Search results for: international clinic od rehabilitation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4916

Search results for: international clinic od rehabilitation

4616 Seroprevalence and Determinants of Toxoplasmosis in Pregnant Women Attending Antenatal Clinic at the University Teaching Hospital, Lusaka, Zambia: A Cross-Sectional Study

Authors: Christiana Frimpong, Mpundu Makasa, Lungowe Sitali, Charles Michelo

Abstract:

Background: Toxoplasmosis is a neglected zoonotic disease which is prevalent among pregnant women especially in Africa. This study aimed to determine the seroprevalence and determinants of the disease among pregnant women attending the antenatal clinic at the University Teaching Hospital (UTH). Method: A cross-sectional study was employed where 411 pregnant women attending the antenatal clinic at UTH were interviewed using closed-ended questionnaires. Their blood was also tested for Toxoplasma gondii IgG and IgM antibodies using the OnSite Toxo IgG/IgM Combo Rapid Test cassettes by CTK Biotech, Inc, USA. Result: The overall seroprevalence of the infection (IgG) was 5.87%. There was no seropositive IgM result. Contact with cats showed 7.81 times the risk of contracting the infection in the pregnant women and being a farmer/being involved in construction work showed 15.5 times likelihood of contracting the infection. Socio-economic status of the pregnant women also presented an inverse relationship (showed association) with the infection graphically. However, though there were indications of the association between contact with cats, employment type as well as the socioeconomic status of the pregnant women with the infection, there was not enough evidence to suggest these factors as significant determining factors of Toxoplasma gondii infection in our study population. Conclusion: There is a low prevalence of Toxoplasma gondii infection among pregnant women in Lusaka, Zambia. Screening for the infection among pregnant women can be done once or twice during pregnancy to help protect both mother and child from the disease. Health promotion among women of child bearing age on the subject is of immense importance in order to help curb the situation. Further studies especially that of case-control and cohort studies should be carried out in the country in order to better ascertain the extent of the condition nationwide.

Keywords: determinants, pregnant women, seroprevalence, toxoplasmosis, University Teaching Hospital (UTH), Zambia

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4615 International College Students Understand Entrepreneurial Readiness and Business-Related Skills: A Qualitative Study

Authors: Aleksandar Chonevski

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The free-market economy provides many opportunities for entrepreneurship or starting one’s own business, attracting many students to study business at for-profit colleges in the United States. This is also true for international students, many of whom are filled with the hope of making a better life for themselves and their families through entrepreneurial endeavors. This qualitative research showed that not all graduates business students start their own business. In investigating this phenomenon, the effectiveness of entrepreneurship curricula at international colleges needs to be examined in order to adjust, improve and reform entrepreneurship curricula. This qualitative study will explore how business skills learned in college for-profit play a role in the entrepreneurial readiness of undergraduate business students in the south Florida. Business curricula helps international students achieve goals and transform their actions to understand challenges in a corporate society. Students will be interviewed to gain information about the students’ experience with entrepreneurship curricula in a for-profit college in south Florida.

Keywords: business skills, college curriculum, entrepreneurial readiness, international students

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4614 Applying the Eye Tracking Technique for the Evaluation of Oculomotor System in Patients Survived after Cerebellar Tumors

Authors: Marina Shurupova, Victor Anisimov, Alexander Latanov

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Background: The cerebellar lesions inevitably provoke oculomotor impairments in patients of different age. Symptoms of subtentorial tumors, particularly medulloblastomas, include static and dynamic coordination disorders (ataxia, asynergia, imbalance), hypo-muscle tonus, disruption of the cranial nerves, and within the oculomotor system - nystagmus (fine or gross). Subtentorial tumors can also affect the areas of cerebellum that control the oculomotor system. The noninvasive eye-tracking technology allows obtaining multiple oculomotor characteristics such as the number of fixations and their duration, amplitude, latency and velocity of saccades, trajectory and scan path of gaze during the process of the visual field navigation. Eye tracking could be very useful in clinical studies serving as convenient and effective tool for diagnostics. The aim: We studied the dynamics of oculomotor system functioning in patients undergoing remission from cerebellar tumors removal surgeries and following neurocognitive rehabilitation. Methods: 38 children (23 boys, 15 girls, 9-17 years old) that have recovered from the cerebellar tumor-removal surgeries, radiation therapy and chemotherapy and were undergoing course of neurocognitive rehabilitation participated in the study. Two tests were carried out to evaluate oculomotor performance - gaze stability test and counting test. The monocular eye movements were recorded with eye tracker ArringtonResearch (60 Hz). Two experimental sessions with both tests were conducted before and after rehabilitation courses. Results: Within the final session of both tests we observed remarkable improvement in oculomotor performance: 1) in the gaze stability test the spread of gaze positions significantly declined compared to the first session, and 2) the visual path in counting test significantly shortened both compared to the first session. Thus, neurocognitive rehabilitation improved the functioning of the oculomotor system in patients following the cerebellar tumor removal surgeries and subsequent therapy. Conclusions: The experimental data support the effectiveness of the utilization of the eye tracking technique as diagnostic tool in the field of neurooncology.

Keywords: eye tracking, rehabilitation, cerebellar tumors, oculomotor system

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4613 Caregiver’s Perception Regarding Diagnosis Disclosure to Children Living with Human Immunodeficiency Virus in Resource-Limited Settings: Observational Study from India

Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar

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Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.

