Search results for: female managers

Authors: Mazoun Nasser Rashid Al Kharusi, Nada Al Siyabi

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Objectives: The main aim of this study is to Find the rate of susceptibility of ESBL E. coli causing UTI to oral antibiotics. Secondary objectives: Prevalence of ESBL E. coli from community urine samples, identify the best empirical oral antibiotics with the least resistance rate for UTI and identify alternative oral antibiotics for testing and utilization. Methods: This study is a retrospective descriptive study of the last three years in five major hospitals in Oman (Khowla Hospital, AN’Nahdha Hospital, Rustaq Hospital, Nizwa Hospital, and Ibri Hospital) equipped with a microbiologist. Inclusion criteria include all eligible outpatient urine culture isolates, excluding isolates from admitted patients with hospital-acquired urinary tract infections. Data was collected through the MOH database. The MOH hospitals are using different types of testing, automated methods like Vitek2 and manual methods. Vitek2 machine uses the principle of the fluorogenic method for organism identification and a turbidimetric method for susceptibility testing. The manual method is done by double disc diffusion for identifying ESBL and the disc diffusion method is for antibiotic susceptibility. All laboratories follow the clinical laboratory science institute (CLSI) guidelines. Analysis was done by SPSS statistical package. Results: Total urine cultures were (23048). E. coli grew in (11637) 49.6% of the urine, whereas (2199) 18.8% of those were confirmed as ESBL. As expected, the resistance rate to amoxicillin and cefuroxime is 100%. Moreover, the susceptibility of those ESBL-producing E. coli to nitrofurantoin, trimethoprim+sulfamethoxazole, ciprofloxacin and amoxicillin-clavulanate is progressing over the years; however, still low. ESBL E. coli was predominating in the female gender and those aged 66-74 years old throughout all the years. Other oral antibiotic options need to be explored and tested so that we add to the pool of oral antibiotics for ESBL E. coli causing UTI in the community. Conclusion: High rate of ESBL E. coli in urine from the community. The high resistance rates to oral antibiotics highlight the need for alternative treatment options for UTIs caused by these bacteria. Further research is needed to identify new and effective treatments for UTIs caused by ESBL-E. Coli.

Keywords: UTI, ESBL, oral antibiotics, E. coli, susceptibility

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Authors: Mansoureh Zangiabadi, Shamil Velji, Rajendra Kelkar, Neal Wade, Volker Pickert

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The EU has set itself a long-term goal of reducing greenhouse gas emissions by 80-95% of the 1990 levels by 2050 as set in the Energy Roadmap 2050. This paper reports on the European Union H2020 funded E-Lobster project which demonstrates tools and technologies, software and hardware in integrating the grid distribution, and the railway power systems with power electronics technologies (Smart Soft Open Point - sSOP) and local energy storage. In this context this paper describes the existing policies and regulatory frameworks of the energy market at European level with a special focus then at National level, on the countries where the members of the consortium are located, and where the demonstration activities will be implemented. By taking into account the disciplinary approach of E-Lobster, the main policy areas investigated includes electricity, energy market, energy efficiency, transport and smart cities. Energy storage will play a key role in enabling the EU to develop a low-carbon electricity system. In recent years, Energy Storage System (ESSs) are gaining importance due to emerging applications, especially electrification of the transportation sector and grid integration of volatile renewables. The need for storage systems led to ESS technologies performance improvements and significant price decline. This allows for opening a new market where ESSs can be a reliable and economical solution. One such emerging market for ESS is R+G management which will be investigated and demonstrated within E-Lobster project. The surplus of energy in one type of power system (e.g., due to metro braking) might be directly transferred to the other power system (or vice versa). However, it would usually happen at unfavourable instances when the recipient does not need additional power. Thus, the role of ESS is to enhance advantages coming from interconnection of the railway power systems and distribution grids by offering additional energy buffer. Consequently, the surplus/deficit of energy in, e.g. railway power systems, is not to be immediately transferred to/from the distribution grid but it could be stored and used when it is really needed. This will assure better energy management exchange between the railway power systems and distribution grids and lead to more efficient loss reduction. In this framework, to identify the existing policies and regulatory frameworks is crucial for the project activities and for the future development of business models for the E-Lobster solutions. The projections carried out by the European Commission, the Member States and stakeholders and their analysis indicated some trends, challenges, opportunities and structural changes needed to design the policy measures to provide the appropriate framework for investors. This study will be used as reference for the discussion in the envisaged workshops with stakeholders (DSOs and Transport Managers) in the E-Lobster project.

Keywords: light railway, electrical distribution network, Electrical Energy Storage, policy

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Authors: Folajimi Oladimeji Shorunke

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Background: As of October 9, 2023, diphtheria has been noted to be re-emerging in four African countries: Algeria, Guinea, Niger, and Nigeria. 14,587 cases with a case fatality rate of 4.1% have been reported across these regions, with Nigeria alone responsible for over 90% of the cases. In Taraba State Nigeria, the index case of Diphtheria was reported on epidemic week 34, August 24, 2023 with 75 confirmed cases found 3 months after the index case and a case fatality of 1.3%. it described the distribution, trend and common symptoms found during the Outbreak. Methods: The Taraba State Diphtheria Outbreak line list on the Surveillance Outbreak Response Management & Analysis System (SORMAS) for all its 16 local government areas (LGAs) was analyzed using descriptive statistics (graphs, chats and maps) for the period between 24th August to 25th November 2023. Primary data was collected through the use of case investigation forms and variables like Age, gender, date of disease onset, LGA of residence, and symptoms exhibited were collected. Naso-pharyngeal and oro-pharyngeal samples were also collected for Laboratory confirmation. The most common diphtheria symptoms during the outbreak were also highlighted. Results: A total of 75 Diphtheria cases were diagnosed in 10 of the 16 LGAs in Taraba State between 24th August to 25th November 2023, 72% of the cases were female, with the age range 0-9 years having the highest proportion of 34 (45.3%), the number of positive diagnosis reduces with age among cases. The Northern part of the State had the highest proportion of cases, 68 (90.7%), with Ardo-Kola LGA having the highest 28 (29%). The remaining 9.2% of cases is shared among the middle belt and southern part of the State. The Epi-curve took the characteristic shape of a propagated infection with peaks at the 37th, 39th and 45th epidemic weeks. The most common symptoms found in cases were fever 71 (94.7%), pharyngitis 65( 86.7%), tonsillitis 60 (80%), and laryngitis 53 (71%). Conclusions: The number of confirmed cases of Diphtheria in Taraba State, Nigeria between 24th August to 25th November 2023 is 75. The condition is higher among females than male and mostly affected children between ages 0-9 with the northern part of the state most affected. The most common symptoms exhibited by cases include fever, pharyngitis, tonsillitis and laryngitis.

Keywords: diphtheria outbreak, taraba nigeria, descriptive epidemiology, trend

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Authors: Zainab Olabisi Tairu

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The human species is facing some of the most challenging issues encountered as civilization and development occurs. The most salient factors threatening all species globally are habitats loss and degradation, overexploitation, competition with unwanted invasive species, pollution, global climate and various individual lifestyles of indigenous species. In order to avoid or minimize the effect of our actions on the environment and to balance employee work life with their private life, Green Human Resource is important and must be practiced in every organization including Higher Learning Institutions. This study addressed Green HRM from an institutional perspective, University systems are involved in numerous and complex social, educational and extra-curricular activities. The University community must be challenged to rethink and re-construct their environmental policies and practices in order to contribute to sustainable development. Many institutions only look at sustainability from the technology improvement aspect and waste management. People are the principal actors for sustainability development at the institutional level. The aim of the study is to explore the concept of Green Human Resource Management at a case site. Divine Word University (DWU) an Institution of Higher Education that embraced the ‘Printing & Paper use Policy’, also commonly referred to as the ‘paperless policy’, the use of solar as an alternative source of energy, water conservation and improvement in internet technology (IT) with the aim of becoming a green institution in effort to help save the environment. This study used Participatory Action Research as the Overarching methodological framework and Egg of sustainability and Wellbeing as the theoretical perspective in analyzing the data, engaging Case study strategy and a mixed method design at DWU. Focus group interview were conducted with three departments at the University, semi-structure interviews with the senior managers, survey questionnaire administered to students and staff with a sample size of 176 participants, in addition, policy documents were also exploited as extra source of data. Waste management including e-waste appeared to be one of the main concerns at DWU. A vast majority of DWU staff and students expressed the need for their institution to do more on sustainability education. The findings revealed that members of the community are not fully integrated like the Egg of sustainability and wellbeing in order to achieve sustainable development goal. The concept of Green Human Resource Management in Universities lies with the idea that Universities must bear profound responsibilities to manage its stakeholders in an environmental friendly way. Human resource management can help local institutions to recognize the need for changes of lifestyle, production, consumption as well as the end product in order to combat or at least reduce human Induced which produce or aggravate it.

