Search results for: primary side regulation

Authors: Dan Richard D. Fernandez

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This study determined the perspectives of community health workers’ perspectives in the sustainability of primary health care. Eight community health workers, two community officials and a rural health midwife in a rural community in the in the Philippines were enjoined to share their perspectives in the sustainability of primary health care. The study utilized the critical research method. The critical research assumes that there are ‘dominated’ or ‘marginalized’ groups whose interests are not best served by existing societal structures. Their experiences highlighted that the challenges of their role include unkind and uncooperative patients, the lack of institutional support mechanisms and conflict of their roles with their family responsibilities. Their most revealing insight is the belief that primary health care is within their grasp. Finally, they believe that the burden to sustain primary health care rests on their shoulders alone. This study establishes that Multi-stakeholder participation is and Gender-sensitivity is integral to the sustainability of Primary Health Care. It also observed that the ingrained Expert-Novice or Top-down Management Culture and the marginalisation of BHWs within the system is a threat to PHC sustainability. This study also recommends to expand the study and to involve the local government units and academe in lobbying the integration of gender-sensitivity and multi-stake participatory approaches to health workforce policies. Finally, this study recognised that the CHWs’ role is indispensable to the sustainability of primary health care.

Keywords: community health workers, multi-stakeholder participation, sustainability, gender-sensitivity

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Authors: Zhongyang Sun, Shu Zhang

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In osteoblasts, L-type voltage sensitive calcium channels (LTCCs), especially the Cav1.2 LTCCs, play fundamental roles in cellular responses to external stimuli including both mechanical forces and hormonal signals. Several lines of evidence have revealed that the density of bone is increased and the resorption of bone is decreased when these calcium channels in osteoblasts are activated. And numerous studies have shown that mechanical loading promotes bone formation in the modeling skeleton, whereas removal of this stimulus in microgravity results in a reduction in bone mass. However, the effect of microgravity on LTCCs in osteoblasts is still unknown. The aim of this study was to determine whether microgravity exerts influence on LTCCs in osteoblasts and the possible mechanisms underlying. In this study, we demonstrate that simulated microgravity substantially inhibits LTCCs in osteoblast by suppressing the expression of Cav1.2. Then we show that the up-regulation of miR-103 is involved in the down-regulation of Cav1.2 expression and inhibition of LTCCs by simulated microgravity in osteoblasts. Our study provides a novel mechanism of simulated microgravity-induced adverse effects on osteoblasts, offering a new avenue to further investigate the bone loss caused by microgravity.

Keywords: L-type voltage sensitive calcium channels, Cav1.2, osteoblasts, microgravity

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Authors: Mahdi Farajzadeh Ajirlou

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The detailed serious adverse effects raised the stresses around the safety of individuals who have gotten COVID-19 vaccines. Numerous verification referrers that disease with COV-19 causes neurological dysfunction in a significant proportion of influenced patients, where these side effects show up seriously amid the disease, and still less is known approximately the potential long-term results for the brain, where the loss of olfaction could be a neurological sign and simple indications of COVID-19. Since publishing effective clinical trial results of mRNA coronavirus disease 2019 (COVID-19) and injecting it to the volunteers in 2020, numerous reports have emerged approximately about cardiovascular complications followed by the mRNA vaccination. Vaccination-associated adenopathy could be a constant imaging finding after the organization of COVID-19 antibodies that will lead to a symptomatic problem in patients with shown or suspected cancer, in whom it may be vague from dangerous nodal inclusion. In spite of all the benefits and viability of the coronavirus infection 2019 (COVID-19) antibodies specified in later clinical trials, a few other post-vaccination side impacts, such as lymphadenopathy (LAP), were observed. Also, numerous variables, including financial conditions, have played a critical part in expanding the number of people with COVID-19 infection and also much more side effects in that country. Amid the Coronavirus widespread, Iran has been experiencing extreme sanctions, which has faced this nation with an extreme financial crisis. Additionally, with COVID-19 widespread, there was a developing concern around the abuse of imaging exams extraordinarily within the pediatric populace, which highlights the issues pointed out by this review.

Keywords: radiology, vaccines, COVID-19, side effect

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Authors: Thuraya Ahmed Hamood Al Shidhani

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Sports Medicine injuries are very common in primary health care. It is not necessary related to direct trauma, but it could be because of repetitive stress and overuse injuries. Knowledge of Primary Health care providers about the common sports medicine injuries and when to refer to a specialist is essential. Common sports injuries are muscle strain, joint sprain, bone bruise, Patellofemoral pain syndrome, Anterior cruciate ligament injuries, meniscal injuries, ankle ligaments injuries, concussion, Rotator cuff tendinosis/impingement syndrome, lateral and medial epicondylitis and fractures. Systematic approach is very useful in evaluation of sports injuries. RICE is important in initial management. Physiotherapy is essential for rehabilitation. Definitive Management is dependent on patient’s condition and function.

