Search results for: political efficacy

Authors: Jordan Daud, Satriya Wibawa, Wahyu Wardhana

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In the summer of 2014, the leaders of the Islamic State of Iraq and Syria proclaimed the founding of religious-political system known as the caliphate which titled Islamic State (IS). As Caliph, Abu Bakr Baghdadi advocated Jihad from the Ummah (the Muslim community) to defend the Islamic state from unbelievers. This call for Jihad by IS had encouraged some radical organization in Southeast Asia pledge allegiance to IS and established bases for IS operation in Southeast Asia. This development had increased security concern for possible terrorism action in Southeast Asia, which currently not very active due to counterterrorism efforts from ASEAN member states and its cooperation with the world. This paper firstly tries to draw understanding from Ulema (Muslim cleric) about the conception of caliphate and Jihad based on Quran and Hadith. Secondly, this paper will elaborate counterterrorism efforts from ASEAN countries to prevent radicalization and terrorism act in addressing the call for jihad to establish IS in Southeast Asia. The third, this paper will recommend the role of the social community, especially Ulema, in Southeast Asia to prevent the misunderstanding of Jihad which usually used by terrorist to justify their action. Hopefully, this social community role will decrease the radicalization of Muslim community in Southeast Asia alongside with the counterterrorism efforts to create secure and stable ASEAN community based on shared norm and values.

Keywords: caliphate, jihad, ASEAN, counterterrorism, social community

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Authors: Alessandro Giardino

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The Iranian Revolution has been the object of numberless historical and semi-fictional accounts, often providing a monolithic perspective on the events, due to the westerner positioning of those recounting them. Against this tradition, two contemporary French-Iranian novels "Disoriental" (2016) by Negar Djavadi and "Marx and The Doll" (2017) by Maryam Madjidi have offered readers a female-oriented and interestingly layered representation of the Iranian Revolution, hence addressing the responsibilities and misconceptions of Western countries. Furthermore, these two women writers have shed light on the disenchantment of the Iranian intellectual class vis-à-vis the foundation of the Islamic Republic, by particularly focusing on the deterioration of women’s rights, as well as the repression of political, ethnical, religious and sexual minorities. By a psycholinguistic and semasiological analysis of the two novels by Djavadi and Madjidi, this essay will focus on alternative accounts of the revolution in order to reflect upon the role of intersectional literature to the understanding of history. More specifically, as both women, refugees, and bi-cultural writers, Djavadi and Madjidi unearthed moments and figures of the revolution which had disappeared from the prevalent narrative. In doing so, however, these two writers resorted to entirely opposite styles of writing that, it will be argued, stem from different types of female resistance. In defining these two approaches as a "narrative resistance" and a "photographic resistance," the essay will elucidate the dependence of these writers’ language on generational and psychological factors, but it will also stir a reflection on their different communicative strategies.

Keywords: Iranian revolution, French-Iranian, intersectionality, literature, women writers

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Authors: Khwaja Bahman Qaderi, Noorullah Rafiqee

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Background: With today's increasing Internet users, e-commerce has become a viable model for strengthening relationships between sellers, entrepreneurs, and consumers due to its speed, efficiency, and cost reduction. Agriculture is the economic backbone for 80 percent of the Afghan population. According to MCIT statistics, there are currently around 10 million internet users in Afghanistan. With this data, it was expected that Afghan people should have utilized e-commerce in their agricultural aspects, although it appears to be less used. Objective: This study examines the scope of e-commerce in Afghanistan's agriculture enterprises, how they harness the potential of internet users, and what obstacles they face in implementing e-commerce in their businesses. Method: The study distributed a 39-question questionnaire to agribusinesses in five different zones of Afghanistan. After extracting the responses and excluding the incomplete questionnaires, 280 were included in the analysis step to perform a non-parametric sign test. Result: E-commerce in Afghanistan faces four major political, economic, Internet, and technological obstacles, and no company in the country has implemented e-commerce. In addition, e-commerce is still in its infancy among agricultural companies in the country. Internet use is still primarily limited to email and sharing product images on Facebook & Instagram for advertising purposes. There are no companies that conduct international transactions via the Internet. Conclusion: This study contributes to knowing the challenges and barriers that the agriculture e-commerce faces in Afghanistan to find the effective solutions to use the capacity of internet users in the country and increase the sales rate of agricultural products through the Internet.

Keywords: E-commerce, barriers and challenges, agriculture companies, Afghanistan

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Authors: Fahimeh Khatami, Elham Sanagar Darbani, Behnosh Khir Khah, R.Khatami

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Rural and ruralism is one of the residential forms that form in special natural areas, and the Interaction between their internal and external forces cause developments and changes that are different in time and space. Over time, historical developments, social and economic changes in the political system cause developments and rapid growth of the rural to urban settlements. However, criteria for recognizing rural settlements to the city are different in every land. One of the problems in modern plan is inattention to indicators and criteria of changing these settlements to the city. The method of this research is a type of applied and compilation research and library and field methods are used in it. And also qualitative and quantitative indicators have been provided while collecting documents and studies from rural districts like Dehnow, Virani, Abardeh, Zoshk, Nowchah, Jaqarq in tourism area of Mashhad. In this research, the used tool is questionnaire and for analyzing quantitative variables by Morris and Mac Granahan examination, the importance of each factor and the development settlements are evaluated, and the rural that can convert to the city was defined. In result, according to Askalvgram curve obtained from analysis, it was found that among the mentioned villages, Virani and Nowchah rural districts have this ability to convert to the city; Zoshk rural district will be converting to the city in future and Dehnow, Abardeh and Jaqarq rural districts won’t be converting.

Keywords: rural settlements, city, indicators, Torqabe and Shandiz rural districts

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Authors: Ridho Al-Hamdi, Sakir, Tanto Lailam

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During the democratic period of 1999-present, Indonesia has consistently applied a List Proportional Representation (List PR) system in the parliamentary election. Between 1999 and 2004, it adopted a closed-list proportional representation (CLPR) system. In the meantime, it employed open-list proportional representation (OLPR) system from 2009 to 2019. Recently, some parties intended to propose the application of CLPR while others are still consistent in adopting OLPR. An unfinished debate is taking place. Thus, this article aims to evaluate the application of CLPR in Indonesia and, in turn, analyze its compatibility in contemporary parliamentary election system. From a methodological standpoint, it is qualitative research by applying a case study approach. Data-gathering relies on field data, mainly focus group discussion (FGD) and in-depth interviews with political parties, electoral management bodies (EMBs), NGO activists, and scholars spread in six provinces and nine regencies/cities across the country. Using SWOT analysis and the compatibility of CLPR and embedded democracy framework, the finding demonstrates that CLPR is no longer relevant for contemporary Indonesian elections. This paper recommends OLPR by considering that CLPR has numerous weaknesses and threats that can jeopardize embedded democracy. More importantly, CLPR can remove inclusive suffrage significantly.

