Ethical Permission Research Articles

Improving the performance of EM and K-means algorithms for breast lesion segmentation

Aims: Breast cancer is the most common type of cancer in women and accounts for a large portion of cancer-related deaths. As in the other types of cancer, the prevention and early diagnosis of breast cancer gain importance day after day. For this purpose, the artificial intelligence-based decision support systems become popular in recent years. In this study, an automatic breast lesion segmentation process is proposed to detect breast lesions in the images taken with magnetic resonance imaging (MRI) protocol. 
 Methods: Two most popular segmentation methods: expectation maximization (EM) and K-means algorithms are used to determine the region of breast lesions. Furthermore, superpixel based fuzzy C-means (SPFCM) algorithm is applied after EM and K-means methods to improve the lesion segmentation performance.
 Results: The proposed methods are evaluated on the private database constructed by the authors with ethical permission. The performances of the utilized methods are analyzed by comparing the lesion areas determined by a radiologist (ground-truth) and areas that are achieved by automatic segmentation algorithms. 
 Conclusion: Dice coefficient, Jaccard index (JI), and area under curve (AUC) metrics are calculated for performance comparison. According to the simulation results, EM, K-means, EM+SPFCM, and K-means+SPFCM methods provides good segmentation performance on breast MRI database. The best segmentation results are obtained by using EM+SPFCM hybrid method. The results of the EM+SPFCM method are 0,8711, 0,8979, and 0,9981 for JI, Dice, and AUC, respectively.

Self-Reported Side Effects of Different COVID-19 Vaccines in Bangladesh- A Vaccine Recipient Survey

Background: COVID-19 (Corona Virus disease 2019) is a newly discovered disease that originated in China and quickly spread throughout the world, killing millions of people and infecting many more. People have a new hope due to newly discovered vaccines for this fatal disease. However, the vaccines showed a number of side effects on the people receiving them. Nonetheless, it has proven to be helpful in providing protection against the fatal infection. Purpose: To analyze the probable side effects of the vaccines experienced by vaccine recipient and their belief regarding vaccine. Method: An online survey was conducted through different social media platforms and Email from 11 July’2021 to 16 July’2021. Ethical permission and consent was taken prior to the survey and data collections. Occurance and the extent of vaccine side effects were analyzed using descriptive and logistic regression analysis. Result: Among 175 vaccine recipients, 92 (52.58%) received one dose and 83 (47.42%) received two doses, with 93 (53.1) receiving SinoPharm vaccine, 78 (44.6) receiving AstraZeneca vaccine, and 4 (2.3%) receiving Pfizer vaccine. More than half of the respondents experienced side effects among which headaches (50.3%) and drowsiness (45.71%) were common followed by fever (36%) and muscle ache (32%). Female (P=0.000) and vaccine concerned group (P=0.033) experienced more side effects. Headache (68.8%), fever (40.9%) and drowsiness (50.5%) were more common among Sinopharm recipients. Fever (50%) and muscle ache (50%) were more common among Pfizer recipients while muscle ache (43.5%) and drowsiness (42.3%) were common among AstraZaneca recipients group. Conclusion: Headache, fever, muscular discomfort, soreness at the injection site, drowsiness, nausea, and other adverse effects are common with the COVID vaccination. Females are more susceptible to side effects than males, and the probability of experiencing them increases with the second dose. AstraZeneca vaccine recipient experiencing more side effects than other types of vaccine recipients. Update Dent. Coll. j: 2023; 13(2):3-8

Adölesanlarda Beslenme, Egzersiz Davranışları ile İnternet Bağımlılığı Arasındaki İlişkinin İncelenmesi

