. In addition, a questionnaire was given to the parents to control for other confounding variables, such as socio-economic status (SES), home language, developmental disorders, etc. Results: There were no differences between groups concerning non-verbal intelligence and verbal intelligence. Furthermore, the immersion learners showed overall faster reaction times on both congruent and incongruent trials compared to the traditional learners, but only after 5 years of training, not before. Conclusion: These results show that the cognitive benefits found in ‘full’ bilinguals also appear in children involved in immersion education, but only after a sufficient exposure to the second language. Our results suggest that the amount of second language training needs to be sufficient before these cognitive effects may emerge.

Keywords: bilingualism, executive functions, immersion education, Simon task

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Authors: Nasiruddin Khan

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The increased use of caffeinated beverages and energy drink is posing threat to all ages and gender especially, younger adults. There is a lack of scientific evidence in Oman regarding caffeine and energy drink consumption. Our study aims to demonstrate the prevalence, pattern, knowledge and awareness, and side effects of caffeine intake among university students. This cross-sectional study including (N=365) apparently healthy male and female Omani university students aged 18-30 years, was carried out from February 2018-June 2018. A self-administered questionnaire with various sections was used to obtain information. The prevalence of caffeinated beverage consumption was commonly high among participants (97%). The males preferred Nescafe, coffee (both p < 0.001), espresso (p < 0.022), and soda (p < 0.008) while females consumed more tea (p < 0.029). The awareness about negative health impact of caffeine intake was significantly higher in females rather than males (p < 0.002). The overall prevalence of energy drink consumption was 42.1% (n=149), and higher in males (75%, p < 0.001). More males consumed 3-5 and > 5 cans/day while females used 1-2 cans/day. The starting age of energy drink use was higher in females (16-20 years (51.1%)) as compared to males (11-15 years (33.3%)). Females were more aware of caffeine as energy drink ingredient (p < 0.036) than males. The major source of information about enery drink was family and friends (58.3%). Red Bull was the commonly used brand (55.5%) among participants. Common reasons for high energy drink consumption were energy boost (68.4 %), taste (62.9%), reduce fatigue (52.1%), and better performance (47.3%). Females reported breathing problem, and abnormal heart beat (p < 0.004, 0.054, respectively), while more males reported irritability than females (p < 0.052). The prevalence of caffeinated beverage and energy drink consumption is high among participants. The awareness, and knowledge among university student is not satisfactory and needs immediate action to avoid excess use of such consumption.

Keywords: energy drink, caffeinated beverages, awareness, Oman

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Authors: Shamila Manie, Soraya Maart, Ayesha Osman

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Introduction: People diagnosed with multidrug resistant pulmonary tuberculosis (MDR-PTB) is subjected to prolonged hospitalization in South Africa. It has thus become essential for research to shift its focus from a purely medical approach, but to include social and environmental factors when looking at the impact of the disease on those affected. Aim: To explore the factors affecting individuals with multi-drug resistant pulmonary tuberculosis during long-term hospitalization using the comprehensive ICF core-sets for obstructive pulmonary disease (OPD) and cardiopulmonary (CPR) conditions at Brooklyn Chest Hospital (BCH). Methods: A quantitative descriptive, cross-sectional study design was utilized. A convenient sample of 19 adults at Brooklyn Chest Hospital were interviewed. Results: Most participants reported a decrease in exercise tolerance levels (b455: n=11). However it did not limit participation. Participants reported that a lack of privacy in the environment (e155) was a barrier to health. The presence of health professionals (e355) and the provision of skills development services (e585) are facilitators to health and well-being. No differences exist in the functional ability of HIV positive and negative participants in this sample. Conclusion: The ICF Core Sets appeared valid in identifying the barriers and facilitators experienced by individuals with MDR-PTB admitted to BCH. The hospital environment must be improved to add to the QoL of those admitted, especially improving privacy within the wards. Although the social grant is seen as a facilitator, greater emphasis must be placed on preparing individuals to be economically active in the labour for when they are discharged.

Keywords: multidrug resistant tuberculosis, MDR ICF core sets, health-related quality of life (HRQoL), hospitalization

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Authors: Danièle Peto

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A qualitative research based on twenty-eight semi-structured interviews of students in Social Work, in Brussels (Belgium), showed specific results for the Arab and Muslim students: second and third generations immigrants build their identity on the basis of a mix of differentiation with and recognition of their parents' culture of origin. Building a bridge between Modernity and Tradition, they claim active citizenship; at the same time they show and live by values and religious believes which reinforce the link to their parents’ origins. But they present those values and believes as their own rational choices among other choices, all available and rich for our multicultural society. The way they speak of themselves is highly modern. But, they still have to build a third way to find a place for themselves in society: one allowing them to live their religion as a partially public matter (when the Occidental society leaves no such place for religion) while ensuring, at the same time, the development of independent critical thought. On this basis, other semi-structured interviews are being laid with Social workers working with families from diverse ethnic backgrounds. They will verify the reality of those identity and cultural bricolages when those young adults of second and third generations build their own family. In between the theoretical models of traditional family and modern family, shall we find a new model, hybrid and more or less stable, combining some aspects of the former and the latter? The exploratory research phase focuses on three aspects of building a family life in this context : the way those generations play, discursively or not, in between their parents and the society in which they grew up; the importance of intercultural dialogue in this process of building; and testing the hypothesis that some families, in our society, show a special way of courting Modernity.