Keywords: closed-list proportional representation, embedded democracy, Indonesia, parliamentary election

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Authors: Al Asyary, Meita Veruswati, Dian Ayyubi

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Sukabumi municipal has highest rank for maternal mortality in Indonesia with 102 by 100,000 live birth with almost 80% of birth were not attended by skilled birth attendant (SBA). Although universal health coverage has been implemented, availability and sufficiency of SBA, such as midwife in this developing country, are problematic agenda for the quality of public healthcare as well as decreasing maternal mortality rate. This study aims to describe the equal distribution of midwives in Sukabumi municipal as support of government’s program named Millennium Development Goals (MDGs) that suppressed maternal mortality rate in Indonesia. We conducted an observational study with Workload Indicator of Staffing Need (WISN) analysis to present the dispersion of midwives by their activities and workloads in 37 Puskesmas. We also generated in-depth interview with several executive chief of health sections, including chief of health offices in Sukabumi municipal. It resulted inferentially that several activities in midwives’ program were differed at once of existing than needed condition ideally (ρ value = 0.002 < 0.05). Meanwhile, decision for midwives’ procurement and placement were held by un-systematically procedure such as based on where the midwife was staying, and it also progressed by neighborhood issue priorities. The absence of formal regulation in local government is a serious problem that indicated poor political commitment, while access to SBA shall be focused carefully.

Keywords: developing country, health professional resources, health policy, need assessment

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Authors: Sara A. Pakvis, Giulia Scalet, Stefania Marconi, Ferdinando Auricchio, Matthijs Langelaar

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In recent developments in the field of multi-material additive manufacturing, differences in material properties are exploited to create printed shape-memory structures, which are referred to as 4D-printed structures. New printing techniques allow for the deliberate introduction of prestresses in the specimen during manufacturing, and, in combination with the right design, this enables new functionalities. This research focuses on bi-polymer 4D-printed structures, where the transformation process is based on a heat-induced glass transition in one material lowering its Young’s modulus, combined with an initial prestress in the other material. Upon the decrease in stiffness, the prestress is released, which results in the realization of an essentially pre-programmed deformation. As the design of such functional multi-material structures is crucial but far from trivial, a systematic methodology to find the design of 4D-printed structures is developed, where a finite element model is combined with a density-based topology optimization method to describe the material layout. This modeling approach is verified by a convergence analysis and validated by comparing its numerical results to analytical and published data. Specific aspects that are addressed include the interplay between the definition of the prestress and the material interpolation function used in the density-based topology description, the inclusion of a temperature-dependent stiffness relationship to simulate the glass transition effect, and the importance of the consideration of geometric nonlinearity in the finite element modeling. The efficacy of topology optimization to design 4D-printed structures is explored by applying the methodology to a variety of design problems, both in 2D and 3D settings. Bi-layer designs composed of thermoplastic polymers are printed by means of the fused deposition modeling (FDM) technology. Acrylonitrile butadiene styrene (ABS) polymer undergoes the glass transition transformation, while polyurethane (TPU) polymer is prestressed by means of the 3D-printing process itself. Tests inducing shape transformation in the printed samples through heating are performed to calibrate the prestress and validate the modeling approach by comparing the numerical results to the experimental findings. Using the experimentally obtained prestress values, more complex designs have been generated through topology optimization, and samples have been printed and tested to evaluate their performance. This study demonstrates that by combining topology optimization and 4D-printing concepts, stimuli-responsive structures with specific properties can be designed and realized.

Keywords: 4D-printing, glass transition, shape memory polymer, topology optimization

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Authors: Suchismita Dattagupta

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Social rules and guidelines specify how a body should be clothed and how it should look. The social rules have made the body a space for expression, oppression and sexual 'commodification'. Being a malleable aspect of the human body, hair has always been worn in a number of ways and this characteristic of hair has made it an essential vehicle for conveying symbolic meaning. Hair, particularly women’s hair has always been considered to be associated with richness and beauty, apart from being associated with sexual power. Society has always had a preoccupation with hair bordering on obsession and has projected its moral and political supremacy by controlling and influencing how an individual wears their hair. Irrespective of the gender of the individual, society has tried to control an individual’s hair to express its control. However, with time, there has been a marked change in the way hair has been used by the individual. Hair has always been the focus of scholarly studies; not just aesthetically, but also in the cultural and social context. The fascination with hair rises from the fact that it is the only part of the human body that is always on display. Fetishization of hair is common in literature and goes ahead to reveal the character’s social and moral status. Modern authors for children and young adults have turned this concept on its head to point out how characters are breaking away from the mould and establishing their personal, moral and social boundaries. This paper will trace the change in hair symbolism in literature for children and young adults to understand how it has changed over the course of the time and what light it throws on the changing pattern of women’s position in society.

Keywords: gender, hair, social symbols, society, women's role

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Authors: Nadjet Mekaouche, Hanane Zitouni, Fatma Boudia, Habiba Fetati, A. Saleh, A. Lardjam, H. Geniaux, A. Coubret, H. Toumi

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Medicines have undeniably played a major role in prolonging shelf life and improving quality. The absolute efficacy of the drug remains a lever for innovation, its benefit/risk balance is not always assured and it does not always have the expected effects. Prior to marketing, knowledge about adverse drug reactions is incomplete. Once on the market, phase IV drug studies begin. For years, the drug was prescribed with less care to a large number of very heterogeneous patients and often in combination with other drugs. It is at this point that previously unknown adverse effects may appear, hence the need for the implementation of a pharmacovigilance system. Pharmacovigilance represents all methods for detecting, evaluating, informing and preventing the risks of adverse drug reactions. The most severe adverse events occur frequently in hospital and that a significant proportion of adverse events result in hospitalizations. In addition, the consequences of hospital adverse events in terms of length of stay, mortality and costs are considerable. It, therefore, appears necessary to develop ‘hospital pharmacovigilance’ aimed at reducing the incidence of adverse reactions in hospitals. The most widely used monitoring method in pharmacovigilance is spontaneous notification. However, underreporting of adverse drug reactions is common in many countries and is a major obstacle to pharmacovigilance assessment. It is in this context that this study aims to describe the experience of the pharmacovigilance service at the University Hospital of Oran (EHUO). This is a retrospective study extending from 2011 to 2017, carried out on archived records of declarations collected at the level of the EHUO Pharmacovigilance Department. Reporting was collected by two methods: ‘spontaneous notification’ and ‘active pharmacovigilance’ targeting certain clinical services. We counted 217 statements. It involved 56% female patients and 46% male patients. Age ranged from 5 to 78 years with an average of 46 years. The most common adverse reaction was drug toxidermy. For the drugs in question, they were essentially according to the ATC classification of anti-infectives followed by anticancer drugs. As regards the evolution of declarations by year, a low rate of notification was noted in 2011. That is why we decided to set up an active approach at the level of some services where a resident of reference attended the staffs every week. This has resulted in an increase in the number of reports. The declarations came essentially from the services where the active approach was installed. This highlights the need for ongoing communication between all relevant health actors to stimulate reporting and secure drug treatments.