Keywords: common, sports medicine injuries, primary health care, injuries

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Authors: M. Abbasi

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A spillway structure is used to pass excess water and floods from upstream or upstream to downstream or tributary. The spillway is considered one of the most key members of the dam, and the failure of many dams is attributed to the inefficiency of their spillway. Weirs should be selected as strong, reliable and high-performance structures, and weirs should be ready for use in all conditions and able to drain the flood so that we do not witness many casualties and financial losses when a flood occurs. The purpose of this study is to simulate the flow pattern passing over the peak spillway in order to optimize and adjust the height of the spillway walls. In this research, the effect of the shape of the side wings on the flow pattern over the peak spillways of the Gotvand reservoir dam was simulated and modelled using Flow3D software. In this research, side wings with rounded walls with six different approach angles were used. In addition, the different value of H/Hd was used to check the effect of the tank head. The results showed that with the constant H/Hd ratio and the increase of the approach angle of the side wing, the flow depth first decreases and then increases. These changes were the opposite regarding the depth average speed of the flow and the depth average concentration of the air entering the flow. At the same time, with the constant angle of approach of the side wing and with the increase of H/Hd ratio, the flow depth increases. In general, a correct understanding of the operation of overflows and a correct design can significantly reduce construction costs and solve flooding problems.

Keywords: effect of the shape, gotvand reservoir dam, narrowing coefficients, supports of the gates

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Authors: Rose Mwanza

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This paper investigates security factors influencing primary school pupils’ school participation in Kenya. Schools, communities and the Government all have roles to play in enhancing primary school pupil’s school participation. The effective security system of a country provides the necessary avenues to facilitate improved health services protection of children and allows free movement of the country’s citizens which leads to a conducive atmosphere for school participation. Kenya is a signatory to international commitments and conventions related to security such as the National Policy on Peace Building and Conflict Management, United Nations Development Assistance Framework and Key Security Unity, which enable primary school pupils to participate in education. The paper also looks at the strategies the Government of Kenya has put in place to ensure effective pupil school participation.

Keywords: ethnicity, social media, participation in school, poverty, terrorism

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Authors: Sarah Sayed El- Tawab, Emmanuel Kamal Azix Saba

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Objectives: Somatosensory blink reflex (SBR) is an eye blink response obtained from electrical stimulation of peripheral nerves or skin area of the body. It has been studied in various neurological diseases as well as among healthy subjects in different population. We designed this study to detect SBR positivity in patients with facial palsy and patients with post facial syndrome, to relate the facial palsy severity and the presence of SBR, and to associate between trigeminal BR changes and SBR positivity in peripheral facial palsy patients. Methods: 50 patients with peripheral facial palsy and post-facial syndrome 31 age and gender matched healthy volunteers were enrolled to this study. Facial motor conduction studies, trigeminal BR, and SBR were studied in all. Results: SBR was elicited in 67.7% of normal subjects, in 68% of PFS group, and in 32% of PFP group. On the non-paralytic side SBR was found in 28% by paralyzed side stimulation and in 24% by healthy side stimulation among PFP patients. For PFS group SBR was found on the non- paralytic side in 48%. Bilateral SBR elicitability was higher than its unilateral elicitability. Conclusion: Increased brainstem interneurons excitability is not essential to generate SBR. The hypothetical sensory-motor gating mechanism is responsible for SBR generation.

Keywords: somatosensory evoked blink reflex, post facial syndrome, blink reflex, enchanced gain

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Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

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Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

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Authors: Othman Salim Hussein Al-Fleesy

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Background: Studies showed that sudden infant death syndrome (SIDS) has association with sleeping positions. Up-to-date no study explained how could they prevent it? Objectives: 1-To determine which sleeping position is certainly safe one to prevent SIDS. 2-To establish criteria for suggesting definition and making diagnosis for SIDS. 3-To discuss the controversy surrounding SUND, ALTE, NM, as compared to SIDS. Method: This literature review was built on a previous literature. Articles were obtained randomly according to their availability to the author. For the purpose of this work an easy approach was built by modeling an overview on SIDS topic after clarifying the misconception and misinterpretation of a number of controversial issues in regard to SIDS such as: asphyxia, sudden unexpected death among adults (Bangungut or Pokkuri), apparent life threatening event (ALTE), Nightmare, and comparing the findings with the literature review results..By this unique method we got a clue for prevention of Sudden Infant Death Syndrome. Results: The revision revealed with no doubt that no study before have studied right-side sleeping position at all. The author determined right side as the only safe position to preventing SIDS. A new definition for SIDS is suggested. The author postulated a Right side position hypothesis (Alfleesy hypothesis) which is a testable hypothesis in front of all researchers for further study . Conclusion: Our results contradict totally all previous studies and recommendations. We recommended strongly the right side position only for sleeping to prevent SIDS. New definition is suggested and a new hypothesis is postulated.

Keywords: SIDS, ALTE, nightmare, forensic sciences

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Authors: Kazuyoshi Mori

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Examples of parameterization of stabilizing controllers that require only one of right-/left-coprime factorizations are presented. One parameterization method requires one side coprime factorization. The other requires no coprime factorization. The methods are based on the factorization approach so that a number of models can be applied the method we use in this paper.

