Search results for: healthcare ethical implications 
Commenced in January 2007
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Edition: International
Paper Count: 4865

Search results for: healthcare ethical implications 

1355 Comparison of Regional and Local Indwelling Catheter Techniques to Prolong Analgesia in Total Knee Arthroplasty Procedures: Continuous Peripheral Nerve Block and Continuous Periarticular Infiltration

Authors: Jared Cheves, Amanda DeChent, Joyce Pan

Abstract:

Total knee replacements (TKAs) are one of the most common but painful surgical procedures performed in the United States. Currently, the gold standard for postoperative pain management is the utilization of opioids. However, in the wake of the opioid epidemic, the healthcare system is attempting to reduce opioid consumption by trialing innovative opioid sparing analgesic techniques such as continuous peripheral nerve blocks (CPNB) and continuous periarticular infiltration (CPAI). The alleviation of pain, particularly during the first 72 hours postoperatively, is of utmost importance due to its association with delayed recovery, impaired rehabilitation, immunosuppression, the development of chronic pain, the development of rebound pain, and decreased patient satisfaction. While both CPNB and CPAI are being used today, there is limited evidence comparing the two to the current standard of care or to each other. An extensive literature review was performed to explore the safety profiles and effectiveness of CPNB and CPAI in reducing reported pain scores and decreasing opioid consumption. The literature revealed the usage of CPNB contributed to lower pain scores and decreased opioid use when compared to opioid-only control groups. Additionally, CPAI did not improve pain scores or decrease opioid consumption when combined with a multimodal analgesic (MMA) regimen. When comparing CPNB and CPAI to each other, neither unanimously lowered pain scores to a greater degree, but the literature indicates that CPNB decreased opioid consumption more than CPAI. More research is needed to further cement the efficacy of CPNB and CPAI as standard components of MMA in TKA procedures. In addition, future research can also focus on novel catheter-free applications to reduce the complications of continuous catheter analgesics.

Keywords: total knee arthroplasty, continuous peripheral nerve blocks, continuous periarticular infiltration, opioid, multimodal analgesia

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1354 Associated Factors the Safety of the Patient in Hemodialysis Clinics of a Brazilian Municipality: Cross-Sectional Study

Authors: Magda Milleyde de Sousa Lima, Letícia Lima Aguiar, Marina Guerra Martins, Erika Veríssimo Dias Sousa, Lizandra Sampaio de Oliveira, Lívia Moreira Barros, Joselany Áfio Caetano

Abstract:

Patients with chronic kidney disease are vulnerable to episodes which make the safety of their health vulnerable, mainly due to the treatment process that exposes them to high rates of interventions during hemodialysis sessions. Some factors associated with health care contribute to the risk of death and complications. However, there are a small number of scientific studies evaluating the level of safety of hemodialysis clinics, and the sociodemographic characteristics of patients and professionals associated with this safety. Therefore, the present study aims to examine the level of patient safety in hemodialysis clinics in the Brazilian capital, to identify the sociodemographic and clinical factors of patients and nursing staff associated with the level of safety. This is an observational, descriptive and quantitative research conducted in three hemodialysis clinics placed in the city of Fortaleza-CE, Brazil, from September to November 2019. The sample was formed after a sample calculation for finite inhabitants of correlation with 200 chronic renal patients, 30 nursing technicians and seven nurses. Conventional sampling was used based on the inclusion criteria: being present at the hemodialysis session on the day the researcher performed the data collection and being 18 years of age or older. Participants who presented communication difficulties to listen to and/or answer the sociodemographic and clinical questionnaire were excluded. Two instruments were applied: sociodemographic and clinical characterization form and Chronic Renal Patient Safety Assessment Scale on Hemodialysis (EASPRCH). The data were analyzed using the Kruskal Walls Test for categorical variables and Spearman correlation coefficient for non-categorical variables, using the Statistical Package SPSS version 20.0. The present study respected the ethical and legal principles determined by resolution 466/2012 of the National Health Council, under the approval of the Ethics and Research Committee with an opinion number: 3,255,635. The results showed that a hemodialysis clinic presented unsafe care practices of 32 points in the EASPRCH (p=0.001). A statistical association was identified between the level of safety and the variables of the patients: level of education (p=0.018), family income (p=0.049), type of employment (p=0.012), venous access site (p=0.009), use of medication during the session (p=0.008) and time of hemodialysis (p=0.002). When evaluating the profile of nurses, a statistical association was evidenced between the level of safety with the variables: marital status (p=0.000), race (p=0.017), schooling (p= 0.000), income (p=0.013), age (p=0.000), clinic workload (p=0.000), time working with hemodialysis (p=0.000), time working in the clinic (p= 0.007) and clinic sizing (p=0.000). In order, the sociodemographic factors of nursing technicians associated with the level of patient safety were: race (p= 0.001) and weekly workload at (p=0.010). Therefore, it is concluded that there is a non-conformity in the level of patient safety in one of the clinics studied and, that sociodemographic and clinical factors of patients and health professionals corroborate the level of safety of the health unit.

Keywords: hemodialysis, nursing, patient safety, quality improvement

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1353 Canada's "Flattened Curve": A Geospatial Temporal Analysis of Canada's Amelioration of the Sars-COV-2 Pandemic Through Coordinated Government Intervention

Authors: John Ahluwalia

Abstract:

As an affluent first-world nation, Canada took swift and comprehensive action during the outbreak of the SARS-CoV-2 (COVID-19) pandemic compared to other countries in the same socio-economic cohort. The United States has stumbled to overcome obstacles most developed nations have faced, which has led to significantly more per capita cases and deaths. The initial outbreaks of COVID-19 occurred in the US and Canada within days of each other and posed similar potentially catastrophic threats to public health, the economy, and governmental stability. On a macro level, events that take place in the US have a direct impact on Canada. For example, both countries tend to enter and exit economic recessions at approximately the same time, they are each other’s largest trading partners, and their currencies are inexorably linked. Why is it that Canada has not shared the same fate as the US (and many other nations) that have realized much worse outcomes relative to the COVID-19 pandemic? Variables intrinsic to Canada’s national infrastructure have been instrumental in the country’s efforts to flatten the curve of COVID-19 cases and deaths. Canada’s coordinated multi-level governmental effort has allowed it to create and enforce policies related to COVID-19 at both the national and provincial levels. Canada’s policy of universal healthcare is another variable. Health care and public health measures are enforced on a provincial level, and it is within each province’s jurisdiction to dictate standards for public safety based on scientific evidence. Rather than introducing confusion and the possibility of competition for resources such as PPE and vaccines, Canada’s multi-level chain of government authority has provided consistent policies supporting national public health and local delivery of medical care. This paper will demonstrate that the coordinated efforts on provincial and federal levels have been the linchpin in Canada’s relative success in containing the deadly spread of the COVID-19 virus.

