Search results for: migration status

Authors: Wisdom Robert Duruji, Moses Kanayochukwu Ifoh, Efeoghene Edward Esiemunobo

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This study examines the impact of natural and artificial disasters, lackadaisical and semantic approach in risk management, and mitigation implication for sustainable development goals in Nigeria, from 2009 to 2022. The study utilizes a range of research methods to achieve its objectives. These include literature review, website knowledge, Google search, news media information, academic journals, field-work and on-site observations. These diverse methods allow for a comprehensive analysis on the impact and the implications being study. The study finds that paradigm shift from remediating seismic, flooding, environmental pollution and degradation natural disasters by Nigeria Emergency Management Agency (NEMA), to political and charity organization; has plunged risk reduction strategies to embezzling opportunities. However, this lackadaisical and semantic approach in natural disaster mitigation, invariably replicates artificial disasters in Nigeria through: Boko Haram terrorist organization, Fulani herdsmen and farmers conflicts, political violence, kidnapping for ransom, ethnic conflicts, Religious dichotomy, insurgency, secession protagonists, unknown-gun-men, and banditry. This study also, finds that some Africans still engage in self-imposed slavery through human trafficking, by nefariously stow-away to Europe; through Libya, Sahara desert and Mediterranean sea; in search for job opportunities, due to ineptitude in governance by their leaders; a perilous journey that enhanced artificial disasters in Nigeria. That artificial disaster fatality in Nigeria increased from about 5,655 in 2009 to 114,318 in 2018; and to 157,643 in 2022. However, financial and material loss of about $9.29 billion was incurred in Nigeria due to natural disaster, while about $70.59 billion was accrued due to artificial disaster; from 2009 to 2018. Although disaster risk mitigation and politics can synergistically support sustainable development goals; however, they are different entities, and need for distinct separations in Nigeria, as in reality and perception. This study concluded that referendum should be conducted in Nigeria, to ascertain its current status as a nation. Therefore it is recommended that Nigerian governments should refine its naturally endowed crude oil locally; to end fuel subsidy scam, corruption and poverty in Nigeria!

Keywords: corruption, crude oil, environmental risk analysis, Nigeria, referendum, terrorism

Procedia PDF Downloads 42

Authors: I. Gupta, N. Setia

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Introduction. Buyer conduct is a progression of practices or examples that buyers pursue before making a buy. It begins when the shopper ends up mindful of a need or wish for an item, at that point finishes up with the buying exchange. Business visionaries can't generally simply shake hands with their intended interest group people and become more acquainted with them. Research is often necessary, so every organization primarily involves doing continuous research to understand and satisfy consumer needs pattern. Aims and Objectives: The aim of the present study is to examine the different behaviors of the consumer, including pre-purchase, purchase, and post-purchase behavior. Materials and Methods: In order to get results, face to face interview held with 80 people which comprise a larger part of female individuals having upper as well as middle-class status. The prime source of data collection was primary. However, the study has also used the theoretical contribution of many researchers in their respective field. Results: Majority of the respondents were females (70%) from the age group of 20-50. The collected data was analyzed through hypothesis testing statistical techniques such as correlation analysis, single regression analysis, and ANOVA which has rejected the null hypothesis that there is no relation between researching the consumer behavior at different stages and organizational performance. The real finding of this study is that simply focusing on the buying part isn't enough to gain profits and fame, however, understanding the pre, buy and post-buy behavior of consumer performs a huge role in organization success. The outcomes demonstrated that the organization, which deals with the three phases of research of purchasing conduct is able to establish a great brand image as compare to their competitors. Alongside, enterprises can observe customer conduct in a considerably more proficient manner. Conclusion: The analyses of consumer behavior presented in this study is an attempt to understand the factors affecting consumer purchasing behavior. This study has revealed that those corporations are more successful, which work on understanding buying behavior instead to just focus on the selling products. As a result, organizations perform good and grow rapidly because consumers are the one who can make or break the company. The interviews that were conducted face to face, clearly revealed that those organizations become at top-notch whom consumers are satisfied, not just with product but also with services of the company. The study is not targeting the particular class of audience; however, it brings out benefits to the masses, in particular to business organizations.

Keywords: consumer behavior, pre purchase, post purchase, consumer satisfaction

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Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Obada Ahmad Al Jayyousi, Ihdaa Mahmoud Bani Khalaf, Eman E. Alshial

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Background: Bipolar disorder, formerly known as manic depression, is a mental health status that leads to extreme mood swings that include emotional lows (depression) and highs (mania or hypomania). This systematic review and meta-analysis aimed to assess the safety and efficacy of lithium versus valproate among bipolar patients. Methods: A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until June 2022. Studies comparing lithium versus valproate among bipolar patients were selected for the analysis, and all relevant outcomes were pooled in the meta-analysis using Review Manager Software. Results: 11 Randomized Clinical Trials were included in this meta-analysis with a total of 4159 patients. Our meta showed that lithium was superior to valproate in terms of Young Mania Rating Scale (YMRS) (MD = 0.00 with 95% CI, (-0.55 – 0.55; I2 = 0%), P = 1.00). The results of the Hamilton Depression Rating Scale (HDRS) showed that the overall effect favored the valproate treated group (MD = 1.41 with 95% CI, (-0.15 – 2.67; I2 = 0%), P = 0.03). Concerning the results of the Montgomery-Asberg Depression Rating Scale (MADRS), the results showed that the lithium was superior to valproate (MD = 0.03 with 95% CI, (-0.80 to 0.87; I2 = 40%), P = 0.94). In terms of the sexual side effect, we found that the valproate was superior to lithium (RR 1.19 with 95% CI, (0.74 to 1.91; I2 = 0%), P = 0.47). The lithium-treated group was superior in comparison to valproate treated group in terms of Abnormal Involuntary Movement Scale (AIMS) (MD = -0.03 with 95% CI (-0.38 to 0.32; I2 = 0%), P = 0.87). The lithium was more favorable in terms of Simpson-Agnes scale (MD = -0.40 with 95% CI, (-0.86 to 0.06; I2 = 0%), P = 0.09). The results of the Barnes akathisia scale showed that the overall effect of the valproate was more favorable in comparison to lithium (MD = 0.05 with 95% CI, (-0.12 to 0.22; I2 = 0%), P = 0.57). Conclusion: Our study revealed that on the scales of efficacy Lithium treated group surpassed Valproate treated group in terms of Young Mania Rating Scale (YMRS), Abnormal Involuntary Movement Scale (AIMS) and Simpson-Agnes scale, but valproate surpassed it in Barnes Akathisia scale. Furthermore, on the scales of depression Hamilton Depression Rating Scale (HDRS) showed that the overall effect favored Valproate treated group, but Lithium surpassed valproate in terms of Montgomery-Asberg Depression Rating Scale (MADRS). Valproate surpassed Lithium in terms of sexual side effects.

Keywords: bipolar, mania, bipolar-depression, sexual dysfunction, sexual side effects, treatment

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Authors: Harini Atturu, Divyani Byagari, Bindhu Rani Thumkunta, Sahitya Bammidi, Manasa Badveli