Keywords: family models, identity bricolages, intercultural, modernity and tradition

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Authors: Uday Shanker Goel, Vinay Vasant Mahashabde, Biswajit Ghosh, Arvind Jha, Amit Kumar, Sanjay Kumar Patel, Uma Shanker Pattanaik, Vinit Kumar Shah, Chaitanya Bhanu

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Pinch rolls of the Hot Mills must possess resistance to wear, thermal stability, high thermal conductivity and through hardness. Conventionally, pinch rolls have been procured either as new ones or refurbished ones. Discarded Work Rolls from the Cold Mill were taken and machined inhouse at Tata Steel to be used subsequently as the bottom pinch rolls of the Hot Mill. The hardness of the scrapped work rolls from CRM is close to 55HRC and the typical composition is ( C - 0.8% , Mn - 0.40 % , Si - 0.40% , Cr - 3.5% , Mo - 0.5% & V - 0.1% ).The Innovation was the use of a roll which would otherwise have been otherwise discarded as scrap. Also, the innovation helped in using the scrapped roll which had better wear and heat resistance. In a conventional Pinch roil (Hardness 50 HRC and typical chemistry - C - 10% , Mo+Co+V+Nb ~ 5 % ) , Pick-up is a condition whereby foreign material becomes adhered to the surface of the pinch roll during service. The foreign material is usually adhered metal from the actual product being rolled. The main attributes of the weld overlay rolls are wear resistance and crack resistance. However, the weld overlay roll has a strong tendency for strip pick-up particularly in the area of bead overlap. However, the greatest disadvantage is the depth of weld deposit, which is less than half of the usable shell thickness in most mills. Because of this, the stainless rolls require re-welding on a routine basis. By providing a significantly cheaper in house and more robust alternative of the existing bottom pinch rolls , this innovation results in significant lower worries for the roll shop. Pinch rolls now don't have to be sent outside Jamshedpur for refurbishment or for procuring new ones. Scrapped rolls from adjacent Cold Mill are procured and sent for machining to our Machine Shop inside Tata Steel works in Jamshedpur. This is far more convenient than the older methodology. The idea is also being deployed to the other hot mills of Tata Steel. Multiple campaigns have been tried out at both down coilers of Hot Strip with significantly lower wear.

Keywords: hot rolling flat, cold mill work roll, hot strip pinch roll, strip surface

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Authors: Alexandra Telitsyna, Galina Semya, Elvira Garifulina

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Introduction: Starting from 2012 Russia conducts deinstitutionalization policy and now the main indicator of success is the number of children living in institutions. Active family placement process has resulted in residents of the institution now mainly consists of adolescents with behavioral and emotional problems, children with disabilities and groups of siblings. Purpose of science research: The purpose of science research is to identify factors for child’s wellbeing while temporary stay in an orphanage and the subjective assessment of children's level of well-being (psychological well-being). Methods: The data used for this project was collected by the questionnaire of 72 indicators, a tool for monitoring the behavior of children and caregivers, an additional questionnaire for children; well-being assessment questionnaire containing 10 scales for three age groups from preschool to older adolescents. In 2016-2018, the research was conducted in 1873 institution in 85 regions of Russia. In each region a team of academics, specialists from Non-profits, independent experts was created. Training was conducted for team members through a series of webinars prior to undertaking the assessment. The results: To ensure the well-being of the children, the following conditions are necessary: 1- Life of children in institution is organised according to the principles of family care (including the creation of conditions for attachment to be formed); 2- Contribution to find family-based placement for children (including reintegration into the primary family); 3- Work with parents of children, who are placed in an organization at the request of parents; 4- Children attend schools according to their needs; 5- Training of staff and volunteers; 6- Special environment and services for children with special needs and children with disabilities; 7- Cooperation with NGOs; 8 - Openness and accessibility of the organization. Conclusion: A study of the psychological well-being of children showed that the most emotionally stressful for children were questions about the presence and frequency of contact with relatives, and the level of well-being is higher in the presence of a trusted adult and respect for rights. The greatest contribution to the trouble is made by the time the child is in the orphanage, the lack of contact with parents and relatives, the uncertainty of the future.

Keywords: identifying factors, orphans, Russia, wellbeing

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Authors: Kanikanun Photchong, Phusit Phukamchanoad

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The objective of this research is to study the people’s level of participation in activities of the community, their satisfaction towards the community, the attachment they have to the community, factors that influence the attachment, as well as the characteristics of the relationships of military families’ of the Royal Guards community of Dusit District. The method used was non-probability sampling by quota sampling according to people’s age. The determined age group was 18 years or older. One set of a sample group was done per family. The questionnaires were conducted by 287 people. Snowball sampling was also used by interviewing people of the community, starting from the Royal Guards Community’s leader, then by 20 of the community’s well-respected persons. The data was analyzed by using descriptive statistics, such as arithmetic mean and standard deviation, as well as by inferential statistics, such as Independent - Samples T test (T-test), One-Way ANOVA (F-test), Chi-Square. Descriptive analysis according to the structure of the interview content was also used. The results of the research is that the participation of the population in the Royal Guards Community in various activities is at a medium level, with the average participation level during Mother’s and Father’s Days. The people’s general level of satisfaction towards the premises of the Royal Guards Community is at the highest level. The people were most satisfied with the transportation within the community and in contacting with people from outside the premises. The access to the community is convenient and there are various entrances. The attachment of the people to the Royal Guards Community in general and by each category is at a high level. The feeling that the community is their home rated the highest average. Factors that influence the attachment of the people of the Royal Guards Community are age, status, profession, income, length of stay in the community, membership of social groups, having neighbors they feel close and familiar with, and as well as the benefits they receive from the community. In addition, it was found that people that participate in activities have a high level of positive relationship towards the attachment of the people to the Royal Guards Community. The satisfaction of the community has a very high level of positive relationship with the attachment of the people to the Royal Guards Community. The characteristics of the attachment of military families’ is that they live in big houses that everyone has to protect and care for, starting from the leader of the family as well as all members. Therefore, they all love the community they live in. The characteristics that show the participation of activities within the community and the high level of satisfaction towards the premises of the community will enable the people to be more attached to the community. The people feel that everyone is close neighbors within the community, as if they are one big family.