Keywords: parametrization, coprime factorization, factorization approach, linear systems

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Authors: Mohamed Almagsoudi

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The aim of this paper is to deal with two issues. One of them is about the theoretical side of codification, and the other is related to the practical side. At first, I have tried to criticize the debate running about codification of Islamic and Saudi Law, through observing and analyzing views of opponents and advocates. I tried to prove a hypothesis that both parties could not completely succeed in reviewing the theoretical base of this topic where discussion would not deal with irrelevant matters. It is a crucial shortcoming that made advocates unable to answer the critical questions addressed by those opponents.

Keywords: Codification, Saudi Law, Islamic law, Sharia

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Authors: Pankhudi Khandelwal

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The revenue models of digital giants such as Facebook and Google, use targeted advertising for revenues. Such a model requires huge amounts of consumer data. While the data protection law deals with the protection of personal data, however, this data is acquired by the companies on the basis of consent, performance of a contract, or legitimate interests. This paper analyses the role that competition law can play in evading these loopholes for the protection of data and privacy of online consumers. Digital markets have certain distinctive features such as network effects and feedback loop, which gives incumbents of these markets a first-mover advantage. This creates a situation where the winner takes it all, thus creating entry barriers and concentration in the market. It has been also seen that this dominant position is then used by the undertakings for leveraging in other markets. This can be harmful to the consumers in form of less privacy, less choice, and stifling innovation, as seen in the cases of Facebook Cambridge Analytica, Google Shopping, and Google Android. Therefore, the article aims to provide a legal framework wherein the data protection law and competition law can come together to provide a balance in regulating digital markets. The issue has become more relevant in light of the Facebook decision by German competition authority, where it was held that Facebook had abused its dominant position by not complying with data protection rules, which constituted an exploitative practice. The paper looks into the jurisdictional boundaries that the data protection and competition authorities can work from and suggests ex ante regulation through data protection law and ex post regulation through competition law. It further suggests a change in the consumer welfare standard where harm to privacy should be considered as an indicator of low quality.

Keywords: data protection, dominance, ex ante regulation, ex post regulation

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Authors: Erin McKellar, Narelle Yeo

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Gender disparity can be found in the representation of the female characters in Leonard Bernstein’s musical West Side Story. As a postmodern composer, Bernstein was open about his social activism, yet did not consider his compositional portrayal of female characters as part of that activism. Using discretization as an analysis tool, this thesis explores the melodic contours of male and female songs in West Side Story to show differences in complexity between male and female characterisation. The analysis explores the intervallic relationship between the vocal line and melodic color in relation to the accompaniment harmony, taking into consideration the use of consonance and dissonance. West Side Story is commonly known for its distinct use of the tritone motif and its inherent dissonance. It is evident when reviewing the findings of this study that there is a distinct disparity between male-led and female-led music. The male-led numbers consistently adhere to a dissonant aesthetic with the tritone motif implemented in all of the extracted songs. By contrast, the female songs remain consonant with simple intervallic movements. By examining the results of this study through the lens of Equality Feminism, this thesis finds that Bernstein has simplified the characterisations of the female leads. The thesis further proposes that without cognisant consideration of the compositional portrayal of women, the musical theatre will continue to reinforce gender stereotypes, as evident through this study of Bernstein’s West Side Story.

Keywords: music theatre, gender bias, composition, Leonard Bernstein

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Authors: Cristina Costescu, Carmen David, Adrian Roșan

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Executive functions (EF) and emotion regulation strategies are processes that allow individuals to function in an adaptative way and to be goal-oriented, which is essential for success in daily living activities, at school, or in social contexts. The Emotion Regulation and Executive Functioning Scale for Children and Adolescents (REMEX) represents an empirically based tool (based on the model of EF developed by Diamond) for evaluating significant dimensions of child and adolescent EFs and emotion regulation strategies, mainly in school contexts. The instrument measures the following dimensions: working memory, inhibition, cognitive flexibility, executive attention, planning, emotional control, and emotion regulation strategies. Building the instrument involved not only a top-down process, as we selected the content in accordance with prominent models of FE, but also a bottom-up one, as we were able to identify valid contexts in which FE and ER are put to use. For the construction of the instrument, we implemented three focus groups with teachers and other professionals since the aim was to develop an accurate, objective, and ecological instrument. We used the focus group method in order to address each dimension and to yield a bank of items to be further tested. Each dimension is addressed through a task that the examiner will apply and through several items derived from the main task. For the validation of the instrument, we plan to use item response theory (IRT), also known as the latent response theory, that attempts to explain the relationship between latent traits (unobservable cognitive processes) and their manifestations (i.e., observed outcomes, responses, or performance). REMEX represents an ecological scale that integrates a current scientific understanding of emotion regulation and EF and is directly applicable to school contexts, and it can be very useful for developing intervention protocols. We plan to test his convergent validity with the Childhood Executive Functioning Inventory (CHEXI) and Emotion Dysregulation Inventory (EDI) and divergent validity between a group of typically developing children and children with neurodevelopmental disorders, aged between 6 and 9 years old. In a previous pilot study, we enrolled a sample of 40 children with autism spectrum disorders and attention-deficit/hyperactivity disorder aged 6 to 12 years old, and we applied the above-mentioned scales (CHEXI and EDI). Our results showed that deficits in planning, bebavior regulation, inhibition, and working memory predict high levels of emotional reactivity, leading to emotional and behavioural problems. Considering previous results, we expect our findings to provide support for the validity and reliability of the REMEX version as an ecological instrument for assessing emotion regulation and EF in children and for key features of its uses in intervention protocols.

