Search results for: secondary postpartum hemorrhage

Authors: Nicole Banton

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The maternal and infant mortality rate of Blacks is three times that of Whites in the US. Research indicates that breastfeeding lowers both. In this paper, the researcher examines how the ideas that Black/African American mothers had about breastfeeding before, during, and after pregnancy (postpartum) affected whether or not they initiated breastfeeding. The researcher used snowball sampling to recruit thirty African-American mothers from the Orlando area. At the time of her interview, each mother had at least one child who was at least three years old. Through in-depth face-to-face interviews, the researcher investigated how mothers’ healthcare providers affected their decision-making about infant feeding, as well as how the type of birth that she had (e.g., preterm, vaginal, c-section, full term) affected her actual versus idealized infant feeding practice. Through our discussions, we explored how pre-pregnancy perceptions, birth and postpartum experiences, social support, and the discourses surrounding motherhood within an African-American context affected the perceptions and experiences that the mothers in the study had with their infant feeding practice(s). Findings suggest that the pregnancy and birth experiences of the mothers in the study influenced whether or not they breastfed exclusively, combined breastfeeding and infant formula use, or used infant formula exclusively. Specifically, the interplay of invocation of agency (the ability to control their bodies before, during, and after birth), birth outcomes, and the interaction that the mothers in this study had with resources, human and material, had the highest impact on the initiation, duration, and attitude toward breastfeeding.

Keywords: African American mothers, maternal health, breastfeeding, birth, midwives, obstetricians, hospital birth, breast pumps, formula use, infant feeding, lactation consultant, postpartum, vaginal birth, c-section, familial support, social support, work, pregnancy

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Authors: H. Heydari, B. Konuklugil, P. Proksch

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Marine-derived fungi can produce interesting bioactive secondary metabolites that can be considered the potential for drug development. Turkey is a country of a peninsula surrounded by the Black Sea at the north, the Aegean Sea at the west, and the Mediterranean Sea at the south. Despite the approximately 8400 km of coastline, studies on marine secondary metabolites and their biological activity are limited. In our ongoing search for new natural products with different bioactivities produced by the marine-derived fungi, we have investigated secondary metabolites of Turkish collection of the marine sea slug (Peltodoris atromaculata) associated fungi Hypocrea nigricans collected from Seferihisar in the Egean sea. According to the author’s best knowledge, no study was found on this fungal species in terms of secondary metabolites. Isolated from ethyl acetate extract of the culture of Hypocrea nigricans were (isodihydroauroglaucin,tetrahydroauroglaucin and dihydroauroglaucin. The structures of the compounds were established based on an NMR and MS analysis. Structural elucidation of another isolated secondary metabolite/s continues.

Keywords: Hypocrea nigricans, isolation, marine fungi, secondary metabolites

Procedia PDF Downloads 132

Authors: Nikol Žižková, Šárka Keprdová, Rostislav Drochytka

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The paper focuses on the study of the properties of cement-based composites produced using secondary crystallization (crystalline additive). In this study, cement mortar made with secondary crystallization was exposed to an aggressive environment and the influence of secondary crystallization on the degradation of the cementitious composite was investigated. The results indicate that the crystalline additive contributed to increasing the resistance of the cement-based composite to the attack of the selected environments (sodium sulphate solution and ammonium chloride solution).

Keywords: secondary crystallization, cement-based composites, durability, degradation of the cementitious composite

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Authors: Ilma Robo, Saimir Heta, Nedja Hysi, Vera Ostreni

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Introduction: Marginal gingivitis is a disease with considerable frequency among patients who present routinely for periodontal control and treatment. In fact, this disease may not have alarming symptoms in patients and may go unnoticed by themselves when personal hygiene conditions are optimal. The aim of this study was to collect retrograde data on the prevalence of marginal gingiva in the respective group of patients, evaluated according to specific periodontal diagnostic tools. Materials and methods: The study was conducted in two patient groups. The first group was with 34 patients, during December 2019-January 2020, and the second group was with 64 patients during 2010-2018 (each year in the mentioned monthly period). Bacterial plaque index, hemorrhage index, amount of gingival fluid, presence of xerostomia and candidiasis were recorded in patients. Results: Analysis of the collected data showed that susceptibility to marginal gingivitis shows higher values according to retrograde data, compared to cross-sectional ones. Susceptibility to candidiasis and the occurrence of xerostomia, even in the combination of both pathologies, as risk factors for the occurrence of marginal gingivitis, show higher values ​​according to retrograde data. The female are presented with a reduced bacterial plaque index than the males, but more importantly, this index in the females is also associated with a reduced index of gingival hemorrhage, in contrast to the males. Conclusions: Cross-sectional data show that the prevalence of marginal gingivitis is more reduced, compared to retrograde data, based on the hemorrhage index and the bacterial plaque index together. Changes in production in the amount of gingival fluid show a higher prevalence of marginal gingivitis in cross-sectional data than in retrograde data; this is based on the sophistication of the way data are recorded, which evolves over time and also based on professional sensitivity to this phenomenon.

