Search results for: Suzanne Cross

Authors: Jansirani Natarajan, Mickael Antoinne Joseph

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The COVID-19 pandemic has interrupted face-to-face education and forced universities into an emergency remote teaching curriculum over a short duration. This abrupt transition in the Spring 2020 semester left both faculty and students without proper preparation for continuing higher education in an online environment. Online learning took place in different formats, including fully synchronous, fully asynchronous, and blended in our university through the e-learning platform MOODLE. Studies have shown that students’ engagement, is a critical factor for optimal online teaching. Very few studies have assessed online engagement with ERT during the COVID-19 pandemic. Purpose: Therefore, this study, sought to understand how the sudden transition to emergency remote teaching impacted nursing students’ engagement with online courses in a Middle Eastern public university. Method: A cross-sectional descriptive research design was adopted in this study. Data were collected through a self-reported online survey using Dixon’s online students’ engagement questionnaire from a sample of 177 nursing students after the ERT learning semester. Results The maximum possible engagement score was 95, and the maximum scores in the domains of skills engagement, emotional engagement, participation engagement, and performance engagement were 30, 25, 30, and 10 respectively. Dixson (2010) noted that a mean item score of ≥3.5 (total score of ≥66.5) represents a highly engaged student. The majority of the participants were females (71.8%) and 84.2% were regular BSN students. Most of them (32.2%) were second-year students and 52% had a CGPA between 2 and 3. Most participants (56.5%) had low engagement scores with ERT learning during the COVID lockdown. Among the four engagement domains, 78% had low engagement scores for the participation domain. There was no significant association found between the engagement and the demographic characteristics of the participants. Conclusion The findings supported the importance of engaging students in all four categories skill, emotional, performance, and participation. Based on the results, training sessions were organized for faculty on various strategies for engaging nursing students in all domains by using the facilities available in the MOODLE (online e-learning platform). It added value as a dashboard of information regarding ERT for the administrators and nurse educators to introduce numerous active learning strategies to improve the quality of teaching and learning of nursing students in the University.

Keywords: engagement, perception, emergency remote learning, COVID-19

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Authors: Morteza Rahbar Taramsari, Arya Mahdavi Baramchi, Mercedeh Enshaei, Ghazaleh Keshavarzi Baramchi

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Introduction: Malingering is one of the most challenging issues in the forensic psychology and imposes a heavy financial burden on health care and legal systems. It seems that some mental and personality abnormalities might have a crucial role in developing this condition. Materials and Methods: In this cross-sectional study, we aimed to assess 100 malingering clients of Gilan province general office of forensic medicine, all filled the related questionnaires. The data about some psychometric characteristics were collected through the 71-items version- short form- of Minnesota Multiphasic Personality Inventory (MMPI) questionnaire and the personality traits were assessed by NEO Personality Inventory-Revised (NEO PI-R) - including 240 items- as a reliable and accurate measure of the five domains of personality. Results: The 100 malingering clients (55 males and 45 females) ranged from 23 to 45 (32+/- 5.6) years old. Regarding marital status, 36% were single, 57% were married and 7% were divorced. Almost two-thirds of the participants (64%) were unemployed, 21% were self-employed and the rest of them were employed. The data of MMPI clinical scales revealed that the mean (SD) T score of Hypochondrias (Hs) was 67(9.2), Depression (D) was 87(7.9), Hysteria (Hy) was 74(5.8), Psychopathic Deviate (Pd) was 62(8.5), Masculinity-Feminity (MF) was 76(8.4), Paranoia (Pa) was 62(4.5), Psychasthenia (Pt) was 80(7.9), Schizophrenia (Sc) was 69(6.8), Hypomania (Ma) was 64(5.9)and Social Introversion (Si) was 58(4.3). NEO PI-R test showed five domains of personality. The mean (SD) T score of Neuroticism was 65(9.2), Extraversion was 51(7.9), Openness was 43(5.8), Agreeableness was 35(3.4) and Conscientiousness was 42(4.9). Conclusion: According to MMPI test in our malingering clients, Hypochondriasis (Hs), depression (D), Hysteria (Hy), Muscularity-Feminity (MF), Psychasthenia (Pt) and Schizophrenia (Sc) had high scores (T >= 65) which means pathological range and psychological significance. Based on NEO PI-R test Neuroticism was in high range, on the other hand, Openness, Agreeableness, and Conscientiousness were in low range. Extroversion was in average range. So it seems that malingerers require basic evaluations of different psychological fields. Additional research in this area is needed to provide stronger evidence of the possible positive effects of the mentioned factors on malingering.

Keywords: malingerers, mental profile, MMPI, NEO PI-R, personality profile

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Authors: Souzan Al Sayegh, Izzeldin Ibrahim, Mercia Van Der Walt, Mohamed Al-Kuwari

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Background: Walking is the most common form of physical activity which can promote a healthy well-being among people of different age groups. In this regard, pedometers are becoming more popular within research and are considered useful tools in monitoring physical activity levels based on individuals’ daily steps. A value of ˂5,000 steps/day is identified as a sedentary lifestyle index where individuals are physically inactive. Those achieving 5,000-7,499 steps/day have a low active lifestyle as they do not meet the moderate-to-vigorous physical activity (MVPA) recommendations. Moreover, individuals achieving ≥7,500 steps/day are classified as physically active. The objective of this study is to assess the physical activity levels of adult population in Qatar through a pedometer-based program over a one-year period. Methods: A cross-sectional analysis, as part of a longitudinal study, was carried out over one year to assess the daily step count. 'Step into Health' is a community-based program launched by Aspire as an approach for the purpose of improving physical activity across the population of Qatar. The program involves the distribution of pedometers to registered members which is supported by a self-monitoring online account and linked to a web database. Daily habitual physical activity (daily total step count) was assessed through Omron HJ-324U pedometer. Analyses were done on data extracted from the web database. Results: A total of 1,988 members were included in this study (males: n=1,143, 57%; females: n=845, 43%). Average age was 37.8±10.9 years distributed as 60% of age between age 25-54 (n=1,186), 27% of age 45-64 (n=546), and 13% of age 18-24 years (n=256). Majority were non-Qataris, 81% (n=1,609) compared with 19% of the Qatari nationality (n=379). Average body mass index (BMI) was 27.8±6.1 (kg/m2) where most of them (41%, n=809) were found to be overweight, between 25-30 kg/m2. Total average step count was 5,469±3,884. Majority were found to be sedentary (n=1110, 55.8%). Middle aged individuals were more active than the other two age groups. Males were seen as more active than females. Those who were less active had a higher BMI. Older individuals were more active. There was a variation in the physical activity level throughout the year period. Conclusion: It is essential to further develop the available intervention programs and increase their physical activity behavior. Planning such physical activity interventions for female population should involve aspects such as time, environmental variables and aerobic steps.

Keywords: adults, pedometer, physical activity, step-count

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Authors: Angana Chatterjee

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The feminist scholars point out the various problematic issues in the traditional mainstream western thought and theories. The thought practices behind the discriminatory and oppressive social practices are based on concepts that play a pivotal role in theorisation. Therefore, many feminist philosophers take up reformation or reconceptualisation projects. Such projects have bearings on various aspects of philosophical thought, namely, ontology, epistemology, logic, ethics, social, political thought, and so on. In tune with this spirit, the present paper suggests a well-established thought pattern which is not western but has got the potential to deal with the problems of mainstream western thought culture that are identified by the feminist critics. The Indian thought pattern is theorised in the domain of Indian logic, which is a study of inference patterns. As, in the Indian context, the inference is considered as a source of knowledge, certain epistemological questions are linked with the discussion of inference. One of the key epistemological issues is one regarding justification. The study about the nature of derivation of knowledge from available evidence, and the nature of the evidence itself, are integral parts of the discipline called Indian logic. But if we contrast the western tradition of thought with the Indian one, we can find that the Indian logic has got some peculiar features which may be shown to deal with the problems identified by the feminist scholars in western thought culture more plausibly. The tradition of western logic, starting from Aristotle, has been maintaining sharp differences between two forms of reasoning, namely, deductive and inductive. These two different forms of reasoning have been theorised and dealt with separately within the domain of the study called ‘logic.’ There are various philosophical problems that are raised around concepts and issues regarding both deductive and inductive reasoning. Indian logic does not distinguish between deduction and induction as thought patterns, but their distinction is very usual to make in the western tradition. Though there can be found various interpretations about this peculiarity of Indian thought pattern, these mixed patterns were actually very close to the cross-cultural pattern in which human beings would tend to argue or infer from the available data or evidence. The feminist theories can successfully operate in the domain of lived experience if they make use of such a mixed pattern of reasoning or inference. By offering sound inferential knowledge on contextual evidences, the Indian thought pattern is potent to serve the feminist purposes in a meaningful way.