Keywords: COVID-19, Canada, GIS, temporal analysis, ESRI

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1352 Legal Allocation of Risks: A Computational Analysis of Force Majeure Clauses

Authors: Farshad Ghodoosi

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This article analyzes the effect of supervening events in contracts. Contracts serve an important function: allocation of risks. In spite of its importance, the case law and the doctrine are messy and inconsistent. This article provides a fresh look at excuse doctrines (i.e., force majeure, impracticability, impossibility, and frustration) with a focus on force majeure clauses. The article makes the following contributions: First, it furnishes a new conceptual and theoretical framework of excuse doctrines. By distilling the decisions, it shows that excuse doctrines rests on the triangle of control, foreseeability, and contract language. Second, it analyzes force majeure clauses used by S&P 500 companies to understand the stickiness and similarity of such clauses and the events they cover. Third, using computational and statistical tools, it analyzes US cases since 1810 in order to assess the weight given to the triangle of control, foreseeability, and contract language. It shows that the control factor plays an important role in force majeure analysis, while the contractual interpretation is the least important factor. The Article concludes that it is the standard for control -whether the supervening event is beyond the control of the party- that determines the outcome of cases in the force majeure context and not necessarily the contractual language. This article has important implications on COVID-19-related contractual cases. Unlike the prevailing narrative that it is the language of the force majeure clause that’s determinative, this article shows that the primarily focus of the inquiry will be on whether the effects of COVID-19 have been beyond the control of the promisee. Normatively, the Article suggests that the trifactor of control, foreseeability, and contractual language are not effective for allocation of legal risks in times of crises. It puts forward a novel approach to force majeure clauses whereby that the courts should instead focus on the degree to which parties have relied on (expected) performance, in particular during the time of crisis.

Keywords: contractual risks, force majeure clauses, foreseeability, control, contractual language, computational analysis

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1351 Breeding Cotton for Annual Growth Habit: Remobilizing End-of-season Perennial Reserves for Increased Yield

Authors: Salman Naveed, Nitant Gandhi, Grant Billings, Zachary Jones, B. Todd Campbell, Michael Jones, Sachin Rustgi

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Cotton (Gossypium spp.) is the primary source of natural fiber in the U.S. and a major crop in the Southeastern U.S. Despite constant efforts to increase the cotton fiber yield, the yield gain has stagnated. Therefore, we undertook a novel approach to improve the cotton fiber yield by altering its growth habit from perennial to annual. In this effort, we identified genotypes with high-expression alleles of five floral induction and meristem identity genes (FT, SOC1, FUL, LFY, and AP1) from an upland cotton mini-core collection and crossed them in various combinations to develop cotton lines with annual growth habit, optimal flowering time and enhanced productivity. To facilitate the characterization of genotypes with the desired combinations of stacked alleles, we identified markers associated with the gene expression traits via genome-wide association analysis using a 63K SNP Array (Hulse-Kemp et al. 2015 G3 5:1187). Over 14,500 SNPs showed polymorphism and were used for association analysis. A total of 396 markers showed association with expression traits. Out of these 396 markers, 159 mapped to genes, 50 to untranslated regions, and 187 to random genomic regions. Biased genomic distribution of associated markers was observed where more trait-associated markers mapped to the cotton D sub-genome. Many quantitative trait loci coincided at specific genomic regions. This observation has implications as these traits could be bred together. The analysis also allowed the identification of candidate regulators of the expression patterns of these floral induction and meristem identity genes whose functions will be validated via virus-induced gene silencing.

Keywords: cotton, GWAS, QTL, expression traits

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1350 Utility of CK7, CK20 and CDX-2 as a Potential Panel in Differentiating Primary Ovarian Surface Epithelial Tumors from Metastatic Adenocarcinoma to the Ovary

Authors: Ghada Esheba, Ghadeer Aldoobi, Salwa Almalk, Abrar Alshareef, Eman Al-khairi, Eman Yaseen

Abstract:

Background: In Saudi Arabia, ovarian cancer ranked seventh among female population and is the most common female genital tract malignancy after endometrial cancer. A slight increase in the incidence of ovarian cancer was observed from 2001–2008. Makkah, Riyadh, and the eastern region of Saudi Arabia had the highest incidence rate ratio for the number of ovarian cancer cases (1). Differentiating metastatic adenocarcinomas from primary ovarian carcinomas, especially those of endometrioid and mucinous type is clinically significant and a challenge for clinicians and pathologists, yet the distinction has important therapeutic and prognostic implications. Aim: To clarify the most important histopathological criteria to differentiate between primary ovarian surface epithelial tumors especially mucinous and endometrioid subtypes, and metastatic adenocarcinoma and to evaluate the value of a panel of antibodies consisting of CK7, CK20, and CDX-2 in the distinction between primary ovarian surface epithelial tumors and metastatic adenocarcinoma. Material and methods: This study was carried out on 26 cases of primary ovarian surface epithelial neoplasms and 14 cases of metastatic ovarian adenocarcinoma. All cases were studied immunohistochemically using CK7, CK20, and CDX-2. Results: All cases of primary ovarian adenocarcinoma were positive for CK7. 25% and 58% of mucinous borderline mucinous tumor and mucinous carcinoma respectively were positive for CK20. Only 42% of mucinous carcinoma were positive for CDX-2. All cases of endometrioid carcinomas were negative for both CK20 and CDX-2. All cases of metastatic adenocarcinoma from the colon were negative for CK7 and positive for CK20 and CDX-2. Conclusions: CK7 is an important positive marker for primary ovarian tumors, while CK20 and CDX-2 are useful markers for colorectal carcinoma metastatic to the ovary. Caution should be taken as primary ovarian mucinous tumors may stain positive for CK20, CDX-2, or both, however, they usually exhibit a focal pattern of reactivity.

Keywords: adenoma, endometrioid, malignancy, ovarian

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1349 Mobile-Assisted Language Learning (MALL) Applications for Interactive and Engaging Classrooms: APPsolutely!

Authors: Ajda Osifo, Amanda Radwan

Abstract:

Mobile-assisted language learning (MALL) or m-learning which is defined as learning with mobile devices that can be utilized in any place that is equipped with unbroken transmission signals, has created new opportunities and challenges for educational use. It introduced a new learning model combining new types of mobile devices, wireless communication services and technologies with teaching and learning. Recent advancements in the mobile world such as the Apple IOS devices (IPhone, IPod Touch and IPad), Android devices and other smartphone devices and environments (such as Windows Phone 7 and Blackberry), allowed learning to be more flexible inside and outside the classroom, making the learning experience unique, adaptable and tailored to each user. Creativity, learner autonomy, collaboration and digital practices of language learners are encouraged as well as innovative pedagogical applications, like the flipped classroom, for such practices in classroom contexts are enhanced. These developments are gradually embedded in daily life and they also seem to be heralding the sustainable move to paperless classrooms. Since mobile technologies are increasingly viewed as a main platform for delivery, we as educators need to design our activities, materials and learning environments in such a way to ensure that learners are engaged and feel comfortable. For the purposes of our session, several core MALL applications that work on the Apple IPad/IPhone will be explored; the rationale and steps needed to successfully implement these applications will be discussed and student examples will be showcased. The focus of the session will be on the following points: 1-Our current pedagogical approach, 2-The rationale and several core MALL apps, 3-Possible Challenges for Teachers and Learners, 4-Future implications. This session is aimed at instructors who are interested in integrating MALL apps into their own classroom planning.