Objective: This study aims to determine the relationship between adolescents' nutritionexercise behaviors and internet addiction, as well as identify the factors affecting their eating-exercise behaviors and internet addiction. 
 Material and Method: This cross-sectional descriptive correlational study was performed in Fethiye. The sample of the study consisted of 421 students attending 11 secondary schools. Data were collected using a descriptive data form, the Internet Addiction Scale and the Nutrition Exercise Behavior Scale. The data were collected by the researcher after obtaining ethical committee and institutional permissions. 
 Results: The students' psychological/addictive eating behavior subscale mean score was 38.9±8.8, their healthy eating/exercise subscale mean score was 47.6±9.4, the unhealthy eating/exercise behavior subscale mean score was 49.0±7.0, and the meal pattern subscale mean score was 23.4±4.5. The internet addiction scale mean score was 19.6±7.5. The regression analysis showed that variables pertaining to the students’ psychological/ addictive eating behavior, meal patterns, unhealthy nutrition/exercise behavior, their use of the internet for social media and other purposes, their class, and their consciousness of eating during the COVID-19 pandemic explained 35.8% of internet addiction, meaning that the model was statistically significant. An inverse correlation was found between the variables of psychological/addictive eating, meal patterns, unhealthy nutrition/exercise and being conscious of what one was eating during the COVID-19 pandemic, while a positive correlation was found between the variables of using the internet for social media and class. 
 Conclusion: Pediatric nurses play an important role in supporting the healthy development of adolescents by creating programs to instill healthy lifestyle habits

Assessment of Quality of Life and Long-term Health-related Problems Among Children with Intracranial Tumor

Introduction: The most prevalent type of solid tumor in children is the intracranial tumor. The treatment of pediatric intracranial tumors has acute and late side effects on the physical, cognitive, emotional, and social health of children, which negatively impact their HRQoL. Objectives: To assess the quality of life (QoL) and long-term health-related problems in children with intracranial tumors. Method: A descriptive study was conducted involving 70 children with intracranial tumors visiting OPD for their post-treatment follow-up. Ethical permission was granted from the Institutional Ethical Committee. Tools used to collect were Sociodemographic and clinical profile sheets of the children, Problem assessment proforma, and PedsQL TM Generic Core 4.0 Scale. Results: The age of children ranged from 4 to 18 years with a mean age of 11.31 + 4.28 years. Fatigue (57.1%) was the most common problem experienced by children followed by weakness (41.4%) and headache (25.7%). In neurocognitive dysfunction, decreased attention was seen in 30% of children followed by difficulty in thinking and reading/writing. Muscle power-related problems, endocrine problems, and psychological and behavioral problems were also seen in these children. The total score of QoL of children with intracranial tumors was 70.8 ± 24.6. The most affected domain of QoL was school functioning, followed by physical functioning. Conclusion: Children with intracranial tumor show average HRQoL and these children are at a higher risk for late consequences, which may influence several life domains.

ROLE OF HEMATOLOGICAL SCORING SYSTEM IN DIAGNOSIS OF NEONATAL SEPSIS

Introduction: Neonatal sepsis is a clinical syndrome resulting from pathophysiologic effects of local and systemic infection in the 1st month of life. Septicemia usually consists of bacteremia with a constellation of signs and symptoms caused by microorganisms or their toxic products in the circulation. Neonatal sepsis was one of the common causes of neonatal mortality, contributing to 16% of all intramural deaths. Early diagnosis of neonatal septicemia is a vexing problem because of its nonspecific clinical picture. Method: This study was prospective observational study of 210 Cases received from August 2020 to August 2022 for Neonatal Sepsis. This prospective study was carried out in Department of Pathology of a tertiary care teaching hospital. The ethical permission has been obtained from Institutional Ethics Committee for conducting the study. Hemogram was obtained for each case using five part automated hematology analyser. Result: Hematological scoring system was useful test in the early diagnosis of neonatal sepsis. Diagnostic accuracy was 92.39% in this study,>=3 score was sensitive and >=4 score was specific for early diagnosis of neonatal sepsis Conclusion: The HSS increases the diagnostic accuracy of the complete blood cell count as a screening test for sepsis and simplifies and standardizes its interpretation.