Keywords: executive functions, emotion regulation, children, item response theory, focus group

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Authors: Tahmina Huq

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Action research equips teachers with the skills needed to work on a particular situation in their classroom. This paper aims to introduce a strategy, visual dialogue between student and teacher, used by the researcher to help autistic students with intellectual disabilities to regulate their immediate emotions to achieve their academic goals. This research has been conducted to determine whether teaching self-regulation strategies can be effective instead of segregating them. The researcher has identified that visual dialogue between the student and teacher is a helpful technique for teaching self-regulation. For this particular research, action research suits the purpose as the findings can be applied immediately in the classroom. Like many autistic students, the teacher had two 15 years old autistic students with intellectual disabilities in class who had difficulty in controlling their emotions and impulses. They expressed their emotions through aggressive behavior, such as shouting, screaming, biting teachers or any adult who was in their sight, and destroying school property. They needed two to four hours to recover from their meltdowns with the help of a psychologist. The students missed the classes as they were often isolated from the classroom and stayed in the calming room until they calmed down. This negatively affected their learning. Therefore, the researcher decided to implement a self-regulation strategy, a visual dialogue between students and teachers, instead of isolating them to recover from the meltdown. The data was collected through personal observations, a log sheet, personal reflections, and pictures. The result shows that the students can regulate their emotions shortly in the classroom (15 to 30 minutes). Through visual dialogue, they can express their feelings and needs in socially appropriate ways. The finding indicates that autistic students can regulate their emotions through visual dialogues and participate in activities by staying in the classroom. Thus it positively impacted their learning and social lives. In this paper, the researcher discussed the findings of exploring how teachers can successfully implement a self-regulation strategy for autistic students in classroom settings. The action research describes the strategy that has been found effective for managing the emotions of autistic students with intellectual disabilities.

Keywords: action research, self-regulation, autism, visual communication

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Authors: Chia-Chi Cheng

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After the implementation of “the internet plus,” several puzzles emerge as below: why does China impose more regulation and laws on economic development on the Internet? Why does China urge the importance of manufacturing industry? Why does China’s local government passively implement the policy imposed by the central government? What kind of factors can influence China’s local government’s economic preference? In the framework of neo-institutionalism, this research considers China’s local government as changing agents to analyze its preferences and behavior. In general, the interests urged by the local government will decide its preference and behaviors. They will change its counterpart to cooperate if the change will bring more benefits. Thus, they will change its preference and behavior while the external environment alters. While the local government has the same definition on political activity and economic interest, they will prefer to cooperate with the local enterprises in the way of laying symbiont, within the presumption that the institution remains. While the local government has the different positions on political activity and economic interest, they will re-define the existed regulation or create new regulation in the condition of institution vacuum. Sequentially, they will replace the targets, and the policy, which does not fit in the Central government’s policy, will emerge.

Keywords: China, institutional change, government enterprise relationship, e-commercial policy

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Authors: Eugene Mashapa

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The age of information has witnessed countless unprecedented technological developments, which signal the articulation of succinct technological capabilities that can match these cutting-edge technological trends. These changes have impacted patterns in the production, distribution, and consumption of media content, a space that the Film and Publication Board (FPB) is concerned with. Consequently, the FPB is keen to understand the nature and impact of these technological changes on media content regulation. This exploratory study sought to investigate how content regulators in high and middle-income economies have adapted to the changes in this space, seeking insights into innovations, technological and operational, that facilitate continued relevance during this fast-changing environment. The study is aimed at developing recommendations that could assist and inform the organisation in regulating media content as it evolves. Thus, the overall research strategy in this analysis is applied research, and the analytical model adopted is a mixed research design guided by both qualitative and quantitative research instruments. It was revealed in the study that the FPB was significantly impacted by the unprecedented technological advancements in the media regulation space. Additionally, there exists a need for the FPB to understand the current and future penetrations of 4IR technology in the industry and its impact on media governance and policy implementation. This will range from reskilling officials to align with the technological skills to developing technological innovations as well as adopting co-regulatory or self-regulatory arrangements together with content distributors, where more content is distributed in higher volumes and with increased frequency. Importantly, initiating an interactive learning process for both FPB employees and the general public can assist the regulator and improve FPB’s operational efficiency and effectiveness.