Keywords: community attachment, community satisfaction, royal guards community, activities of the community

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Authors: Olajumoke Temilola Fatimat, Fasasi Fausat Kikelomo, Ishola Ganiyat Folasayo, Omayeka Mary

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Psychoactive substances are chemical substances that affect the normal functioning of the brain and cause changes in behavior, mood, and consciousness. Psychoactive substance abuse constitutes one of the most important risk–taking behavior among adolescents and young adults in secondary schools. The study, therefore, assessed the factors influencing the use of psychoactive substances among senior secondary students in Ibadan South–West Local Government Area, Oyo State. A descriptive non-experimental design was adopted; purposive and simple random sampling techniques were used to select 330 respondents, while questionnaires were used for data collection. The descriptive statistics of frequency count, percentages, inferential statistics of chi-square, and analysis of variance were used for the analysis. The results revealed that the majority of the respondents had heard of the term substance abuse before 226 (75.3%); it was also revealed that the majority of the respondents had good knowledge of psychoactive substances, 67.8%. There was no significant relationship between age and knowledge of psychoactive substances among senior secondary students, with a p-value of 0.199. The outcome of this study indicates that drug abuse is increasing day by day among secondary school students and may have greatly contributed to poor performance in examinations as well as undermining academic ability and performance among students. It was recommended that efforts should be made by the school authorities of the secondary schools in Ibadan South–West Local Government Area, Oyo State, and in Oyo State generally in collaboration with health personnel to educate adolescents on psychoactive substance abuse. This is to ensure that adolescents are adequately educated and updated on knowledge of psychoactive substance abuse.

Keywords: factors, influence, psychoactive substance, secondary school

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Authors: Hannele Laaksonen, Seija Nyqvist, Kari Nurmes

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Objectives: In the year 2011 the City of Vaasa started to develop know-how in the technology and the introduction of services for aging people in cooperation with the Polytechnic Novia University of Applied Sciences and VAMK, University of Applied Sciences. The project´s targets included: to help elderly people to maintain their ability to function, to provide them social and physical activities, to prevent their social exclusion, to decrease their feelings of loneliness and insecurity and to develop their technical know-how. Methods: The project was built based on open source code, tailor-made service system and user interface for the elderly living at home and their families, based on the users´ expectations and experiences of services. Activation-TV®-project vas carried out 1.4.2011-31.3.2014. A pilot group of eight elderly persons, who were living at home, were selected to the project. All necessary technical means as well as guidance and teaching equipment were provided to the pilot group. The students of University of Applied Sciences (VAMK, Novia) and employees of Center of Ageing were made all programs to the Activation-TV®. The project group were interviewed after and before intervention. The data were evaluated both qualitatively and quantitatively. Results: The built service includes a video library, a group room for interactive programs and a personal room for bilateral meetings and direct shipment. The program is bilingual and produced in both national languages. The Activation TV® reduced elderly peoples´ (n=8) feelings of emptiness, added mental well-being and quality of life with social contacts. Relatives felt, that they were able to get in to older peoples´ everyday life with Activation TV®. Discussion: The built application was tailored to the model that has not been developed elsewhere in Finland. This model can be copied from one server to another and thus transferred to other municipalities but the program requires its own personnel system management and maintenance as well as program production cooperation between the different actors. This service can be used for the elderly who are living at home without dementia.

Keywords: mental well-being, quality of life, elderly people, Finland

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Authors: Mohammad Muslim, M. Shafiq Ansari, Fazil Hasan

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Bracon hebetor Say (Hymenoptera: Braconidae) is considered as a highly cosmopolitan ecto-parasitoid of various species of order Lepidoptera. To study the influence of lepidopteran hosts on population growth of B. hebetor, the newly mated gravid females were released on various host and the eggs laid by such females on respective host were counted and a single egg was allow to develop on single host larvae. The experiment was conducted at 27 ± 1°C, 65 ± 5% RH and 14L: 10D hr in Biological Oxygen Demand (BOD) chamber. Upon hatching the tiny larvae of parasitoid pierced the body of insect host, enter into them and consumed the internal body contents of paralyzed host larvae. Present findings showed that B. hebetor took ~36 days to complete its survivorship on Corcyra cephalonica and Galleria mellonella. However, on Spodoptera littoralis the survivorship decreased to 24 days. Nevertheless, development of H. hebetor’s immature was significantly prolonged on S. littoralis and S. litura compared to other insect hosts tested. Female of B. hebetor took longer time to lay eggs on C. cephalonica and G. mellonella than other hosts tested in this study. Longevity of male and female is significantly prolonged on C. cephalonica and G. mellonella compared to others insect hosts tested. Population growth parameters like mx Ro, rm, Tc, and τ was considerably highest on C. cephalonica and lowest on S. littoralis. Based on the demographic studies C. cephalonica and H. armegera were proved to be the most suitable host for the mass rearing of B. hebetor. Nevertheless, results of present investigation could be utilized to improve the mass-breeding program of B. hebetor, so that sufficient number of B. hebetor’s adults could be provided time to time for the effective control of lepidopteran pests of various economically important crops.

Keywords: Bracon hebetor, lepidopteran hosts, demography, biology, development

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Authors: Sevilay Çankaya

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The detection of deception in children’s interviews is essential for statement veracity. The widely used method for deception detection is building cognitive load, which is the logic of the cognitive interview (CI), and its effectiveness for adults is approved. This meta-analysis delves into the effectiveness of inducing cognitive load as a means of enhancing veracity detection during interviews with children. Additionally, the effectiveness of cognitive load on children's total number of events recalled is assessed as a second part of the analysis. The current meta-analysis includes ten effect sizes from search using databases. For the effect size calculation, Hedge’s g was used with a random effect model by using CMA version 2. Heterogeneity analysis was conducted to detect potential moderators. The overall result indicated that cognitive load had no significant effect on veracity outcomes (g =0.052, 95% CI [-.006,1.25]). However, a high level of heterogeneity was found (I² = 92%). Age, participants’ characteristics, interview setting, and characteristics of the interviewer were coded as possible moderators to explain variance. Age was significant moderator (β = .021; p = .03, R2 = 75%) but the analysis did not reveal statistically significant effects for other potential moderators: participants’ characteristics (Q = 0.106, df = 1, p = .744), interview setting (Q = 2.04, df = 1, p = .154), and characteristics of interviewer (Q = 2.96, df = 1, p = .086). For the second outcome, the total number of events recalled, the overall effect was significant (g =4.121, 95% CI [2.256,5.985]). The cognitive load was effective in total recalled events when interviewing with children. All in all, while age plays a crucial role in determining the impact of cognitive load on veracity, the surrounding context, interviewer attributes, and inherent participant traits may not significantly alter the relationship. These findings throw light on the need for more focused, age-specific methods when using cognitive load measures. It may be possible to improve the precision and dependability of deceit detection in children's interviews with the help of more studies in this field.