Keywords: HIV, children, India, disclosure

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4612 Role of Speech Language Pathologists in Vocational Rehabilitation

Authors: Marlyn Mathew

Abstract:

Communication is the key factor in any vocational /job set-up. However many persons with disabilities suffer a deficit in this very area in terms of comprehension, expression and cognitive skills making it difficult for them to get employed appropriately or stay employed. Vocational Rehabilitation is a continuous and coordinated process which involves the provision of vocational related services designed to enable a person with disability to obtain and maintain employment. Therefore the role of the speech language pathologist is crucial in assessing the communication deficits and needs of the individual at the various phases of employment- right from the time of seeking a job and attending interview with suitable employers and also at regular intervals of the employment. This article discusses the various communication deficits and the obstacles faced by individuals with special needs including but not limited to cognitive- linguistic deficits, execution function deficits, speech and language processing difficulties and strategies that can be introduced in the workplace to overcome these obstacles including use of visual cues, checklists, flow charts. The paper also throws light on the importance of educating colleagues and work partners about the communication difficulties faced by the individual. This would help to reduce the communication barriers in the workplace, help colleagues develop an empathetic approach and also reduce misunderstandings that can arise as a result of the communication impairment.

Keywords: vocational rehabilitation, disability, speech language pathologist, cognitive, linguistics

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4611 A Systematic Review on Communication and Relations between Health Care Professionals and Patients with Cancer in Outpatient Settings Matter

Authors: Anne Prip, Kirsten Alling Møller, Dorte Lisbet Nielsen, Mary Jarden, Marie-Helene Olsen, Anne Kjaergaard Danielsen

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Background: The development in cancer care has shifted towards shorter hospital stays and more outpatient treatment. Today, cancer care and treatment predominantly takes place in outpatient settings where encounters between patients and health care professionals are often brief. This development will probably continue internationally as the global cancer burden seems to be growing significantly. Furthermore, the number of patients who require ambulatory treatments such as chemotherapy is increasing. Focusing on the encounters between health care professionals and patients during oncology treatment has thus become increasingly important due to a growing trend in outpatient cancer management. Objective: The aim of the systematic review was to summarize the literature from the perspective of the patient, on experiences of and the need for communication and relationships with the health care professional during chemotherapy treatment in an outpatient setting. Method: The review was designed and carried out according to the PRISMA guidelines and PICO framework. The systematic search was conducted in Medline, CINAHL, The Cochrane Library and Joanna Briggs Institute Evidence Based Practice Database. Results: In all, 1174 studies were identified by literature search. After duplicates were removed, the remaining studies (n = 1053) were screened for inclusion. Nine studies were included; qualitative (n = 5) and quantitative (n = 4) as they met the inclusions criteria. The review identified that communication and relationships between health care professionals and patients were important for the patients’ ability to cope with cancer and also had an impact on patients’ satisfaction with care in the outpatient clinic. Furthermore, the review showed that hope and positivity was a need and strategy for patients with cancer and was facilitated by health care professionals. Finally, it revealed that outpatient clinic visits framed and influenced communication and relationships. Conclusions: This review identified the significance of communication and the relationships between patients and health care professionals in the outpatient setting as it supports patients’ ability to cope with cancer. The review showed the need for health care professionals to pay attention to the relational aspects of communication in an outpatient clinic as encounters are often brief. Furthermore, the review helps to specify which elements of the communication are central in the patient-health care professional interaction from the patients' perspective. Finally, it shows a need for more research to investigate which type of interaction and intervention would be the most effective in supporting patients’ coping during chemotherapy in an outpatient clinic.

Keywords: ambulatory chemotherapy, communication, health care professional-patient relation, nurse-patient relation, outpatient care, systematic review

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4610 Measures Adopted by FIFA and UEFA against Russian Athletes: A Human Rights Perspective

Authors: Ayyoub Jamali, Alena Kozlova

Abstract:

The Russian invasion of Ukraine has tested the mettle of the international community, prompting not only States but also non-state actors to take deterrent action in response. Indeed, international sports organisations, namely FIFA and UEFA, have been rather successful in shifting the power dynamics by introducing a complete ban on the Russian national and club teams. This article aims to inquire into the human rights implications of such actions taken by international sports organisations. First, the article departs from an assessment of the legal status of FIFA and UEFA under international law and reflects on how a legal link could be established vis-à-vis their human rights obligations. Second, it examines the human rights aspects of the impugned measures by FIFA and UEFA on the part of the Russian athletes, further scrutinising them against the international human rights law principle of non-discrimination through a proportionality test. Last, it draws basic pathways for how possible human rights violations committed in the context of measures adopted by such organisations could be remedied, outlining the challenges of arbitration and litigation in Switzerland.

Keywords: FIFA, UEFA, FUR, ban, human rights, Russia, Ukraine, non-state actors

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4609 Cardiac Rehabilitation Program and Health-Related Quality of Life; A Randomized Control Trial