Evaluation of the incidence and risk factors of ocular disorder in primary school children: a cross-section analysis

Background: School health is an essential part of any public health program. Poor vision in childhood can affect school performance and affect children later in life. Pupils can be affected by various eye diseases such as refractive errors, strabismus, color blindness, eyelid problems and cataracts. The aim of this study is to determine the incidence and risk factors of eye diseases in children aged 6-12 years. Methods: This school-based cross-sectional study selected children aged 6-12 years from December 2018 to March 2019 from 09 primary schools in the Kanpur district. The institutional ethical clearance and appropriate permissions from the school authorities were obtained through the medical officer of Kalyanpur PHC and consent 51 from parents. Results: A total of 2,100 students from 09 different schools, 1,070 boys and 1,030 girls, were tested. The most common eye diseases are myopic astigmatism with 16.6% (348 people), myopic astigmatism with 78.2% (272 people), 192 were against the rule astigmatisms, 80 were with the rule astigmatism astigmatisms, followed by simple myopic with 15.2% (53 people) and hypermetropic astigmatism with 1.7% (6 people). The next most common disease is allergic disease with 1.6% (34). The 1.4% (30) of children have strabismus. Blindness 0.26% (5), colour blindness 0.2% (4); eyelid and adnexal disease 0.13% (3) and cataract 0.03% (1) Conclusions: Eye diseases in school-aged children can be easily detected by regular eye examinations; this research shows that vision deficiency is likely to be affected.

KNOWLEDGE REGARDING UPPER RESPIRATORY TRACT INFECTION (URI) AND ITS PREVENTION AMONG UNDER FIVE CHILDREN, IN SELECTED COMMUNITY AREA, DEHRADUN

Aim: A descriptive cross-sectional study was conducted with aim to assess the knowledge regarding upper respiratory tract infection (URI) and its prevention among mothers of under five children, in selected community area, Dehradun and to find out association between knowledge score of mothers regarding upper respiratory tract infection & its prevention and selected socio-demographic profile. Materials and Methods:After obtaining the ethical permission from the ethical committee a quantitative research approach with descriptive cross-sectional study was conducted to assess the knowledge regarding upper respiratory tract infection and its prevention among mothers of under five children in selected community area of Dehradun. Total 60 mothersof under five children were selected based on inclusion criteria by using purposive sampling technique through structured knowledge questionnaire tool. The exclusion criteria for mothers of under five children were who are sick during data collection, having any chronic illness, children above five years and for children were who are physically disabled and mentally retarded children, children had URI with other disease condition. Results: In the present study revealed thatmore than (65%) mothers were between the age group of 26-33, nearly (40%) mothers were graduated andthe mother who are employed were (67%), (60%) mothers having girl child,(55%) mothers having child between 3-5 years and(75%) children were immunized up to their age. The result findings conclude that 18% (10) of mother had excellent knowledge regarding prevention of URI approximately half of 45% (27) of study participants had good knowledge 28% (17) of mothers had average knowledge and only 10% (6) of study participants had poor knowledge regarding prevention of URIThe result finding reveals that there is association between socio- demographic variables and knowledge score of mothers. Conclusion:The present study concludethathalfof the 45% (27) mothers had good knowledge regarding URI and itsprevention, 18% (10) mothers having excellent knowledge and 10% (6) mothers having poor knowledge. Thus, it is concluded that some of the mothers need training and teaching to improve knowledge regarding Upper respiratory tract infection and its prevention among mothers of under five children and decrease the childhood acute respiratory infection.

Effects of Core Stabilization Exercises on Low Back Pain, Disability and Back Muscle Endurance in Patients with Lumbar Disc Herniation

Background: Lumbar disc herniation is a common musculoskeletal disorder leading to spinal degeneration. Core stability influences lumbar biomechanics, which improves muscle endurance through decreased pain of the lower back leading to minimal chances of disability.
 Objective: To determine the effects of Core stabilizing exercises on low back pain, disability and endurance of back muscles in Lumbar Disc Herniation patients.
 Methods: Randomized controlled trial was conducted on 52 patients . it was conducted 3 times a week for 30 minutes for 6 months. Participants allocated into two equal groups by lottery method. Group A was treated with controlled conventional treatment and core stabilizing exercises. Group B received only conventional treatment. This information was collected using NPRS and ODI. Besides this Biering-Sorenson and trunk flexion endurance tests were used. Probability sampling was used .Settings included AMTH, PSRD and NHMC. The study was conducted for 6 months. Ethical permission by ethical review board. data analysis by SPSS. This included male and female patients, age 20 to 60 years with disc herniation. Participants with recent surgery, inflammatory arthritis, cauda equina syndrome and spinal tumor were excluded.
 Results: After 8-weeks of core stabilization exercises, values of Group A are 1.93 for pain, 16.08 for disability, 1.27 and 40.54 for endurance whereas Group B showed values of 4.74 for pain, 34.08 for disability, 2.15 and 34.81 for endurance. Independent t-test showed significant difference between 2 groups with p value < 0.05. Results of current study showed considerable reduction in low back pain and disability, and a significant increase in back muscles endurance in the treatment group. 
 Conclusion: Core stabilization exercises were effective in improving function, reducing pain, reducing functional disability and enhancing endurance in patients of lumbar disc herniation and lower back pain