Keywords: sustainability, environmental management, higher education institutions, green human resource management

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Authors: Ylva Fältholm, Cathrine Norberg

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One of the major threats identified to successful future mining is that women do not find the industry attractive. Many attempts have been made, for example in Sweden and Australia, to create organizational structures and mining communities attractive to both genders. Despite such initiatives, many mining areas are developing into gender-segregated fly-in/fly out communities dominated by men with both social and economic consequences. One of the challenges facing many mining companies is thus to break traditional gender patterns and structures. To do this increased knowledge about gender in the context of mining is needed. Since language both constitutes and reproduces knowledge, increased knowledge can be gained through an exploration and description of the mining discourse from a gender perspective. The aim of this study is to explore what conceptual ideas are activated in connection to the physical/geographical mining area and to work within the mining industry. We use a combination of critical discourse analysis implying close reading of selected texts, such as policy documents, interview materials, applications and research and innovation agendas, and analyses of linguistic patterns found in large language corpora covering millions of words of contemporary language production. The quantitative corpus data serves as a point of departure for the qualitative analysis of the texts, that is, suggests what patterns to explore further. The study shows that despite technological and organizational development, one of the most persistent discourses about mining is the conception of dangerous and unfriendly areas infused with traditional notions of masculinity ideals and manual hard work. Although some of the texts analyzed highlight gender issues, and describe gender-equalizing initiatives, such as wage-mapping systems, female networks and recruitment efforts for women executives, and thereby render the discourse less straightforward, it is shown that these texts are not unambiguous examples of a counter-discourse. They rather illustrate that discourses are not stable but include opposing discourses, in dialogue with each other. For example, many texts highlight why and how women are important to mining, at the same time as they suggest that gender and diversity are all about women: why mining is a problem for them, how they should be, and what they should do to fit in. Drawing on a constitutive view of discourse, knowledge about such conflicting perceptions of women is a prerequisite for succeeding in attracting women to the mining industry and thereby contributing to the development of future mining.

Keywords: discourse, corpus linguistics, gender, mining

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Authors: Clarence Dissanayake, Anishka A. Hettiarachchi

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Landscape architecture needs to encompass a placemaking process carefully composing and manipulating landscape elements to address perceptual needs of humans, especially aesthetic, psychological and spiritual. The objective of this qualitative investigation is to inquire the impact of elements of rock and water combination on landscape perception and related feelings, emotions, and behavior. The past empirical studies have assessed the impact of landscape elements in isolation on user preference, yet the combined effect of elements have been less considered. This research was conducted with reference to the verity of qualities of water and rock through a visual landscape quality assessment focusing on landscape qualities derived from five visual concepts (coherence, historicity imageability, naturalness, and ephemera). 'Kaludiya Pokuna' archeological site in Anuradhapura was investigated with a sample of University students (n=19, male 14, female 5, age 20-25) using a five-point Likert scale via a perception based questionnaire and a visitor employed photographic survey (VEP). Two hypothetical questions were taken into investigation concerning biophilic (naturalness) and topophilic (historicity) aspects of humans to prefer a landscape with rock and water. The findings revealed that this combination encourages both biophilic and topophilic aspects, but in varying degrees. The identified hierarchy of visual concepts based on visitor’s preference signify coherence (93%), historicity (89%), imageability (79%), naturalness (75%) and ephemera (70%) respectively. It was further revealed that this combination creates a scenery more coherent dominating information processing aspect of humans to perceive a landscape over the biophilic and topophilic aspects. Different characteristics and secondary landscape effects generated by rock and water combination were found to affect in transforming a space into a place, full filling the aesthetic and spiritual aspects of the visitors. These findings enhance a means of making places for people, resource management and historical landscape conservation. Equalization of gender based participation, taking diverse cases and increasing the sample size with more analytical photographic analysis are recommended to enhance the quality of further research.

Keywords: landscape perception, visitor’s preference, rock and water combination, visual concepts

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Authors: Susana Silva, Dora Martins

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The recent political, economic, social technological and employment changes significantly affect the tourism organizations and consequently the changing nature of the employment experience of the tourism workforce. Such scene leads several researchers and labor analysts to reflect about what kinds of jobs, knowledge and competences are need to ensure the success to teach, to learning and to work on this sector. In recent years the competency-based approach in high education level has become of significant interest. On the one hand, this approach could leads to the forming of the key students’ competences which contribute their better preparation to the professional future and on the other hand could answer better to practical demands from tourism job market. The goals of this paper are (1) to understand the expectations of university tourism students in relation to the present and future tourism competences demands, (2) to identify the importance put on the soft skills, (3) to know the importance of high qualification to their future professional activity and (4) to explore the students perception about present and future tourist sector specificities. To this proposal, a questionnaire was designed and distributed to every students who participate on classes of Hospitality Management under degree and master from one public Portuguese university. All participants were invited, during December 2014 and September 2015, to answer the questionnaire at the moment and on presence of one researcher of this study. Fulfilled the questionnaire 202 students (72, 35,6% male and 130, 64.4% female), the mean age was 21,64 (SD=5,27), 91% (n=86) were undergraduate and 18 (9%) were master students. 80% (n=162) of our participants refers as a possibility to look for a job outside the country.42% (n=85) prefers to work in a medium-sized tourism units (with 50-249 employees). According to our participants the most valued skills in tourism are the domain of foreign languages (87.6%, n=177), the ability to work as a team (85%), the personal persistence (83%, n=168), the knowledge of the product/services provided (73.8%, n=149), and assertiveness (66.3%, n=134). 65% (n=131) refers the availability to look for a job in a home distance of 1000 kilometers and 59% (n=119) do not consider the possibility to work in another area than tourism. From the results of this study we are in the position of confirming the need for universities to maintain a better link with the professional tourism companies and to rethink some competences into their learning course model. Based on our results students, universities and companies could understand more deeply the motivations, expectations and competences need to build the future career who study and work on the tourism sector.

Keywords: human capital, employability, students’ competencies perceptions, soft skills, tourism

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Authors: Hacer Erdöl, Merve Aydın, Hacer Kobya Bulut, Kıymet Yeşilçiçek Çalık

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Like all occupations, nursing is significantly influenced by the society which it serves and it also affects it. Social structure affects attitudes of nurses, nursing practice, society's attitudes towards nursing and those who have chosen nursing as a profession. People who choose nursing schools take the views of the society’s they live in on nursing to nursing school. Until the 1960s, many nursing schools had not accepted men as students and women had received nursing education and profession had been carried out by women. In our country, in 2007 an amendment to article eight of Nursing Law was passed and with these changes men also began to be able to choose the nursing as a profession. In Turkish, nurse means 'sister'. Hence, in this study to determine the problems that male nursing students likely encounter at the clinic, non-clinical environment and in their private life regarding the title of nurse, among qualitative research methods phenomenological research design was used. Using purpose sampling method, a total of 18 voluntary male students-13 in third grade and 5 in fourth grade at nursing school- were taken to the study. Data were collected through interviews and by the ethical principles much attention was paid to ensure the confidentiality and to protect participants’ identity. During the interviews lasting 30-40 minutes on average, nine pre-configured standard questions were asked and when necessary free questions were also used in order to ensure the clarity of the responses. With pre- configured standard questions, the reasons why students chose the profession, the problems they had in clinical and non-clinical environment and the potential problems they might encounter in their private lives regarding the title of nurse were questioned. Content analysis was performed on data collected and three main themes were obtained. According to the findings of the evaluation of data, it was found that almost all the students preferred the profession due to possible work opportunities, there were students who did not bother nurse title as well as the ones who did bother and as the most important problem they might encounter in their private lives was to feel worried if their kids had to answer "What does your father" question as "my dad is a nurse" and being ridiculed afterwards. The results of this study show that studies should be done to change the social judgment stemmed from the recognition of nursing as a female profession and take advantage of media through creating public spotlight to accomplish this.