Keywords: feminist thought, Indian logic, inference, justification, mixed thought pattern

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Authors: Liaquat Ali, Khurshid Natasha

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Low resource countries are not usually equipped with the organizational tools to implement health care for chronic diseases, and thus, providing effective diabetes care in such countries is a challenging task. Diabetic Association of Bangladesh (BADAS in Bengali acronym) has created a stimulating example to meet this challenge. Starting its journey in 1956 with 39 patients in a small tin shed clinic BADAS, and its affiliated associations now operate 90 hospitals and health centres all over the country. Together, these facilities provide integrated health care to about 1.5 million registered diabetic patients which constitute about 20% of the estimated diabetic population in the country. BADAS has also become a pioneer in health manpower generation in Bangladesh. Along with its affiliates, it now runs 3 Medical Colleges (to generate graduate physicians), 2 Nursing Institutes, and 2 Postgraduate Institutes which conduct 25 postgraduate courses (under the University of Dhaka) in various basic, clinical and public health disciplines. BADAS gives great emphasis on research, which encompasses basic, clinical as well as public health areas. BADAS is an ideal example of public-private partnership in health as most of its infrastructure has been created through government support but it is almost self-reliant in managing its revenue budget which approached approximately 40 million US dollar during 2010. BADAS raises resources by providing high-quality services to the people, both diabetic and non-diabetic. At the same time, BADAS has developed a cross financing model, to support diabetic patients in general and poor diabetic patients (identified through a social welfare network) in particular, through redistribution of the resources. Along with financial sustainability BADAS ensure organizational sustainability through a process of decentralization, community ownership, and democratic management. Presently a large scale pilot project (named as a Health Care Development Project or HCDP) is under implementation under BADAS umbrella with an objective to transform the diabetes care model to a health care model in general. It is expected to create further evidence on providing sustainable (with social safety net) health care delivery for diabetes, and other chronic illnesses as an integral part of general health care delivery in a resource constrained setting.

Keywords: Bangladesh, self sustain, health care, constrain

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Authors: Ivan M. Taremwa, Scholastic Ashaba, Harriet O. Adrama, Carlrona Ayebazibwe, Daniel Omoding, Imelda Kemeza, Jane Yatuha, Thadeus Turuho, Noni E. MacDonald, Robert Hilliard

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Background: The burden of malaria in Uganda remains unacceptably high, especially among children and pregnant women. To prevent malaria related complications, household possession and use of Insecticide Treated mosquito Nets (ITNs) has become a common practice in the country. Despite the availability of ITNs, the number of malaria cases has not gone down. We sought to explore knowledge, attitude, and behaviour towards the use of ITNs as a nightly malaria prevention strategy among pregnant women and children under five years of age in rural southwest Uganda. Materials and Methods: This was a community based, descriptive cross-sectional study, in which households with children under 5 years, and/or pregnant women were enrolled. We used a structured questionnaire to collect data on participants’ understanding of the causes, signs and symptoms of malaria; use of ITNs to prevent malaria; attitudes and behaviours towards the use of ITNs. We also conducted key informant interviews (KIIs) to get in-depth understanding of responses from the participants. We analysed quantitative data using STATA version 12. Qualitative findings from the KIIs were transcribed and translated, and manually analysed using thematic content analysis. Results: Of the 369 households enrolled, 98.6% (N=363) households had children under five. Most participants (41.2%, N=152) were in the 21-30 years of age category (mean age; 32.2). 98.6% (N=362) of the respondents considered ITNs a key malaria prevention strategy. The ITN possession rate was 84.0% (N=310), of these, 67.0% (N=205) consistently used them. 39% of the respondents did not have a positive attitude towards ITNs, as they considered more the perceived effects of ITNs. Conclusions: Although 84.0% of the respondents possessed ITNs, many were not consistently using them. There is need to engage all stakeholders (including cultural leaders, community health workers, religious leaders and the government) in the malaria prevention campaigns using ITNs through: a) government’s concerted effort to ensure universal access of good quality ITNs, b) end-user directed education to correct false beliefs and misinformation, c) telling the ITN success stories to improve on the usage.

Keywords: ITNs use, malaria, pregnant women, rural Uganda

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Authors: Yung-Chih Kuo, Yung-I Lou

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Cationic solid lipid nanoparticles (CSLNs) with anti-melanotransferrin (AMT) and apolipoprotein E (ApoE) were used to carry antimitotic doxorubicin (Dox) across the blood–brain barrier (BBB) for glioblastoma multiforme (GBM) treatment. Dox-loaded CSLNs were prepared in microemulsion, grafted covalently with AMT and ApoE, and applied to human brain microvascular endothelial cells (HBMECs), human astrocytes, and U87MG cells. Experimental results revealed that an increase in the weight percentage of stearyl amine (SA) from 0% to 20% increased the size of AMT-ApoE-Dox-CSLNs. In addition, an increase in the stirring rate from 150 rpm to 450 rpm decreased the size of AMT-ApoE-Dox-CSLNs. An increase in the weight percentage of SA from 0% to 20% enhanced the zeta potential of AMT-ApoE-Dox-CSLNs. Moreover, an increase in the stirring rate from 150 rpm to 450 rpm reduced the zeta potential of AMT-ApoE-Dox-CSLNs. AMT-ApoE-Dox-CSLNs exhibited a spheroid-like geometry, a minor irregular boundary deviating from spheroid, and a somewhat distorted surface with a few zigzags and sharp angles. The encapsulation efficiency of Dox in CSLNs decreased with increasing weight percentage of Dox and the order in the encapsulation efficiency of Dox was 10% SA > 20% SA > 0% SA. However, the reverse order was true for the release rate of Dox, suggesting that AMT-ApoE-Dox-CSLNs containing 10% SA had better-sustained release characteristics. An increase in the concentration of AMT from 2.5 to 7.5 μg/mL slightly decreased the grafting efficiency of AMT and an increase in that from 7.5 to 10 μg/mL significantly decreased the grafting efficiency. Furthermore, an increase in the concentration of ApoE from 2.5 to 5 μg/mL slightly reduced the grafting efficiency of ApoE and an increase in that from 5 to 10 μg/mL significantly reduced the grafting efficiency. Also, AMT-ApoE-Dox-CSLNs at 10 μg/mL of ApoE could slightly reduce the transendothelial electrical resistance (TEER) and increase the permeability of propidium iodide (PI). An incorporation of 10 μg/mL of ApoE could reduce the TEER and increase the permeability of PI. AMT-ApoE-Dox-CSLNs at 10 μg/mL of AMT and 5-10 μg/mL of ApoE could significantly enhance the permeability of Dox across the BBB. AMT-ApoE-Dox-CSLNs did not induce serious cytotoxicity to HBMECs. The viability of HBMECs was in the following order: AMT-ApoE-Dox-CSLNs = AMT-Dox-CSLNs = Dox-CSLNs > Dox. The order in the efficacy of inhibiting U87MG cells was AMT-ApoE-Dox-CSLNs > AMT-Dox-CSLNs > Dox-CSLNs > Dox. A surface modification of AMT and ApoE could promote the delivery of AMT-ApoE-Dox-CSLNs to cross the BBB via melanotransferrin and low density lipoprotein receptor. Thus, AMT-ApoE-Dox-CSLNs have appropriate physicochemical properties and can be a potential colloidal delivery system for brain tumor chemotherapy.