Keywords: deceit detection, cognitive load, memory recall, children interviews, meta-analysis

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Authors: Jorge Martinez, Brandon Roberts, Holly Payton Toca

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Background: Therapeutic hypothermia (TH) is the international standard of care for all comatose patients after cardiac arrest, but criticism focuses on poor outcomes. We sought to develop criteria to identify American urban patients more likely to benefit from TH. Methods: Retrospective chart review of 107 consecutive adults undergoing TH in downtown New Orleans from 2010-2014 yielded records for 99 patients with all 44 survivors or families contacted up to four years. Results: 69 males and 38 females with a mean age of 60.2 showed 63 dead (58%) and 44 survivors (42%). Presenting cardiac rhythm was divided into shockable (Pulseless Ventricular Tachycardia, Ventricular Fibrillation) and non-shockable (Pulseless Electrical Activity, Asystole). Presenting in shockable rhythms with ROSC <20 minutes were 21 patients with 15 (71%) survivors (p=.001). Time >20 minutes until ROSC in shockable rhythms had 5 patients with 3 survivors (78%, p=0.001). Presenting in non-shockable rhythms with ROSC <20 minutes were 54 patients with 18 survivors (33%, p=.001). ROSC >20 minutes in non-shockable rhythms had 19 patients with 2 survivors (8%, p=.001). Survivors of shockable rhythms showed 19 (100%) living post TH. 15 survivors (79%, n=19, p=.001) had CPC score 1 or 2 with 4 survivors (21%, n=19) having a CPC score of 3. A total of 25 survived non-shockable rhythm. Acute survival of patients with non-shockable rhythm showed 18 expired <72 hours (72%, n=25) with long-term survival of 4 patients (5%, n=74) and CPC scores of 1 or 2 (p=.001). Interestingly, patients with time to ROSC <20 minutes exhibiting more than one loss of sustained ROSC showed 100% mortality (p=.001). Patients presenting with shockable >20 minutes ROSC had overall survival of 70% (p=.001), but those undergoing >3 cardiac rhythm changes had 100% mortality (p=.001). Conclusion: Patients presenting with shockable rhythms undergoing TH had overall acute survival of 70% followed by long-term survival of 100% after 4 years. In contrast, patients presenting with non-shockable rhythm had long-term survival of 5%. TH is not recommended for patients presenting with non-shockable rhythm and requiring greater than 20 minutes for restoration of ROSC.

Keywords: cardiac rhythm changes, Pulseless Electrical Activity (PEA), Therapeutic Hypothermia (TH)

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Authors: Kalpana Gupta

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Sexually transmitted infections (STIs) are infections that are spread primarily through sexual contact. In our daily practice, we see gonorrhea, chancroid, syphilis, and chlamydial infections that can be cured, as well as HIV, genital herpes, HPV, and hepatitis B infections that cannot be cured but can be managed with available treatments. Many people in India are infected with Sexually transmitted diseases (STDs), and the figures are quite high because of a lack of awareness and communication, as well as a taboo against these diseases. Numerous taboos and associated stigma shape patients’ lives and have a significant impact on health care policies, medical research, and current issues in medical ethics. Current statistics emphasize the importance of delivering sex education to this important demographic promptly. The long-standing tradition of girls marrying very young, especially in rural areas, and often too much older men, causes a slew of STIs. Stigma and HIV have a cyclical relationship; people who experience stigma and discrimination are marginalized and made more vulnerable to HIV/STDs, while those living with HIV are more vulnerable to stigma and discrimination. As urban pressures have grown, so have slums - and they have fast become ideal breeding grounds for STDs. In developed countries, strict laws have been enacted requiring people suffering from STDs to seek immediate treatment as well as contact the health department. Unfortunately, because of the stigma associated with the disease, patients in India are reluctant to reveal the source of infection. With various schemes, India is attempting to promote sex education and awareness. For example, the Ministry of Health and Family Welfare developed the National Adolescent Health Programme (also known as the Rashtriya Kishor Swasthya Karyakram) in partnership with the United Nations Population Fund (UNFPA). Whereas, National AIDS Control Organisation was set up so that every person living with HIV has access to quality care and is treated with dignity and breaking all taboos. It becomes clear that research and healthcare policies will not be effective in assisting patients with STDs unless these "nonscientific" elements are taken into account.

Keywords: sexually transmitted diseases, sexually transmitted infections, taboo, stigma, HIV/STDs, sex education and awareness, treatment, quality care, medications, healthcare policies

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Authors: Amin Nazifi, Amir Raki, Doga Istanbulluoglu

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The incorporation of technological advancements into financial services, commonly referred to as Fintech, is primarily aimed at promoting services that are accessible, convenient, and inclusive, thereby benefiting both consumers and businesses. Fintech services employ a variety of technologies, including Artificial Intelligence (AI), blockchain, and big data, to enhance the efficiency and productivity of traditional services. Cryptocurrency, a component of Fintech, is projected to be a trillion-dollar industry, with over 320 million consumers globally investing in various forms of cryptocurrencies. However, these potentially transformative services can also lead to adverse outcomes. For instance, recent Fintech innovations have been increasingly linked to misconduct and disservice, resulting in serious implications for consumer well-being. This could be attributed to the ease of access to Fintech, which enables adults to trade cryptocurrencies, shares, and stocks via mobile applications. However, there is little known about the darker aspects of technological advancements, such as Fintech. Hence, this study aims to generate scholarly insights into the design of robust and resilient Fintech services that can add value to businesses and enhance consumer well-being. Using a mixed-method approach, the study will investigate the personal and contextual factors influencing consumers’ adoption and usage of technology innovations and their impacts on consumer well-being. First, semi-structured interviews will be conducted with a sample of Fintech users until theoretical saturation is achieved. Subsequently, based on the findings of the first study, a quantitative study will be conducted to develop and empirically test the impacts of these factors on consumers’ well-being using an online survey with a sample of 300 participants experienced in using Fintech services. This study will contribute to the growing Transformative Service Research (TSR) literature by addressing the latest priorities in service research and shedding light on the impact of fintech services on consumer well-being.