Keywords: choice of profession, the title of the profession, title problems, nursing

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Authors: Sookbin Im, Myounglyun Heo

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This study aims at analyzing composition and effects of the preliminary intervention to promote resiliency of children whose parents suffer mental illness, and considerations according to the program, and developing the resiliency promotion program for children of psychiatric patients. For participants of preliminary intervention, they were recruited through a community mental health and social welfare center in a city, and there were 10 children (eight girls and two boys) who are from second to five graders in elementary school, and whose parents suffer schizophrenia, depression, or alcoholism, etc. The program was conducted in the seminar room of the community mental illness and social welfare center from October to December 2015 and from July to September 2016. The elements of resiliency were figured out by reviewing the literature. And therapeutic activities to promote resiliency was composed, and total twice, 8 sessions(two hours, once a week) were applied. Each session consisted of playgroup activities, art activities, and role-playing with feedback for achieving goals to promote self-awareness, self-efficacy, positive outlook, ability to solve problems, empathy for others, peer group acceptance, having goals and aspirations, and assertiveness. In addition, auxiliary managers as many as children played a role as mentor and role model, and children's behaviors were collected by participatory observation. As a result of the study, four children quit the program because the schedules of their own school programs were overlapped with it. Therefore, six children completed the program. Children who completed it became active, positive, decreased compulsive actions, and increased self-expressions. The participants reacted the 8-session program is too short and regretted about it. However, recruiting the participants were difficult, and too distracting children caused negative influences in the group activities. Based on the results, the program was developed as follows: The program would consist of total 11 sessions, and the first eight sessions would be made of plays, art activities, role-plays, and presentations for promoting self-understanding, improving positiveness, providing meaning for experiences, emotional control, and interpersonal relations. In order to balance various contents, methods such as structuring environments, storytelling, emotional coaching, and group feedback would be applied, and the ninth to eleventh sessions would be booster sessions consisting of optional activities for children. This program is for children who attend school with active linguistic communications and interactions with peers. Especially, considering that effective development starts at around 10 years old, it would be for children who are third and fourth graders in elementary school. These result showed that this program was useful for improving the key elements of resiliency such as positive thinking or impulse control. It is suggested the necessary of resiliency promoting program model and practical guidance with comprehensive measuring methods(narratives, drawing, self-reported questionnaire, behavioral observation). Also, it is necessary to make a training program for the coaches or leaders to operate this program to spread out for child health.

Keywords: children, mental, parents, resilience

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Authors: Abbas Sheikhtaheri, Nasim Hashemi

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Health information systems have great benefits for clinical and managerial processes of health care organizations. However, identifying and removing constraints and barriers of implementing and using health information systems before any implementation is essential. Physicians are one of the main users of health information systems, therefore, identifying the causes of their resistance and concerns about the barriers of the implementation of these systems is very important. So the purpose of this study was to determine the barriers of the development and implementation of health information systems in terms of the Iranian physicians’ perspectives. In this study conducted in 8 selected hospitals affiliated to Tehran and Iran Universities of Medical Sciences, Tehran, Iran in 2014, physicians (GPs, residents, interns, specialists) in these hospitals were surveyed. In order to collect data, a research made questionnaire was used (Cronbach’s α = 0.95). The instrument included 25 about organizational (9), personal (4), moral and legal (3) and technical barriers (9). Participants were asked to answer the questions using 5 point scale Likert (completely disagree=1 to completely agree=5). By using a simple random sampling method, 200 physicians (from 600) were invited to study that eventually 163 questionnaires were returned. We used mean score and t-test and ANOVA to analyze the data using SPSS software version 17. 52.1% of respondents were female. The mean age was 30.18 ± 7.29. The work experience years for most of them were between 1 to 5 years (80.4 percent). The most important barriers were organizational ones (3.4 ± 0.89), followed by ethical (3.18 ± 0.98), technical (3.06 ± 0.8) and personal (3.04 ± 1.2). Lack of easy access to a fast Internet (3.67±1.91) and the lack of exchanging information (3.61±1.2) were the most important technical barriers. Among organizational barriers, the lack of efficient planning for the development and implementation systems (3.56±1.32) and was the most important ones. Lack of awareness and knowledge of health care providers about the health information systems features (3.33±1.28) and the lack of physician participation in planning phase (3.27±1.2) as well as concerns regarding the security and confidentiality of health information (3.15 ± 1.31) were the most important personal and ethical barriers, respectively. Women (P = 0.02) and those with less experience (P = 0.002) were more concerned about personal barriers. GPs also were more concerned about technical barriers (P = 0.02). According to the study, technical and ethics barriers were considered as the most important barriers however, lack of awareness in target population is also considered as one of the main barriers. Ignoring issues such as personal and ethical barriers, even if the necessary infrastructure and technical requirements were provided, may result in failure. Therefore, along with the creating infrastructure and resolving organizational barriers, special attention to education and awareness of physicians and providing solution for ethics concerns are necessary.

Keywords: barriers, development health information systems, implementation, physicians

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Authors: Mdluli Fezile, Schmidt Stefan, Thamaga-Chitja Joyce

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In view of the frequently reported foodborne disease outbreaks caused by contaminated fresh produce, consumers have a preference for foods that meet requisite hygiene standards to reduce the risk of foodborne illnesses. Producing good quality fresh produce then becomes critical in improving market access and food security, especially for small-scale farmers. Questions of hygiene and subsequent microbiological quality in the rural small-scale farming sector of South Africa are even more crucial, given the policy drive to develop small-scale farming as a measure for reinforcement of household food security and reduction of poverty. Farming practices and methods, throughout the fresh produce value chain, influence the quality of the final product, which in turn determines its success in the market. This study’s aim was to therefore determine the extent to which training on organic farming methods, including modules such as Importance of Production Hygiene, influenced the hygienic farming practices employed by eTholeni small-scale organic farmers in uMbumbulu, KwaZulu-Natal- South Africa. Questionnaires were administered to 73 uncertified organic farmers and analysis showed that a total of 33 farmers were trained and supplied the local Agri-Hub while 40 had not received training. The questionnaire probed respondents’ attitudes, knowledge of hygiene and composting practices. Data analysis included descriptive statistics such as the Chi-square test and a logistic regression model. Descriptive analysis indicated that a majority of the farmers (60%) were female, most of which (73%) were above the age of 40. The logistic regression indicated that factors such as farmer training and prior experience in the farming sector had a significant influence on hygiene practices both at 5% significance levels. These results emphasize the importance of training, education and farming experience in implementing good hygiene practices in small-scale farming. It is therefore recommended that South African policies should advocate for small-scale farmer training, not only for subsistence purposes, but also with an aim of supplying produce markets with high fresh produce.

Keywords: small-scale farmers, leafy salad vegetables, organic produce, food safety, hygienic practices, food security

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Authors: Shivani Thakur, Jasmin Dominguez Cervantes, Ahmed Zabiba, Fatima Zabiba, Sandhini Agarwal, Kamalpreet Kaur, Hussein Maatouk, Shae Chand, Omar Madriz, Tiffany Huang, Saloni Bansal

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The prevalence of lymphedema in women in rural communities highlights the importance of developing effective treatment and prevention methods. Subjects with secondary lymphedema in California’s Central Valley were surveyed at 6 surgical clinics to assess demographics and symptoms of lymphedema. Additionally, subjects on semaglutide treatment for obesity and/or T2DM were monitored for their diabetes management, weight loss progress, and lymphedema symptoms compared to subjects who were not treated with semaglutide. The subjects were followed for 12 months. Subjects who were treated with semaglutide completed pre-treatment questionnaires and follow-up post-treatment questionnaires at 3, 6, 9, 12 months, along with medical assessment. The untreated subjects completed similar questionnaires. The questionnaires investigated subjective feelings regarding lymphedema symptoms and management using a Likert-scale; quantitative leg measurements were collected, and blood work reviewed at these appointments. Paired difference t-tests, chi-squared tests, and independent sample t-tests were performed. 50 subjects, aged 18-75 years, completed the surveys evaluating secondary lymphedema: 90% female, 69% Hispanic, 45% Spanish speaking, 42% disabled, 57 % employed, 54% income range below 30 thousand dollars, and average BMI of 40. Both treatment and non-treatment groups noted the most common symptoms were leg swelling (x̄=3.2, ▁d= 1.3), leg pain (x̄=3.2, ▁d=1.6 ), loss of daily function (x̄=3, ▁d=1.4 ), and negative body image (x̄=4.4, ▁d=0.54). Subjects in the semaglutide treatment group >3 months of treatment compared to the untreated group demonstrated: 55% subject in the treated group had a 10% weight loss vs 3% in the untreated group (average BMI reduction by 11% vs untreated by 2.5%, p<0.05) and improved subjective feelings about their lymphedema symptoms: leg swelling (x̄=2.4, ▁d=0.45 vs x̄=3.2, ▁d=1.3, p<0.05), leg pain (x̄=2.2, ▁d=0.45 vs x̄= 3.2, ▁d= 1.6, p<0.05), and heaviness (x̄=2.2, ▁d=0.45 vs x̄=3, ▁d=1.56, p<0.05). Improvement in diabetes management was demonstrated by an average of 0.9 % decrease in A1C values compared to untreated 0.1 %, p<0.05. In comparison to untreated subjects, treatment subjects on semaglutide noted 6 cm decrease in the circumference of the leg, knee, calf, and ankle compared to 2 cm in untreated subjects, p<0.05. Semaglutide was shown to significantly improve weight loss, T2DM management, leg circumference, and secondary lymphedema functional, physical and psychosocial symptoms.