Keywords: anti-melanotransferrin, apolipoprotein E, cationic catanionic solid lipid nanoparticle, doxorubicin, U87MG cells

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Authors: Moshe Mello, Hilary Rutto, Tumisang Seodigeng

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The nature of tires makes them extremely challenging to recycle due to the available chemically cross-linked polymer and, therefore, they are neither fusible nor soluble and, consequently, cannot be remolded into other shapes without serious degradation. Open dumping of tires pollutes the soil, contaminates underground water and provides ideal breeding grounds for disease carrying vermins. The thermal decomposition of tires by pyrolysis produce char, gases and oil. The composition of oils derived from waste tires has common properties to commercial diesel fuel. The problem associated with the light oil derived from pyrolysis of waste tires is that it has a high sulfur content (> 1.0 wt.%) and therefore emits harmful sulfur oxide (SOx) gases to the atmosphere when combusted in diesel engines. Desulphurization of TPO is necessary due to the increasing stringent environmental regulations worldwide. Hydrodesulphurization (HDS) is the commonly practiced technique for the removal of sulfur species in liquid hydrocarbons. However, the HDS technique fails in the presence of complex sulfur species such as Dibenzothiopene (DBT) present in TPO. This study aims to investigate the viability of photodegradation (Photocatalytic oxidative desulphurization) and adsorptive desulphurization technologies for efficient removal of complex and non-complex sulfur species in TPO. This study focuses on optimizing the cleaning (removal of impurities and asphaltenes) process by varying process parameters; temperature, stirring speed, acid/oil ratio and time. The treated TPO will then be sent for vacuum distillation to attain the desired diesel like fuel. The effect of temperature, pressure and time will be determined for vacuum distillation of both raw TPO and the acid treated oil for comparison purposes. Polycyclic sulfides present in the distilled (diesel like) light oil will be oxidized dominantly to the corresponding sulfoxides and sulfone via a photo-catalyzed system using TiO2 as a catalyst and hydrogen peroxide as an oxidizing agent and finally acetonitrile will be used as an extraction solvent. Adsorptive desulphurization will be used to adsorb traces of sulfurous compounds which remained during photocatalytic desulphurization step. This desulphurization convoy is expected to give high desulphurization efficiency with reasonable oil recovery.

Keywords: adsorption, asphaltenes, photocatalytic oxidation, pyrolysis

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Authors: Samson Viulu, Hugo Hebala, Duddley Kopu

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Constituency Development Fund (CDF) is a controversial fund that has existed in the Solomon Islands since the early 90s to date. It is largely controversial because it is directly handled by members of parliament (MPs) of the Solomon Islands legislation chamber. It is commonly described as a political slash fund because only voters of MPs benefit from it to retain loyalty. The CDF was established by a legislative act in 2013; however, it does not have any subsidiary regulations to it, therefore, very weak governance. CDF is purposely to establish development projects in the rural areas of the Solomon Islands to spur economic growth. Although almost USD500M was spent in CDF in the last decade, there has been no growth in the economy of the Solomon Islands; rather, a regress. Solomon Islands has now formulated a first home-grown policy aimed at guiding the overall development of the fifty constituencies, improving delivery mechanisms of the CDF, and strengthening its governance through the regulation of the CDF Act 2013. The Solomon Islands Constituency Development Policy is the first for the country since gaining independence in 1978 and gives strong emphasis on a cross-sectoral approach through effective partnerships and collaborations and decentralizing government services to the isolated rural areas of the country. The new policy is driving the efforts of the political government to decentralize government services to isolated rural communities to encourage the participation of rural dwellers in economic activities. The decentralization will see the establishment of constituency offices within all constituencies and the piloting of townships in constituencies that have met the statutory requirements of the state. It also encourages constituencies to become development agents of the national government than being mere political boundaries. The decentralization will go in line with the establishment of the Solomon Islands Special Economic Zones (SEZ), where investors will be given special privileges and exemptions from government taxes and permits to attract tangible development to occur in rural constituencies. The design and formulation of the new development policy are supported by the UNDP office in the Solomon Islands. The new policy is promoting a reorientation on the allocation of resources more toward the productive and resource sectors, making access to finance easier for entrepreneurs and encouraging growth in rural entrepreneurship in the fields of agriculture, fisheries, down streaming, and tourism across the Solomon Islands. This new policy approach will greatly assist the country to graduate from the least developed countries status in a few years’ time.

Keywords: decentralization, constituency development fund, Solomon Islands constituency development policy, partnership, entrepreneurship

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Authors: Shannon Glaspy, Gerald Boon, Jack Lambert

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Studies on AE of highly active antiretroviral therapy (HAART) in children and adolescents are rare. The aim of this study is to observe the frequency of treatment limiting adverse drug reactions against years on ARVs and specific ARV regimen. Methods: A retrospective cohort study was conducted in East London, South Africa. All patient files in the pediatric (0 – 18 years) ARV cohort were examined, selecting only those patients started on HAART. ARV regimen changes explicitly due to AE, age on ARV treatment onset, age of AE onset, and gender were extrapolated. Eligible subjects were obtained from patient folders, anonymized and cross-referenced with data obtained from electronic records. A total of 1120 patients [592 male (52.9%) and 528 female (47.1%)] were charted by incidence and year. Additional information was extrapolated in cases where the patient experienced lipodystrophy and lipoatrophy to include the number of years on ARVs prior to the onset of the AE. Results: Of the 1120 HIV infected children of the hospital cohort, a total of 105 (9.37%) AE (53.3% male) observed were deemed eligible for the study due to completeness of medical history and agreement between electronic records and paper files. The AE cited were as follows: lipoatrophy 62 (5.53% of all subjects), lipodystrophy 27 (2.41%), neuropathy 9 (0.8%), anemia 2 (0.17%), Steven Johnsons Syndrome 1 (0.08%), elevated LFTs 1 (0.8%), breast hypertrophy (0.08%), gastritis 1 (0.08%) and rash 1 (0.08%). The most prevalence ARV regimens associated with the onset of the AE are: D4T/3TC/EFV 72 cases (64.86% of all AE), D4T/3TC/LOPr 24 cases (21.62%). Lipoatrophy and lipodystrophy combined represent 84.76% (89 cases) of all adverse events documented in this cohort. Within the 60 cases of lipoatrophy, the average number of years on ARVs associated with an AE is 3.54, with 14 cases experiencing an AE between 0-2 years of HAART. Within the 29 cases of lipodystrophy, the average number of years on ARVs associated with an AE is 3.89, with 4 cases experiencing an AE between 0-2 years on HAART. The regimen D4T/3TC/EFV is associated with 43 cases (71.66%) of lipoatrophy and 21 cases (72.41%) of lipodystrophy. D4T/3TC/LOPr is associated with 15 cases (25%) of lipoatrophy and 7 cases (24.14%) of lipodystrophy. The frequency of AE associated with ARV regimens could be misrepresented due to prevalence of different 1st line regimens which were not captured in this study, particularly with the systematic change of 1st line drugs from D4T to ABC in 2010. Conclusion: In this descriptive study we found a 9.37% prevalence of AE were significant enough to be treatment limiting among our cohort. Lipoatrophy accounted for 59.04% of all documented AE. Overall, D4T/3TC/EFV was associated with 64.86% of all AE, 71.66% of lipoatrophy cases and 72.41% of lipodystrophy cases.