Examination of Dysfunctional Beliefs and Attitudes About Symptoms, Sleep Quality and Sleep in Patients Receiving Hemodialysis Treatment

Objective: This study was conducted to examine the relationship between symptoms, sleep quality, and dysfunctional beliefs and attitudes about sleep in patients receiving hemodialysis treatment.
 Material and Methods: This descriptive and correlational study was conducted with 120 patients undergoing hemodialysis in a private hemodialysis center. Data were collected using the Descriptive Information Form, Dialysis Symptom Index (DSI), Pittsburgh Sleep Quality Index (PSQI), and Dysfunctional Beliefs and Attitudes About Sleep Scale-16 (DBAS-16). The statistical analysis of the data obtained as a result of the study was analyzed using number, percentage, standard deviation and arithmetic mean as descriptive statistics, Pearson correlation test and structural equation modeling in IBM SPSS 26 program. Ethics committee approval and permission from the research institution were obtained for the conduct of the study. 
 Results: The most common hemodialysis-related symptoms were fatigue (70.8%), feeling irritable (61.7%), difficulty falling asleep (60.8%). The mean PSQI Global sleep score of the patients was 7.40±5.02 points. Dialysis Symptom Index explained 26.5% of the change in PSQI Global sleep score in a statistically significant way (F=42.479 p

Clinicopathological Profile of Appendicular Disease in Children: A Tertiary Health Care Center Study.

Background Acute appendicitis (AA) is the most common surgical emergency worldwide. Delay in diagnosis of disease often leads to serious complications such as perforation appendicitis (PA) and gangrenous appendicitis (GA). Aims and objectives The purpose of the study is to document clinicopathological outcomes in pediatric age group patients in a tertiary health care center. Material and method This study was a prospective observation study of 50 patients with pediatric appendicitis who had undergone emergency appendectomy from January 2022 to December 2022. All pediatric patients below 15 years of age with a diagnosis of AA were included. Institute ethical permission was granted before the study, and parent consent was taken for the surgery and also for inclusion in the study. After proper resuscitation, all patients underwent appendectomy, and necessary specimens were sent for histological examination. Based on histopathology reports, all patients were classified into four groups: AA, PA, GA, and normal appendix (NA). Results Out of 50 patients, 33 (66%) patients were males and 17 (34%) patients were females. The mean age of the patients was 10.22 ± 2.73 years. The mean age of AA, PA, GA, and NA patients were 10.25 ± 2.6 years, 9.78 ± 2.99 years, 10.00 ± 4.6 years, and 12.00 ± 2.8 years, respectively. The mean duration of symptoms at the time of hospital admission was 2.42 ± 0.97 days forhistopathologically proven AA patients, 4.67 ± 2.1 days for GA patients, 2.8 ± 0.83 for PA patients, and one day for NA patients. Overall clinical presentation was right iliac fossa (RIF) pain in 36 (72%) patients, migration of pain in 31 (62%) patients, anorexia in 37 (74%) patients, nausea and vomiting in 43 (86%) patients fever in 26 (52%) patients, RIF tenderness in 50 (100%) patients, rebound tenderness in 39 (78%) patients, guarding in 19 (38%) patients, Psoas's sign in nine (18% patients), and Rovsing's sign in 19 (38%) patients. On histopathological examination of the sent specimen, AA was found in 36 (72%) patients, PA was found in nine (18%) patients, GA was found in three (6%) patients, and NA was found in two (4%) patients. Wound infection was the most common complication and was found in five (10%) patients. The average duration of hospital stay for AA, PA, GA, and NA was 4.33 ± 1.04 days, 9.56 ± 4.2 days, 12.33 ± 8.5 days, and 3.50 ± 0.71 days, respectively. Conclusion The appendicular disease is common in teenage male children. Fever, dehydration, and rebound tenderness at the RIF are clinically significant findings. Duration of symptoms at the time of diagnosis, post-appendectomy complication, and duration of hospital stay significantly correlated with histopathological findings.