Keywords: diabetes, secondary lymphedema, semaglutide, obesity

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Authors: Ana Pinheiro, Fatima Suleman

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Literature has revealed strong awareness of companies in regard of expatriation, but issues associated with repatriation of employees after an international assignment have been overlooked. Repatriation is one of the most challenging human resource practices that affect how companies benefit from acquired skills and high potential employees; and gain competitive advantage through network developed during expatriation. However, empirical evidence achieved so far suggests that expatriates have been disappointed because companies lack an effective repatriation strategy. Repatriates’ professional and emotional needs are often unrecognized, while repatriation is perceived as a non-issue by companies. The underlying assumption is that the return to parent company, and original country, culture and language does not demand for any particular support. Unfortunately, this basic view has non-negligible consequences on repatriates, especially on expatriate retention and turnover rates after expatriation. The goal of our study is to examine the specific policies and practices adopted by companies to support employees after an international assignment. We assume that expatriation is process which ends with repatriation. The latter is such a crucial issue as the expatriation and require due attention through appropriate design of human resource management policies and tools. For this purpose, we use data from a qualitative research based on interviews to a sample of firms operating in Portugal. We attempt to compare how firms accommodate the concerns with repatriation in their policies and practices. Therefore, the interviews collect data on both expatriation and repatriation process, namely the selection and skills of candidates to expatriation, training, mentoring, communication and pay policies. Portuguese labor market seems to be an interesting case study for mainly two reasons. On the one hand, Portuguese Government is encouraging companies to internationalize in the context of an external market-oriented growth model. On the other hand, expatriation is being perceived as a job opportunity in the context of high unemployment rates of both skilled and non-skilled. This is an ongoing research and the data collected until now indicate that companies follow the pattern described in the literature. The interviewed companies recognize the higher relevance of repatriation process than expatriation, but disregard specific human resource policies. They have perceived that unfavorable labor market conditions discourage mobility across companies. It should be stressed that companies underline that employees enhanced the relevance of stable jobs and attach far less importance to career development and other benefits after expatriation. However, there are still cases of turnover and difficulties of retention. Managers’ report non-negligible cases of turnover associated with lack of effective repatriation programs and non-recognition of good performance. Repatriates seem to having acquired entrepreneurial spirit and skills and often create their own company. These results suggest that even in the context of worsening labor market conditions, there should be greater awareness of the need to retain talents, experienced and highly skills employees. Ultimately, other companies poach invaluable assets, while internationalized companies risk being training providers.

Keywords: expatriates, expatriation, international management, repatriation

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Authors: Michelle Ablian Mejica

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Female drop-outs due to teenage pregnancy and gender-based violence in schools are two of the most contentious and current gender-related issues faced by the Department of Education (DepEd) in the Philippines. The country adopted gender mainstreaming as the main strategy to eliminate gender inequalities in all aspects of the society including education since 1990. This research examines the extent and magnitude by which gender mainstreaming is implemented in the basic education from the national to the school level. It seeks to discover the challenges faced by the central and field offices, particularly by the principals who served as decision-makers in the schools where teaching and learning take place and where opportunities that may aggravate, conform and transform gender inequalities and hierarchies exist. The author conducted surveys and interviews among 120 elementary and secondary principals in the Division of Zambales as well as selected gender division and regional focal persons within Region III- Central Luzon. The study argues that DepEd needs to review, strengthen and revitalize its gender mainstreaming because the efforts do not penetrate the schools and are not enough to lessen or eliminate gender inequalities within the schools. The study found out some of the major challenges in the implementation of gender mainstreaming as follows: absence of a national gender-responsive education policy framework, lack of gender responsive assessment and monitoring tools, poor quality of gender and development related training programs and poor data collection and analysis mechanism. Furthermore, other constraints include poor coordination mechanism among implementing agencies, lack of clear implementation strategy, ineffective or poor utilization of GAD budget and lack of teacher and learner centered GAD activities. The paper recommends the review of the department’s gender mainstreaming efforts to align with the mandate of the agency and provide gender responsive teaching and learning environment. It suggests that the focus must be on formulation of gender responsive policies and programs, improvement of the existing mechanism and conduct of trainings focused on gender analysis, budgeting and impact assessment not only for principals and GAD focal point system but also to parents and other school stakeholders.

Keywords: curriculum and instruction, gender analysis, gender budgeting, gender impact assessment

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Authors: Leyla Sattarzadeh, Shahin Fathi Molk Kian, Maghsoud Peeri, Mohammadali Azarbaijani, Hasan Matin Homaee

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Inflammation by various mechanisms may cause atherosclerosis. Systemic circulating inflammatory markers such as C-reactive protein (CRP), pro-inflammatory cytokines such as Interleukin-6 (IL-6), vascular inflammatory markers as adhesion molecules like Intracellular Adhesion Molecule-1 (ICAM-1) and Vascular Cell Adhesion Molecule-1 (VCAM-1) are the predictors of cardiovascular diseases. Regarding the conflicting results about the effect of different patterns of resistance exercise training on these inflammatory markers, present study aimed to examine the effect of different patterns of eight week resistance exercise training on CRP, IL-6, ICAM-1 and VCAM-1 levels in healthy untrained women. 56 healthy volunteered untrained female university students (aged: 21 ± 3 yr., Body Mass Index: 21.5 ± 3.5 kg/m²) were selected purposefully and divided into four groups. At the end of training protocol and after subject drop during the protocol, upper body exercise training (n=11), lower body (n=12) and whole body resistance exercise training group (n=11) completed the eight weeks of training period although the control group (n=7) did anything. Blood samples gathered pre and post-experimental period and CRP, IL-6, ICAM-1 and VCAM-1 levels were evaluated using special laboratory kits, then the difference of pre and post values of each indices analyzed using one-way analysis of variance (α < 0.05). The results of one way ANOVA for difference of pre and post values of CRP, ICAM-1 and VCAM-1 showed no significant changes due to the exercise training, but there were significant differences between groups about IL-6. Tukey post- hoc test indicated that there is significant difference between the differences of pre and post values of IL-6 between lower body exercise training group and control group, and eight weeks of lower body exercise training lead to significant changes in IL-6 values. There were no changes in anthropometric indices. The findings show that the different patterns of upper, lower and whole body exercise training by involving the different amounts of muscles altered the IL-6 values in lower body exercise training group probably because of engaging the bigger amount of muscles, but showed any significant changes about CRP, ICAM-1 and VCAM-1 probably due to intensity and duration of exercise or the lower levels of these markers at baseline of healthy people.