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Introduction: Biological, psychological and social domains influence the outcomes of pregnancy. The COVID19 pandemic had a significant effect on the psychological and social domains of pregnant women all over the world. Everyone has inherent coping mechanisms which ultimately determine the actual impact of such external stimulus on outcomes of pregnancy. This study aims to understand the coping strategies used by pregnant women to overcome the psychological impact of the first wave of the COVID 19 pandemic. Methods: Institutional ethics permission was sought. All pregnant women attending antenatal clinics in the institution during September 2020 were included in the study. Brief-COPE, a self-rated questionnaire, was provided to understand the coping strategies used by them. The Questionnaire consists of 28 questions that fall into 14 themes. These 14 themes were mapped into four domains consisting of Approaching coping (APC) styles, Avoidant Coping (AVC) styles, Humor and Religion. The results were analyzed using univariate and multivariate analysis. Factor analysis was performed to identify themes that are most frequently used. Results: 162 pregnant women were included in the study. The majority of the women were aged between 18 and 30 (90.1%). 60.9% of the respondents were having their first pregnancy and were in the 2nd trimester (59.6%). The majority of them were living in the city (74%), belonged to the middle class (77.6%) and were not working (70.1%). 56 respondents (34.6%) reported that they had contact with suspected or Covid positive patients. Many were worried that their pregnancy might be complicated (43%), their baby may contract COVID (45%) and their family members could get COVID during the hospital visits for antenatal check-ups. 33.6% of women admitted missing their regular antenatal check-ups because of the above concerns. All respondents used various coping strategies to overcome the psychological impact of COVID 19. Out of the 4 coping strategies, participants scored high on Religion with a mean of 5.471.45 followed by Approaching Coping (APC) styles (5.131.25), Humor (4.592.07) and Avoidant Coping (AVC) styles (4.130.88). Religion as a coping strategy scored high for all respondents irrespective of age, parity, trimester, social and employment status. Exploratory Factor analysis revealed two cluster groups that explained 68% of the variance, with Component 1 contributing to 58.9% and component 2 contributing 9.13% of the variance. Humor, Acceptance, Planning, and Religion were the top 4 factors that showed strong loadings. Conclusion: Most of the pregnant women were worried about the negative impact of COVID 19 on the outcomes of their pregnancy. Religion and Approaching coping styles seem to be the predominant coping strategies used by them. Interventionists and policymakers should consider these factors while providing support to such women.

Keywords: coping strategies, pregnancy, COVID-19, brief-COPE

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Authors: Golnoush Rostami, Farzam Kharvari

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In recent years, developments in the field of architectural education have resulted in a shift from conventional teaching methods to alternative state-of-the-art approaches in teaching methods and strategies. Criticism in architecture has been a key player both in the profession and education, but it has been mostly offered by renowned individuals. Hence, not only students or other professionals but also critics themselves may not have the option to experience buildings and rely on available 2D materials, such as images and plans, that may not result in a holistic understanding and evaluation of buildings. On the other hand, immersive environments provide students and professionals the opportunity to experience buildings virtually and reflect their evaluation by experiencing rather than judging based on 2D materials. Therefore, the aim of this study is to compare the effect of experiencing buildings in immersive environments and 2D drawings, including images and plans, on architecture criticism and architectural education. As a result, three buildings that have parametric brick facades were studied through 2D materials and in Unreal Engine v. 24 as an immersive environment among 22 architecture students that were selected using convenient sampling and were divided into two equal groups using simple random sampling. This study used mixed methods, including quantitative and qualitative methods; the quantitative section was carried out by a questionnaire, and deep interviews were used for the qualitative section. A questionnaire was developed for measuring three constructs, including privacy regulation based on Altman’s theory, the sufficiency of illuminance levels in the building, and the visual status of the view (visually appealing views based on obstructions that may have been caused by facades). Furthermore, participants had the opportunity to reflect their understanding and evaluation of the buildings in individual interviews. Accordingly, the collected data from the questionnaires were analyzed using independent t-test and descriptive analyses in IBM SPSS Statistics v. 26, and interviews were analyzed using the content analysis method. The results of the interviews showed that the participants who experienced the buildings in the immersive environment were able to have a thorough and more precise evaluation of the buildings in comparison to those who studied them through 2D materials. Moreover, the analyses of the respondents’ questionnaires revealed that there were statistically significant differences between measured constructs among the two groups. The outcome of this study suggests that integrating immersive environments into the profession and architectural education as an effective and efficient tool for architecture criticism is vital since these environments allow users to have a holistic evaluation of buildings for vigorous and sound criticism.

Keywords: immersive environments, architecture criticism, architectural education, occupant-centric evaluation, pre-occupancy evaluation

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Authors: Teodorica G. Ani

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Economic activity requires an encouraging regulatory environment and effective rules that are transparent and accessible to all. The World Bank has been publishing the annual Doing Business reports since 2004 to investigate the scope and manner of regulations that enhance business activity and those that constrain it. A streamlined business environment supporting the development of competitive small and medium enterprises (SMEs) may expand employment opportunities and improve the living conditions of low income households. Asia has emerged as one of the most attractive markets in the world. Economies in East Asia and the Pacific were among the most active in making it easier for local firms to do business. The study aimed to describe the ease of doing business and its effect to economic growth among selected economies in Asia for the year 2014. The study covered 29 economies in East Asia, Southeast Asia, South Asia and Middle Asia. Ease of doing business is measured by the Doing Business indicators (DBI) of the World Bank. The indicators cover ten aspects of the ease of doing business such as starting a business, dealing with construction permits, getting electricity, registering property, getting credit, protecting investors, paying taxes, trading across borders, enforcing contracts and resolving insolvency. In the study, Gross Domestic Product (GDP) was used as the proxy variable for economic growth. Descriptive research was the research design used. Graphical analysis was used to describe the income and doing business among selected economies. In addition, multiple regression was used to determine the effect of doing business to economic growth. The study presented the income among selected economies. The graph showed China has the highest income while Maldives produces the lowest and that observation were supported by gathered literatures. The study also presented the status of the ten indicators of doing business among selected economies. The graphs showed varying trends on how easy to start a business, deal with construction permits and to register property. Starting a business is easiest in Singapore followed by Hong Kong. The study found out that the variations in ease of doing business is explained by starting a business, dealing with construction permits and registering property. Moreover, an explanation of the regression result implies that a day increase in the average number of days it takes to complete a procedure will decrease the value of GDP in general. The research proposed inputs to policy which may increase the awareness of local government units of different economies on the simplification of the policies of the different components used in measuring doing business.

Keywords: doing business, economic growth, gross domestic product, Asia

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Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

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Authors: Anietie J. Atangwho, Udeme E. Asibong, Item J. Atangwho, Ndifreke E. Udonwa

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Diabesity, a syndrome where diabetes and obesity occur simultaneously in a single patient, has emerged as a recent challenge to the medical world and is already at epidemic proportion in some countries. Therefore, this study aimed to determine the prevalence of diabesity among adult patients attending the General Outpatient clinic of three healthcare facilities in Calabar in a bid to improve healthcare delivery to patients at risk. A cross-sectional descriptive study design was employed using a mixed method approach that comprised quantitative and qualitative components i.e., Focused Group Discussion (FGD) and Key Informant Interview (KII). One hundred and ninety (190) participants aged 18 to 72 years and body mass index (BMI) ≥ 30kg/m2 were recruited as the study population for the quantitative study using systematic random sampling technique and analysed using SPSS version 25. The qualitative component performed 4 FGDs and 3 KIIs. Results of sociodemographic variables showed respondents aged 35 – 44 as highest in number (37.3%). Of this number, 83.7% were females, 76.8% married, and 3.7% earned USD1,110.00 monthly. Whereas majority of the participants (65.8 %) were within class 1 obesity, only 38% considered themselves obese. Diabesity occurrence was found to be 12.6% (i.e. BMI ≥ 30 to 45.2kg/m2 vs FBS ≥ 7.0 – 14.8mmo/l), with 38% of them being previously undiagnosed. About 48.4 % of the respondents ate two meals only per day; with 90.5% eating between meals. Snacking was predominant, mostly pastries (67.9%), with 58.9% taking cola drinks alongside. Sixty-one percent participated in one form of exercise or the other, with walking/trekking as the most common; 34.4 % had no regular exercise schedule. Only about 39.5% of the participants spent less than an hour on devices like phone, television, and laptops. Additionally, previously known and newly diagnosed hypertensive patients were 27.9% and 7.2%, respectively. Qualitative assessment with KII and FGDs showed eating unhealthy diets and lack of exercise as major factors responsible for diabesity. The bivariate analysis revealed significant association between diabesity with marital status and hypertension (p = 0.007 and p = 0.005, respectively). Also, positive association with diabesity were eating snacking (p = 0.017) and number of times a respondent snacks per day (p = 0.035). Overall, the study has revealed the occurrence of diabesity in Calabar at 12.6 % of the study population, with 38 % of them previously undiagnosed; it identified unhealthy diets and lack of exercise as causative factors as well as hypertension as snacking associatory indicators of diabesity.