Developing a new focal vibration and heat therapy system

Abstract Vibrational heating therapy is a type of physical therapy that uses the application of heat and vibrations to stimulate the body’s healing process. The therapy is believed to promote circulation, reduce inflammation, and relieve muscle tension. It is often used to treat conditions such as arthritis, fibromyalgia, and sports injuries. This paper presents the design-decisions for a device treating muscle soreness and to increase muscle strength through a combination of heat and vibration therapy to the upper leg. The system comprises farinfrared heat elements for heat transfer and two types of eccentric rotating masses (ERMs) and a linear resonant actuator (LRA) to vibrate muscle tissue. It discusses heating and vibration capability and performance. To optimize the mechanical effects of vibration therapy, the device must excite the muscle with an acceleration of more than 2 g and with a bandwidth as wide as the range of the muscle natural frequencies. For testing the heating and vibrational systems, they were tested in the same device on six different subjects with ethics permission from Technical University of Hamburg to obtain accurate results. Both ERMs were driven by DC power and yielded a bandwidth of about 30 Hz with a linear progression of acceleration over frequency, while the LRA was driven by AC power and achieved a bandwidth of about 24 Hz in the form of a bell curve. Also the selected heating element provides the desired temperature between 40 ∘C to 50 ∘C. Overall, the initial technical study showed promising measurement results and a mechanical effect in using this combination of heat and vibration therapy. As an outlook, the technical design of the next version of the device will include multiple actuators around the leg to provide more acceleration and aims to combine multiple LRAs with slightly shifted natural frequencies into one actuator module to extend the bandwidth.

Surgical Site Bacterial Infection in a General Hospital, Al-Jouf Region, Saudi Arabia: A Retrospective Study.

Background Surgical site infection (SSI) is a major healthcare problem with a great impact on patient morbidity, mortality, and healthcare cost all over the world. It accounts for 20% of healthcare-associated infections (HAIs), with higher frequency in low- and middle-income countries where it affects about 30% of the patients undergoing surgery. Aim The current study aims to assess the prevalence of SSI in a general hospital in Sakaka, Al-Jouf region, Saudi Arabia. The types of bacteria causing SSI were also determined. Subjects and methods A retrospective cross-sectional study was done by reviewing the hospital records of patients who got SSI during the period between 2020 and 2022. Data collection was done during 2022 and 2023 after taking ethical approval and permission from the hospital management. Results The numberof patients who underwent surgical procedures during 2020, 2021, and 2022 were 689, 867, and 1119, respectively. Most of the cases were cholecystectomy and appendectomy. The cases that developed surgical site infection after cholecystectomy and/or appendectomy during 2021 and 2022 were 15.45% and 9.29% cases, respectively, and they were mainly associated with appendectomy. A culture and sensitivity test revealed methicillin-resistant Staphylococcus aureus (MRSA)and Klebsiella pneumonia. Nearly all patients have received ciprofloxacin for seven days and improved with treatment. Conclusion The number of cases that developed SSI has decreased gradually due to the application of infection control measures and strict follow-up.