Keywords: adverse drug reactions, hospital, pharmacovigilance, spontaneous notification

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Authors: Rudolf Egger

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This article shows some results of an ongoing project in Kosova. This project deals with the meaning of social transformation processes in the life-courses of Kosova people. One goal is to create an oral history archive in this country. In the last seven years we did some interpretative work (using narrative interviews) concerning the experiences and meanings of social changes from the perspective of life course. We want to reconstruct the individual possibilities in creating one's life in new social structures. After the terrible massacres of ethnical-territorially defined nationalism in former Yugoslavia it is the main focus to find out something about the many small daily steps which must be done, to build up a kind of “normality” in this country. These steps can be very well reconstructed by narrations, by life stories, because personal experiences are naturally linked with social orders. Each individual story is connected with further stories, in which the collective history will be negotiated and reflected. The view on the biographical narration opens the possibility to analyze the concreteness of the “individual case” in the complexity of collective history. Life stories contain thereby a kind of a transition character, that’s why they can be used for the reconstruction of periods of political transformation. For example: In the individual story we can find very clear the national or mythological character of the Albanian people in Kosova. The shown narrations can be read also as narrative lines in relation to the (re-)interpretation of the past, in which lived life is fixed into history in the so-called collective memory in Kosova.

Keywords: biographical learning, adult education, social change, post war societies

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Authors: Enva Doda

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Recent statistical analyses within the European Union (EU) underscore the enduring significance of the Gender Pay Gap in amplifying the Gender Pension Gap, a phenomenon resisting proportional reduction over time. This study meticulously calculates the Pension Gap, scrutinizing contributing variables within diverse pension systems. Furthermore, it investigates whether the "unexplained" segment of the Gender Gap correlates with political institutions, economic systems, historical events, or discrimination, utilizing quantitative methods and the Blinder-Oaxaca Decomposition Method to pinpoint potential discriminatory factors. The descriptive analysis reveals a conspicuous Gender Pension Gap across European nations, displaying notable variation. While an overall reduction in the Gender Gap is observed, the degree of improvement varies among countries. Subsequent analyses will delve into the specific reasons or variables influencing distinct Gender Gap percentages, forming the basis for nuanced policy recommendations. This comprehensive research enriches the ongoing discourse on gender equality and economic equity. By focusing on the root causes of the Pension Gap, the study has the potential to instigate policy adjustments, urging policymakers to reassess systemic structures and contribute to informed decision-making. Emphasizing gender equality as essential for a flourishing and resilient economy, the research aspires to drive positive change on academic and policy fronts.

Keywords: blinder Oaxaca decomposition method, discrimination, gender pension gap, quantitative methods, unexplained gender gap

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Authors: Talita Cavaignac

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Adorno's critique of totality, especially in a split society marked by reification, also rests on the impossibility of generalizing normative principles. Given the unfeasibility of normative universalizations, which conditions can justify the possibility of criticism and normativity in Adorno's thought? If reason itself is still entangled in alienation from the model of the domination of nature, how could be possible a critical theory? In political terms, if the notion of totality is challenged by the critique of identity, how can Adorno maintain the ideal of liberation and reconciliation between private interests and the possibility of some sort of ethics without giving up a materialist theory of society and without betting in a necessary link between redemption and history? Faced with this complex of questions, it is intended to reflect on the sense in which the notion of ‘suffering’ could throw help to the epistemological problem of the foundations of criticism in Adorno's work. The idea is that, in contrast to a universalizable model of justice, Adorno mobilizes in the notion of ‘suffering’ a gateway to the critical reflection of society. He would thus develop an approach to moral problems through the sensual-bodily perspective, fear, pain, and somatic factors. Nevertheless, due to the attention to the damaged experience and to the constitution of subjectivity -a sense in which the concept of mimesis continues to stand out- we understand suffering as an expression of an objective reification. Following the statement of other authors, the intention is to think how the resources linked to the idea of ‘suffering’ in Adorno's writings are engaged in the reflection of the problem of morality and of the contradictions between universal and particular (articulated in Hegel's tradition).

Keywords: ethics, morality, sensitive, Theodor Adorno

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Authors: Meeta Ratawa Tiwary

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Damaturu is the capital of Yobe State in northeastern Nigeria where civic amenities and facilities are not adequate even after 24 years of its existence. The volatile security and political situations are most significant causes for the same. The basic facility for the citizens in terms of drinking water and electricity are not available. For the drinking water, they have to rely on personal bore holes or the filtered borehole waters available in packaged sachets in the market. The present study is concerned with the environmental impact of indiscriminate disposal of drinking synthetic polythene water sachets in Damaturu. The sachet water is popularly called as ‘pure water’, but its purity is questionable. Increased production and consumption of sachet water has led to indiscriminate dumping and disposal of empty sachets leading to a serious environmental threat. The evidence of this is seen in the amount of disposed sachets littering the streets and also the drainages blocked by ‘blocks’ of water sachet waste. Sachet water gained much popularity in Nigeria because the product is convenient for use, affordable and economically viable. The present study aims to find out the solution to this environmental problem. The field-based study has found some significant factors that cause environmental and socio-economic effect due to this. Some recommendations have been made based on research findings regarding sustainable waste management, recycling and re-use of the non-biodegradable products in society.

Keywords: civic amenities, non-biodegradable, pure water, sustainable environment, waste disposal

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Authors: Laura Ramona Nae

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The issue of risks faced by companies providing tourist and hotel services in the HoReCa field, related to the goods belonging to consumer tourists left in hotel storage, has acquired a new dimension in the context of the economic and geo-political influences that have recently intervened at the global level. Thus, hoteliers and not only had to create contractual mechanisms regarding the risks and to protect the businesses in this field of activity. This situation has led to a reassessment of the importance of insurance, in particular with regard to hotel liability insurance-premises liability, safety, and security of goods. Interpretation of clauses in contracts concluded between hoteliers and tourists consuming hotel services and products, all the more so in the current pandemic context of Covid 19, stressed the increase in the number of disputes generated by them. This article presents a general picture of the significance of the risks related to the activity carried out in the hospitality industry, tourism, respectively within the HoReCa field. The study mainly marks the specificities of the hotel deposit contract, as well as the related insurance specific to the field, as a way to cover these risks. The article also refers to alternative methods of out-of-court settlement of disputes (ADR) in the HoReCa domain, generally used in both Romania and the European Union.