Authors: Zia Ul Haq, Saleem Muhammad, Naeem Ullah, Abbas Shah, Abdullah Shah

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Pakistan being the developing country is facing double burden of communicable and non-communicable disease. The aspect of secondary prevention of ischemic heart disease in developing countries is the dire need for public health specialists, clinicians and policy makers. There is some evidence that psychotherapeutic measures, including psychotherapy, recreation, exercise and stress management training have positive impact on secondary prevention of cardiovascular diseases but there are some contradictory findings as well. Cardiac rehabilitation program (CRP) has not yet fully implemented in Pakistan. Psychological, physical and specific health-related quality of life (HRQoL) outcomes needs assessment with respect to its practicality, effectiveness, and success. Objectives: To determine the effect of cardiac rehabilitation program (CRP) on the health-related quality of life (HRQoL) measures of post MI patients compared to the usual care. Hypothesis: Post MI patients who receive the interventions (CRP) will have better HRQoL as compared to those who receive the usual cares. Methods: The randomized control trial was conducted at a Cardiac Rehabilitation Unit of Lady Reading Hospital (LRH), Peshawar. LRH is the biggest hospital of the Province Khyber Pakhtunkhwa (KP). A total 206 participants who had recent first myocardial infarction were inducted in the study. Participants were randomly allocated into two group i.e. usual care group (UCG) and cardiac rehabilitation group (CRG) by permuted-block randomization (PBR) method. CRP was conducted in CRG in two phases. Three HRQoL outcomes i.e. general health questionnaire (GHQ), self-rated health (SRH) and MacNew quality of life after myocardial infarction (MacNew QLMI) were assessed at baseline and follow-up visits among both groups. Data were entered and analyzed by appropriate statistical test in STATA version 12. Results: A total of 195 participants were assessed at the follow-up period due to lost-to-follow-up. The mean age of the participants was 53.66 + 8.3 years. Males were dominant in both groups i.e. 150 (76.92%). Regarding educational status, majority of the participants were illiterate in both groups i.e. 128 (65.64%). Surprisingly, there were 139 (71.28%) who were non-smoker on the whole. The comorbid status was positive in 120 (61.54%) among all the patients. The SRH at follow-up among UCG and CRG was 4.06 (95% CI: 3.93, 4.19) and 2.36 (95% CI: 2.2, 2.52) respectively (p<0.001). GHQ at the follow-up of UCG and CRG was 20.91 (95% CI: 18.83, 21.97) and 7.43 (95% CI: 6.59, 8.27) respectively (p<0.001). The MacNew QLMI at follow-up of UCG and CRG was 3.82 (95% CI: 3.7, 3.94) and 5.62 (95% CI: 5.5, 5.74) respectively (p<0.001). All the HRQoL measures showed strongly significant improvement in the CRG at follow-up period. Conclusion: HRQOL improved in post MI patients after comprehensive CRP. Education of the patients and their supervision is needed when they are involved in their rehabilitation activities. It is concluded that establishing CRP in cardiac units, recruiting post-discharged MI patients and offering them CRP does not impose high costs and can result in significant improvement in HRQoL measures. Trial registration no: ACTRN12617000832370

Keywords: cardiovascular diseases, cardiac rehabilitation, health-related quality of life, HRQoL, myocardial infarction, quality of life, QoL, rehabilitation, randomized control trial

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4608 Neuropsychological Assessment and Rehabilitation Settings for Developmental Dyslexia in Children in Greece: The Use of Music at Intervention Protocols

Authors: Argyris B. Karapetsas, Rozi M. Laskaraki, Aikaterini A. Karapetsa, Maria Bampou, Valentini N. Vamvaka

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The main aim of the current protocol is the contribution of neuropsychology in both assessment and rehabilitation settings for children with dyslexia. Objectives: The purpose of this study was to evaluate the significant role of neuropsychological assessment including both Psychometric and electrophysiological tests as well as to investigate the effectiveness of an Auditory Training program, designed via Music designed for children with Developmental Dyslexia (DD). Materials: In our study, participated 45 third-, and fourth-grade students with DD and a matched control group (n=45). Method: At the first phase of the protocol, children underwent a clinical assessment, including both electrophysiological, i.e. Event Related Potentials (ERPs) esp. P300 waveform, and psychometric tests, being conducted in Laboratory of Neuropsychology, at University of Thessaly, in Volos, Greece. Assessment’s results confirmed statistically significant lower performance for children with DD for all tests, compared to the typical readers of the control group. After evaluation, a subgroup of children with DD participated in a Rehabilitation Program including digitized musical auditory training activities. Results: The electrophysiological recordings after the intervention revealed shorter, almost similar, P300 latency values for children with DD to those of the control group, indicating the beneficial effects of the Intervention, thus enabling children develop reading skills and become successful readers. Discussion: Similar research data confirm the crucial role of neuropsychology in both diagnosis and treatment of common disorders, observed in children. Indeed, as for DD, there is growing evidence that brain activity dysfunction does occur, as it is confirmed by neuropsychological assessment and also musical auditory training may have remedial effects. Conclusions: The outcomes of the current study suggest that due to the neurobiological origin of DD, neuropsychology may give the means in both neuropsychological assessment and rehabilitation, enabling professionals to cope with cerebral dysfunction and recovery more efficiently.

Keywords: diagnosis, dyslexia, ERPs, Music, neuropsychology, rehabilitation

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4607 An Investigation of Tourists’ Destination Loyalty: A Case Study of Bangkok, Thailand

Authors: Sukritta Larsen, Kevin Wongleedee

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The purposes of this research were to study tourists’ destination loyalty from the perspective of international tourists in Bangkok and to study the level of interest to revisit Bangkok in the near future. A probability random sampling of 200 international tourists was utilized. Half of the sample group was male and the other half was female. A Likert-five-scale questionnaire was designed to collect the data and small in-depth interviews were also used to obtain their opinions. The findings revealed that the majority of respondents had a medium level of loyalty. When examined in detail, the destination loyalty indicators can be ranked according to the mean average from high to low as follows: to recommend the visit, to say positive things, to revisit in the next three years, to refer the information, and to plan to visit regularly. Finally, the findings from the in-depth interviews with small group of international tourists revealed that the major obstacles that prevented many international tourists who may interested in revisiting Thailand included traffic congestions, high crime rate, and political instability.

Keywords: destination loyalty, international tourists, revisit, Bangkok

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4606 Offender Rehabilitation: The Middle Way of Maimonides to Mental and Social Health

Authors: Liron Hoch

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Traditional religious and spiritual texts offer a surprising wealth of relevant theoretical and practical knowledge about human behavior. This wellspring may contribute significantly to expanding our current body of knowledge in the social sciences and criminology in particular. In Jewish religious texts, specifically by Maimonides, we can find profound analyses of human traits and guidelines for a normative way of life. Among other things, modern criminological literature attempts to link certain character traits and divergent behaviors. Using the hermeneutic phenomenological approach, we analyzed the writings of Maimonides, mainly Laws of Human Dispositions, in order to understand Moses ben Maimon's (1138–1204) view of character traits. The analysis yielded four themes: (1) Human personality between nature and nurture; (2) The complexity of human personality, imbalance and criminality; (3) Extremism as a way to achieve balance; and (4) The Middle Way, flexibility and common sense. These themes can serve therapeutic purposes, as well as inform a rehabilitation model. Grounded in a theoretical rationale about the nature of humans, this model is designed to direct individuals to balance their traits by self-reflection and constant practice of the Middle Way. The proposal we will present is that implementing this model may promote normative behavior and thus contribute to rehabilitating offenders.

