Search results for: middle cerebral infarct
1492 Social Networks in Business: The Complex Concept of Wasta and the Impact of Islam on the Perception of This Practice
Authors: Sa'ad Ali
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This study explores wasta as an example of a social network and how it impacts business practice in the Arab Middle East, drawing links with social network impact in different regions of the world. In doing so, particular attention will be paid to the socio-economic and cultural influences on business practice. In exploring relationships in business, concepts such as social network analysis, social capital and group identity are used to explore the different forms of social networks and how they influence business decisions and practices in the regions and countries where they prevail. The use of social networks to achieve objectives is known as guanxi in China, wasta in the Arab Middle East and blat in ex-Soviet countries. Wasta can be defined as favouritism based on tribal and family affiliation and is a widespread practice that has a substantial impact on political, social and business interactions in the Arab Middle East. Within the business context, it is used in several ways, such as to secure a job or promotion or to cut through bureaucracy in government interactions. The little research available is fragmented, and most studies reveal a negative attitude towards its usage in business. Paradoxically, while wasta is widely practised, people from the Arab Middle East often deny its influence. Moreover, despite the regular exhibition of a negative opinion on the practice of wasta, it can also be a source of great pride. This paper addresses this paradox by conducting a positional literature review, exploring the current literature on wasta and identifying how the identified paradox can be explained. The findings highlight how wasta, to a large extent, has been treated as an umbrella concept, whilst it is a highly complex practice which has evolved from intermediary wasta to intercessory wasta and therefore from bonding social capital relationships to more bridging social capital relationships. In addition, the research found that Islam, as the predominant religion in the region and the main source of ethical guidance for the majority of people from the region, plays a substantial role in this paradox. Specifically, it is submitted that wasta can be viewed positively in Islam when it is practised to aid others without breaking Islamic ethical guidelines, whilst it can be viewed negatively when it is used in contradiction with the teachings of Islam. As such, the unique contribution to knowledge of this study is that it ties together the fragmented literature on wasta, highlighting and helping us understand its complexity. In addition, it sheds light on the role of Islam in wasta practices, aiding our understanding of the paradoxical nature of the practice.Keywords: Islamic ethics, social capital, social networks, Wasta
Procedia PDF Downloads 1411491 Aspects of Environmental Sustainability in the Operation of Onshore Hydrocarbon Pipelines
Authors: Emil Aliyev
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The main focus of this conference paper is on the aspects of the environmental sustainability of onshore hydrocarbon pipelines. The latter is notorious for being a source of major environmental contamination and a consumer of vast amounts of natural resources such as water, land, steel, etc. Therefore, the environmentally sustainable operation of pipelines is a concern that requires attention and research. The geographical scope of the paper is confined to onshore hydrocarbon pipelines operated in the Middle East region. The research contains elements of originality as it draws on the author’s field experience and practical implementation of environmental and sustainability solutions in a major Middle East-based pipeline organization. The authors describe some of the most common significant environmental aspects of pipeline operations and provide examples of various approaches and technologies that can be successfully utilized to make pipelines more environmentally sustainable. The author concludes that the operation of onshore hydrocarbon pipelines can be made environmentally sustainable. This can be achieved by adopting a systematic framework, focusing limited resources on significant aspects, integrating a circular economy into day-to-day activities, and having strong management support.Keywords: pipelines, onshore hydrocarbon pipelines, environmental sustainability, significant environmental aspects
Procedia PDF Downloads 801490 Simulation Study on Effects of Surfactant Properties on Surfactant Enhanced Oil Recovery from Fractured Reservoirs
Authors: Xiaoqian Cheng, Jon Kleppe, Ole Torsaeter
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One objective of this work is to analyze the effects of surfactant properties (viscosity, concentration, and adsorption) on surfactant enhanced oil recovery at laboratory scale. The other objective is to obtain the functional relationships between surfactant properties and the ultimate oil recovery and oil recovery rate. A core is cut into two parts from the middle to imitate the matrix with a horizontal fracture. An injector and a producer are at the left and right sides of the fracture separately. The middle slice of the core is used as the model in this paper, whose size is 4cm x 0.1cm x 4.1cm, and the space of the fracture in the middle is 0.1 cm. The original properties of matrix, brine, oil in the base case are from Ekofisk Field. The properties of surfactant are from literature. Eclipse is used as the simulator. The results are followings: 1) The viscosity of surfactant solution has a positive linear relationship with surfactant oil recovery time. And the relationship between viscosity and oil production rate is an inverse function. The viscosity of surfactant solution has no obvious effect on ultimate oil recovery. Since most of the surfactant has no big effect on viscosity of brine, the viscosity of surfactant solution is not a key parameter of surfactant screening for surfactant flooding in fractured reservoirs. 2) The increase of surfactant concentration results a decrease of oil recovery rate and an increase of ultimate oil recovery. However, there are no functions could describe the relationships. Study on economy should be conducted because of the price of surfactant and oil. 3) In the study of surfactant adsorption, assume that the matrix wettability is changed to water-wet when the surfactant adsorption is to the maximum at all cases. And the ratio of surfactant adsorption and surfactant concentration (Cads/Csurf) is used to estimate the functional relationship. The results show that the relationship between ultimate oil recovery and Cads/Csurf is a logarithmic function. The oil production rate has a positive linear relationship with exp(Cads/Csurf). The work here could be used as a reference for the surfactant screening of surfactant enhanced oil recovery from fractured reservoirs. And the functional relationships between surfactant properties and the oil recovery rate and ultimate oil recovery help to improve upscaling methods.Keywords: fractured reservoirs, surfactant adsorption, surfactant concentration, surfactant EOR, surfactant viscosity
Procedia PDF Downloads 1671489 A Novel Mediterranean Diet Index from the Middle East and North Africa Region: Comparison with Europe
Authors: Farah Naja, Nahla Hwalla, Leila Itani, Shirine Baalbaki, Abla Sibai, Lara Nasreddine
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Purpose: To propose an index for assessing adherence to a Middle-Eastern version of the Mediterranean diet as represented by the traditional Lebanese Mediterranean diet (LMD), to evaluate the association between the LMD and selected European Mediterranean diets (EMD); to examine socio-demographic and lifestyle correlates of adherence to Mediterranean diet (MD) among Lebanese adults. Methods: Using nationally representative dietary intake data of Lebanese adults, an index to measure adherence to the LMD was derived. The choice of food groups used for calculating the LMD score was based on results of previous factor analyses conducted on the same dataset. These food groups included fruits, vegetables, legumes, olive oil, burghol, dairy products, starchy vegetables, dried fruits, and eggs. Using Pearson’s correlation and scores tertiles distributions agreement, the derived LMD index was compared to previously published EMD indexes from Greece, Spain, Italy, France, and EPIC. Results: Fruits, vegetables and olive oil were common denominators to all MD scores. Food groups, specific to the LMD, included burghol and dried fruits. The LMD score significantly correlated with the EMD scores, while being closest to the Italian (r=0.57) and farthest from the French (r=0.21). Percent agreement between scores’ tertile distributions and Kappa statistics confirmed these findings. Multivariate linear regression showed that older age, higher educational, female gender, and healthy lifestyle characteristics were associated with increased adherence to all MD studied. Conclusion: A novel LMD index was proposed to characterize Mediterranean diet in Lebanon, complementing international efforts to characterize the MD and its association with disease risk.Keywords: mediterranean diet, adherence, Middle-East, Lebanon, Europe