Keywords: consumer tourist, disputes and ADR methods, deposit contract, hotel warehouse and hotelier insurance, hotel services and tourist products, HoReCa

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Authors: Md Iqbal Hossain, Tahmeed Ahmed, Kenneth H. Brown

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Objective: To assess the effect of community-based follow up, with or without food-supplementation and/or psychosocial stimulation, as an alternative to current hospital-based follow-up of children with moderate-acute-malnutrition (WHZ < -2 to -3) (MAM). Design/methods: The study was conducted at the ICDDR,B Dhaka Hospital and in four urban primary health care centers of Dhaka, Bangladesh during 2005-2007. The efficacy of five different randomly assigned interventions was compared with respect to the rate of completion of follow-up, growth and morbidity in 227 MAM children aged 6-24 months who were initially treated at ICDDR,B for diarrhea and/or other morbidities. The interventions were: 1) Fortnightly follow-up care (FFC) at the ICDDR,B’s outpatient-unit, including growth monitoring, health education, and micro-nutrient supplementation (H-C, n=49). 2) FFC at community follow-up unit (CNFU) [established in the existing urban primary health-care centers close to the residence of the child] but received the same regimen as H-C (C-C, n=53). 3) As per C-C plus cereal-based supplementary food (SF) (C-SF, n=49). The SF packets were distributed on recruitment and at every visit in CNFU [@1 packet/day for 6–11 and 2 packets/day for 12-24 month old children. Each packet contained 20g toasted rice-powder, 10g toasted lentil-powder, 5g molasses, and 3g soy bean oil, to provide a total of ~ 150kcal with 11% energy from protein]. 4) As per C-C plus psychosocial stimulation (PS) (C-PS, n=43). PS consisted of child-stimulation and parental-counseling conducted by trained health workers. 5) As per C-C plus both SF+PS (C-SF+PS, n=33). Results: A total of 227children (48.5% female), with a mean ± SD age of 12.6 ±3.8 months, and WHZ of - 2.53±0.28 enrolled. Baseline characteristics did not differ by treatment group. The rate of spontaneous attendance at scheduled follow-up visits gradually decreased in all groups. Follow-up attendance and gain in weight and length were greater in groups C-SF, C-SF+PS, and C-PS than C-C, and these indicators were observed least in H-C. Children in the H-C group more often suffered from diarrhea (25 % vs. 4-9%) and fever (28% vs. 8-11%) than other groups (p < 0.05). Children who attended at least five of the total six scheduled follow-up visits gained more in weight (median: 0.86 vs. 0.62 kg, p=0.002), length (median: 2.4 vs. 2.0 cm, p=0.009) than those who attended fewer. Conclusions: Community-based service delivery, especially including supplementary food with or without psychosocial stimulation, permits better rehabilitation of children with MAM compared to current hospital outpatients-based care. By scaling the community-based follow-up including food supplementation with or without psychosocial stimulation, it will be possible to rehabilitate a greater number of MAM children in a better way.

Keywords: community-based management, moderate acute malnutrition, psychosocial stimulation, supplementary food

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Authors: Cleopatra Oluseye Ibukun

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Following the endogenous growth theory, entrepreneurship has been considered pivotal to economic growth and development, particularly in developing countries like Nigeria. Meanwhile, efforts to reduce unemployment has yielded minimal result with over 36% of youth unemployment and a dwindling economic growth despite the country’s natural and human resource endowment. This study, therefore, investigates the effects of entrepreneurship and institutional quality on economic growth and unemployment in Nigeria over the period 1996 to 2018. The data is obtained from the National Bureau of Statistics (NBS), World Bank’s World Development Indicators (WDI), and the World Bank’s World Governance Indicators (WGI). The study period is guided by the availability of data, and the study employs both descriptive and econometric techniques of analysis (specifically, the Auto-regressive Distributed Lag Approach). This approach is preferable given that the variables are stationary at the first difference, while the bounds test suggests the existence of co-integration among the variables. By implication, an increase in entrepreneurship significantly improves economic growth, and it reduces unemployment in both the short-run and the long-run. Besides, institutional quality proxied by the control of corruption, political stability, and government effectiveness significantly mediates the interaction between entrepreneurship and macroeconomic performance. This study concludes that improved institutional quality enhances the effect of entrepreneurship on economic growth and unemployment in Nigeria, and it recommends an improvement in Nigeria’s institutional quality because it can jeopardise or augment the effect of entrepreneurship on macroeconomic performance.

Keywords: entrepreneurship, institutional quality, unemployment, gross domestic product, Nigeria

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Authors: Alene Toulany, Elizabeth Dettmer, Seena Grewal, Kaley Roosen, Andrea Regina, Cathleen Steinegger, Kate Stadelman, Melissa Chambers, Lindsay Lochhead, Kelsey Gallagher, Alissa Steinberg, Andrea Leyser, Allison Lougheed, Jill Hamilton

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Obesity and psychiatric disorders occur together so frequently that the combination has been coined an epidemic within an epidemic. Youth living with obesity are at increased risk for trauma, depression, anxiety and disordered eating. Although symptoms of binge eating disorder are common in paediatric obesity management programs, they are often not identified or addressed within treatment. At The Hospital for Sick Children (SickKids), a tertiary care paediatric hospital in Toronto, Canada, adolescents with obesity are treated in an interdisciplinary outpatient clinic (1-2 hours/week). This intensity of care is simply not enough to help these extremely complex patients. Existing day treatment programs for eating, and psychiatric disorders are not well suited for patients with obesity. In order to address this identified care gap, a unique collaboration was formed between the obesity, psychiatry, and eating disorder programs at SickKids in 2015. The aim of this collaboration was to provide an enhanced treatment arm to our general psychiatry day hospital program that addresses both the mental health issues and the lifestyle challenges common to youth with obesity and binge eating. The program is currently in year-one of a two-year pilot project and is designed for a length of stay of approximately 6 months. All youth participate in daily group therapy, academics, and structured mealtimes. The groups are primarily skills-based and are informed by cognitive/dialectical behavioural therapies. Weekly family therapy and individual therapy, as well as weekly medical appointments with a psychiatrist and a nurse, are provided. Youth in the enhanced treatment arm also receive regular sessions with a dietitian to establish normalized eating behaviours and monthly multifamily meal sessions to address challenges related to behaviour change and mealtimes in the home. Outcomes that will be evaluated include measures of mental health, anthropometrics, metabolic status, and healthcare satisfaction. At the end of the two years, it is expected that we will have had about 16 youth participants. This model of care delivery will be the first of its kind in Canada and is expected to inform future paediatric treatment practices.