Keywords: rehabilitation, traits, offenders, maimonides, middle way

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4605 Children in Conflict: Institutionalization as a Rehabilitative Mechanism in Jammu and Kashmir

Authors: Moksha Singh

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The proponents of deinstitutionalization, including Goffman and others, in their works, have regarded institutions (orphanages to be specific) as regulated social arrangements that negatively impinge upon a resident’s development. They, therefore, propose alternative forms of care. However, even after five decades of this critique institutionalization remains the only hope for children with social, physical and mental disabilities in larger parts of the developing world such as the conflict affected state of Jammu and Kashmir in India. This paper is based on the experiences of children who lost their parents to insurgency and counter-insurgency operations and the rehabilitation process. This study is qualitative in nature and adopts descriptive-cum-exploratory research design. Using theoretical sampling, six orphanages and thirty one child residents who lost their parent(s) in the course of the armed conflict in the state of Jammu and Kashmir in India were studied in the year 2009-2010. It included interviews, observation, life histories and introspective accounts of the orphans and the management. The results were drawn through the qualitative examination, understanding, and interpretation of the primary and secondary data. The findings suggested that rehabilitation of these conflict-affected children is taking place mainly through residential child care facilities run by non-governmental bodies. Alternative forms of rehabilitation are not functional in the state because of various geopolitical and socio-cultural complexities. Even after five years of arriving at these conclusions and more, the state of Jammu and Kashmir still lacks a comprehensive rehabilitation plan for these children. This has further encouraged a mushroomed growth of legal and illegal institutions. Some of these institutions compromise the standard norms of functioning and yet remain the only hope for thousands rendered orphan. These institutions, therefore, are there to stay as other alternative forms of care are not available in the state. A comprehensive intervention policy is needed based on the cultural specifics of the state and incorporation of views of institutions offering aid, the state and the children. The paper introduces Small Group Residential Care Model through which it is expected that the restoration process can be made smooth and effective.

Keywords: armed conflict, children's rights, institutionalization, orphanages, rehabilitation

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4604 The Perceptions of Patients with Osteoarthritis at a Public Community Rehabilitation Centre in the Cape Metropole for Using Digital Technology in Rehabilitation

Authors: Gabriela Prins, Quinette Louw, Dawn Ernstzen

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Background: Access to rehabilitation services is a major challenge globally, especially in low-and-middle income countries (LMICs) where resources and infrastructure are extremely limited. Telerehabilitation (TR) has emerged in recent decades as a highly promising method to dramatically expand accessibility to rehabilitation services globally. TR provides rehabilitation care remotely using communication technologies such as video conferencing, smartphones, and internet-connected devices. This boosts accessibility to underprivileged regions and allows for greater flexibility for patients. Despite this, TR is hindered by several factors, including limited technological resources, high costs, lack of digital access, and the unavailability of healthcare systems, which are major barriers to widespread adoption among LMIC patients. These barriers have collectively hindered the potential implementation and adoption of TR services in LMICs healthcare settings. Adoption of TR will also require the buy-in of end users and limited information is known on the perspectives of the SA population. Aim: The study aimed to understand patients' perspectives regarding the use of digital technology as part of their OA rehabilitation at a public community healthcare centre in the Cape Metropole Area. Methods: A qualitative descriptive study design was used on 10 OA patients from a public community rehabilitation centre in South Africa. Data collection included semi-structured interviews and patient-reported outcome measures (PSFS, ASES-8, and EuroQol EQ-5D-5L) on functioning and quality of life. Transcribed interview data were coded in Atlas.ti. 22.2 and analyzed using thematic analysis. The results were narratively documented. Results: Four themes arose from the interviews. The themes were Telerehabilitation awareness (Use of Digital Technology Information Sources and Prior Experience with Technology /TR), Telerehabilitation Benefits (Access to healthcare providers, Access to educational information, Convenience, Time and Resource Efficiency and Facilitating Family Involvement), Telerehabilitation Implementation Considerations (Openness towards TR Implementation, Learning about TR and Technology, Therapeutic relationship, and Privacy) and Future use of Telerehabilitation (Personal Preference and TR for the next generation). The ten participants demonstrated limited awareness and exposure to TR, as well as minimal digital literacy and skills. Skepticism was shown when comparing the effectiveness of TR to in-person rehabilitation and valued physical interactions with health professionals. However, some recognized potential benefits of TR for accessibility, convenience, family involvement and improving community health in the long term. Willingness existed to try TR with sufficient training. Conclusion: With targeted efforts addressing identified barriers around awareness, technological literacy, clinician readiness and resource availability, perspectives on TR may shift positively from uncertainty towards endorsement of this expanding approach for simpler rehabilitation access in LMICs.

Keywords: digital technology, osteoarthritis, primary health care, telerehabilitation

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4603 Ecotourism and Orangutan Conservation in City Landscape: The Case of Semenggoh Wildlife Centre

Authors: N. E. F. Jaddil, S. Silang, J. H. Chong

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Semenggoh Wildlife Centre (SWC) begins its journey as an important orangutan rehabilitation centre in Sarawak. Strategically located about 25 km from Kuching, the capital city of Malaysian Sarawak in Borneo Island. This paper sought to access the progression of Semenggoh Wildlife Centre from a rehabilitation into one of the top ecotourism destination in Kuching. The existing semi-wild orangutans (attraction)-ecotourism interaction in city landscape setting is evaluated. With the ever-increasing demand of ecotourism activity in SWC, this study is intended to explore and understand the current status of ecotourism activity in SWC by analysing visitors, and economic statistic, issues and challenges and strategically propose way-forward to enhance the sustainability of ecotourism in SWC.

