Search results for: victim intervention marketing

Authors: Eisa Younes Alblooshi

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Counterterrorism strategies, to be effective and efficient, require a sound understanding of the dynamics, the interlinked organizational elements of the terrorist outfits being combated, with a view to having cognizance of their strong points to be guarded against, as well as the vulnerable zones that can be targeted for optimal results in a timely fashion by counterterrorism agencies. A unique model regarding the organizational imperatives was evolved in this research through likening the terrorist organizations with the traditional commercial ones, with a view to understanding in detail the dynamics of interconnectivity and dependencies, and the related compulsions facing the leaderships of such outfits that provide counterterrorism agencies with opportunities for forging better strategies. It involved assessing the evolving organizational dynamics and imperatives of different types of terrorist organizations, to enable the researcher to construct a prototype model that defines the progression and linkages of the related organizational elements of such organizations. It required detailed analysis of how the various elements are connected, with sequencing identified, as any outfit positions itself with respect to its external environment and internal dynamics. A case study focusing on a transnational radical religious state-sponsored terrorist organization was conducted to validate the research findings and to further strengthen the specific counterterrorism strategies. Six different variants of the business model of terrorist organizations were identified, categorized based on their outreach, mission, and status of any state sponsorship. The variants represent vast majority of the range of terrorist organizations acting locally or globally. The model shows the progression and dynamics of these organizations through various dimensions including mission, leadership, outreach, state sponsorship status, resulting in the organizational structure, state of autonomy, preference divergence in its fold, recruitment core, propagation avenues, down to their capacity to adapt, resulting critically in their own life cycles. A major advantage of the model is the utility of mapping terrorist organizations according to their fits to the sundry identified variants, allowing for flexibility and differences within, enabling the researchers and counterterrorism agencies to observe a neat blueprint of the organization’s footprint, along with highlighting the areas to be evaluated for focused target zone selection and timing of counterterrorism interventions. Special consideration is given to the dimension of financing, keeping in context the latest developments regarding cryptocurrencies, hawala, and global anti-money laundering initiatives. Specific counterterrorism strategies and intervention points have been identified for each of the respective model variants, with a view to efficient and effective deployment of resources.

Keywords: terrorism, counterterrorism, model, strategy

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Authors: Şeyda Kaya

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The aim of this study is to examine the relationship between corporate social responsibility perception and organizational commitment among Turkish cabin crew. At the same time, the social responsibility perception and organizational commitment scores of the participants were compared according to their gender, age, education level, title, and work experience. In the globalizing world, businesses have developed some innovative marketing methods in order to survive and strengthen their place in the market. Nowadays, consumers who are connected to the brand with an emotional bond rather than being just consumers. Corporate Social Responsibility Projects, on the one hand, provide social benefit, on the other hand, increase the brand awareness of businesses by providing credibility in the eyes of consumers. The rapid increase of competition, requires businesses to use their human resources, which is the most important resource to sustain their existence, in the most effective and efficient way. For this reason, the concept of ‘Organizational Commitment’ has become an important research topic for business and academics. Although there are studies in the literature to determine the effect of the perception of corporate social Responsibility on Organizational Commitment in Banking and Finance and Tourism sectors, there are no studies conducted specifically for the Turkish aviation sector to our best knowledge. Personal information form, CSR scale, Importance of CSR scale, Organizational commitment scale were used as data collection tools in the research. CSR Scale created by Türker (2006). was used to find out how employees felt about CSR. Importance of CSR Scale through a subscale of the Perceived Role of Ethics and Social Responsibility (PRESOR) that Etheredge (1999) converted into a two-factor framework, the significance of social responsibility for employees was assessed. Organizational Commitment Scale, Mowday, Steers, and Porter (1979) created the OCQ, which uses 15 measures to evaluate global commitment to the organization. As a result of the study, there is a significant positive relationship between the participants' CSR scale sub-dimensions, CSR to Employees, CSR to Customers, CSR to Society, CSR to Government, CSR to Natural Environment, CSR to Next Generation, CSR to Governmental Organizations, Importance of CSR, and Organizational Commitment scores. As a result; as the participants' Corporate Social Responsibility scores increase, their organizational commitment increases. To summarize the findings of our study, the scores obtained from the CSR scale and the scores obtained from the Organizational Commitment scale were found to have a positive and significant relationship. In other words, if the participants value the corporate social responsibility projects of the institution they work for and think that they spare time and effort, the importance they attach to the corporate social responsibility projects and their organizational commitment to the institution they work for, increase. Similarly, the scores obtained from the Importance of CSR and the scores obtained from the Organizational Commitment scale also have a positive and significant relationship. As the importance given to corporate social responsibility projects by the participants increases, their organizational commitment to the institution they work for also increases.

Keywords: corporate social responsibility, organizational commitment, Turkish cabin crew, aviation

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Authors: Abdulwakeel B. Raji

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This paper introduces a concept of an intelligent virtual learning environment that involves communication between learners and an artificially intelligent teaching agent in an attempt to replicate classroom learning interactions. The benefits of this technology over current e-learning practices is that it creates a virtual classroom where real time adaptive learning interactions are made possible. This is a move away from the static learning practices currently being adopted by e-learning systems. Over the years, artificial intelligence has been applied to various fields, including and not limited to medicine, military applications, psychology, marketing etc. The purpose of e-learning applications is to ensure users are able to learn outside of the classroom, but a major limitation has been the inability to fully replicate classroom interactions between teacher and students. This study used comparative surveys to gain information and understanding of the current learning practices in Nigerian universities and how they compare to these practices compare to the use of a developed e-learning system. The study was conducted by attending several lectures and noting the interactions between lecturers and tutors and as an aftermath, a software has been developed that deploys the use of an artificial intelligent teaching-agent alongside an e-learning system to enhance user learning experience and attempt to create the similar learning interactions to those found in classroom and lecture hall settings. Dialogflow has been used to implement a teaching-agent, which has been developed using JSON, which serves as a virtual teacher. Course content has been created using HTML, CSS, PHP and JAVASCRIPT as a web-based application. This technology can run on handheld devices and Google based home technologies to give learners an access to the teaching agent at any time. This technology also implements the use of definite clause grammars and natural language processing to match user inputs and requests with defined rules to replicate learning interactions. This technology developed covers familiar classroom scenarios such as answering users’ questions, asking ‘do you understand’ at regular intervals and answering subsequent requests, taking advanced user queries to give feedbacks at other periods. This software technology uses deep learning techniques to learn user interactions and patterns to subsequently enhance user learning experience. A system testing has been undergone by undergraduate students in the UK and Nigeria on the course ‘Introduction to Database Development’. Test results and feedback from users shows that this study and developed software is a significant improvement on existing e-learning systems. Further experiments are to be run using the software with different students and more course contents.

Keywords: virtual learning, natural language processing, definite clause grammars, deep learning, artificial intelligence

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Authors: Mladen Milicevic

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This presentation will address how the statistical analysis of digitized popular music influences the music creation and emotionally manipulates consumers.Furthermore, it will deal with semiological aspect of uniformization of musical taste in order to predict the potential revenues generated by popular music sales. In the USA, we live in an age where most of the popular music (i.e. music that generates substantial revenue) has been digitized. It is safe to say that almost everything that was produced in last 10 years is already digitized (either available on iTunes, Spotify, YouTube, or some other platform). Depending on marketing viability and its potential to generate additional revenue most of the “older” music is still being digitized. Once the music gets turned into a digital audio file,it can be computer-analyzed in all kinds of respects, and the similar goes for the lyrics because they also exist as a digital text file, to which any kin of N Capture-kind of analysis may be applied. So, by employing statistical examination of different popular music metrics such as tempo, form, pronouns, introduction length, song length, archetypes, subject matter,and repetition of title, the commercial result may be predicted. Polyphonic HMI (Human Media Interface) introduced the concept of the hit song science computer program in 2003.The company asserted that machine learning could create a music profile to predict hit songs from its audio features Thus,it has been established that a successful pop song must include: 100 bpm or more;an 8 second intro;use the pronoun 'you' within 20 seconds of the start of the song; hit the bridge middle 8 between 2 minutes and 2 minutes 30 seconds; average 7 repetitions of the title; create some expectations and fill that expectation in the title. For the country song: 100 bpm or less for a male artist; 14-second intro; uses the pronoun 'you' within the first 20 seconds of the intro; has a bridge middle 8 between 2 minutes and 2 minutes 30 seconds; has 7 repetitions of title; creates an expectation,fulfills it in 60 seconds.This approach to commercial popular music minimizes the human influence when it comes to which “artist” a record label is going to sign and market. Twenty years ago,music experts in the A&R (Artists and Repertoire) departments of the record labels were making personal aesthetic judgments based on their extensive experience in the music industry. Now, the computer music analyzing programs, are replacing them in an attempt to minimize investment risk of the panicking record labels, in an environment where nobody can predict the future of the recording industry.The impact on the consumers taste through the narrow bottleneck of the above mentioned music selection by the record labels,created some very peculiar effects not only on the taste of popular music consumers, but also the creative chops of the music artists as well. What is the meaning of this semiological shift is the main focus of this research and paper presentation.