Keywords: adolescent, binge eating, mental illness, obesity

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Authors: Shiva Shakori Poshteh

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Lung cancer is a highly prevalent and devastating disease, representing a significant global health concern with profound implications for healthcare systems and society. Its high incidence, mortality rates, and late-stage diagnosis contribute to its formidable nature. To address these challenges, nanoparticle-based drug delivery has emerged as a promising therapeutic strategy. Curcumin (CUR), a natural compound derived from turmeric, has garnered attention as a potential nanomedicine for lung cancer treatment. Nanoparticle formulations of CUR offer several advantages, including improved drug delivery efficiency, enhanced stability, controlled release kinetics, and targeted delivery to lung cancer cells. CUR exhibits a diverse array of effects on cancer cells. It induces apoptosis by upregulating pro-apoptotic proteins, such as Bax and Bak, and downregulating anti-apoptotic proteins, such as Bcl-2. Additionally, CUR inhibits cell proliferation by modulating key signaling pathways involved in cancer progression. It suppresses the PI3K/Akt pathway, crucial for cell survival and growth, and attenuates the mTOR pathway, which regulates protein synthesis and cell proliferation. CUR also interferes with the MAPK pathway, which controls cell proliferation and survival, and modulates the Wnt/β-catenin pathway, which plays a role in cell proliferation and tumor development. Moreover, CUR exhibits potent antioxidant activity, reducing oxidative stress and protecting cells from DNA damage. Utilizing CUR as a standalone treatment is limited by poor bioavailability, lack of targeting, and degradation susceptibility. Nanoparticle-based delivery systems can overcome these challenges. They enhance CUR’s bioavailability, protect it from degradation, and improve absorption. Further, Nanoparticles enable targeted delivery to lung cancer cells through surface modifications or ligand-based targeting, ensuring sustained release of CUR to prolong therapeutic effects, reduce administration frequency, and facilitate penetration through the tumor microenvironment, thereby enhancing CUR’s access to cancer cells. Thus, nanoparticle-based CUR delivery systems promise to improve lung cancer treatment outcomes. This article provides an overview of lung cancer, explores CUR nanoparticles as a treatment approach, discusses the benefits and challenges of nanoparticle-based drug delivery, and highlights prospects for CUR nanoparticles in lung cancer treatment. Future research aims to optimize these delivery systems for improved efficacy and patient prognosis in lung cancer.

Keywords: lung cancer, curcumin, nanomedicine, nanoparticle-based drug delivery

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Authors: Geetanjali Sharma

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There are always provincial variations which deserve more detailed treatment. Before the arrival of modern era, geography and cultural homogeneity were determining factors of human habitat and migration. Boundaries as if we see them, did not exist earlier. The connectivity of the world was also different as of now. The reinforcement of the old silk route will improve economic cooperation and connectivity between Asian, European and African countries, but obviously, it is designed to improve China’s geopolitical and geostrategic position in the world. The paper is based on the secondary sources of data. Analytical and historical approach has been used to clarify the ties between the old silk routes and new One-Belt-One-Road initiative China. The paper begins with an explanation of the historical background of the old Silk Route, its origin and development, trailed by an analysis of latest declarations by the Chinese leaders to revive it. It also discusses the impacts of this initiative on India’s economy and cultural exchange between associated regions. Lastly, the paper sums up the findings and suggestions for keeping a balance between the security and economic relationship between the countries. It concludes that the silk route is an effort in commencing a ‘grand strategy’ for global trade and cooperation with hidden objectives of China to increase the investment of China in other continents as well. The revival of silk route may prove to be a very helpful in reinforcing cooperation and raising it to a new level of economic establishments. However, China has yet to promote the much-needed political and strategic trust.

Keywords: OBOR (One-Belt-One-Road), geopolitics, economic relation, security concerns

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Authors: Yogita Patil-Sen

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Superparamagnetic Iron Oxide Nanoparticles (SPIONs) have become increasingly important materials for separation of specific bio-molecules, drug delivery vehicle, contrast agent for MRI and magnetic hyperthermia for cancer therapy. Hyperthermia is emerging as an alternative cancer treatment to the conventional radio- and chemo-therapy, which have harmful side effects. When subjected to an alternating magnetic field, the magnetic energy of SPIONs is converted into thermal energy due to movement of particles. The ability of SPIONs to generate heat and potentially kill cancerous cells, which are more susceptible than the normal cells to temperatures higher than 41 °C forms the basis of hyerpthermia treatement. The amount of heat generated depends upon the magnetic properties of SPIONs which in turn is affected by their properties such as size and shape. One of the main problems associated with SPIONs is particle aggregation which limits their employability in in vivo drug delivery applications and hyperthermia cancer treatments. Coating the iron oxide core with thermally responsive lipid based nanostructures tend to overcome the issue of aggregation as well as improve biocompatibility and can enhance drug loading efficiency. Herein we report suitability of SPIONs and silica coated core-shell SPIONs, which are further, coated with various lipids for drug delivery and magnetic hyperthermia applications. The synthesis of nanoparticles is carried out using the established methods reported in the literature with some modifications. The nanoparticles are characterised using Infrared spectroscopy (IR), X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM) and Vibrating Sample Magnetometer (VSM). The heating ability of nanoparticles is tested under alternating magnetic field. The efficacy of the nanoparticles as drug carrier is also investigated. The loading of an anticancer drug, Doxorubicin at 18 °C is measured up to 48 hours using UV-visible spectrophotometer. The drug release profile is obtained under thermal incubation condition at 37 °C and compared with that under the influence of alternating magnetic field. The results suggest that the nanoparticles exhibit superparamagnetic behaviour, although coating reduces the magnetic properties of the particles. Both the uncoated and coated particles show good heating ability, again it is observed that coating decreases the heating behaviour of the particles. However, coated particles show higher drug loading efficiency than the uncoated particles and the drug release is much more controlled under the alternating magnetic field. Thus, the results demonstrate that lipid coated SPIONs exhibit potential as drug delivery vehicles for magnetic hyperthermia based cancer therapy.

