Search results for: general medical

Authors: Mariana Mangas, Yaroslava Martins, Ana Matos Pires

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Introduction: Stigmatization is a common problem to overcome for people suffering from chronic diseases. It usually follows mental disorders and complicates the course of illness and reduces quality of life for people with mental illness. Objective: unsystematic review concerning stigma and mental illness, its impact on psychiatric disease and strategies to eradicate stigma. Methods: A search was conducted on PubMed, using keywords 'stigma' and 'mental illness'. Results and Discussion: Stigma is a psychosocial process that identifies individuals by the negative label of their differences. Stigma often brings a loss of occupational success and social support, reduced functioning and lower quality of life. The sense of stigma is common in individuals with mental illness and has considerable negative repercussions: delays treatment achievement, promotes social isolation, stress and maladaptive coping behaviors and it is associated with higher symptom levels, placing these individuals at higher risk for a poorer outcome and prognoses. Conclusion: Given the interrelation between stigma, symptoms, treatment seeking and disease management, stigma is a key construct in mental illness upon which anti-stigma initiatives may have considerable therapeutic potential. It will take multidisciplinary interventions to overcome mental illness stigma, including changes in social policy, attitudes and practices among mental health professionals, liaison between general public and people with a mental illness under conditions of equity and parity, family support, and easy access to evidence-based treatments.

Keywords: discrimination, stigma, mental illness, quality of life

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Authors: Xian Chen

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In recent years, the tendency that the decline of material and social vitality of old city in China becomes more and more serious. Nowadays, transformation and renewal of the old city have become a hot topic in urban research. The traditional mode of large-scale promotion has been criticized. Thus, exploration of new ways to update the city turns to be a necessity on the way of sustainable urban development. Pocket Park is a small city open space, its location choose is based on abandoned or idle lands on urban structure, is scattered or hidden in corner of the urban. It has a great significance on improving the old city environment. Based on the theory of ‘pocket park’, this paper summarizes the successful experience of domestic and foreign practice, and discusses the update strategies which are suitable for China's national conditions according to the characteristics and predicament of the old city in China. The main methods and results are as follows: 1)Based on the conception of ‘pocket park’, though describing the research status in domestic and foreign, summarizing the experience which is worth learning and existing problems. 2) From the analysis of ‘pocket park’ function, general design principles and types of the deep-seated difficulties in renewal the old city and the possibility of the application of ‘pocket park’,the varied implementation of ‘pocket park’ form are established, and application value in the old city renewal are summed up. 3) It can’t be denied that pocket park plays an irreplaceable role in solving the recession and renewing the vitality of the old city. Anymore, It is recommended to develop corresponding supportive development policies.

Keywords: sustainable development, strategy, old city renewal, pocket park

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Authors: I. Stathopoulos, V. Syrgiamiotis, E. Karavasilis, A. Ploussi, I. Nikas, C. Hatzigiorgi, K. Platoni, E. P. Efstathopoulos

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Introduction: Brain and central nervous system (CNS) tumors form the second most common group of cancer in children, accounting for 30% of all childhood cancers. MRI is the key imaging technique used for the visualization and management of pediatric brain tumors. Initial characterization of tumors from MRI scans is usually performed via a radiologist’s visual assessment. However, different brain tumor types do not always demonstrate clear differences in visual appearance. Using only conventional MRI to provide a definite diagnosis could potentially lead to inaccurate results, and so histopathological examination of biopsy samples is currently considered to be the gold standard for obtaining definite diagnoses. Machine learning is defined as the study of computational algorithms that can use, complex or not, mathematical relationships and patterns from empirical and scientific data to make reliable decisions. Concerning the above, machine learning techniques could provide effective and accurate ways to automate and speed up the analysis and diagnosis for medical images. Machine learning applications in radiology are or could potentially be useful in practice for medical image segmentation and registration, computer-aided detection and diagnosis systems for CT, MR or radiography images and functional MR (fMRI) images for brain activity analysis and neurological disease diagnosis. Purpose: The objective of this study is to provide an automated tool, which may assist in the imaging evaluation and classification of brain neoplasms in pediatric patients by determining the glioma type, grade and differentiating between different brain tissue types. Moreover, a future purpose is to present an alternative way of quick and accurate diagnosis in order to save time and resources in the daily medical workflow. Materials and Methods: A cohort, of 80 pediatric patients with a diagnosis of posterior fossa tumor, was used: 20 ependymomas, 20 astrocytomas, 20 medulloblastomas and 20 healthy children. The MR sequences used, for every single patient, were the following: axial T1-weighted (T1), axial T2-weighted (T2), FluidAttenuated Inversion Recovery (FLAIR), axial diffusion weighted images (DWI), axial contrast-enhanced T1-weighted (T1ce). From every sequence only a principal slice was used that manually traced by two expert radiologists. Image acquisition was carried out on a GE HDxt 1.5-T scanner. The images were preprocessed following a number of steps including noise reduction, bias-field correction, thresholding, coregistration of all sequences (T1, T2, T1ce, FLAIR, DWI), skull stripping, and histogram matching. A large number of features for investigation were chosen, which included age, tumor shape characteristics, image intensity characteristics and texture features. After selecting the features for achieving the highest accuracy using the least number of variables, four machine learning classification algorithms were used: k-Nearest Neighbour, Support-Vector Machines, C4.5 Decision Tree and Convolutional Neural Network. The machine learning schemes and the image analysis are implemented in the WEKA platform and MatLab platform respectively. Results-Conclusions: The results and the accuracy of images classification for each type of glioma by the four different algorithms are still on process.

