Search results for: primary immuno deficiency

Authors: Anne-Loes K. Warps, Rob A. E. M. Tollenaar, Pieter J. Tanis, Jan Willem T. Dekker

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Anastomotic leakage after colorectal cancer surgery remains a severe complication. Early diagnosis and treatment are essential to prevent further adverse outcomes. In the literature, it has been suggested that earlier reintervention is associated with better survival, but anastomotic leakage can occur with a highly variable time interval to index surgery. This study aims to evaluate the time-interval between rectal cancer resection with primary anastomosis creation and reoperation, in relation to short-term outcomes, stratified for the use of a defunctioning stoma. Methods: Data of all primary rectal cancer patients that underwent elective resection with primary anastomosis during 2013-2019 were extracted from the Dutch ColoRectal Audit. Analyses were stratified for defunctioning stoma. Anastomotic leakage was defined as a defect of the intestinal wall or abscess at the site of the colorectal anastomosis for which a reintervention was required within 30 days. Primary outcomes were new stoma construction, mortality, ICU admission, prolonged hospital stay and readmission. The association between time to reoperation and outcome was evaluated in three ways: Per 2 days, before versus on or after postoperative day 5 and during primary versus readmission. Results: In total 10,772 rectal cancer patients underwent resection with primary anastomosis. A defunctioning stoma was made in 46.6% of patients. These patients had a lower anastomotic leakage rate (8.2% vs. 11.6%, p < 0.001) and less often underwent a reoperation (45.3% vs. 88.7%, p < 0.001). Early reoperations (< 5 days) had the highest complication and mortality rate. Thereafter the distribution of adverse outcomes was more spread over the 30-day postoperative period for patients with a defunctioning stoma. Median time-interval from primary resection to reoperation for defunctioning stoma patients was 7 days (IQR 4-14) versus 5 days (IQR 3-13 days) for no-defunctioning stoma patients. The mortality rate after primary resection and reoperation were comparable (resp. for defunctioning vs. no-defunctioning stoma 1.0% vs. 0.7%, P=0.106 and 5.0% vs. 2.3%, P=0.107). Conclusion: This study demonstrated that early reinterventions after anastomotic leakage are associated with worse outcomes (i.e. mortality). Maybe the combination of a physiological dip in the cellular immune response and release of cytokines following surgery, as well as a release of endotoxins caused by the bacteremia originating from the leakage, leads to a more profound sepsis. Another explanation might be that early leaks are not contained to the pelvis, leading to a more profound sepsis requiring early reoperations. Leakage with or without defunctioning stoma resulted in a different type of reinterventions and time-interval between surgery and reoperation.

Keywords: rectal cancer surgery, defunctioning stoma, anastomotic leakage, time-interval to reoperation

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Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda

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Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.

Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management

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Authors: Elena Pello, Martin Bobak, Yuri Nikitin

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In current issue we evaluated integration of magnesium with lipids; the attractive findings were obtained in men and women; the crucial ties of magnesium with total cholesterol in hypertensive men, with total cholesterol in concordance with low-density lipoprotein cholesterol in hypertensive women were disclosed; unanswered questions were trapped, difficulties were surmounted, and magnesium deficiency perseverance in pathogenesis of cardiovascular disease development was expressed; nutrients as well as risk factors may contribute to cardiovascular complications.

Keywords: dietary, magnesium, hypertension, lipids

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Authors: A. Bouaouiche, M. S. Boulakoud

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The functioning of the pineal gland, the transducer body of environmental information to the neuroendocrine system is subject to a circadian rhythm. Melatonin is the main neuro-hormone expressing this operation. It is synthesized in the pinealocytes after conversion serotonin via N-acetyl-transferase enzyme, itself subject to a photoperiodic modulation (activation dark inhibition by light). Some authors have suggested that melatonin is involved in diabetic disease and found that it could have a diabetogenic effect. To this study the effect of this hormone on glucose metabolism has long been subject to controversy. Agreeing in effect and hyperinsulinemic hypoglycemic effect. In order to illustrate the level of interaction of melatonin with neuro-immune- corticotropin axis and its impact on carbohydrate metabolism, we studied the impact homeostatic (glucose) through the solicitation of two control systems (gland pineal and corticotropin axis). We then found that melatonin could have an indirect influence on insulin control (glucose metabolism) to the levels of the growth hormone axis (somatostatin) and adrenocorticotropic (corticotropin). In addition, we have suggested that melatonin might limit the hyperglycemic action of corticosteroids by direct action at peripheral level.