Keywords: music, semiology, commercial, taste

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Authors: Benoit Atge, Alice Dhersin, Oscar Da Silva Cacao, Beatrice Martinez, Dominique Ducint, Catherine Verdun-Esquer, Isabelle Baldi, Mathieu Molimard, Antoine Villa, Mireille Canal-Raffin

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Introduction: Healthcare workers' exposure to antineoplastic drugs (AD) is a burning issue for occupational medicine practitioners. Biological monitoring of occupational exposure (BMOE) is an essential tool for assessing AD contamination of healthcare workers. In addition to BMOE, surface sampling is a useful tool in order to understand how workers get contaminated, to identify sources of environmental contamination, to verify the effectiveness of surface decontamination way and to ensure monitoring of these surfaces. The objective of this work was to develop a complete tool including a kit for surface sampling and a quantification analytical method for AD traces detection. The development was realized with the three following criteria: the kit capacity to sample in every professional environment (healthcare services, veterinaries, etc.), the detection of very low AD traces with a validated analytical method and the easiness of the sampling kit use regardless of the person in charge of sampling. Material and method: AD mostly used in term of quantity and frequency have been identified by an analysis of the literature and consumptions of different hospitals, veterinary services, and home care settings. The kind of adsorbent device, surface moistening solution and mix of solvents for the extraction of AD from the adsorbent device have been tested for a maximal yield. The AD quantification was achieved by an ultra high-performance liquid chromatography method coupled with tandem mass spectrometry (UHPLC-MS/MS). Results: With their high frequencies of use and their good reflect of the diverse activities through healthcare, 15 AD (cyclophosphamide, ifosfamide, doxorubicin, daunorubicin, epirubicin, 5-FU, dacarbazin, etoposide, pemetrexed, vincristine, cytarabine, methothrexate, paclitaxel, gemcitabine, mitomycin C) were selected. The analytical method was optimized and adapted to obtain high sensitivity with very low limits of quantification (25 to 5000ng/mL), equivalent or lowest that those previously published (for 13/15 AD). The sampling kit is easy to use, provided with a didactic support (online video and protocol paper). It showed its effectiveness without inter-individual variation (n=5/person; n= 5 persons; p=0,85; ANOVA) regardless of the person in charge of sampling. Conclusion: This validated tool (sampling kit + analytical method) is very sensitive, easy to use and very didactic in order to control the chemical risk brought by AD. Moreover, BMOE permits a focal prevention. Used in routine, this tool is available for every intervention of occupational health.

Keywords: surface contamination, sampling kit, analytical method, sensitivity

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Authors: Khaled Alabduljabbar

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Background: Benign, isolated, recurrent sixth nerve palsy is very rare in children. Here we report a case of recurrent abducens nerve palsy with no obvious etiology. It is a diagnosis of exclusion. A recurrent benign form of 6th nerve palsy, a rarer still palsy, has been described in the literature, and it is of most likely secondary to inflammatory causes, e.g, following viral and bacterial infections. Purpose: To present a case of 14 months old girl with recurrent attacks of isolated left sixth cranial nerve palsy following upper respiratory tract infection. Observation: The patient presented to opthalmology clinic with sudden onset of inward deviation (esotropia) of the left eye with a compensatory left face turn one week following signs of upper respiratory tract infection. Ophthalmological examination revealed large angle esotropia of the left eye in primary position, with complete limitation of abduction of the left eye, no palpebral fissure changes, and abnormal position of the head (left face turn). Visual acuity was normal, and no significant refractive error on cycloplegic refraction for her age. Fundus examination was normal with no evidence of papilledema. There was no relative afferent pupillary defect (RAPD) and no anisocoria. Past medical history and family history were unremarkable, with no history of convulsion attacks or head trauma. Additional workout include CBC. Erythrocyte sedimentation rate, Urgent magnetic resonance imaging (MRI), and angiography of the brain were performed and demonstrated the absence of intracranial and orbital lesions. Referral to pediatric neurologist was also done and concluded no significant finding. The patient showed improvement of the left sixth cranial nerve palsy and left face turn over a period of two months. Seven months since the first attack, she experienced a recurrent attack of left eye esotropia with left face turn concurrent with URTI. The rest of eye examination was again unremarkable. CT scan and MRI scan of brain and orbit were performed and showed only signs of sinusitis with no intracranial pathology. The palsy resolved spontaneously within two months. A third episode of left 6th nerve palsy occurred 6 months later, whichrecovered over one month. Examination and neuroimagingwere unremarkable. A diagnosis of benign recurrent left 6th cranial nerve palsy was made. Conclusion: Benign sixth cranial nerve palsy is always a diagnosis of exclusion given the more serious and life-threatening alternative causes. It seems to have a good prognosis with only supportive measures. The likelihood of benign 6th cranial nerve palsy to resolve completely and spontaneously is high. Observation for at least 6 months without intervention is advisable.

Keywords: 6th nerve pasy, abducens nerve pasy, recurrent nerve palsy, cranial nerve palsy

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Authors: Richard Vuijk, Arnoud Arntz

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Rationale: To our knowledge treatment of personality disorder comorbidity in adults with autism spectrum disorder (ASD) is understudied and is still in its infancy: We do not know if treatment of personality disorders may be applicable to adults with ASD. In particular, it is unknown whether patients with ASD benefit from experiential techniques that are part of schema therapy developed for the treatment of personality disorders. Objective: The aim of the study is to investigate the efficacy of a schema mode focused treatment with adult clients with ASD and comorbid personality pathology (i.e. at least one personality disorder). Specifically, we investigate if they can benefit from both cognitive-behavioral, and experiential interventions. Study design: A multiple baseline case series study. Study population: Adult individuals (age > 21 years) with ASD and at least one personality disorder. Participants will be recruited from Sarr expertise center for autism in Rotterdam. The study requires 12 participants. Intervention: The treatment protocol consists of 35 weekly offered sessions, followed by 10 monthly booster sessions. A multiple baseline design will be used with baseline varying from 5 to 10 weeks, with weekly supportive sessions. After baseline, a 5-week exploration phase follows with weekly sessions during which current and past functioning, psychological symptoms, schema modes are explored, and information about the treatment will be given. Then 15 weekly sessions with cognitive-behavioral interventions and 15 weekly sessions with experiential interventions will be given. Finally, there will be a 10-month follow-up phase with monthly booster sessions. Participants are randomly assigned to baseline length, and respond weekly during treatment and monthly at follow-up on Belief Strength of negative core beliefs (by VAS), and fill out SMI, SCL-90 and SRS-A 7 times during screening procedure (i.e. before baseline), after baseline, after exploration, after cognitive and behavioral interventions, after experiential interventions, and after 5- and 10- month follow-up. The SCID-II will be administered during screening procedure (i.e. before baseline), at 5- and at 10-month follow-up. Main study parameters: The primary study parameter is negative core beliefs. Secondary study parameters include schema modes, personality disorder manifestations, psychological symptoms, and social interaction and communication. Discussion: To the best of author’s knowledge so far no study has been published on the application of schema mode focused interventions in adult patients with ASD and comorbid PD(s). This study offers the first systematic test of application of schema therapy for adults with ASD. The results of this study will provide initial evidence for the effectiveness of schema therapy in treating adults with both ASD and PD(s). The study intends to provide valuable information for future development and implementation of therapeutic interventions for adults with both ASD and PD(s).