Keywords: image classification, machine learning algorithms, pediatric MRI, pediatric oncology

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Authors: Nalinee Sophatsathit

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The objectives of memorabilia of Suan Sunandha are to develop a general knowledge presentation about the historical royal garden through interactive graphic simulation technique and to employ high-functionality context in enhancing interactive user navigation. The approach infers non-intrusive display of relevant history in response to situational context. User’s navigation runs through the virtual reality campus, consisting of new and restored buildings. A flash back presentation of information pertaining to the history in the form of photos, paintings, and textual descriptions are displayed along each passing-by building. To keep the presentation lively, graphical simulation is created in a serendipity game play so that the user can both learn and enjoy the educational tour. The benefits of this human-computer interaction development are two folds. First, lively presentation technique and situational context modeling are developed that entail a usable paradigm of knowledge and information presentation combinations. Second, cost effective training and promotion for both internal personnel and public visitors to learn and keep informed of this historical royal garden can be furnished without the need for a dedicated public relations service. Future improvement on graphic simulation and ability based display can extend this work to be more realistic, user-friendly, and informative for all.

Keywords: interactive user navigation, high-functionality context, situational context, human-computer interaction

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Authors: Moulfi Bouchra, Ferouani Souheyla, Ziani Kerarti Djalal, Moulessehoul Wassila

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The wireless body network (WBAN) is the most interesting network these days and especially with the appearance of contagious illnesses such as covid 19, which require surveillance in the house. In this article, we have designed a circular microstrip antenna. Gold is the material used respectively for the patch and the ground plane and Gallium (εr=12.94) is chosen as the dielectric substrate. The dimensions of the antenna are 82.10*62.84 μm2 operating at a frequency of 3.85 THz. The proposed, designed antenna has a return loss of -46.046 dB and a gain of 3.74 dBi, and it can measure various physiological parameters and sensors that help in the overall monitoring of an individual's health condition.

Keywords: circular patch antenna, Terahertz transmission, WBAN applications, real-time monitoring

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Authors: Y. Ghiassi-Farrokhfal

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The number of electric vehicles (EVs) is increasing worldwide. Replacing gas fueled cars with EVs reduces carbon emission. However, the extensive energy consumption of EVs stresses the energy systems, requiring non-green sources of energy (such as gas turbines) to compensate for the new energy demand caused by EVs in the energy systems. To make EVs even a greener solution for the future energy systems, new EV charging stations are equipped with solar PV panels and batteries. This will help serve the energy demand of EVs through the green energy of solar panels. To ensure energy availability, solar panels are combined with batteries. The energy surplus at any point is stored in batteries and is used when there is not enough solar energy to serve the demand. While EV charging stations equipped with solar panels and batteries are green and ecologically optimal, they might not be financially viable solutions, due to battery prices. To make the system viable, we should size the battery economically and operate the system optimally. This is, in general, a challenging problem because of the stochastic nature of the EV arrivals at the charging station, the available solar energy, and the battery operating system. In this work, we provide a mathematical model for this problem and we compute the return on investment (ROI) of such a system, which is designed to be ecologically and financially optimal. We also quantify the minimum required investment in terms of battery and solar panels along with the operating strategy to ensure that a charging station has enough energy to serve its EV demand at any time.