Keywords: consumer well-being, financial literacy, Fintech, service innovation

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Authors: Vaishali Patil, Neeraj Masand

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In older people, Alzheimer’s disease (AD) is turning out to be a lethal disease. According to the amyloid hypothesis, aggregation of the amyloid β–protein (Aβ), particularly its 42-residue variant (Aβ42), plays direct role in the pathogenesis of AD. Aβ is generated through sequential cleavage of amyloid precursor protein (APP) by β–secretase (BACE) and γ–secretase (GS). Thus in the treatment of AD, γ-secretase modulators (GSMs) are potential disease-modifying as they selectively lower pathogenic Aβ42 levels by shifting the enzyme cleavage sites without inhibiting γ–secretase activity. This possibly avoids known adverse effects observed with complete inhibition of the enzyme complex. Virtual screening, via drug-like ADMET filter, QSAR and molecular docking analyses, has been utilized to identify novel γ–secretase modulators with sulphonamide nucleus. Based on QSAR analyses and docking score, some novel analogs have been synthesized. The results obtained by in silico studies have been validated by performing in vivo analysis. In the first step, behavioral assessment has been carried out using Scopolamine induced amnesia methodology. Later the same series has been evaluated for neuroprotective potential against the oxidative stress induced by Scopolamine. Biochemical estimation was performed to evaluate the changes in biochemical markers of Alzheimer’s disease such as lipid peroxidation (LPO), Glutathione reductase (GSH), and Catalase. The Scopolamine induced amnesia model has shown increased Acetylcholinesterase (AChE) levels and the inhibitory effect of test compounds in the brain AChE levels have been evaluated. In all the studies Donapezil (Dose: 50µg/kg) has been used as reference drug. The reduced AChE activity is shown by compounds 3f, 3c, and 3e. In the later stage, the most potent compounds have been evaluated for Aβ42 inhibitory profile. It can be hypothesized that this series of alkyl-aryl sulphonamides exhibit anti-AD activity by inhibition of Acetylcholinesterase (AChE) enzyme as well as inhibition of plaque formation on prolong dosage along with neuroprotection from oxidative stress.

Keywords: gamma-secretase inhibitors, Alzzheimer's disease, sulphonamides, QSAR

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Authors: Beata Patuszynska

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Children are largely absent from Polish social discourse, a fact which is mirrored in urban planning processes. Their absence creates a vicious circle – an unfriendly urban space discourages children from going outside on their own, meaning adults do not see a need to make spaces more friendly for a group, not present. The pandemic and lockdown, with their closed schools and temporary ban on unaccompanied minors on the streets, have only reinforced this. The project – co-writing with children a book concerning their first steps into urban independence - aims at empowering children, enabling them to find their voice when it comes to urban space. The foundation for the book was data collected during research and workshops with children from Warsaw primary schools, aged 7-10 - the age they begin independent travel in the city. The project was carried out with the participation and involvement of children at each creative step. Children were (1) models: the narrator is an 7-year-old boy getting ready for urban independence. He shares his experience as well as the experience of his school friends and his 10-year-old sister, who already travels on her own. Children were (2) teachers: the book is based on authentic children’s stories and experience, along with the author’s findings from research undertaken with children. The material was extended by observations and conclusions made during the pandemic. Children were (3) reviewers: a series of draft chapters from the book underwent review by children during workshops performed in a school. The process demonstrated that all children experience similar pleasures and worries when it comes to interaction with urban space. Furthermore, they also have similar needs that need satisfying. In my article, I will discuss; (1) the advantages of creating together with children; (2) my conclusions on how to work with children in participatory processes; (3) research results: perceptions of urban space by children age 7-10, when they begin their independent travel in the city; the barriers to and pleasures derived from independent urban travel; the influence of the pandemic on children’s feelings and their behaviour in urban spaces.

Keywords: children, urban space, co-creation, participation, human rights

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Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour, Parisa Hasankhani Tehrani

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Background And Objective: Haematopoietic stem cell transplant is a potentially curative treatment option in various benign and malignant haematological diseases. Patients undergoing stem cell transplant procedure require blood transfusion on a daily basis. Currently, there is paucity of data from developing countries on transfusion practices. This audit was undertaken to determine the consumption of packed red blood cells (PRBCs) transfusion in the bone marrow transplant unit of the Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran. Subjects And Methods: A retrospective audit was conducted for packed red cell transfusion ordering practice over a period from March 2017 to march 2018. All consecutive patients admitted for stem cell transplant procedure for various underlying diseases were included. Outcome measures used in this study were (i) cross match to transfusion (C: T) ratio and (ii) transfusion trigger. Results: During the study period, n=13 patients underwent a haematopoietic stem cell transplant. There were n=10 males and n=3 females. One patient was less than 15 years of age, while rests were adults. Median age±SD was 26.5±14.5 years (12∼54 years). The underlying diagnosis included Aplastic anemia (n=4), Thalassemia major (n=1), Multiple Myeloma (n=3), Acute leukemia (n=3), Hodgkin's lymphoma (n=1), PRCA (n=1). Grand total consumption of PRBCs during the study period was 204, while 258 products were crossmatch. The C:T ratio was 1.26. The transfusion trigger was Hb level of less than 8 gr/dl. Conclusion: The results of our BMT unit indicate that the C:T ratio and transfusion trigger is comparable to the international criteria and pioneer country in BMT transplantation. Also, we hope that our blood consumption become less than it is now.