Keywords: MALL, educational technology, iPads, apps

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1348 Sleep Health Management in Residential Aged Care Facilities

Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini

Abstract:

Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.

Keywords: registered nurses, residential aged care facilities, sedative use, sleep

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1347 Coumestrol Induced Apoptosis in Breast Cancer MCF-7 Cells via Redox Cycling of Copper and ROS Generation: Implications of Copper Chelation Strategy in Cancer Treatment

Authors: Atif Zafar Khan, Swarnendra Singh, Imrana Naseem

Abstract:

Breast cancer is one of the most frequent malignancies in women worldwide and a leading cause of cancer-related deaths among women. Therefore, there is a need to identify new chemotherapeutic strategies for cancer treatment. Unlike normal cells, cancer cells contain elevated copper levels which play an integral role in angiogenesis. Copper is an important metal ion associated with the chromatin DNA, particularly with guanine. Thus, targeting copper via copper-specific chelators in cancer cells can serve as effective anticancer strategy. Keeping in view these facts, we evaluated the anticancer activity and copper-dependent cytotoxic effect of coumestrol (phytoestrogen in soybean products) in breast cancer MCF-7 cells. Coumestrol inhibited proliferation and induced apoptosis in MCF-7 cells, which was prevented by copper chelator neocuproine and ROS scavengers. Coumestrol treatment induced ROS generation coupled to DNA fragmentation, up-regulation of p53/p21, cell cycle arrest at G1/S phase, mitochondrial membrane depolarization and caspases 9/3 activation. All these effects were suppressed by ROS scavengers and neocuproine. These results suggest that coumestrol targets elevated copper for redox cycling to generate ROS leading to DNA fragmentation. DNA damage leads to p53 up-regulation which directs the cell cycle arrest at G1/S phase and promotes caspase-dependent apoptosis of MCF-7 cells. In conclusion, coumestrol induces pro-oxidant cell death by chelating cellular copper to produce copper-coumestrol complexes that engages in redox cycling in breast cancer cells. Thus, targeting elevated copper levels might be a potential therapeutic strategy for selective cytotoxic action against malignant cells.

Keywords: apoptosis, breast cancer, copper chelation, coumestrol, reactive oxygens species, redox cycling

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1346 A Comparative Analysis of Clustering Approaches for Understanding Patterns in Health Insurance Uptake: Evidence from Sociodemographic Kenyan Data

Authors: Nelson Kimeli Kemboi Yego, Juma Kasozi, Joseph Nkruzinza, Francis Kipkogei

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The study investigated the low uptake of health insurance in Kenya despite efforts to achieve universal health coverage through various health insurance schemes. Unsupervised machine learning techniques were employed to identify patterns in health insurance uptake based on sociodemographic factors among Kenyan households. The aim was to identify key demographic groups that are underinsured and to provide insights for the development of effective policies and outreach programs. Using the 2021 FinAccess Survey, the study clustered Kenyan households based on their health insurance uptake and sociodemographic features to reveal patterns in health insurance uptake across the country. The effectiveness of k-prototypes clustering, hierarchical clustering, and agglomerative hierarchical clustering in clustering based on sociodemographic factors was compared. The k-prototypes approach was found to be the most effective at uncovering distinct and well-separated clusters in the Kenyan sociodemographic data related to health insurance uptake based on silhouette, Calinski-Harabasz, Davies-Bouldin, and Rand indices. Hence, it was utilized in uncovering the patterns in uptake. The results of the analysis indicate that inclusivity in health insurance is greatly related to affordability. The findings suggest that targeted policy interventions and outreach programs are necessary to increase health insurance uptake in Kenya, with the ultimate goal of achieving universal health coverage. The study provides important insights for policymakers and stakeholders in the health insurance sector to address the low uptake of health insurance and to ensure that healthcare services are accessible and affordable to all Kenyans, regardless of their socio-demographic status. The study highlights the potential of unsupervised machine learning techniques to provide insights into complex health policy issues and improve decision-making in the health sector.

Keywords: health insurance, unsupervised learning, clustering algorithms, machine learning

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1345 Sentiment Mapping through Social Media and Its Implications

Authors: G. C. Joshi, M. Paul, B. K. Kalita, V. Ranga, J. S. Rawat, P. S. Rawat

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Being a habitat of the global village, every place has established connection through the strength and power of social media piercing through the political boundaries. Social media is a digital platform, where people across the world can interact as it has advantages of being universal, anonymous, easily accessible, indirect interaction, gathering and sharing information. The power of social media lies in the intensity of sharing extreme opinions or feelings, in contrast to the personal interactions which can be easily mapped in the form of Sentiment Mapping. The easy access to social networking sites such as Facebook, Twitter and blogs made unprecedented opportunities for citizens to voice their opinions loaded with dynamics of emotions. These further influence human thoughts where social media plays a very active role. A recent incident of public importance was selected as a case study to map the sentiments of people through Twitter. Understanding those dynamics through the eye of an ordinary people can be challenging. With the help of R-programming language and by the aid of GIS techniques sentiment maps has been produced. The emotions flowing worldwide in the form of tweets were extracted and analyzed. The number of tweets had diminished by 91 % from 25/08/2017 to 31/08/2017. A boom of sentiments emerged near the origin of the case, i.e., Delhi, Haryana and Punjab and the capital showed maximum influence resulting in spillover effect near Delhi. The trend of sentiments was prevailing more as neutral (45.37%), negative (28.6%) and positive (21.6%) after calculating the sentiment scores of the tweets. The result can be used to know the spatial distribution of digital penetration in India, where highest concentration lies in Mumbai and lowest in North East India and Jammu and Kashmir.