Keywords: media, regulation, technology, film and publications board

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Authors: Mei Teng Woo, Keith Davids, Jarmo Liukkonen, Jia Yi Chow, Timo Jaakkola

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Wearable garments such as tapes, compression garments, and braces could improve proprioception and reduced postural sway. The aim of this study was to examine the effects of wearable garments on postural regulation in a sample of community-dwelling elderly individuals, aged 65 years. It was hypothesized that wearable garments such as socks would provide stimulation to lower leg mechanoreceptors, and help participants achieve better postural regulation. Participants (N=63) performed a 30-s Romberg balance test protocol under four conditions (barefoot; wearing commercial socks; wearing clinical compression socks; wearing non-clinical compression socks), in a counterbalanced order, with four levels of performance difficulty: (1) standing on a stable surface with open eyes (SO); (2) a stable surface with closed eyes (SC); (3) a foam surface with open eyes (FO); and (4) a foam surface with closed eyes (FC). Centre of pressure (CoP) measurements included postural sway area (C90 area), trace length (TL) and sway velocity. Thirty-five participants (55.6%) showed positive effects of wearing the socks (responded group). In the responded group, it was revealed that socks showed significant differences in SO, SC and FO conditions for the two CoP measurements - TL and sway velocity (p < 0.05). In contrast, in the non-responded group, barefoot condition significantly decreased the TL and velocity in the SO condition. From the positive effects observed in the responded group, it is possible that wearable garments provide sensory cues that could interact with a biological cueing system to enhance performance in the postural regulation system. This study suggests that individuals respond to the socks treatments differently and future research should be undertaken to examine the factors that benefited the responded group of participants.

Keywords: community-dwelling, elderly adults, postural regulation, wearable garments

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Authors: Amanda Cristina da Silva Reis, Bruno Paulino Venâncio, Cristina Theada Ferreira, Andrea Fialho do Prado, Lucimara Guedes dos Santos, Aline de Souza Gravatá, Larissa Lima Gonçalves, Isabella Aparecida Ferreira Moretto, João Carlos Ferrari Corrêa, Fernanda Ishida Corrêa

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Objective: To compare two protocols of Transcranial Magnetic Stimulation (TMS) on quadriceps muscle spasticity in individuals diagnosed with Multiple Sclerosis (MS). Method: Clinical, crossover study, in which six adult individuals diagnosed with MS and spasticity in the lower limbs were randomized to receive one session of high-frequency (≥5Hz) and low-frequency (≤ 1Hz) TMS on motor cortex (M1) hotspot for quadriceps muscle, with a one-week interval between the sessions. To assess the spasticity was applied the Ashworth scale and were analyzed the latency time (ms) of the motor evoked potential (MEP) and the central motor conduction time (CMCT) of the bilateral quadriceps muscle. Assessments were performed before and after each intervention. The difference between groups was analyzed using the Friedman test, with a significance level of 0.05 adopted. Results: All statistical analyzes were performed using the SPSS Statistic version 26 programs, with a significance level established for the analyzes at p<0.05. Shapiro Wilk normality test. Parametric data were represented as mean and standard deviation for non-parametric variables, median and interquartile range, and frequency and percentage for categorical variables. There was no clinical change in quadriceps spasticity assessed using the Ashworth scale for the 1 Hz (p=0.813) and 5 Hz (p= 0.232) protocols for both limbs. Motor Evoked Potential latency time: in the 5hz protocol, there was no significant change for the contralateral side from pre to post-treatment (p>0.05), and for the ipsilateral side, there was a decrease in latency time of 0.07 seconds (p<0.05 ); for the 1Hz protocol there was an increase of 0.04 seconds in the latency time (p<0.05) for the contralateral side to the stimulus, and for the ipsilateral side there was a decrease in the latency time of 0.04 seconds (p=<0.05), with a significant difference between the contralateral (p=0.007) and ipsilateral (p=0.014) groups. Central motor conduction time in the 1Hz protocol, there was no change for the contralateral side (p>0.05) and for the ipsilateral side (p>0.05). In the 5Hz protocol for the contralateral side, there was a small decrease in latency time (p<0.05) and for the ipsilateral side, there was a decrease of 0.6 seconds in the latency time (p<0.05) with a significant difference between groups (p=0.019). Conclusion: A high or low-frequency session does not change spasticity, but it is observed that when the low-frequency protocol was performed, there was an increase in latency time on the stimulated side, and a decrease in latency time on the non-stimulated side, considering then that inhibiting the motor cortex increases cortical excitability on the opposite side.

Keywords: multiple sclerosis, spasticity, motor evoked potential, transcranial magnetic stimulation

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Authors: Jaimala Ghambir, Tilak Thakur, Puneet Chawla

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As per the statistical data, the Doubly-fed Induction Generator (DFIG) based wind turbine with variable speed and variable pitch control is the most common wind turbine in the growing wind market. This machine is usually used on the grid connected wind energy conversion system to satisfy grid code requirements such as grid stability, fault ride through (FRT), power quality improvement, grid synchronization and power control etc. Though the requirements are not fulfilled directly by the machine, the control strategy is used in both the stator as well as rotor side along with power electronic converters to fulfil the requirements stated above. To satisfy the grid code requirements of wind turbine, usually grid side converter is playing a major role. So in order to improve the operation capacity of wind turbine under critical situation, the intensive study of both machine side converter control and grid side converter control is necessary In this paper DFIG is modeled using power components as variables and the performance of the DFIG system is analysed under grid voltage fluctuations. The voltage fluctuations are made by lowering and raising the voltage values in the utility grid intentionally for the purpose of simulation keeping in view of different grid disturbances.