Keywords: ARV, adverse events, HAART, pediatric

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Authors: Zbigniew Czyż, Adam Majczak, Lukasz Grabowski

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The paper presents a description of geometric models, computational algorithms, and results of numerical analyses of charge exchange in a two-stroke opposed-piston engine. The research engine was a newly designed internal Diesel engine. The unit is characterized by three cylinders in which three pairs of opposed-pistons operate. The engine will generate a power output equal to 100 kW at a crankshaft rotation speed of 3800-4000 rpm. The numerical investigations were carried out using ANSYS FLUENT solver. Numerical research, in contrast to experimental research, allows us to validate project assumptions and avoid costly prototype preparation for experimental tests. This makes it possible to optimize the geometrical model in countless variants with no production costs. The geometrical model includes an intake manifold, a cylinder, and an outlet manifold. The study was conducted for a series of modifications of manifolds and intake and exhaust ports to optimize the charge exchange process in the engine. The calculations specified a swirl coefficient obtained under stationary conditions for a full opening of intake and exhaust ports as well as a CA value of 280° for all cylinders. In addition, mass flow rates were identified separately in all of the intake and exhaust ports to achieve the best possible uniformity of flow in the individual cylinders. For the models under consideration, velocity, pressure and streamline contours were generated in important cross sections. The developed models are designed primarily to minimize the flow drag through the intake and exhaust ports while the mass flow rate increases. Firstly, in order to calculate the swirl ratio [-], tangential velocity v [m/s] and then angular velocity ω [rad / s] with respect to the charge as the mean of each element were calculated. The paper contains comparative analyses of all the intake and exhaust manifolds of the designed engine. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK "PZL-KALISZ" S.A." and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: computational fluid dynamics, engine swirl, fluid mechanics, mass flow rates, numerical analysis, opposed-piston engine

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Authors: D. Densenbal, Ts. Naidansuren, M. Oyunchimeg, Ts. Manaljav, D. Udval, L. Khosbayar, Kh. Solongo, D. Ichinnorov, B. Solongo

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Background: The rapid economic growth and to the common use of smoky fuel such as coal in the small traditional houses (Ger) in Mongolia is worsening its air pollution problem. In addition, the smoking rate is considered to be high. Despite these conditions, few prevalence studies of COPD epidemiology and diagnose have been performed in Mongolia. The spirometric test is a widely used diagnose for COPD. Aims: Healthy and over the 40 aged adults were evaluated of Pulmonary function test in Ulaanbaatar. Methods: Healthy, over the 40 aged residences were admitted for this study from II sub-district, in Khan-Uul district of Ulaanbaatar city. In this cross-sectional study. Health information was collected 184 subjects between 01-03 July in 2013; spirometry device was named Hichest–105 Japan that was employed for this study. Studies were using the acceptability standards outlined, and data were compared with personal reference data generated on Asian subjects which were performed abnormally to evaluated by global initiative obstructive lung decreases (GOLD). Data were analyzed using SPSS 20 software. Results: A total of 134 subjects (age 52.9±9.8, man 32.8%) were performed PFT which were interpreted normal 73.9% (sum of man 65.0% and woman 79.4% ), abnormal 26.1% which were typed obstruction 17.2% (23), restriction 6% (8), mixed 3% (4). Airflow obstruction were determined in all man 25% (11), woman 13.3% (12) which were classified mild 43.4% (man 54.5%, woman 33.3%), moderate 52.2% (36.3% vs. 66.7%) and severe 4.3% man 1 GOLD degree. Undetermined a very severe obstruction. Normal PFT subjects were compared a group of gender and age group which man was significantly higher than the women (p<0.05). Age group of PFT decrease was no difference in gender (p>0.05) also no difference in BMI (p>0.05). Normal PFT subjects were compared with predicted values were used to Asian population which was significantly lower than FEV1 (0.15±0.36 l), PEF (1.92±1.31 l) and same deference occurred man (FEV1 0.19±0.42 l, PEF 2.04±1.64), women (0.14±0.33 l vs. 1.86±1.15 l). The decrease of FEV1 was defined in over the 60 age group higher than other age groups. Conclusion: Not only observed an air flow limitation prevalence dominance in all case but also COPD prevalence diagnosed man were higher than women. Normal PFT subjects were compared with predicted values were used to Asian population which was significant air flow limitation started early.

Keywords: PFT, obstruction, FEV1, COPD

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Authors: Yasser Sanad, Thu Trang Dao

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Introduction: Implementing the One Health (OH) approach requires an integrated, interdisciplinary, and cross-sectoral methodology. OH is a key tool for developing and implementing programs and projects and includes developing ambitious policies that consider the common needs and benefits of human, animal, plant, and ecosystem health. OH helps humanity readjust its path to environmentally friendly and impartial sustainability. As co-leader of the Global Health Security Agenda’s Zoonotic Disease Action Package, Vietnam pioneered a strong OH approach to effectively address early waves of the COVID-19 outbreak in-country. Context and Aim: The repeated surges in COVID-19 in Vietnam challenged the capabilities of the national system and disclosed the gaps in multi-sectoral coordination and resilience. To address this, FHI 360 advocated for the standardization of the OH platform by government actors to increase the resiliency of the system during and post COVID-19. Methods: FHI 360 coordinated technical resources to develop and implement evidence-based OH policies, promoting high-level policy dialogue between the Ministries of Health, Agriculture, and the Environment, and policy research to inform developed policies and frameworks. Through discussions, an OH-building Partnership (OHP) was formed, linking climate change, the environment, and human and animal health. Findings: The OHP Framework created a favorable policy environment within and between sectors, as well as between governments and international health security partners. It also promoted strategic dialogue, resource mobilization, policy advocacy, and integration of international systems with National Steering Committees to ensure accountability and emphasize national ownership. Innovative contribution to policy, practice and/or research: OHP was an effective evidence-based research-to-policy platform linking to the National One Health Strategic Plan (2021-2025). Collectively they serve as a national framework for the implementation and monitoring of OH activities. Through the adoption of policies and plans, the risk of zoonotic pathogens, environmental agent spillover, and antimicrobial resistance can be minimized through strengthening multi-sectoral OH collaboration for health security.

Keywords: one health, national policies, health security, COVID-19, Vietnam

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Authors: C. Scurr, J. Jeans, S. Srivastava

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Introduction: Acute type two respiratory failure (T2RF) has become a common presentation over the last two decades primarily due to an increase in the prevalence of chronic lung disease. Acute exacerbations can be managed either medically or in combination with non-invasive ventilation (NIV) which should be monitored with regular arterial blood gas samples (ABG). Arterial lines allow more frequent arterial blood sampling with less patient discomfort. We present the experience from a teaching hospital emergency department (ED) and level 2 medical high-dependency unit (HDU) that together form the pathway for management of acute type 2 respiratory failure. Methods: Patients acutely presenting to Charing Cross Hospital, London, with T2RF requiring non-invasive ventilation (NIV) over 14 months (2011 to 2012) were identified from clinical coding. Retrospective data collection included: demographics, co-morbidities, blood gas numbers and timing, if arterial lines were used and who performed this. Analysis was undertaken using Microsoft Excel. Results: Coding identified 107 possible patients. 69 notes were available, of which 41 required NIV for type 2 respiratory failure. 53.6% of patients had an arterial line inserted. Patients with arterial lines had 22.4 ABG in total on average compared to 8.2 for those without. These patients had a similar average time to normalizing pH of (23.7 with arterial line vs 25.6 hours without), and no statistically significant difference in mortality. Arterial lines were inserted by Foundation year doctors, Core trainees, Medical registrars as well as the ICU registrar. 63% of these were performed by the medical registrar rather than ICU, ED or a junior doctor. This is reflected in that the average time until an arterial line was inserted was 462 minutes. The average number of ABGs taken before an arterial line was 2 with a range of 0 – 6. The average number of gases taken if no arterial line was ever used was 7.79 (range of 2-34) – on average 4 times as many arterial punctures for each patient. Discussion: Arterial line use was associated with more frequent arterial blood sampling during each inpatient admission. Additionally, patients with an arterial line have less individual arterial punctures in total and this is likely more comfortable for the patient. Arterial lines are normally sited by medical registrars, however this is normally after some delay. ED clinicians could improve patient comfort and monitoring thus allowing faster titration of NIV if arteral lines were regularly inserted in the ED. We recommend that ED doctors insert arterial lines when indicated in order improve the patient experience and facilitate medical management.