Keywords: solar energy, battery storage, electric vehicle, charging stations

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Authors: Mushtaq H. Khan, Antonio Andreoni, Pallavi Roy

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Developing countries are characterized by political settlements where formal rules are generally weakly enforced and widely violated. Conventional anti-corruption strategies that focus on improving the general enforcement of a rule of law and raising the costs of corruption facing individual public officials have typically delivered poor results in these contexts. Our alternative approach is to identify anti-corruption strategies that have a high impact and that are feasible to implement in these contexts. Our alternative approach identifies anti-corruption strategies from the bottom up. This involves identifying the characteristics of the corruption constraining particular development outcomes. By drawing on theories of rents and rent seeking, and theories of political settlements, we can assess the developmental impact of particular anti-corruption strategies and the feasibility of implementing these strategies. We argue that feasible anti-corruption in these contexts cannot be solely based on conventional anti-corruption strategies. In societies that have widespread rule violations, high-impact anti-corruption is only likely to be feasible if the overall strategy succeeds in aligning the interests and capabilities of powerful organizations at the sectoral level to support the enforcement of particular sets of rules. We examine four related strategies for changing these incentives and capabilities of critical stakeholders at the local or sectoral level, and we argue that this can provide a framework for organizing research on the impact and feasibility of anti-corruption activities in different priority areas in particular countries.

Keywords: anti-corruption, development, political settlements analysis, rule of law

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Authors: Barrere Sarah

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The area of liberty, security, and justice within the European Union is still a work in progress. No one can deny that the EU struggles between a monistic and a dualist approach. The aim of our essay is to first review how the European law is perceived by the rest of the international scene. It will then discuss two main mechanisms at play: the interpretation of larger international treaties and the penal mechanisms of European law. Finally, it will help us understand the role of a penal Europe on the international scene with concrete examples. Special attention will be paid to cases that deal with fundamental rights as they represent an interesting case study in Europe and in the rest of the World. It could illustrate the aforementioned duality currently present in the Union’s interpretation of international public law. On the other hand, it will explore some specific European penal mechanism through mutual recognition and the European arrest warrant in the transnational criminality frame. Concerning the interpretation of the treaties, it will first, underline the ambiguity and the general nature of some treaties that leave the EU exposed to tension and misunderstanding then it will review the validity of an EU act (whether or not it is compatible with the rules of International law). Finally, it will focus on the most complete manifestation of liberty, security and justice through the principle of mutual recognition. Used initially in commercial matters, it has become “the cornerstone” of European construction. It will see how it is applied in judicial decisions (its main event and achieving success is via the European arrest warrant) and how European member states have managed to develop this cooperation.

Keywords: European penal law, international scene, liberty security and justice area, mutual recognition

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

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

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

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Authors: Kimberley K. Whyte-Jones

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Public participation may improve the quality of environmental management decisions. However, the quality of such a decision is strongly dependent on the quality of the process that leads to it. In order to ensure an effective and efficient process, key features of best practice in participation should be carefully observed; this would also combat disillusionment of citizens, decision-makers and practitioners. The overarching aim of this study is to determine what constitutes an effective public participation process relevant to the Newfoundland and Labrador, Canada context, and to discover whether the public participation process that led to the 2014-2024 Provincial Sustainable Forest Management Strategy (PSFMS) met best practices criteria. The research design uses an exploratory case study strategy to consider a specific participatory process in environmental decision-making in Newfoundland and Labrador. Data collection methods include formal semi-structured interviews and the review of secondary data sources. The results of this study will determine the validity of a specific public participation best practice framework. The findings will be useful for informing citizen participation processes in general and will deduce best practices in public participation in environmental management in the province. The study is, therefore, meaningful for guiding future policies and practices in the management of forest resources in the province of Newfoundland and Labrador, and will help in filling a noticeable gap in research compiling best practices for environmentally related public participation processes.