Keywords: DFIG, dynamic modeling, DPC, sag, swell, voltage fluctuations, FRT

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Authors: Steven Hidalgo, Patricio Neumann

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The growth of societies has increased the consumption of raw materials and food obtained from nature. This has influenced the services offered by ecosystems to humans, mainly supply and regulation services. One of the indicators used to evaluate these services is Net Primary Productivity (NPP), which is understood as the energy stored in the form of biomass by primary organisms through the process of photosynthesis and respiration. The variation of NPP by defined area produces changes in the properties of terrestrial and aquatic ecosystems, which alter factors such as biodiversity, nutrient cycling, carbon storage and water quality. The analysis of NPP to evaluate variations in ecosystem services includes harvested NPP (understood as provisioning services), which is the raw material from agricultural systems used by humans as a source of energy and food, and the remaining NPP (expressed as a regulating service) or the amount of biomass that remains in ecosystems after the harvesting process, which is mainly related to factors such as biodiversity. Given that agriculture is a fundamental pillar of Chile's integral development, the purpose of this study is to evaluate provisioning and regulating ecosystem services in the agricultural sector, specifically in cereal production, in the communes of the central-southern regions of Chile through a conceptual framework based on the quantification of the fraction of Human Appropriation of Net Primary Productivity (HANPP) and the fraction remaining in the ecosystems (NPP remaining). A total of 161 communes were analyzed in the regions of O'Higgins, Maule, Ñuble, Bio-Bío, La Araucanía and Los Lagos, which are characterized by having the largest areas planted with cereals. It was observed that the region of La Araucanía produces the greatest amount of dry matter, understood as provisioning service, where Victoria is the commune with the highest cereal production in the country. In addition, the maximum value of HANPP was in the O'Higgins region, highlighting the communes of Coltauco, Quinta de Tilcoco, Placilla and Rengo. On the other hand, the communes of Futrono, Pinto, Lago Ranco and Pemuco, whose cereal production was important during the study, had the highest values of remaining NPP as a regulating service. Finally, an inverse correlation was observed between the provisioning and regulating ecosystem services, i.e., the higher the cereal or dry matter production in a defined area, the lower the net primary production remaining in the ecosystems. Based on this study, future research will focus on the evaluation of ecosystem services associated with other crops, such as forestry plantations, whose activity is an important part of the country's productive sector.

Keywords: provisioning services, regulating services, net primary productivity, agriculture

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Authors: Shahriar Shahbazpanahi, Mohammad Hemen Jannaty, Alaleh Kamgar

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Shear strengthening can be carried out in concrete structures by external fibre reinforced polymer (FRP). In the present investigation, a new fracture mechanics model is developed to model side face of strengthened concrete beam by external FRP. Discrete crack is simulated by a spring element with softening behavior ahead of the crack tip to model the cohesive zone in concrete. A truss element is used, parallel to the spring element, to simulate the energy dissipation rate by the FRP. The strain energy release rate is calculated directly by using a virtual crack closure technique and then, the crack propagation criterion is presented. The results are found acceptable when compared to previous experimental results and ABAQUS software data. It is observed that the length of the fracture process zone (FPZ) increases with the application of FRP in side face at the same load in comparison with that of the control beam.

Keywords: FPZ, fracture, FRP, shear

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Authors: Geraldine Macdonald, Oliver Perra, Nina O’Neill, Laura Neeson, Kathryn Higgins

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Background: Despite improvements in recent years, almost one in six children in Northern Ireland (NI) leaves primary school without achieving the expected level in English and Maths. By early adolescence, this ratio is one in five. In 2010-11, around 9000 pupils in NI had failed to achieve the required standard in literacy and numeracy by the time they left full-time education. This paper reports the findings of an experimental evaluation of a programmed designed to improve educational outcomes of a cohort of children starting primary school in areas of high social disadvantage in Northern Ireland. The intervention: ‘Ready to Learn’ comprised two key components: a literacy-rich After School programme (one hour after school, three days per week), and a range of activities and support to promote the engagement of parents with their children’s learning, in school and at home. The intervention was delivered between September 2010 and August 2013. Study aims and objectives: The primary aim was to assess whether, and to what extent, ‘Ready to Learn’ improved the literacy of socially disadvantaged children entering primary schools compared with children in schools without access to the programme. Secondary aims included assessing the programme’s impact on children’s social, emotional and behavioural regulation, and parents’ engagement with their children’s learning. In total, 505 children (almost all) participated in the baseline assessment for the study, with good retention over seven sweeps of data collection. Study design: The intervention was evaluated by means of a cluster randomized trial, with schools as the unit of randomization and analysis. It included a qualitative component designed to examine process and implementation, and to explore the concept of parental engagement. Sixteen schools participated, with nine randomized to the experimental group. As well as outcome data relating to children, 134 semi-structured interviews were conducted with parents over the three years of the study, together with 88 interviews with school staff. Results: Given the children’s ages, not all measures used were direct measures of reading. Findings point to a positive impact of “Ready to Learn” on children’s reading achievement (comprehension and fluency), as assessed by the York Assessment of Reading Comprehension (YARC) and decoding, assessed using the Word Recognition and Phonic Skills (WRaPS3). Effects were not large, but evidence suggests that it is unusual for an after school programme to clearly to demonstrate effects on reading skills. No differences were found on three other measures of literacy-related skills: British Picture Vocabulary Scale (BPVS-II), Naming Speed and Non-word Reading Tests from the Phonological Assessment Battery (PhAB) or Concepts about Print (CAP) – the last due to an age-related ceiling effect). No differences were found between the two groups on measures of social, emotional and behavioural regulation, and due to low levels of participation, it was not possible directly to assess the contribution of the parent component to children’s outcomes. The qualitative data highlighted conflicting concepts of engagement between parents and school staff. Ready to Learn is a promising intervention that merits further support and evaluation.