Keywords: non invasive ventilation, arterial blood gas, acute type, arterial line

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Authors: Naziema B. Jappie

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Over the last 23 years leaders in government, political parties and universities have been spending much time on identifying and discussing various gaps in the system that impact systematically on students especially those from historically Black communities. Equity and access to higher education were two critical aspects that featured in achieving the transformation goals together with a funding model for those previously disadvantaged. Free education was not a feasible option for the government. Institutional leaders in higher education face many demands on their time and resources. Often, the time for crisis management planning or consideration of being proactive and preventative is not a standing agenda item. With many issues being priority in academia, people become complacent and think that crisis may not affect them or they will cross the bridge when they get to it. Historically South Africa has proven to be a country of militancy, strikes and protests in most industries, some leading to disastrous outcomes. Higher education was not different between October 2015 and late 2016 when the #Rhodes Must Fall which morphed into the # Fees Must Fall protest challenged the establishment, changed the social fabric of universities, bringing the sector to a standstill. Some institutional leaders and administrators were better at handling unexpected, high-consequence situations than others. At most crisis leadership is viewed as a situation more than a style of leadership which is usually characterized by crisis management. The objective of this paper is to show how institutions managed catastrophes of disastrous proportions, down through unexpected incidents of 2015/2016. The content draws on the vast past crisis management experience of the presenter and includes the occurrences of the recent protests giving an event timeline. Using responses from interviews with institutional leaders and administrators as well as students will ensure first-hand information on their experiences and the outcomes. Students have tasted the power of organized action and they demand immediate change, if not the revolt will continue. This paper will examine the approaches that guided institutional leaders and their crisis teams and sector crisis response. It will further expand on whether the solutions effectively changed governance in higher education or has it minimized the need for more protests. The conclusion will give an insight into the future of higher education in South Africa from a leadership perspective.

Keywords: crisis, governance, intervention, leadership, strategies, protests

Procedia PDF Downloads 127

Authors: J. J. Lee, S. R. Sung, E. J. Yum, S. C. Kim, B. H. Hyun, M. Her, H. S. Lee

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Canine brucellosis is a critical problem in dogs leading to reproductive diseases which are mainly caused by Brucella canis. There are, nonetheless, not clear symptoms so that it may go unnoticed in most of the cases. Serodiagnosis for canine brucellosis has not been confirmed. Moreover, it has substantial difficulties due to broad cross-reactivity between the rough cell wall antigens of B. canis and heterospecific antibodies present in normal, uninfected dogs. Thus, this study was conducted to characterize the immunogenic proteins in cytoplasmic antigen (CPAg) of B. canis, which defined the antigenic sensitivity of the humoral antibody responses to B. canis-infected dogs. In analysis of B. canis CPAg, first, we extracted and purified the cytoplasmic proteins from cultured B. canis by hot-saline inactivation, ultrafiltration, sonication, and ultracentrifugation step by step according to the sonicated antigen extract method. For characterization of this antigen, we checked the sort and range of each protein on SDS-PAGE and verified the immunogenic proteins leading to reaction with antisera of B. canis-infected dogs. Selected immunodominant proteins were identified using MALDI-MS/MS. As a result, in an immunoproteomic assay, several polypeptides in CPAg on one or two-dimensional electrophoresis (DE) were specifically reacted to antisera from B. canis-infected dogs but not from non-infected dogs. The polypeptides with approximate 150, 80, 60, 52, 33, 26, 17, 15, 13, 11 kDa on 1-DE were dominantly recognized by antisera from B. canis-infected dogs. In the immunoblot profiles on 2-DE, ten immunodominant proteins in CPAg were detected with antisera of infected dogs between pI 3.5-6.5 at approximate 35 to 10 KDa, without any nonspecific reaction with sera in non-infected dogs. Ten immunodominant proteins identified by MALDI-MS/MS were identified as superoxide dismutase, bacteroferritin, amino acid ABC transporter substrate-binding protein, extracellular solute-binding protein family3, transaldolase, 26kDa periplasmic immunogenic protein, Rhizopine-binding protein, enoyl-CoA hydratase, arginase and type1 glyceraldehyde-3-phosphate dehydrogenase. Most of these proteins were determined by their cytoplasmic or periplasmic localization with metabolism and transporter functions. Consequently, this study discovered and identified the prominent immunogenic proteins in B. canis CPAg, highlighting that those antigenic proteins may accomplish a specific serodiagnosis for canine brucellosis. Furthermore, we will evaluate those immunodominant proteins for applying to the advanced diagnostic methods with high specificity and accuracy.

Keywords: Brucella canis, Canine brucellosis, cytoplasmic antigen, immunogenic proteins

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Authors: Mohammad Mahbub Alam Talukder, Shahnewaz, Hasanat-E-Rabbi, Mohammed Nazrul Islam

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Road traffic accident is a global problem which is severe in the developing countries like Bangladesh. In consequence, in developing countries road trauma has now been recognized as an increasing public health hazards and economic burning issue. And after road traffic accidents the lack of management and economic costs related with health seeking behavior have a disproportionate impact on lower income groups, thus contributing to the persistence of poverty in conjunction with disability. This cross sectional study, carried out during July 2012 to June 2013, aimed to explore health seeking decision and culture of handling the road traffic accident related victims, as taken from experiences of the poor disabled people of slum dwellers of Dhaka city. The present study has been designed based on qualitative techniques such as in-depth interview and case studies. Additionally, a survey questionnaire was used to collect the demographic characteristics of the study population (n=150) and to select participants purposely for in-depth interview (n=50) and case study (n=30). Content analysis of qualitative data was done through theme coding and matrix analysis of case study was done to use relevant verbatim. Most of the time the health seeking decision totally depended on the surrounded people of the accidental place, their knowledge, awareness and remaining facility and capacity regarding proper management of the victims. However, most of the cases the victims did not get any early treatment and it took 2-12 hours to get even the first aid because of distance, shortage of money, lack of availability of getting the aid, lack of mass awareness etc. Under the reality of discriminated and unaffordable health service provision better treatment could not turn out due to economic inability of the poor victims. To avoid the severe trauma, treatment delay must be reduced by providing first aid within very short time and to do so, mass awareness campaign is necessary for handing the victims. Moreover, necessary measures should be taken to ensure cost free health service provision to treat the chronic disabled condition of the road traffic accident related poor victims.