Keywords: pinéal gland, melatonin, neuro-immuno-corticotrop, metabolism

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Authors: Nanteza Rachel

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Background: Worldwide, there were 36.7 million people living with Human Immunodeficiency Virus (HIV) in 2015, up from 35 million at the end of 2013. Wakiso district is one of the hotspots for the Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) infection in Uganda, with the prevalence of 8.1 %. Herbal medicine has gained popularity among Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) patients as adjuvant therapy to reduce the adverse effects of ART. Regardless of the subsidized and physical availability of the Anti-Retroviral Therapy (ART), majority of Africans living with Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) resort to adding to their ART traditional medicine. Result found out from a pilot observation made by the PI that indicate 13 out of 30 People Living with AIDS(PLWA) who are attending Human Immunodeficiency Virus (HIV) clinics in Wakiso district reported to be using herbal preparations despite the fact that they were taking Anti Retro Viral (ARVs) this prompted this study to be done. Purpose of the study: To determine the prevalence and factors associated with concurrent use of herbal medicine and anti-retroviral therapy among HIV/AIDS patients attending selected HIV clinics in Wakiso district. Methodology: This was a cross sectional study with both quantitative data collection (use of a questionnaire) and qualitative data collection (key informants’ interviews). A mixed method of sampling was used, that is, purposive and random sampling. Purposive sampling was based on the location in the district and used to select 7 health facilities basing on the 7 health sub districts from Wakiso. Simple random sampling was used to select one HIV clinic from each of the 7 health sub districts. Furthermore, the study units were enrolled in to the study as they entered into the HIV clinics, and 105 respondents were interviewed. Both manual and computer packages (SPSS) were used to analyze the data Results: The prevalence of concurrent use of herbal medicine and ART was 38 (36.2%). Commonly HIV symptom treated with herbs was fever 27(71.1%), diarrhea 3(7.9%) and cough 2(5.3%). Commonly used herbs for fever (Omululuza (Vernonica amydalina), Ekigagi (Aloe sp), Nalongo (Justicia betonica Linn) while for diarrhea was Ntwatwa. The side effects also included; too much pain, itchy pain of HIV, aneamia,felt sick, loss/gain appetite, joint pain and bad dreams. Herbs used to sooth the side effects were; for aneamia was avocado leaves Parea Americana mill The significant factors associated with concurrent use of herbal medicine were being familiar with herbs and conventional medicine for management HIV symptoms being expensive. The other significant factor was exhibiting hostility to patients by health personnel providing HIV care. Conclusion: Herbal medicine is widely used by clients in HIV/AIDS care. Patients being familiar with herbs and conventional medicine being expensive were associated with concurrent use of herbal medicine and ART. The exhibition of hostility to the HIV/AIDS patients by the health care providers was also associated with concurrent use of herbal medicine and ART among HIV/AIDS patients.

Keywords: HIV patients, herbal medicine, antiretroviral therapy, factors associated

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Authors: Kyung Hwa Shin

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Primary school music education plays a crucial role in nurturing students' musical abilities and fostering a lifelong appreciation for music. As we embark on the 21st century, it becomes imperative to explore advanced approaches that can effectively engage and empower students in the realm of music. This study aims to shed light on the aspects of primary school music education in South Korea, with a specific focus on the incorporation of the Zoltán Kodály Concept. The Zoltán Kodály Concept, developed by Hungarian composer and educator Zoltán Kodály (Kodály, 1974) advocates for a holistic music education that integrates singing, movement, and music literacy. This concept has gained recognition worldwide for its effectiveness in developing musicianship and enhancing music learning experiences. This study will delve into the ways in which the Zoltán Kodály Concept has been adapted and implemented in the context of South Korean primary school music education. It will highlight the benefits of this approach in nurturing students' musical skills, fostering creativity, and promoting cultural understanding through music. Furthermore, it will enhance the delivery of the Kodály-based curriculum challenges posed by the 21st-century digital age. Drawing on this research, pedagogical practices, and case studies, this study will provide valuable insights into the practical applications of the Zoltán Kodály Concept in South Korean primary school music education. It will discuss the impact of this approach on student engagement, motivation, and achievement, as well as the role of teachers in facilitating effective implementation. Additionally, it will address the professional development opportunities available to music educators to enhance their pedagogical skills in line with the Kodály philosophy. Ultimately, it aims to inspire and empower educators, policymakers, and researchers to embrace the Zoltán Kodály Concept as a transformative and forward-thinking approach to primary school music education in the 21st century. By embracing current aspects and progressive methodologies, South Korea can continue to strengthen its music education system and cultivate a generation of musically literate and culturally enriched individuals.

Keywords: primary school music education, Zoltán Kodály concept, 21st century, South Korea, music literacy, pedagogy, curriculum

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Authors: Sonia Mahajan Dinesh, Anant Dinesh, Madhavi Tripathi, Vinod Kumar Ramteke, Rajnish Sharma, Anupam Mondal

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Background: Neo-adjuvant chemotherapy plays an important role in treatment of breast cancer by decreasing the tumour load and it offers an opportunity to evaluate response of primary tumour to chemotherapy. Standard anatomical imaging modalities are unable to accurately reflect the response to chemotherapy until several cycles of drug treatment have been completed. Metabolic imaging using tracers like 18F-fluorodeoxyglucose (FDG) as a marker of glucose metabolism or amino acid tracers like L-methyl-11C methionine (MET) have potential role for the measurement of treatment response. In this study, our objective was to compare these two PET tracers for assessment of response to neoadjuvant chemotherapy, in locally advanced breast carcinoma. Methods: In our prospective study, 20 female patients with histology proven locally advanced breast carcinoma underwent PET-CT imaging using FDG and MET before and after three cycles of neoadjuvant chemotherapy (CAF regimen). Thereafter, all patients were taken for MRM and the resected specimen was sent for histo-pathological analysis. Tumour response to the neoadjuvant chemotherapy was evaluated by PET-CT imaging using PERCIST criteria and correlated with histological results. Responses calculated were compared for statistical significance using paired t- test. Results: Mean SUVmax for primary lesion in FDG PET and MET PET was 15.88±11.12 and 5.01±2.14 respectively (p<0.001) and for axillary lymph nodes was 7.61±7.31 and 2.75±2.27 respectively (p=0.001). Statistically significant response in primary tumour and axilla was noted on both FDG and MET PET after three cycles of NAC. Complete response in primary tumour was seen in only 1 patient in FDG and 7 patients in MET PET (p=0.001) whereas there was no histological complete resolution of tumor in any patient. Response to therapy in axillary nodes noted on both PET scans were similar (p=0.45) and correlated well with histological findings. Conclusions: For the primary breast tumour, FDG PET has a higher sensitivity and accuracy than MET PET and for axilla both have comparable sensitivity and specificity. FDG PET shows higher target to background ratios so response is better predicted for primary breast tumour and axilla. Also, FDG-PET is widely available and has the advantage of a whole body evaluation in one study.