Keywords: marginal gingivitis, cross-sectional, retrograde, prevalence

Procedia PDF Downloads 133

Authors: Sarah K. Basudan, Ragad I. Al Jazzar, Zeinah Sulaihim, Hanan M. Al-Kadri

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Background: Cesarean section has been increasing in recent years, with a wide range of etiologies contributing to this rise. This study aimed to assess the indications, outcomes, and complications in Riyadh, Saudi Arabia. Methods: A Retrospective Cohort study was conducted at King Abdulaziz medical city. The study includes two cohorts: G1 (2009) and G2 (2020) groups who met the inclusion criteria. The data was transferred to the SPSS (statistical package for social sciences) version 24 for analysis. The initial descriptive statistics were run for all variables, including numerical and categorical data. The numerical data were reported as median, and standard deviation and categorical data were reported as frequencies and percentages. Results: The data were collected from 399 women who were divided into two groups, G1(199) and G2(200). The mean age of all participants is 32+-6​; G1 and G2 had significant differences in age means with 30+-6 and 34+-5, respectively, with a p-value of <0.001, which indicates delayed fertility by four years. Moreover, a breech presentation was less likely to occur in G2 (OR 0.64, CI: 0.21-0.62. P<0.001). Nonetheless, maternal causes such as repeated C-sections and maternal medical conditions were more likely to happen in G2 (OR 1.5, CI: 1.04-2.38, p=0.03) and (OR 5.4, CI: 1.12-23.9, P=0.01), respectively. Furthermore, postpartum hemorrhage showed an increase of 12% in G2 (OR 5.4, CI: 2.2-13.4, p<0.001). G2 was more likely to be admitted to the neonatal intensive care unit (NICU) (OR 16, CI: 7.4-38.7) and to special care baby (SCB) (OR 7.2, CI: 3.9-13.1), both with a p-value<0.001 compared to regular nursery admission. Conclusion: There are multiple factors that are contributing to the increase in c section rate in a Saudi tertiary hospitals. The factors were suggested to be previous c-sections, abnormal fetal heart rate, malpresentation, and maternal or fetal medical conditions.

Keywords: cesarean sections, maternal indications, maternal complications, neonatal condition

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Authors: M. J. Park, S. H. Lee, C. H. Lee, O. M. Kwon

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This paper studies a secondary voltage control framework of the microgrids based on the consensus for a communication network of multiagent. The proposed control is designed by the communication network with one-way links. The communication network is modeled by a directed graph. At this time, the concept of sampling is considered as the communication constraint among each distributed generator in the microgrids. To analyze the sampling effects on the secondary voltage control of the microgrids, by using Lyapunov theory and some mathematical techniques, the sufficient condition for such problem will be established regarding linear matrix inequality (LMI). Finally, some simulation results are given to illustrate the necessity of the consideration of the sampling effects on the secondary voltage control of the microgrids.

Keywords: microgrids, secondary control, multiagent, sampling, LMI

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Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

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Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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Authors: Moyosola Jude Akomolafe

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Career commitment among employees is crucial to the success of any organization. However, career commitment has been reported to be very low among teachers in the public secondary schools in Nigeria. This study, therefore, examined the contributions of emotional intelligence and general self-efficacy to career commitment of among secondary school teachers in Nigeria. Descriptive research design of correlational type was adopted for the study. It made use of stratified random sampling technique was used in selecting two hundred and fifty (250) secondary schools teachers for the study. Three standardized instruments namely: The Big Five Inventory (BFI), Emotional Intelligence Scale (EIS), General Self-Efficacy Scale (GSES) and Career Commitment Scale (CCS) were adopted for the study. Three hypotheses were tested at 0.05 level of significance. Data collected were analyzed through Multiple Regression Analysis to investigate the predicting capacity of emotional intelligence and general self-efficacy on career commitment of secondary school teachers. The results showed that the variables when taken as a whole significantly predicted career commitment among secondary school teachers. The relative contribution of each variable revealed that emotional intelligence and general self-efficacy significantly predicted career commitment among secondary school teachers in Nigeria. The researcher recommended that secondary school teachers should be exposed to emotional intelligence and self-efficacy training to enhance their career commitment.

Keywords: career commitment, emotional intelligence, general self-efficacy, secondary school teachers

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Authors: Mohammed A. Alfayyadh, Halla A. AlAbdulhadi, Mahdi H. Almubarak

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Purpose: Eales’ disease is an idiopathic vasculitis that affects the peripheral retina. It is characterized by recurrent vitreous hemorrhage as a complication of retinal neovascularization. It is more prevalent in India and affects young males. Here we present a patient with neovascular glaucoma as a rare first presentation of Eales’ disease. Observations: This is a 24-year-old Indian gentleman, who complained of a sudden decrease in vision in the left eye over less than 24 hours, along with frontal headache and eye pain for the last three weeks. Ocular examination revealed peripheral retinal ischemia in the right eye, very high intraocular pressure, rubeosis iridis, vitreous hemorrhage and extensive retinal ischemia in the left eye, vascular sheathing and neovascularization in both eyes. Purified protein derivative skin test was positive. The patient was managed with anti-glaucoma, intravitreal anti-vascular endothelial growth factor and laser photocoagulation. Systemic steroids and anti-tuberculous therapy were also initiated. Conclusions: Neovascular glaucoma is an infrequent complication of Eales’ disease. However, the lack of early detection of the disease in the early stages might lead to such serious complication.