Keywords: ecotourism, orangutan, Semenggoh, urban wildlife park

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4602 A Wearable Device to Overcome Post–Stroke Learned Non-Use; The Rehabilitation Gaming System for wearables: Methodology, Design and Usability

Authors: Javier De La Torre Costa, Belen Rubio Ballester, Martina Maier, Paul F. M. J. Verschure

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After a stroke, a great number of patients experience persistent motor impairments such as hemiparesis or weakness in one entire side of the body. As a result, the lack of use of the paretic limb might be one of the main contributors to functional loss after clinical discharge. We aim to reverse this cycle by promoting the use of the paretic limb during activities of daily living (ADLs). To do so, we describe the key components of a system that is composed of a wearable bracelet (i.e., a smartwatch) and a mobile phone, designed to bring a set of neurorehabilitation principles that promote acquisition, retention and generalization of skills to the home of the patient. A fundamental question is whether the loss in motor function derived from learned–non–use may emerge as a consequence of decision–making processes for motor optimization. Our system is based on well-established rehabilitation strategies that aim to reverse this behaviour by increasing the reward associated with action execution as well as implicitly reducing the expected cost associated with the use of the paretic limb, following the notion of the reinforcement–induced movement therapy (RIMT). Here we validate an accelerometer–based measure of arm use, and its capacity to discriminate different activities that require increasing movement of the arm. We also show how the system can act as a personalized assistant by providing specific goals and adjusting them depending on the performance of the patients. The usability and acceptance of the device as a rehabilitation tool is tested using a battery of self–reported and objective measurements obtained from acute/subacute patients and healthy controls. We believe that an extension of these technologies will allow for the deployment of unsupervised rehabilitation paradigms during and beyond the hospitalization time.

Keywords: stroke, wearables, learned non use, hemiparesis, ADLs

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4601 The Applicability of International Humanitarian Law to Non-State Actors

Authors: Yin Cheung Lam

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In 1949, the ratification of the Geneva Conventions heralded the international community’s adoption of a new universal and non-discriminatory approach to human rights in situations of conflict. However, with the proliferation of international terrorism after the 9/11 attacks on the United States (U.S.), the international community’s uneven and contradictory implementations of international humanitarian law (IHL) questioned its agenda of universal human rights. Specifically, the derogation from IHL has never been so pronounced in the U.S. led ‘War on Terror’. While an extensive literature has ‘assessed the impact’ of the implementation of the Geneva Conventions, limited attention has been paid to interrogating the ways in which the Geneva Conventions and its resulting implementation have functioned to discursively reproduce certain understandings of human rights between states and non-state actors. Through a discursive analysis of the Geneva Conventions and the conceptualization of human rights in relation to terrorism, this thesis problematises the way in which the U.S. has understood and reproduced understandings of human rights. Using the U.S. ‘War on Terror’ as an example, it seeks to extend previous analyses of the U.S.’ practice of IHL through a qualitative discursive analysis of the human rights content that appears in the Geneva Conventions in addition to the speeches and policy documents on the ‘War on Terror’.

Keywords: discursive analysis, human rights, non-state actors, war on terror

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4600 Kinematic Modelling and Task-Based Synthesis of a Passive Architecture for an Upper Limb Rehabilitation Exoskeleton

Authors: Sakshi Gupta, Anupam Agrawal, Ekta Singla

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An exoskeleton design for rehabilitation purpose encounters many challenges, including ergonomically acceptable wearing technology, architectural design human-motion compatibility, actuation type, human-robot interaction, etc. In this paper, a passive architecture for upper limb exoskeleton is proposed for assisting in rehabilitation tasks. Kinematic modelling is detailed for task-based kinematic synthesis of the wearable exoskeleton for self-feeding tasks. The exoskeleton architecture possesses expansion and torsional springs which are able to store and redistribute energy over the human arm joints. The elastic characteristics of the springs have been optimized to minimize the mechanical work of the human arm joints. The concept of hybrid combination of a 4-bar parallelogram linkage and a serial linkage were chosen, where the 4-bar parallelogram linkage with expansion spring acts as a rigid structure which is used to provide the rotational degree-of-freedom (DOF) required for lowering and raising of the arm. The single linkage with torsional spring allows for the rotational DOF required for elbow movement. The focus of the paper is kinematic modelling, analysis and task-based synthesis framework for the proposed architecture, keeping in considerations the essential tasks of self-feeding and self-exercising during rehabilitation of partially healthy person. Rehabilitation of primary functional movements (activities of daily life, i.e., ADL) is routine activities that people tend to every day such as cleaning, dressing, feeding. We are focusing on the feeding process to make people independent in respect of the feeding tasks. The tasks are focused to post-surgery patients under rehabilitation with less than 40% weakness. The challenges addressed in work are ensuring to emulate the natural movement of the human arm. Human motion data is extracted through motion-sensors for targeted tasks of feeding and specific exercises. Task-based synthesis procedure framework will be discussed for the proposed architecture. The results include the simulation of the architectural concept for tracking the human-arm movements while displaying the kinematic and static study parameters for standard human weight. D-H parameters are used for kinematic modelling of the hybrid-mechanism, and the model is used while performing task-based optimal synthesis utilizing evolutionary algorithm.