Keywords: adults, autism spectrum disorder, personality disorder, schema therapy

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Authors: Joshua Loebner

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Tectonic shifts within the advertising industry regularly and repeatedly present a deluge of data to be intuited across a spectrum of key performance indicators with innumerable interpretations where live campaigns are vivisected to pivot towards coalescence amongst a digital diaspora. But within this amalgam of analytics, validation, and creative campaign manipulation, where do diversity and disability inclusion fit in? In 2018 several major brands were able to answer this question definitely and directly by incorporating people with disabilities into advertisements. Disability inclusion, representation, and portrayals are documented annually across a number of different media, from film to primetime television, but ongoing studies centering on advertising have not been conducted. Symbols and semiotics in advertising often focus on a brand’s features and benefits, but this analysis on advertising and disability shows, how in 2018, creative campaigns and the disability community came together with the goal to continue the momentum and spark conversations. More brands are welcoming inclusion and sharing positive portrayals of intersectional diversity and disability. Within the analysis and surrounding scholarship, a multipoint analysis of each advertisement and meta-interpretation of the research has been conducted to provide data, clarity, and contextualization of insights. This research presents an advertising disability index that can be monitored for trends and shifts in future studies and to provide further comparisons and contrasts of advertisements. An overview of the increasing buying power within the disability community and population changes among this group anchors the significance and size of the minority in the US. When possible, viewpoints from creative teams and advertisers that developed the ads are brought into the research to further establish understanding, meaning, and individuals’ purposeful approaches towards disability inclusion. Finally, the conclusion and discussion present key takeaways to learn from the research, build advocacy and action both within advertising scholarship and the profession. This study, developed into an advertising disability index, will answer questions of how people with disabilities are represented in each ad. In advertising that includes disability, there is a creative pendulum. At one extreme, among many other negative interpretations, people with disables are portrayed in a way that conveys pity, fosters ableism and discrimination, and shows that people with disabilities are less than normal from a societal and cultural perspective. At the other extreme, people with disabilities are portrayed with a type of undue inspiration, considered inspiration porn, or superhuman, otherwise known as supercrip, and in ways that most people with disabilities could never achieve, or don’t want to be seen for. While some ads reflect both extremes, others stood out for non-polarizing inclusion of people with disabilities. This content analysis explores television commercial advertisements to determine the presence of people with disabilities and any other associated disability themes and/or concepts. Content analysis will allow for measuring the presence and interpretation of disability portrayals in each ad.

Keywords: advertising, brand, disability, marketing

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Authors: Dembel Bonta Gebeyehu

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In the study area, the impacts of deforestation for environmental degradation and livelihood of farmers manifest in different faces. They are more vulnerable as they depend on rain-fed agriculture and immediate natural forests. On the other hand, after planting seedling, waste disposal and management system of the plastic cover is poorly practiced and administered in the country in general and in the study area in particular. If this situation continues, the plastic waste would also accentuate land degradation. Besides, there is the absence of empirical studies conducted comprehensively on the research under study the case. The results of the study could suffice to inform any intervention schemes or to contribute to the existing knowledge on these issues. The study employed a qualitative approach based on intensive fieldwork data collected via various tools namely open-ended interviews, focus group discussion, key-informant interview and non-participant observation. The collected data was duly transcribed and latter categorized into different labels based on pre-determined themes to make further analysis. The major causes of deforestation were the expansion of agricultural land, poor administration, population growth, and the absence of conservation methods. The farmers are vulnerable to soil erosion and soil infertility culminating in low agricultural production; loss of grazing land and decline of livestock production; climate change; and deterioration of social capital. Their adaptation and coping strategies include natural conservation measures, diversification of income sources, safety-net program, and migration. Due to participatory natural resource conservation measures, soil erosion has been decreased and protected, indigenous woodlands started to regenerate. These brought farmers’ attitudinal change. The existing forestation program has many flaws. Especially, after planting seedlings, there is no mechanism for the plastic waste disposal and management. It was also found out organizational challenges among the mandated offices In the studied area, deforestation is aggravated by a number of factors, which made the farmers vulnerable. The current forestation programs are not well-planned, implemented, and coordinated. Sustainable and efficient seedling plastic cover collection and reuse methods should be devised. This is possible through creating awareness, organizing micro and small enterprises to reuse, and generate income from the collected plastic etc.

Keywords: land-cover and land-dynamics, vulnerability, adaptation strategy, mitigation strategies, sustainable plastic waste management

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Authors: Eleanor Nel

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Research output is an indicator of institutional performance (and quality), resulting in increased pressure on academic institutions to perform in the research arena. Research output is further utilised to obtain research funding. Resultantly, academic institutions face significant pressure from governing bodies to provide evidence on the return for research investments. Research output has thus become a substantial discourse within institutions, mainly due to the processes linked to evaluating research output and the associated allocation of research funding. This focus on research outputs often surpasses the development of robust, widely accepted tools to additionally measure research impact at institutions. A publication writing programme, for enhancing research output, was launched at a South African university in 2011. Significant amounts of time, money, and energy have since been invested in the programme. Although participants provided feedback after each session, no formal review was conducted to evaluate the research output directly associated with the programme. Concerns in higher education about training costs, learning results, and the effect on society have increased the focus on value for money and the need to improve training, research performance, and productivity. Furthermore, universities rely on efficient and reliable monitoring and evaluation systems, in addition to the need to demonstrate accountability. While publishing does not occur immediately, achieving a return on investment from the intervention is critical. A multi-method study, guided by the New World Kirkpatrick Model (NWKM), was conducted to determine the impact of the publication writing programme for the period of 2011 to 2018. Quantitative results indicated a total of 314 academics participating in 72 workshops over the study period. To better understand the quantitative results, an open-ended questionnaire and semi-structured interviews were conducted with nine participants from a particular faculty as a convenience sample. The purpose of the research was to collect information to develop a comprehensive framework for impact evaluation that could be used to enhance the current design and delivery of the programme. The qualitative findings highlighted the critical role of a multi-stakeholder strategy in strengthening support before, during, and after a publication writing programme to improve the impact and research outputs. Furthermore, monitoring on-the-job learning is critical to ingrain the new skills academics have learned during the writing workshops and to encourage them to be accountable and empowered. The NWKM additionally provided essential pointers on how to link the results more effectively from publication writing programmes to institutional strategic objectives to improve research performance and quality, as well as what should be included in a comprehensive evaluation framework.

Keywords: evaluation, framework, impact, research output

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Authors: Hsing-Hua Stella Chang, Mong-Ching Lin, Cher-Min Fong

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Using surrogate boycotts as a coercive tactic to force the offending party into changing its approaches has been increasingly significant over the last several decades, and is expected to increase in the future. Research shows that surrogate boycotts are often triggered by controversial international events, and particular foreign countries serve as the offending party in the international marketplace. In other words, multinational corporations are likely to become surrogate boycott targets in overseas markets because of the animosity between their home and host countries. Focusing on the surrogate boycott triggered by a severe situation animosity, this research aims to examine how social media influencers (SMIs) serving as electronic key opinion leaders (EKOLs) in an international crisis facilitate and organize a boycott, and persuade consumers to participate in the boycott. This research suggests that SMIs could be a particularly important information source in a surrogate boycott sparked by a situation of animosity. This research suggests that under such a context, SMIs become a critical information source for individuals to enhance and update their understanding of the event because, unlike traditional media, social media serve as a platform for instant and 24-hour non-stop information access and dissemination. The Xinjiang cotton event was adopted as the research context, which was viewed as an ongoing inter-country conflict, reflecting a crisis, which provokes animosity against the West. Through online panel services, both studies recruited Mainland Chinese nationals to be respondents to the surveys. The findings show that: 1. Social media influencer message is positively related to a negative attitude toward the offending country. 2. Attitude toward the offending country is positively related to boycotting participation. To address the unexplored question – of the effect of social media influencer influence on consumer participation in boycotts, this research presents a finer-grained examination of boycott motivation, with a special focus on a situational animosity context. This research is split into two interrelated parts. In the first part, this research shows that attitudes toward the offending country can be socially constructed by the influence of social media influencers in a situational animosity context. The study results show that consumers perceive different strengths of social pressure related to various levels of influencer messages and thus exhibit different levels of attitude toward the offending country. In the second part, this research further investigates the effect of attitude toward the offending country on boycott participation. The study findings show that such attitude exacerbated the effect of social media influencer messages on boycott participation in a situation of animosity.