Procedia PDF Downloads 4041488 Royal Tourism: Conscious Perspicacity of Dubai
Authors: Aarti Suryawanshi
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Royal Tourism has always been a popular niche activity for many tourists around the world. The United Kingdom being at the heart of it, has been a pioneering nation for Royal tourists. Though many other countries with monarchies such as India, Thailand, Japan, Spain, Netherlands, and many more have attracted tourists with the motivation to see and experience the royalty to their nations, the Middle Eastern countries have never really been the attraction for Royal tourists. Royalty in the middle east is fast emerging as a tourist product and also paving way to marketing opportunity that may lead to the increased popularity of the Royal Houses of the region. Dubai has been garnering the centre stage for futuristic developments, economic growth initiatives, and continuous efforts towards urbanisation which has brought the lime light on the Royal house of the Al Maktoum globally, along with the younger royal members being extensively recognised and appreciated for their public and private adventures which are shared through various social media platforms. The objective of this paper is to analyse the popularity of His Highness Sheikh Hamdan Bin Mohammed Bin Rashid Al Maktoum through social media platforms and the possibility of inducing Royal Tourism in Dubai. An empirical study has been performed to describe the automated repositioning of the city of Dubai as a royal tourism hub.Keywords: royalty, royal tourism, monarchy, marketing strategy, repositioning
Procedia PDF Downloads 931487 Colorful Ethnoreligious Map of Iraq and the Current Situation of Minorities in the Country
Authors: Meszár Tárik
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The aim of the study is to introduce the minority groups living in Iraq and to shed light on their current situation. The Middle East is a rather heterogeneous region in ethnic terms. It includes many ethnic, national, religious, linguistic, or ethnoreligious groups. The relationship between the majority and minority is the main cause of various conflicts in the region. It seems that most of the post-Ottoman states have not yet developed a unified national identity capable of integrating their multi-ethnic societies. The issue of minorities living in the Middle East is highly politicized and controversial, as the various Arab states consider the treatment of minorities as their internal affair, do not recognize discrimination or even deny the existence of any kind of minorities on their territory. This attitude of the Middle Eastern states may also be due to the fact that the minority issue can be abused and can serve as a reference point for the intervention policies of Western countries at any time. Methodologically, the challenges of these groups are perceived through the manifestos of prominent individuals and organizations belonging to minorities. The basic aim is to present the minorities’ own history in dealing with the issue. It also introduces the different ethnic and religious minorities in Iraq and analyzes their situation during the operation of the terrorist organization „Islamic State” and in the aftermath. It is clear that the situation of these communities deteriorated significantly with the advance of ISIS, but it is also clear that even after the expulsion of the militant group, we cannot necessarily report an improvement in this area, especially in terms of the ability of minorities to assert their interests and physical security. The emergence of armed militias involved in the expulsion of ISIS sometimes has extremely negative effects on them. Until the interests of non-Muslims are adequately represented at the local level and in the legislature, most experts and advocates believe that little will change in their situation. When conflicts flare, many Iraqi citizens usually leave Iraq, but because of the poor public security situation (threats from terrorist organizations, interventions by other countries), emigration causes serious problems not only outside the country’s borders but also within the country. Another ominous implication for minorities is that their communities are very slow if ever, to return to their homes after fleeing their own settlements. An important finding of the study is that this phenomenon is changing the face of traditional Iraqi settlements and threatens to plunge groups that have lived there for thousands of years into the abyss of history. Therefore, we not only present the current situation of minorities living in Iraq but also discuss their future possibilities.Keywords: Middle East, Iraq, Islamic State, minorities
Procedia PDF Downloads 831486 The Characteristics of Islamic Concept In Contemporary Mosque Design With The Case Modulation of Study: Kauman Mosque Yogyakarta Indonesia
Authors: Sulihantoro, Muhamad Irga Fahreza
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Age of onset of the crisis makes more advanced understanding of the values of Islam that has been etched in architectural design. The majority Muslim mosque architecture designing buildings when they designed the architecture of Islam has always stuck in a cultural symbol, the shape of the facade, carving calligraphy, and all things that are closely related to the culture of the Middle East. As well as the interpretation of symbols, by designing a dome in every mosque, calligraphy carvings inside the mosque, and the other elements in the building which is interpreted by middle eastern culture. So here we have a problem understanding the meaning of Islam with kaf fah (overall), which appears distorted understanding to distinguish between cultural values and theological in design. This paper will try to evaluate the design of a contemporary mosque in Indonesia, with a case study in Masjid Kauman Yogyakarta Indonesia. building characteristics focused on the function of the building, history, aesthetics, comfort, and safety. The results of this study should be found on the evaluation of the integrated design of contemporary mosques are based on a study of the Quran and Hadith.Keywords: characteristics, Islamic concept, culture, Kauman Mosque
Procedia PDF Downloads 2161485 Benefits of Whole-Body Vibration Training on Lower-Extremity Muscle Strength and Balance Control in Middle-Aged and Older Adults
Authors: Long-Shan Wu, Ming-Chen Ko, Chien-Chang Ho, Po-Fu Lee, Jenn-Woei Hsieh, Ching-Yu Tseng
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This study aimed to determine the effects of whole-body vibration (WBV) training on lower-extremity muscle strength and balance control performance among community-dwelling middle-aged and older adults in the United States. Twenty-nine participants without any contraindication of performing WBV exercise completed all the study procedures. Participants were randomly assigned to do body weight exercise with either an individualized vibration frequency and amplitude, a fixed vibration frequency and amplitude, or no vibration. Isokinetic knee extensor power, limits of stability, and sit-to-stand tests were performed at the baseline and after 8 weeks of training. Neither the individualized frequency-amplitude WBV training protocol nor the fixed frequency-amplitude WBV training protocol improved isokinetic knee extensor power. The limits of stability endpoint excursion score for the individualized frequency-amplitude group increased by 8.8 (12.9%; p = 0.025) after training. No significant differences were observed in fixed and control group. The maximum excursion score for the individualized frequency-amplitude group at baseline increased by 9.2 (11.5%; p = 0.006) after training. The average weight transfer time score significantly decreased by 0.21 s in the fixed group. The participants in the individualized group showed a significant increase (3.2%) in weight rising index score after 8 weeks of WBV training. These results suggest that 8 weeks of WBV training improved limit of stability and sit-to-stand performance. Future studies need to determine whether WBV training improves other factors that can influence posture control.Keywords: whole-body vibration training, muscle strength, balance control, middle-aged and older adults