Keywords: case report, Eales’ disease, mycobacterium tuberculosis, neovascular glaucoma

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Authors: J. Kosikova, B. Vacenovska, M. Vyhnankova

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The paper reports on the subject of recycling and further use of secondary raw materials obtained from solar panels, which is becoming a very up to date topic in recent years. Recycling these panels is very difficult and complex, and the use of resulting secondary raw materials is still not fully resolved. Within the research carried out at the Brno University of Technology, new polymer materials used for industrial floors are being developed. Secondary raw materials are incorporated into these polymers as fillers. One of the tested filler materials was glass obtained from solar panels. The following text describes procedures and results of the tests that were performed on these materials, confirming the possibility of the use of solar panel glass in industrial polymer flooring systems.

Keywords: fillers, industrial floors, recycling, secondary raw material, solar panel

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Authors: Moon Jung Kim, Guil Rhim

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The clinical sensitivity of the “VEUPLEXTM TBI assay”, a clinical trial medical device, in mild traumatic brain injury was 28.6% (95% CI, 19.7%-37.5%), and the clinical specificity was 94.0% (95% CI, 89.3%). -98.7%). In addition, when the results analyzed by marker were put together, the sensitivity was higher when interpreting the two tests together than the two tests, UCHL1 and GFAP alone. Additionally, when sensitivity and specificity were analyzed based on CT results for the mild traumatic brain injury patient group, the clinical sensitivity for 2 CT-positive cases was 50.0% (95% CI: 1.3%-98.7%), and 19 CT-negative cases. The clinical specificity for cases was 68.4% (95% CI: 43.5% - 87.4%). Since the low clinical sensitivity for the two CT-positive cases was not statistically significant due to the small number of samples analyzed, it was judged necessary to secure and analyze more samples in the future. Regarding the clinical specificity analysis results for 19 CT-negative cases, there were a large number of patients who were actually clinically diagnosed with mild traumatic brain injury but actually received a CT-negative result, and about 31.6% of them showed abnormal results on VEUPLEXTM TBI assay. Although traumatic brain injury could not be detected in 31.6% of the CT scans, the possibility of actually suffering a mild brain injury could not be ruled out, so it was judged that this could be confirmed through follow-up observation of the patient. In addition, among patients with mild traumatic brain injury, CT examinations were not performed in many cases because the symptoms were very mild, but among these patients, about 25% or more showed abnormal results in the VEUPLEXTM TBI assay. In fact, no damage is observed with the naked eye immediately after traumatic brain injury, and traumatic brain injury is not observed even on CT. But in some cases, brain hemorrhage may occur (delayed cerebral hemorrhage) after a certain period of time, so the patients who did show abnormal results on VEUPLEXTM TBI assay should be followed up for the delayed cerebral hemorrhage. In conclusion, it was judged that it was difficult to judge mild traumatic brain injury with the VEUPLEXTM TBI assay only through clinical findings without CT results, that is, based on the GCS value. Even in the case of CT, it does not detect all mild traumatic brain injury, so it is difficult to necessarily judge that there is no traumatic brain injury, even if there is no evidence of traumatic brain injury in CT. And in the long term, more patients should be included to evaluate the usefulness of the VEUPLEXTM TBI assay in the detection of microscopic traumatic brain injuries without using CT.

Keywords: brain injury, traumatic brain injury, GFAP, UCHL1

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Authors: Verónica Diaz Quezada

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This research examines the teaching models used by secondary math teachers when teaching logarithmic, quadratic and exponential functions. For this, descriptive case studies have been carried out on 5 secondary teachers. These teachers have been chosen from 3 scientific-humanistic and technical schools, in Chile. Data have been obtained through non-participant class observation and the application of a questionnaire and a rubric to teachers. According to the results, the didactic model that prevails is the one that starts with an interactive strategy, moves to a more content-based structure, and ends with a reinforcement stage. Nonetheless, there is always influence from teachers, their methods, and the group of students.