Keywords: best practices, environmental decision-making, forest management, public participation

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Authors: Kais Nasser, Ronit Levine-Schnur

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Due to the prolonged negligence of planning institutions, a large portion of Palestinian localities in Israel lack basic infrastructure, development, and urbanism and suffer from a severe shortage of housing. In the past years, planning institutions in Israel began to promote master planning for Palestinian localities and for new neighborhoods. Land readjustment plans (PLIs) were the primary planning mechanism. According to Israel’s planning institutions, readjustment plans aimed to afford housing and to ensure that new neighborhoods enjoy developed infrastructure, modern construction, public lands and urbanism. However, a wide group of Palestinian landowners and stakeholders opposed PLIs. This article exposes the reasons behind such objections. Methodology: The research carried out an in-depth analysis of approximately 1,780 objections to PLIs that have been advanced in recent years. These objections reveal what really concerns landowners, what they defend indeed, and how planning institutions dealt with their arguments. Initial Findings: Exploring the objections submitted by landowners to readjustment plans reveals a conceptual and cultural conflict between landowners and the planning institutions. While planning institutions believe that these plans can transform landowners and Arab society in general from a rural, local, and conservative life to a modern- urban life, the landowners believe that planning institutions strive to change their way of life and force them to adopt an urban life without giving much attention and respect to their tradition, habits and cultural way of life.

Keywords: land readjustment, culture, urbanization, minority

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Authors: Vidishaa Jali, Amit Sinha, Kameshwar Prasad

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Background and Objective: Cerebral microbleeds are frequently found in healthy elderly individuals. We performed a meta- analysis to determine the prevalence of cerebral microbleeds in apparently healthy, elderly population and to determine the effect of age, smoking and hypertension on the occurrence of cerebral microbleeds. Methods: Relevant literature was searched using electronic databases such as MEDLINE, EMBASE, PubMed, Cochrane database, Google scholar to identify studies on the prevalence of cerebral microbleeds in general elderly population till March 2016. STATA version 13 software was used for analysis. Fixed effect model was used if heterogeneity was less than 50%. Otherwise, random effect model was used. Meta- regression analysis was performed to check any effect of important variables such as age, smoking, hypertension. Selection Criteria: We included cross-sectional studies performed in apparently healthy elderly population, who had age more than 50 years. Results: The pooled proportion of cerebral microbleeds in healthy population is 12% (95% CI, 0.11 to 0.13). No significant effect of age was found on the prevalence of cerebral microbleeds (p= 0.99). A linear relationship between increase in hypertension and the prevalence of cerebral microbleeds was found, however, this linear relationship was not statistically significant (p=0.16). Similarly, A linear relationship between increase in smoking and the prevalence of cerebral microbleeds was found, however, this linear relationship was also not statistically significant (p=0.21). Conclusion: Presence of cerebral microbleeds is evident in apparently healthy, elderly population, in more than 10% of individuals.

Keywords: apparently healthy, elderly, prevalence, cerebral microbleeds

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Authors: Elina Brahma Hazarika, Jeuti Basumatary, Deepanka Saikia, Jaydeep Das, Micky Moni D'mary, Fungkha Basumatary

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This study includes development of two varieties of biscuits incorporated with: the seeds of Jack fruit (Artocarpus heterophyllus), which post-consumption of it’s pulp, is discarded as a waste, and Cassava (Manihot esculenta) tubers.The jack fruit seeds and cassava were first ground into flour and its proximate and physiochemical properties were studied. The biscuits that were developed incorporating them had 50% wheat flour and 50% jackfruit seed flour and 50% cassava flours as the major composition, apart from the other general ingredients use in making biscuits. Various trials of compositions were made for baking to get the overall desirable acceptability in biscuits through sensory evaluation. Finally, the best composition of ingredients was selected to make the biscuits, and hence studies were done accordingly to compare it with the properties of their respective raw flours. The results showed that the proximate composition of the biscuits fared better than that of their respective flours: There was a decrease in the Moisture content of both Jackfruit Seed Biscuits and Cassava Biscuits to 4.5% and 6.7% than that of their respective raw flours (8 and 12%). Post-baking, there is increase in the percentages of ash, protein, and fibre contents in both Jackfruit Seed Biscuits and Cassava Biscuits; the values being 3% and 3.8%, 13.2% and 3.3%, and 3.2 and 4.1% respectively. Also the total carbohydrate content in Jackfruit Seed Biscuits and Cassava Biscuits were 66.7% and 71.7% respectively. Their sensory evaluation and texture study also yielded a clear review that they have an overall good acceptability.