Procedia PDF Downloads 2201484 The Child Attachment Interview: A Psychometric Longitudinal Validation Study in a German Sample
Authors: Jorn Meyer, Stefan Sturmer
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The assessment of attachment patterns in toddlers and adults has been well researched, and valid diagnostic methods (e.g., Strange Situation Test, Adult Attachment Interview) are applicable. For middle and late childhood, on the other hand, there are only few validated methods available so far. For the Child Attachment Interview (CAI) promising validation studies from English-speaking countries are available, but so far a comprehensive study on the validity of a German sample is lacking. Within the scope of a longitudinal project, the results of the first point of measurement are reported in this study. A German-language version of the CAI was carried out with 111 primary school children (56% female; age: M = 8.34, SD = 0.49). In relation to psychometric quality criteria, parameters on interrater reliability, construct validity and discriminant, and convergent validity are reported. Analyses of the correlations between attachment patterns and internalizing and externalizing behavior problems from parent and teacher reports are presented. The implications for the German-language assessment of attachment in middle and late childhood in research and individual case diagnostics, e.g., in the context of conducting expert evaluation reports for family courts, are discussed.Keywords: attachment, attachment assessment, developmental psychology, longitudinal study
Procedia PDF Downloads 2311483 The Development of User Behavior in Urban Regeneration Areas by Utilizing the Floating Population Data
Authors: Jung-Hun Cho, Tae-Heon Moon, Sun-Young Heo
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A lot of urban problems, caused by urbanization and industrialization, have occurred around the world. In particular, the creation of satellite towns, which was attributed to the explicit expansion of the city, has led to the traffic problems and the hollowization of old towns, raising the necessity of urban regeneration in old towns along with the aging of existing urban infrastructure. To select urban regeneration priority regions for the strategic execution of urban regeneration in Korea, the number of population, the number of businesses, and deterioration degree were chosen as standards. Existing standards had a limit in coping with solving urban problems fundamentally and rapidly changing reality. Therefore, it was necessary to add new indicators that can reflect the decline in relevant cities and conditions. In this regard, this study selected Busan Metropolitan City, Korea as the target area as a leading city, where urban regeneration such as an international port city has been activated like Yokohama, Japan. Prior to setting the urban regeneration priority region, the conditions of reality should be reflected because uniform and uncharacterized projects have been implemented without a quantitative analysis about population behavior within the region. For this reason, this study conducted a characterization analysis and type classification, based on the user behaviors by using representative floating population of the big data, which is a hot issue all over the society in recent days. The target areas were analyzed in this study. While 23 regions were classified as three types in existing Busan Metropolitan City urban regeneration priority region, 23 regions were classified as four types in existing Busan Metropolitan City urban regeneration priority region in terms of the type classification on the basis of user behaviors. Four types were classified as follows; type (Ⅰ) of young people - morning type, Type (Ⅱ) of the old and middle-aged- general type with sharp floating population, type (Ⅲ) of the old and middle aged-24hour-type, and type (Ⅳ) of the old and middle aged with less floating population. Characteristics were shown in each region of four types, and the study results of user behaviors were different from those of existing urban regeneration priority region. According to the results, in type (Ⅰ) young people were the majority around the existing old built-up area, where floating population at dawn is four times more than in other areas. In Type (Ⅱ), there were many old and middle-aged people around the existing built-up area and general neighborhoods, where the average floating population was more than in other areas due to commuting, while in type (Ⅲ), there was no change in the floating population throughout 24 hours, although there were many old and middle aged people in population around the existing general neighborhoods. Type (Ⅳ) includes existing economy-based type, central built-up area type, and general neighborhood type, where old and middle aged people were the majority as a general type of commuting with less floating population. Unlike existing urban regeneration priority region, these types were sub-divided according to types, and in this study, approach methods and basic orientations of urban regeneration were set to reflect the reality to a certain degree including the indicators of effective floating population to identify the dynamic activity of urban areas and existing regeneration priority areas in connection with urban regeneration projects by regions. Therefore, it is possible to make effective urban plans through offering the substantial ground by utilizing scientific and quantitative data. To induce more realistic and effective regeneration projects, the regeneration projects tailored to the present local conditions should be developed by reflecting the present conditions on the formulation of urban regeneration strategic plans.Keywords: floating population, big data, urban regeneration, urban regeneration priority region, type classification
Procedia PDF Downloads 2101482 Study on the Focus of Attention of Special Education Students in Primary School
Authors: Tung-Kuang Wu, Hsing-Pei Hsieh, Ying-Ru Meng
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Special Education in Taiwan has been facing difficulties including shortage of teachers and lack in resources. Some students need to receive special education are thus not identified or admitted. Fortunately, information technologies can be applied to relieve some of the difficulties. For example, on-line multimedia courseware can be used to assist the learning of special education students and take pretty much workload from special education teachers. However, there may exist cognitive variations between students in special or regular educations, which suggests the design of online courseware requires different considerations. This study aims to investigate the difference in focus of attention (FOA) between special and regular education students of primary school in viewing the computer screen. The study is essential as it helps courseware developers in determining where to put learning elements that matter the most on the right position of screen. It may also assist special education specialists to better understand the subtle differences among various subtypes of learning disabilities. This study involves 76 special education students (among them, 39 are students with mental retardation, MR, and 37 are students with learning disabilities, LDs) and 42 regular education students. The participants were asked to view a computer screen showing a picture partitioned into 3 × 3 areas with each area filled with text or icon. The subjects were then instructed to mark on the prior given paper sheets, which are also partitioned into 3 × 3 grids, the areas corresponding to the pictures on the computer screen that they first set their eyes on. The data are then collected and analyzed. Major findings are listed: 1. In both text and icon scenario, significant differences exist in the first preferred FOA between special and regular education students. The first FOA for the former is mainly on area 1 (upper left area, 53.8% / 51.3% for MR / LDs students in text scenario; and 53.8% / 56.8% for MR / LDs students in icons scenario), while the latter on area 5 (middle area, 50.0% and 57.1% in text and icons scenarios). 