Keywords: animosity, social media marketing, boycott, attitude toward the offending country

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Authors: Arpit Sachan, Nilanshu Kumar

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This paper tries to understand the nuances of feminisation of agriculture in the Indian context and how that is associated with better intrahousehold bargaining power for women. The economic survey of India indicates a constant increase in the share of the female workforce in Indian agriculture in the past few decades. This can be accounted for by many factors like the migration of male workers to urban areas and, therefore, the complete burden of agriculture shifting on the female counterparts. Therefore this study is an attempt to study that how this increase in the female workforce corresponds to a better decision-making ability for women in rural farm households. This paper is an attempt to carefully evaluate this aspect of the feminisation of Indian agriculture. The paper tries to study how various factors that improve the status of women in agriculture change with things like resource ownership. This paper uses both the macro-level and micro-level data to study the dynamics of the proportion of the workforce in agriculture across different states in India and how that has translated into better indicators for women in rural areas. The fall in India’s rank in the global gender wage gap index is alarming in such a context, and this creates a puzzle with increasing female workforce participation. The paper will consider if the condition of women improved over time with the increased share of employment or not? Using field survey data, this paper tries to understand if there exists any digression for some of the indicators both at the macro and micro level. The paper also tries to integrate the economic understanding of gender aspects of the workforce and the sociological stance prevailing in the existing literature. Therefore, this paper takes a mixed-method approach to better understand the role that social structure plays in the improved status of women within and across various households. Therefore, this paper will finally help us understanding if at all there is a feminisation of Indian agriculture or it's just exploitation of a different kind. This study intends to create a distinction between the gendered labour force in Indian agriculture and the complete democratization of Indian agriculture. The study is primarily focused on areas where the exodus of male migrants pushes women to work on agricultural farms. The question posits is whether it is the willingness of women to work in agriculture or is it urbanisation and development-induced conditions that make women work in agriculture as farm labourers? The motive is to understand if factors like resource ownership and the ability to autonomous decision-making are interlinked with an increased proportion of the female workforce or not? Based on this framework, we finally provide a brief comment on policy implications of government intervention in improving Indian agriculture and the gender aspects associated with it.

Keywords: feminisation, intrahousehold bargaining, farm households, migration, agriculture, decision-making

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Authors: Usha S. Adiga, Sachidanada Adiga

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Introduction: Diabetes Mellitus (DM) is one of the most common non-communicable diseases which imposes a large economic burden on the global health-care system. Cost of illness studies in India have assessed the health care cost of DM, but have certain limitations due to lack of standardization of the methods used, improper documentation of data, lack of follow up, etc. The objective of the study was to estimate the cost of illness of uncomplicated versus complicated type 2 diabetes mellitus in Coastal Karnataka, India. The study also aimed to find out the trend of cost of illness of the disease over a decade. Methodology: A prevalence based bottom-up approach study was carried out in two tertiary care hospitals located in Coastal Karnataka after ethical approval. Direct Medical costs like annual laboratory costs, pharmacy cost, consultation charges, hospital bed charges, surgical /intervention costs of 238 diabetics and 340 diabetic patients respectively from two hospitals were obtained from the medical record sections. Patients were divided into six groups, uncomplicated diabetes, diabetic retinopathy(DR), nephropathy(DN), neuropathy(DNeu), diabetic foot(DF), and ischemic heart disease (IHD). Different costs incurred in 2008 and 2017 in these groups were compared, to study the trend of cost of illness. Kruskal Wallis test followed by Dunn’s test were used to compare median costs between the groups and Spearman's correlation test was used for correlation studies. Results: Uncomplicated patients had significantly lower costs (p <0.0001) compared to other groups. Patients with IHD had highest Medical expenses (p < 0.0001), followed by DN and DF (p < 0.0001 ). Annual medical costs incurred were 1.8, 2.76, 2.77, 1.76, and 4.34 times higher in retinopathy, nephropathy, diabetic foot, neuropathy and IHD patients as compared to the cost incurred in managing uncomplicated diabetics. Other costs also showed a similar pattern of rising. A positive correlation was observed between the costs incurred and duration of diabetes, a negative correlation between the glycemic status and cost incurred. The cost incurred in the management of DM in 2017 was found to be elevated 1.4 - 2.7 times when compared to that in 2008. Conclusion: It is evident from the study that the economic burden due to diabetes mellitus is substantial. It poses a significant financial burden on the healthcare system, individual and society as a whole. There is a need for the strategies to achieve optimal glycemic control and operationalize regular and early screening methods for complications so as to reduce the burden of the disease.

Keywords: COI, diabetes mellitus, a bottom up approach, economics

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Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Vivane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Neonatal sepsis is a systemic response to the acute generalized infection caused by one or more bacterial agents, representing the main infectious cause of neonatal mortality in dogs during the first three weeks of life. This study aims to describe the incidence of sepsis in neonate dogs, as well as the main clinical signs and mortality rates. The study included 735 neonates admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, between January 2018 and November 2019. Seven hundred thirty-five neonates, 14% (98/703) presented neonatal sepsis. The main sources of infection for the neonates were intrauterine (72.5%, 71/98), lactogenic (13.2%, 13/98), umbilical (5.1%, 5/98) and unidentified sources (9.2%, 9/98). The main non-specific clinical signs observed in the newborns were weakness, depression, impaired or absent reflexes, hypothermia, hypoglycemia, dehydration, reduced muscle tonus and diarrhea. The newborns also manifested clinical signs of severe infection, such as hyperemia in the abdominal and anal regions, omphalitis, hematuria, abdomen and extremities with purplish-blue coloration necrosing injuries in the pads, bradycardia, dyspnea, epistaxis, hypotension and evolution to septic shock. Infections acquired during intrauterine life led to the onset of the clinical signs at the time of birth, with fast evolution during the first hours of life. On the other hand, infections acquired via milk or umbilical cord presented clinical signs later. The total mortality rate was 5.4% (38/703) and the mortality rate among the neonates with sepsis was 38.7% (38/98). The early mortality rate (0 to 2 days) accounted for 86.9% (33/38) and the late mortality rate (3 to 30 days) for 13.1% (5/38) of the deaths among the newborns with sepsis. The main bacterial agents observed were Staphylococcus spp., Streptococcus spp., Proteus spp. Mannheimia spp. and Escherichia coli. Neonatal sepsis evolves quickly and may lead to high mortality in a litter. The prognosis is usually favorable if the diagnosis is reached early and the antibiotic therapy instituted as soon as possible, even before the results of blood cultures and antibiograms. The therapeutic recommendations should meet the special physiological conditions of a neonate in terms of metabolism and excretion of medication. Therefore, it is of utmost importance that the veterinarian is knowledgeable regarding neonatology to provide effective intervention and improve the survival rates of these patients.