Keywords: sentiment mapping, digital literacy, GIS, R statistical language, spatio-temporal

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1344 Vanadium (V) Complexes of a Tripodal Ligand, Their Characterization and Biological Implications

Authors: Mannar R. Maurya, Bhawna Uprety, Fernando Avecilla, Pedro Adão, J. Costa Pessoa

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The reaction of the tripodal tetradentate dibasic ligand 6,6'–(2–(pyridin–2–yl)ethylazanediyl)bis(methylene)bis(2,4–di–tert–butylphenol), H2L1 I, with [VIVO(acac)2] in CH3CN gives the VVO–complex, [VVO(acac)(L1)] 1. Crystallization of 1 in CH3CN at ~0 ºC, gives dark blue crystals of 1, while at room temperature it affords dark green crystals of [{VVO(L1)}2µ–O] 3. Upon prolonged treatment of 1 in MeOH [VVO(OMe)(MeOH)(L1)] 2 is obtained. All three complexes are analyzed by single–crystal X–ray diffraction, depicting distorted octahedral geometry around vanadium. In the reaction of H2L1 with VIVOSO4 partial hydrolysis of the tripodal ligand results in elimination of the pyridyl fragment of L1 and the formation of H[VVO2(L2)] 4, containing the ONO tridentate ligand 6,6'–azanediylbis(methylene)bis(2,4–di–tert–butylphenol), H2L2 II. Compound 4, which was not fully characterized, undergoes dimerization in acetone yielding the hydroxido–bridged [{VVO(L2)}2µ–(HO)2] 5, having distorted octahedral geometry around each vanadium. In contrast, from a solution of 4 in acetonitrile, the dinuclear compound [{VVO(L2)}2µ–O] 6 is obtained, with trigonal bipyramidal geometry around each vanadium. The methoxido complex 2 is successfully employed as a functional catechol–oxidase mimic in the oxidation of catechol to o–quinone under air. The process is confirmed to follow a Michaelis–Menten type kinetics with respect to catechol, the Vmax and KM values obtained being 7.66×10–6 M min -1 and 0.0557 M, respectively, and the turnover frequency is 0.0541 min–1. Complex 2 is also used as a catalyst precursor for the oxidative bromination of thymol in aqueous medium. The selectivity shows quite interesting trends, namely when not using excess of primary oxidizing agent, H2O2 the para mono–brominated product corresponds to ~93 % of the products and no dibromo derivative is formed.

Keywords: oxidovanadium (V) complexes, tripodal ligand, crystal structure, catechol oxidase mimetic activity

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1343 A Tool to Represent People Approach to the Use of Pharmaceuticals and Related Criticality and Needs: A Territory Experience

Authors: Barbara Pittau, Piergiorgio Palla, Antonio Mastino

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Communication is fundamental to health education. The proper use of medicinal products is a crucial aspect of the health of citizens that affects both safety and health care spending. Therefore, encouraging/promoting communication, concerning the importance of proper use of pharmaceuticals, has substantial implications in terms of individual health, health care, and health care system sustainability. In view of these considerations, in the context of two projects, one of which is still in progress, a relational database-backed web application named COLLABORAFARMACISOLA has been designed and developed as a tool to analyze and visualize how people approach the use of medicinal products, with the aim of improving and enhancing communication efficacy. The software application is being used to collect information (anonymously and voluntarily) from the citizens of Sardinia, an Italian region, regarding their knowledge, experiences, and opinions towards pharmaceuticals. This study that was conducted to date on thousand of interviewed people, has focused on different aspects such as: the treatment interruption and the "self-prescription” without medical consultation, the attention paid to reading the leaflets, the awareness of the economic value of the pharmaceuticals, the importance of avoiding the waste of medicinal products and the attitudes towards the use of generics. To this purpose, our software application provides a set of ad hoc parsing routines, to store information into the structure of a relational database and to process and visualize it through a set of interactive tools aimed to emphasize the findings and the insights obtained. The results of our preliminary analysis show the efficacy of the awareness plan and, at the same time, the criticality and the needs of the territory under examination. The ultimate goal of our study is to provide a contribution to the community by improving communication that can result in a benefit for public health in a context strictly connected to the reality of the territory.

Keywords: communication, pharmaceuticals, public health, relational database, tool, web application

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1342 Reversal of Testicular Damage and Subfertility by Resveratrol

Authors: Samy S. Eleawa, Mahmoud A. Alkhateeb, Fahaid H. Alhashem, Ismaeel bin-Jaliah, Hussein F. Sakr, Hesham M. Elrefaey, Abbas O. Elkarib, Mohammad A. Haidara, Abdullah S. Shatoor, Mohammad A. Khalil

Abstract:

This effect of Resveratrol (RES) against CdCl2- induced toxicity in the rat testes was investigated. Seven experimental groups of adult male rats were formulated as follows: A) Controls + NS, B) Control+ vehicle (saline solution of hydroxypropyl cyclodextrin), C) RES treated, D) CdCl2 +NS, E) CdCl2+ vehicle, F) RES followed by CdCl2 and M) CdCl2 followed by RES. At the end of the protocol, serum levels of FSH, LH, and testosterone were measured in all groups. Testicular levels of TBARS and Super Oxide Dismutase (SOD) activity were also measured. Epidydidimal semen analysis was performed and testicular expression of Bcl-2, p53 and Bax were assessed by RT-PCR. Also, histopathological changes of testes were examined microscopically and described. Pre and Post administration of RES in cadmium chloride-intoxicated rats improved semen parameters including count, motility, daily sperm production and morphology, increased serum concentrations of gonadotropins and testosterone, decreased testicular lipid peroxidation and increased SOD activity. Not only RES attenuated cadmium chloride induced testicular histopathology but was also able to protect against the onset of cadmium chloride testicular toxicity. Cadmium chloride downregulated the anti-apoptotic gene Bcl2 and upregulated the expression of both pro-apoptotic genes p53 and Bax. Resveratrol protected from and partially reversed cadmium chloride testicular via upregulation of Bcl2 and down regulation of p53 and Bax gene expression. Antioxidant activity of RES protects against cadmium chloride testicular toxicity and partially reverses its effect via upregulation of BCl2 and downregulation of p53 and Bax expression. These findings have far reaching implications on subfertility and impotency frequently seen in hypertensive as well as metabolic syndrome patients.

Keywords: resveratrol, cadmium, infertility, sperm, testis, metabolic syndrome

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1341 Research Writing Anxiety among Engineering Postgraduate Students in Taiwan

Authors: Mei-Ching Ho

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Graduate-level writing practices have gained increasing scholarly attention in recent years. Due to its discipline-specific conventions and requirements, research writing can cause various levels of anxiety for native English speaking and English as a second/foreign language (ESL/EFL) postgraduate students. Although many studies have investigated how writing anxiety can negatively affect writing performance, self-efficacy, and disciplinary discourse socialization process, relatively few have examined the impact of writing anxiety from the perspectives of postgraduate students in EFL contexts. This study aims to 1) examine the level of and the relationship between research writing anxiety and self-efficacy among Taiwanese EFL students at the master's and doctoral levels and 2) to uncover the causes of students' research writing anxiety. The data was collected from an adapted version of Second Language Writing Anxiety Inventory (SLWAI) and Research Writing Self-Efficacy Scale with 218 EFL graduate students in engineering-related fields at two research-oriented universities in Taiwan. A pilot study was conducted to ensure the construct and content validity of the instruments. Semi-structured interviews were also undertaken with 30 survey respondents to better understand the causes of their writing anxiety. The results revealed that while both master's and doctoral students had low to moderate research writing anxiety and self-efficacy, the doctoral students with more experiences in writing research papers in English were more anxious but not necessarily more confident than the master's students. A significantly weak negative correlation was found between the two constructs. The contributing factors for these results include different degree of writing exigency, perceived importance and types of writing tasks, writing for publication as graduation thresholds, and mentoring relationship with thesis/dissertation advisers. The study also identified several causes of graduate-level writing anxiety, of which writing under time constraints and concern on linguistic and rhetorical proficiency appeared to be the major concern. Pedagogical implications regarding facilitating graduate students' writing process and reducing anxiety will also be drawn.