Keywords: teaching models, math teachers, functions, secondary education

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Authors: Mansur Agzamov, Valery Bersnev, Natalia Ivanova, Istam Agzamov, Timur Khayrullaev, Yulduz Agzamova

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Objectives. Treatment of hypertensive intracerebral hematoma (ICH) is controversial. Advantage of one surgical method on other has not been established. Recent reports suggest a favorable effect of minimally invasive surgery. We conducted a small comparative study of different surgical methods. Methods. We analyzed the result of surgical treatment of 176 patients with intracerebral hematomas at the age from 41 to 78 years. Men were been113 (64.2%), women - 63 (35.8%). Level of consciousness: conscious -18, lethargy -63, stupor –55, moderate coma - 40. All patients on admission and in the dynamics underwent computer tomography (CT) of the brain. ICH was located in the putamen in 87 cases, thalamus in 19, in the mix area in 50, in the lobar area in 20. Ninety seven patients of them had an intraventricular hemorrhage component. The baseline volume of the ICH was measured according to a bedside method of measuring CT intracerebral hematomas volume. Depending on the intervention of the patients were divided into three groups. Group 1 patients, 90 patients, operated open craniotomy. Level of consciousness: conscious-11, lethargy-33, stupor–18, moderate coma -18. The hemorrhage was located in the putamen in 51, thalamus in 3, in the mix area in 25, in the lobar area in 11. Group 2 patients, 22 patients, underwent smaller craniotomy with endoscopic-assisted evacuation. Level of consciousness: conscious-4, lethargy-9, stupor–5, moderate coma -4. The hemorrhage was located in the putamen in 5, thalamus in 15, in the mix area in 2. Group 3 patients, 64 patients, was conducted minimally invasive removal of intracerebral hematomas using the original device (patent of Russian Federation № 65382). The device - funnel cannula - which after the special markings introduced into the hematoma cavity. Level of consciousness: conscious-3, lethargy-21, stupor–22, moderate coma -18. The hemorrhage was located in the putamen in 31, in the mix area in 23, thalamus in 1, in the lobar area in 9. Results of treatment were evaluated by Glasgow outcome scale. Results. The study showed that the results of surgical treatment in three groups depending on the degree of consciousness, the volume and localization of hematoma. In group 1, good recovery observed in 8 cases (8.9%), moderate disability in 22 (24.4%), severe disability - 17 (18.9%), death-43 (47.8%). In group 2, good recovery observed in 7 cases (31.8%), moderate disability in 7 (31.8%), severe disability - 5 (29.7%), death-7 (31.8%). In group 3, good recovery was observed in 9 cases (14.1%), moderate disability-17 (26.5%), severe disability-19 (29.7%), death-19 (29.7%). Conclusions. The method of using cannulae allowed to abandon from open craniotomy of the majority of patients with putaminal hematomas. Minimally invasive technique reduced the postoperative mortality and improves treatment outcomes of these patients.

Keywords: nontraumatic intracerebral hematoma, minimal invasive surgical technique, funnel canula, differentiated surcical treatment

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Authors: V. Pentland, S. Spilsbury, A. Biswas, M. F. Mottola, S. Paplinskie, M. S. Mitchell

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Postpartum depression (PPD) is a form of major depressive disorder that afflicts 10–22% of mothers worldwide. Rising demands for traditional PPD treatment options (e.g., psychiatry), especially in the context of the COVID-19 pandemic, are increasingly difficult to meet. More accessible treatment options (e.g., walking) are needed. The objective of this review is to determine the impact of walking on PPD severity. A structured search of seven electronic databases for randomised controlled trials published between 2000 and July 29, 2021, was completed. Studies were included if walking was the sole or primary aerobic exercise modality. A random-effects meta-analysis was conducted for studies reporting PPD symptoms measured using a clinically validated tool. A simple count of positive/null effect studies was undertaken as part of a narrative summary. Five studies involving 242 participants were included (mean age=~28.9 years; 100% with mild-to-moderate depression). Interventions were 12 (n=4) and 24 (n=1) weeks long. Each assessed PPD severity using the Edinburgh Postnatal Depression Scale (EPDS) and was included in the meta-analysis. The pooled effect estimate suggests that relative to controls, walking yielded clinically significant decreases in mean EPDS scores from baseline to intervention end (pooled MD=-4.01; 95% CI:-7.18 to -0.84, I2=86%). The narrative summary provides preliminary evidence that walking-only, supervised, and group-based interventions, including 90-120+ minutes/week of moderate-intensity walking, may produce greater EPDS reductions. While limited by a relatively small number of included studies, pooled effect estimates suggest walking may help mothers manage PPD. This is the first time walking as a treatment for PPD, an exercise modality that uniquely addresses many barriers faced by mothers has been summarized in a systematic way. Trial registration: PROSPERO (CRD42020197521) on August 16th, 2020

Keywords: postpartum, exercise, depression, walking

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Authors: Sidra Rizwan

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The article focuses on the training needs of secondary school teachers related to the knowledge component of instructional planning and strategies as stated in the National professional standards for teachers in Pakistan. The study aimed to determine the training needs of secondary school teachers on different aspects of knowledge & understanding component of instructional planning and strategies. The target population of the study was the secondary school teachers across Pakistan. For this purpose, a sample of 400 secondary school teachers was selected through multistage sampling from all the four provinces and Federal capital area. Survey method was adopted to assess the training needs by using a self reporting tool. The tool helped to gauge the training needs through indirect inventory questions as well as a ranking list in which the respondents themselves prioritized their training areas. The results showed variation between the direct and indirect reporting of the teachers on the basis of which it was concluded that the secondary school teachers needed awareness about the knowledge component of instructional planning and strategies in order to redefine their actual training needs. The researcher further identified the training needs of secondary school teachers within each province and Islamabad capital territory; including an analysis of variations between strata. As teachers are considered agents of change, their training according to the professional standards should provide a solid base for “rethinking education”.