2. The second most preferred area in text scenario for students with MR and LDs are area 2 (upper-middle, 20.5%) and 5 (middle area, 24.3%). In icons scenario, the results are similar, but lesser in percentage. 3. Students with LDs that show similar preference (either in text or icons scenarios) in FOA to regular education students tend to be of some specific sub-type of learning disabilities. For instance, students with LDs that chose area 5 (middle area, either in text or icon scenario) as their FOA are mostly ones that have reading or writing disability. Also, three (out of 13) subjects in this category, after going through the rediagnosis process, were excluded from being learning disabilities. In summary, the findings suggest when designing multimedia courseware for students with MR and LDs, the essential learning elements should be placed on area 1, 2 and 5. In addition, FOV preference may also potentially be used as an indicator for diagnosing students with LDs.Keywords: focus of attention, learning disabilities, mental retardation, on-line multimedia courseware, special education
Procedia PDF Downloads 1611481 Morphological Studies of the Gills of the Red Swamp Freshwater Crayfish Procambarus clarkii (Crustacea: Decapoda: Cambarids) (Girard 1852) from the River Nile and Its Branches in Egypt
Authors: Mohamed M. A. Abumandour
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The red swamp freshwater crayfish breathe through three types of feather-like trichobranchiate gills; podobranchiae, arthrobranchiae and pleurobranchiae. All gills have the same general structure and appearance; plume-like with single broad setiferous, and single axis. The gill consists of axis with numerous finger-like filaments, having three morphological types; round, pointed and somewhat hooked shaped. The direction of filaments vary according their position; in middle region were nearly perpendicular to gill axis while in the apex were nearly parallel to axis. There were characteristic system of gill spines on; central axis (two types were distinguishable by presence of socket), basal plate, setobranch (long non-branched and short multidenticulate) and on the bilobed epipodal plate. There are four shape of spinated-like distal region of setobranch seta; two pointed processes (longitudinal arrangement and irregular arranged) and two broad processes (transverse triangular and multidenticulate). The bilobed epipodal plate devoid from any filaments and extended from outer side of podobranchiae as triangular basal part then extended between the gills as cord-like middle part then pass under the gill to lies against the thoracic body wall. By SEM, the apical part of bilobed epipodal plate have serrated free border and corrugated surface while the middle part have none serrated free border. There are two methods of gill cleaning mechanism in crayfish; passive and active method. The passive method occurred by; setae of setobranch, branchiostegite, bilobed epipodal plate, setiferous arthrodial lamellae and reversing the respiratory water through a narrow spaced branchial chamber.Keywords: crayfis, gill spines, setobranch, gill setae, cleaning mechanisms
Procedia PDF Downloads 4041480 Shale Gas and Oil Resource Assessment in Middle and Lower Indus Basin of Pakistan
Authors: Amjad Ali Khan, Muhammad Ishaq Saqi, Kashif Ali
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The focus of hydrocarbon exploration in Pakistan has been primarily on conventional hydrocarbon resources. Directorate General Petroleum Concessions (DGPC) has taken the lead on the assessment of indigenous unconventional oil and gas resources, which has resulted in a ‘Shale Oil/Gas Resource Assessment Study’ conducted with the help of USAID. This was critically required in the energy-starved Pakistan, where the gap between indigenous oil & gas production and demand continues to widen for a long time. Exploration & exploitation of indigenous unconventional resources of Pakistan have become vital to meet our energy demand and reduction of oil and gas import bill of the country. This study has attempted to bridge a critical gap in geological information about the potential of shale gas & oil in Pakistan in the four formations, i.e., Sembar, Lower Goru, Ranikot and Ghazij in the Middle and Lower Indus Basins, which were selected for the study as for resource assessment for shale gas & oil. The primary objective of the study was to estimate and establish shale oil/gas resource assessment of the study area by carrying out extensive geological analysis of exploration, appraisal and development wells drilled in the Middle and Lower Indus Basins, along with identification of fairway(s) and sweet spots in the study area. The Study covers the Lower parts of the Middle Indus basins located in Sindh, southern Punjab & eastern parts of the Baluchistan provinces, with a total sedimentary area of 271,795 km2. Initially, 1611 wells were reviewed, including 1324 wells drilled through different shale formations. Based on the availability of required technical data, a detailed petrophysical analysis of 124 wells (21 Confidential & 103 in the public domain) has been conducted for the shale gas/oil potential of the above-referred formations. The core & cuttings samples of 32 wells and 33 geochemical reports of prospective Shale Formations were available, which were analyzed to calibrate the results of petrophysical analysis with petrographic/ laboratory analyses to increase the credibility of the Shale Gas Resource assessment. This study has identified the most prospective intervals, mainly in Sembar and Lower Goru Formations, for shale gas/oil exploration in the Middle and Lower Indus Basins of Pakistan. The study recommends seven (07) sweet spots for undertaking pilot projects, which will enable to evaluate of the actual production capability and production sustainability of shale oil/gas reservoirs of Pakistan for formulating future strategies to explore and exploit shale/oil resources of Pakistan including fiscal incentives required for developing shale oil/gas resources of Pakistan. Some E&P Companies are being persuaded to make a consortium for undertaking pilot projects that have shown their willingness to participate in the pilot project at appropriate times. The location for undertaking the pilot project has been finalized as a result of a series of technical sessions by geoscientists of the potential consortium members after the review and evaluation of available studies.Keywords: conventional resources, petrographic analysis, petrophysical analysis, unconventional resources, shale gas & oil, sweet spots
Procedia PDF Downloads 361479 Protection against the Hazards of Stress on Health in Older Adults through Mindfulness
Authors: Cindy de Frias, Erum Whyne
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Objectives: The current study examined whether the link between stress and health-related quality of life was buffered by protective factors, namely mindfulness, in a sample of middle-aged and older adults. Method: In this cross-sectional study, 134 healthy, community-dwelling adults (aged 50–85 years) were recruited from Dallas, Texas. The participants were screened for depressive symptoms and severity (using the Patient Health Questionnaire [PHQ-9]). All participants completed measures of self-reported health status (i.e., SF-36v2: mental and physical health composites), life stress (using the Elder’s Life Stress Inventory [ELSI]), and trait mindfulness (i.e., Mindful Attention Awareness Scale). Results: Hierarchical regressions (covarying for age, gender, and education) showed that life stress was inversely related to physical and mental health. Mindfulness was positively related to mental health. The negative effect of life stress on mental health was weakened for those individuals with greater trait mindfulness. Discussion: The results suggest that mindfulness is a powerful, adaptive strategy that may protect middle-aged and older adults from the well-known harmful effects of stress on healthy aging.Keywords: health, stress, mindfulness, aging
Procedia PDF Downloads 4601478 Mother-Child Attachment and Anxiety Symptoms in Middle Childhood: Differences in Levels of Attachment Security