Keywords: diabesity, obesity, diabetes, unhealthy diet

Procedia PDF Downloads 79

Authors: R. L. P. de Lima, F. C. B. Boogaard, D. Setyo Rini, P. Arisandi, R. E. de Graaf-Van Dinther

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Water quality in many Asian countries is very poor due to inefficient solid waste management, high population growth and the lack of sewage and purification systems for households and industry. A consortium of Indonesian and Dutch organizations has begun a large-scale international research project to evaluate and propose solutions to face the surface water pollution challenges in Brantas Basin, Indonesia (East Java: Malang / Surabaya). The first phase of the project consisted in a baseline study to assess the current status of surface water bodies and to determine the ambitions and strategies among local stakeholders. This study was conducted with high participatory / collaborative and knowledge sharing objectives. Several methods such as using mobile sensors (attached to boats or underwater drones), test strips and mobile apps, bio-monitoring (sediments), ecology scans using underwater cameras, or continuous / static measurements, were applied in different locations in the regions of the basin, at multiple locations within the water systems (e.g. spring, upstream / downstream of industry and urban areas, mouth of the Surabaya River, groundwater). Results gave an indication of (reference) values of basic water quality parameters such as turbidity, electrical conductivity, dissolved oxygen or nutrients (ammonium / nitrate). An important outcome was that collecting random samples may not be representative of a body of water, given that water quality parameters can vary widely in space (x, y, and depth) and time (day / night and seasonal). Innovative / dynamic monitoring methods (e.g. underwater drones, sensors on boats) can contribute to better understand the quality of the living environment (water, ecology, sediment) and factors that affect it. The field work activities, in particular, underwater drones, revealed potential as awareness actions as they attracted interest from locals and local press. This baseline study involved the cooperation with local managing organizations with Dutch partners, and their willingness to work together is important to ensure participatory actions and social awareness regarding the process of adaptation and strengthening of regulations, or for the construction of facilities such as sewage.

Keywords: water quality monitoring, pollution, underwater drones, social awareness

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Authors: Talal Alharigi, Kawther Alshlash, Mariska Weijerman

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The government of Saudi Arabia has developed an ambitious “Vision 2030”, which includes a Green Initiative (i.e., the planting of 10 billion trees) and the establishment of seven Royal Reserves as protected areas that comprise 13% of the total land area. The main objective of the reserves is to restore ecosystem balance and reconnect people with nature. Two royal reserves are managed by The Imam Abdulaziz bin Mohammed Royal Reserve Development Authority, including Imam Abdulaziz bin Mohammed Royal Reserve and King Khalid Royal Reserve. The authority has developed a management plan to enhance the habitat through seed dispersal and the planting of 10 million trees, and to restock wildlife that was once abundant in these arid ecosystems (e.g., oryx, Nubian ibex, gazelles, red-necked ostrich). Expectations are that with the restoration of the native vegetation, soil condition and natural hydrologic processes will improve and lead to further enhancement of vegetation and, over time, an increase in biodiversity of flora and fauna. To evaluate the management strategies in reaching these expectations, a comprehensive monitoring and evaluation program was developed. The main objectives of this program are to (1) monitor the status and trends of indicator species, (2) improve desert ecosystem understanding, (3) assess the effects of human activities, and (4) provide science-based management recommendations. Using a random stratified survey design, a diverse suite of survey methods will be implemented, including belt and quadrant transects, camera traps, GPS tracking devices, and drones. Data will be gathered on biotic parameters (plant and animal diversity, density, and distribution) and abiotic parameters (humidity, temperature, precipitation, wind, air, soil quality, vibrations, and noise levels) to meet the goals of the monitoring program. This case study intends to provide a detailed overview of the management plan and monitoring program of two royal reserves and outlines the types of data gathered which can be made available for future research projects.

Keywords: camera traps, desert ecosystem, enhancement, GPS tracking, management evaluation, monitoring, planting, restocking, restoration

Procedia PDF Downloads 117

Authors: Alireza Karimi

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Artificial Intelligence (AI) is reshaping various industries, and accounting is no exception. With the ability to process vast amounts of data quickly and accurately, AI is revolutionizing how financial professionals manage, analyze, and report financial information. In this article, we will explore the diverse applications of AI in accounting and its profound impact on the field. Automation of Repetitive Tasks: One of the most significant contributions of AI in accounting is automating repetitive tasks. AI-powered software can handle data entry, invoice processing, and reconciliation with minimal human intervention. This not only saves time but also reduces the risk of errors, leading to more accurate financial records. Pattern Recognition and Anomaly Detection: AI algorithms excel at pattern recognition. In accounting, this capability is leveraged to identify unusual patterns in financial data that might indicate fraud or errors. AI can swiftly detect discrepancies, enabling auditors and accountants to focus on resolving issues rather than hunting for them. Real-Time Financial Insights: AI-driven tools, using natural language processing and computer vision, can process documents faster than ever. This enables organizations to have real-time insights into their financial status, empowering decision-makers with up-to-date information for strategic planning. Fraud Detection and Prevention: AI is a powerful tool in the fight against financial fraud. It can analyze vast transaction datasets, flagging suspicious activities and reducing the likelihood of financial misconduct going unnoticed. This proactive approach safeguards a company's financial integrity. Enhanced Data Analysis and Forecasting: Machine learning, a subset of AI, is used for data analysis and forecasting. By examining historical financial data, AI models can provide forecasts and insights, aiding businesses in making informed financial decisions and optimizing their financial strategies. Artificial Intelligence is fundamentally transforming the accounting profession. From automating mundane tasks to enhancing data analysis and fraud detection, AI is making financial processes more efficient, accurate, and insightful. As AI continues to evolve, its role in accounting will only become more significant, offering accountants and finance professionals powerful tools to navigate the complexities of modern finance. Embracing AI in accounting is not just a trend; it's a necessity for staying competitive in the evolving financial landscape.

Keywords: artificial intelligence, accounting automation, financial analysis, fraud detection, machine learning in finance

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Authors: Nupur A. D., Miah M. S., Moniruzzaman S. K.

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Autism is a neurobiological disorder that affects physical, social, and language skills of a person. A child with autism feels difficulty for processing, integrating, and responding to sensory stimuli. Current estimates have shown that 45% to 96 % of children with Autism Spectrum Disorder demonstrate sensory difficulties. As autism is a worldwide burning issue, it has become a highly prioritized and important service provision in Bangladesh. The sensory deficit does not only hamper the normal development of a child, it also hampers the learning process and functional independency. The purpose of this study was to find out the prevalence of sensory dysfunction among children with autism and recognize common patterns of sensory dysfunction. A cross-sectional study design was chosen to carry out this research work. This study enrolled eighty children with autism and their parents by using the systematic sampling method. In this study, data were collected through the Short Sensory Profile (SSP) assessment tool, which consists of 38 items in the questionnaire, and qualified graduate Occupational Therapists were directly involved in interviewing parents as well as observing child responses to sensory related activities of the children with autism from four selected autism centers in Dhaka, Bangladesh. All item analyses were conducted to identify items yielding or resulting in the highest reported sensory processing dysfunction among those children through using SSP and Statistical Package for Social Sciences (SPSS) version 21.0 for data analysis. This study revealed that almost 78.25% of children with autism had significant sensory processing dysfunction based on their sensory response to relevant activities. Under-responsive sensory seeking and auditory filtering were the least common problems among them. On the other hand, most of them (95%) represented that they had definite to probable differences in sensory processing, including under-response or sensory seeking, auditory filtering, and tactile sensitivity. Besides, the result also shows that the definite difference in sensory processing among 64 children was within 100%; it means those children with autism suffered from sensory difficulties, and thus it drew a great impact on the children’s Daily Living Activities (ADLs) as well as social interaction with others. Almost 95% of children with autism require intervention to overcome or normalize the problem. The result gives insight regarding types of sensory processing dysfunction to consider during diagnosis and ascertaining the treatment. So, early sensory problem identification is very important and thus will help to provide appropriate sensory input to minimize the maladaptive behavior and enhance to reach the normal range of adaptive behavior.