Keywords: Neonatal infection , bacteria, puppies, newborn

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Authors: Pragati Sirohi, Vivek Singh Rana

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Brand is a name, term, sign, symbol or design or a combination of all these which is intended to identify the goods or services of one seller or a group of sellers and to differentiate them from those of the competitors and perception influences purchase decisions here and so building that perception is critical. The FMCG industry is a low margin business. Volumes hold the key to success in this industry. Therefore, the industry has a strong emphasis on marketing. Creating strong brands is important for FMCG companies and they devote considerable money and effort in developing brands. Brand loyalty is fickle. Companies know this and that is why they relentlessly work towards brand building. The purpose of the study is a comparison between Indian and Multinational companies with regard to FMCG sector in India. It has been hypothesized that after liberalization the Indian companies has taken up the challenge of globalization and some of these are giving a stiff competition to MNCs. There is an existence of strong brand image of MNCs compared to Indian companies. Advertisement expenditures of MNCs are proportionately higher compared to Indian counterparts. The operational area of the study is the country as a whole. Continuous time series data is available from 1996-2014 for the selected 8 companies. The selection of these companies is done on the basis of their large market share, brand equity and prominence in the market. Research methodology focuses on finding trend growth rates of market capitalization, net worth, and brand values through regression analysis by the usage of secondary data from prowess database developed by CMIE (Centre for monitoring Indian Economy). Estimation of brand values of selected FMCG companies is being attempted, which can be taken to be the excess of market capitalization over the net worth of a company. Brand value indices are calculated. Correlation between brand values and advertising expenditure is also measured to assess the effect of advertising on branding. Major results indicate that although MNCs enjoy stronger brand image but few Indian companies like ITC is the outstanding leader in terms of its market capitalization and brand values. Dabur and Tata Global Beverages Ltd are competing equally well on these values. Advertisement expenditures are the highest for HUL followed by ITC, Colgate and Dabur which shows that Indian companies are not behind in the race. Although advertisement expenditures are playing a role in brand building process there are many other factors which affect the process. Also, brand values are decreasing over the years for FMCG companies in India which show that competition is intense with aggressive price wars and brand clutter. Implications for Indian companies are that they have to consistently put in proactive and relentless efforts in their brand building process. Brands need focus and consistency. Brand longevity without innovation leads to brand respect but does not create brand value.

Keywords: brand value, FMCG, market capitalization, net worth

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Authors: Hamid Abbasi, Neda Jourabchi, Ranasadat Abedi, Kiarash Tajernarenj, Mehdi Farhoudi, Sarvin Sanaie

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Background: Alpha lipoic acid (ALA), fat- and water-soluble, coenzyme with sulfuret content, has received considerable attention for its potential therapeutic role in diabetes, cardiovascular diseases, cancers, and central nervous disease. This investigation aims to evaluate the probable protective effects of ALA in stroke patients. Methods: Based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, This meta-analysis was performed. The PICO criteria for this meta-analysis were as follows: Population/Patients (P: stroke patients); Intervention (I: ALA); Comparison (C: control); Outcome (O: blood glucose, lipid profile, oxidative stress, inflammatory factors).In addition, Studies that were excluded from the analysis consisted of in vitro, in vivo, and ex vivo studies, case reports, quasi-experimental studies. Scopus, PubMed, Web of Science, EMBASE databases were searched until August 2023. Results: Of 496 records that were screened in the title/abstract stage, 9 studies were included in this meta-analysis. The sample sizes in the included studies vary between 28 and 90. The result of risk of bias was performed via risk of bias (RoB) in randomized-controlled trials (RCTs) based on the second version of the Cochrane RoB assessment tool. 8 studies had a definitely high risk of bias. Discussion: To the best of our knowledge, The present meta-analysis is the first study addressing the effectiveness of ALA supplementation in enhancing post-stroke metabolic markers, including lipid profile, oxidative stress, and inflammatory indices. It is imperative to acknowledge certain potential limitations inherent in this study. First of all, type of treatment (oral or intravenous infusion) could alter the bioavailability of ALA. Our study had restricted evidence regarding the impact of ALA supplementation on included outcomes. Therefore, further research is warranted to develop into the effects of ALA specifically on inflammation and oxidative stress. Funding: The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 72825). Registration: This study was registered in the International prospective register of systematic reviews (PROSPERO ID: CR42023461612).

Keywords: alpha-lipoic acid, lipid profile, blood glucose, inflammatory factors, oxidative stress, meta-analysis, post-stroke

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Authors: Nursyafiq Ali Shibramulisi, Nor Farah Fauzi, Nur Azniza Zawin Anuar, Nurul Atikah Azmi, Janice Hew Pei Fang

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Background: Work related musculoskeletal disorders (WRMD) among dental personnel have been underestimated and under-reported worldwide and specifically in Malaysia. The problem will arise and progress slowly over time, as it results from accumulated injury throughout the period of work. Several risk factors, such as repetitive movement, static posture, vibration, and adapting poor working postures, have been identified to be contributing to WRMSD in dental practices. Dental personnel is at higher risk of getting this problem as it is their working nature and core business. This would cause pain and dysfunction syndrome among them and result in absence from work and substandard services to their patients. Methodology: A cross-sectional study involving 19 government dental clinics in Perak was done over the period of 3 months. Those who met the criteria were selected to participate in this study. Malay version of the Self-Reported Nordic Musculoskeletal Discomfort Form was used to identify the prevalence of WRMSD, while the intensity of pain in the respective regions was evaluated using a 10-point scale according to ‘Pain as The 5ᵗʰ Vital Sign’ by MOH Malaysia and later on were analyzed using SPSS version 25. Descriptive statistics, including mean and SD and median and IQR, were used for numerical data. Categorical data were described by percentage. Pearson’s Chi-Square Test and Spearman’s Correlation were used to find the association between the prevalence of WRMSD and other socio-demographic data. Results: 159 dentists, 73 dental therapists, 26 dental lab technicians, 81 dental surgery assistants, and 23 dental attendants participated in this study. The mean age for the participants was 34.9±7.4 and their mean years of service was 9.97±7.5. Most of them were female (78.5%), Malay (71.3%), married (69.6%) and right-handed (90.1%). The highest prevalence of WRMSD was neck (58.0%), followed by shoulder (48.1%), upper back (42.0%), lower back (40.6%), hand/wrist (31.5%), feet (21.3%), knee (12.2%), thigh 7.7%) and lastly elbow (6.9%). Most of those who reported having neck pain scaled their pain experiences at 2 out of 10 (19.5%), while for those who suffered upper back discomfort, most of them scaled their pain experience at 6 out of 10 (17.8%). It was found that there was a significant relationship between age and pain at neck (p=0.007), elbow (p=0.027), lower back (p=0.032), thigh (p=0.039), knee (p=0.001) and feet (p=0.000) regions. Job position also had been found to be having a significant relationship with pain experienced at the lower back (p=0.018), thigh (p=0.011), knee, and feet (p=0.000). Conclusion: The prevalence of WRMSD among dental personnel in Perak was found to be high. Age and job position were found to be having a significant relationship with pain experienced in several regions. Intervention programs should be planned and conducted to prevent and reduce the occurrence of WRMSD, as all harmful or unergonomic practices should be avoided at all costs.