Keywords: writing affect, writing anxiety, writing self-efficacy, EFL, postgraduate students

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1340 Genetically Modified Organisms

Authors: Mudrika Singhal

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The research paper is basically about how the genetically modified organisms evolved and their significance in today’s world. It also highlights about the various pros and cons of the genetically modified organisms and the progress of India in this field. A genetically modified organism is the one whose genetic material has been altered using genetic engineering techniques. They have a wide range of uses such as transgenic plants, genetically modified mammals such as mouse and also in insects and aquatic life. Their use is rooted back to the time around 12,000 B.C. when humans domesticated plants and animals. At that humans used genetically modified organisms produced by the procedure of selective breeding and not by genetic engineering techniques. Selective breeding is the procedure in which selective traits are bred in plants and animals and then are domesticated. Domestication of wild plants into a suitable cultigen is a well known example of this technique. GMOs have uses in varied fields ranging from biological and medical research, production of pharmaceutical drugs to agricultural fields. The first organisms to be genetically modified were the microbes because of their simpler genetics. At present the genetically modified protein insulin is used to treat diabetes. In the case of plants transgenic plants, genetically modified crops and cisgenic plants are the examples of genetic modification. In the case of mammals, transgenic animals such as mice, rats etc. serve various purposes such as researching human diseases, improvement in animal health etc. Now coming upon the pros and cons related to the genetically modified organisms, pros include crops with higher yield, less growth time and more predictable in comparison to traditional breeding. Cons include that they are dangerous to mammals such as rats, these products contain protein which would trigger allergic reactions. In India presently, group of GMOs include GM microorganisms, transgenic crops and animals. There are varied applications in the field of healthcare and agriculture. In the nutshell, the research paper is about the progress in the field of genetic modification, taking along the effects in today’s world.

Keywords: applications, mammals, transgenic, engineering and technology

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1339 Effects of Non-Diagnostic Haptic Information on Consumers' Product Judgments and Decisions

Authors: Eun Young Park, Jongwon Park

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A physical touch of a product can provide ample diagnostic information about the product attributes and quality. However, consumers’ product judgments and purchases can be erroneously influenced by non-diagnostic haptic information. For example, consumers’ evaluations of the coffee they drink could be affected by the heaviness of a cup that is used for just serving the coffee. This important issue has received little attention in prior research. The present research contributes to the literature by identifying when and how non-diagnostic haptic information can have an influence and why such influence occurs. Specifically, five studies experimentally varied the content of non-diagnostic haptic information, such as the weight of a cup (heavy vs. light) and the texture of a cup holder (smooth vs. rough), and then assessed the impact of the manipulation on product judgments and decisions. Results show that non-diagnostic haptic information has a biasing impact on consumer judgments. For example, the heavy (vs. light) cup increases consumers’ perception of the richness of coffee in it, and the rough (vs. smooth) texture of a cup holder increases the perception of the healthfulness of fruit juice in it, which in turn increases consumers’ purchase intentions of the product. When consumers are cognitively distracted during the touch experience, the impact of the content of haptic information is no longer evident, but the valence (positive vs. negative) of the haptic experience influences product judgments. However, consumers are able to avoid the impact of non-diagnostic haptic information, if and only if they are both knowledgeable about the product category and undistracted from processing the touch experience. In sum, the nature of the influence by non-diagnostic haptic information (i.e., assimilation effect vs. contrast effect vs. null effect) is determined by the content and valence of haptic information, the relative impact of which depends on whether consumers can identify the content and source of the haptic information. Theoretically, to our best knowledge, this research is the first to document the empirical evidence of the interplay between cognitive and affective processes that determines the impact of non-diagnostic haptic information. Managerial implications are discussed.

Keywords: consumer behavior, haptic information, product judgments, touch effect

Procedia PDF Downloads 139
1338 Insulin Resistance in Patients with Chronic Hepatitis C Virus Infection: Upper Egypt Experience

Authors: Ali Kassem

Abstract:

Background: In the last few years, factors such as insulin resistance (IR) and hepatic steatosis have been linked to progression of hepatic fibrosis.Patients with chronic liver disease, and cirrhosis in particular, are known to be prone to IR. However, chronic HCV (hepatitis C) infection may induce IR, regardless of the presence of liver cirrhosis. Our aims are to study insulin resistance (IR) assessed by HOMA-IR (Homeostatic Model Assessment Insulin Resistance) as a possible risk factor in disease progression in cirrhotic patients and to evaluate the role of IR in hepatic fibrosis progression. The correlations of HOMA-IR values to laboratory, virological and histopathological parameters of chronic HCV are also examined. Methods: The study included 50 people divided into 30 adult chronic hepatitis C patients diagnosed by PCR (polymerase chain reaction) within previous 6 months and 20 healthy controls. The functional and morphological status of the liver were evaluated by ultrasonography and laboratory investigations including liver function tests and by liver biopsy. Fasting blood glucose and fasting insulin levels were measured and body mass index and insulin resistance were calculated. Patients having HOMA-IR >2.5 were labeled as insulin resistant. Results: Chronic hepatitis C patients with IR showed significantly higher mean values of BMI (body mass index) and fasting insulin than those without IR (P < 0.000). Patients with IR were more likely to have steatosis (p = 0.006), higher necroinflammatory activity (p = 0.05). No significant differences were found between the two groups regarding hepatic fibrosis. Conclusion: HOMA-IR measurement could represent a novel marker to identify the cirrhotic patients at greater risk for the progression of liver disease. As IR is a potentially modifiable risk factor, these findings may have important prognostic and therapeutic implications. Assessment of IR by HOMA-IR and improving insulin sensitivity are recommended in patients with HCV and related chronic liver disease.

Keywords: hepatic fibrosis, hepatitis C virus infection, hepatic steatosis, insulin resistance

Procedia PDF Downloads 134
1337 The Nimbārka School of Vedānta and the Indian Classical Dance: The Philosophical Relevance through Rasa Theory

Authors: Shubham Arora

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This paper illustrates a relationship between the Dvaitādvaita (dualistic non-dualistic) doctrine of Nimbārka school of Vedānta and philosophy of Indian classical dance, through the Rasa theory. There would be a separate focus on the philosophies of both the disciplines and then analyzing Rasa theory as a connexion between them. The paper presents ideas regarding the similarity between the Brahman and the dancer, manifestation of enacting character and the Jīva (soul), the existence of the phenomenal world and the imaginary world classification of rasa on the basis of three modes of nature, and the feelings and expressions depicting the Dvaita and Advaita. The reason behind choosing such a topic is an intention to explore the relativity of the Vedantic philosophy of this school in real manner. It is really important to study the practical implications and relevance of the doctrine with other disciplines for perceiving it cogently. In our daily lives, we use various forms of facial expressions and bodily gestures in order to communicate, along with the oral and written means of communication. What if, when gestures and expressions mingle with the music beats, in order to present an idea? Indian Classical dance is highly rich in expressing the emotions using extraordinary expressions, unconventional bodily gestures and mesmerizing music beats. Ancient scriptures like Nāṭyaśāstra of Bharata Muni and Abhinava Bhārati by Abhinavaguptā recount aesthetics in a well-defined and structured way of acting and dancing and also reveal the grammar of rasa theory. Indian Classical dance is not only for entertainment but it is deeply in contact with divinity. During the period of Bhakti movement in India, this art form was used as a means to narrate the vignettes from epics like Rāmāyana and Mahābhārata and Purānas. Even in present era, this art has a deep rooted philosophy within.