Keywords: autism, sensory processing difficulties, sensory profile, occupational therapy

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Authors: Uwizera Egide

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Introduction: Dermatological conditions are one of the most burdensome diseases in our health system. Global studies suggest that around 1 in 3 people gets a skin disease at a certain point in their life, though this does not necessarily guarantee the urge to consult. For a high-ranking disease, it is surprising how there is not enough data to support its effect on the economy and the general health system impact. It is for that reason that this study’s aim is to identify the burden of dermatological conditions in Rwanda so as to have a general picture of what our population is going through in regards to dermatological conditions. Methods: We used a cross sectional retrospective study. Data were obtained from patient’s information recorded in an open clinic at CHUB in a period of six months from July to December of the year 2021. Results: The study had a total of 4600 patients who attended dermatology service in a period of six months from July to December of the year 2021. We found a list of 102 dermatological diseases that presented at variable rates. The most prevalent disease was atopic dermatitis, at a rate of 23%. About 90% of presented conditions had only one choice of treatment from the hospital pharmacy. Most patients who presented were between 18-35 years old and with a predominance of the female gender; the level of education was either secondary or University Degree in our study, 65.4% of patients who presented were female; the majority, around 45% were between 18-35 years old, mostly being single 56%. The majority came from Southern province as it is the location of the hospital. The insurance mostly used was community-based health insurance with 63.8%, followed by RSSB with 18.5%, MS/UR, and other private insurances. The frequency of group drugs prescribed among all dermatological medications, steroids were the most commonly given medications at a rate of 39%, followed by emollients, antibiotics, and antifungal. The drugs prescribed were mostly available in the pharmacy of CHUB, with 60% and 40% being found in pharmacies outside the hospital. Conclusion: Dermatological conditions are prevalent in all age groups and distributed through all socioeconomic classes. About 9.2% of patient who consulted CHUB in 2021 presented one Dermatological condition of which 40 % of prescribed medications is never found in Hospital urging a need to buy medication in private pharmacies with more expenses and a risk of not complying on prescribed medication if in case they can’t afford paying them outside the CHUB. This finding urges a need to avail all essential dermatological drugs in hospital pharmacies to allow our patients to get them for the proper compliance of prescribed drugs in the management of skin diseases.

Keywords: atopic dermatitis, CHUB (centre hopitalier univerisitaire de butare), dermatological condition, fungal infections

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Authors: Beom-Seok Ko, Yoo-Seok Kim, Woo-Sung Lim, Ku-Sang Kim, Hyun-Ah Kim, Jin-Sun Lee, An-Bok Lee, Jin-Gu Bong, Tae-Hyun Kim, Sei-Hyun Ahn

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Background: Breast conserving surgery (BCS) followed by radiation therapy is today standard therapy for early breast cancer. It is safe therapeutic procedure in early breast cancers, because it provides the same level of overall survival as mastectomy. There are a number of different types of incisions used to BCS. Avoiding scars on the breast is women’s desire. Numerous minimal approaches have evolved due to this concern. Periareolar incision is often used when the small tumor relatively close to the nipple. But periareolar incision has a disadvantages include limited exposure of the surgical field. In plastic surgery, various methods such as zigzag incisions have been recommended to achieve satisfactory esthetic results. Periareolar zigzag incision has the advantage of not only good surgical field but also contributed to better surgical scars. The purpose of this study was to evaluate the oncological safety of procedures by studying the status of the surgical margins of the excised tumor specimen and reduces the need for further surgery. Methods: Between January 2016 and September 2016, 148 women with breast cancer underwent BCS or mastectomy by the same surgeon in ASAN medical center. Patients with exclusion criteria were excluded from this study if they had a bilateral breast cancer or underwent resection of the other tumors or taken axillary dissection or performed other incision methods. Periareolar zigzag incision was performed and excision margins of the specimen were identified frozen sections and paraffin-embedded or permanent sections in all patients in this study. We retrospectively analyzed tumor characteristics, the operative time, size of specimen, the distance from the tumor to nipple. Results: A total of 148 patients were reviewed, 72 included in the final analysis, 76 excluded. The mean age of the patients was 52.6 (range 25-19 years), median tumor size was 1.6 cm (range, 0.2-8.8), median tumor distance from the nipple was 4.0 cm (range, 1.0-9.0), median excised specimen sized was 5.1 cm (range, 2.8-15.0), median operation time was 70.0 minute (range, 39-138). All patients were discharged with no sign of infection or skin necrosis. Free resection margin was confirmed by frozen biopsy and permanent biopsy in all samples. There were no patients underwent reoperation. Conclusions: We suggest that periareolar zigzag incision can provide a good surgical field to remove a relatively large tumor and may provide cosmetically good outcomes.

Keywords: periareolar zigzag incision, breast conserving surgery, breast cancer, resection margin

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Authors: Esther Yin-Nei Cho

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There is inconsistency among studies about whether there is an association between poverty and the subjective wellbeing of children. Some have found a positive association, though its magnitude could be limited, others have shown no association. One possible explanation for this inconsistency is that household income, an often-adopted measure of child poverty, may not accurately and stably reflect the actual life experience of children. Some studies have suggested, however, that material deprivation covering various dimensions of children’s lives could be a better measure of child poverty. Another possible explanation for the inconsistency is that the link between poverty and subjective wellbeing of children may not be that straightforward, as there could be underlying mechanisms, such as mediation and moderation, influencing its direction or strength. While a mediator refers to the mechanism through which an independent variable affects a dependent variable, a moderator changes the direction or strength of the relationship between an independent variable and a dependent variable. As suggested by empirical evidence, family relationships and friendships could be potential mediators or moderators of the link between poverty and subjective well-being: poverty affects relationships; relationships are an important element in children’s subjective well-being; and economic status affects child outcomes, though not necessarily subjective wellbeing, through relationships. Since the potential links have not been adequately understood, this study fills this gap by examining the possible role of family relationships and friendships as mediators or moderators between poverty (using child-derived material deprivation as measure) and the subjective wellbeing of children. Improving subjective wellbeing is increasingly considered as a policy goal. The finding of no or a limited association between poverty and subjective wellbeing of children could be a justification for less effort to improve poverty in this regard. But if the observed magnitude of that association is due to some underlying mechanisms at work, the effect of poverty may be underestimated and the potentially useful strategies that take into account both poverty and other mediators or moderators for improving children’s subjective well-being may be overlooked. Multiple mediation, and multiple moderation models, based on regression analyses, are performed to a sample of approximately 1,600 children, who are aged 10 to 15, from the wellbeing survey conducted by The Children’s Society in England from 2010 to 2011. Results show that the effect of children’s material deprivation on their subjective well-being is mediated by their family relationships and friendships. Moreover, family relationships are a significant moderator. It is found that the negative impact of child deprivation on subjective wellbeing could be exacerbated if family relationships are not going well, while good family relationships may prevent the further decline in subjective well-being. Policy implications of the findings are discussed. In particular, policy measures that focus on strengthening the family relationships or nurturing home environment through supporting household’s economic security and parental time with children could promote the subjective wellbeing of children.