Keywords: drug delivery, hyperthermia, lipids, superparamagnetic iron oxide nanoparticles (SPIONS)

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Authors: Shashi Bala, Neha A. Chugh, Subhash C. Bansal, Mohal L. Garg, Ashwani Koul

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Purpose: The present study was designed to evaluate the radioprotective efficacy of Aloe vera from whole body X-ray exposure in rodents. Materials and Methods: For this purpose, after on week’s acclimatization, male balb/c mice procured from Central Animal House, Panjab University, Chandigarh (India), were divided into four groups: Group I mice served as control. Group II mice were orally administrated Aloe vera pulp extract (50 mg/ kg body weight) on alternate days for 30 days. Group III mice were subjected to whole body X-ray irradiation to cumulative dose of 2Gy (0.258Gy twice a day for four days in the last week). Group IV animals were pretreated with Aloe vera pulp extract on alternate days as in Group II and in the last week of the study, they were exposed to X-ray as in Group III. Results: Spleen of X-ray irradiated mice showed histopathological alterations accompanied with enhanced activity of lactate dehydrogenase (LDH) in serum. Elevated levels of reactive oxygen species (ROS), lipid peroxidation (LPO), enhanced activities in Glutathione based enzymes such as Glutathione peroxidase (GSH-Px), Glutathione reductase (GR), Catalase (CAT), Superoxide dismutase (SOD) associated with depletion in reduced Glutathione (GSH) concentration were observed after X-ray exposure in blood plasma and spleen.. Pro-inflammatory cytokines like tumor necrosis factors (TNF-α) and Inteleukin-6 (IL-6) levels were also found to be enhanced in serum of irradiated mice. Irradiation-induced significant elevation in Total leucocyte counts (TLC), neutrophil counts and decline in platelet counts, associated with unaltered levels of red blood cell counts (RBC’s) and haemoglobin (Hb) in various treatment groups. Clastogenic damage and apoptosis was also found to be increase in splenic tissue of X-ray exposed mice as assessed by micronucleus and TUNEL assay. However, X-ray irradiated animals administered with Aloe vera revealed significant improvement in levels of ROS/ LPO, LDH activity, and antioxidant mechanism. Aloe vera pretreated animals exhibited less severe damage, and early recovery in micronucleated cells, hematological parameters, apoptotic cells and inflammatory markers as compared to X-ray exposed mice. Conclusion: These results indicate that the radioprotective potential of Aloe vera against X-ray induced damage. This may be due to its free radical scavenging, antioxidant, anti-apoptotic and anti-inflammatory properties.

Keywords: aloe vera, antioxidant defense system, lactate dehydrogenase (LDH), micronucleus assay, x-ray

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Authors: Hui-Ling Yang, Kuei-Ru Chou

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Background: Studies show that cognitive training can effectively delay cognitive failure. However, there are several gaps in the previous studies of cognitive training in mild cognitive impairment: 1) previous studies enrolled mostly healthy older adults, with few recruiting older adults with cognitive impairment; 2) they also had limited generalizability and lacked long-term follow-up data and measurements of the activities of daily living functional impact. Moreover, only 37% were randomized controlled trials (RCT). 3) Limited cognitive training has been specifically developed for mild cognitive impairment. Objective: This study sought to investigate the changes in cognitive function, activities of daily living and degree of depressive symptoms in older adults with mild cognitive impairment after cognitive training. Methods: This double-blind randomized controlled study has a 2-arm parallel group design. Study subjects are older adults diagnosed with mild cognitive impairment in residential care facilities. 124 subjects will be randomized by the permuted block randomization, into intervention group (Cognitive training, CT), or active control group (Passive information activities, PIA). Therapeutic adherence, sample attrition rate, medication compliance and adverse events will be monitored during the study period, and missing data analyzed using intent-to-treat analysis (ITT). Results: Training sessions of the CT group are 45 minutes/day, 3 days/week, for 12 weeks (36 sessions each). The training of active control group is the same as CT group (45min/day, 3days/week, for 12 weeks, for a total of 36 sessions). The primary outcome is cognitive function, using the Mini-Mental Status Examination (MMSE); the secondary outcome indicators are: 1) activities of daily living, using the Lawton’s Instrumental Activities of Daily Living (IADLs) and 2) degree of depressive symptoms, using the Geriatric Depression Scale-Short form (GDS-SF). Latent growth curve modeling will be used in the repeated measures statistical analysis to estimate the trajectory of improvement by examining the rate and pattern of change in cognitive functions, activities of daily living and degree of depressive symptoms for intervention efficacy over time, and the effects will be evaluated immediate post-test, 3 months, 6 months and one year after the last session. Conclusions: We constructed a rigorous CT program adhering to the Consolidated Standards of Reporting Trials (CONSORT) reporting guidelines. We expect to determine the improvement in cognitive function, activities of daily living and degree of depressive symptoms of older adults with mild cognitive impairment after using the CT.

Keywords: mild cognitive impairment, cognitive training, randomized controlled study

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Authors: T. Ferreira, A. Kulkarni, C. Bretscher, K. Richter, M. Ehrlich, A. Marchini

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H-1 protoparvovirus (H-1PV) is a virus with inherent oncolytic and oncosuppressive activities while remaining non-pathogenic in humans. H-1PV was the first oncolytic parvovirus to undergo clinical testing. Results from trials in patients with glioblastoma or pancreatic carcinoma showed an excellent safety profile and first signs of efficacy. H-1PV infection is vastly dependent on cellular factors, from cell attachment and entry to viral replication and egress. Hence, we believe that the characterisation of the parvovirus life cycle would ultimately help further improve H-1PV clinical outcome. In the present study, we explored the entry pathway of H-1PV in cervical HeLa and glioma NCH125 cancer cell lines. Electron and confocal microscopy showed viral particles associated with clathrin-coated pits and vesicles, providing the first evidence that H-1PV cell entry occurs through clathrin-mediated endocytosis. Accordingly, we observed that by blocking clathrin-mediated endocytosis with hypertonic sucrose, chlorpromazine, or pitstop 2, H-1PV transduction was markedly decreased. Accordingly, siRNA-mediated knockdown of AP2M1, which retains a crucial role in clathrin-mediated endocytosis, verified the reliance of H-1PV on this route to enter HeLa and NCH125 cancer cells. By contrast, we found no evidence of viral entry through caveolae-mediated endocytosis. Indeed, pre-treatment of cells with nystatin or methyl-β-cyclodextrin, both inhibitors of caveolae-mediated endocytosis, did not affect viral transduction levels. Unexpectedly, siRNA-mediated knockdown of caveolin-1, the main driver of caveolae-mediated endocytosis, increased H-1PV transduction, suggesting caveolin-1 is a negative modulator of H-1PV infection. We also show that H-1PV entry is dependent on dynamin, a protein responsible for mediating the scission of vesicle neck and promoting further internalisation. Furthermore, since dynamin inhibition almost completely abolished H-1PV infection, makes it unlikely that H-1PV uses macropinocytosis as an alternative pathway to enter cells. After viral internalisation, H-1PV passes through early to late endosomes as observed by confocal microscopy. Inside these endocytic compartments, the acidic environment proved to be crucial for a productive infection. Inhibition of acidification of pH dramatically reduced H-1PV transduction. Besides, a fraction of H-1PV particles was observed inside LAMP1-positive lysosomes, most likely following a non-infectious route. To the author's best knowledge, this is the first study to characterise the cell entry pathways of H-1PV. Along these lines, this work will further contribute to understand H-1PV oncolytic properties as well as to improve its clinical potential in cancer virotherapy.