Keywords: 11C-methionine, 18F-FDG, breast carcinoma, neoadjuvant chemotherapy

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Authors: Ivonete Teresinha Schulter Buss Heidemann, Michelle Kuntz Durand, Aline Megumi Arakawa-Belaunde, Sandra Mara Corrêa, Leandro Martins Costa Do Araujo, Kamila Soares Maciel

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Primary Health Care is defined as the level of a system of services that enables the achievement of answers to health needs. This level of care produces services and actions of attention to the person in the life cycle and in their health conditions or diseases. Primary Health Care refers to a conception of care model and organization of the health system that in Brazil seeks to reorganize the principles of the Unified Health System. This system is based on the principle of health as a citizen's right and duty of the State. Primary health care has family health as a priority strategy for its organization according to the precepts of the Unified Health System, structured in the logic of new sectoral practices, associating clinical work and health promotion. Thus, this study seeks to know the possibilities and limits of the care developed by professionals working in Primary Health Care. It was conducted by a qualitative approach of the participant action type, based on Paulo Freire's Research Itinerary, which corresponds to three moments: Thematic Investigation; Encoding and Decoding; and, Critical Unveiling. The themes were investigated in a health unit with the development of a culture circle with 20 professionals, from a municipality in southern Brazil, in the first half of 2021. The participants revealed as possibilities the involvement, bonding and strengthening of the interpersonal relationships of the professionals who work in the context of primary care. Promoting welcoming in primary care has favoured care and teamwork, as well as improved access. They also highlighted that care planning, the use of technologies in the process of communication and the orientation of the population enhances the levels of problem-solving capacity and the organization of services. As limits, the lack of professional recognition and the scarce material and human resources were revealed, conditions that generate tensions for health care. The reduction in the number of professionals and the low salary are pointed out as elements that boost the motivation of the health team for the development of the work. The participants revealed that due to COVID-19, the flow of care had as a priority the pandemic situation, which affected health care in primary care, and prevention and health promotion actions were canceled. The study demonstrated that empowerment and professional involvement are fundamental to promoting comprehensive and problem-solving care. However, limits of the teams are observed when exercising their activities, these are related to the lack of human and material resources, and the expansion of public health policies is urgent.

Keywords: health promotion, primary health care, health professionals, welcoming.

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Authors: A. Zurraini, Syed Alwi Sar, H. Helmy, H. Nazeefah

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Early Dementia Questionnaire (EDQ) was developed as a screening tool to detect patients with early dementia in primary care. It was developed based on 20 symptoms of dementia. From a preliminary study, EDQ had been shown to be a promising alternative for screening of early dementia. This study was done to further test on EDQ’s reliability and validity. Using a systematic random sampling, 200 elderly patients attending primary health care centers in Kuching, Sarawak had consented to participate in the study and were administered the EDQ. Geriatric Depression Scale (GDS) was used to exclude patients with depression. Those who scored >21 MMSE, were retested using the EDQ. Reliability was determined by Cronbach’s alpha for internal consistency and construct validity was assessed using confirmatory factor analysis (principle component with varimax rotation). The result showed that the overall Cronbach’s alpha coefficient was good which was 0.874. Confirmatory factor analysis on 4 factors indicated that the Cronbach’s alpha for each domain were acceptable with memory (0.741), concentration (0.764), emotional and physical symptoms (0.754) and lastly sleep and environment (0.720). Pearson correlation coefficient between the first EDQ score and the retest EDQ score among those with MMSE of >21 showed a very strong, positive correlation between the two variables, r = 0.992, N=160, P <0.001. The results of the validation study showed that Early Dementia Questionnaire (EDQ) is a valid and reliable tool to be used as a screening tool to detect early dementia in primary care.

Keywords: Early Dementia Questionnaire (EDQ), screening, primary care, construct validity

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Authors: Soumaya Mrabet, Taieb Ach, Imen Akkari, Amira Atig, Neirouz Ghannouchi, Koussay Ach, Elhem Ben Jazia