Keywords: child poverty, mediation, moderation, subjective well-being of children

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Authors: Danni Cheng

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Background: Preclinical and epidemiological studies have reported potential protective effects of low-density lipoprotein cholesterol (LDL-C) lowering drugs on head and neck squamous cell cancer (HNSCC) survival, but the causality was not consistent. Genetic variants associated with LDL-C lowering drug targets can predict the effects of their therapeutic inhibition on disease outcomes. Objective: We aimed to evaluate the causal association of genetically proxied cholesterol-lowering drug targets and circulating lipid traits with cancer survival in HNSCC patients stratified by human papillomavirus (HPV) status using two-sample Mendelian randomization (MR) analyses. Method: Single-nucleotide polymorphisms (SNPs) in gene region of LDL-C lowering drug targets (HMGCR, NPC1L1, CETP, PCSK9, and LDLR) associated with LDL-C levels in genome-wide association study (GWAS) from the Global Lipids Genetics Consortium (GLGC) were used to proxy LDL-C lowering drug action. SNPs proxy circulating lipids (LDL-C, HDL-C, total cholesterol, triglycerides, apoprotein A and apoprotein B) were also derived from the GLGC data. Genetic associations of these SNPs and cancer survivals were derived from 1,120 HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) and 2,570 non-HPV-driven HNSCC patients in VOYAGER program. We estimated the causal associations of LDL-C lowering drugs and circulating lipids with HNSCC survival using the inverse-variance weighted method. Results: Genetically proxied HMGCR inhibition was significantly associated with worse overall survival (OS) in non-HPV-drive HNSCC patients (inverse variance-weighted hazard ratio (HR IVW), 2.64[95%CI,1.28-5.43]; P = 0.01) but better OS in HPV-positive OPSCC patients (HR IVW,0.11[95%CI,0.02-0.56]; P = 0.01). Estimates for NPC1L1 were strongly associated with worse OS in both total HNSCC (HR IVW,4.17[95%CI,1.06-16.36]; P = 0.04) and non-HPV-driven HNSCC patients (HR IVW,7.33[95%CI,1.63-32.97]; P = 0.01). A similar result was found that genetically proxied PSCK9 inhibitors were significantly associated with poor OS in non-HPV-driven HNSCC (HR IVW,1.56[95%CI,1.02 to 2.39]). Conclusion: Genetically proxied long-term HMGCR inhibition was significantly associated with decreased OS in non-HPV-driven HNSCC and increased OS in HPV-positive OPSCC. While genetically proxied NPC1L1 and PCSK9 had associations with worse OS in total and non-HPV-driven HNSCC patients. Further research is needed to understand whether these drugs have consistent associations with head and neck tumor outcomes.

Keywords: Mendelian randomization analysis, head and neck cancer, cancer survival, cholesterol, statin

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Authors: Yuliia Skrynnik

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This research focuses on the interaction of verbal, non-verbal, and super-verbal communicative components used by the speaker changing social roles in the marketing discourse. The changing/performing of social roles is implemented through communicative strategies and tactics, the structural, semantic, and linguo-pragmatic means of which are characterized by specific features and differ for the performance of either a role of a supplier or a customer. Communication within the marketing discourse is characterized by symmetrical roles’ relation between communicative opponents. The strategy of a supplier’s social role realization and the strategy of a customer’s role realization influence the discursive personality's linguistic repertoire in the marketing discourse. This study takes into account that one person can be both a supplier and a customer under different circumstances, thus, exploring the one individual who can be both a supplier and a customer. Cooperative and non-cooperative tactics are the instruments for the implementation of these strategies. In the marketing discourse, verbal and non-verbal behaviour of the speaker performing a customer’s social role is highly informative for speakers who perform the role of a supplier. The research methods include discourse, context-situational, pragmalinguistic, pragmasemantic analyses, the method of non-verbal components analysis. The methodology of the study includes 5 steps: 1) defining the configurations of speakers’ social roles on the selected material; 2) establishing the type of the discourse (marketing discourse); 3) describing the specific features of a discursive personality as a subject of the communication in the process of social roles realization; 4) selecting the strategies and tactics which direct the interaction in different roles configurations; 5) characterizing the structural, semantic and pragmatic features of the strategies and tactics realization, including the analysis of interaction between verbal and non-verbal components of communication. In the marketing discourse, non-verbal behaviour is usually spontaneous but not purposeful. Thus, the adequate decoding of a partner’s non-verbal behavior provides more opportunities both for the supplier and the customer. Super-verbal characteristics in the marketing discourse are crucial in defining the opponent's social status and social role at the initial stage of interaction. The research provides the scenario of stereotypical situations of the play of a supplier and a customer. The performed analysis has perspectives for further research connected with the study of discursive variativity of speakers' verbal and non-verbal behaviour considering the intercultural factor influencing the process of performing the social roles in the marketing discourse; and the formation of the methods for the scenario construction of non-stereotypical situations of social roles realization/change in the marketing discourse.

Keywords: discursive personality, marketing discourse, non-verbal component of communication, social role, strategy, super-verbal component of communication, tactic, verbal component of communication

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Authors: Priyal Sepaha

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A refugee crisis is manifested by challenges, both for the refugees and the asylum giving state. The situation turns into a mega-crisis when the situation is prejudicially handled by the home state, inappropriate refugee laws, exploding refugee population, and above all, no hope of any foreseeable solution or remedy. This paper studies the impact on the capability of stateless Rohingyas to migrate and seek refuge due to the enforcement of rigid criteria of movement imposed both by Myanmar as well as the adjoining countries in the name of national security. This theoretical study identifies the issues and the key factors and players which have precipitated the crisis. It further discusses the possible ramifications in the home, asylum giving, and the adjoining countries for not discharging their roles aptly. Additionally, an attempt has been made to understand the scarce response given to the impending crisis by the regional organizations like SAARC, ASEAN and CHOGAM as well as international organizations like United Nations Human Rights Council, Security Council, Office of High Commissioner for Refugees and so on, in the name of inadequacy of monetary funds and physical resources. Based on the refugee laws and practices pertaining to the case of Rohingyas, this paper analyses that the Rohingya Crisis is in dire need of an effective action plan to curb and resolve the biggest humanitarian crisis situation of the century. This mounting human tragedy can be mitigated permanently, by strengthening existing and creating new interdependencies among all stakeholders, as further ignorance can drive the countries of the Indian Sub-continent, in particular, and South East Asia, by and large into a violent civil war for seizing long-awaited civil rights by the marginalized Rohingyas. To curb this mass crisis, it will require the application of coercive pressure and diplomatic pursuance on the home country to acknowledge the rights of its fleeing citizens. This further necessitates mustering adequate monetary funds and physical resources for the asylum providing state. Additional challenges such as devising mechanisms for the refugee’s safe return, comprehensive planning for their holistic economic development and rehabilitation plan are needed. These, however, can only come into effect with a conscious strive by the regional and international community to fulfil their assigned role.

Keywords: asylum, citizenship, crisis, humanitarian, human rights, refugee, rohingya

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Authors: Soma Sarkar

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A number of authors have recently argued that there are strong links between ecosystem services and sustainable development, particularly development efforts that aim to reduce rural poverty. We see two distinct routes by which the science of ecosystem services can contribute to both nature conservation and sustainable development. First, a thorough accounting of ecosystem services and a better understanding of how and at what rates ecosystems produce these services can be used to motivate payment for nature conservation. At least part of the generated funds can be used to compensate people who suffer lost economic opportunities to protect these services. For example, if rural poor are asked to take actions that reduce farm productivity to protect and regulate water supply, those farmers could be compensated for the reduced productivity they experience. When the benefits of natural ecosystems are explicitly quantified, those benefits are more valued both by the people who directly interact with the ecosystems and the governmental and other agencies that would have to pay for substitute sources of these services if these ecosystems should become impaired. Appreciating the value of ecosystem services can motivate increased conservation investment to prevent having to pay for substitutes later. This approach could be characterized as a ‘‘government investment’’ approach because the payments will generally come from beneficiaries outside of the local area, and a governmental or other agency is typically responsible for collecting and redistributing the funds. Second, a focus on the conservation of ecosystem services could improve the success of projects that attempt to both conserve nature and improve the welfare of the rural poor by fostering markets for the goods and services that local people produce or extract from ecosystems. These projects could be characterized as more ‘‘community based’’ because the goal is to foster the more organic, or grassroots, development of cottage industries, such as ecotourism, or the production of non-timber forest products, that are enhanced by better protection of local ecosystems. Using this framework, we discuss the factors that may have contributed to failure or success for several projects in the district of Purulia, one of the most backward districts of India and inhabited by indigenous group of people. A large majority of people in this district are dependent on environment based incomes for their sustenance. The erosion of natural resource base owing to poor governance in the district has led to the reductions in the household incomes of these people. The scale of our analysis is local or project level. The plight of poor has little to do with the production functions of ecosystem services. But for rural poor, at the local level, the status of ecosystem services can make a big difference in their daily lives.