Keywords: passive mechanism, task-based synthesis, emulating human-motion, exoskeleton

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4599 China and the Criminalization of Aggression. The Juxtaposition of Justice and the Maintenance of International Peace and Security

Authors: Elisabetta Baldassini

Abstract:

Responses to atrocities are always unique and context-dependent. They cannot be foretold nor easily prompted. However, the events of the twentieth century had set the scene for the international community to explore new and more robust systems in response to war atrocities, with the ultimate goal being the restoration and maintenance of peace and security. The outlawry of war and the attribution of individual liability for international crimes were two major landmarks that set the roots for the development of international criminal law. From the London Conference (1945) for the establishment of the first international military tribunal in Nuremberg to Rome at the inauguration of the first permanent international criminal court, the development of international criminal law has shaped in itself a fluctuating degree of tensions between justice and maintenance of international peace and security, the cardinal dichotomy of this article. The adoption of judicial measures to achieve peace indeed set justice as an essential feature at the heart of the new international system. Blackhole of this dichotomy is the crime of aggression. Aggression was at first the key component of a wide body of peace projects prosecuted under the charges of crimes against peace. However, the wide array of controversies around aggression mostly related to its definition, determination and the involvement of the Security Council silenced, partly, a degree of efforts and agreements. Notwithstanding the establishment of the International Criminal Court (ICC), jurisdiction over the crime of aggression was suspended until an agreement over the definition and the conditions for the Court’s exercise of jurisdiction was reached. Compromised over the crime was achieved in Kampala in 2010 and the Court’s jurisdiction over the crime of aggression was eventually activated on 17 July 2018. China has steadily supported the advancement of international criminal justice together with the establishment of a permanent international judicial body to prosecute grave crimes and has proactively participated at the various stages of the codification and development of the crime of aggression. However, China has also expressed systematic reservations and setbacks. With the use of primary and secondary sources, including semi-structured interviews, this research aims at analyzing the role that China has played throughout the substantive historical development of the crime of aggression, demonstrating a sharp inclination in the maintenance of international peace and security. Such state behavior seems to reflect national and international political mechanisms that gravitate around a distinct rationale that involves a share of culture and tradition.

Keywords: maintenance of peace and security, cultural expression of justice, crime of aggression, China

Procedia PDF Downloads 201
4598 An Examination of Criminology and Cyber Crime in Contemporary Society

Authors: Uche A. Nnawulezi

Abstract:

The evolving global environment has as of late seen formative difficulties bordering on cyber crime and its attendant effects. This paper looks at what constitutes an offense of cyber crime under the tenets of International Law as no nation can lay bona-fide claim in managing cyber crime as a criminal phenomenon. Therefore, there has been a plethora of ideological, conceptual and mental propositions of policies aimed at domesticating cyber crimes – an international crime. These policies were as a result of parochial consideration and social foundations which negate the spirit of internationally accepted procedures. The study also noted that the non-domestication of cyber crime laws by most countries has led to an increase in cyber crimes and its attendant effects have remained unabated. The author has pointed out emerging international rules as a panacea for a sustainable cyber crime-free society. The paper relied on documentary evidence and hence scooped much of the data from secondary sources such as text books, journals, articles and periodicals and more so, opinion papers, emanating from international criminal court. It concludes that the necessary recommendations made in this paper, if fully adopted, shall go a long way in maintaining a cyber crime-free society. Ultimately, the domestic and international law mechanisms capable of dealing with cyber crime offenses should be expanded and be made proactive in order to deal with the demands of modern day challenges.

Keywords: criminology, cyber crime, domestic law, international law

Procedia PDF Downloads 166
4597 Surgical School Project: Implementation Educational Plan for Adolescents Awaiting Bariatric Surgery

Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez

Abstract:

Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.

Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training

Procedia PDF Downloads 41
4596 The Impact of the Russian Democratic Weaknesses on the International Society

Authors: Leone Sherman

Abstract:

While the democratic rights of a citizen may be very clearly outlined in a country’s constitution, it’s not uncommon for political elite to undermine those rights and gain more power and control over a country than it is allowed by this constitution. Moreover, while such a change in some smaller states may not have a substantial impact on the international community, the same change in countries with vast resources and political influence, such as Russia, is always a considerable factor for the world policy. This article aims to research the weaknesses of the Russian democratic system and their effect on the international policy through the three key aspects: The Russian people’s ability to produce the required political will to control their government’s decisions, the current development of the Russian political environment, and the affection of this environment on the world community as a whole during the recent years. The used methodology is a narrative analysis of recent political events, official statistics, international investigations and media statements. As a result, the ever-widening gap between the people and the government becomes evidently seen, as well as the challenges it imposes on the political world arena, both current and those that still lie ahead of us.

Keywords: Russia, political analysis, democratic weaknesses, international society

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4595 Re-Defining Academic Literacy: An Information Literacy Approach to Helping Chinese International Students Succeed in American Colleges

Authors: Yi Ding

Abstract:

With the upsurge of Chinese international students in American higher education, serious academic problems Chinese international students are suffering from are also striking. While most practices and research in higher education focus on the role of professors, writing centers, and tutoring centers to help international students succeed in college, this research study focuses on a more fundamental skill that is neglected in most conversations: information literacy, which is usually addressed by academic librarians. Transitioning from an East-Asian, developing educational system that values authority, set knowledge more than independent thinking, scholarly conversation, Chinese international students need support from academic librarians to acquire information literacy, which is crucial to understand expectations of a Western academic setting and thus to succeed in college. This research study illustrates how academic librarians can play an integral role in helping Chinese international students acclimate to the expectations of American higher education by teaching information literacy as academic literacy unique to the Western academic setting. Six keys of information literacy put forward by Association of College and Research Libraries, which are 'Authority Is Constructed and Contextual', 'Information Creation as a Process', 'Information Has Value', 'Research as Inquiry', 'Scholarship as Conversation', and 'Searching as Strategic Exploration', are analyzed through the lens of Chinese educational system and students’ backgrounds. Based on the analysis as well as results from surveys and interviews among academic librarians, professors, and international students, this research further examines current practices from a wide range of academic libraries and finally, provides evidence-based recommendations for academic librarians to use information literacy instruction to help Chinese international students succeed in American higher education.