Keywords: training needs, secondary school teachers, instructional planning & strategies, knowledge & understanding

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Authors: Ali Aghazadegan, Ali Shokri, Julia Mullarney

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River confluences are areas where there is a lot of mixing, which is often caused by the formation of shear layers and helical motions. The hydrodynamics of secondary circulation at river confluences with low flow discharge ratios and a 90° junction angle are investigated in this study. The analysis is based on Delft 3D modelling, which includes a three-dimensional time-averaged velocity field, turbulence, and water surface levels that have been validated using laboratory data. Confluence structure was characterized by shear layer, secondary circulation, and mixing at the junction and post confluence channel. This study analysis formation of the shear layer by generation of secondary circulations in variation discharge ratios. The values of streamwise, cross-wise, and vertical components are used to estimate the secondary circulation observed within and downstream of the tributary mouth. These variables are estimated for three horizontal planes at Z = [0.14; 0.07; 0.02] and for eight cross-sections at X = [-0.1; 0.00; 0.10; 0.2; 0.30; 0.4; 0.5; 0.6] within a range of 0.05 Y 0.30.

Keywords: river confluence, shear layer, secondary circulation, hydrodynamics

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Authors: Nasser Marshad Alzeer

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This study examines the spatial distribution of secondary schools in Riyadh. It considers both public girls and boys sector provision and assesses the efficiency of the spatial distribution of secondary schools. Since the establishment of the Ministry of Education (MOE) in 1953 and General Presidency for Female Education, (GPFE) in 1960, there has been a great expansion of education services in Saudi Arabia, particularly during the 1980s. However, recent years have seen much slower rates of increase in the public education sector but the population continues to grow rapidly. This study investigates the spatial distribution of schools through the use of questionnaire surveys and applied GIS. Overall, the results indicate a shortage of public secondary schools, especially in the north of the city. It is clear that there is overcrowding in the majority of secondary schools. The establishment of new schools has been suggested to solve the problem of overcrowding. A number of socio-economic and demographic factors are associated with differences in the utilization of the public secondary schools. A GIS was applied in this study in order to assess the spatial distribution of secondary schools including the modification of existing catchment area boundaries and locating new schools. This modification could also reduce the pupil pressure on certain schools and further benefits could probably be gained.

Keywords: analysis, distribution, Saudi, GIS, schools

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Authors: Vivian Polak, Lena Verdeli, Wendy Lou, Caroline Lovett

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Postnatal depression (PND) is a common complication of childbirth that increases the risk of future depressive episodes in women, postpartum depression in partners, as well as social, emotional, behavioural, language, and cognitive problems in offspring. Although psychotherapy, and in particular Group Interpersonal Psychotherapy (IPT-G), has been proven effective in treating PND, it remains largely inaccessible. However, research has indicated that online synchronous group therapy can be equally as effective as in-person therapy and is a more affordable and accessible modality of treatment. This study aimed to ascertain whether delivering IPT-G virtually when compared to treatment as usual, could more effectively reduce depressive and anxiety symptoms, enhance mother-infant attachment, improve the couple relationship, augment social support, improve overall functioning, and enhance the quality of life for women in rural and northern Ontario who are suffering from PND. By bridging the gap in access to mental health services during the postpartum period, this study seeks to improve the well-being of mothers and their families in rural and northern Ontario, Canada. A randomized controlled trial was conducted to determine whether virtual IPT-G plus treatment as usual would be more effective than treatment as usual alone in treating women with PND in Ontario, Canada. Preliminary results indicate that women who received virtual IPT-G had a clinically and statistically significant decrease in overall depressive symptoms compared to their counterparts who received only the treatment as usual. As such, providing online synchronous IPT-G in the perinatal period not only has the potential to improve women's outcomes in the present but also to decrease future health costs, reduce the burden on the educational and justice systems, and decrease the number of disability life years lost to postnatal depression.