Keywords: resistance training, C-reactive protein, interleukin-6, intracellular adhesion molecule-1, vascular cell adhesion molecule-1

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Authors: H. Y. Al-Matubsi, G. A. Oriquat, M. Abu-Samak, O. A. Al Hanbali, M. Salim

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Background: Uncontrolled diabetes mellitus (DM) is an etiological factor for recurrent pregnancy loss and major congenital malformations in the offspring. Antioxidant therapy has been advocated to overcome the oxidant-antioxidant disequilibrium inherent in diabetes. The aims of this study were to evaluate the protective effect of lipoic acid (LA) on fetal outcome and to elucidate changes that may be involved in the mechanism(s) implicit diabetic fetopathy. Methods: Female rats were rendered hyperglycemic using streptozocin and then mated with normal male rat. Pregnant non-diabetic (group1; n=9; and group2; n=7) or pregnant diabetic (group 3; n=10; and group 4; n=8) rats were treated daily with either lipoic acid (LA) (30 mg/kg body weight; groups 2 and 4) or vehicle (groups 1 and 3) between gestational days 0 and 15. On day 15 of gestation, the rats were sacrificed, and the fetuses, placentas and membranes dissected out of the uterine horns. Following morphological examination, the fetuses, placentas and membranes were homogenized, and used to measure cyclooxygenases (COX) activities and metabolisms of prostaglandin (PG) E2 (PGEM) and PGF2 (PGFM) levels. Maternal liver and plasma total glutathione levels were also determined. Results: Supplementation of diabetic rats with LA was found to significantly (P<0.05) reduce resorption rates in diabetic rats and increased mean fetal weight compared to diabetic group. Treatment of diabetic rats with LA leads to a significant (P<0.05) increase in liver and plasma total glutathione, in comparison with diabetic rats. Decreased levels of PGEM and elevated levels of PGFM in the fetuses, placentas and membranes were characteristic of experimental diabetic gestation associated with malformation. LA treatment to diabetic mothers failed to normalize levels of PGEM to the non-diabetic control rats. However, the levels of PGEM in malformed fetuses from LA-treated diabetic mothers was significantly (P < 0.05) higher than those in malformed fetuses from diabetic rats. Conclusions: We conclude that LA can reduce congenital malformations in the offspring of diabetic rats at day 15 of gestation. However, LA treatment did not completely prevent the occurrence of malformations, other factors, such as arachidonic acid deficiency and altered prostaglandin metabolismmay be involved in the pathogenesis of diabetes-induced congenital malformations.

Keywords: diabetes, lipoic acid, pregnancy, prostaglandins

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Authors: Mehwish Jawaad

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Purpose: The concept of GrSCM (Green Supply Chain Management) in the academic and research field is still thought to be in the development stage especially in Asian Emerging Economies. The purpose of this paper is to contribute significantly to the first wave of empirical investigation on GrSCM Practices and Firm Performance measures in Pakistan. The aim of this research is to develop a more holistic approach towards investigating the impact of Green Supply Chain Management Practices (Ecodesign, Internal Environmental Management systems, Green Distribution, Green Purchasing and Cooperation with Customers) on multiple dimensions of Firm Performance Measures (Economic Performance, Environmental Performance and Operational Performance) with a mediating role of Investment Recovery and Competitiveness. This paper also serves as an initiative to identify if the relationship between Investment Recovery and Firm Performance Measures is mediated by Competitiveness. Design/ Methodology/Approach: This study is based on survey Data collected from 272, ISO (14001) Certified Textile Firms Based in Lahore, Faisalabad, and Karachi which are involved in Spinning, Dyeing, Printing or Bleaching. A Theoretical model was developed incorporating the constructs representing Green Activities and Firm Performance Measures of a firm. The data was analyzed using Partial Least Square Structural Equation Modeling. Senior and Mid-level managers provided the data reflecting the degree to which their organizations deal with both internal and external stakeholders to improve the environmental sustainability of their supply chain. Findings: Of the 36 proposed Hypothesis, 20 are considered valid and significant. The statistics result reveal that GrSCM practices positively impact Environmental Performance followed by Economic and Operational Performance. Investment Recovery acts as a strong mediator between Intra organizational Green activities and performance outcomes. The relationship of Reverse Logistics influencing outcomes is significantly mediated by Competitiveness. The pressure originating from customers exert significant positive influence on the firm to adopt Green Practices consequently leading to higher outcomes. Research Contribution/Originality: Underpinning the Resource dependence theory and as a first wave of investigating the impact of Green Supply chain on performance outcomes in Pakistan, this study intends to make a prominent mark in the field of research. Investment and Competitiveness together are tested as a mediator for the first time in this arena. Managerial implications: Practitioner is provided with a framework for assessing the synergistic impact of GrSCM practices on performance. Upgradation of Accreditations and Audit Programs on regular basis are the need of the hour. Making the processes leaner with the sale of excess inventories and scrap helps the firm to work more efficiently and productively.

Keywords: economic performance, environmental performance, green supply chain management practices, operational performance, sustainability, a textile sector of Pakistan

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Authors: Isalira Peroba Ramos, Cherley Borba Vieira de Andrade, Grazielle Suhett, Camila Salata, Paulo Cesar Canary, Guilherme Visconde Brasil, Antonio Carlos Campos de Carvalho, Regina Coeli dos Santos Goldenberg

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Background: The therapeutic options for patients with cancer now include increasingly complex combinations of medications, radiation therapy (RT), and surgical intervention. Many of these treatments have important potential adverse cardiac effects and are likely to have significant effects on patient outcomes. Cell therapy appears to be promising for the treatment of chronic and degenerative diseases, including cardiomyopathy induced by RT, as the current therapeutic options are insufficient. Aims: To evaluate the potential of bone marrow mesenchymal cells (BMMCs) in radioinduced cardiac damage Methods: Female Wistar rats, 3 months old (Ethics Committee 054/14), were divided into 2 groups, non-treated irradiated group (IR n=15) and irradiated and BMMC treated (IRT n=10). Echocardiography was performed to evaluate heart function. After euthanasia, 3 months post treatment; the left ventricle was removed and prepared for RT-qPCR (VEGF and Pro Collagen I) and histological (picrosirius) analysis. Results: In both groups, 45 days after irradiation, ejection fraction (EF) was in the normal range for these animals (> 70%). However, the BMMC treated group had EF (83.1%±2.6) while the non-treated IR group showed a significant reduction (76.1%±2.6) in relation to the treated group. In addition, we observed an increase in VEGF gene expression and a decrease in Pro Collagen I in IRT when compared to IR group. We also observed by histology that the collagen deposition was reduced in IRT (10.26%±0.83) when compared to IR group (25.29%±0.96). Conclusions: Treatment with BMMCs was able to prevent ejection fraction reduction and collagen deposition in irradiated animals. The increase of VEGF and the decrease of pro collagen I gene expression might explain, at least in part, the cell therapy benefits. All authors disclose no financial or personal relationships with individuals or organizations that could be perceived to bias their work. Sources of funding: FAPERJ, CAPES, CNPq, MCT.

Keywords: mesenchymal cells, radioation, cardiotoxicity, bone marrow

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Authors: Ana Bermudez de Castro Muela, Xiomara Santos Salas, Silvia Cayon Somacarrera

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The aim of this review is to explain what is the intracranial hypotension and its main causes, and also to approach to the diagnostic management in the different clinical situations, understanding radiological findings, and physiopathological substrate. An approach to the diagnostic management is presented: what are the guidelines to follow, the different tests available, and the typical findings. We review the myelo-CT and myelo-RM studies in patients with suspected CSF fistula or hypotension of unknown cause during the last 10 years in three centers. Signs of intracranial hypotension (subdural hygromas/hematomas, pachymeningeal enhancement, venous sinus engorgement, pituitary hyperemia, and lowering of the brain) that are evident in baseline CT and MRI are also sought. The intracranial hypotension is defined as a lower opening pressure of 6 cmH₂O. It is a relatively rare disorder with an annual incidence of 5 per 100.000, with a female to male ratio 2:1. The clinical features it’s an orthostatic headache, which is defined as development or aggravation of headache when patients move from a supine to an upright position and disappear or typically relieve after lay down. The etiology is a decrease in the amount of cerebrospinal fluid (CSF), usually by loss of it, either spontaneous or secondary (post-traumatic, post-surgical, systemic disease, post-lumbar puncture etc.) and rhinorrhea and/or otorrhea may exist. The pathophysiological mechanisms of hypotension and CSF hypertension are interrelated, as a situation of hypertension may lead to hypotension secondary to spontaneous CSF leakage. The diagnostic management of intracranial hypotension in our center includes, in the case of being spontaneous and without rhinorrhea and/or otorrhea and according to necessity, a range of available tests, which will be performed from less to more complex: cerebral CT, cerebral MRI and spine without contrast and CT/MRI with intrathecal contrast. If we are in a situation of intracranial hypotension with the presence of rhinorrhea/otorrhea, a sample can be obtained for the detection of b2-transferrin, which is found in the CSF physiologically, as well as sinus CT and cerebral MRI including constructive interference steady state (CISS) sequences. If necessary, cisternography studies are performed to locate the exact point of leakage. It is important to emphasize the significance of myelo-CT / MRI to establish the diagnosis and location of CSF leak, which is indispensable for therapeutic planning (whether surgical or not) in patients with more than one lesion or doubts in the baseline tests.