Keywords: ecosystem services, governance, rural poor, community based natural resource management

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Authors: Tim Crocker-Buque, Sandra Mounier-Jack, Natasha Howard

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Background: Due to both the increasing scale and speed of urbanisation, urban areas in low and middle-income countries (LMICs) host increasingly large populations of under-immunized children, with the additional associated risks of rapid disease transmission in high-density living environments. Multiple interdependent factors are associated with these coverage disparities in urban areas and most evidence comes from relatively few countries, e.g., predominantly India, Kenya, Nigeria, and some from Pakistan, Iran, and Brazil. This study aimed to identify, describe, and assess the main tools used to measure or improve coverage of immunisation services in poor urban areas. Methods: Authors used a qualitative review design, including academic and non-academic literature, to identify tools used to improve coverage of public health interventions in urban areas. Authors selected and extracted sources that provided good examples of specific tools, or categories of tools, used in a context relevant to urban immunization. Diagnostic (e.g., for data collection, analysis, and insight generation) and programme tools (e.g., for investigating or improving ongoing programmes) and interventions (e.g., multi-component or stand-alone with evidence) were selected for inclusion to provide a range of type and availability of relevant tools. These were then prioritised using a decision-analysis framework and a tool selection guide for programme managers developed. Results: Authors reviewed tools used in urban immunisation contexts and tools designed for (i) non-immunization and/or non-health interventions in urban areas, and (ii) immunisation in rural contexts that had relevance for urban areas (e.g., Reaching every District/Child/ Zone). Many approaches combined several tools and methods, which authors categorised as diagnostic, programme, and intervention. The most common diagnostic tools were cross-sectional surveys, key informant interviews, focus group discussions, secondary analysis of routine data, and geographical mapping of outcomes, resources, and services. Programme tools involved multiple stages of data collection, analysis, insight generation, and intervention planning and included guidance documents from WHO (World Health Organisation), UNICEF (United Nations Children's Fund), USAID (United States Agency for International Development), and governments, and articles reporting on diagnostics, interventions, and/or evaluations to improve urban immunisation. Interventions involved service improvement, education, reminder/recall, incentives, outreach, mass-media, or were multi-component. The main gaps in existing tools were an assessment of macro/policy-level factors, exploration of effective immunization communication channels, and measuring in/out-migration. The proposed framework uses a problem tree approach to suggest tools to address five common challenges (i.e. identifying populations, understanding communities, issues with service access and use, improving services, improving coverage) based on context and available data. Conclusion: This study identified many tools relevant to evaluating urban LMIC immunisation programmes, including significant crossover between tools. This was encouraging in terms of supporting the identification of common areas, but problematic as data volumes, instructions, and activities could overwhelm managers and tools are not always suitably applied to suitable contexts. Further research is needed on how best to combine tools and methods to suit local contexts. Authors’ initial framework can be tested and developed further.

Keywords: health equity, immunisation, low and middle-income countries, poverty, urban health

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Authors: Woolfrey K., Woolfrey M., Bolton C. L., Warchuk D.

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Objectives: Osteoarthritis is the most common joint disease of adults worldwide. Despite total knee arthroplasty (TKA) demonstrating high levels of success, 20% of patients report dissatisfaction with their result. VOXX Wellness Stasis Socks are embedded with a proprietary pattern of neuro-receptor activation points that have been proven to activate a precise neuro-response, according to the pattern theory of haptic perception, which stimulates improvements in pain and function. The use of this technology in TKA patients may prove beneficial as an adjunct to recovery as many patients suffer from deficits to their proprioceptive system caused by ligamentous damage and alterations to mechanoreceptors during the procedure. We hypothesized that VOXX Wellness Stasis Socks are a safe, cost-effective, and easily scalable strategy to support TKA patients through their recovery. Design: Double-blinded, placebo-controlled randomized trial. Participants: Patients scheduled to receive TKA were considered eligible for inclusion in the trial. Interventions: Intervention group (I): VOXX Wellness Stasis socks containing receptor point-activation technology. Control group (C): VOXX Wellness Stasis socks without receptor point-activation technology. Sock use during the waking hours x 6 weeks. Main Outcome Measures: Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire completed at baseline, 2 weeks, and 6 weeks to assess pain, stiffness, and physical function. Results: Data analysis using SPSS software. P-values, effect sizes, and confidence intervals are reported to assess clinical relevance of the finding. Physical status classifications were compared using t-test. Within-subject and between-subject differences in the mean WOMAC were analyzed by ANOVA. Effect size was analyzed using Cramer’s V. Consistent improvement in WOMAC scores for pain and stiffness at 2 weeks post op in the I over the C group. The womac scores assessing physical function showed a consistent improvement at both 2 and 6 weeks post op in the I group compared to C group. Conclusions: VOXX proved to be a low cost, safe intervention in TKA to help patients improve with regard to pain, stiffness, and physical function. Disclosures: None

Keywords: osteoarthritis, RCT, pain management, total knee arthroplasty

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Authors: Farah Amalina Mohamed Affandi, Redhwan Ahmad Al-Naggar, Seok Mui Wang, Thanikasalam Kathiresan

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Gestational choriocarcinoma is a condition in which there is an abnormal growth or a tumor inside the women’s uterus after conception. It is a type of gestational trophoblastic disease which is relatively rare and malignant. The current epidemiological data of this disease are inadequate. The purposes of this study are to examine the epidemiology of choriocarcinoma and their risk factors based on all available population-based and hospital-based data of the disease. In this study, we searched The MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases using the keywords ‘choriocarcinoma’, ‘gestational’, ‘gestational choriocarcinoma’ and ‘epidemiology’. We included only human studies published in English between 1995 and 2015 to ensure up to date evidence. Case studies, case reports, animal studies, letters to the editor, news, and review articles were excluded. Retrieved articles were screened in three phases. In the first phase, any articles that did not match the inclusion criteria based solely on titles were excluded. In the second phase, the abstracts of remaining articles were screened thoroughly; any articles that did not meet our inclusion criteria were excluded. In the final phase, full texts of the remaining articles were read and assessed to exclude articles that did not meet the inclusion criteria or any articles that fulfilled the exclusion criteria. Duplicates articles were also removed. Systematic reviews and meta-analysis were excluded. Extracted data were summarized in table and figures descriptively. The reference lists of included studies were thoroughly reviewed in search for other relevant studies. A total of ten studies met all the selection criteria. Nine were retrospective studies and one was cohort study. Total numbers of 4563 cases of choriocarcinoma were reviewed from several countries which are Korea, Japan, South Africa, USA, New Mexico, Finland, Turkey, China, Brazil and The Netherlands. Different studies included different range of age with their mean age of 28.5 to 30.0 years. All studies investigated on the disease’s incidence rate, only two studies examined on the risk factors or associations of the disease. Approximately 20% of the studies showed a reduction in the incidence of choriocarcinoma while the other 80% showed inconsistencies in rate. Associations of age, fertility age, occupations and socio-demographic with the status remains unclear. There is limited information on the epidemiological aspects of gestational choriocarcinoma. The observed results indicated there was a decrease in the incidence rate of gestational choriocarcinoma globally. These could be due to the reduction in the incidence of molar pregnancy and the efficacy of the treatment, mainly by chemotherapy.