Authors: Simran Sharda
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There is increasing evidence that leads psychologists today to believe that the attachment formed between a mother and child plays a much more profound role in later-life outcomes than previously expected. Particularly, the fact that a link may exist between maternal attachment and the development in addition to the severity of social anxiety in middle childhood seems to be gaining ground. This research will examine and address a myriad of major issues related to the impact of mother-child attachment: behaviors of children with different levels of secure attachment, various aspects of anxiety in relation to attachment security as well as other styles of mother-child attachments, especially avoidant attachment and over-attachment. This analysis serves to compile previous literature on the subject and touch light upon a logical extension of the research. Moreover, researchers have identified links between attachment and the externalization of problem behaviors: these behaviors may later manifest as social anxiety as well as increased severity and likelihood of PTSD diagnosis (an anxiety disorder). Furthermore, secure attachment has been linked to increased health benefits, cognitive skills, emotive socialization, and developmental psychopathology.Keywords: child development, anxiety, cognition, developmental psychopathology, mother-child relationships, maternal, cognitive development
Procedia PDF Downloads 1511477 Empowering Middle School Math Coordinators as Agents of Transformation: The Impact of the Mitar Program on Mathematical Literacy and Social-Emotional Learning Integration
Authors: Saleit Ron
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The Mitar program was established to drive a shift in middle school mathematics education, emphasizing the connection of math to real-life situations, exploring mathematical modeling and literacy, and integrating social and emotional learning (SEL) components for enhanced excellence. The program envisions math coordinators as catalysts for change, equipping them to create educational materials, strengthen leadership skills, and develop SEL competencies within coordinator communities. These skills are then employed to lead transformative efforts within their respective schools. The program engaged 90 participants across six math coordinator communities during 2022-2023, involving 30-60 hours of annual learning. The process includes formative and summative evaluations through questionnaires and interviews, revealing participants' high contentment and successful integration of acquired skills into their schools. Reflections from participants highlighted the need for enhanced change leadership processes, often seeking more personalized mentoring to navigate challenges effectively.Keywords: math coordinators, mathematical literacy, mathematical modeling, SEL competencies
Procedia PDF Downloads 481476 Comparisons of Depressive Symptoms and Cognitive Appraisals in Different Age Groups under Abusive Leadership
Authors: Shao-Ying Wang, Shin-I Shih, Chi-Cheng Wu
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Background: By following to the maturity theory about age, the manifestation of depression in different age groups under occupational stressors still remains unclear. Therefore, the aim of this study was to examine the depression within four main symptoms clusters: cognition, affect, physical complaints and interpersonal difficulty among the different age groups. Additionally, this study also used the stress appraisal theory, through the examination of challenge and hindrance appraisals, the effects of cognitive factors were expected to give therapeutic indication for the future treatment of depression under abusive leadership. Methods (Participants and Procedure): The data were collected in two waves from employees of local companies in Taiwan. The participants (58 males and 167 females) were native Chinese speakers, ranging in age from 20 to 59 years (M= 36.51). Up to 80% educational level of participants were above senior high. The married population was approximately at 43%. Measures; 1. Abusive Leadership: To measure abusive leadership, we used 15-item scale of abusive supervision which anchored on a 7-point Likert-type scale. (α= .96) 2. Depression: We used Taiwanese Depression Scale to measure the 4 clusters (cognition, affect, physical complaints and interpersonal difficulty) of symptoms. Participants responded for depression anchored on a 7-point Likert-type scale (α= .96). 3. Stress Appraisal Scale: To measure challenge and hindrance types of appraisal, participants responded to 33-item measure anchored on a 7-point Likert-type scale. (Challenge appraisal; α= .90; hindrance appraisal α= .87). Results: The results of correlation showed that there was a significant and negative correlation between abusive leadership and age (r = - .21, p < .01). Abusive leadership was positive correlated significantly with hindrance appraisal (r = .52, p < .01) and depression (r = .20, p < .01). The results also showed that hindrance appraisal was correlated to depression positively (r = .36, p < .01). A one-way ANOVA was conducted to compare the effect of lower/middle/order age groups on each cluster of depressive symptoms. The results showed that the effect of age groups on cognition was significant F (2, 157) =3.66, P < .05. Older age group (M=13.43 SD=6.84) reported less cognitive symptoms of depression than the middle (M=16.77 SD=7.49) and lower age (M=16.91 SD=6.97) groups. Besides, the effect of age groups on affect was also significant F (2,157)= 4.09 P < .05. Older age group (M=18.68 SD=8.98) reported less affective symptoms of depression than the middle (M=22.01 SD=7.96) and lower age (M=23.56 SD=7.67) groups. Moreover, the main effect of hindrance appraisal was found F (2, 157) =3.81, P < .05. Older age group (M=9.44 SD=2.89) reported fewer score on hindrance appraisals than the middle (M=11.06 SD=4.02) and lower age (M=9.62 SD=3.17) groups. To conclude, the severity of depression symptoms varies across different age groups. Maturity seems to be the protective factor to depression, accompanying with lower hindrance appraisals.Keywords: abusive leadership, affective commitment, depression symptoms, psychological well-being
Procedia PDF Downloads 2001475 The Need for Including Hepatitis a Vaccine in Routine Childhood Immunization Programs in Europe as a Response to the Influx of Refugees from the Middle East and North Africa (MENA) Regions
Authors: S. Ramia, N. Melhem, K. Kreidieh
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The world is facing an unprecedented displacement crisis. Recently, over 1.1 million asylum seekers have been granted protection status in the European Union (EU). The majority of these asylum seekers were from countries of the Middle East and North Africa (MENA) region.This influx carries with it a potential introduction of infectious diseases that have been eliminated in the EU, which poses a challenge for EU health authorities. Compared to MENA region countries where Hepatitis A Virus (HAV) endemicity is high to intermediate, member states of the EU show very low (Western Europe) to low (Eastern Europe) levels of HAV endemicity. Because of this situation, there is an ongoing public health concern in high-income countries, like members of the EU, that many adults remain susceptible to HAV outbreaks. The overwhelming majority of the EU members’ states do not include HAV vaccine in their immunization calendars. Hence, this paper urgently calls for the implementation of new policies regarding HAV in EU members’ states.Keywords: European union, hepatitis A, MENA region refugees, vaccine preventable diseases
Procedia PDF Downloads 2691474 Shared Beliefs and Behavioral Labels in Bullying among Middle Schoolers: Qualitative Analysis of Peer Group Dynamics
Authors: Malgorzata Wojcik