Keywords: blood consumption, C: T ratio, PRBCs, stem cell transplant, tabriz, Iran

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Authors: Ebru Ergi̇n, Funda Kutlu

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Emerging adulthood is a developmental period and the formation of identity is crucial task of emerging adults in this period. In this frame, the main aim of the study was to compare college students and full-time workers on emerging adulthood dimensions and identity statuses in relation to some demographic variables in Turkey. The participants of the study were university students studying in Ankara and the employees working full-time in Ankara and Bursa. The mean age of the sample was 20.84 (sd=1.84), ranging from 18 to 25. The measurement instruments of the study were Inventory of Dimensions of Emerging Adulthood and Extended Objective Measure of Ego Identity Status (EOMEIS-II). The participants’ data (N=313) were analyzed to test the research questions and hypotheses of the study. A series of MANOVA were performed to test the group differences for some demographic characteristics (such as: employee/student, male/female, living with family/living apart from family) on scores of emerging adulthood dimensions and identity status. The results of the MANOVAs indicated that students, females and participants who live apart from their families had higher scores on emerging adulthood dimensions. The results of the identity status scores differences depending on the demographic characteristic pointed out that there were a significant group differences for identity foreclosure identity scores between employees and students. Employees’ foreclosure identity scores were higher than students. Furthermore, the identity scores were differed significantly according to gender of the participants. Male participants had higher scores in moratorium and foreclosure identity and female participants have higher achievement identity scores than males. Also, the participants who live with their family scored higher in foreclosure identity and the participants who live apart from their family scored higher in identity achievement status.

Keywords: college students, emerging adulthood, full-time employees, identity statuses

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Authors: Sana Iqbal

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The female voice in Sufi poetry has been studied as a symbol of humility and devotion. Throughout the centuries, the Sufi shrines have also sheltered women and have served as a source of emotional strength in times of difficulty. Although women have been central to Sufi Islam, female-led rituals and performances (of veneration) are rarely studied as acts of empowerment and symbols of healing. This is especially true for rituals performed in informal spaces, which require going beyond the shrine practices. The rituals and meanings associated with Khizr Khwaja (or Sindhi Hindu god Jhelelal) among women in Punjab can serve as a useful case study to unpack some of these meanings. The paper aims to shed light on female-led rituals among women from Punjab associated with the folkloric traditions associated with Khizar Khwaja, Zinda Pir, Jhulelal or river god in the South Asian region to protect mariners from possible risks (since trade was primarily dependent on water channels) or for inducing timely rain date back to the 10th century in Sindh. However, these meanings and associations have evolved and the paper thus aims to establish a relationship between this figure and the women in Punjab by analysing the findings from an ethnographic study. It traces the historical meanings and significance attached to the divine figure and the wells (informal spaces) associated with him since the rituals performed by women is now infused solely with seeking fertility or to be blessed with a successful pregnancy, as opposed to him being celebrated for other reasons in older times. These associations beg the question of what women gain out of these rituals and making offerings to the mysterious figure of Khizr. Anecdotal evidence in the form of interviews conducted in Bhakar and Talwandi (Punjab) during the summer of 2015 helped to explore the stories related to this legend while also allowing us to witness some of the female-led ritual practices. It can be said that the symbols adopted in the ritual practices invoke liminality for women, which is a blend of opposites. The paper argues that this liminality/journey has been used as a vehicle to transcend all worldly structures of power and it symbolically emphasises the richness of feminine love/devotion and grants healing to female devotees.

Keywords: transgression, gender, liminality, ritual

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Authors: Takeo Shibata, Arihito Endo, Akemi Kunimatsu, Chika Hiraga, Yoko Shimizu

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Introduction: Yuzawa Town, located in the Niigata prefecture of Japan, is famous for its hot springs. A health promotion program, Yuzawa family health plan, was initiated in 2002. It has been held for fifteen years. We evaluated the profiles of brushing teeth in adults. Subjects: 368 questionnaires were corrected from people who live in Yuzawa town. The range of age was between nineteen and sixty-four years old. Methods: Mann-Whitney’s U test and Kruskal-Wallis test were used to evaluate significant differences in frequencies of brushing teeth per a day. Chi-square test and the adjusted residuals were used to evaluate when they brush their teeth. Results: Women showed greater frequencies of brushing teeth per a day than men. No difference was shown by age. Construction workers showed fewer frequencies of brushing teeth. Specialized technicians, clerical workers, and housewives showed greater frequencies. People who know Yuzawa family health plan, take a regular life, or take a breakfast every day showed greater frequencies. People who think not healthy, don’t care a balance of foods, don’t take yearly health check-up, or smoke showed fewer frequencies. After breakfast, women and specialized technicians showed greater frequencies, and construction workers and self-employed workers showed fewer frequencies. After lunch, clerical workers and specialized technicians showed greater frequencies. There was no significant difference at after waking up, after dinner, and before going to bed. Construction workers showed a lower rate of having a marital partner and having information of health. Conclusion: Gender and occupational differences were shown in frequencies of brushing teeth per a day. A promotion of teeth brushing for male, especially construction workers and self-employed workers, is needed.