Keywords: family wellbeing, group psychotherapy, interpersonal psychotherapy, postnatal depression, virtual psychotherapy

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Authors: Seema Chopra, Amandeep Kaur, Vanita Suri, Shalini Gainder, Minakshi Rohilla

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Background: Acute kidney injury (AKI) associated with pregnancy is a serious medical complication which can lead to significant maternal as well as perinatal morbidity and mortality. Material and methods: This prospective observational study was carried out in the Obstetrics and Gynaecology department and dialysis unit of Nephrology department of PGIMER, Chandigarh from July 2013 to June 2014. Forty antenatal/postnatal/postabortal patients who fulfilled the AKIN criteria were enrolled in the study. All patients were followed up till 3 months postpartum. Results: Majority of the patients 23/40 (57.5%) with AKI presented in postpartum period, 14/40 (35%) developed AKI in antenatal period, and 3/40 (7.5%) were postabortal. AKI was attributable mostly to sepsis in 11/40 (27.5%) and PPH in 5/40 (12.5%). Hypertension and its complications causing AKI included eclampsia in 5/40 (12.5%) followed by 3/40 (7.5%) as HELLP syndrome and abruption placentae in 2/40(5%) patients. Three patients each (7.5%) had AFLP, TMA, and HEV as the cause of AKI. Renal replacement therapy in the form of hemodialysis was the treatment in majority of them (28 (70%)). After the acute event, 25 (62.5%) had complete recovery of their renal functions at 3 months follow up. Maternal mortality was seen in 25% (n=10) of the study patients. Conclusion: Timely initiation of RRT in patients with AKI associated with pregnancy has a good maternal outcome in the form of complete recovery of renal functions in 62.5% (25/40) of patients.

Keywords: AKI, dialysis, hypertension, sepsis, renal parameters

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Authors: Ellen A. Kalinga

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Moodle is an open source learning management system that enables creation of a powerful and flexible learning environment. Many organizations, especially learning institutions have customized Moodle open source LMS for their own use. In general open source LMSs are of great interest due to many advantages they offer in terms of cost, usage and freedom to customize to fit a particular context. Tanzania Secondary School e-Learning (TanSSe-L) system is the learning management system for Tanzania secondary schools. TanSSe-L system was developed using a number of methods, one of them being customization of Moodle Open Source LMS. This paper presents few areas on the way Moodle OS LMS was customized to produce a functional TanSSe-L system fitted to the requirements and specifications of Tanzania secondary schools’ context.

Keywords: LMS, Moodle, e-learning, Tanzania, secondary school

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Authors: Joella Mukashyaka, Rose Mukarubayiza, Emmanuel Habumugisha, Francois-Xavier Sunday, Kellen Muganwa, Valens Mbarushimana, Pamela Meharry

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Background: Breastfeeding in the first hour post-birth can decrease neonatal morbidity and mortality. Disease prevention and health outcomes differ immensely between newborns who receive human milk and those who do not. Rwanda has high breastfeeding rates, though factors associated with early initiation of breastfeeding (EIBF) are unknown. Objective: To assess factors associated with EIBF among mothers in immediate postpartum units at two hospitals. Methods: A cross-sectional study design and a convenience sample of 187 mothers were used. An interviewer-administered questionnaire was used for data collection. A Chi-square test showed the relationship between EIBF and sociodemographic factors. Results: The findings showed less than one quarter (20.5%) breastfed within the first hour after birth. The majority was < 25 years (52.4%), had some primary education (27.7%) employed (66.7%), urban dweller (58.1%), attendance of one ANC visit or more (81.3%), vaginal birth (58.8%), and did not receive EIBF health education (92.0%). The majority (78.5%) was too tired to initiate breastfeeding, and many supplemented (41.9%) due to perceived insufficient breastmilk. Conclusion: Most mothers did not initiate breastfeeding within the first hour after birth. Sociodemographic factors were associated with EIBF. A program to promote, protect, and support EIBF is urgently needed the community.

Keywords: breastfeeding, early initiation, neonates, morbidity, mortality, sub-Saharan Africa

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Authors: Azizul Baten, Kamrul Hossain, Abdullah-Al-Zabir

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The objective of this study is to develop an appropriate stochastic frontier secondary schools efficiency model by ICT Intervention and to examine the impact of ICT challenges on secondary schools efficiency in the Sylhet division in Bangladesh using stochastic frontier analysis. The Translog stochastic frontier model was found an appropriate than the Cobb-Douglas model in secondary schools efficiency by ICT Intervention. Based on the results of the Cobb-Douglas model, it is found that the coefficient of the number of teachers, the number of students, and teaching ability had a positive effect on increasing the level of efficiency. It indicated that these are related to technical efficiency. In the case of inefficiency effects for both Cobb-Douglas and Translog models, the coefficient of the ICT lab decreased secondary school inefficiency, but the online class in school was found to increase the level of inefficiency. The coefficients of teacher’s preference for ICT tools like multimedia projectors played a contributor role in decreasing the secondary school inefficiency in the Sylhet division of Bangladesh. The interaction effects of the number of teachers and the classrooms, and the number of students and the number of classrooms, the number of students and teaching ability, and the classrooms and teaching ability of the teachers were recorded with the positive values and these have a positive impact on increasing the secondary school efficiency. The overall mean efficiency of urban secondary schools was found at 84.66% for the Translog model, while it was 83.63% for the Cobb-Douglas model. The overall mean efficiency of rural secondary schools was found at 80.98% for the Translog model, while it was 81.24% for the Cobb-Douglas model. So, the urban secondary schools performed better than the rural secondary schools in the Sylhet division. It is observed from the results of the Tobit model that the teacher-student ratio had a positive influence on secondary school efficiency. The teaching experiences of those who have 1 to 5 years and 10 years above, MPO type school, conventional teaching method have had a negative and significant influence on secondary school efficiency. The estimated value of σ-square (0.0625) was different from Zero, indicating a good fit. The value of γ (0.9872) was recorded as positive and it can be interpreted as follows: 98.72 percent of random variation around in secondary school outcomes due to inefficiency.