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Groups are a powerful and significant part of human development. They serve as major emergent microsocial structures in children’s and youth’s ecological system. During middle and secondary school, peer groups become a particularly salient influence. While they promote a range of prosocial and positive emotional and behavioral attributes, they can also elicit negative or antisocial attributes, effectively “bringing out the worst” in some individuals. The grounded theory approach was employed to guide data collection and analysis, as it allows for a deeper understanding of the group processes and students’ perspectives on complex intragroup relations. Students’ perspectives on bullying cases were investigated by observing daily interactions among those involved and interviewing 47 students. The results complement theories of labeling in bullying by showing that all students self-label themselves and find it difficult to break patterns of behaviors related to bullying, such as supporting the bully or not defending the victim. In terms of the practical implications, the findings indicate that it could be beneficial to use non-punitive, restorative anti-bullying interventions that implement peer influence to transform bullying relations by removing behavioral labels.Keywords: bullying, peer group, victimization, class reputation
Procedia PDF Downloads 1111473 Prediction of Outcome after Endovascular Thrombectomy for Anterior and Posterior Ischemic Stroke: ASPECTS on CT
Authors: Angela T. H. Kwan, Wenjun Liang, Jack Wellington, Mohammad Mofatteh, Thanh N. Nguyen, Pingzhong Fu, Juanmei Chen, Zile Yan, Weijuan Wu, Yongting Zhou, Shuiquan Yang, Sijie Zhou, Yimin Chen
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Background: Endovascular Therapy (EVT)—in the form of mechanical thrombectomy—following intravenous thrombolysis is the standard gold treatment for patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). It is well established that an ASPECTS ≥ 7 is associated with an increased likelihood of positive post-EVT outcomes, as compared to an ASPECTS < 7. There is also prognostic utility in coupling posterior circulation ASPECTS (pc-ASPECTS) with magnetic resonance imaging for evaluating the post-EVT functional outcome. However, the value of pc-ASPECTS applied to CT must be explored further to determine its usefulness in predicting functional outcomes following EVT. Objective: In this study, we aimed to determine whether pc-ASPECTS on CT can predict post-EVT functional outcomes among patients with AIS due to LVO. Methods: A total of 247 consecutive patients aged 18 and over receiving EVT for LVO-related AIS were recruited into a prospective database. The data were retrospectively analyzed between March 2019 to February 2022 from two comprehensive tertiary care stroke centers: Foshan Sanshui District People’s Hospital and First People's Hospital of Foshan in China. Patient parameters included EVT within 24hrs of symptom onset, premorbid modified Rankin Scale (mRS) ≤ 2, presence of distal and terminal cerebral blood vessel occlusion, and subsequent 24–72-hour post-stroke onset CT scan. Univariate comparisons were performed using the Fisher exact test or χ2 test for categorical variables and the Mann–Whitney U test for continuous variables. A p-value of ≤ 0.05 was statistically significant. Results: A total of 247 patients met the inclusion criteria; however, 3 were excluded due to the absence of post-CTs and 8 for pre-EVT ASPECTS < 7. Overall, 236 individuals were examined: 196 anterior circulation ischemic strokes and 40 posterior strokes of basilar artery occlusion. We found that both baseline post- and pc-ASPECTS ≥ 7 serve as strong positive markers of favorable outcomes at 90 days post-EVT. Moreover, lower rates of inpatient mortality/hospice discharge, 90-day mortality, and 90-day poor outcome were observed. Moreover, patients in the post-ASPECTS ≥ 7 anterior circulation group had shorter door-to-recanalization time (DRT), puncture-to-recanalization time (PRT), and last known normal-to-puncture-time (LKNPT). Conclusion: Patients of anterior and posterior circulation ischemic strokes with baseline post- and pc-ASPECTS ≥ 7 may benefit from EVT.Keywords: endovascular therapy, thrombectomy, large vessel occlusion, cerebral ischemic stroke, ASPECTS
Procedia PDF Downloads 1011472 Interventions to Improve the Performance of Community Based Health Insurance in Low- and Lower Middle-Income-Countries: a Systematic Review
Authors: Scarlet Tabot Enanga Longsti
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Community-Based Health Insurance (CBHI) schemes have been proposed as a possible means to achieve affordable health care in low-and lower-middle-income countries. The existing evidence provides mixed results on the impact of CBHI schemes on healthcare utilisation and out -of-pocket payments (OOPP) for healthcare. Over 900 CBHI schemes have been implemented in underdeveloped countries, and these schemes have undergone different modifications over the years. Prior reviews have suggested that different designs of CBHI schemes may result in different outcomes. Objectives: This review sought to determine the interventions that affect the impact of CBHI schemes on OOPP and health service utilisation. Interventions in this study referred to any action or modification in the design of a CBHI scheme that affected the impact of the scheme on OOPP and/or healthcare utilization. Methods: Any CBHI study that was done in a lower middle-income country, that used an experimental design, that included OOPP or health care utilisation as outcome variables, and that was published in either English or French was included in this study. Studies were searched for in MEDLINE, Embase, CINAHL, EconLit, IBSS, Web of Science, Cochrane Library, and Global Index Medicus from July to August 2023. Bias was assessed using Joanna Brigs Institute tools for quality assessment for randomized control trials and quasi experimental studies. A narrative synthesis was done. Results: 12 studies were included in the review, with a total of 69 villages, 13,653 households, and 62,786 participants. Average premium collection was 4.8 USD/year. Most CBHI schemes had flat rates. The study revealed that a range of interventions impact OOPP and health care utilisation. Five categories of interventions were identified. The intervention with the highest impact on OOPP and utilisation was “Audit visits”. Next in line came external funds, training scheme workers, and engaging community leaders and village heads to advertise the scheme. Free healthcare led to a significant increase in utilisation of health services, a significant reduction in Catastrophic health expenditure, but an insignificant effect on OOPP among insured compared with uninsured. Conclusions: Community-Based Health Insurance could pave the way for Universal Health Care in low and middle-income countries. However, this can only be possible if careful thought is given to how schemes are designed. Due to the heterogeneity of studies and results on CBHI schemes, there is need for further research for more effective designs to be developed.Keywords: community based health insurance, developing countries, health service utilisation, out of pocket payment
Procedia PDF Downloads 611471 Different Approaches to the Study of Territorial Dispute between China and India
Authors: Albina Muratbekova
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One of the main tensions and challenges in the development of Sino-Indian relation is the demarcation of its frontiers. The fact that throughout the history borders had never been demarcated on ground occur a dispute between China and India after receiving sovereignty. Boundaries of India and China are divided into three sectors: Eastern, Middle and Western. The middle sector runs from India’s Uttar Pradesh to the Punjab, 545 km length of the Line of Actual Control, the lines of which was confirmed at the 9th meeting of the Expert Group held in 2001, in New Delhi. Other two sectors are still not determined and cause disputes. A western sector of the frontier is the Aksai Chin plateau, covers areas of Ladakh, Tibet, and Sinkiang. Another disputed area lies in the Eastern sector in the Himalayan region, which after 1986 became the Indian state called Arunachal Pradesh. There are two different approaches in the ways of resolving the border dispute. Chinese side keeps an opinion that the border dispute must be resolved in a timely matter unless it is favorable for China, the resolution can be left to a later generation. While India’s government due to security reasons is eager to demarcate the border. In order to study this conflict was used as a descriptive-comparative-analytical method. Also, it was done a profound analyze of conflict nature.Keywords: border dispute, China, India, territorial claim
Procedia PDF Downloads 3011470 Paleobathymetry and Biostratigraphy of Sambipitu Formation and Its Relation with the Presence of Ichnofossil in Geoheritage Site Ngalang River Yogyakarta
Authors: Harman Dwi R., Alwin Mugiyantoro, Heppy Chintya P.