Keywords: WRMSD, ergonomic, dentistry, dental

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Authors: Scott Wysong

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Qatar will spend billions of dollars to host the 2022 World Cup. While football fans around the globe get excited to cheer on their favorite team every four years, critics debate the merits of a country hosting such an expensive and large-scale event. That is, the host countries spend billions of dollars on stadiums and infrastructure to attract these mega sporting events with the hope of equitable returns in economic impact and creating jobs. Yet, in many cases, the host countries are left in debt with decaying venues. There are benefits beyond the economic impact of hosting mega-events. For example, citizens are often proud of their city/country to host these famous events. Yet, often overlooked in the literature is the proposition that serving as the host for a mega-event may enhance the country’s brand image, not only as a tourist destination but for the products made in that country of origin. This research aims to explore this phenomenon by taking an exploratory look at consumer perceptions of three host countries of a mega-event in sports. In 2014, the U.S., Chinese and Finn (Finland) consumer attitudes toward Brazil and its products were measured before and after the World Cup via surveys (n=89). An Analysis of Variance (ANOVA) revealed that there were no statistically significant differences in the pre-and post-World Cup perceptions of Brazil’s brand personality or country-of-origin image. After the World Cup in 2018, qualitative interviews were held with U.S. sports fans (n=17) in an effort to further explore consumer perceptions of products made in the host country: Russia. A consistent theme of distrust and corruption with Russian products emerged despite their hosting of this prestigious global event. In late 2021, U.S. football (soccer) fans (n=42) and non-fans (n=37) were surveyed about the upcoming 2022 World Cup. A regression analysis revealed that how much an individual indicated that they were a soccer fan did not significantly influence their desire to visit Qatar or try products from Qatar in the future even though the country was hosting the World Cup—in the end, hosting a mega-event as grand as the World Cup showcases the country to the world. However, it seems to have little impact on consumer perceptions of the country, as a whole, or its brands. That is, the World Cup appeared to enhance already pre-existing stereotypes about Brazil (e.g., beaches, partying and fun, yet with crime and poverty), Russia (e.g., cold weather, vodka and business corruption) and Qatar (desert and oil). Moreover, across all three countries, respondents could rarely name a brand from the host country. Because mega-events cost a lot of time and money, countries need to do more to market their country and its brands when hosting. In addition, these countries would be wise to measure the impact of the event from different perspectives. Hence, we put forth a comprehensive future research agenda to further the understanding of how countries, and their brands, can benefit from hosting a mega sporting event.

Keywords: branding, country-of-origin effects, mega sporting events, return on investment

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Authors: Lívia Pinheiro Carvalho, Luciana Di Thommazo-Luporini, Rafael Luís Luporini, José Carlos Bonjorno Junior, Renata Pedrolongo Basso Vanelli, Manoel Carneiro de Oliveira Junior, Rodolfo de Paula Vieira, Renata Trimer, Renata G. Mendes, Mylène Aubertin-Leheudre, Audrey Borghi-Silva

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Rationale: Cardiorespiratory fitness (CRF) and functional capacity in young obese and normal-weight people are associated with metabolic and cardiovascular diseases and mortality. However, it remains unclear whether their metabolically healthy (MH) or at risk (AR) phenotype influences cardiorespiratory fitness in this vulnerable population such as obese adults but also in normal-weight people. HOMA insulin resistance index (HI) and leptin-adiponectin ratio (LA) are strong markers for characterizing those phenotypes that we hypothesized to be associated with physical fitness. We also hypothesized that an easy and feasible exercise test could identify a subpopulation at risk to develop metabolic and related disorders. Methods: Thirty-nine sedentary men and women (20-45y; 18.530 kg.m-2) underwent a clinical evaluation, including the six-minute step test (ST), a well-validated and reliable test for young people. Body composition assessment was done by a tetrapolar bioimpedance in a fasting state and in the folicular phase for women. A maximal cardiopulmonary exercise testing, as well as the ST, evaluated the oxygen uptake at the peak of the test (VO2peak) by an ergospirometer Oxycon Mobile. Lipids, glucose, insulin were analysed and the ELISA method quantified the serum leptin and adiponectin from blood samples. Volunteers were divided in two groups: AR or MH according to a HI cutoff of 1.95, which was previously determined in the literature. T-test for comparison between groups, Pearson´s test to correlate main variables and ROC analysis for discriminating AR from up-and-down cycles in ST (SC) were applied (p<0.05). Results: Higher LA, fat mass (FM) and lower HDL, SC, leg lean mass (LM) and VO2peak were found in AR than in MH. Significant correlations were found between VO2peak and SC (r= 0.80) as well as between LA and FM (r=0.87), VO2peak (r=-0.73), and SC (r=-0.65). Area under de curve showed moderate accuracy (0.75) of SC <173 to discriminate AR phenotype. Conclusion: Our study found that at risk obese and normal-weight subjects showed an unhealthy metabolism as well as a poor CRF and functional daily activity capacity. Additionally, a simple and less costly functional test associated with above-mentioned aspects is able to identify ‘at risk’ subjects for primary intervention with important clinical and health implications.

Keywords: aerobic capacity, exercise, fitness, metabolism, obesity, 6MST

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Authors: Y. A. Sani., A. A. Yakubu., A. A. Jamilu., J. Omeke, I. J. Sambo

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With the rising global threat of food security, cancer, and related diseases (carcinogenic) because of increased usage of inorganic substances in agricultural food production, the Ministry of Food Agriculture and Livestock of the Republic of Turkey organized an International Workshop on Organic Agriculture between 8–12th December 2014 at the International Agricultural Research and Training Center, Izmir. About 21 countries, including Nigeria, were invited to attend the training workshop. Several topics on organic agriculture were presented by renowned scholars, ranging from regulation, certification, crop, animal, seed production, pest and disease management, soil composting, and marketing of organic agricultural products, among others. This paper purposely selected two countries (Macedonia and Iran) out of the 21 countries to assess their level of development in terms of organic agriculture as compared to Nigeria. Macedonia, with a population of only 2.1 million people as of 2014, started organic agriculture in 2005 with only 266ha of land and has grown significantly to over 5,000ha in 2010, covering such crops as cereals (62%), forage (20%) fruit orchard (7%), vineyards (5%), vegetables (4%), oil seed and industrial crops (1%) each. Others are organic beekeeping from 110 hives to over 15,000 certified colonies. As part of government commitment, the level of government subsidy for organic products was 30% compared to the direct support for conventional agricultural products. About 19 by-laws were introduced on organic agricultural production that was fully consistent with European Union regulations. The republic of Iran, on the other hand, embarked on organic agriculture for the fact, that the country recorded the highest rate of cancer disease in the world, with over 30,000 people dying every year and 297 people diagnosed every day. However, the host country, Turkey, is well advanced in organic agricultural production and now being the largest exporter of organic products to Europe and other parts of the globe. A technical trip to one of the villages that are under the government scheme on organic agriculture reveals that organic agriculture was based on market-demand-driven and the support of the government was very visible, linking the farmers with private companies that provide inputs to them while the companies purchase the products at harvest with a high premium price. However, in Nigeria, research on organic agriculture was very recent, and there was very scanty information on organic agriculture due to poor documentation and very low awareness, even among the elites. The paper, therefore, recommends that the government should provide funds to NARIs to conduct research on organic agriculture and to establish clear government policy and good pre-conditions for sustainable organic agricultural production in the country.

Keywords: organic agriculture, food security, food safety, food nutrition

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Authors: Andrea Fiorista

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The learning of prepositions is a quite problematic aspect in foreign language instruction, and Italian is certainly not an exception. In their prototypical function, prepositions express schematic relations of two entities in a highly abstract, typically image-schematic way. In other terms, prepositions assume concepts such as directionality, collocation of objects in space and time and, in Cognitive Linguistics’ terms, the position of a trajector with respect to a landmark. Learners of different native languages may conceptualize them differently, implying that they are supposed to operate a recategorization (or create new categories) fitting with the target language. However, most current Italian Foreign/Second Language handbooks and didactic grammars do not facilitate learners in carrying out the task, as they tend to provide partial and idiosyncratic descriptions, with the consequent learner’s effort to memorize them, most of the time without success. In their prototypical meaning, prepositions are used to specify precise topographical positions in the physical environment which become less and less accurate as they radiate out from what might be termed a concrete prototype. According to that, the present study aims to elaborate a cognitive and conceptually well-grounded analysis of some extensive uses of the Italian preposition a, in order to propose effective pedagogical solutions in the Teaching/Learning process. Image schemas, cognitive metaphors and embodiment represent efficient cognitive tools in a task like this. Actually, while learning the merely spatial use of the preposition a (e.g. Sono a Roma = I am in Rome; vado a Roma = I am going to Rome,…) is quite straightforward, it is more complex when a appears in constructions such as verbs of motion +a + infinitive (e.g. Vado a studiare = I am going to study), inchoative periphrasis (e.g. Tra poco mi metto a leggere = In a moment I will read), causative construction (e.g. Lui mi ha mandato a lavorare = He sent me to work). The study reports data from a teaching intervention of Focus on Form, in which a basic cognitive schema is used to facilitate both teachers and students to respectively explain/understand the extensive uses of a. The educational material employed translates Cognitive Linguistics’ theoretical assumptions, such as image schemas and cognitive metaphors, into simple images or proto-scenes easily comprehensible for learners. Illustrative material, indeed, is supposed to make metalinguistic contents more accessible. Moreover, the concept of embodiment is pedagogically applied through activities including motion and learners’ bodily involvement. It is expected that replacing rote learning with a methodology that gives grammatical elements a proper meaning, makes learning process more effective both in the short and long term.