Keywords: efficiency, secondary schools, ICT, stochastic frontier analysis

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Authors: Cory A. Bennett

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Teaching and learning through the use of discourse support students’ conceptual understanding by attending to key concepts and relationships. One discourse structure used in primary classrooms is number talks wherein students mentally calculate, discuss, and reason about the appropriateness and efficiency of their strategies. In the secondary mathematics classroom, the mathematics understudy does not often lend itself to mental calculations yet learning to reason, and articulate reasoning, is central to learning mathematics. This qualitative case study discusses how one secondary school in the Middle East adapted the number talk protocol for secondary mathematics classrooms. Several challenges in implementing ‘reasoning talks’ became apparent including shifting current discourse protocols and practices to a more student-centric model, accurately recording and probing student thinking, and specifically attending to reasoning rather than computations.

Keywords: discourse, reasoning, secondary mathematics, teacher development

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Authors: Richard Ayobayowa Foyewa

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This work examined the application of ICT in the teaching and learning of English language in Nigerian secondary schools. The definition of ICT was given briefly before areas in which the ICT could be applied in teaching and learning of English language were observed. Teachers’ attitudes towards the use of the computer and Internet facilities were also observed. The conclusion drawn was that ICT is very relevant in the teaching and learning of English language in Nigerian secondary schools. It was therefore recommended that teachers who are not computer literate should go for the training without further delay; government should always employ English language teachers who are computer literates. Government should make fund available in schools for the training and re-training of English language teachers in various computer programmes and in making internet facilities available in secondary schools.

Keywords: ICT, Nigerian secondary schools, teaching and learning of English

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Authors: Umar Mamman

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The study investigated the impact of school environment and peer relations on antisocial behaviour of the students of science secondary schools in Katsina State. The study sought to achieve the following objectives: to determine whether school influences antisocial behaviour among science secondary school students, and to determine whether peer relation influences anti-social behaviour among science secondary school students. The study population composed of all the students in science secondary schools in Katsina State. The study used a sample of 378 students and 18 teachers randomly selected from eleven science secondary schools in Katsina state. Three instruments were used to collect data for the study, thus: socio-economic status background questionnaire, antisocial process screening device (APSD), and inventory of parent and peer relationship questionnaire. The study findings revealed that school environment has significant effect on antisocial behaviour of the students in science secondary school (F (7, 372) = 52.08, p ≤ .01), and there is a significant effect of peer relation on antisocial behaviour of the students in science secondary school (F (7, 372) = 14.229, p ≤ .01). Based on these findings the following major recommendations were made: School environment should be made attractive and conducive for learning and character development. Teachers, as role model, should desist from indecent acts. School environment should be made learner-centered and friendly. Functional guidance and counselling outfits need to be provided in all secondary schools in Katsina state.

Keywords: school environment, peer relation, anti-social behaviour, psychology

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Authors: S. Vignesh, N. Vishnu, S. Vigneshwaran, M. Vishnu Anand, Dinesh Kumar Babu, V. R. Sanal Kumar

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The study of the primary flow velocity and the self impinging secondary jet flow mixing is important from both the fundamental research and the application point of view. Real industrial configurations are more complex than simple shear layers present in idealized numerical thrust-vectoring models due to the presence of combustion, swirl and confinement. Predicting the flow features of self impinging secondary jets in a supersonic primary flow is complex owing to the fact that there are a large number of parameters involved. Earlier studies have been highlighted several key features of self impinging jets, but an extensive characterization in terms of jet interaction between supersonic flow and self impinging secondary sonic jets is still an active research topic. In this paper numerical studies have been carried out using a validated two-dimensional k-omega standard turbulence model for the design optimization of a thrust vector control system using shock induced self impinging secondary flow sonic jets using non-reacting flows. Efforts have been taken for examining the flow features of TVC system with various secondary jets at different divergent locations and jet impinging angles with the same inlet jet pressure and mass flow ratio. The results from the parametric studies reveal that in addition to the primary to the secondary mass flow ratio the characteristics of the self impinging secondary jets having bearing on an efficient thrust vectoring. We concluded that the self impinging secondary jet nozzles are better than single jet nozzle with the same secondary mass flow rate owing to the fact fixing of the self impinging secondary jet nozzles with proper jet angle could facilitate better thrust vectoring for any supersonic aerospace vehicle.