Keywords: cerebrospinal fluid, neuroradiology brain, magnetic resonance imaging, fistula

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Authors: Norbert W. Paul

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In 1988, parts of the scientific community still heralded findings to support that AIDS was likely to remain largely a ‘gay disease’. The value-ladden terminology of some of the articles suggested that rectum and fragile urethra are not sufficiently robust to provide a barrier against infectious fluids, especially body fluids contaminated with HIV while the female vagina, would provide natural protection against injuries and trauma facilitating HIV-infection. Anal sexual intercourse was constituted not only as dangerous but also as unnatural practice, while penile-vaginal intercourse would follow natural design and thus be relatively safe practice minimizing the risk of HIV. Statements like the latter were not uncommon in the early times of HIV/AIDS and contributed to captious certainties and an underestimation of heterosexual risks. Pseudo-scientific discourses on the origin of HIV were linked to local and global health politics in the 1980ies. The pathways of infection were related to normative concepts like deviant, subcultural behavior, cultural otherness, and guilt used to target, tag and separate specific groups at risk from the ‘normal’ population. Controlling populations at risk became the top item on the agenda rather than controlling modes of transmission and the virus. Hence, the Thai strategy to cope with HIV/AIDS by acknowledging social and sexual practices as they were – not as they were imagined – has become a role model for successful prevention in the highly scandalized realm of sexually transmitted disease. By accepting the globalized character of local HIV-risk and projecting the risk onto populations which are neither particularly vocal groups nor vested with the means to strive for health and justice Thailand managed to culturally implement knowledge-based tools of prevention. This paper argues, that pertinent cultural collisions regarding our strategies to cope with HIV/AIDS are deeply rooted in misconceptions, misreadings and scandalizations brought about in the early history of HIV in the 1980ties. The Thai strategy is used to demonstrate how local values can be balanced against globalized health risk and used to effectuated prevention by which knowledge and norms are translated into local practices. Issues of global health and injustice will be addressed in the final part of the paper dealing with the achievability of health as a human right.

Keywords: bioethics, HIV, global health, justice

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Authors: Muhammad Shafi'u Adamu

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This study examined the effects of two Group Cognitive Behavioural Therapies (Cognitive Restructuring and Rational Emotive Behavioural Therapy) on Psychological Distress of awaiting-trial Inmates in Correctional Centres in North-West, Nigeria. The study had four specific objectives, four research questions, and four null hypotheses. The study used a quasi-experimental design that involved pre-test and post-test. The population comprised of all 7,962 awaiting-trial inmates in correctional centres in North-west, Nigeria. 131 awaiting trial inmates from three intact Correctional Centres were randomly selected using the census technique. The respondents were sampled and randomly put into 3 groups (CR, REBT and Control). Kessler Psychological Distress Scale (K10) was adapted for data collection in the study. The instrument was validated by experts and subjected to pilot study using Cronbach's Alpha with reliability co-efficient of 0.772. Each group received treatment for 8 consecutive weeks (60 minutes/week). Data collected from the field were subjected to descriptive statistics of mean, standard deviation and mean difference to answer the research questions. Inferential statistics of ANOVA and independent sample t-test were used to test the null hypotheses at P≤ 0.05 level of significance. Results in the study revealed that there was no significant difference among the pre-treatment mean scores of experimental and control groups. Statistical evidence also showed a significant difference among the mean sores of the three groups, and thus, results of the Post Hoc multiple-comparison test indicating the posttreatment reduction of psychological distress on the awaiting-trial inmates. Documented output also showed a significant difference between the post-treatment psychologically distressed mean scores of male and female awaiting-trial inmates, but there was no difference on those exposed to REBT. The research recommends that a standardized structured CBT counselling technique treatment should be designed for correctional centres across Nigeria, and CBT counselling techniques could be used in the treatment of PD in both correctional and clinical settings.

Keywords: awaiting-trial inmates, cognitive restructuring, correctional centres, group cognitive behavioural therapies, rational emotive behavioural therapy

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Authors: J. George, M. Al Mutairi, W. Aljuryyad, A. Alhussanan, A. Alkashan, T. Aldoghiri, Z. Alamari, A. Albakr

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Introduction: Students make plans for their career and are keen in exploring options of employment in those carriers. They make their employment choice based on their desires and preferences. This study aims to identify if students of King Saud Bin Abdulaziz for Health Sciences, College of Applied Medical Sciences after obtaining appropriate education prefer to work as clinicians, university faculty, or full-time researchers. There are limited studies in Saudi Arabia exploring the university student’s employment choices and preferences. This study would help employers to build the required job positions and prevent misleading employers from opening undesired positions in the job market. Methodology: The study included 394 students from third and fourth years both male and female among the eighth programs of college of applied medical sciences, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh campus. A prospective quantitative cross-sectional study was conducted; data were collected by distributing a seven item questionnaire and analyzed using SPSS. Results: Among the participants, 358 (90.9%) of them chose one of the three listed career choices, 263 (66.8%) decided to work as hospital staff after their education, 75 students (19.0%) chose to work as a faculty member in a university after obtaining appropriate degree, 20 students (5.1%) preferred to work as full-time researcher after obtaining appropriate degree, the remaining 36 students (9.1%) had different career goals, such as obtaining a master degree after graduating, to obtain a bachelor of medicine and bachelor in surgery degree, and working in the private sector. The most recurrent reason behind the participants' choice was "career goal", where 276 (70.1%) chose it as a reason. Conclusion: The findings of the study showed that most student’s preferred to work in hospitals as clinicians, followed by choice of working as a faculty in a university, the least choice was to be working as full-time researchers.

Keywords: College of Applied Medical Sciences, employment ambitions, graduating students, King Saud bin Abdulaziz University for Health Sciences

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Authors: Pirakorn Sukonthaman, Paphitchaya Temphattharachok, Warangkana Thammasanya, Kraichart Tantrakarnarpa, Tanongson Tientavorn

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Agriculture is the main occupation in Thailand. Excessive amount of pesticides are used to increase the products but are toxic to human body. In 2009, Bureau of Epidemiology received 1,691 cases reported with pesticides toxicity (2.66:100,000) which 10.61 % of them is caused by Organophosphate. The purposes are to find factors associated with pesticides used and plasma cholinesterase level and other emerging issues that previous studies did not explain among agricultural workers in Baan Na Yao, Chachoengsao, Thailand. This research was an exploratory mixed method study. Qualitative interviews and quantitative questionnaires were used together in order to gather information from the agricultural workers (mainly cassava and rice farming) directly exposed to pesticides within 2 months simultaneously. Qualitative participants were selected by purposive sampling and a total survey for quantitative ones. The quantitative data was statistically analyzed by using multiple logistic regression model. Qualitative data was transcribed verbatim and thematically analyzed. For qualitative study, 15 participants were interviewed and 300/323 participants (92.88%) were given questionnaires, of which were 175 male and 125 female and 113 among them were spraymen. The prevalence of abnormal plasma cholinesterase level was 92.28% (Safe 7.72% Risky 49.33% and Unsafe 42.95%). Participants with inappropriate behaviors during spraying had a significant association with plasma cholinesterase level (95%CI=1.399-14.858) but other factors such as age, gender, education, attitude and knowledge had no association. They also had encountered various symptoms from pesticides such as fatigue (61%), vertigo (59.67%) and headache (58.86%), etc. Although they had high knowledge and attitude they still had poor behaviors. Moreover, our qualitative component showed that though they had worn the personal protective equipment (PPE) regularly, their PPE was not standard. Not only substandard PPE, but also there were obstacles of wearing such as the hot climate and inconvenience. They misunderstood their symptoms from using pesticides as allergy. Therefore, they did not seek for proper medical check-ups and treatment. This research revealed almost all of the participants have abnormal levels of plasma cholinesterase related especially those with poor behaviors. They also wore PPE but inadequately and misunderstood the symptoms produced by organophosphate use as allergy. Therefore, they did not seek for medical treatment. Occupation health education, modification of PPE and periodic medical checking are ways to make agricultural workers concern and know if there is any progression in a long term.