Keywords: academic librarians, Chinese international students, information literacy, student success

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4594 Evaluation of Orthodontic Patients’ Dental Visits and Problems During Covid-19 Pandemic in Sari Dental School in 2021

Authors: Mobina Bagherianlemraski, Parastoo Namdar

Abstract:

Background: The ongoing coronavirus disease has affected most countries. This virus has high transmission power. Due to the closure of most dental clinics, millions of orthodontic patients missed their appointments during the COVID-19 pandemic. Methods: A questionnaire was developed and sent to patients receiving orthodontic treatment at a public or private clinic. Results: A total of 200 responses were analyzed: These included 153 women (76.5%) and 47 men (23.5%). The mean and standard deviation of their age was 18.92±7.23 years, with an age range of 8 to 40 years. One hundred eighty-nine patients (94.5%) had fixed appliances, and 11 patients (5.5%) had removable appliances. Of all participants, 35% (70) missed their appointments. The highest and lowest reasons for stopping appointments were concerned about the spread of COVID-19 with 28 cases (40%) and the closure of the clinic with 15 cases (21.4%). Of the 53 patients who contacted their orthodontists, 86.8 % (46) communicated via office phone and 5.7% (3) through social media. Conclusion: This study determined that the coronavirus pandemic and quarantine have had an important impact on orthodontic treatments. The greatest concern of orthodontic patients was increasing in treatment duration. Patients who used fixed appliances reported missing dental appointments more than others. Therefore, during COVID 19 Pandemic, orthodontists should prepare patients to solve their problems linked to orthodontic appliances when possible.

Keywords: orthodontic patients, coronavirus pandemic, appointments, COVID-19

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4593 EMG Based Orthosis for Upper Limb Rehabilitation in Hemiparesis Patients

Authors: Nancy N. Sharmila, Aparna Mishra

Abstract:

Hemiparesis affects almost 80% of stroke patients each year. It is marked by paralysis or weakness on one half of the body. Our model provides both assistance and physical therapy for hemiparesis patients for swift recovery. In order to accomplish our goal a force is provided that pulls the forearm up (as in flexing the arm), and pushes the forearm down (as in extending the arm), which will also assist the user during ADL (Activities of Daily Living). The model consists of a mechanical component which is placed around the patient’s bicep and an EMG control circuit to assist patients in daily activities, which makes it affordable and easy to use. In order to enhance the neuromuscular system’s effectiveness in synchronize the movement, proprioceptive neuromuscular facilitation (PNF) concept is used. The EMG signals are acquired from the unaffected arm as an input to drive the orthosis. This way the patient is invigorated to use the orthosis for regular exercise.

Keywords: EMG, hemiparesis, orthosis, rehabilitation

Procedia PDF Downloads 418
4592 Utilisation of Sports and Games for Psychosocial Rehabilitation of Internally Displaced Persons in Maiduguri, Nigeria

Authors: Stephen Hamafyelto, Hussaini Garba, Mary Pindar Ndahi

Abstract:

The study was carried out with the intent to mitigate the trauma experienced by victims of insurgent attacks by the so-called Boko Haram militants in Borno state of Nigeria. The area was ridden by the crisis over the past 9 years. As a result, many people were killed, maimed and raped. Some others suffered all manner of inhuman treatment at the hands of their captors. The extent to which this dehumanized treatment has gone and impacted on the people in this area has left most of them traumatised. Victims who survived the attacks have been resettled in camps provided by government where their needs have been cared for. This can never be the same with their natural habitats. Many interventions have also been done by government, non-governmental organisations and corporate and individual bodies. In this regard, social needs of the victims have been the immediate concerns of most organisations, where food, shelter, and clothing were provided. However, there is little that has been done to rehabilitate these victims psychosocially. In this regard, sports and games including the victims’ local games were used to provide psychosocial rehabilitation of victims. The intent was to bring them back to social reality, social inclusion, and stable emotions and peer integration. Descriptive statistics and Multivariate analysis were done. No statistically significant difference was found among male and female children and adults in terms of psychosocial rehabilitation using sports and games.

Keywords: social reality, social inclusion, emotional intellegence, peer model

Procedia PDF Downloads 184
4591 A New Approach to Retrofit Steel Moment Resisting Frame Structures after Mainshock

Authors: Amir H. Farivarrad, Kiarash M. Dolatshahi

Abstract:

During earthquake events, aftershocks can significantly increase the probability of collapse of buildings, especially for those with induced damages during the mainshock. In this paper, a practical approach is proposed for seismic rehabilitation of mainshock-damaged buildings that can be easily implemented within few days after the mainshock. To show the efficacy of the proposed method, a case study nine story steel moment frame building is chosen which was designed to pre-Northridge codes. The collapse fragility curve for the aftershock is presented for both the retrofitted and non-retrofitted structures. Comparison of the collapse fragility curves shows that the proposed method is indeed applicable to reduce the seismic collapse risk.

Keywords: aftershock, the collapse fragility curve, seismic rehabilitation, seismic retrofitting

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4590 The Mitigation of Human Trafficking through Agricultural Development: A Proactive International Approach

Authors: Brianna Douglas

Abstract:

A literary Meta-Analysis was conducted in order to form a proactive solution to the systematic issue of international human trafficking stemming from the Asia-Pacific region. This approach seeks to resolve the low economic prospect for women in the region, along with other identified drivers, to mitigate human trafficking before it begins. Through the reallocation of aid in agriculture, implementation of an education-for-education model, and provision of access to market information to the women in rural regions, the retraction of both the supply and international demand curves of trafficked humans is possible; resulting in the shutdown of the market as a whole. This report provides a basic and adaptable proposal to mitigation the selling of Asia Pacific women within international trafficking schemes with byproduct effects of increasing food, sustainability and decreasing government spending.