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Introduction: Celiac disease (CD) and type 1 diabetes mellitus (T1D) are complex disorders with shared genetic components. The association between CD and T1D has been reported in many pediatric series. The aim of our study is to describe the epidemiological, clinical and evolutive characteristics of adult patients presenting this association. Material and Methods: This is a retrospective study including patients diagnosed with CD and T1D, explored in Internal Medicine, Gastroenterology and Endocrinology and Diabetology Departments of the Farhat Hached University Hospital, between January 2005 and June 2016. Results: Among 57 patients with CD, 15 patients had also T1D (26.3%). There are 11 women and 4 men with a median age of 27 years (16-48). All patients developed T1D prior to the diagnosis of CD with an average duration of 47 months between the two diagnosis (6 months-5 years). CD was revealed by recurrent abdominal pain in 11 cases, diarrhea in 10 cases, bloating in 8 cases, constipation in 6 cases and vomiting in 2 cases. Three patients presented cycle disorders with secondary amenorrhea in 2 patients. Anti-Endomysium, anti-transglutaminase and Anti-gliadin antibodies were positive respectively in 57, 54 and 11 cases. The biological tests revealed anemia in 10 cases, secondary to iron deficiency in 6 cases and folate and vitamin B12 deficiency in 4 cases, hypoalbuminaemia in 4 cases, hypocalcemia in 3 cases and hypocholesterolemia in 1 patient. Upper gastrointestinal endoscopy showed an effacement of the folds of the duodenal mucosa in 6 cases and a congestive duodenal mucosa in 3 cases. The macroscopic appearance was normal in the others cases. Microscopic examination showed an aspect of villous atrophy in 57 cases, which was partial in 10 cases and total in 47 cases. After an average follow-up of 3 years 2 months, the evolution was favorable in all patients under gluten-free diet with the necessity of less important doses of insulin in 10 patients. Conclusion: In our study, the prevalence of T1D in adult patients with CD was 26.3%. This association can be attributed to overlapping genetic HLA risk loci. In recent studies, the role of gluten as an important player in the pathogenesis of CD and T1D has been also suggested.

Keywords: celiac disease, gluten, prevalence, type 1 diabetes

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Authors: K. Matušínská, H. Starzyczná, M. Stoklasa

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The paper deals with finding and describing of the effective marketing communication forms relating to the segment 50+ in the financial market in the Czech Republic. The segment 50+ can be seen as a great marketing potential in the future but unfortunately the Czech financial institutions haven´t still reacted enough to this fact and they haven´t prepared appropriate marketing programs for this customers´ segment. Demographic aging is a fundamental characteristic of the current European population evolution but the perspective of further population aging is more noticeable in the Czech Republic. This paper is based on data from one part of primary marketing research. Paper determinates the basic problem areas as well as definition of marketing communication in the financial market, defining the primary research problem, hypothesis and primary research methodology. Finally suitable marketing communication approach to selected sub-segment at age of 50-60 years is proposed according to marketing research findings.

Keywords: population aging in the Czech Republic, segment 50+, financial services, marketing communication, marketing research, marketing communication approach

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Authors: Moon Moon Devi, Ran Budnik

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The current large area cosmic ray detector surface arrays typically measure only the net flux and arrival-time of the charged particles produced in an extensive air shower (EAS). Measurement of the individual charged particles at a surface array will provide additional distinguishing parameters to identify the primary and to map the very high energy interactions in the upper layers of the atmosphere. In turn, these may probe anomalies in QCD interactions at energies beyond the reach of current accelerators. The recent attempts of studying the individual muon tracks are limited in their expandability to larger arrays and can only probe primary particles with energy up to about 10^15.5 eV. New developments in detector technology allow for a realistic cost of large area detectors, however with limitations on energy resolutions, directional information, and dynamic range. In this study, we perform a simulation study using CORSIKA to combine the energy spectrum and lateral spread of the muons with the longitudinal depth (Xmax) of an EAS initiated by a primary at ultra high energies (10¹⁶ – 10¹⁹) eV. Using proton and iron as the shower primaries, we show that the muon observables and Xmax together can be used to distinguish the primary. This study can be used to design a future detector for the surface array, which will be able to enhance our knowledge of primaries and QCD interactions.

Keywords: ultra high energy extensive air shower, muon tracking, air shower primaries, QCD interactions

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Authors: Tsebe Wilfred Molotja, Mahlapahlapane Themane, Kgetja Maruma

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It is globally accepted that reading in the primary schools serves as a foundational basis for good reading skills. This is evident in the students’ academic success throughout their studying life. However, the PIRLS (2016) report on Literacy performance found that primary school learners are not able to read as fluently as expected. The results from ANA (2012) also indicated that South African learners achieved the lowest as compared to other global ones. The purpose of this study is to investigate the approaches employed by educators in developing learners’ reading and writing skills and to workshop them on the best reading and writing approaches to be implemented. The study adopted an explorative qualitative design where 27 educators from primary schools around the University of Limpopo were purposefully sampled to participate in this study. Data was collected through interviews and classroom observation during class visits facilitated by research assistants. The study found that teachers are aware of different approaches to developing learners’ reading and writing skills even thou these are not aligned with the curriculum. However, the problem is with implementation, as the conditions in the classrooms are not conducive for such. The study recommends that more workshops on capacitating teachers with the pedagogical approaches to teaching reading be held. The appeal is also made to the Department of Basic Education that it makes the classrooms to be conducive for teaching and learning to take place.