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The location of this research is a part of Geoheritage that located in Nglipar, Gunung Kidul Regency, Yogyakarta Special Region. Whereas in this location, the carbonate sandstone of Sambipitu Formation (early-middle Miocene) is well exposed along Ngalang River, also there are ichnofossil presence which causes this formation to be interesting. The determination of paleobathymetry is particularly important in determining paleoenvironment and paleogeographic. Paleobathymetry can be determined by identifying the presence of Foraminifera bentonik fossil and parasequence emerge. The methods that used in this study are spatial method of field observation with systematic sampling, descriptive method of paleontology, biostratigraphy analysis, geometrical analysis of Ichnofossil, and study literature. The result obtained that paleobathymetry of this location is bathyal zone with maximum regression known by Bulliminoides williamsonianus showing depth 17 fathoms at the age of N3-N5 (Oligocenne-Early Miocene) and the maximum transgression is known by Cibicides pseudoungarianus showing depth 862 fathoms at the age of N8-N9 (Early-Middle Miocene). Where the obtained paleobathymetry supported of the presence and formed the pattern of ichnofossil that found in the study area.Keywords: paleobathymetry, biostratigraphy, ichnofossil, Ngalang river
Procedia PDF Downloads 1591469 Shoring System Selection for Deep Excavation
Authors: Faouzi Ahtchi-Ali, Marcus Vitiello
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A study was conducted in the east region of the Middle East to assess the constructability of a shoring system for a 12-meter deep excavation. Several shoring systems were considered in this study including secant concrete piling, contiguous concrete piling, and sheet-piling. The excavation was carried out in a very dense sand with the groundwater level located at 3 meters below ground surface. The study included conducting a pilot test for each shoring system listed above. The secant concrete piling included overlapping concrete piles to a depth of 16 meters. Drilling method with full steel casing was utilized to install the concrete piles. The verticality of the piles was a concern for the overlap. The contiguous concrete piling required the installation of micro-piles to seal the gap between the concrete piles. This method revealed that the gap between the piles was not fully sealed as observed by the groundwater penetration to the excavation. The sheet-piling method required pre-drilling due to the high blow count of the penetrated layer of saturated sand. This study concluded that the sheet-piling method with pre-drilling was the most cost effective and recommended a method for the shoring system.Keywords: excavation, shoring system, middle east, Drilling method
Procedia PDF Downloads 4651468 Outcome of Naive SGLT2 Inhibitors Among ICU Admitted Acute Stroke with T2DM Patients a Prospective Cohort Study in NCMultispecialty Hospital, Biratnagar, Nepal
Authors: Birendra Kumar Bista, Rhitik Bista, Prafulla Koirala, Lokendra Mandal, Nikrsh Raj Shrestha, Vivek Kattel
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Introduction: Poorly controlled diabetes is associated with cause and poor outcome of stroke. High blood sugar reduces cerebral blood flow, increases intracranial pressure, cerebral edema and neuronal death, especially among patients with poorly controlled diabetes.1 SGLT2 inhibitors are associated with 50% reduction in hemorrhagic stroke compared with placebo. SGLT2 inhibitors decrease cardiovascular events via reducing glucose, blood pressure, weight, arteriosclerosis, albuminuria and reduction of atrial fibrillation.2,3 No study has been documented in low income countries to see the role of post stroke SGLT2 inhibitors on diabetic patients at and after ICU admission. Aims: The aim of the study was to measure the 12 months outcome of diabetic patients with acute stroke admitted in ICU set up with naïve SGLT2 inhibitors add on therapy. Method: It was prospective cohort study carried out in a 250 bedded tertiary neurology care hospital at the province capital Biratnagar Nepal. Diabetic patient with acute stroke admitted in ICU from 1st January 2022 to 31st December 2022 who were not under SGLT2 inhibitors were included in the study. These patients were managed as per hospital protocol. Empagliflozin was added to the alternate enrolled patients. Empagliflozin was continued at the time of discharged and during follow up unless contraindicated. These patients were followed up for 12 months. Outcome measured were mortality, morbidity requiring readmission or hospital visit other than regular follow up, SGLT2 inhibitors related adverse events, neuropsychiatry comorbidity, functional status and biochemical parameters. Ethical permission was taken from hospital administration and ethical board. Results: Among 147 diabetic cases 68 were not treated with empagliflozin whereas 67 cases were started the SGLT2 inhibitors. HbA1c level and one year mortality was significantly low among patients on empaglifozin arm. Over a period of 12 months 427 acute stroke patients were admitted in the ICU. Out of them 44% were female, 61% hypertensive, 34% diabetic, 57% dyslipidemia, 26% smoker and with median age of 45 years. Among 427 cases 4% required neurosurgical interventions and 76% had hemorrhagic CVA. The most common reason for ICU admission was GCS<8 (51%). The median ICU stay was 5 days. ICU mortality was 21% whereas 1 year mortality was 41% with most common reason being pneumonia. Empaglifozin related adverse effect was seen in 11% most commonly lower urinary tract infection in 6%. Conclusion: Empagliflozin can safely be started among acute stroke with better Hba1C control and low mortality outcome compared to treatment without SGLT2 inhibitor.Keywords: diabetes, ICU, mortality, SGLT2 inhibitors, stroke
Procedia PDF Downloads 541467 Natural Forest Ecosystem Services and Local Populations
Authors: Mohammed Sghir Taleb
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Located at the northwest corner of the African continent between 21 ° and 36 ° north latitude and between the 1st and the 17th degree of west longitude, Morocco, with a total area of 715,000 km², enjoys a privileged position with a coastline of 3 446 km long opening to the Mediterranean and the Atlantic Ocean. Its privileged location with a double coastline and its diverse mountain with four major mountain ranges: the Rif, Middle Atlas, High Atlas, and Anti Atlas, with altitudes exceeding 2000 m in the Rif, 3000 m in the Middle Atlas, and 4000 m in the High Atlas. Morocco is characterized by an important forest genetic diversity represented by a rich and varied flora and many ecosystems: forest, preforest, presteppe, steppe, Sahara that spans a range of bioclimatic zones: arid, semiarid, subhumid, and humid. The vascular flora of Morocco is rich and highly diversified, with a very significant degree of endemism. Natural flora and ecosystems provide important services to populations represented by grazing, timber harvest, harvesting of medicinal and aromatic plants. This work will be focused on the Moroccan biodiversity and natural ecosystem services and on the interaction between local populations and ecosystemsKeywords: biodiversity, forest, ecosystem, services, Morocco
Procedia PDF Downloads 801466 The Use of Rotigotine to Improve Hemispatial Neglect in Stroke Patients at the Charing Cross Neurorehabilitation Unit
Authors: Malab Sana Balouch, Meenakshi Nayar
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Hemispatial Neglect is a common disorder primarily associated with right hemispheric stroke, in the acute phase of which it can occur up to 82% of the time. Such individuals fail to acknowledge or respond to people and objects in their left field of vision due to deficits in attention and awareness. Persistent hemispatial neglect significantly impedes post-stroke recovery, leading to longer hospital stays post-stroke, increased functional dependency, longer-term disability in ADLs and increased risk of falls. Recently, evidence has emerged for the use of dopamine agonist Rotigotine in neglect. The aim of our Quality Improvement Project (QIP) is to evaluate and better the current protocols and practice in assessment, documentation and management of neglect and rotigotine use at the Neurorehabilitation unit at Charing Cross Hospital (CNRU). In addition, it brings light to rotigotine use in the management of hemispatial neglect and paves the way for future research in the field. Our QIP was based in the CNRU. All patients admitted to the CNRU suffering from a right-sided stroke from 2nd of February 2018 to the 2nd of February 2021 were included in the project. Each patient’s multidisciplinary team report and hospital notes were searched for information, including bio-data, fulfilment of the inclusion criteria (having hemispatial neglect) and data related to rotigotine use. This includes whether or not the drug was administered, any contraindications to drug