Keywords: clathrin-mediated endocytosis, H-1 parvovirus, oncolytic virus, virus entry

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Authors: Y. Yılmaz, C. Ünal, A. Dursun

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Distribution channels play significant role for hotels. Direct and indirect selling options of hotel rooms have been increased especially with the help of new technologies, i.e. hotel’s own web sites and online booking sites. Although these options emerged as tools for diversifying the distribution channels, vast number of hotels -mostly resort hotels- is still heavily dependent upon international tour operators when selling their products. On the other hand, hotel sector is so vulnerable against crises. Economic, political or any other crisis can affect hotels very badly and so it is critical to have the right balance of distribution channel to avoid the adverse impacts of a crisis. In this study, it is aimed to search the impacts of a general crisis on the selling prices of hotels which have different weights of distribution channels. The study was done in Turkey where various crises occurred in 2015 and 2016 which had great negative impacts on Turkish tourism and led enormous occupancy rate and selling price reductions. 112 upscale resort hotel in Antalya, which is the most popular tourism destination of Turkey, joined to the research. According to the results, hotels with high dependency to international tour operators are more forced to reduce their room prices in crisis time compared to the ones which use their own web sites more. It was also found that the decline in room prices is limited for hotels which are working with national tour operators and travel agencies in crisis time.

Keywords: marketing channels, crisis, hotel, international tour operators, online travel agencies

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Authors: Ayako Otomo

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This paper will examines the rise of a feminine orientation regarding arts and culture associated with the notion of Sensibility during the early part of the English long eighteenth century. As is widely known, the prosperous modernisation that occurred in this period was a significant factor in the nation taking a leading role in the emergent Enlightenment via the social, political and scientific advancement of Britain. As a result, this prompted the relaxing of the strictures of class and gender hierarchies in line with the new consumerism and cosmopolitanism of the nation. Accordingly, there was a significant increase of female involvement in artistic and cultural consumption. This can be understood in terms of the notion of Sensibility, associating it further with the fields of physiology, psychology and aesthetics, indebted in their turn to British Empiricism. This paper first traces the background of how women were recognisably involved in artistic and cultural circulation within an historical perspective that is articulated by the notion of Sensibility. Then, the discussion turns to the confluence of the issues of female association, creativity and the feminisation of the aesthetic of the arts and culture employing an interdisciplinary perspective. Arts and culture can also classified by public and private social spheres and gender according to Jürgen Habermas. The relationship between women and the theatre became a public issue. Music-making such as playing the harpsichord, reading, and conversation within the ritualistic teatime space dominated many of the artistic and cultural activities within the domestic private sphere.

Keywords: theatre, arts, sensibility, 18th century England

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Authors: F. A. Thomas, M. Schrafl-Altermatt, R. Treier, S. Kaufmann

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Stroke is the main cause of adult disability. Especially upper limb function is affected in most patients. Recently, cooperative hand movements have been shown to be a promising type of upper limb training in stroke rehabilitation. In these movements, which are frequently found in activities of daily living (e.g. opening a bottle, winding up a blind), the force of one upper limb has to be equally counteracted by the other limb to successfully accomplish a task. The use of standardized and reliable clinical assessments is essential to evaluate the efficacy of therapy and the functional outcome of a patient. Many assessments for upper limb function or impairment are available. However, the evaluation of cooperative hand movement tasks are rarely included in those. Thus, the aim of this study was (i) to develop a novel clinical assessment (CASA - Cooperative Activity Stroke Assessment) for the evaluation of patients’ capacity to perform cooperative hand movements and (ii) to test its inter- and interrater reliability. Furthermore, CASA scores were compared to current gold standard assessments for upper extremity in stroke patients (i.e. Fugl-Meyer Assessment, Box & Blocks Test). The CASA consists of five cooperative activities of daily living including (1) opening a jar, (2) opening a bottle, (3) open and closing of a zip, (4) unscrew a nut and (5) opening a clipbox. Here, the goal is to accomplish the tasks as fast as possible. In addition to the quantitative rating (i.e. time) which is converted to a 7-point scale, also the quality of the movement is rated in a 4-point scale. To test the reliability of CASA, fifteen stroke subjects were tested within a week twice by the same two raters. Intra-and interrater reliability was calculated using the intraclass correlation coefficient (ICC) for total CASA score and single items. Furthermore, Pearson-correlation was used to compare the CASA scores to the scores of Fugl-Meyer upper limb assessment and the box and blocks test, which were assessed in every patient additionally to the CASA. ICC scores of the total CASA score indicated an excellent- and single items established a good to excellent inter- and interrater reliability. Furthermore, the CASA score was significantly correlated to the Fugl-Meyer and Box & Blocks score. The CASA provides a reliable assessment for cooperative hand movements which are crucial for many activities of daily living. Due to its non-costly setup, easy and fast implementation, we suggest it to be well suitable for clinical application. In conclusion, the CASA is a useful tool in assessing the functional status and therapy related recovery in cooperative hand movement capacity in stroke patients.

Keywords: activitites of daily living, clinical assessment, cooperative hand movements, reliability, stroke

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Authors: Santhani M. Selveindran

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Background: Natural disasters are traumatic global events that are becoming increasing more common, with significant psychosocial impact on survivors. This impact results not only in psychosocial distress but, for many, can lead to psychosocial disorders and chronic psychopathology. While there are currently available interventions that seek to prevent and treat these psychosocial sequelae, their effectiveness is uncertain. The evidence-base is emerging with more primary studies evaluating the effectiveness of various psychosocial interventions for survivors of natural disasters, which remains to be synthesized. Aim of Review: To identify, critically appraise and synthesize the current evidence-base on the effectiveness of psychosocial interventions in preventing or treating Post-Traumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD) and/or Generalized Anxiety Disorder (GAD) in adults and children who are survivors of natural disasters. Methods: A protocol was developed as a guide to carry out this review. A systematic search was conducted in eight international electronic databases, three grey literature databases, one dissertation and thesis repository, websites of six humanitarian and non-governmental organizations renowned for their work on natural disasters, as well as bibliographic and citation searching for eligible articles. Papers meeting the specific inclusion criteria underwent quality assessment using the Downs and Black checklist. Data were extracted from the included papers and analysed by way of narrative synthesis. Results: Database and website searching returned 3777 papers where 31 met the criteria for inclusion. Additional 2 papers were obtained through bibliographic and citation searching. Methodological quality of most papers was fair. Twenty-five studies evaluated psychological interventions, five, social interventions whereas three studies evaluated ‘mixed’ psychological and social interventions. All studies, irrespective of methodological quality, reported post-intervention reductions in symptom scores for PTSD, depression and/or anxiety and where assessed, reduced diagnosis of PTSD and MDD, and produced improvements in self-efficacy and quality of life. Statistically significant results were seen in 27 studies. However, three studies demonstrated that the evaluated interventions may not have been very beneficial. Conclusions: The overall positive results suggest that any psychosocial interventions are favourable and should be delivered to all natural disaster survivors, irrespective of age, country, and phase of disaster. Yet, heterogeneity and methodological shortcomings of the current evidence-base makes it difficult to draw definite conclusions needed to formulate categorical guidance or frameworks. Further, rigorously conducted research is needed in this area, although the feasibility of such, given the context and nature of the problem, is also recognized.