Keywords: Advaita, Brahman, Dvaita, Jiva, Nimbarka, Rasa, Vedanta

Procedia PDF Downloads 280
1336 A Preliminary Comparative Study Between the United Kingdom and Taiwan: Public Private Collaboration and Cooperation in Tackling Large Scale Cyberattacks

Authors: Chi-Hsuan Cheng

Abstract:

This research aims to evaluate public-private partnerships against cyberattacks by comparing the UK and Taiwan. First, the study analyses major cyberattacks and factors influencing cybersecurity in both countries. Second, it assesses the effectiveness of current cyber defence strategies in combating cyberattacks by comparing the approaches taken in the UK and Taiwan, while also evaluating the cyber resilience of both nations. Lastly, the research evaluates existing public-private partnerships by comparing those in the UK and Taiwan, and proposes recommendations for enhancing cooperation and collaboration mechanisms in tackling cyberattacks. Grounded theory serves as the core research method. Theoretical sampling is used to recruit participants in both the UK and Taiwan, including investigators, police officers, and professionals from cybersecurity firms. Semi-structured interviews are conducted in English in the UK and Mandarin in Taiwan, recorded with consent, and pseudonymised for privacy. Data analysis involves open coding, grouping excerpts into codes, and categorising codes. Axial coding connects codes into categories, leading to the development of a codebook. The process continues iteratively until theoretical saturation is reached. Finally, selective coding identifies the core topic, evaluating public-private cooperation against cyberattacks and its implications for social and policing strategies in the UK and Taiwan, which highlights the current status of the cybersecurity industry, governmental plans for cybersecurity, and contributions to cybersecurity from both government sectors and cybersecurity firms, with a particular focus on public-private partnerships. In summary, this research aims to offer practical recommendations to law enforcement, private sectors, and academia for reflecting on current strategies and tailoring future approaches in cybersecurity

Keywords: cybersecurity, cybercrime, public private partnerships, cyberattack

Procedia PDF Downloads 40
1335 Real-World Economic Burden of Musculoskeletal Disorders in Nigeria

Authors: F. Fatoye, C. E. Mbada, T. Gebrye, A. O. Ogunsola, C. Fatoye, O. Oyewole

Abstract:

Musculoskeletal disorders (MSDs) such as low back pain (LBP), cervical spondylosis (CSPD), sprain, osteoarthritis (OA), and post immobilization stiffness (PIS) have a major impact on individuals, health systems and society in terms of morbidity, long-term disability, and economics. This study estimated the direct and indirect costs of common MSDs in Osun State, Nigeria. A review of medical charts for adult patients attending Physiotherapy Outpatient Clinic at the Obafemi Awolowo University Teaching Hospitals Complex, Osun State, Nigeria between 2009 and 2018 was carried out. The occupational class of the patients was determined using the International Labour Classification (ILO). The direct and indirect costs were estimated using a cost-of-illness approach. Physiotherapy related health resource use, and costs of the common MSDs, including consultation fee, total fee charge per session, costs of consumables were estimated. Data were summarised using descriptive statistics mean and standard deviation (SD). Overall, 1582 (Male = 47.5%, Female = 52.5%) patients with MSDs population with a mean age of 47.8 ± 25.7 years participated in this study. The mean (SD) direct costs estimate for LBP, CSPD, PIS, sprain, OA, and other conditions were $18.35 ($17.33), $34.76 ($17.33), $32.13 ($28.37), $35.14 ($44.16), $37.19 ($41.68), and $15.74 ($13.96), respectively. The mean (SD) indirect costs estimate of LBP, CSPD, PIS, sprain, OA, and other MSD conditions were $73.42 ($43.54), $140.57 ($69.31), $128.52 ($113.46), sprain $140.57 ($69.31), $148.77 ($166.71), and $62.98 ($55.84), respectively. Musculoskeletal disorders contribute a substantial economic burden to individuals with the condition and society. The unacceptable economic loss of MSDs should be reduced using appropriate strategies. Further research is required to determine the clinical and cost effectiveness of strategies to improve health outcomes of patients with MSDs. The findings of the present study may assist health policy and decision makers to understand the economic burden of MSDs and facilitate efficient allocation of healthcare resources to alleviate the burden associated with these conditions in Nigeria.

Keywords: economic burden, low back pain, musculoskeletal disorders, real-world

Procedia PDF Downloads 189
1334 Migration in Times of Uncertainty

Authors: Harman Jaggi, David Steinsaltz, Shripad Tuljapurkar

Abstract:

Understanding the effect of fluctuations on populations is crucial in the context of increasing habitat fragmentation, climate change, and biological invasions, among others. Migration in response to environmental disturbances enables populations to escape unfavorable conditions, benefit from new environments and thereby ride out fluctuations in variable environments. Would populations disperse if there is no uncertainty? Karlin showed in 1982 that when sub-populations experience distinct but fixed growth rates at different sites, greater mixing of populations will lower the overall growth rate relative to the most favorable site. Here we ask if and when environmental variability favors migration over no-migration. Specifically, in random environments, would a small amount of migration increase the overall long-run growth rate relative to the zero migration case? We use analysis and simulations to show how long-run growth rate changes with migration rate. Our results show that when fitness (dis)advantages fluctuate over time across sites, migration may allow populations to benefit from variability. When there is one best site with highest growth rate, the effect of migration on long-run growth rate depends on the difference in expected growth between sites, scaled by the variance of the difference. When variance is large, there is a substantial probability of an inferior site experiencing higher growth rate than its average. Thus, a high variance can compensate for a difference in average growth rates between sites. Positive correlations in growth rates across sites favor less migration. With multiple sites and large fluctuations, the length of shortest cycle (excursion) from the best site (on average) matters, and we explore the interplay between excursion length, average differences between sites and the size of fluctuations. Our findings have implications for conservation biology: even when there are superior sites in a sea of poor habitats, variability and habitat quality across space may be key to determining the importance of migration.