Keywords: pesticides, plasma cholinesterase level, spraymen, agricultural workers

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Authors: Qirat Naz, Abasiokpon Udoakah

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In developed countries, global migration is diversifying. The minority ethnic population, including refugees and asylum seekers who, fled their home countries due to war, terrorism, oppression, or natural disasters, and returning home is dangerous for them. They need sanctuary and peaceful environment in host countries. They begin the process of acculturation, in which a person adopts the social mores and behavioral patterns of the dominant culture, yet they still have unique multicultural needs that the dominant society fails to address. The aim of this research is to provide a holistic understanding of the living experiences of a minority population, particularly migrants, including asylum seekers and refugees, in the health and social care system of South Wales. The purpose of this study is to investigate three research objectives: the multicultural health care needs of minorities, as well as the barriers to seeking health and social care facilities. There are Welsh policies for promoting cultural competence in the health and social care sectors; this research will explore the implications and impact of these policies on the target population. This research study will be conducted using qualitative research methods, tools, and techniques. This research is an inductive approach to coming up with a grounded theory. The sample will be divided into two groups: migrants and professionals providing any kind of services to migrants; each group will contain 30 participants. Interpretive phenomenological analysis would be utilized during the process of coding and developing the main themes of this research. The positionality of the researcher would be minimized by unloaded and open-ended questions, researcher’s work experience in research, continuous evaluation of her positionality, daily base reflection of fieldwork and seeking the help of male and female gatekeepers. The research findings would be based on emic perspective, and by documenting the emic perspective of minorities, this research will contribute to the knowledge of appropriate channels, including organizations, academics, and policymakers, to discover possible solutions and coping mechanisms to deal with the challenges and meet the multicultural demands of minorities. This research will provide a more in-depth understanding of minorities and will help to promote the diversity of health and social care in South Wales.

Keywords: migration, migrants, cultural competence, cultural barriers, healthcare challenges

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Authors: Ella Sever, Irena Glažar, Ema Saltović

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Conventional cigarette smoking is associated with an increased risk of oral diseases and oral symptoms such as dry mouth, bad breath, burning sensation, and changes in taste sensation. The harmful effects of conventional cigarette smoking on oral health have been extensively studied previously. However, there is a severe lack of studies investigating the effects of Tobacco Heating System (THS) on oral structures. As a preventive measure, a new alternative Tobacco THS has been developed, and according to the manufacturer, it has fewer potentially harmful and harmful constituents and consequently, lowers the risk of developing tobacco-related diseases. The aim is to analyze the effects of conventional cigarettes and THS on salivary flow rate (SFR), and self-reported oral symptoms.The stratified cross-sectional study included 90 subjects divided into three groups: THS smokers, conventional cigarette smokers, and nonsmokers. The subjects completed questionnaires on smoking habits, and symptoms (dry mouth, bad breath, burning sensation, and changes in taste sensation). SFR test were performed on each subject. The lifetime exposure to smoking was calculated using the Brinkman index (BI). Participants were 20-55 years old (median 31), and 66.67 % were female. The study included three groups of equal size (n = 20), and no statistically significant differences were found between the groups in terms of age (p = 0.632), sex (p = 1.0), and lifetime exposure to smoking (the BI) (p=0,129). Participants from the smoking group had an average of 10 (2-30) years of smoking experience in the conventional cigarettes group and 6 (1-20) years of smoking experience in the THS group. Daily consumption of cigarettes/heets per day was the same for both smokers’ groups (12(2-20) cigarettes/heets per day). The self-reported symptoms were present in 40 % of participants in the smokers group. There were significant differences in the presence of halitosis (p = 0.025) and taste sensation (p=0.013). There were no statistical differences in the presence of dry mouth (p =0.416) and burning sensation (0.7). The SFR differed between groups (p < 0.001) and was significantly lower in the THS and conventional cigarette smokers’ groups than the nonsmokers’ group. There were no significant differences between THS smokers and conventional cigarette smokers. The results of the study show that THS products have a similar effect to conventional cigarettes on oral cavity structures, especially in terms of SFR, self-reported halitosis, and changes in taste.

Keywords: oral health, tobacco products, halitosis, cigarette smoking

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Authors: Antonio Casero Martínez, María de Lluch Rayo Llinas

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This work is part of an investigation into the relationship between romantic love and self-esteem in college students, performed by the students of matter "methods and techniques of social research", of the Master Gender at the University of Balearic Islands, during 2014-2015. In particular, we have investigated the relationships that may exist between self-esteem, gender and field of study. They are known as gender differences in self-esteem, and the relationship between gender and branch of study observed annually by the distribution of enrolment in universities. Therefore, in this part of the study, we focused the spotlight on the differences in self-esteem between the sexes through the various branches of study. The study sample consists of 726 individuals (304 men and 422 women) from 30 undergraduate degrees that the University of the Balearic Islands offers on its campus in 2014-2015, academic year. The average age of men was 21.9 years and 21.7 years for women. The sampling procedure used was random sampling stratified by degree, simple affixation, giving a sampling error of 3.6% for the whole sample, with a confidence level of 95% under the most unfavorable situation (p = q). The Spanish translation of the Rosenberg Self-Esteen Scale (RSE), by Atienza, Moreno and Balaguer was applied. The psychometric properties of translation reach a test-retest reliability of 0.80 and an internal consistency between 0.76 and 0.87. In this paper we have obtained an internal consistency of 0.82. The results confirm the expected differences in self-esteem by gender, although not in all branches of study. Mean levels of self-esteem in women are lower in all branches of study, reaching statistical significance in the field of Science, Social Sciences and Law, and Engineering and Architecture. However, analysed the variability of self-esteem by the branch of study within each gender, the results show independence in the case of men, whereas in the case of women find statistically significant differences, arising from lower self-esteem of Arts and Humanities students vs. the Social and legal Sciences students. These findings confirm the results of numerous investigations in which the levels of female self-esteem appears always below the male, suggesting that perhaps we should consider separately the two populations rather than continually emphasize the difference. The branch of study, for its part has not appeared as an explanatory factor of relevance, beyond detected the largest absolute difference between gender in the technical branch, one in which women are historically a minority, ergo, are no disciplinary or academic characteristics which would explain the differences, but the differentiated social context that occurs within it.

Keywords: study branch, gender, self-esteem, applied psychology

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Authors: Aaron Kim, Nydia Hernandez

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Despite the known deficits in sleep duration among adolescents and the increasing prevalence of substance use behaviors among this group, relatively little is known about how insufficient sleep is related to various substance use behaviors and the underlying mechanisms. Informed by the literature suggesting the predictive role of insufficient sleep for substance use and depressive symptoms, we hypothesized that adolescents who lack sufficient sleep during school nights would report a higher level of depressive symptoms and substance use than their counterparts with sufficient sleep. We also hypothesized that depressive symptoms would explain the association of insufficient sleep with substance use, suggesting that mental health plays an important role as a mechanism between insufficient sleep and substance use. This study used the data drawn from the 2019 Youth Risk Behavior Surveillance System Data, which includes a nationally representative sample of U.S. high school students (N=13,677, 49.4% Female, 9th-12th graders). Self-report measures of insufficient sleep (sleeping<7 h on an average school night), depressive symptoms (yes/no), any past 30-day use of cigarette (yes/no), e-cigarette (yes/no), alcohol (yes/no), and marijuana (yes/no). Among the total sample, 47.9% of students reported that they did not have sufficient sleep on school nights, indicating sleeping less than 7 hours. Regarding depressive symptoms, 36.7% of students reported feeling sad or hopeless almost every day for two weeks or more in a row during the past 12 months. Also, the percentages of students who reported one or more times of cigarette use, e-cigarette use, alcohol use, and marijuana use in the past month were 5.32%, 30.11%, 26.83%, and 21.65%, respectively. For bivariate associations among these study variables, insufficient sleep was positively associated with other variables: depressive symptoms (r=.08, p<.001), cigarette use (r=.03, p<.001), e-cigarette use (r=.04, p<.001), alcohol use (r=.07, p<.001), and marijuana use (r=.08, p<.001). After controlling for students’ characteristics (i.e., age, gender, race/ethnicity, grades), sleeping less than 7 hours on school nights (vs. sleeping more than 7 hours) was significantly associated with the past 30-day use of alcohol and marijuana, whereas cigarette and e-cigarette uses were not. That is, the students who reported having an insufficient sleep on school nights had higher odds of alcohol (Odds Ratio [OR]=1.15, 95% Confidence Interval [CI]=1.014-1.301) and marijuana use (OR=1.36, 95% CI=1.132-1.543). In a subsequent analysis including depressive symptoms together with insufficient sleep, the association of insufficient sleep with alcohol use (OR=1.13, 95% CI=1.011-1.297) and marijuana use (OR=1.33, 95% CI=1.130-1.521) were attenuated and explained by depressive symptoms. Depressive symptoms significantly increased the odds of alcohol use by 32.2% (OR=1.32, 95% CI=1.131-1.557) and marijuana use by 202.1% (OR=2.02, 95% CI=1.672-2.502). These findings together suggest that insufficient sleep may contribute to increased risks of substance uses among adolescents. The current study also shows that psychological disorders of adolescents play important roles in understanding the association between insufficient sleep and substance use, suggesting insufficient sleep is related to substance use indirectly through depressive symptoms. This study indicates the importance of sleep deprivation among adolescents and screening for insufficient sleep in preventing/intervening in substance use.