Keywords: academic success, reading and writing, community based, approaches

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Authors: Mohammad Ansari, Satinder Mann, Ahmed Ismail

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Primary care patients in Emergency Departments (ED) have been the topic of discussion since 1998 in the United Kingdom. Numerous studies have analysed attendances in EDs retrospectively and suggest that at least one third to fifty percent patients attending ED with problems which could be managed appropriately in General Practice or minor injuries units. The pattern of ED Usage seems to be International. In Australia and many departments in the United States include walk in facilities staffed by physicians on family practice residency programme. It clearly appears in the United Kingdom that EDs have to accept that such patients with primary care problems will attend the ED and facilities will have to be provided to see and treat such patients. Urgent care centres were introduced in the United Kingdom nearly a decade ago to reduce the pressure on EDs. Most of these were situated near pre-existing EDs. Unfortunately these centres failed to have the desired effect of reducing the number of patients visiting EDs, it has been noticed that when more patients were seen in Urgent Care centres there were increased attendances in ED as well. A new model of Urgent Care centre was started in the ED of George Eliot Hospital, Nuneaton, UK. We looked at the working of the centre by looking at the number of patients seen daily against the number of total attendances in the ED. We studied the number and type of patients seen by the Urgent Care Doctor. All the medical records of the patients were seen and the time patients spent in the Urgent Care centre was recorded. The total number of patients seen during this study were 1532. 219 (14.3% ) were seen within our Urgent Care centre. None of the patients waited over four hours to be seen. It has been recognised that primary care patients in the ED are a major part of attendances of the department and unless these patients are seen in Urgent Care centres, overcrowding and long waits cannot been avoided. It has been shown that employing primary care Physicians in Urgent Care centres reduces overall cost because they do not carry out as many investigations as Junior Doctors. In our study over 14% patients were seen by Urgent Care Physicians and none of the patients waited for more than four hours and we feel that care provided to the patients by Urgent Care centre was highly effective and satisfying for the patient.

Keywords: urgent care centres, primary care physicians, overcrowding, cost

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Authors: Atefeh Ahmadi, Mohamed Sharif Mustaffa

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Mental health problems that children introspect them are hardly identified. The internalizing nature of Anxiety Disorders as the most prevalent psychological diseases, make them been under recognized by parents and teachers and so become under attended by school counsellors and subsequently under referred to clinicians. The aim of this study is to investigate the level of Anxiety Disorders to clarify if it is necessary to run screening programs in rural educational settings. Spence children anxiety scale-malay-child for the first time in Malaysia distributed among 640 Malay rural primary school students aged from 9-11 years old. Cut-off score was considered one standard deviation more than the mean of all students’ scores. The results of descriptive analyses revealed the mean for scores of SCAS was 32.84 and 15.6% of students had high level of anxiety. In addition, the level and prevalence of six types of anxiety disorders based on SCAS were described. In regards to the study outcomes, screening for anxiety disorders in academic settings could prevent and reduce their side effects by early identification.

Keywords: anxiety disorders, primary schools, SCAS, screening

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Authors: Adeyinka Adeniran, Omowunmi Bakare, Esther Oluwole, Florence Chieme, Temitope Durojaiye, Modupe Akinyinka, Omobola Ojo, Babatunde Olujobi, Marcus Ilesanmi, Akintunde Ogunsakin

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Introduction: Globally, COVID-19 has greatly impacted the human race physically, socially, mentally, and economically. However, healthcare workers seemed to bear the greatest impact. The study, therefore, sought to assess the impact of COVID-19 on the primary healthcare workers in Ekiti, South-west Nigeria. Methods: The study was a cross-sectional descriptive study using a quantitative data collection method of 716 primary healthcare workers in Ekiti state. Respondents were selected using an online convenience sampling method via their social media platforms. Data was collected, collated, and analyzed using SPSS version 25 software and presented as frequency tables, mean and standard deviation. Bivariate and multivariate analyses were conducted using a t-test, and the level of statistical significance was set at p<0.05. Results: Less than half (47.1%) of respondents were between 41-50 age group and a mean age of 44.4+6.4SD. A majority (89.4%) were female, and almost all (96.2%) were married. More than (90%) had ever heard of Coronavirus, and (85.8%) had to spend more money on activities of daily living such as transportation (90.1%), groceries (80.6%), assisting relations (95.8%) and sanitary measures (disinfection) at home (95.0%). COVID-19 had a huge negative impact on about (89.7%) of healthcare workers, with a mean score of 22+4.8. Conclusion: COVID-19 negatively impacted the daily living and professional duties of primary healthcare workers, which reflected their psychological, physical, social, and economic well-being. Disease outbreaks are unlikely to disappear in the near future. Hence, global proactive interventions and homegrown measures should be adopted to protect healthcare workers and save lives.

Keywords: Covid-19, health workforce, primary health care, health systems, depression

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Authors: Fionnuala Tynan, Margaret Nohilly