Conceptual and Contextual Analysis of Spirituality in Adolescents with Grounded Theory Approach

This research aims to contribute to understanding the concept of spirituality among individuals of the Z Generation by delineating more specific boundaries within the field of spiritual studies. The connections within the minds of adolescent individuals between the concept of spirituality and the areas of socialization that start in childhood and accelerate during adolescence, within the context of their own cultural codes, have been examined to address the need for understanding. Given the developmental stage that the youth of the 21st century are in, where they construct their own concepts of value, it is noteworthy how they establish cognitive contexts, social interaction areas, and their associations with the concept of spirituality at this critical juncture. The notion of spirituality among young individuals, which is continuously discussed to a certain extent in relevant media and public domains, necessitates opening up to their world, and understanding the spiritual perception needs and expectations of young individuals, from their perspective. This study aims to reveal the perception of spirituality in adolescents, understanding the conceptual, operational, traditional, environmental, and socio-political codes of spirituality within their contexts. In line with this purpose, the behaviors attributed to spirituality by young individuals, the values they inherit as cultural, spiritual heritage, their awareness of the spiritual values of their peer groups, their perspectives on the societal order they live in, the characteristics they emphasize in their self-identifications, the relationship they establish between religion and spirituality, and their perceived levels of religiousness have been investigated. To both trace the connections of the individual and interpret the regions being studied and analyzed, a predictive paradigm was adopted, and a qualitative design was preferred. Ethical committee permission was obtained on 09.03.2023. The research was conducted between 10.04.2023 and 10.05.2023 for data collection. The sample group was composed of students attending formal education in Ankara, from Yenimahalle Tevfik İleri Anatolian Imam Hatip High School, Mamak Hüseyin Gazi Anatolian Imam Hatip High School, and Mamak Volkan Gürbüzalp Anatolian High School. Data were obtained from 36 young individuals aged between 13 and 18, through 11 fully structured open-ended questions. The data were collected using a semi-structured interview form. Following one-on-one interviews, the data obtained were analyzed through thematic coding and grounded theory analysis. As a result of the study, participants' spirituality was shaped around three core categories. When positioning their spirituality, adolescent individuals create relational connections, such as friendships, institutions (religious and national education institutions), social relationships, politics, and structural connections. They develop their concepts of spirituality by drawing on information from family, culture, and religious institutions. Furthermore, in intrinsic experiences, the concept of spirituality shaped through material phenomena, self-state, and connection with the transcendent stands apart from others. Each core category provides a detailed structure of adolescent individuals' spirituality through sub-categories. Contrary to common belief, it was observed that the concept of spirituality among adolescent individuals is similarly nourished as in adults. Additionally, feelings related to individual well-being, material possessions received as gifts, and established family and friendship bonds, were found to be part of adolescents' definitions of spirituality, distinct from a purely religious context. Feelings of individual well-being are defined as their spirituality, independent of religious sentiment. These feelings encompass the sense of belonging felt in established family and friendship bonds, the memory of gifted and cherished items, and the pride of being an individual who displays socially accepted behavior and does what is right when interacting with society. It was found that young individuals express these feelings in the form of spirituality. * This study was started in 2023 under the supervision of Assist. Assoc. Dr. Zehra Erşahin's master's thesis titled "Conceptual and Contextual Analysis of Spirituality

Introducing standard patient-reported measures (PRMs) into routine maternity care: A pre-implementation qualitative study on women’s perspectives in Finland

BackgroundSystematically using standard patient-reported measures (PRMs) in clinical routines is trending. The International Consortium for Health Outcomes Measurement (ICHOM) has developed condition-specific standard sets of patient-centred measures, one of which is the Pregnancy and Childbirth Standard (PCB) set, where standard PRMs are included. There is limited knowledge on the use of ICHOM PCB set-included PRMs (ICHOM-PCB-PRMs) in routine care. This study investigates women’s perspectives on the future implementation of standard ICHOM-PCB-PRMs in routine maternity care in Finland.MethodsSemi-structured interviews were conducted. Pregnant and postpartum women were asked to evaluate each ICHOM-PCB-PRM in several dimensions, e.g., importance and quality of questions, and to provide their views on future implementation in terms of benefits, difficulties, and practices. With the predefined topics and themes, deductive analysis was applied. Ethical committee approval (HUS 220/880/2015) and research permissions were obtained.Results22 women participated. Participants felt that most of the ICHOM-PCB-PRMs were important, relevant, understandable, and appropriately designed, and agreed that some changes in ICHOM-PCB-PRMs were needed, e.g., adding other important measures, changing the wording, and adding open-ended questions. Women would be hesitant to answer questions honestly if follow-up actions were unclear. Most “outcome” measures could be asked repeatedly as maternal health status changes over time, and “experience” measures could be asked separately for different service providers. Disagreements regarding data collection at birth were observed. PRMs were regarded as a way for women to express their thoughts and feelings. Our participants were concerned about the possible consequences of negatively answering the PREMs questions and the availability of follow-up care. Participants expected that they could answer short and easy questions digitally before appointments, and that instructions and follow-up actions based on their answers should be available.ConclusionICHOM-PCB-PRMs could be applicable in Finnish maternity care, but some modifications may be required. Careful consideration is needed regarding how and when PRMs questions are asked for eliciting more accurate and honest answers and minimizing women feeling judged, embarrassed, or offended. Follow-ups should be available according to women’s responses and needs. This study provides insights on the adoption and implementation of standard PRMs in routine maternity care.