Keywords: adolescents, depressive symptoms, sleep, substance use

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Authors: Juan C. Martínez-Alfaro, Aracely Zúñiga, Fernando Ruíz-Zarate

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In recent years, the Katahdin sheep breeds have been one of the breeds with greater acceptance by sheep farmers in southwestern Mexico. The Hair Sheep breeds from tropical latitudes (16° to 21° North Latitude) show low estrus activity from January to May. By contrast, these breeds of sheep exhibit high estrus activity from August to December. However, the reproductive management of Hair Sheep crossbred is very limited, independently of the socioeconomic levels of sheep farmers. Thus, in crossbred of Hair Sheep, occurrence of lambing is greater in autumn (84%) than spring (16%). In this sense, the aim of this study was to determine the lambing in Crossbred of Katahdin sheep during different seasons of the year. The Hypothesis was that in crossbred of Katahdin sheep, the lambing period has a behavior seasonal in the Southwestern Mexico. The study design consisted in evaluating the lambing proportion in one herds of Katahdin ewes crossbred during one year (October 1st, 2015 to October 1st, 2016). The study was realized in a farm located in the municipality of Jiquipilas, in the State of Chiapas, Mexico (16° North Latitude). A total of 40 female sheep homogeneous in terms of physical condition, age and physiological state were selected; and they were fed in grazing continuous, mainly with Africa star grass (Cynodon lemfuensis) and they are provided with water and mineral salts ad libitum; during the dry season, the ewes were supplemented with a diet of maize and sorghum, and the reproductive management was continuous mating. The lambing proportion was analyzed by chi-squared test, using SAS statistical software. The proportion of Katahdin ewes crossbred that lambed during the study period was high (100%; 40/40), the prolificacy was 1.42 (lamb/lambing). The proportion of lambing was higher (P<0.05) in autumn (67.5%; 27/40), than winter, spring and summer (32.5%; 13/40; 0%; 0/40; 0%; 0/40; respectively). The proportion of lambing was greater (P<0.05) in November (50%; 20/40), compared to October, December and January (2.5%; 1/40; 27.5%; 11/40; 20%; 8/40, respectively). The results are consistent with the fact that in the Hair Sheep Breeds, the lambing appears behave seasonally. The most important finding is that the lambing period in the crossbred of Katahdin Sheep is similar to the crossbred of Hair Sheep in tropical regions of Mexico. Therefore, the period of greater sexual activity occurs in the spring season. In conclusion, the period of lambing in crossbred of Katahdin ewes appears behave seasonally. Further researches to assess the ovarian activity in different breeds of Hair Ewes are under assessment.

Keywords: Katahdin ewes, lambing, prolificacy, seasonality

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Authors: Josiah O. Carter, Charlotte Hayden, Elizabeth Arthurs

Abstract:

Background: During the COVID-19 pandemic, hospital management policies have changed frequently and rapidly. This has created novel challenges in keeping the workforce abreast of these changes to enable them to deliver safe and effective care. Traditional communication methods, e.g. email, do not keep pace with the rapidly changing environment in the hospital, resulting in inaccurate, irrelevant, or outdated information being communicated, resulting in inefficiencies in patient care. Methods: The creation of a WhatsApp messaging group within the medical division at the Bristol Royal Infirmary has enabled senior clinicians and the hospital management team to update the medical workforce in real-time. It has two primary functions: (1) To enable dissemination of a concise, important operational summary. This comprises information on bed status and infection control procedural changes. It is fed directly from a daily critical incident briefing (2) To facilitate a monthly scheduled question and answer (Q&A) session for junior doctors to clarify issues with clinical directors, rota, and management staff. Additional ad-hoc updates are sent out for time-critical information; otherwise, it mainly functions as a broadcast-only group to prevent important information from being lost amongst other communication. All junior doctors within the medical division were invited to join the group. At present, the group comprises 131 participants, of which 10 are administrative staff (rota coordinators, management staff & clinical directors); the remaining 121 are junior clinicians working within the medical division. An electronic survey via Microsoft forms was sent out to junior doctors via the WhatsApp group and via email to assess its utilisation and effectiveness with the aim of quality improvements. Results: Of the 121 group participants, 19 completed the questionnaire (response rate 15.7%). Of these, 16/19 (84.2%) used it regularly, and 12/19 (63.2%) rated it as the most useful source for reliable updates relating to the hospital response to the COVID-19 pandemic, whereas only 2/19 (10.5%) found the trust intranet and the trust COVID-19 operational email update most useful. Respondents rated the WhatsApp group more useful as an information source (mean score 7.7/10) than as a means of providing feedback to management staff (mean score 6.3/10). Qualitative feedback suggested information around ward closures and changes to COVID cohorting, along with updates on staffing issues, were most useful. Respondents also noted the Q&A sessions were an efficient way of relaying feedback about management decisions but that it would be preferable if these sessions could be delivered more frequently. Discussion: During the current global COVID-19 pandemic, there is an increased need for rapid dissemination of critical information within NHS trusts; this includes communication between junior doctors, managers, and senior clinicians. The versatility of WhatsApp permits a variety of functions allowing for regular updates, the dissemination of time-critical information, and enables conversing and feedback. The project has demonstrated that reserved and well-managed use of a WhatsApp group is a welcome, efficient and practical means of communication between the senior management team and the junior medical workforce.

Keywords: communication, COVID-19, hospital management, WhatsApp

Procedia PDF Downloads 113

Authors: Akemi Nasu, Keiko Matsumoto

Abstract:

Rehabilitation for cancer requires setting up individual goals for each patient and an approach that properly fits the stage of cancer when putting into practice. In order to cope with the daily changes in the patients' condition, the establishment of a good cooperative relationship between the nurses and the physiotherapists, occupational therapists, and speech-language-hearing therapists (therapists) becomes essential. This study will focus on the present situation of the cooperation between nurses and therapists, especially the speech-language-hearing therapists, and aim to elucidate what develops there. A semi-structured interview was conducted targeted at a physical therapist having practical experience in working in collaboration with nurses. The contents of the interview were transcribed and converted to data, and the data was encoded and categorized with sequentially increasing degrees of abstraction to conduct a qualitative explorative factor analysis of the data. When providing ethical explanations, particular care was taken to ensure that participants would not be subjected to any disadvantages as a result of participating in the study. In addition, they were also informed that their privacy would be ensured and that they have the right to decline to participate in the study. In addition, they were also informed that the results of the study would be announced publicly at an applicable nursing academic conference. This study has been approved following application to the ethical committee of the university with which the researchers are affiliated. The survey participant is a female speech-language-hearing therapist in her forties. As a result of the analysis, 6 categories were extracted consisting of 'measures to address appetite and aspiration pneumonia prevention', 'limitation of the care a therapist alone could provide', 'the all-inclusive patient- supportive care provided by nurses', 'expand the beneficial cooperation with nurses', 'providing education for nurses on the swallowing function utilizing videofluoroscopic examination of swallowing', 'enhancement of communication including conferences'. In order to improve the team performance, and for the teamwork competency necessary for the provision of safer care, mutual support is essential. As for the cooperation between nurses and therapists, this survey indicates that the maturing of the cooperation between professionals in order to improve nursing professionals' knowledge and enhance communication will lead to an improvement in the quality of the rehabilitation for cancer.

Keywords: cancer rehabilitation, nurses, speech-language-hearing therapists, interprofessional work

Procedia PDF Downloads 133