Keywords: accident, injury, disabled, qualitative, slum

Procedia PDF Downloads 337

Authors: Ke Wang, Zhu Wang

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Coordinating and promoting urban and rural development has been a new round of institutional change in Zhejiang province since 2004. And this plan was fully implemented, which showed that the isolation between the urban and rural areas had gradually diminished. Little by little, an infiltration interface that is dynamic, flexible and interactive is formed, and this morphological structure starts to appear on the landscape form in the surrounding villages. In order to study the specific function and formation of the structure in the context of industrial revolution, Bimen village located on the interface between Anji Township, Huzhou and Yuhang District, Hangzhou is taken as the case. Anji township is in the cross area between Yangtze River delta economic circle and innovation center in Hangzhou. Awarded with ‘Chinese beautiful village’, Bimen has witnessed the growing process of infiltration in ecology, economy, technology and culture on the interface. Within the opportunity, Bimen village presents internal reformation to adapt to the energy exchange with urban areas. In the research, the reformation is to adjust the industrial structure, to upgrade the local special bamboo crafts, to release space for activities, and to establish infrastructures on the interface. The characteristic of an interface is elasticity achieved by introducing an Internet platform using ‘O2O’ agriculture method to connect cities and farmlands. There is a platform of this kind in Bimen named ‘Xiao Mei’. ‘Xiao’ in Chinese means small, ‘Mei’ means beautiful, which indicates the method to refine the landscape form. It turns out that the new agriculture mode will strengthen the interface by orienting the Third Party Platform upon the old dynamic basis and will bring new vitality for economy development in Bimen village. The research concludes opportunities and challenges generated by the evolution of the infiltration interface. It also proposes strategies for how to organically adapt to the urbanization process. Finally it demonstrates what will happen by increasing flexibility in the landscape forms of suburbs in the Bimen village.

Keywords: Bimen village, infiltration interface, flexibility, suburban landscape form

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Authors: Melek Göregenli, Işık Gürşimşek

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There has been a great deal of research in the past few decades examining attitudes toward homosexuals.Theoretic research has demonstrated that antihomosexual attitudes are expressed in cognitive, affective, behavioral and cultural components. Homophobia is generally defined as hostility towards or fear of LGBTI people, but can also refer to social and cultural ideologies which stigmatize homosexuality. Negative feelings or attitudes towards non-heterosexual behavior, identity, relationships and community can lead to homophobic behavior and is the root of the discrimination experienced by many lesbian, gay, bisexual and transgender (LGBTI) people. Since the increase in number of hate crimes during the last decade, there has been a sense of urgency to respond to the problem of hate violence in Turkey. The LGBTI Rights Association KAOS-GL indicated that the most of lesbian, gay, bisexual, travesty and transsexuals reported some form of victimization in their lifetimes based on their sexual orientation in Turkey. This study explored the relations between homophobia, right-wing authoritarianism, social dominance orientation and just world belief attitudes towards LGBTI individuals in a sample of 393 Turkish college students from Ege University in Izmir, Turkey. Data were collected with a questionnaire including the Homosexism Scale, the Right-Wing Authoritarianism Scale, Social Dominance Orientation Scale and Just World Belief Scale. Participants completed a questionnaire containing the attitude measures and other several questions related with the socio-demographic variables. Consistent with the previous finding males were more homophobic than females. Contrary to this finding the main effects of other demographic variables (age, income, place of birth, class) were not statistically significant except the department of participants. These findings imply that efforts to garner wide-ranging support for policies designed to change negative attitudes to LGBT people and to enhance the given awareness on homophobia. The results of the study were discussed in cross-cultural and social psychological perspective considering cultural and social values of Turkey and current political circumstances of the country.

Keywords: homophobia, just world belief, right-wing authoritarianism, social dominance orientation, Turkey

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Authors: Susan Ka Yee Chow

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Effective clinical preceptorship is affecting students’ competence and fostering their growth in applying theoretical knowledge and skills in clinical settings. Any difference between the expected and actual learning experience will reduce nursing students’ interest in clinical practices and having a negative consequence with their clinical performance. This cross-sectional study is an attempt to compare the differences between preferred and actual preceptorship experience of final year nursing students, and to examine the relationship between the actual preceptorship experience and perceived clinical competence of the students in a tertiary institution. Participants of the study were final year bachelor nursing students of a self-financing tertiary institution in Hong Kong. The instruments used to measure the effectiveness of clinical preceptorship was developed by the participating institution. The scale consisted of five items in a 5-point likert scale. The questions including goals development, critical thinking, learning objectives, asking questions and providing feedback to students. The “Clinical Competence Questionnaire” by Liou & Cheng (2014) was used to examine students’ perceived clinical competences. The scale consisted of 47 items categorized into four domains, namely nursing professional behaviours; skill competence: general performance; skill competence: core nursing skills and skill competence: advanced nursing skills. There were 193 questionnaires returned with a response rate of 89%. The paired t-test was used to compare the differences between preferred and actual preceptorship experiences of students. The results showed significant differences (p<0.001) for the five questions. The mean for the preferred scores is higher than the actual scores resulting statistically significance. The maximum mean difference was accepted goal and the highest mean different was giving feedback. The Pearson Correlation Coefficient was used to examine the relationship. The results showed moderate correlations between nursing professional behaviours with asking questions and providing feedback. Providing useful feedback to students is having moderate correlations with all domains of the Clinical Competence Questionnaire (r=0.269 – 0.345). It is concluded that nursing students do not have a positive perception of the clinical preceptorship. Their perceptions are significantly different from their expected preceptorship. If students were given more opportunities to ask questions in a pedagogical atmosphere, their perceived clinical competence and learning outcomes could be improved as a result.

Keywords: clinical preceptor, clinical competence, clinical practicum, nursing students

Procedia PDF Downloads 107

Authors: Mulugeta Shegaze, Mekitie Wondafrash, Alemayehu A. Alemayehu, Shikur Mohammed, Zewdu Shewangezaw, Mukerem Abdo, Gebresilasea Gendisha

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Background: The 2004 World Health Assembly called for specific actions to halt the overweight and obesity epidemic that is currently penetrating urban populations in the developing world. Adolescents require particular attention due to their vulnerability to develop obesity and the fact that adolescent weight tracks strongly into adulthood. However, there is scarcity of information on the modifiable risk factors to be targeted for primary intervention among urban adolescents in Ethiopia. This study was aimed at determining the magnitude and risk factors of overweight and obesity among high school adolescents in Addis Ababa. Methods: An institution-based cross-sectional study was conducted in February and March 2014 on 456 randomly selected adolescents from 20 high schools in Addis Ababa city.  Demographic data and other risk factors of overweight and obesity were collected using self-administered structured questionnaire, whereas anthropometric measurements of weight and height were taken using calibrated equipment and standardized techniques. The WHO STEPS instrument for chronic disease risk was applied to assess dietary habit and physical activity. Overweight and obesity status was determined based on BMI-for-age percentiles of WHO 2007 reference population. Results: The prevalence rates of overweight, obesity, and overall overweight/ obesity among high school adolescents in Addis Ababa were 9.7% (95%CI = 6.9-12.4%), 4.2% (95%CI = 2.3-6.0%), and 13.9% (95%CI = 10.6-17.1%), respectively. Overweight/obesity prevalence was highest among female adolescents, in private schools, and in the higher wealth category. In multivariable regression model, being female [AOR(95%CI) = 5.4(2.5,12.1)], being from private school [AOR(95%CI) = 3.0(1.4,6.2)], having >3 regular meals [AOR(95%CI) = 4.0(1.3,13.0)], consumption of sweet foods [AOR(95%CI) = 5.0(2.4,10.3)] and spending >3 hours/day sitting [AOR(95%CI) = 3.5(1.7,7.2)] were found to increase overweight/ obesity risk, whereas high Total Physical Activity level [AOR(95%CI) = 0.21(0.08,0.57)] and better nutrition knowledge [AOR(95%CI) = 0.160.07,0.37)] were found protective. Conclusions: More than one in ten of the high school adolescents were affected by overweight/obesity with dietary habit and physical activity are important modifiable risk factors. Well-tailored nutrition education program targeting lifestyle change should be initiated with more emphasis to female adolescents and students in private schools.