Keywords: cognitive approaches to language teaching, image schemas, embodiment, Italian as FL/SL

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Authors: Wei-Chih Huang, Pei-Lung Chung, Ching-Heng Lin, Hsuan-Chia Yang, Der-Ming Liou

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Background: In-Hospital Cardiac Arrest (IHCA) threaten life of the inpatients, cause serious effect to patient safety, quality of inpatients care and hospital service. Health providers must identify the signs of IHCA early to avoid the occurrence of IHCA. This study will consider the potential association between early signs of IHCA and the essence of patient care provided by nurses and other professionals before an IHCA occurs. The aim of this study is to identify significant associations between nursing interventions and abnormal early evaluation results of IHCA that can assist health care providers in monitoring inpatients at risk of IHCA to increase opportunities of IHCA early detection and prevention. Materials and Methods: This study used one of the data mining techniques called association rules mining to compute associations between nursing interventions and abnormal early evaluation results of IHCA. The nursing interventions and abnormal early evaluation results of IHCA were considered to be co-occurring if nursing interventions were provided within 24 hours of last being observed in abnormal early evaluation results of IHCA. The rule based methods were utilized 23.6 million electronic medical records (EMR) from a medical center in Taipei, Taiwan. This dataset includes 733 concepts of nursing interventions that coded by clinical care classification (CCC) codes and 13 early evaluation results of IHCA with binary codes. The values of interestingness and lift were computed as Q values to measure the co-occurrence and associations’ strength between all in-hospital patient care measures and abnormal early evaluation results of IHCA. The associations were evaluated by comparing the results of Q values and verified by medical experts. Results and Conclusions: The results show that there are 4195 pairs of associations between nursing interventions and abnormal early evaluation results of IHCA with their Q values. The indication of positive association is 203 pairs with Q values greater than 5. Inpatients with high blood sugar level (hyperglycemia) have positive association with having heart rate lower than 50 beats per minute or higher than 120 beats per minute, Q value is 6.636. Inpatients with temporary pacemaker (TPM) have significant association with high risk of IHCA, Q value is 47.403. There is significant positive correlation between inpatients with hypovolemia and happened abnormal heart rhythms (arrhythmias), Q value is 127.49. The results of this study can help to prevent IHCA from occurring by making health care providers early recognition of inpatients at risk of IHCA, assist with monitoring patients for providing quality of care to patients, improve IHCA surveillance and quality of in-hospital care.

Keywords: in-hospital cardiac arrest, patient safety, nursing intervention, association rule mining

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Authors: Lutaf Ali, Haris Ahmed, Hina Najmi

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Background: Access, better counseling and quality in the provision of family planning services remain big challenges. Sukh Initiative (a project of three different foundations) is a multi-pronged approach, working in one million underserved population residing peri urban slums in Karachi and providing door to door services by lady health workers (LHWs) and community health workers (CHWs) linked with quality family planning and reproductive (FP/RH) services both at public and private health care facilities. Objective: To assess the improvement in family planning and reproductive health behavior among MWRAs by improving access in peri-urban-underserved population of Karachi. Methodology: Using cross sectional study design 3866 married women with reproductive age (MWRAs) were interviewed in peri urban region of Karachi during November 2016 to January 2017. All face to face structured interviews were conducted with women aged 15-49 currently living with their husbands. Based on the project intervention question on reproductive health were developed and questions on contraceptive use were adopted from PDHS- Pakistan 2013. Descriptive and inferential analysis was performed on SPSS version 22. Results: 65% of population sample are literate, 51% women were in young age group- 15–29. On the poverty index, 6% of the population sample living at national poverty line 1.25$ and 52% at 2.50$. During the project years 79% women opted for facility based delivery; private facilities are the priority choice. 61.7% women initiated the contraceptive use in last two years (after the project).Use of family planning was increased irrespective of education level and poverty index- about 55.5% women with no formal education are using any form of contraception and trend of current modern contraceptives across poverty scores strata equally distributed amongst all groups. Age specific modern contraceptive prevalence rate (mCPR)(between 25-34) was found to be 43.8%. About 23% of this contraceptive ascertained from door to door services- short acting, (pills and condoms) are common, 29.5% from public facilities and 47.6% are from public facilities in which long acting and permanent method most received methods. Conclusion: Strategy of expanding access and choice in the form of providing family planning information and supplies at door step and availability of quality family planning services in the peripheries of underserved may improve the behavior of women regarding FP/RH.

Keywords: access, family planning, underserved population, socio-demographic facts

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Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

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Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

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Authors: Halimat M. Ajose-Adeogun, Zaynab A. Bello

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Artificial Intelligence (AI) and Natural Language Processing (NLP) have transformed computer language comprehension, allowing computers to comprehend spoken and written language with human-like cognition. NLP, a multidisciplinary area that combines rule-based linguistics, machine learning, and deep learning, enables computers to analyze and comprehend human language. NLP applications in medicine range from tackling issues in electronic health records (EHR) and psychiatry to improving diagnostic precision in orthopedic surgery and optimizing clinical procedures with novel technologies like chatbots. The technology shows promise in a variety of medical sectors, including quicker access to medical records, faster decision-making for healthcare personnel, diagnosing dysplasia in Barrett's esophagus, boosting radiology report quality, and so on. However, successful adoption requires training for healthcare workers, fostering a deep understanding of NLP components, and highlighting the significance of validation before actual application. Despite prevailing challenges, continuous multidisciplinary research and collaboration are critical for overcoming restrictions and paving the way for the revolutionary integration of NLP into medical practice. This integration has the potential to improve patient care, research outcomes, and administrative efficiency. The research methodology includes using NLP techniques for Sentiment Analysis and Emotion Recognition, such as evaluating text or audio data to determine the sentiment and emotional nuances communicated by users, which is essential for designing a responsive and sympathetic chatbot. Furthermore, the project includes the adoption of a Personalized Intervention strategy, in which chatbots are designed to personalize responses by merging NLP algorithms with specific user profiles, treatment history, and emotional states. The synergy between NLP and personalized medicine principles is critical for tailoring chatbot interactions to each user's demands and conditions, hence increasing the efficacy of mental health care. A detailed survey corroborated this synergy, revealing a remarkable 20% increase in patient satisfaction levels and a 30% reduction in workloads for healthcare practitioners. The poll, which focused on health outcomes and was administered to both patients and healthcare professionals, highlights the improved efficiency and favorable influence on the broader healthcare ecosystem.

