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Background: Breast cancer is one of the most common malignant diseases in women and adjuvant combination chemotherapy has been shown to reduce mortality from this disease. Adherence to medical treatment is a multifaceted issue that can substantially alter the outcomes of therapy. Patient non-adherence to chemotherapy is the ultimate barrier to the treatment effectiveness. Objective: This study was carried out to determine the relationship between cancer chemotherapy adherence and breast cancer staging, patient’s perception of cancer care and patient’s socio-demographic characteristics. Material and method: This was a cross sectional study selection of respondents and was based on simple random sampling technique, 184 patients were interviewed and data was collected using a semi-structured questionnaire to obtain socio-demographic data, adherence data, and facility-related information. Results: There was a significant association between marital status and non-adherence (P = 0.013). Both separated and single subjects had higher proportion of non-adherence compared with married subjects. Analysis of perception of chemotherapy care revealed a significant association between the satisfaction score and non-adherence, with non-adherent patients showing higher scores or being less satisfied. The quality of service (P = 0.0052); rating of needs been met (P = 0.0079); rating on whether the services helped the subject (P = 0.0405); rating on the general satisfaction of the services provided (P = 0.0115); and rating on whether subject would seek help again (P = 0.0320) all had a significant association with non-adherence. Conclusion: The awareness of oncologist and patient of the problem of non-adherence and communication regarding the importance of adherence to therapy may improve health outcomes.

The purpose of our study was to compare patient satisfaction level among tertiary public and private hospitals. We carried out a multi-centre cross-sectional study using Patient SatisfactionQuestionnaire-18 to assess patient satisfaction in a major private and public hospital in Islamabad. Out of 1301 participants, 636 (48.9%) patients were at the public hospital, while 665(51.1%) were at the private hospital. Time spent with doctor, communication, accessibility and convenience component score was significantly higher in patients at the private hospital (p0.05 each). Interpersonal manner component score was higher at the public hospital (p0.05). Female patients, patients admitted in medical specialty and patients admitted in private hospitals had higher patient satisfaction scorelt;0.05 each). Significant efforts should be made to improve the quality of care provided to patients admitted in public-sector health facilities.

Thispaper aims to determine the feasibility of integrating STEM into the earlychildhood education. As such, a survey design was deemed appropriate. Purposivesampling technique was used in which 22 early childhood teachers from 19 urbanand rural childcare centres in Malaysia were selected for this study. These 22early childhood teachers were familiarised to the use of Problem-Based Inquiry Learning (PIL) in integrating STEM bymeans of 10 authors-developed STEM Projects through a three-day fullyresidential training workshop. Upon the completion of the training workshop,the teachers were supported in integrating STEM in their respective classroomsfor five-month duration during which, an implementation of a maximum of fiveSTEM Projects was aspired. Two sources of data were gathered from the teachersto determine the suitability of STEM integration in early childhood education:(1) at the end of the training workshop where teachers reported on thesuitability of the STEM Projects for early childhood pupils aged 3 to 4+, and(2) at the end of the five-month classroom implementation where teachersreported on the STEM Projects which they have carried out with their 3-4+year-old children. Findings indicated that, while two of the 10 STEM Projectswere perceived as less appropriate by at least 50% of the teachers, eight otherSTEM Projects were deemed as appropriate. The actual implementation of STEMProjects among the teachers ranges between 60% to 100%, with a mean of 81%.This paper ends with a discussion on the characteristics of the appropriateSTEM projects for 3 to 4+ year olds, and equally, implications for STEMeducation are proffered.&nbsp