Keywords: health promotion, Yuzawa family health plan, brushing teeth, occupational difference

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Authors: Ngabilas Salama

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Background: Indonesia has the 2nd highest number of incidents of tuberculosis (TB). It accounts for 1.020.000 new cases per year, only 30% of which has been reported. To find the lost 70%, a massive active case discovery was conducted through two programs: Ketuk Pintu Layani Dengan Hati (KPLDH) and Kader Juru Pemantau Batuk (Jumantuk cadres), who also plays a role in child TB screening. Methods: Data was collected and analyzed through Tuberculosis Integrated Online System from 2014 to 2017 involving 129 DOTS facility with 86 primary health centers in East Jakarta. Results: East Jakarta consists of 2.900.722 people. KPLDH program started in February 2016 consisting of 84 teams (310 people). Jumantuk cadres was formed 4 months later (218 orang). The number of new TB cases in East Jakarta (primary health center) from 2014 to June 2017 respectively is as follows: 6.499 (2.637), 7.438 (2.651), 8.948 (3.211), 5.701 (1.830). Meanwhile, the percentage of child TB case discovery in primary health center was 8,5%, 9,8%, 12,1% from 2014 to 2016 respectively. In 2017, child TB case discovery was 13,1% for the first 3 months and 16,5% for the next 3 months. Discussion: Increased TB incidence rate from 2014 to 2017 was 14,4%, 20,3%, and 27,4% respectively in East Jakarta, and 0,5%, 21,1%, and 14% in primary health center. This reveals the positive role of KPLDH and Jumantuk in TB detection and reporting. Likewise, these programs were responsible for the increase in child TB case discovery, especially in the first 3 months of 2017 (Ketuk Pintu TB Day program) and the next 3 months (active TB screening). Conclusion: KPLDH dan Jumantuk are actively involved in increasing TB case discovery in both adults and children.

Keywords: tuberculosis, case discovery program, primary health center, cadre

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Authors: Zahra F. Al-Khateeb, Shenel Shekerzade, Hasna Boumenar, Siân M. Henson, Jordi L. Tremoleda, A. T. Michael-Titus

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Traumatic brain injury (TBI) is the leading cause of disability and death in young adults and also increases the risk ofneurodegeneration. The mechanisms linking moderate to severe TBI to neurodegeneration are not known. It has been proposed that cellular senescence inductionpost-injury could amplify neuroinflammation and induce long-term changes. The impact of these processes after injury to an immature brain has not been characterised yet. We carried out a controlled cortical impact injury (CCI) in juvenile 1 month-old male CD1 mice. Animals were anesthetised and received a unilateral CCI injury. The sham group received anaesthesia and had a craniotomy. A naïve group had no intervention. The brain tissue was analysed at 5 days and 35 days post-injury using immunohistochemistry and markers for microglia, astrocytes, and senescence. Compared tonaïve animals, injured mice showed an increased microglial and astrocytic reaction early post-injury, as reflected in Iba1 and GFAP markers, respectively; the GFAP increase persisted in the later phase. The senescence analysis showed a significant increase inγH2AX-53BP1 nuclear foci, 8-oxoguanine, p19ARF, p16INK4a, and p53 expression in naïve vs. sham groups and naïve vs. CCI groups, at 5 dpi. At 35 days, the difference was no longer statistically significant in all markers. The injury induced a decrease p21 expression vs. the naïve group, at 35 dpi. These results indicate the induction of a complex senescence response after immature brain injury. Some changes occur early and may reflect the activation/proliferation of non-neuronal cells post-injury that had been hindered, whereas changes such as p21 downregulation may reflect a delayed response and pro-repair processes.

Keywords: cellular senescence, traumatic brain injury, brain injury, controlled cortical impact

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Authors: Pirjo Kaakinen, Helvi Kyngäs, Danica Železnik

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People live longer than earlier and healthy lifestyle is one of the important issue to prevent functional inability and chronic disease. Aim of this study was describe the lifestyle changes of Carintia region’s people. The study was cross-sectional study. Data were collected by questionnaire in two period, first May 2013 (N=63) and on March 2014 (N=77) at the University of College of ‘Health Sciences Slovenj Gradec’. The study was part of project ‘Choose a healthy lifestyle - an investment for the future’. The questionnaire included self-estimated questions about physical activity, nutrition, grocery habit, smoking habit and alcohol use. Participants were measured clinical parameters such as blood pressure, blood glucose, BMI. Most of participants were women (61%) and they were over 60 years old (64%). Participants have a high BMI (75%) and elevated blood pressure (64%). However, almost all participants (89%) had normal blood glucose level. Slightly more than half of participants (54%) have normal cholesterol level. Participants (83%) eat breakfast in the morning and most of them have three or four daily meals. Fruit and vegetable consumption decrease during this study. Half of participants (51%) drank a litre of water per day and popular beverage was coffee or tea. To drink carbonate beverages was not so popular over 60 year’s old participants than younger one. There was less smokers in 2014 than 2013. Intensity of daily physical activity increased during healthy lifestyle project. The most popular form of physical activity was hiking. This study showed that the project can be effective in the Carintia region’s people lifestyle changes even it was short time. People did changes in their daily life and there were a positive influence physical activity, meal frequency, fruit, vegetable and alcohol consumption. In the future is needed the follow up study to get out longitudinal lifestyle changes.

Keywords: adults, healthy lifestyle, health education, quality of life

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Authors: Pattaka Sa-Ngimnet

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That the University as we have known it is no longer serving the needs of the vast majority of students and potential students has been a topic of much discussion. Institutions of higher education, in this age of global culture, are in a process of metamorphosis. Technology is being used to allow more students, older students, working students and disabled students, who cannot attend conventional classes, to have greater access to higher education through the internet. But change must come about only after much evaluation and experimentation or education will simply become a commodity as, in some cases, it already has. This paper will be concerned with the meaning and methods of change and evaluation as they are applied to institutions of higher education. Organization’s generally have different goals and different approaches in order to be successful. However, the means of reaching those goals requires rational and effective planning. Any plans for successful change in any institution must take into account both effectiveness and efficiency and the differences between them. “Effectiveness” refers to an adequate means of achieving an objective. “Efficiency” refers to the ability to achieve an objective without waste of time or resources (The Free Dictionary). So an effective means may not be efficient and an efficient means may not be effective. The goal is to reach a synthesis of effectiveness and efficiency that will maximize both to the extent each is limited by the other. This focus of this paper then is to determine how an educational institution can become either successful or oppressive depending on the kinds of planning, evaluating and changes that operate by and on the administration. If the plan is concerned only with efficiency, the institution can easily become oppressive and lose sight of its purpose of educating students. If it is overly concentrated on effectiveness, the students may receive a superior education in the short run but the institution will face operating difficulties. In becoming only goal oriented, institutions also face problems. Simply stated, if the institution reaches its goals, the stake holders may become satisfied and fail to change and keep up with the needs of the times. So goals should be seen only as benchmarks in a process of becoming even better in providing quality education. Constant and consistent evaluation is the key to making all these factors come together in a successful process of planning, testing and changing the plans as needed. The focus of the evaluation has to be considered. Evaluations must take into account progress and needs of students, methods and skills of instructors, resources available from the institution and the styles and objectives of administrators. Thus the role of evaluation is pivotal in providing for the maximum of both effective and efficient change in higher education institutions.