Keywords: natural language processing, artificial intelligence, healthcare communication, electronic health records, patient care

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Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

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Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

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Authors: B. S. Premalatha, Kausalya Sahani

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Background: Voice is multidimensional which convey emotion, feelings, and communication. Voice disorders have an adverse effect on the physical, emotional and functional domains of an individual. Self-rating by clients about their voice problem helps the clinicians to plan intervention strategies. Voice handicap index is one such self-rating scale contains 30 questions that quantify the functional, physical and emotional impacts of a voice disorder on a patient’s quality of life. Each subsection has 10 questions. Though adapted and validated versions of VHI are available in other Indian languages but not in Telugu, which is a Dravidian language native to India. It is mainly spoken in Andhra Pradesh and neighbouring states in southern India. Objectives: To adapt and validate the English version of Voice Handicap Index (VHI) into Telugu language and evaluate its internal consistency and clinical validate in Telugu speaking population. Materials: The study carried out in three stages. First stage was a forward translation of English version of VHI, was given to ten experts, who were well proficient in writing and reading Telugu and five speech-language pathologists to translate into Telugu. Second Stage was backward translation where translated version of Telugu was given to a different group of ten experts (who were well proficient in writing and reading Telugu) and five speech-language pathologists who were native Telugu speakers and had good proficiency in Telugu and English. The third stage was an administration of translated version on Telugu to the targeted population. Totally 40 clinical subjects and 40 normal controls served as participants, and each group had 26 males and 14 females’ age range of 20 to 60 years. Clinical group comprised of individuals with laryngectomee with the Tracheoesophageal puncture (n=18), laryngitis (n=11), vocal nodules (n=7) and vocal fold palsy (n=4). Participants were asked to mark of their each experience on a 5 point equal appearing scale (0=never, 1=almost never, 2=sometimes, 3=almost always, 4=always) with a maximum total score of 120. Results: Statistical analysis was made by using SPSS software (22.0.0 Version). Mean, standard deviation and percentage (%) were calculated all the participants for both the groups. Internal consistency of VHI in Telugu was found to be excellent with the consistency scores for all the domains such as physical, emotional and functional are 0.742, 0.934and 0.938. The validity of scores showed a significant difference between clinical population and control group for domains like physical, emotional and functional and total scores. P value found to be less than 0.001( < 0.001). Negative correlation found in age and gender among self-domains such as physical, emotional and functional total scores in dysphonic and control group. Conclusion: The present study indicated that VHI in Telugu is able to discriminate participants having voice pathology from normal populations, which make this as a valid tool to collect information about their voice from the participants.

Keywords: adaptation, Telugu Version, translation, Voice Handicap Index (VHI)

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Authors: Canan Gunay Yazici, Zubeyir Sarı, Devrim Tarakci

Abstract:

Background: Hippotherapy considered as global techniques used in rehabilitation of children with cerebral palsy as it improved gait pattern, balance, postural control, balance and gross motor skills development but it encounters some problems (such as the excess of the cost of horses' care, nutrition, housing). Hippotherapy simulator is being developed in recent years to overcome these problems. These devices aim to create the effects of hippotherapy made with a real horse on patients by simulating the movements of a real horse. Objectives: To evaluate the efficacy of hippotherapy simulator on gross motor functions, sitting postural control and dynamic balance of children with cerebral palsy (CP). Methods: Fourteen children with CP, aged 6–15 years, seven with a diagnosis of spastic hemiplegia, five of diplegia, two of triplegia, Gross Motor Function Classification System level I-III. The Horse Riding Simulator (HRS), including four-speed program (warm-up, level 1-2-3), was used for hippotherapy simulator. Firstly, each child received Neurodevelopmental Therapy (NDT; 45min twice weekly eight weeks). Subsequently, the same children completed HRS+NDT (30min and 15min respectively, twice weekly eight weeks). Children were assessed pre-treatment, at the end of 8th and 16th week. Gross motor function, sitting postural control, dynamic sitting and standing balance were evaluated by Gross Motor Function Measure-88 (GMFM-88, Dimension B, D, E and Total Score), Trunk Impairment Scale (TIS), Pedalo® Sensamove Balance Test and Pediatric Balance Scale (PBS) respectively. Unit of Scientific Research Project of Marmara University supported our study. Results: All measured variables were a significant increase compared to baseline values after both intervention (NDT and HRS+NDT), except for dynamic sitting balance evaluated by Pedalo®. Especially HRS+NDT, increase in the measured variables was considerably higher than NDT. After NDT, the Total scores of GMFM-88 (mean baseline 62,2 ± 23,5; mean NDT: 66,6 ± 22,2; p < 0,05), TIS (10,4 ± 3,4; 12,1 ± 3; p < 0,05), PBS (37,4 ± 14,6; 39,6 ± 12,9; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 92,3 ± 5,2; p > 0,05) and Pedalo® standing balance points (80,2 ± 10,8; 82,5 ± 11,5; p < 0,05) increased by 7,1%, 2%, 3,9%, 5,2% and 6 % respectively. After HRS+NDT treatment, the total scores of GMFM-88 (mean baseline: 62,2 ± 23,5; mean HRS+NDT: 71,6 ± 21,4; p < 0,05), TIS (10,4 ± 3,4; 15,6 ± 2,9; p < 0,05), PBS (37,4 ± 14,6; 42,5 ± 12; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 93,8 ± 3,7; p > 0,05) and standing balance points (80,2 ± 10,8; 86,2 ± 5,6; p < 0,05) increased by 15,2%, 6%, 7,3%, 6,4%, and 11,9%, respectively, compared to the initial values. Conclusion: Neurodevelopmental therapy provided significant improvements in gross motor functions, sitting postural control, sitting and standing balance of children with CP. When the hippotherapy simulator added to the treatment program, it was observed that these functions were further developed (especially with gross motor functions and dynamic balance). As a result, this pilot study showed that the hippotherapy simulator could be a useful alternative to neurodevelopmental therapy for the improvement of gross motor function, sitting postural control and dynamic balance of children with CP.

Keywords: balance, cerebral palsy, hippotherapy, rehabilitation

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Authors: Stephanie PB Caligiuri, Harold M Aukema, Delfin Rodriguez-Leyva, Amir Ravandi, Randy Guzman, Grant N. Pierce

Abstract:

Background: Hypertension leads to cardiac and cerebral events and therefore is the leading risk factor attributed to death in the world. Oxylipins may be mediators in these events as they can regulate vascular tone and inflammation. Oxylipins are derived from fatty acids. Dietary flaxseed is rich in the n3 fatty acid, alpha-linolenic acid, and, therefore, may have the ability to change the substrate profile of oxylipins. As a result, this could alter blood pressure. Methods: A randomized, double-blinded, controlled clinical trial, the Flax-PAD trial, was used to assess the impact of dietary flaxseed on blood pressure (BP), and to also assess the relationship of plasma oxylipins to BP in 81 patients with peripheral arterial disease (PAD). Patients with PAD were chosen for the clinical trial as they are at an increased risk for hypertension and cardiac and cerebral events. Thirty grams of ground flaxseed were added to food products to consume on a daily basis for 6 months. The control food products contained wheat germ, wheat bran, and mixed dietary oils instead of flaxseed. Central BP, which is more significantly associated to organ damage, cardiac, and cerebral events versus brachial BP, was measured by pulse wave analysis at baseline and 6 months. A plasma profile of 43 oxylipins was generated using solid phase extraction, HPLC-MS/MS, and stable isotope dilution quantitation. Results: At baseline, the central BP (systolic/diastolic) in the placebo and flaxseed group were, 131/73 ± 2.5/1.4 mmHg and 128/71 ± 2.6/1.4 mmHg, respectively. After 6 months of intervention, the flaxseed group exhibited a decrease in blood pressure of 4.0/1.0 mmHg. The 6 month central BP in the placebo and flaxseed groups were, 132/74 ± 2.9/1.8 mmHg and 124/70 ± 2.6/1.6 mmHg (P<0.05). Correlation and logistic regression analyses between central blood pressure and oxylipins were performed. Significant associations were observed between central blood pressure and 17 oxylipins, primarily produced from arachidonic acid. Every 1 nM increase in 16-hydroxyeicosatetraenoic acid (HETE) increased the odds of having high central systolic BP by 15-fold, of having high central diastolic BP by 6-fold and of having high central mean arterial pressure by 15-fold. In addition, every 1 nM increase in 5,6-dihydroxyeicosatrienoic acid (DHET) and 11,12-DHET increased the odds of having high central mean arterial pressure by 45- and 18-fold, respectively. Flaxseed induced a significant decrease in these as well as 4 other vasoconstrictive oxylipins. Conclusion: Dietary flaxseed significantly lowered blood pressure in patients with PAD and hypertension. Plasma oxylipins were strongly associated with central blood pressure and may have mediated the flaxseed-induced decrease in blood pressure.

Keywords: hypertension, flaxseed, oxylipins, peripheral arterial disease

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

Abstract:

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

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

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