Keywords: adolescents, NCDs, overweight, obesity

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Authors: Rana Alkhamra

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Background: Child's earliest experiences with books and stories during the first years of his life are strongly linked with the development of his early language and literacy skills. Interacting in routine learning activities, such as shared book reading, storytelling, and teaching about the letters of the alphabet make a critical foundation for early learning, language growth and emergent literacy. Aim: The current study explores family and preschool early interactive literacy practices in families and preschools (nursery and kindergarten) in Jordan. It highlights the importance of early interactive literacy activities on child language and literacy growth and development. Methods: This is a cross sectional study that surveyed 243 Jordanian families. The survey investigated literacy routine practices, largely shared books reading, at home and at preschool; child speech and language development; and family demographics. Results: Around 92.5% of the families read books and stories to their children, as frequently as 1-2 times weekly or monthly (75%). Only 19.6% read books on daily basis. Many families reported preferring story-telling (97%). Despite that families acknowledged the importance of early literacy activities, on language, reading and writing, cognitive, and academic development, 45% asked for education and training pertaining to specific ways and ideas to help their young children develop language and literacy skills. About 69% of the families reported reading books and stories to their children for 15 minutes a day, while 71.2% indicated having their children watch television for 3 to > 6 hours a day. At preschool, only 52.8% of the teachers were reported to read books and stories. Factors like parent education, monthly income, living inside (33.6%) or outside (66.4%) the capital city of Amman significantly (p < 0.05) affected child early literacy interactive activities whether at home or at preschool. Conclusion: Early language and literacy skills depend largely on the opportunities and experiences provided to children in the home and in preschool environment. Family literacy programs can play an important role in bridging the gap in early literacy experiences for families that need help. Also, speech therapists can work in collaboration with families and educators to ensure that young children have high quality and sufficient opportunities to participate in early literacy activities both at home and in preschool environments.

Keywords: literacy, interactive activities, language, practices, family, preschool, Jordan

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Authors: Baluku Nathan

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Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients and attendants. It is, therefore, important for all EMTs and patients to adhere to them strictly. It is also imperative for administrators to ensure the implementation of the infection control program for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against Infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other Factors influencing Infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, majority16(50%) always used protective gear when doing clinical work,14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. Regarding disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5(15.6%) in yellow buckets and only5(15.6%) in black buckets and 12(37.5%) didn’t respond. However, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17(53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms,15(46.9%) said they had never had quality assurance monitoring events,14(43.8%) said monitoring was continuous while15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: infection prevention, influencing factors, emergency medical technician (EMT), emergency unit

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Authors: Baluku Nathan

Abstract:

Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients, and attendants. It is, therefore important for all emergency medical technicians (EMTs) and patients to strictly adhere to them. It is also imperative for administrators to ensure the implementation of the infection control programme for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other factors influencing infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, the majority 16 (50%) always used protective gear when doing clinical work, 14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. About disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5 (15.6%) in yellow buckets, and only 5(15.6%) in black buckets, and 12(37.5%) didn’t respond, however, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17 (53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms, 15(46.9%) said they have never had quality assurance monitoring events, 14(43.8%) said monitoring was continuous while 15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: emergency medical technician, infection prevention, influencing factors, infection control

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Authors: M. Bassas, J. Grané-Morcillo, J. Segura, J.M. Soldevila

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Mental health prevention is key in a society where, according to the World Health Organization, the fourth leading cause of death worldwide is suicide. Compassion is closely linked to personal growth. It shows once again that therapies based on prevention remain an urgent and social need. In this sense, a growing body of research demonstrates how cultivating a compassionate mind can help alleviate and prevent a variety of psychological problems. In the early 21st century, there has been a boom in third-generation compassion-based therapies, although there is a lack of empirical evidence of their efficacy. This study proposes a psychotherapy method (‘Being Method’), whose central axis revolves around emotional management through the cultivation of compassion. Therefore, the objective of this research was to analyze the effectiveness of this method with regard to the emotional changes experienced when we focus on what we are concerned about through the filter of compassion. The Being Method was born from the influence of Buddhist philosophy and contemporary psychology based mainly on Western rationalist currents. A quantitative cross-sectional study has been carried out in a sample of women between 18 and 53 years old (n=47; Mage=36.02; SDage= 11.86) interested in personal growth in which the following 6 measuring instruments were administered: Peace of mind Scale (PoM), Rosenberg Self-Esteem Scale (RSES), Subjective Happiness Scale (SHS), 2 Sacles of the Compassionate Action and Engagement Scales (CAES), Coping Response Inventory for Adults (CRI-A) and Cognitive-Behavioral Strategies Evaluation Scale (MOLDES). Following an experimental method approach, participants were divided into an experimental and control group. Longitudinal analysis was also carried out through a pre-post program comparison. Pre-post comparison outcomes indicated significant differences (p<.05) between before and after the therapy in the variables Peace of Mind, Self-esteem, Happiness, Self-compassion (A-B), Compassion (A-B), in several mental molds, as well as in several coping strategies. Also, between-groups tests proved significantly higher means obtained in the experimental group. Thus, these outcomes highlighted the effectiveness of the therapy, improving all the analyzed dimensions. The social, clinical and research implications are discussed.

Keywords: being method, compassion, effectiveness, emotional management, intervention program, personal growth therapy

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Authors: Roberto Coppo, Francesca Orso, Daniela Dettori, Elena Quaglino, Lei Nie, Mehran M. Sadeghi, Daniela Taverna

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Malignant melanoma is currently the fifth most common cancer in the white population and it is fatal in its metastatic stage. Several research studies in recent years have provided evidence that cancer initiation and progression are driven by genetic alterations of the tumor and paracrine interactions between tumor and microenvironment. Scattered data show that the Endothelial and Smooth muscle cell-Derived Neuropilin-like molecule (ESDN) controls cell proliferation and movement of stroma and tumor cells. To investigate the role of ESDN in the tumor microenvironment during melanoma progression, murine melanoma cells (B16 or B16-F10) were injected in ESDN knockout mice in order to evaluate how the absence of ESDN in stromal cells could influence melanoma progression. While no effect was found on primary tumor growth, increased cell extravasation and lung metastasis formation was observed in ESDN knockout mice compared to wild type controls. In order to understand how cancer cells cross the endothelial barrier during metastatic dissemination in an ESDN-null microenvironment, structure, and permeability of lung blood vessels were analyzed. Interestingly, ESDN knockout mice showed structurally altered and more permeable vessels compared to wild type animals. Since cell surface molecules mediate the process of tumor cell extravasation, the expression of a panel of extravasation-related ligands and receptors was analyzed. Importantly, modulations of N-cadherin, E-selectin, ICAM-1 and VAP-1 were observed in ESDN knockout endothelial cells, suggesting the presence of a favorable tumor microenvironment which facilitates melanoma cell extravasation and metastasis formation in the absence of ESDN. Furthermore, a potential contribution of immune cells in tumor dissemination was investigated. An increased recruitment of macrophages in the lungs of ESDN knockout mice carrying subcutaneous B16-F10 tumors was found. In conclusion, our data suggest a functional role of ESDN in the tumor microenvironment during melanoma progression and the identification of the mechanisms that regulate tumor cell extravasation could lead to the development of new therapies to reduce metastasis formation.

Keywords: melanoma, tumor microenvironment, extravasation, cell surface molecules

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Authors: Tanvir A. Uddin, Blake Goud

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Emerging trends in FinTech-enabled alternative finance, which includes channels and instruments emerging outside the traditional financial system, heralds unprecedented opportunities to improve financial intermediation and increase access to finance. With widespread criticism of the mainstream Islamic banking and finance sector as either mimicking the conventional system, failing to achieve inclusive growth or both, industry stakeholders are turning to technology to show that finance can be done differently. This paper will outline the critical elements for successful deployment of technology to maximize benefit and minimize potential for harm from introduction of Islamic FinTech and propose recommendations for Islamic financial institutions, FinTech companies, regulators and other stakeholders who are integrating or who are considering introducing FinTech solutions. The paper will present an overview of literature, present relevant case studies and summarize the lessons from interviews conducted with Islamic FinTech founders from around the world. With growing central bank concerns about leveraged loans and ballooning private credit markets globally (estimated at $1.4 trillion), current and future Islamic FinTech operators are at risk of contributing to the problems they aim to solve by operating in a 'shadow banking' system. The paper will show that by systematising a robust theory of change linked to positive outcomes, utilising objective impact frameworks (e.g., the Impact Measurement Project) and instilling a risk management culture that is proactive about potential social harm (e.g., irresponsible lending), FinTech can enable the Islamic finance industry to support positive social impact and minimize harm in support of the maqasid. The adoption of FinTech within the Islamic finance context is still at a nascent stage and the recommendations we provide based on the limited experience to date will help address some of the major cross-cutting issues related to FinTech. Further research will be needed to elucidate in more detail issues relating to individual sectors and countries within the broader global Islamic finance industry.