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Wellbeing in not only a national priority in Ireland but in the international context. A review of the literature highlights the consistent efforts of researchers to define the concept of wellbeing. This study sought to explore the understating of Wellbeing in Irish primary schools. National Wellbeing Guidelines in the Irish context frame the concept of wellbeing through a mental health paradigm, which is but one aspect of wellbeing. This exploratory research sought the views of Irish primary-school teachers on their understanding of the concept of wellbeing and the practical application of strategies to promote wellbeing both in the classroom and across the school. Teacher participants from four counties in the West of Ireland were invited to participate in focus group discussion and workshops through the Education Centre Network. The purpose of this process was twofold; firstly to explore teachers’ understanding of wellbeing in the primary school context and, secondly, for teachers to be co-creators in the development of practical strategies for classroom and whole school implementation. The voice of the teacher participants was central to the research design. The findings of this study indicate that the definition of wellbeing in the Irish context is too abstract a definition for teachers and the focus on mental health dominates the discourse in relation to wellbeing. Few teachers felt that they were addressing wellbeing adequately in their classrooms and across the school. The findings from the focus groups highlighted that while teachers are incorporating a range of wellbeing strategies including mindfulness and positive psychology, there is a clear disconnect between the national definition and the implementation of national curricula which causes them concern. The teacher participants requested further practical strategies to promote wellbeing at whole school and classroom level within the framework of the Irish Primary School Curriculum and enable them to become professionally confident in developing a culture of wellbeing. In conclusion, considering wellbeing is a national priority in Ireland, this research promoted the timely discussion the wellbeing guidelines and the development of a conceptual framework to define wellbeing in concrete terms for practitioners. The centrality of teacher voices ensured the strategies proposed by this research is both practical and effective. The findings of this research have prompted the development of a national resource which will support the implementation of wellbeing in the primary school at both national and international level.

Keywords: primary education, shared understanding, teacher voice, wellbeing

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Authors: Md Fazlul Kader, Soo Young Shin

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In this paper, we consider a cognitive relay network (CRN) in which the primary receiver (PR) is protected by peak transmit power $\bar{P}_{ST}$ and/or peak interference power Q constraints. In addition, the interference effect from the primary transmitter (PT) is considered to show its impact on the performance of the CRN. We investigate the outage probability (OP) and outage capacity (OC) of the CRN by deriving closed-form expressions over Rayleigh fading channel. Results show that both the OP and OC improve by increasing the cooperative relay nodes as well as when the PT is far away from the SR.

Keywords: cognitive relay, outage, interference limited, decode-and-forward (DF)

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Authors: Jingwen Shan

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In order to explore the key factors affecting the robot program learning intention of school students, this study takes the technology acceptance model as the theoretical basis and invites 167 students from Jiading District of Shanghai as the research subjects. In the robot course, the model of school students on their learning behavior is constructed. By verifying the causal path relationship between variables, it is concluded that teachers can enhance students’ perceptual usefulness to robotics courses by enhancing subjective norms, entertainment perception, and reducing technical anxiety, such as focusing on the gradual progress of programming and analyzing learner characteristics. Students can improve perceived ease of use by enhancing self-efficacy. At the same time, robot hardware designers can optimize in terms of entertainment and interactivity, which will directly or indirectly increase the learning intention of the robot course. By changing these factors, the learning behavior of primary and secondary school students can be more sustainable.

Keywords: TAM, learning behavior intentions, robot courses, primary and secondary school students

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Authors: Rapuane Eric Jan Pule

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Sport participation plays a significant role in learners’ well-being and lifestyle. Learners spend most of their time in the school environment, where they are monitored, guided and advised by teachers. Teachers have a good relationship with the learners, therefore they can play a major role in promoting and influencing learners to participate in physical activities, both competitive and recreational purposes. Their influence and involvement could assist in increasing the number learners' involvement in physical activities, sport and recreation at Township schools. The national sport and recreation plan in South Africa, recommends that promotion of sport and physical activities at primary and secondary schools should play an important role in helping learners commit to a live-long participation in sport, recreational and physical activities. Schoolteachers could play an influential role in ensuring that learners spent their leisure time productively through physical and recreational activities. However, the role and the influence of teachers in promoting physical and recreational activities have been previously overlooked in the literature. Part of this study focuses on the in-depth challenges encountered by primary and secondary school teachers at Township schools in promoting and influencing learners’ involvement in sport, recreation and physical activities. 109 primary and secondary teachers at Township schools agreed to participate in the study through the provision of informed consent. The participants consisted of 49 primary school teachers and 60 secondary school teachers. Quantitative approach was followed using validated structured questionnaire comprising 12 close-ended items were used. Findings indicated that teachers' can play a significant role in influencing and encouraging learners to participate in sport, recreation or physical activities. Teachers view physical activity as an important developmental component for learners. Primary school teachers believe that they have a significant role to play in encouraging and promoting physical activities, sport and recreation, as compared to the secondary school teachers. Both group of teachers at primary and secondary schools, believe that infrastructure development, financial support, and extra incentives could motivate them to promote physical, recreational and sporting activities at schools. Teachers also acknowledge that schools are facing challenges in implementing and coordinating physical activities and recreational programmes as required by the Department of sport and recreation South Africa. It is recommended that the Department of Basic Education and Sport and Recreation South Africa revise their policies regarding the role of teachers in promoting and administering physical and recreational activities at schools.

Keywords: township, physical activities, sport and recreation participation, learners, teachers, primary and secondary schools, physical education

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Authors: Justina Jor, Mahmud Pinga