Keywords: fluidic thrust vectoring, rocket steering, supersonic to sonic jet interaction, TVC in aerospace vehicles

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Authors: Marianna De Almeida

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Greek secondary education is a highly selective system with regard to the access of students to Greek universities. Since access from elementary to lower secondary education and afterward to upper secondary education is rather liberal and almost free of selective mechanisms, the basic selection process comes after graduating from upper secondary school into play when students go through a highly selective process for university entry. This structure is responsible for the experience of extreme stress on the part of the candidates during a period of at least two years before the entrance examination leading to a radical change in students' everyday life routines. Instead of the school being an important agent for academic and psychological support, it seems that other agents, such as the informal private preparatory school and the student's families, take on the supportive role.

Keywords: stress, entrance examinations, family support, secondary education

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Authors: Seyyed Abdollah Hojjati

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Review in the areas of secondary education; it is a kind of comparative requires very careful scrutiny in educational structure of different countries,In upcoming review of the basic structure of our educational system in Islamic republic of Iran with somedeveloped countries in the world, Analyzing of strengthsand weaknesses in main areas, A simple review of the above methods do not consider this particular community, Modifythe desired result can be expressed in the secondary school curriculum and academic guidance of under graduate students in a skill-driven and creativity growth, It not just improves the health and dynamism of this period and increases the secondary teachers' authority and the relationship between teacher and student in this course will be meaningful and attractive, But with reduced of false prosperity and guaranteed institutes and quizzes, areas will be provided for students to enjoy the feeling ofthe psychological comfort and to have the highest growth of creativity .

Keywords: comparative, curriculum of secondary education, curriculum, Iran, developed countries

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Authors: Aakansha Gupta, Neha Vadnere, Tapasvi Soni, M. Anbarsi

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Protein secondary structure prediction is one of the most important goals pursued by bioinformatics and theoretical chemistry; it is highly important in medicine and biotechnology. Some aspects of protein functions and genome analysis can be predicted by secondary structure prediction. This is used to help annotate sequences, classify proteins, identify domains, and recognize functional motifs. In this paper, we represent protein secondary structure as a mathematical model. To extract and predict the protein secondary structure from the primary structure, we require a set of parameters. Any constants appearing in the model are specified by these parameters, which also provide a mechanism for efficient and accurate use of data. To estimate these model parameters there are many algorithms out of which the most popular one is the EM algorithm or called the Expectation Maximization Algorithm. These model parameters are estimated with the use of protein datasets like RS126 by using the Bayesian Probabilistic method (data set being categorical). This paper can then be extended into comparing the efficiency of EM algorithm to the other algorithms for estimating the model parameters, which will in turn lead to an efficient component for the Protein Secondary Structure Prediction. Further this paper provides a scope to use these parameters for predicting secondary structure of proteins using machine learning techniques like neural networks and fuzzy logic. The ultimate objective will be to obtain greater accuracy better than the previously achieved.

Keywords: model parameters, expectation maximization algorithm, protein secondary structure prediction, bioinformatics

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Authors: S. Yeo, M. Mathur

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Introduction: Obesity, defined as a Body Mass Index (BMI) of more than or equal to 30kg/m, is associated with an increased risk of complications during pregnancy and delivery. During labour, obese mothers often require greater intervention and have higher rates of caesarean section. Despite a low overall rate of serious complications following caesarean section, a high BMI predisposes to a higher risk of postoperative complications. Our study, therefore, aimed to investigate the impact of antenatal obesity on adverse outcomes following caesarean section, particularly wound-related infections. Materials and Methods: A retrospective cohort study of all caesarean deliveries during the first quarter of a chosen year was undertaken in our hospital, which is a tertiary referral centre with > 12,000 deliveries per year. Patients’ health records and data from our hospital’s electronic labour and delivery database were reviewed. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), and odds ratios plus adjusted odd ratios were calculated with 95% confidence intervals (CI). Results: A total of 1829 deliveries were reviewed during our study period. Of these, 180 (9.8%) patients were obese. The rate of caesarean delivery was 48.9% in obese patients versus 28.1% in non-obese patients. Post-operatively, 17% of obese patients experienced wound infection versus 0.2% of non-obese patients. Obese patients were also more likely to experience major postpartum haemorrhage (4.6% vs. 0.2%) and postpartum pyrexia (18.2% vs. 5.0%) in comparison to non-obese patients. Conclusions: Obesity is a significant risk factor in the development of postoperative complications following caesarean section. Wound infection remains a major concern for obese patients undergoing major surgery and results in extensive morbidity during the postnatal period. Postpartum infection can prolong recovery and affect maternal mental health, leading to reduced perinatal bonding with long-term implications on breastfeeding and parenting confidence. This study supports the need for the development of standardized protocols specifically for obese patients undergoing caesarean section. Multidisciplinary team care, in conjunction with anaesthesia, family physicians, and plastic surgery counterparts, early on in the antenatal journey, may be beneficial where wound complications are anticipated and to minimize the burden of postoperative infection in obese mothers.

Keywords: pregnancy, obesity, caesarean, infection

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