Keywords: after-school, education, literacy, parental engagement

Procedia PDF Downloads 338

Authors: Marina Passero, Tianhua Zhai, Zuyi (Jacky) Huang

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Alzheimer’s disease has become a major public health issue, as indicated by the increasing populations of Americans living with Alzheimer’s disease. After decades of extensive research in Alzheimer’s disease, only seven drugs have been approved by Food and Drug Administration (FDA) to treat Alzheimer’s disease. Five of these drugs were designed to treat the dementia symptoms, and only two drugs (i.e., Aducanumab and Lecanemab) target the progression of Alzheimer’s disease, especially the accumulation of amyloid-b plaques. However, controversial comments were raised for the accelerated approvals of either Aducanumab or Lecanemab, especially with concerns on safety and side effects of these two drugs. There is still an urgent need for further drug discovery to target the biological processes involved in the progression of Alzheimer’s disease. Excessive cholesterol has been found to accumulate in the brain of those with Alzheimer’s disease. Cholesterol can be synthesized in both the blood and the brain, but the majority of biosynthesis in the adult brain takes place in astrocytes and is then transported to the neurons via ApoE. The blood brain barrier separates cholesterol metabolism in the brain from the rest of the body. Various proteins contribute to the metabolism of cholesterol in the brain, which offer potential targets for Alzheimer’s treatment. In the astrocytes, SREBP cleavage-activating protein (SCAP) binds to Sterol Regulatory Element-binding Protein 2 (SREBP2) in order to transport the complex from the endoplasmic reticulum to the Golgi apparatus. Cholesterol is secreted out of the astrocytes by ATP-Binding Cassette A1 (ABCA1) transporter. Lipoprotein receptors such as triggering receptor expressed on myeloid cells 2 (TREM2) internalize cholesterol into the microglia, while lipoprotein receptors such as Low-density lipoprotein receptor-related protein 1 (LRP1) internalize cholesterol into the neuron. Cytochrome P450 Family 46 Subfamily A Member 1 (CYP46A1) converts excess cholesterol to 24S-hydroxycholesterol (24S-OHC). Cholesterol has been approved for its direct effect on the production of amyloid-beta and tau proteins. The addition of cholesterol to the brain promotes the activity of beta-site amyloid precursor protein cleaving enzyme 1 (BACE1), secretase, and amyloid precursor protein (APP), which all aid in amyloid-beta production. The reduction of cholesterol esters in the brain have been found to reduce phosphorylated tau levels in mice. In this work, a computational pipeline was developed to identify the protein targets involved in cholesterol regulation in brain and further to identify chemical compounds as the inhibitors of a selected protein target. Since extensive evidence shows the strong correlation between brain cholesterol regulation and Alzheimer’s disease, a detailed literature review on genes or pathways related to the brain cholesterol synthesis and regulation was first conducted in this work. An interaction network was then built for those genes so that the top gene targets were identified. The involvement of these genes in Alzheimer’s disease progression was discussed, which was followed by the investigation of existing clinical trials for those targets. A ligand-protein docking program was finally developed to screen 1.5 million chemical compounds for the selected protein target. A machine learning program was developed to evaluate and predict the binding interaction between chemical compounds and the protein target. The results from this work pave the way for further drug discovery to regulate brain cholesterol to combat Alzheimer’s disease.

Keywords: Alzheimer’s disease, drug discovery, ligand-protein docking, gene-network analysis, cholesterol regulation

Procedia PDF Downloads 42

Authors: Chui Ka Shing

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This case study research attempts to examine the use of the Bar Model Method approach in learning and teaching mathematics in a primary school in Hong Kong. The objectives of the study are to find out to what extent (a) the Bar Model Method approach enhances the construction of students’ mathematics concepts, and (b) the school-based mathematics curriculum development with adopting the Bar Model Method approach. This case study illuminates the effectiveness of using the Bar Model Method to solve mathematics problems from Primary 1 to Primary 6. Some effective pedagogies and assessments were developed to strengthen the use of the Bar Model Method across year levels. Suggestions including school-based curriculum development for using Bar Model Method and further study were discussed.