Keywords: baking, proximate, sensory, texture

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Authors: Mohammad Sharifi Bohlouli

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Turkish language with many dialects is native or official language of great number of people all around the world. The Qashqaie dialect of Turkish language is spoken by the Qashqaie tribe mostly scattered in the southern part of Iran. This paper aims at analyzing the tense system of this dialect to detect the type and number of tense and aspects available to its speakers. To collect a reliable data, a group of 50 old native speakers were randomly chosen as the informants and different techniques such as; Shuy et al interviews, selective listening ,and eavesdropping were used. The results of data analysis showed that the tense system in the Qashqaie dialect of Turkish language includes 3 absolute tenses , 6 aspectual , and 2 subjunctive ones. The interesting part of the study is that Qashqaie dialect enables its speakers to make a kind of aspectual opposition through verb structure which seems to be almost impossible through verb forms in any other nonturkish languages. For example in the following examples sentences 1 &2 and 3&4 have the same translation In English although they are different in both meaning and structure. 1. Ali ensha yazirdi. 2. Ali ensha yazirmush. (Ali was writing a composition.) 3. Ali yadmishdi. 4. Ali yadmishimish. ( Ali had slept.) The changes in the verb structure in Qashqaie dialect enables its speakers to say that whether the doer of the action remembers the process of doing the action or not. So, it presents a new aspectual opposition as Observed /nonobserved. The research findings reveal many other regularities and linguistic features that can be useful for linguists interested in Turkish in general and for those interested in tense and aspect and also they can be helpful for different pedagogical purposes including teaching and translating.

Keywords: qashqaie dialect, tense, aspect, linguistics, Turkish Language

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Authors: Abdel-Tawab H. Mossa

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Synthetic pesticides are widely used in large-scale worldwide for control pests in agriculture and public health sectors in both developed and developing countries. Although the positive role of pesticides, they have many adverse toxic effects on humans, animals, and the ecosystem. Therefore, in the last few years, scientists have been searching for new active compounds from natural resources as an alternative to synthetic pesticides. Currently, many commercial natural pesticides are available commercially worldwide. These products are recommended for uses in organic farmers and considered as safe pesticides. This paper focuses on the adverse effects of natural pesticides on mammals. Available commercial pesticides in the market contain essential oils (e.g. pepper, cinnamon, and garlic), plant extracts, microorganism (e.g. bacteria, fungi or their toxin), mineral oils and some active compounds from natural recourses e.g. spinosad, neem, pyrethrum, rotenone, abamectin and other active compounds from essential oils (EOs). Some EOs components, e.g., thujone, pulegone, and thymol have high acute toxicity (LD50) is 87.5, 150 and 980 mg/kg. B.wt on mice, respectively. Natural pesticides such as spinosad, pyrethrum, neem, abamectin, and others have toxicological effects to mammals and ecosystem. These compounds were found to cause hematotoxicity, hepato-renal toxicity, biochemical alteration, reproductive toxicity, genotoxicity, and mutagenicity. It caused adverse effects on the ecosystem. Therefore, natural pesticides in general not safe and have high acute toxicity and can induce adverse effects at long-term exposure.

Keywords: natural pesticides, toxicity, safety, genotoxicity, ecosystem, biochemical

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Authors: Rafael Ricieri, Rogerio Barros, Francisco Clovis

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Objective– The Objective of this is study is to report a rare case of dermoid cyst, with a sublingual location and cutaneous fistula in a 4 year-old child.Methods: This study is a case report. The main study instrument was the medical record and the radiological and intraoperative image bank. Results: Infants with congenital cervical lesions eventually need tomography for diagnostic elucidation, and health services should be structured to perform sedation and thin tomographic sections in order to reduce morbidity.

Keywords: congenital, sublingual dermoid cyst, fistula, pediatric surgery, head and kneck surgery

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Authors: Jocelyn Lachance, Francis Jauréguiberry