Keywords: human trafficking, agricultural development, Asia Pacific, women's empowerment

Procedia PDF Downloads 126
4589 The ICC, International Criminal Justice and International Politics

Authors: Girma Y. Iyassu Menelik

Abstract:

The international community has gone through indescribable atrocities resulting from acts of war. These atrocities turned Europe and Africa into a wilderness of bloodshed and crime. In the period 1960- 1970s Africa witnessed unprecedented and well-documented assaults on life and property. This necessitated the adoption, signing and ratification of the International Criminal Court, establishment of the International Court of Justice which is a great achievement for the protection and fulfilling of human rights in the context of international political instability. The ICC came as an important opportunity to advance justice for serious crimes committed in violation of international law. Thus the Rome statute has become a formidable contribution to peace and security. There are concerns that the ICC is targeting African states. However, the ICC cannot preside over cases that are not parties to the Rome statute unless the UN Security council refers the situation or the relevant state asks the court to become involved. The instable international political situation thus deals with criminal prosecutions where amnesty is not permissible or is strongly repudiated. The court has become important justice instruments for states that are unable or unwilling to fulfill their obligation to address legacies of massive human rights violations. The ICJ as a court has a twofold role; to settle legal disputes submitted to it by states, and to give advisory opinions on legal questions referred to it by duly authorized United Nations organs and specialized agencies. All members of the UN are ipso facto parties to the statute of the ICJ. The court gives advisory opinion on any legal question. These courts are the most appropriate fora to pronounce on international crimes and are in a better position to know and apply international law. Cases that have been brought to the courts include Rwanda’s genocide, Liberia’s Charles Taylor etc. The receptiveness and cooperation of the local populations are important to the courts and if the ICC and ICJ can provide appropriate protections for the physical and economic safety of victims then peace and human rights observance can be attained. This paper will look into the effectiveness and impediments of these courts in handling criminal and injustices in international politics as while as what needs to be done to strengthen the capacity of these courts.

Keywords: ICC, international politics, justice, UN security council, violence, protection, fulfilling

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4588 Multi-National Corporations and International Communication. An Analysis of Arçelik globals’ Online Presences

Authors: Aisha Iddrsiu

Abstract:

Public Relations (PR) has rapidly evolved around the world, just as companies have expanded to reach other parts of the world. With most multinational corporations conducting businesses in more than one country, only a few of these Multinational Corporations (MNC’s) are actual public relations firms, many have public relations departments or divisions that conduct public relations practices internationally. Hence international public relations is seen as a fast-growing specialty in the field of Public Relations. Multinational companies have devised strategies to effectively communicate and execute their roles within and between foreign publics and other cultures in which they operate through various means including the internet which is among the major inventions that have enabled corporations to establish their presents while targeting anonymous and diverse publics from varied cultures. International public relations practitioners rely on strategies coupled with internet use to communicate among and with foreign publics. Corporate websites and various social media handles have served as an important channel for public relations activities targeting both internal and international publics. In an incessant expansion of corporations and interactions with the publics from different cultures, it has become eminent to understand the public relation strategies used by MNCs in their international communication. This study therefore seeks to establish the international public relation strategies or models employed by Multinational Corporations specifically Arcelik Global in the management of its subsidiaries and communicating with international public. This study analyses both Arçelik global’s (one of the largest multinational companies in Turkey) website and social media accounts to understand the management strategy used with it subsidiary as well as strategies used to communicate with its global and local publics. Other underlying objective of this study are, 1. To examine the dominant international public relations models used by Multinational Corporations (Arcelik global). 2. To understand how Multinational Corporations manage (Arcelik global) its subsidiaries. 3. To understand how Multinational Corporations (Arcelik global) communicate with international or global publics. Research Questions 1. The main global PR strategies employed by multinational corporations (Arcelik global) 2. How subsidiaries of multinational corporations like Arcelik Global are managed. 3. How multinational corporations, like Arcelik worldwide, interact with international publics.

Keywords: multinational corporation, ethnocentric model, polycentric model, international public relations

Procedia PDF Downloads 57
4587 Understanding Europe’s Role in the Area of Liberty, Security, and Justice as an International Actor

Authors: Barrere Sarah

Abstract:

The area of liberty, security, and justice within the European Union is still a work in progress. No one can deny that the EU struggles between a monistic and a dualist approach. The aim of our essay is to first review how the European law is perceived by the rest of the international scene. It will then discuss two main mechanisms at play: the interpretation of larger international treaties and the penal mechanisms of European law. Finally, it will help us understand the role of a penal Europe on the international scene with concrete examples. Special attention will be paid to cases that deal with fundamental rights as they represent an interesting case study in Europe and in the rest of the World. It could illustrate the aforementioned duality currently present in the Union’s interpretation of international public law. On the other hand, it will explore some specific European penal mechanism through mutual recognition and the European arrest warrant in the transnational criminality frame. Concerning the interpretation of the treaties, it will first, underline the ambiguity and the general nature of some treaties that leave the EU exposed to tension and misunderstanding then it will review the validity of an EU act (whether or not it is compatible with the rules of International law). Finally, it will focus on the most complete manifestation of liberty, security and justice through the principle of mutual recognition. Used initially in commercial matters, it has become “the cornerstone” of European construction. It will see how it is applied in judicial decisions (its main event and achieving success is via the European arrest warrant) and how European member states have managed to develop this cooperation.

Keywords: European penal law, international scene, liberty security and justice area, mutual recognition

Procedia PDF Downloads 380