On the ethical permissibility of in situ reperfusion in cardiac transplantation after the declaration of circulatory death

Transplant surgeons in the USA have begun performing a novel organ procurement protocol in the setting of circulatory death. Unlike traditional donation after circulatory death (DCD) protocols, in situ normothermic...

Awareness and knowledge of HIV/AIDS in school going children of Surat, Gujarat

Background: Adolescents are susceptible to unhealthy practices due to a lack of knowledge and curiosity to try new things. Adolescent age also forms the base for behaviors throughout their lives. This study therefore aimed to understand adolescents’ present knowledge and attitude towards HIV/AIDS. Methods: A questionnaire was created with knowledge and attitude-based questions regarding HIV/AIDS. The questionnaire was embedded in google Forms and was sent via WhatsApp, to collect responses from school going children of age 14 to 18. Ethical permissions and consents were taken and the data collection went on for a week. Results: 2000 children took part in the study, out of that 732 were males and 1268 were females. The mean score of all the participants was calculated to be 68.52% with a standard deviation of 17.18. There was no statistical significance of gender and the mean score of the participants, whereas statistical significance was found for age-wise distribution of mean score. Participants scored well on basic knowledge-based questions like “causative organism’’ but failed to do good on little complicated questions like ‘’Route of transmission’’ Conclusions : The results from this study can be applied to similar regions of Gujarat and other states as well. This would help in making changes in the education of this age group of children. Such studies also form the base of future studies to evaluate the difference in knowledge of the school going children over a period of time by comparing this data.

Reviewing academic coordination on the rural distributed training platform in South Africa.

Distributed training of students from a variety of health professions is increasing in South Africa because of the type of learning it offers and that it caters for the increasing number of students being accepted into health sciences programs. Challenges and facilitators to distributed training are well documented in the literature, and include increased distance from the academic home, human resources for health challenges, student access to support systems, and identifying learning environments to match learning outcomes. In the case of the Rural Clinical School in the Western Cape, South Africa, 'academic coordinators' were employed on site to fulfil the role of coordinating and supervising student learning and community engagement. This article explores their experiences. A large-scale qualitative study was conducted in 2017 exploring the history and development of the Ukwanda Centre for Rural Health and the Rural Clinical School. Part of this study included semi-structured individual and focus group interviews with consenting academic coordinators exploring their experiences of developing and working on a rural distributed training platform in South Africa. Data were inductively analysed. Ethical approval and institutional permission were obtained for this study, and all participants provided consent. In addition to previously published challenges that clinical supervisors who are employed by the health system face, the academic coordinators reported facing challenges related to professional isolation, boundary blurring between providing student support versus acting as clinical educator, juggling multiple line managers and administrative responsibilities, navigating the new field of academia, and not having the potential for career progression. Reflecting on the needs of academic coordinators expressed in this article, we identified four conditions that may promote sustained and continuous academic coordination at rural or remote distributed training sites. These conditions are (1) living and working local; (2) having a dual role in academia and the health system; (3) having access to academic support; and (4) regular engagement with the academic home, the value of which is detailed in this article. These recommendations can be adopted to optimise and sustain academic engagement on the distributed training platform, especially in light of the current expansion of health professions training and subsequent need to attract and retain clinician-academics in remote locations.

Can Risk Communication Surveillance Prompt COVID-19 Vaccine Acceptance among Internet users? Applying the Situational Theory of Problem Solving: A Cross-Sectional Study.