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In a few years, the exceptionality of the situation of an individual who could be reached at any time and at any time was replaced by the normality of instantly hearing the voice or immediately seeing the face of the person. This participates in the transformation of our representations of time and space, which gives rise to new expectations. Expectations that parents formulate more or less clearly to their children. The obligation to remain reachable seems to be asserting itself as a general norm which, having imposed itself on adults, now extends to the youngest. In the case of parents and their children, the rationale for this ongoing connection is not always based on actual and imminent dangers. It is the potential for dangerous events that underpins the indisputable argument for the importance of remaining reachable. It is the contingent nature of the risks that imposes itself on these young people as an argument of authority. By entering this connected world, the younger generations also end up adhering in many cases to this reassuring standard of connection. Many teenagers in ours researches nonetheless firmly believe that their freedom of movement is subject to the obligation to carry their smartphone with them. In this way, a connection "pact" is generally established, concluded under pressure, which implies first and foremost that contact be possible at any time, hence the importance of keeping it within reach, and often of '' be attentive to calls and texts sent by parents, at the risk of losing a recently acquired freedom. In this context, if adolescents are growing up in a connected world today, it is also because of the connection the parents are expecting from them. In our conference, by evoking situations reported by teenagers and parents of teenagers during our surveys, we propose to think about the role of the parents in making their child connected and about the desire of the disconnection of the teens.

Keywords: connection, disconnection, smartphone, parents, ritual

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Authors: Syed Asif Hassan, Tabrej Khan

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The use of traditional medicines for the treatment of various diseases as well as maintaining a healthy lifestyle has gained a significant acceptance across the globe. The increasing popularity of Herbal Medicine can be owed to the fact that is relatively inexpensive and has lesser side effects as compared to general medicines. The Kingdom of Saudi Arabia has a rich heritage of herbal medicine for overages. However, the information about essential traditional herbs of Arabian origin and their implication in the treatment of various diseases are not well documented in an organized manner. Therefore, the requirement of a local platform (database system) for herbal medicines of Arab origin is the need of the day. In this context, various questionnaire and surveys were conducted over a period of 6 months. The surveys were targeted to identify a range of herbal remedies used by the communities of Saudi Arabia e.g., pharmacists and local people. The survey leads us to identify many of the mysterious local medicinal herbs used for the treatment of various ailments and thus reveals a unique insight into the natural herbal resource of Saudi Arabia. The information of the herbal medicines will be further used to develop a Saudi herbal database system using the principles of waterfall method. An interactive dynamic electronic web portal of the herbal database system will be built using MySQL and PHP for accessing the information available in the Saudi herbal database system. The web portal will be a step forward in creating awareness among the Arab nationals of their rich herbal heritage.

Keywords: Saudi herbal medicine, community survey, database system and design, MySQL, PHP

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Authors: Simin Khodabakhshi, Hossein Rassi

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Hyperlipidemia refers to any of several acquired or genetic disorders that result in a high level of lipids circulating in the blood. Helicobacter pylori infection is a contributing factor in the progression of hyperlipidemia with serum lipid changes. The aim of this study was to detect of Helicobacter pylori by PCR and serological methods in patients with hyperlipidemia. In this case-control study, 174 patients with hyperlipidemia and 174 healthy controls were studied. Also, demographics, physical and biochemical parameters were performed in all samples. The DNA extracted from blood specimens was amplified by H pylori cagA specific primers. The results show that H. pylori cagA positivity was detected in 79% of the hyperlipidemia and in 56% of the control group by ELISA test and 49% of the hyperlipidemia and in 24% of the control group by PCR test. Prevalence of H. pylori infection was significantly higher in hyperlipidemia as compared to controls. In addition, patients with hyperlipidemia had significantly higher values for triglyceride, total cholesterol, LDL-C, waist to hip ratio, body mass index, diastolic and systolic blood pressure and lower levels of HDL-C than control participants (all p < 0.0001). Our result detected the ELISA was a rapid and cost-effective detection and considering the high prevalence of cytotoxigenic H. pylori strains, cag A is suggested as a promising target for PCR and ELISA tests for detection of infection with toxigenic strains. In general, it can be concluded that molecular analysis of H. pylori cagA and clinical parameters are important in early detection of hyperlipidemia and atherosclerosis with H. pylori infection by PCR and ELISA tests.