Maternal health care refers to the better outcome of labor and reduced maternal mortality. Antenatal care utilization is an important determinant for improved maternal health care. In this study, we examine how father's involvement influences antenatal and perinatal care utilization by mothers.A community-based cross-sectional study was performed in the Pakistan Institute of Medical Sciences for three months. Systematic random sampling method was used for obtaining the desired sample. Safe Motherhood Questionnaire (Woman) developed by Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO) was adapted and utilized to gather the required data. Sample size for the study was calculated as 303 by the WHO calculator keeping confidence level at 95% and with an associated prevalence of 73%. The data were entered into SPSS version 21 (Chicago, IL). Frequencies and percentages were calculated for qualitative variables. Mean and standard deviation was calculated for quantitative variables.This study revealed that the father's attitude toward antenatal care was found to be significantly (p .05) associated with a higher education and greater income level. While father's favorable attitude toward childbirth was found to be significantly (p .05) associated with higher education and lower age (18-29 years). Frequency of fathers who disagreed to the statement "It is not necessary for a husband/partner to accompany his wife to antenatal care visits" was 204 (67.1%), whereas those who disagreed with the statement "It is not necessary for a husband/partner to accompany his wife when she is giving birth" were 255 (83.8%). While frequency of fathers who disagreed with the statement "Giving birth is mostly a woman's matter; Husbands/partners have little to contribute" was 267 (87.9%).Our study found a positive association between father's involvement in maternal health and factors such as paternal education level, age, income level and father's attitude. Fathers' antenatal involvement was associated with paternal age and income level, while their perinatal involvement was associated with paternal age and education level. Our study on father's attitude toward presence at time of birth showed 83.8% compliance. Similarly, there was 67.1% compliance for presence during antenatal checkups.

Crude oil spill are a global concern due to the environmental and economic impact as well as harm the beauty of the polluted sites. Date Palm leaves fiber (DPLF) as a natural agricultural fiber, which is environmentally materials, biodegradable, renewable, abundant, and cheap. A hollow cellulosic material like DPLF is a potential sorbent to counter the oil spill pollution. The oil sorption capacity (OSC) of fresh and weathered oils into DPLF as a sorbent was studied. The effects of contact time and temperature on sorption were studied in simulated tap water as well as salty water. The OSC increases with increasing the contact time. The DPLF has given oil sorption capacity of 4.534-7.985 g oil/g sorbent for a contact time of 5-90 min for fresh oil (tap water, at room temperature). This OSC are considered to be good for a sorbent considering it is locally available and not expensive. Fresh oil is having higher OSC at room temperature at all the experimental times (5-120 min). At lower temperature, e.g. 15 °C the adsorption of oil having greater role in increasing OSC, since at low temperature the oil having high viscosity and that will increase the adherence of oil onto the surface of the fibers and within the capillary during drainage. At room temperature and little higher e.g. 25 & 30 °C , the oil will have less viscosity and more diffusion and that will increase the absorption within the internal capillary and lumens of the fibers and that increase the OSC. There is decrease in viscosity at higher temperature e.g. 45 & 60 °C that will increase the diffusion in the oil and increase the segmental mobility of the fibers as well as increasing the penetration of oil into the pores and lumens of the fibers. That will increase the OSC, but much oil will come out during the drainage time (5 min).