Keywords: change, effectiveness, efficiency, education

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Authors: Anna-Maria Saarela

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At the Savonia University of Applied Sciences (UAS), curriculum and studies have been improved by applying an Open Innovation Space approach (OIS). It is based on multidisciplinary action learning. The key elements of OIS-ideology are work-life orientation, and student-centric communal learning. In this approach, every participant can learn from each other and innovations will be created. In this social innovation educational approach, all practices are carried out in close collaboration with enterprises in real-life settings, not in classrooms. As an example, in this paper, Savonia UAS’s Future Food RDI hub (FF) shows how OIS practices are implemented by providing food product development and consumer research services for enterprises in close collaboration with academicians, students and consumers. In particular one example of OIS experimentation in the field is provided by a consumer research carried out utilizing verbal analysis protocol combined with audio-visual observation (VAP-WAVO). In this case, all co-learners were acting together in supermarket settings to collect the relevant data for a product development and the marketing department of a company. The company benefitted from the results obtained, students were more satisfied with their studies, educators and academicians were able to obtain good evidence for further collaboration as well as renewing curriculum contents based on the requirements of working life. In addition, society will benefit over time as young university adults find careers more easily through their OIS related food science studies. Also this knowledge interaction model re-news education practices and brings working-life closer to educational research institutes.

Keywords: collaboration, education, food science, industry, knowledge transfer, RDI, student

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Authors: Jacqueline Zammit

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Currently, a considerable number of individuals from different backgrounds are being drawn to Malta due to its favourable environment for business, investment, and employment. This influx has led to a growing interest among expats in learning Maltese as a second language (ML2) to enrich their experience of working and residing in Malta. However, the intricacies of Maltese grammar, particularly challenging for second language (L2) learners unfamiliar with Arabic, can pose difficulties in the learning process. Furthermore, it's worth noting that the teaching of ML2 is an emerging field with limited existing research on effective pedagogical strategies. The realm of second language acquisition (SLA) can be notably demanding for adults, requiring well-founded interventions to facilitate learning. Among these interventions, approaches grounded in empirical evidence have incorporated artistic and musical elements to augment SLA. Both art and music have proven roles in facilitating L2 communication, aiding vocabulary retention, and improving comprehension skills. This study aims to delve into the utilization of music and art as catalysts for enhancing the progress of adult learners in mastering ML2. The research employs a qualitative methodology, employing a sample selected through convenience sampling, which encompassed 37 adult learners of ML2. These participants engaged in individual interviews. The data derived from these interviews were subjected to thorough analysis. The outcomes of the study underscore the substantial positive influence exerted by art and music on the academic advancement of adult ML2 learners. Notably, it emerged from the participants' accounts that the current ML2 curricula lack the integration of art and music. Therefore, this study advocates for the incorporation of art and music components within both traditional classroom settings and online ML2 courses. The intention is to bolster the academic accomplishments of adult learners in the realm of Maltese as a second language, bridging the current gap between theory and practice.

Keywords: academic accomplishment, mature learners, visual art, learning Maltese as a second language, musical involvement, acquiring a second language

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Authors: Carles Ferré, Ferran Llopis, Javier Jacob, Jordi Giol, Xavier Palom, Ignasi Bardés

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Objective: To analyze the characteristics of acute bacterial prostatitis (ABP) in elderly patients attended in the emergency department (ED). Methods: Observational and cohort study with prospective follow-up including patients with ABP presenting to the ED from January-December 2012. Data were collected for demographic variables, comorbidities, clinical and microbiological findings, treatment, outcome, and reconsultation at 30 days follow up. Findings were compared between patients ≥ 75 years (study group) and < 75 years (control group). Results: During the study period 241 episodes of ABP were included for analysis. Mean age was 62,9 ± 16 years, and 64 (26.5%) were ≥ 75 years old. A history of prostate adenoma was reported in 54 cases (22,4%), diabetes mellitus in 47 patients (19,5%) and prior manipulation of the lower urinary tract in 40 (17%). Mean symptoms duration was 3.38 ± 4.04 days, voiding symptoms were present in 176 cases (73%) and fever in 154 (64%). From 216 urine cultures, 128 were positive (59%) and 24 (17,6%) out of 136 blood cultures. Escherichia coli was the main pathogen in 58.6% of urine cultures and 64% of blood cultures (with resistant strains to fluoroquinolones in 27,7%, cotrimoxazole in 22,9% and amoxicillin/clavulanic in 27.7% of cases). Seventy patients (29%) were admitted to the hospital, and 3 died. At 30-day follow-up, 29 patients (12%) returned to the ED. In the bivariate analysis previous manipulation of the urinary tract, history of cancer, previous antibiotic treatment, resistant E. coli strains to amoxicillin-clavulanate and ciprofloxacin and extended spectrum beta-lactamase (ESBL) producers, renal impairment, and admission to the hospital were significantly more frequent (p < 0.05) among patients ≥ 75 years compared to those younger than 75 years. Conclusions: Ciprofloxacin and amoxicillin-clavulanate appear not to be good options for the empiric treatment of ABP for patients ≥ 75 years given the drug-resistance pattern in our series, and the proportion of ESBL-producing strains of E. coli should be taken into account. Awaiting bacteria identification and antibiogram from urine and/or blood cultures, treatment on an inpatient basis should be considered in older patients with ABP.

Keywords: acute bacterial prostatitits, antibiotic resistance, elderly patients, emergency

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