Keywords: Helicobacter pylori, hyperlipidemia, PCR, ELISA

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Authors: Amirreza Razzaghipour Sorkhab

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One of the most common disorders among humans is hearing impairment. This paper provides an evidence base that recovers understanding of Meniere’s disease and highlights the physical and mental health correlates of the disorder. Meniere's disease is more common in the elderly. The term idiopathic endolymphatic hydrops has been attributed to this disease by some in the previous. Meniere’s disease demonstrations a genetic tendency, and a family history is found in 10% of cases, with an autosomal dominant inheritance pattern. The COCH gene may be one of the hereditary factors contributing to Meniere’s disease, and the possibility of a COCH mutation should be considered in patients with Meniere’s disease symptoms. Should be considered Missense mutations in the COCH gene cause the autosomal dominant sensorineural hearing loss and vestibular disorder. Meniere’s disease is a complex, heterogeneous disorder of the inner ear and that is characterized by episodes of vertigo lasting from minutes to hours, fluctuating sensorineural hearing loss, tinnitus, and aural fullness. The existing evidence supports the suggestion that age and sleep disorder are risk factors for Meniere's disease. Many factors have been reported to precipitate the progress of Menier, including endolymphatic hydrops, immunology, viral infection, inheritance, vestibular migraine, and altered intra-labyrinthine fluid dynamics. Although there is currently no treatment that has a proven helpful effect on hearing levels or on the long-term evolution of the disease, however, in the primary stages, the hearing may improve among attacks, but a permanent hearing loss occurs in the majority of cases. Current publications have proposed a role for the intratympanic use of medicine, mostly aminoglycosides, for the control of vertigo. more than 85% of patients with Meniere's disease are helped by either changes in lifestyle and medical treatment or minimally aggressive surgical procedures such as intratympanic steroid therapy, intratympanic gentamicin therapy, and endolymphatic sac surgery. However, unilateral vestibular extirpation methods (intratympanic gentamicin, vestibular nerve section, or labyrinthectomy) are more predictable but invasive approaches to control the vertigo attacks. Medical therapy aimed at reducing endolymph volume, such as low-sodium diet, diuretic use, is the typical initial treatment.

Keywords: meniere's disease, endolymphatic hydrops, hearing loss, vertigo, tinnitus, COCH gene

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Authors: Charity Ngoatle, Tebogo M. Mothiba, Mahlapahlapana J. Themane

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Misapprehension of medications instructions due to poor health literacy is common in diabetic patients, predominantly leading to suboptimal medication therapy caused by taking less than expected, or getting inadequate medication concentration. Globally, 50% of adults have been reported to have misunderstood medication instructions which could be the cause of not using medication as prescribed. Reading material has been found not to improve people’s knowledge to the extent where they would be informed and knowledgeable about their health. This, therefore, depicts that instructive materials alone cannot improve health literacy but further patient education is still needed to explain what the information really mean. The aim of this study was to investigate patients’ interpretation of prescribed medication instructions at Makanye Clinic in Limpopo Province, South Africa. The study used a mixed method approach. A non-probability purposive and simple random sampling strategies will be used to select ten (10) participants for the pilot study. Semi-structured interviews with a guide and self- administered structured questionnaires will be used to collect data. Tesch’s eight steps for qualitative data analysis and SPSS version 24 with descriptive statistics will be adopted. The preliminary findings from other studies show that: (a) poor health literacy negatively affect medication adherence, (b) general literacy influence health literacy, and (c) there are poor health outcomes and medication adverse effects due to poor medication comprehension.

Keywords: instructions, diabetes mellitus, patients, prescribed medication

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Authors: Sanam Mujahid, Aliza Ahmad

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Women education and empowerment has fundamental importance in the development of a civilized society however, in a developing country like Pakistan, there are serious challenges in this regard. Herein, we summarize the findings of 2012 study which revealed the key problems associated with women education and their proposed solutions. A survey tool was used to question female students and female faculty members in 20 different public sector universities of all four provinces of Pakistan. In this study, 1755 female students and 410 female faculty members responded. In addition to survey, semi-structured interview were also conducted with 25 female students and 10 female faculty members. Respondents of the survey emphasize the lack of adequate educational institutions in nearby vicinity, social exclusion including gender discrimination, shortage of female teachers, lack of resources and inefficient government policies are the major factors that influence female education. To solve these problems, the main recommendations by respondents include safe and secure learning environment for females in educational institutions, community and parental support, well qualified and sufficient number of female teachers. One of the most important proposals was the participation of females at policy level. Current study will provide a general layout to design the future educational strategies for promoting women education in all regions of Pakistan thus, developing towards modern educated society.