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Climate change has become a significant worldwide environmental challenge with extensive implications, compelling both governments and non-governmental organizations to remain vigilant, as it seemingly impacts various sectors of the global economy, including education. The study investigates the implementation of smart climate change measures for effective primary school management in Benue State, Nigeria. Theorized by the diffusion of innovations, the study was guided by two research questions, and two null hypotheses were formulated and tested. The study used a descriptive survey design. The population comprised 12,364 teachers from 2,721 primary schools, with a sample of 618 teachers from 136 schools selected through a multistage sampling procedure. Smart climate change measures questionnaire (SCCMQ) and key informant interview (KII) were used for data collection. The data collected were analyzed using mean and standard deviation to answer the research questions, while the Chi-square (χ2) test of goodness-of-fit was used to test the hypotheses at a 0.05 level of significance, with qualitative data analyzed using simple percentages, tables, and bar charts. The findings highlight the significant positive impact of green building practices on the efficient administration of primary schools in Benue State, Nigeria. The crucial integration of environmentally sustainable construction methods is emphasized for enhancing overall management in these educational institutions. In addition, the research demonstrates a favorable impact on the adoption of renewable energy solutions and effective school management. The utilization of renewable energy not only aligns with eco-friendly practices but also contributes to the overall operational efficiency and sustainability of primary schools in the region. The study recommends that educational authorities and policymakers prioritize integrating green building practices and renewable energy solutions, pointing towards the prospect of improved governance and functionality for primary education facilities not only in Benue but throughout Nigeria.

Keywords: smart, climate change, effective management, green building, renewable energy

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Authors: Ana Lucia Molina

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Introduction: Fine motor skills refer to the use of the hands and coordination of the small muscles that control the fingers. A deficiency in fine motor skills is as important as a change in global movements, as fine motor skills directly affect activities of daily living. Fine movements are involved in some functions, such as motor control of the extremities, sensitivity, strength and tonus of the hands. A growing interest in the effects of non-invasive neuromodulation, such as transcranial stimulation technologies, through transcranial magnetic stimulation (TMS), has been observed in the scientific literature, with promising results in fine motor rehabilitation, as it provides modulation of the corresponding cortical activity in the area primary motor skills of the hands in both hemispheres (according to the International System 10-20, corresponding to C3 and C4). Objectives: to carry out a literature review about the effects of TMS on the cortical motor area corresponding to hand motricity. Methodology: This is a bibliographic survey carried out between October 2022 and March 2023 at Pubmed, Google Scholar, Lillacs and Virtual Health Library (BVS), with a national and international database. Some books on neuromodulation were included. Results: 28 articles and 5 books were initially found, and after reading the abstracts, only 14 articles and 3 books were selected, with publication dates between 2008 and 2022, to compose the literature review since it suited the purpose of this study. Conclusion: TMS has shown promising results in the treatment of fine motor rehabilitation, such as improving coordination, muscle strength and range of motion of the hands, being a complementary technique to existing treatments and thus providing more potent results for manual skills in activities of daily living. It is important to emphasize the need for more specific studies on the application of TMS for the treatment of manual disorders, which describe the uniqueness of each movement.

Keywords: transcranial magnetic stimulation, fine motor skills, motor rehabilitation, non-invasive neuromodulation

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Authors: Yazan M. Alatrash, Han-ok Kang, Hyun-gi Yoon, Shen Zhang, Juhyeon Yoon

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Flow coastdown phenomena are very important to secure nuclear fuel integrity during loss of off-site power accidents. In this study, primary coolant flow coastdown phenomena are investigated for the Jordan Research and Training Reactor (JRTR) using a simulation software package, Modular Modelling System (MMS). Two MMS models are built. The first one is a simple model to investigate the characteristics of the primary coolant pump only. The second one is a model for a simulation of the Primary Coolant System (PCS) loop, in which all the detailed design data of the JRTR PCS system are modelled, including the geometrical arrangement data. The same design data for a PCS pump are used for both models. Coastdown curves obtained from the two models are compared to study the PCS loop coolant inertia effect on a flow coastdown. Results showed that the loop coolant inertia effect is found to be small in the JRTR PCS loop, i.e., about one second increases in a coastdown half time required to halve the coolant flow rate. The effects of different flywheel inertia on the flow coastdown are also investigated. It is demonstrated that the coastdown half time increases with the flywheel inertia linearly. The designed coastdown half time is proved to be well above the design requirement for the fuel integrity.

Keywords: flow coastdown, loop inertia, modelling, research reactor

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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: Daruliza Kernain, Shaharum Shamsuddin, See Too Wei Cun

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CTCF is a unique, highly conserved and ubiquitously expressed 11 zinc finger (ZF) transcriptional factor with multiple target sites. It is able to bind to various target sequences to perform different regulatory roles including promoter activation or repression, creating hormone-responsive gene silencing element, and functional block of enhancer-promoter interactions. The binding of CTCF to the essential binding site is through the combination of different ZF domain. On the other hand, BORIS for brother of the regulator of imprinted sites, which expressed only in the testis and certain cancer cell line is homology to CTCF 11 ZF domains. Since both transcriptional factors share the same ZF domains hence there is a possibility for both to bind to the same target sequences. In this study, the interaction of these two proteins to multi-functional Y-box DNA/RNA-binding factor, YB-1 was determined. The protein-protein interaction between CTCF/YB-1 and BORIS/YB-1 were discovered by Co-immuno-precipitation (CO-IP) technique through reciprocal experiment from RGBM total cell lysate. The results showed that both CTCF and BORIS were able to interact with YB-1 in Glioma RGBM cell line. To the best of our knowledge, this is the first findings demonstrating the ability of BORIS and YB-1 to form a complex in vivo.