Keywords: migration, variable-environments, random, dispersal, fluctuations, habitat-quality

Procedia PDF Downloads 112
1333 A Deluge of Disaster, Destruction, Death and Deception: Negative News and Empathy Fatigue in the Digital Age

Authors: B. N. Emenyeonu

Abstract:

Initially identified as sensationalism in the eras of yellow journalism and tabloidization, the inclusion of news which shocks or provokes strong emotional responses among readers, viewers, and browsers has not only remained a persistent feature of journalism but has also seemingly escalated in the current climate of digital and social media. Whether in the relentless revelation of scandals in high places, profiles on people displaced by sporadic wars or natural disasters, gruesome accounts of trucks plowing into pedestrians in a city centre, or the coverage of mourners paying tributes to victims of a mass shooting, mainstream, and digital media are often awash with tragedy, tears, and trauma. While it may aim at inspiring sympathy, outrage, or even remedial reactions, it would appear that the deluge of grief and misery in the news merely generates in the audience a feeling that borders on hearing or seeing too much to care or act. This feeling also appears to be accentuated by the dizzying diffusion of social media news and views, most of whose authenticity is not easily verifiable. Through a survey of 400 regular consumers of news and an in-depth interview of 10 news managers in selected media organizations across the Middle East, this study therefore investigates public attitude to the profusion of bad news in mainstream and digital media. Among other targets, it examines whether the profusion of bad news generates empathy fatigue among the audience and, if so, whether there is any association between biographic variables (profession, age, and gender) and an inclination to empathy fatigue. It also seeks to identify which categories of bad news and media are most likely to drag the audience into indifference. In conclusion, the study discusses the implications of the findings for mass-mediated advocacies such as campaigns against conflicts, corruption, nuclear threats, terrorism, gun violence, sexual crimes, and human trafficking, among other threats to humanity.

Keywords: digital media, empathy fatigue, media campaigns, news selection

Procedia PDF Downloads 31
1332 Recent Climate Variability and Crop Production in the Central Highlands of Ethiopia

Authors: Arragaw Alemayehu, Woldeamlak Bewket

Abstract:

The aim of this study was to understand the influence of current climate variability on crop production in the central highlands of Ethiopia. We used monthly rainfall and temperature data from 132 points each representing a pixel of 10×10 km. The data are reconstructions based on station records and meteorological satellite observations. Production data of the five major crops in the area were collected from the Central Statistical Agency for the period 2004-2013 and for the main cropping season, locally known as Meher. The production data are at the Enumeration Area (EA ) level and hence the best available dataset on crop production. The results show statistically significant decreasing trends in March–May (Belg) rainfall in the area. However, June – September (Kiremt) rainfall showed increasing trends in Efratana Gidim and Menz Gera Meder which the latter is statistically significant. Annual rainfall also showed positive trends in the area except Basona Werana where significant negative trends were observed. On the other hand, maximum and minimum temperatures showed warming trends in the study area. Correlation results have shown that crop production and area of cultivation have positive correlation with rainfall, and negative with temperature. When the trends in crop production are investigated, most crops showed negative trends and below average production was observed. Regression results have shown that rainfall was the most important determinant of crop production in the area. It is concluded that current climate variability has a significant influence on crop production in the area and any unfavorable change in the local climate in the future will have serious implications for household level food security. Efforts to adapt to the ongoing climate change should begin from tackling the current climate variability and take a climate risk management approach.

Keywords: central highlands, climate variability, crop production, Ethiopia, regression, trend

Procedia PDF Downloads 409
1331 Exploration of an Environmentally Friendly Form of City Development Combined with a River: An Example of a Four-Dimensional Analysis Based on the Expansion of the City of Jinan across the Yellow River

Authors: Zhaocheng Shang

Abstract:

In order to study the topic of cities crossing rivers, a Four-Dimensional Analysis Method consisting of timeline, X-axis, Y-axis, and Z-axis is proposed. Policies, plans, and their implications are summarized and researched along with the timeline. The X-axis is the direction which is parallel to the river. The research area was chosen because of its important connection function. It is proposed that more surface water network should be built because of the ecological orientation of the research area. And the analysis of groundwater makes it for sure that the proposal is feasible. After the blue water network is settled, the green landscape network which is surrounded by it could be planned. The direction which is transversal to the river (Y-axis) should run through the transportation axis so that the urban texture could stretch in an ecological way. Therefore, it is suggested that the work of the planning bureau and river bureau should be coordinated. The Z-axis research is on the section view of the river, especially on the Yellow River’s special feature of being a perched river. Based on water control safety demands, river parks could be constructed on the embankment buffer zone, whereas many kinds of ornamental trees could be used to build the buffer zone. City Crossing River is a typical case where we make use of landscaping to build a symbiotic relationship between the urban landscape architecture and the environment. The local environment should be respected in the process of city expansion. The planning order of "Benefit- Flood Control Safety" should be replaced by "Flood Control Safety - Landscape Architecture- People - Benefit".

Keywords: blue-green landscape network, city crossing river, four-dimensional analysis method, planning order

Procedia PDF Downloads 132
1330 The Nexus Between the Rise of Autocratisation and the Deeper Level of BRI Engagement

Authors: Dishari Rakshit, Mitchell Gallagher

Abstract:

The global landscape is witnessing a disconcerting surge in democratic backsliding, engendering concerns over the rise of autocratisation. This research demonstrates the intricate relationship between a nation's domestic propensity for autocratic governance and its trade relations with China. Giving prominence to Belt and Road Initiative (BRI) investments, this study adopts a rigorous neorealist framework to discern the complexities of nations' economic interests amidst an anarchic milieu and how these interests may transcend steadfast adherence to democratic principles. The burgeoning bipolarity in the international political setting serves as a backdrop to our inquiry. To operationalise our hypothesis, we conduct a large-scale 'N' study, encompassing a comprehensive global dataset comprising countries' democracy indicators, total trade volume with China, and cumulative Chinese BRI investments over a substantial temporal expanse. By meticulously examining BRI signatories’, we aim to ascertain the potential accentuation of democratic backsliding among these nations. To test our empirical underpinning, we will validate our findings through cogent case studies. Our analysis adds to the scholarship on multifaceted interactions between trade dynamics and democratic governance within the fabric of the international political landscape. In its culmination, the paper addresses the question- has the erstwhile grandeur of bipolarity resurfaced in the contemporary global panorama? Concurrently, we explore the nexus between the ascendant wave of autocratisation as a by-product of the Beijing Consensus? Pertinent to policymakers, our discoveries stand poised to furnish a comprehensive grasp of the manifold implications arising from the deepening entanglements with China under the auspices of the BRI.