Keywords: bar model method, curriculum development, mathematics education, problem solving

Procedia PDF Downloads 187

Authors: You-Kai Jhang, Yang-Cheng Lu

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Major contributions of this study are threefold: designing a new model of planar-membrane humidifier for Proton Exchange Membrane Fuel Cell (PEMFC), an index to measure the Effectiveness (εT) of that humidifier, and an air compressor system to replicate related planar-membrane humidifier experiments. PEMFC as a kind of renewable energy has become more and more important in recent years due to its reliability and durability. To maintain the efficiency of the fuel cell, the membrane of PEMFC need to be controlled in a good hydration condition. How to maintain proper membrane humidity is one of the key issues to optimize PEMFC. We developed new humidifier to recycle water vapor from cathode air outlet so as to keep the moisture content of cathode air inlet in a PEMFC. By measuring parameters such as dry side air outlet dew point temperature, dry side air inlet temperature and humidity, wet side air inlet temperature and humidity, and differential pressure between dry side and wet side, we calculated indices obtained by dew point approach temperature (DPAT), water flux (J), water recovery ratio (WRR), effectiveness (εT), and differential pressure (ΔP). We discussed six topics including sealing effect, flow rate effect, flow direction effect, channel effect, temperature effect, and humidity effect by using these indices. Gas cylinders are used as sources of air supply in many studies of humidifiers. Gas cylinder depletes quickly during experiment at 1kW air flow rate, and it causes replication difficult. In order to ensure high stable air quality and better replication of experimental data, this study designs an air supply system to overcome this difficulty. The experimental result shows that the best rate of pressure loss of humidifier is 0.133×10³ Pa(g)/min at the torque of 25 (N.m). The best humidifier performance ranges from 30-40 (LPM) of air flow rates. The counter flow configured humidifies moisturizes the dry side inlet air more effectively than the parallel flow humidifier. From the performance measurements of the channel plates various rib widths studied in this study, it is found that the narrower the rib width is, the more the performance of humidifier improves. Raising channel width in same hydraulic diameter (Dh ) will obtain higher εT and lower ΔP. Moreover, increasing the dry side air inlet temperature or humidity will lead to lower εT. In addition, when the dry side air inlet temperature exceeds 50°C, the effect becomes even more obvious.

Keywords: PEM fuel cell, water management, membrane humidifier, heat and mass transfer, humidifier performance

Procedia PDF Downloads 142

Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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Authors: Ratnawati Mohd Asraf, Hazlina Abdullah

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Numerous studies on boys’ performance relative to girls’ have been conducted around the globe. However, little has been done in relation to the literacy of primary school boys in the Malaysian context. This paper discusses the results of a study that sought to determine the literacy performance of Grades 1, 2, and 3 primary school students in the state of Selangor, Malaysia. Data on approximately 85,000 students from each grade level were obtained from the Ministry of Education Malaysia, which conducts national screening on literacy and numeracy, or LINUS, in all government primary schools. Teachers’ views were also sought through focus group interviews and journal entries. The results show that although there is an overall improvement in literacy performance in the Malay language among the students as they go into Grades 2 and 3, girls are found to outperform boys in every screening for all grade levels.

Keywords: boys’ underperformance, literacy, literacy performance, reading

Procedia PDF Downloads 294

Authors: Howard Gomwe, Eunice Seekoe, Philemon Lyoka, Chioneso Show Marange, Dennyford Mafa

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There is arguably a lack of literature regarding body physical fitness and body composition amongst primary school learners in South Africa. For this reason, the study is aimed at investigating and accessing how body composition relates to physical fitness amongst primary school learners in the Eastern Cape Province of South Africa. In order to achieve this, a school-based cross-sectional survey was carried out among 876 primary school learners aged 9 to 14 years. Body composition indicators were measured and/or calculated, whilst physical fitness was evaluated according to the EUROFIT fitness standards by a 20 m shuttle run, push-ups, sit and reach as well as sit-ups. Out of 876 participants, a total of 870 were retained. Of these, 351 (40.34%) were boys, and 519 (59.66%) were girls. The average age of learners was 11.04 ± 1.50 years, with boys having a significantly (p = 0.002) higher mean age (M = 11.24; SD = 1.51 years) as compared to that of girls (M = 10.91; SD = 1.48 years). The non-parametric Spearman Rho correlation coefficients revealed several significant and negative relationships between body composition measurements with physical fitness characteristics, which were stronger in girls than in boys. The findings advocate for policymakers and responsible authorities to initiate the development of policies and interventions targeted at encouraging physical activity and health promotion among primary school learners in South Africa, especially in girls.

Keywords: BMI, body composition, body fat, children, physical fitness, primary school

Procedia PDF Downloads 248

Authors: M. D. Nghiteke, A. Mji, G. T. Molepo

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Inclusive education stems from a philosophy and vision, which argues that all children should learn together at school. It is not only about treating all pupils in the same way. It is also about allowing all children to attend school without any restrictions. Ten primary school teachers in a circuit in Namibia volunteered to participate in face-to-face interviews about inclusive education. The teachers responded to three questions about their (i) understanding of inclusive education; (ii) whether inclusive education was implemented in primary schools; and (iii) whether they were able to work with learners with special needs. Findings indicated that teachers understood what inclusive education entailed; felt that inclusive education was not implemented in their primary schools, and they were unable to work with learners with special needs in their classrooms. Further, the teachers identified training and resources as important components of inclusive education. It is recommended that education authorities should perhaps verify the findings reported here as well as ensure that the concerns raised by the teachers are addressed.

Keywords: classrooms and schools, inclusive education, resources, training

Procedia PDF Downloads 147