Keywords: immunoprecipitation, CTCF/BORIS/YB-1, transcription factor, molecular medicine

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Authors: Ramesh Adsul, Vikas Minchekar

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The present study attempts to explore the differences in academic achievement and psychological well being and its components – satisfaction, efficiency, sociability, mental health, interpersonal relations in low and moderate level of hemoglobin of college female students. It also tries to find out how hemoglobin, psychological well –being and academic achievement correlate to each other. For this study 200 (100 low hemoglobin level and 100 moderate hemoglobin level) college female students were selected by random sampling method. This sample is collected from the project ‘Health awareness and hemoglobin improvement programme’, which is being collaboratively conducted by ‘Akshyabhasha, MESA, U.S.A. and Smt. M.G. Kanya Mahavidyalaya, Sangli, Maharashtra, India. Psychological Well-Being Scale was used to collect the data. Students’ academic achievement was collected through college record, and hemoglobin level of female students was collected from project record. Data was analyzed by using independent ‘t’ test and Pearson’s correlation coefficient. The finding of the study revealed significant differences between low hemoglobin and moderate hemoglobin groups regarding efficiency and mental health. No significant difference was observed on satisfaction, sociability and interpersonal relations. It is also found that there is significant difference between low hemoglobin and moderate hemoglobin groups on academic achievement. The study revealed positive correlation between hemoglobin and academic achievement and psychological well-being and academic achievement. Moderate hemoglobin level create more efficiency, better mental health and good academic achievement in female students. One could say that there is significant role hemoglobin plays in psychological well being and academic achievement of college female students. Anemia is widely prevalent in all the states if India among all age groups. In India, college girls contribute major portion of population. It has been reported that 80% female population has hemoglobin deficiency, due to illiteracy of female, family structure, status of women, diet habits, gender discrimination and various superstitions. The deficiency of hemoglobin affects physical and mental health, general behavior and academic performance of students. This study is useful to educational managements, counselors, parents, students and Government also. In the development of personality physical as well as psychological health is essential. This research findings will create awareness about physical and mental health among people and society.

Keywords: academic achievement, college female students, hemoglobin, psychological well-being

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Authors: Hossein Pourali

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In this paper, we extend the concepts of primal and weakly primal ideals for posets. Further, the diameter of the zero divisor graph of a poset with respect to a non-primal ideal is determined. The relation between primary and primal ideals in posets is also studied.

Keywords: ‎associated prime ideal, ‎‎ideal, ‎‎primary ideal, primal ideal‎, prime‎ ‎ideal, semiprime ideal, ‎weakly primal ideal, zero divisors graph

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Authors: Arielle Ferdinand

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A plant-based diet focuses on foods from plant sources, limiting or altogether omitting animal products. Some of the most common chronic illnesses seen in primary care are hypertension, hyperlipidemia, and diabetes type II. These common chronic illnesses can often be debilitating, costly, time-consuming, and, when left untreated, can lead to an early death. Treatment and maintenance of care are also labor intensive for the patient. They are often required to have at least four blood pressure checks yearly and a hemoglobin A1C checked quarterly. Though preventative interventions and prevention education should be included in patient visits in the primary care setting, education about dietary interventions, such as a plant-based diet, also yields positive outcomes for patients who already have hypertension, hyperlipidemia, and diabetes mellitus type 2. Evidence will show that incorporating a plant-based diet results in decreased blood pressure, as well as decreased levels of LDL-C, improved post-prandial glucose levels, and a reduction in HbA1C. It is cost-effective for the patient by generally lower grocery costs, and it can either reduce or prevent the need to pay for more office visits and pharmacotherapy. Incorporating this method of dietary changes is an easy intervention during a primary care office visit that would greatly benefit the patient in many ways.

Keywords: plant-based, nutrition, diabetes, hyperlipidemia

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Authors: Oluyemi Christianah Ojo

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This study seeks to investigate the quality of ICT provided in the new Caring Heart schools in Ondo State, Nigeria. The population for the study was all caring Heart Mega Schools in Ondo State, Nigeria. Research questions were generated; two instruments CCCMS and TQCUC were used to elicit information from the schools and the teachers. The study adopts descriptive survey approach. The studies revealed and concluded that ICT components were available and adequate in these schools, Charts showing ICT components and other forms of computer devices used as instructional materials were available but were not adequate; teachers teaching computer studies are competent in the delivery of instructions and in handling computer gadgets in the laboratory. The study recommended the provision of steady electricity, uninterrupted internet facilities and provision of adequate ICT components and charts for effective teaching delivery and learning.

Keywords: facilities, information communication technology, mega primary school, primary education

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Authors: Rezky Rifaini, Raden Bagus Fajriya Hakim

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This research was conducted at the Bolo primary health Care in Bima Regency. The purpose of the research is to find out the association pattern that is formed of medical record database from Bolo Primary health care’s patient. The data used is secondary data from medical records database PHC. Sequential pattern mining technique is the method that used to analysis. Transaction data generated from Patient_ID, Check_Date and diagnosis. Sequential Pattern Discovery Algorithms Using Equivalent Classes (SPADE) is one of the algorithm in sequential pattern mining, this algorithm find frequent sequences of data transaction, using vertical database and sequence join process. Results of the SPADE algorithm is frequent sequences that then used to form a rule. It technique is used to find the association pattern between items combination. Based on association rules sequential analysis with SPADE algorithm for minimum support 0,03 and minimum confidence 0,75 is gotten 3 association sequential pattern based on the sequence of patient_ID, check_Date and diagnosis data in the Bolo PHC.

Keywords: diagnosis, primary health care, medical record, data mining, sequential pattern mining, SPADE algorithm

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