Keywords: alternative finance, FinTech, Islamic finance, maqasid, theory of change

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Authors: Shujun Xie, Shirong Zhang, Shenglin Ma

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Background: Chronic inflammation might lead to many malignancies, and inadequate resolution could play a crucial role in tumor invasion, progression, and metastases. A randomised, double-blind, placebo-controlled trial shows that IL-1β inhibition with canakinumab could reduce incident lung cancer and lung cancer mortality in patients with atherosclerosis. The process and secretion of proinflammatory cytokine IL-1β are controlled by the inflammasome. Here we showed the correlation of the innate immune system and afatinib, a tyrosine kinase inhibitor targeting epidermal growth factor receptor (EGFR) in non-small cell lung cancer. Methods: Murine Bone marrow derived macrophages (BMDMs), peritoneal macrophages (PMs) and THP-1 were used to check the effect of afatinib on the activation of NLRP3 inflammasome. The assembly of NLRP3 inflammasome was check by co-immunoprecipitation of NLRP3 and apoptosis-associated speck-like protein containing CARD (ASC), disuccinimidyl suberate (DSS)-cross link of ASC. Lipopolysaccharide (LPS)-induced sepsis and Alum-induced peritonitis were conducted to confirm that afatinib could inhibit the activation of NLRP3 in vivo. Peripheral blood mononuclear cells (PBMCs) from non-small cell lung cancer (NSCLC) patients before or after taking afatinib were used to check that afatinib inhibits inflammation in NSCLC therapy. Results: Our data showed that afatinib could inhibit the secretion of IL-1β in a dose-dependent manner in macrophage. Moreover, afatinib could inhibit the maturation of IL-1β and caspase-1 without affecting the precursors of IL-1β and caspase-1. Next, we found that afatinib could block the assembly of NLRP3 inflammasome and the ASC speck by blocking the interaction of the sensor protein NLRP3 and the adaptor protein ASC. We also found that afatinib was able to alleviate the LPS-induced sepsis in vivo. Conclusion: Our study found that afatinib could inhibit the activation of NLRP3 inflammasome in macrophage, providing new evidence that afatinib could target the innate immune system to control chronic inflammation. These investigations will provide significant experimental evidence in afatinib as therapeutic drug for non-small cell lung cancer or other tumors and NLRP3-related diseases and will explore new targets for afatinib.

Keywords: inflammasome, afatinib, inflammation, tyrosine kinase inhibitor

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Authors: Mohammed Asiri, Saleh Alsuwayt, Mohammed Bin Mugren, Abdulmalik Almufarrih, Tariq Alotaibi, Saad Almodameg

Abstract:

Background: End-stage renal disease is a major public health concern with high incidence and mortality rate. Most of ESRD patients are on hemodialysis therapy which is a long-term treatment that disturbs patients’ lifestyle. As a result, he will be susceptible to develop psychiatric disorders like anxiety that may direct him to non-compliance on physician instructions and hemodialysis therapy. Although there are studies conducted on psychiatric issues in hemodialysis patients, but few studies focused on the effect of anxiety disorder and the patient’s compliance. Hence, we are interested in determining the prevalence of anxiety disorder among hemodialysis patients in Saudi Arabia, as well as in defining the correlation between anxiety disorder and compliance on physician instructions and hemodialysis therapy. We hypothesize that our study will show a higher prevalence of anxiety in hemodialysis patients than in general population. Also, we expect the anxiety to have a negative impact on their compliance. Methodology: We used a cross-sectional study design carried out at dialysis unit of four major hospitals in Riyadh, KSA. We interviewed 235 End Stage Renal Disease male and female patients who are on hemodialysis. We divided the patients into two categories according to their compliance. we used modified general questionnaire to get their demographic data, then we used a psychometric response scale called visual analog scale (VAS) to assess patient’s compliance to hemodialysis and physician’s instructions. Also, we used the Arabic validated version of the hospital anxiety and depression scale (HAD scale) used mainly for anxiety assessment. Results: The overall response rate was 54%. Respondents included 147 (62.6%) males and 88 (37.4%) females. The prevalence of anxiety among hemodialysis patients is 13.3%. According to visual analog scale, we found that 189 compliant patients and 45 non-compliant patients. For HAD scale, the mean ± standard deviation of the total score for females was (4.44 ± 4.7) and it’s higher than males which was 2.65 ± 3.08 (P-value= 0.002). The mean ± standard deviation of HAD score in the non-compliant group was (5.88  4.88) and it was higher than the compliant group (2.7  3.32) (P-value= 0.004). Among non-complaint group, 33.3% of anxious patients were males and 66.6% were females. There was a negative correlation between HAD score of anxiety and visual analog scale (R= - 0.285). Conclusion: We conclude that there is a high prevalence of anxiety among patients with End Stage Renal Disease that was higher in females with association of non-compliance to physician’s instructions and hemodialysis therapy.

Keywords: anxiety, end-stage renal disease, renal failure, anxiety disorder

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Authors: Mahnaz Seyedoshohadaee

Abstract:

Background and Aims: Hospitalization of one of the family members in the hospital, especially in the emergency department, causes anxiety and psychological problems in family members and others. The way nurses interact with patients and their companions can play an important role in controlling and managing their anxiety. This study aims to determine the relationship between the anxiety of family members of patients referring to emergency departments and their views on the communication skills of nurses. Materials and Methods: The current research was a descriptive-correlation cross-sectional study on 263 family members of patients referred to the department. The emergency of two selected medical training centers affiliated with Iran University of Medical Sciences was performed. The samples were selected continuously in 2018 based on the inclusion criteria. Information was collected using the Health Communication Questionnaire (HCCQ) and Beck Anxiety Questionnaire (BAI). To analyze the data, Pearson's correlation coefficient, independent t-tests, analysis of variance, and Kruskal-Wallis were used at a significance level of 0.05. The data was analyzed using SPSS version 16 statistical software. Results: The mean score of communication skills of emergency department nurses from the point of view of patients' companions was at a low level (74.36 with a standard deviation of 3.7). 3.75% of patients' companions had anxiety at a mild level. There was no statistically significant correlation between the anxieties of the patient's companions. The anxiety of the patient's companions had a statistically significant relationship with the educational level (P=0.039), economic status (P=0.033), and family relationship with the patient (P=0.001). Also, the average anxiety score in children was significantly higher than that of patients' wives (P=0.008). The triage level of the patient also had a statistically significant relationship with the anxiety of the patient's companions (P>0.001). Conclusion: Most of the family members of the patients referred to the emergency room experienced mild anxiety. Also, from their point of view, the communication skills of emergency nurses were at a weak level. Despite the fact that there was no statistically significant relationship between the patient's family member's anxiety and their opinion about nurses' communication skills in this study, it seems that the weak communication skills of nurses from the patient's family member's point of view need special attention. The results of the present study can provide the necessary grounds for planning to improve the communication skills of nurses and also control the anxiety of patient caregivers through in-service training or other incentive mechanisms.

Keywords: anxiety, family, emergency department, communication skills, nurse

Procedia PDF Downloads 39