Keywords: epidemiology, gestational choriocarcinoma, incidence, prevalence, risk factor

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Authors: Peng Guo

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Objective: This study investigates the clinical characteristics of sleep disorders (SD) in patients with Alzheimer's disease (AD) and their relationship with cognitive impairment. Methods: According to the inclusion and exclusion criteria of AD, 460 AD patients were consecutively included in Beijing Tiantan Hospital from January 2016 to April 2022. Demographic data, including gender, age, age of onset, course of disease, years of education and body mass index, were collected. The Pittsburgh sleep quality index (PSQI) scale was used to evaluate the overall sleep status. AD patients with PSQI ≥7 was divided into AD with SD (AD-SD) group, and those with PSQI < 7 were divided into AD with no SD (AD-nSD) group. The overall cognitive function of AD patients was evaluated by the scales of Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA), memory was evaluated by the AVLT-immediate recall, AVLT-delayed recall and CFT-delayed memory scales, the language was evaluated by BNT scale, visuospatial ability was evaluated by CFT-imitation, executive function was evaluated by Stroop-A, Stroop-B and Stroop-C scales, attention was evaluated by TMT-A, TMT-B, and SDMT scales. The correlation between cognitive function and PSQI score in AD-SD group was analyzed. Results: Among the 460 AD patients, 173 cases (37.61%) had SD. There was no significant difference in gender, age, age of onset, course of disease, years of education and body mass index between AD-SD and AD-nSD groups (P>0.05). The factors with significant difference in PSQI scale between AD-SD and AD-nSD groups include sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleeping medication and daytime dysfunction (P<0.05). Compared with AD-nSD group, the total scores of MMSE, MoCA, AVLT-immediate recall and CFT-imitation scales in AD-SD group were significantly lower（P＜0.01，P＜0.01，P＜0.01，P＜0.05）. In AD-SD group, subjective sleep quality was significantly and negatively correlated with the scores of MMSE, MoCA, AVLT-immediate recall and CFT-imitation scales (r=-0.277，P=0.000; r=-0.216，P=0.004; r=-0.253，P=0.001; r=-0.239, P=0.004), daytime dysfunction was significantly and negatively correlated with the score of AVLT-immediate recall scale (r=-0.160，P=0.043). Conclusion The incidence of AD-SD is 37.61%. AD-SD patients have worse subjective sleep quality, longer time to fall asleep, shorter sleep time, lower sleep efficiency, severer nighttime SD, more use of sleep medicine, and severer daytime dysfunction. The overall cognitive function, immediate recall and visuospatial ability of AD-SD patients are significantly impaired and are closely correlated with the decline of subjective sleep quality. The impairment of immediate recall is highly correlated with daytime dysfunction in AD-SD patients.

Keywords: Alzheimer's disease, sleep disorders, cognitive impairment, correlation

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Authors: Terefe Fuge, George Tsourtos , Emma Miller

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Objectives: Maintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of adherence and viral suppression, as well as its associated factors in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors to this amongst prisoners in South Ethiopia. Methods: A prospective cohort study was conducted between June 1, 2019 and July 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration-related characteristics was collected using a structured questionnaire. Adherence was determined based on participants’ self-report and pharmacy refill records, and plasma viral load measurements which were undertaken within the study period were prospectively extracted to determine viral suppression. Various univariate and multivariate regression models were used to analyse data. Results: Self-reported dose adherence was approximately similar between ILWHA and non-incarcerated PLWHA (81% and 83% respectively), but ILWHA had a significantly higher medication possession ratio (MPR) (89% vs 75%). The prevalence of viral failure (VF) was slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31-35 years and in those who experienced social stigma, regardless of their incarceration status. Conclusions: This study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to doses and so to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors was found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

Keywords: Adherence , Antiretroviral therapy, Incarceration, South Ethiopia, Viral suppression

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Authors: Ana L. Gonzalez-Celis, Edgardo Ruiz-Carrillo, Karina Reyes-Jarquin, Margarita Chavez-Becerra

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Since recent decades, the aging has been viewed from a more positive perspective, where is not only about losses and damage, but also about being on a stage where you can enjoy life and live with well-being and quality of life. The challenge to feel better is to find those resources that seniors have. For that reason, psychological well-being has shown interest in the study of the affect and life satisfaction (hedonic well-being), while from a more recent tradition, focus on the development of capabilities and the personal growth, considering both as the main indicators of the quality of life. A resource that can be used in the later age is generativity, which refers to the ability of older people to develop and grow through activities that contribute with the improvement of the context in which they live and participate. In this way the generative interest is understood as a favourable attitude that contribute to the common benefit while strengthening and enriching the social institutions, to ensure continuity between generations and social development. On the other hand, generative behavior, differentiating from generative interest, is the expression of that attitude reflected in activities that make a social contribution and a benefit for generations to come. Hence the purpose of the research was to test if there is an association between the generative behaviour type and the psychological well-being with their dimensions. For this reason 188 Mexican adults from 60 to 94 years old (M = 69.78), 67% women, 33% men, completed two instruments: The Ryff’s Well-Being Scales to measure psychological well-being with 39 items with two dimensions (Hedonic and Eudaimonic well-being), and the Loyola’s Generative Behaviors Scale, grouped in five categories: Knowledge transmitted to the next generation, things to be remember, creativity, be productive, contribution to the community, and responsibility of other people. In addition, the socio-demographic data sheet was tested, and self-reported health status. The results indicated that the psychological well-being and its dimensions were significantly associated with the presence of generative behavior, where the level of well-being was higher when the frequency of some generative behaviour excelled; finding that the behavior with greater psychological well-being (M = 81.04, SD = 8.18) was "things to be remembered"; while with greater hedonic well-being (M = 73.39, SD = 12.19) was the behavior "responsibility of other people"; and with greater Eudaimonic well-being (M = 84.61, SD = 6.63), was the behavior "things to be remembered”. The most important findings highlight the importance of generative behaviors in adulthood, finding empirical evidence that the generativity in the last stage of life is associated with well-being. However, by finding differences in the types of generative behaviors at the level of well-being, is proposed the idea that generativity is not situated as an isolated construct, but needs other contextualized and related constructs that can simultaneously operate at different levels, taking into account the relationship between the environment and the individual, encompassing both the social and psychological dimension.

Keywords: eudaimonic well-being, generativity, hedonic well-being, Mexican elders, psychological well-being

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Authors: Salma A. Mahmoud

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Epigenetic, or alteration in gene expression influenced by extragenetic factors, has emerged as one of the most promising areas that will address some of the gaps in our current knowledge in understanding patterns of human variation. In the last decade, the research investigating epigenetic mechanisms in many fields has flourished and witnessed significant progress. It paved the way for a new era of integrated research especially between anthropology/archeology and life sciences. Skeletal remains are considered the most significant source of information for studying human variations across history, and by utilizing these valuable remains, we can interpret the past events, cultures and populations. In addition to archeological, historical and anthropological importance, studying bones has great implications in other fields such as medicine and science. Bones also can hold within them the secrets of the future as they can act as predictive tools for health, society characteristics and dietary requirements. Bones in their basic forms are composed of cells (osteocytes) that are affected by both genetic and environmental factors, which can only explain a small part of their variability. The primary objective of this project is to examine the epigenetic landscape/signature within bones of archeological remains as a novel marker that could reveal new ways to conceptualize chronological events, gender differences, social status and ecological variations. We attempted here to address discrepancies in common variants such as methylome as well as novel epigenetic regulators such as chromatin remodelers, which to our best knowledge have not yet been investigated by anthropologists/ paleoepigenetists using plethora of techniques (biological, computational, and statistical). Moreover, extracting epigenetic information from bones will highlight the importance of osseous material as a vector to study human beings in several contexts (social, cultural and environmental), and strengthen their essential role as model systems that can be used to investigate and construct various cultural, political and economic events. We also address all steps required to plan and conduct an epigenetic analysis from bone materials (modern and ancient) as well as discussing the key challenges facing researchers aiming to investigate this field. In conclusion, this project will serve as a primer for bioarcheologists/anthropologists and human biologists interested in incorporating epigenetic data into their research programs. Understanding the roles of epigenetic mechanisms in bone structure and function will be very helpful for a better comprehension of their biology and highlighting their essentiality as interdisciplinary vectors and a key material in archeological research.