Crystallization rate of partial hydrogenated blend of soybean oil and cottonseed oil used for making vegetable ghee (vanaspati) was investigated, by solid fat content (SFC) using pulsed nuclear magnetic resonance (p-NMR). The effects of adding sucrose fatty acid esters or sucrose polyesters (SPE) on the crystallization rate of the blend fat were studied. Sucrose tetrastearate DK ester F-10 (stearate 70% - palmitate 30%) was added to the fat at different concentration, namely 0.5% and 1.0%. Blank sample and sample containing 0.5% and 1.0% DK ester F-10 / (DK F-10) were chosen to measure the change in SFC at constant temperature of 15ºC for a period of 25 hr. Five determinations of SFC were taken to the fat samples during the 25 hr i.e. 2,5,9,13 and 25th hr. SFC vs. time of crystallization of the three samples showed continuous increasing in SFC in all samples during the 25 hr, with sharp increasing at the first two hours. Samples containing 0.0% and 0.5% DK F-10, showed no significant difference in SFC during the first thirteen hours, while sample containing 1.0% DK F-10, showed higher SFC than the other two samples, through out the period. The amount of SFC for 1.0% DK F-10 sample at the 13th hour is equal to the SFC of the blank (0.0%) sample at the 25th hour. Melting point of the same samples increased with the increasing DK F-10 concentration in the fat samples. The results of SFC make it sure that the addition of 1.0% DK F- 10 will shorten the time required for the crystallization of vegetable ghee while the addition of 0.5% will not have significant effect.Se ha investigado, mediante el contenido en grasa sólida (SFC) por resonancia magnética nuclear pulsada (p-NMR), la velocidad de cristalización de mezcla de aceite de la soja y aceite de semilla del algodón parcialmente hidrogenada utilizada en la elaboración de ghee vegetal (vanaspati). Se han estudiado los efectos de añadir ésteres de sacarosa de ácidos grasos o poliésteres de sacarosa (SPE) sobre la velocidad de cristalización de la mezcla grasa. Se agregó tetraestearato de sacarosa DK ester F-10 (estearato 70% -palmitato 30%) a la grasa en diferentes concentraciones (0.5% y 1.0%). Se determinaron las variaciones del SFC, a temperatura constante de 15ºC, durante 25 horas en muestras que contenían 0.5% y 1.0% de DK ester F-10 (DK F-10) y una muestra en blanco. Se determinaron los contenidos en grasa sólida a las 2, 5, 9, 13 y 25 horas. El incremento en SFC fue continuo en todas las muestras durante las 25 horas, presentando un brusco aumento durante las primeras dos horas. Las muestras que contenían el 0.0% y 0.5% de DK F-10, no mostraron ninguna diferencia significativa en SFC durante las primeras trece horas, mientras que la muestra con el 1.0% de DK F-10, mostró un SFC superior a las otras dos, durante todo el período de tiempo. El SFC de la muestra, con el 1.0% de DK F-10, a las 13 horas, es igual al de la muestra en blanco (0.0%) a las 25 horas. El punto de fusión de las mismas muestras aumentó con la concentración en DK F-10. Los resultados del SFC demuestran que la adición de un 1.0% de DK F - 10 reduce el tiempo de cristalización del ghee vegetal mientras que un 0.5% no produce ningún efecto significativo.

EPS is a major constituent of plastic waste. Reuse of waste EPS which is non-biodegradable, to useful products is a way of effective waste management. Oil is one of the most important energy sources but oil spill accidents often take place during the oil utilization process, resulting in threats to the environment. We report the use of EPS waste to obtain an adsorbent material to cleanup crude oil spill from water. The effects of major factors such as sorption time, adsorbent surface areas, kind of surface (smooth or rough) and thermo-modification and mechanical modification (punching holes) were investigated. The experiments carried out with about 0.900 g EPS sorbent were tested for oil sorption for 5 to 120 min at 400 g oil only and at 50 g oil over 800 mL water surface. Oil sorption increases with increasing the sorption time's and surface areas. Surface areas increase with cutting the EPS pieces with serrated edge knife or/and cutting the EPS to 2, 4, 6 and 8 pieces.Oil sorption capacity (OSC) increased with increasing surface area, and so two pieces have OSC of 1.733 g/g more than one piece of 1.208 g/g of the same weight (0.900 g) and sorption time (5 min). Rough surface of EPS adsorbed more oil than smooth surface. Most of adsorptions were taking place at first 5-15 min. Thermo-modification (50- 90 °C) has no significant effect on oil sorption. Making holes by punching nails (0.1 mm diameter) into EPS contributed to increases OSC to 2.538 g/g for 5 min sorption time (1 piece). Increasing the nails diameter to 1.65 mm resulted to increase in OSC to 3.280 g/g for 5 min sorption time (1 piece) and 7.998 g/g for 6 pieces. The results of investigation indicated that the oil sorption mechanism of EPS waste meanly adsorption with slow capillary action. Oleophilic action between EPS and oil is the mean force governing the oil adsorption into EPS. The use of EPS waste in oil spill cleanup will reduce pollution in two ways. Reducing the garbage and oil spill remediation.

"Transnationalism: a new approach to America's history"