in patients that did not receive it, and any therapeutic benefits(subjective or objective improvement in neglect) in those that did receive the rotigotine. Data was simultaneously entered into excel sheet and further statistical analysis was done on SPSS 20.0. Out of 80 patients suffering from right sided strokes, 72.5% were infarcts and 27.5% were hemorrhagic strokes, with vast majority of both types of strokes were in the middle cerebral artery territory (MCA). A total of 31 (38.8%) of our patients were noted to have hemispatial neglect, with the highest number of cases being associated with MCA strokes. Almost half of our patients with MCA strokes suffered from neglect. Neglect was more common in male patients. Out of the 31 patients suffering from visuospatial neglect, only 16% actually received rotigotine and 80% of them were noted to have an objective improvement in their neglect tests and 20% revealed subjective improvement. After thoroughly going through neglect-associated documentation, the following recommendations/plans were put in place for the future. We plan to liaise with the occupational therapy team at our rehab unit to set a battery of tests that would be done on all patients presenting with neglect and recommend clear documentation of outcomes of each neglect screen under it. Also to create two proformas; one for the therapy team to aid in systematic documentation of neglect screens done prior to and after rotigotine administration and a second proforma for the medical team with clear documentation of rotigotine use, its benefits and any contraindications if not administered.Keywords: hemispatial Neglect, right hemispheric stroke, rotigotine, neglect, dopamine agonist
Procedia PDF Downloads 701465 Therapeutic Challenges in Treatment of Adults Bacterial Meningitis Cases
Authors: Sadie Namani, Lindita Ajazaj, Arjeta Zogaj, Vera Berisha, Bahrije Halili, Luljeta Hasani, Ajete Aliu
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Background: The outcome of bacterial meningitis is strongly related to the resistance of bacterial pathogens to the initial antimicrobial therapy. The objective of the study was to analyze the initial antimicrobial therapy, the resistance of meningeal pathogens and the outcome of adults bacterial meningitis cases. Materials/methods: This prospective study enrolled 46 adults older than 16 years of age, treated for bacterial meningitis during the years 2009 and 2010 at the infectious diseases clinic in Prishtinë. Patients are categorized into specific age groups: > 16-26 years of age (10 patients), > 26-60 years of age (25 patients) and > 60 years of age (11 patients). All p-values < 0.05 were considered statistically significant. Data were analyzed using Stata 7.1 and SPSS 13. Results: During the two year study period 46 patients (28 males) were treated for bacterial meningitis. 33 patients (72%) had a confirmed bacterial etiology; 13 meningococci, 11 pneumococci, 7 gram-negative bacilli (Ps. aeruginosa 2, Proteus sp. 2, Acinetobacter sp. 2 and Klebsiella sp. 1 case) and 2 staphylococci isolates were found. Neurological complications developed in 17 patients (37%) and the overall mortality rate was 13% (6 deaths). Neurological complications observed were: cerebral abscess (7/46; 15.2%), cerebral edema (4/46; 8.7%); haemiparesis (3/46; 6.5%); recurrent seizures (2/46; 4.3%), and single cases of thrombosis sinus cavernosus, facial nerve palsy and decerebration (1/46; 2.1%). The most common meningeal pathogens were meningococcus in the youngest age group, gram negative-bacilli in second age group and pneumococcus in eldery age group. Initial single-agent antibiotic therapy (ceftriaxone) was used in 17 patients (37%): in 60% of patients in the youngest age group and in 44% of cases in the second age group. 29 patients (63%) were treated with initial dual-agent antibiotic therapy; ceftriaxone in combination with vancomycin or ampicillin. Ceftriaxone and ampicillin were the most commonly used antibiotics for the initial empirical therapy in adults > 50 years of age. All adults > 60 years of age were treated with the initial dual-agent antibiotic therapy as in this age group was recorded the highest mortality rate (M=27%) and adverse outcome (64%). Resistance of pathogens to antimicrobics was recorded in cases caused by gram-negative bacilli and was associated with greater risk for developing neurological complications (p=0.09). None of the gram-negative bacilli were resistant to carbapenems; all were resistant to ampicillin while 5/7 isolates were resistant to cefalosporins. Resistance of meningococci and pneumococci to beta-lactams was not recorded. There were no statistical differences in the occurrence of neurological complications (p > 0.05), resistance of meningeal pathogens to antimicrobics (p > 0.05) and the inital antimicrobial therapy (one vs. two antibiotics) concerning group-ages in adults. Conclusions: The initial antibiotic therapy with ceftriaxone alone or in combination with vancomycin or ampicillin did not cover cases caused by gram-negative bacilli.Keywords: adults, bacterial meningitis, outcomes, therapy
Procedia PDF Downloads 1661464 Depth of Penetration and Nature of Interferential Current in Cutaneous, Subcutaneous and Muscle Tissues
Authors: A. Beatti, L. Chipchase, A. Rayner, T. Souvlis
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The aims of this study were to investigate the depth of interferential current (IFC) penetration through soft tissue and to investigate the area over which IFC spreads during clinical application. Premodulated IFC and ‘true’ IFC at beat frequencies of 4, 40 and 90Hz were applied via four electrodes to the distal medial thigh of 15 healthy subjects. The current was measured via three Teflon coated fine needle electrodes that were inserted into the superficial layer of skin, then into the subcutaneous tissue (≈1 cm deep) and then into muscle tissue (≈2 cm deep). The needle electrodes were placed in the middle of the four IFC electrodes, between two channels and outside the four electrodes. Readings were taken at each tissue depth from each electrode during each treatment frequency then digitized and stored for analysis. All voltages were greater at all depths and locations than baseline (p < 0.01) and voltages decreased with depth (P=0.039). Lower voltages of all currents were recorded in the middle of the four electrodes with the highest voltage being recorded outside the four electrodes in all depths (P=0.000).For each frequency of ‘true’ IFC, the voltage was higher in the superficial layer outside the electrodes (P ≤ 0.01).Premodulated had higher voltages along the line of one circuit (P ≤ 0.01). Clinically, IFC appears to pass through skin layers to depth and is more efficient than premodulated IFC when targeting muscle tissue.Keywords: electrotherapy, interferential current, interferential therapy, medium frequency current
Procedia PDF Downloads 3401463 Summer STEM Institute in Environmental Science and Data Sciencefor Middle and High School Students at Pace University
Authors: Lauren B. Birney
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Summer STEM Institute for Middle and High School Students at Pace University The STEM Collaboratory NYC® Summer Fellows Institute takes place on Pace University’s New York City campus during July and provides the following key features for all participants: (i) individual meetings with Pace faculty to discuss and refine future educational goals; (ii) mentorship, guidance, and new friendships with program leaders; and (iii) guest lectures from professionals in STEM disciplines and businesses. The Summer STEM Institute allows middle school and high school students to work in teams to conceptualize, develop, and build native mobile applications that teach and reinforce skills in the sciences and mathematics. These workshops enhance students’STEM problem solving techniques and teach advanced methods of computer science and engineering. Topics include: big data and analytics at the Big Data lab at Seidenberg, Data Science focused on social and environmental advancement and betterment; Natural Disasters and their Societal Influences; Algal Blooms and Environmental Impacts; Green CitiesNYC; STEM jobs and growth opportunities for the future; renew able energy and sustainable infrastructure; and climate and the economy. In order to better align the existing Summer STEM, Institute with the CCERS model and expand the overall network, Pace is actively recruiting new content area specialists from STEM industries and private sector enterprises to participate in an enhanced summer institute in order to1) nurture student progress and connect summer learning to school year curriculum, 2) increase peer-to-peer collaboration amongst STEM professionals and private sector technologists, and 3) develop long term funding and sponsorship opportunities for corporate sector partners to support CCERS schools and programs directly.Keywords: environmental restoration science, citizen science, data science, STEM
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