Keywords: epigenetics, archeology, bones, chromatin, methylome

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Authors: Hanieh Sakha, Nader Nader, Haleh Farzin

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Introduction: Throughout history, pain theories have been supposed by biomedicine, especially regarding its diagnosis and treatment aspects. Therefore, the feeling of pain is not only a personal experience and is affected by social background; therefore, it involves extensive systems of signals. The challenges in emotional and sentimental dimensions of pain originate from scientific medicine (i.e., the dominant theory is also referred to as the specificity theory); however, this theory has accepted some alterations by emerging physiology. Then, Von Frey suggested the theory of cutaneous senses (i.e., Muller’s concept: the common sensation of combined four major skin receptors leading to a proper sensation) 50 years after the specificity theory. The pain pathway was composed of spinothalamic tracts and thalamus with an inhibitory effect on the cortex. Pain is referred to as a series of unique experiences with various reasons and qualities. Despite the gate control theory, the biological aspect overcomes the social aspect. Vrancken provided a more extensive definition of pain and found five approaches: Somatico-technical, dualistic body-oriented, behaviorist, phenomenological, and consciousness approaches. The Western model combined physical, emotional, and existential aspects of the human body. On the other hand, Kotarba felt confused about the basic origins of chronic pain. Freund demonstrated and argued with Durkhemian about the sociological approach to emotions. Lynch provided a piece of evidence about the correlation between cardiovascular disease and emotionally life-threatening occurrences. Helman supposed a distinction between private and public pain. Conclusion: The consideration of the emotional aspect of pain could lead to effective, emotional, and social responses to pain. On the contrary, the theory of embodiment is based on the sociological view of health and illness. Social epidemiology shows an imbalanced distribution of health, illness, and disability among various social groups. The social support and socio-cultural level can result in several types of pain. It means the status of athletes might define their pain experiences. Gender is one of the important contributing factors affecting the type of pain (i.e., females are more likely to seek health services for pain relief.) Chronic non-cancer pain (CNCP) has become a serious public health issue affecting more than 70 million people globally. CNCP is a serious public health issue which is caused by the lack of awareness about chronic pain management among the general population.

Keywords: pain, sociology, sociological, body

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Authors: Ye Sun, Han-Youl Lee, Kathy Musa-Veloso, Nabil Bosco

Abstract:

Japan has been experiencing global ageing of population with the World’s leading life expectancy (80.8 y for men and 86.9 y for women) and among the lowest birth rate. Preventive nutrition-based approaches have been identified by the health authorities as one of the strategies to increase the healthy life expectancy and reduce the healthcare costs. However, the nutritional needs and status of the senior population have not been well characterized to provide targeted solutions. This study aims to describe the age- and gender-specific prevalence of inadequacy of macro- and micronutrients intake based on the latest Japan National Health and Nutrition Survey (JNHNS) 2014. JNHNS collected data on the consumption of foods and beverages using 1-day semi-weight household dietary record. Nutrient intake levels were then calculated using the Japanese standard tables of food composition. Where applicable, Japanese population-specific estimated average requirements (EAR) were used as a benchmark to determine the prevalence of potential nutrient intake inadequacy, and adequate intake (AI) were used for nutrients with no available EARs. In all, 3403 senior adults aged 60 y and above and 3324 young adults aged 19 to 59 y were included in the 2014 JNHNS. Age- and gender-specific differences were observed in the mean nutrient intakes as well as the prevalence of inadequacy. Among the 22 nutrients examined, the prevalence of inadequacy for iron, vitamin C, magnesium, potassium, and folic acid in the senior adults was significantly lower than young adults, suggesting potentially healthier dietary choices by the seniors. However, there was still a considerable proportion of seniors who did not meet the requirement for key nutrients like vitamin B1 (67%), calcium (57%), vitamin A (48%), magnesium (47%), vitamin E (44%), and vitamin B6 (41%). Inadequate nutrient intake is generally more prevalent among elderly males than females for many nutrients, with the exception of iron (prevalence of inadequacy: 21% versus 42%) which could partly be explained by the higher intake recommendations for the females. In conclusion, high prevalence of nutrient inadequacy exists in older adults, with a potentially worsened picture for men. Such inadequacies could have multiple health implications including physical frailty and mental health. Further study is warranted to investigate the food consumption patterns that could explain the observed nutrient inadequacies, and to eventually develop nutrition-based solutions tailored to the needs of specific subgroups of the population.

Keywords: ageing, national health and nutrition survey, nutrients, nutrition

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Authors: Namrata Jain, Vishaka Karnad

Abstract:

Fashion has always fascinated people through ages. Indian women’s wear in particular women's western formal wear has gone through transformational phases during the past decade. Increasing number of working women, independence in deciding financial matters, media exposure and awareness of current trends has provided a different dimension to the apparel segment. With globalization and sharing of cultures, in India formal women’s wear is no longer restricted to ethnic outfits like a sari or salwarkameez. Strong western influence has been observed in the process of designing, production and use of western formal wear by working women as consumers. The present study focuses on the psychographics parameters, consumer buying preferences and their relation to the present market scenario. Qualitative and quantitative data was gathered through a observation, consumer survey and study of brands. A questionnaire was prepared and uploaded as a google form to gather primary data from hundred consumer respondents. The respondent samples were drawn through snowball and purposive sampling technique. Consumers’ buying behavior is influenced by various aspects like age group, occupation, income and their personal preferences. Frequency of use, criteria for brand selection, styles of formal wear and motivating factors for purchase of western formals by working women were the other influential factors under consideration. It was observed that higher consumption and more popularity was indicated by women in the age group of 21-30 years. Amongst western formal wear shirts and trousers were noted to be the most preferred in Mumbai. It may be noted that consumers purchased and used branded western formal wear for reasons of comfort and value for money. Past experience in using the product and price were some of the important criteria for brand loyalty but the need for variety lured consumers to look for other brands. Fit of the garment was rated as the most important motivational factor while selecting products for purchase. With the advancement of women’s economic status, self-reliance, women role and image in the society, impulsive buying has increased with increase in consumerism. There is an ever growing demand for innovations in cuts, styles, designs, colors and fabrics. The growing fashion consciousness at the work place has turned women’s formal wear segment into a lucrative and highly evolving market thus providing space for new entrepreneurs to become a part of this developing sector.

Keywords: buying behavior, consumerism, fashion, western formal wear

Procedia PDF Downloads 467

Authors: Elizabeth Laguaite, Alexandria Purdy

Abstract:

Heart transplant recipients face psycho-physiological stressors, including pain, lengthy hospitalizations, delirium, and existential crises. They pose an increased risk for Post Traumatic Stress Disorder (PTSD) and can be a predictor of poorer mental and physical Health-Related Quality of Life (HRQOL) outcomes and increased mortality. There is limited research on the prevention of Post Traumatic Stress Symptoms (PTSS) in transplant patients. This case report focuses on a collaborative Music and Art Therapy intervention used to improve outcomes for HMH transplant recipient John (Alias). John, a 58-year-old man with congestive heart failure, was admitted to HMH in February of 2021 with cardiogenic shock, cannulated with an Intra-aortic Balloon Pump, Impella 5.5, and Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a bridge to heart and kidney transplant. He was listed as status 1 for transplant. Music Therapy and Art Therapy (MT and AT) were ordered by the physician for mood regulation, trauma processing and anxiety management. During MT/AT sessions, John reported a history of anxiety and depression exacerbated by medical acuity, shortness of breath, and lengthy hospitalizations. He expressed difficulty sleeping, pain, and existential questions. Initially seen individually by MT/AT, it was determined he could benefit from a collaborative approach due to similar thematic content within sessions. A Life Review intervention was developed by MT/AT. The purpose was for him to creatively express, reflect and process his medical narrative, including the identification of positive and negative events leading up to admission at HMH, the journey to transplant, and his hope for the future. Through this intervention, he created artworks that symbolized each event and paired them with songs, two of which were composed with the MT during treatment. As of September 2023, John has not been readmitted to the hospital and expressed that this treatment is what “got him through transplant”. MT and AT can provide opportunities for a patient to reminisce through creative expression, leading to a shift in the personal meaning of these experiences, promoting resolution, and ameliorating associated trauma. The closer to trauma it is processed, the less likely to develop PTSD. This collaborative MT/AT approach could improve long-term outcomes by reducing mortality and readmission rates for transplant patients.

Keywords: art therapy, music therapy, critical care, PTSD, trauma, transplant

Procedia PDF Downloads 80