The World Health Organization has recently raised concerns about the low number of fully vaccinated people against COVID-19 among developing countries. The low ratio of fully vaccinated people and the emergence of renewed infectious variants correspond to worsening public health. Global health managers have highlighted COVID-19 vaccine-related infodemics as the significant risk perception factor that hinders mass vaccination campaigns. Given the ambiguous digital communication environment which has fostered infodemics, developing nations struggle to boost public willingness to get people fully vaccinated. Authorities have launched some risk communication-laden digital interventions in response to infodemics. However, the value of these risk communication strategies employed to tackle infodemics needs to be evaluated. The current research using the tenets of the situational theory of problem-solving is novel, as it explores the impending effects of risk communication strategies. The relationship between infodemic-induced risk perception about COVID-19 vaccine safety and risk communication actions to intensify willingness to get fully vaccinated was examined. This research used a cross-sectional research design vis-à-vis nationally representative online survey. We collected data from 1946 internet users across Pakistan. Participants voluntarily participated in this research after filling consent form and reading the ethical permissions. Responses were received over three months, from May 2022 to July 2022. The results delineated that infodemics positively affect risk perception. This realization pushed the public to engage in risky communicative actions through reliance on and search for accurate information. Therefore, the prospect of managing infodemics through risk information exposure (e.g., digital interventions) using the situational context could predict robust willingness to get fully vaccinated against COVID-19. The pioneering results offer strategic considerations for health authorities to effectively man-age the descending spiral of optimal protection against COVID-19. This research concludes that the likelihood of managing infodemics using the situational context through exposure to relevant information could improve one's knowledge of forfending and selection, which can lead to robust protection against COVID-19. Hence, more situation-specific information about the underpinning problem (i.e., selection of appropriate vaccine) can be made accessible through several official digital sources to achieve a more active public health response.

Role of Post-Isometric Relaxation of Quadriceps and Core Stability Exercises in Vertical Jump Performance

Objective: To determine the role of post isometric relaxation of quadriceps and core stability exercises in vertical jump performance. Methods: A Randomized Clinical Trial, conducted in Islamic International University after having the ethical permission from Institutional review Board of Riphah International University Islamabad. Sampling technique was Non-probability convenience sampling with the sample size of 30 athletes, that were divided by sealed and envelop method into core stability exercise treated group (n=17) and Post isometric relaxation treated group (n= 13). Male Athletes within age range of 20-35 years and playing at the domestic level were
 included and athletes with history of sprain or strain in lower limbs within last 6 month, having neuromusculoskeletal and cardiovascular pathology were excluded from the study. Force plate was used to measure the different parameters of jump. Data were entered and analyzed through SPSS version 22. Results: The mean age of group A and B was 20.35 + 2.01 and 20.03 + 2.42 in years respectively. BMI of core stability exercise treated group and Post isometric relaxation treated group was 22.35 + 2.32, 22.58 + 1.95 respectively in kg/m2. Comparison between core stability exercise treated group and Post isometric relaxation treated group showed that there was no significant immediate effects (F= 1.235; p= 0.852) of treatment on three style of jumps.
 Conclusion: No significant immediate effects of treatment on three styles of jumps was found.

“Just teach them the law!”: the ethics of value inculcation within legal education

ABSTRACT To what extent should law teachers be permitted to advance controversial ethical, moral or political views as part of the LLB curriculum? This short paper grapples with that question by defending the ethical permissibility of such behaviour subject to the important proviso that it does not cause students “pedagogical harm”. In reaching this conclusion, three alternative views are considered and dismissed, each of which seeks either to eliminate value inculcation entirely or to restrict its scope to the moral-political values currently immanent within established law. The approach taken is argumentative, drawing upon analytical philosophy, with each contested and contestable view being presented in propositional form. Ultimately, it is concluded that value inculcation cannot be avoided within legal education and that, given this fact, the question becomes which values law teachers have a responsibility to advance. It is contended that this judgement, fraught though it might be for various reasons, is best left to individual teachers and that, for this reason among others, a permissive “no-harm” approach to value inculcation best justifies current pedagogical practices.