Keywords: democracy, autocracy, china, belt road initiative, international political economy

Procedia PDF Downloads 43
1329 Working in Multidisciplinary Care Teams: Perspectives from Health Care and Social Service Providers

Authors: Lindy Van Vliet, Saloni Phadke, Anthea Nelson, Ann Gallant

Abstract:

Holistic and patient-centred palliative care and support require an integrated system of care that includes health and social service providers working together to ensure that patients and families have access to the care they need. The objective of this study is to further explore and understand the benefits and challenges of mobilizing multidisciplinary care teams for health care professionals and social service providers. Drawing on an interpretivist, exploratory, qualitative design, our multidisciplinary research team (medicine, nursing and social work) conducted interviews with 15 health care and social service providers in the Ottawa region. Interview data was audio-recorded, transcribed, and analyzed using a reflexive thematic analysis approach. The data deepens our understandings of the facilitators and barriers posed by multidisciplinary care teams. Three main findings emerged: First, the data highlighted the benefits of multidisciplinary care teams for both patient outcomes and quality of life and provider mental health; second, the data showed that the lack of a system-wide integrated communication system reduces the quality of patient care and increases provider stress while working in multidisciplinary care teams; finally, the data demonstrated the existence of implicit hierarchies between disciplines, this coupled with different disciplinary perspectives of palliative care provision can lead to friction and challenges within care teams. These findings will have important implications for the future of palliative care as they will help to facilitate and build stronger person-centred/relationship-centred palliative care practices by naming the challenges faced by multidisciplinary palliative care teams and providing examples of best practices.

Keywords: public health palliative care, palliative care nursing, care networks, integrated health care, palliative care approach, public health, multidisciplinary work, care teams

Procedia PDF Downloads 58
1328 Patient-Reported Adverse Reactions to Adolescent Non-Suicidal Self-Injury Disclosures and Implications for Clinical Practice

Authors: Renee Fabian, Jordan Davidson

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Current research on non-suicidal self-injury (NSSI) provides ample insights on best practices for caregivers and clinicians to address and reduce NSSI behavior among adolescents. However, the efficacy of evidenced-based NSSI interventions and their delivery from the perspective of adolescent patients does not receive significant attention, creating a gap between the efficacy of research-based NSSI interventions and adolescent perceptions of NSSI treatment and adolescent willingness to engage in NSSI interventions. To address the gap between practice and patient perspectives and inform more effective treatment outcomes, the current survey aims to identify major patient-reported adverse reactions to NSSI disclosures from caregivers, treating mental health clinicians, and medical professionals using a mixed methods survey of 2,500 people with a history of NSSI completed by editors at a consumer-facing health publication. Based on the analyzed results of the survey, a majority of adolescents with a history of NSSI found parents and caregivers ineffective at empathetically addressing NSSI, and a significant number of participants reported at least one treating mental health professional inadequately responded to NSSI behaviors, in addition to other findings of adverse reactions to NSSI disclosures that serve as a barrier to treatment. NSSI is a significant risk factor for future suicide attempts. Addressing patient-reported adverse reactions to NSSI disclosures in the adolescent population can remove barriers to the effectiveness of caregiver and clinician NSSI interventions and reduce the risk of NSSI-related harm and lower the risk of future suicide attempts or completions.

Keywords: adolescent self-injury, non-suicidal self-injury, patient perspectives, self-harm interventions

Procedia PDF Downloads 88
1327 Traditional Practices of Conserving Biodiversity: A Case Study around Jim Corbett National Park, Uttarakhand, India

Authors: Rana Parween, Rob Marchant

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With the continued loss of global biodiversity despite the application of modern conservation techniques, it has become crucial to investigate non-conventional methods. Accelerated destruction of ecosystems due to altered land use, climate change, cultural and social change, necessitates the exploration of society-biodiversity attitudes and links. While the loss of species and their extinction is a well-known and well-documented process that attracts much-needed attention from researchers, academics, government and non-governmental organizations, the loss of traditional ecological knowledge and practices is more insidious and goes unnoticed. The growing availability of 'indirect experiences' such as the internet and media are leading to a disaffection towards nature and the 'Extinction of Experience'. Exacerbated by the lack of documentation of traditional practices and skills, there is the possibility for the 'extinction' of traditional practices and skills before they are fully recognized and captured. India, as a mega-biodiverse country, is also known for its historical conservation strategies entwined in traditional beliefs. Indigenous communities hold skillsets, knowledge, and traditions that have accumulated over multiple generations and may play an important role in conserving biodiversity today. This study explores the differences in knowledge and attitudes towards conserving biodiversity, of three different stakeholder groups living around Jim Corbett National Park, based on their age, traditions, and association with the protected area. A triangulation designed multi-strategy investigation collected qualitative and quantitative data through a questionnaire survey of village elders, the general public, and forest officers. Following an inductive approach to analyzing qualitative data, the thematic content analysis was followed. All coding and analysis were completed using NVivo 11. Although the village elders and some general public had vast amounts of traditional knowledge, most of it was related to animal husbandry and the medicinal value of plants. Village elders were unfamiliar with the concept of the term ‘biodiversity’ albeit their way of life and attitudes ensured that they care for the ecosystem without having the scientific basis underpinning biodiversity conservation. Inherently, village elders were keen to conserve nature; the superimposition of governmental policies without any tangible benefit or consultation was seen as detrimental. Alienating villagers and consequently the village elders who are the reservoirs of traditional knowledge would not only be damaging to the social network of the area but would also disdain years of tried and tested techniques held by the elders. Forest officers advocated for biodiversity and conservation education for women and children. Women, across all groups, when questioned about nature conservation, showed more interest in learning and participation. Biodiversity not only has an ethical and cultural value, but also plays a role in ecosystem function and, thus, provides ecosystem services and supports livelihoods. Therefore, underpinning and using traditional knowledge and incorporating them into programs of biodiversity conservation should be explored with a sense of urgency.

Keywords: biological diversity, mega-biodiverse countries, traditional ecological knowledge, society-biodiversity links

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1326 Testifying in Court as a Victim of Crime for Persons with Little or No Functional Speech: Vocabulary Implications

Authors: Robyn White, Juan Bornman, Ensa Johnson

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People with disabilities are at a high risk of becoming victims of crime. Individuals with little or no functional speech (LNFS) face an even higher risk. One way of reducing the risk of remaining a victim of crime is to face the alleged perpetrator in court as a witness – therefore it is important for a person with LNFS who has been a victim of crime to have the required vocabulary to testify in court. The aim of this study was to identify and describe the core and fringe legal vocabulary required by illiterate victims of crime, who have little or no functional speech, to testify in court as witnesses. A mixed-method, the exploratory sequential design consisting of two distinct phases was used to address the aim of the research. The first phase was of a qualitative nature and included two different data sources, namely in-depth semi-structured interviews and focus group discussions. The overall aim of this phase was to identify and describe core and fringe legal vocabulary and to develop a measurement instrument based on these results. Results from Phase 1 were used in Phase 2, the quantitative phase, during which the measurement instrument (a custom-designed questionnaire) was socially validated. The results produced six distinct vocabulary categories that represent the legal core vocabulary and 99 words that represent the legal fringe vocabulary. The findings suggested that communication boards should be individualised to the individual and the specific crime. It is believed that the vocabulary lists developed in this study act as a valid and reliable springboard from which communication boards can be developed. Recommendations were therefore made to develop an Alternative and Augmentative Communication Resource Tool Kit to assist the legal justice system.

Keywords: augmentative and alternative communication, person with little or no functional speech, sexual crimes, testifying in court, victim of crime, witness competency

Procedia PDF Downloads 454