Keywords: psychosocial interventions, natural disasters, survivors, effectiveness

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Authors: Aarti Sharma, Sarita Kumar, Pushplata Tripathi

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Aedes aegypti L. is one of the most important insect vectors in the world transmitting several diseases of concern; dengue fever, dengue haemorrhagic fever and yellow fever. Though since ages the control of dengue vector is primarily relied upon the use of synthetic chemical insecticides, the continued and indiscriminate use of insecticides for their control has received wide public apprehension because of multifarious problems including insecticide resistance, resurgence of pest species, environmental pollution, toxic hazards to humans and non-target organisms. These problems have necessitated the need to explore and develop alternative strategies using eco-friendly and bio-degradable plant products. Bio-insecticides, despite being the focus of research nowadays, have not been investigated much regarding their physiological effects on the mosquitoes. Thus, the present studies were carried out to investigate the anti-mosquito potential of the leaf and stem hexane extracts of Achyranthes aspera against early fourth instars of Aedes aegypti L and their effects on the histological architecture of their midgut. The larvicidal bioassays conducted with the A. aspera leaf hexane extracts revealed the respective LC30, LC50 and LC90 values of 66.545 ppm, 82.555 ppm, 139.817 ppm while the assays with stem hexane extracts resulted in respective values of 54.982 ppm, 68.133 ppm, 115.075 ppm. The studies clearly indicate the efficacy of extracts as larvicidal agents against Ae. aegypti, the stem extracts being found more effective than the leaf extracts. When the larvae assayed with extracts were investigated for the modifications in the histo-architecture of the midgut, the studies showed significant damage, shrinkage, distortion and vacuolization of gut tissues and peritrophic membrane causing disintegration of epithelial cells and cytoplasmic organelles; extent of toxicity and damage varied depending upon the concentration and exposure time period. These changes revealed appreciable stomach poison potential of A. aspera extracts against Ae. aegypti larvae, which may have also caused adverse impact on the growth and development of larvae. These effects were also found to be more pronounced with the stem extract than the leaf extract. Our findings may prove significant suggesting the use of A. aspera extract as a bio-insecticide against early fourth instar larvae of Ae. aegypti. Further studies are needed to identify the bioactive component in the extracts and to ascertain the use of component in the fields as anti-mosquito control agent.

Keywords: Achyranthes aspera, Aedes aegypti, histological architecture, larvicidal, midgut, stomach poison

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Authors: Mónica Catarina Soares

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Neoliberal rationality is currently changing the ways concepts like freedom or equality are framed. As an omnipresent and context-sensitive paradigm, homo oeconomicus is continuously taking place in realms of life previously insulated from economic and market-driven principles. This presentation is based on the argument that, more than ever, this paradigm is nowadays framing institutional and everyday discourses in regard to social problems. Although neoliberal rationality is based on the putative ideological basis that everyone is equal, equality seems to be reshaped by specific meanings apprehended by this rationality. In this sense, an illusion of equality seems to be relevant to legitimize different social inequalities (e.g., access to health care or to habitation). Political psychology has studied how ideology is relevant to legitimize market and unequal systems, but still the specific relation between markets, (in)equality and neoliberal languages is not widely addressed. The goal is to discuss the smithereens of the neoliberal rationality when it comes to legitimizing social inequalities by contesting the arguments of meritocracy, progressive freedom and minimal guarantees obeying to market-rules and principles. This analysis can be helpful to grasp for instance the continuously dismantlement of the welfare-state in different countries of the global north and how it is turning the regulation/emancipation tension inside out. The ultimate goal is to contribute to the breaking up of a paradigm that is still too big to capture, too depoliticized and chameleonic to fully acknowledge the biopolitics of power that is helping to create it.

Keywords: discourses, legitimacy, neoliberal rationality, social inequality

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Authors: Vivek Bhat, Rohini Kelkar, Sanjay Biswas

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Introduction: Cancer patients are at increased risk of bacterial infections. This may due to the disease process itself, the effect of chemotherapeutic drugs or invasive procedures such as catheterization. A wide variety of bacteria including some emerging pathogens are increasingly being reported from these patients. The incidence of multidrug-resistant organisms particularly in the Gram negative group is also increasing, with higher resistance rates seen to cephalosporins, β-lactam/β-lactam inhibitor combinations, and the carbapenems. This study documents the bacteriological spectrum of infections and their resistance patterns in cancer patients. Methods: This study includes all bacterial isolates recovered from infections cancer patients over a period of 18 months. Samples included Blood cultures, Pus/wound swabs, urine, tissue biopsies, body fluids, catheter tips and respiratory specimens such as sputum and bronchoalveolar lavage (BAL). All samples were processed in the microbiology laboratory as per standard laboratory protocols. Organisms were identified to species level and antimicrobial susceptibility testing was performed manually by the disc diffusion technique or in the Vitek-2 (Biomereux, France) instrument. Interpretations were as per Clinical laboratory Standards Institute (CLSI) guidelines. Results: A total of 1150 bacterial isolates were cultured from 884 test samples during the study period. Of these 227 were Gram-positive and 923 were Gram-negative organisms. Staphylococcus aureus (99 isolates) was the commonest Gram-positive isolate followed by Enterococcus (79) and Gr A Streptococcus (30). Among the Gram negatives, E. coli (304), Pseudomonas aeruginosa (201) and Klebsiella pneumoniae (190) were the most common. Of the Staphylococcus aureus isolates 27.2% were methicillin resistant. Only 5.06% enterococci were vancomycin resistant. High rates of resistance to cefotaxime and ciprofloxacin were seen amongst E. coli (84.8% & 83.55%) and Klebsiella pneumoniae (71 & 62.1%) respectively. Resistance to carbapenems (meropenem) was high at 70% in Acinetobacter spp.; however all isolates were sensitive to colistin. Among the aminoglycosides, amikacin retained good efficacy against Escherichia coli (82.9%) and Pseudomonas aeruginosa (78.1%). Occasional isolates of emerging pathogens such as Chryseobacterium indologens, Roseomonas, and Achromobacter xyloxidans were also recovered. Conclusion: The common infections in cancer patients include respiratory, wound, tract infections and sepsis. The commonest isolates include Staphylococcus aureus, Enterococci, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. There is a high level of resistance to the commonly used antibiotics among Gram-negative organisms.

Keywords: bacteria, resistance, infection, cancer

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