Keywords: women education, education strategies, developing countries, Pakistan

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Authors: Olumuyiwa I. Ojo, Kola Amao, Josiah A. Adeyemo, Fred A. O. Otieno

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A study was carried out to assess the environmental impact of Kampe (Omi) irrigation scheme with respect to public health hazards, the rising water table, salinity and alkalinity problems on the project site. A structured questionnaire was used as the main tool to gather information on the effect of the irrigation project on the various communities around the project site. The different sections of the questionnaire enabled the gathering of information ranging from general to more specific information. The results obtained from the study showed that the two effects are obvious: the 'positive effects' which include increasing the socioeconomic development of the entire communities, resulting in an increase in employment opportunities and better lifestyle and the 'negative effects' in which malaria (100% occurrence) and schistosomiasis (66.7%) were found to be active diseases caused by irrigation activities. Increase in height of water table and salinity is eminent in the irrigation site unless adequate drainage is provided. The collection and experimental analyses of representation soil and water samples from each scheme were used to assess the current status of each receptor. Results obtained indicate the absence of soil with sodium adsorption ration (SAR) values ranging from 3.0 to 3.89, exchangeable sodium percentage (ESP) ranged from 3.8% to 5.5% while pH values ranged from 6.60 to 7.00. Drainage facilities of the project site are inadequate, therefore making it difficult to leach the soil and flood history is occasional.

Keywords: irrigation, impact, soil analysis, Nigeria

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Authors: Surjeet Bakshi, Surabhi Sharma

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Objective: To assess the impact of educational sessions by reputed regional faculties on knowledge of primary care physicians on evidence based diabetes management methods and practice. Study Design: Retrospective pre-post intervention study. Methodology: Nine cities in Kerala from August to October, 2012 were selected for the study. 125 MBBS doctors participated in the study. 11 regional faculties provided six educational sessions throughout the period. Validated questionnaires were used to evaluate the knowledge of the participants on evidence based diabetes management methods before and after the intervention. Results: The mean score on pre-test was 8 and the mean score on post-test was 9. A paired t-test was conducted on participant’s pre- and post test score and the results were statistically significant (p<0.001). Conclusion: Even though the general attitude to and level of knowledge of diabetes management is good among the primary care physicians in India, there do exist some knowledge gaps which might influence their future practices when it comes to counselling and information on diabetes management methods. In the present study, the performance and awareness level of the participants have expressively improved among primary care physicians. There is a significant improvement in the test score and the training conducted. It seems that if such study programmes are included in the students study programme, it will give higher score in the knowledge and attitude towards diabetes management.

Keywords: diabetes, management, primary care physicians, evidence base, improvement score, knowledge

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Authors: Seyedeh-Fariba Jahanbin, Hasan Yusefzadeh, Bahram Nabilou, Cyrus Alinia, Cyrus Alinia

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Background: Due to the lack of a constant Willingness to Pay per one additional Quality Adjusted Life Years gained based on the preferences of Iran’s general public, the cost-efectiveness of health system interventions is unclear and making it challenging to apply economic evaluation to health resources priority setting. Methods: We have measured this cost-efectiveness threshold with the participation of 2854 individuals from fve provinces, each representing an income quintile, using a modifed Time Trade-Of-based Chained-Approach. In this online-based empirical survey, to extract the health utility value, participants were randomly assigned to one of two green (21121) and yellow (22222) health scenarios designed based on the earlier validated EQ-5D-3L questionnaire. Results: Across the two health state versions, mean values for one QALY gain (rounded) ranged from $6740-$7400 and $6480-$7120, respectively, for aggregate and trimmed models, which are equivalent to 1.35-1.18 times of the GDP per capita. Log-linear Multivariate OLS regression analysis confrmed that respondents were more likely to pay if their income, disutility, and education level were higher than their counterparts. Conclusions: In the health system of Iran, any intervention that is with the incremental cost-efectiveness ratio, equal to and less than 7402.12 USD, will be considered cost-efective.

Keywords: willingness to Pay, QALY, chained-approach, cost-efectiveness threshold, Iran

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Authors: Hanneke J. A. Smaling, Mandy Visser

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One way to reduce the risk of COVID-19 infection is by preventing close interpersonal contact with distancing measures. These social distancing measures presented challenges to the health and wellbeing of people with dementia and their informal and professional caregivers. This study describes the concerns and recommendations of informal and professional caregivers for COVID-19 policy for home care and long-term care for people with dementia during the first and second COVID-19 wave in the Netherlands. In this qualitative interview study, 20 informal caregivers and 20 professional caregivers from home care services and long-term care participated. Interviews were analyzed using an inductive thematic analysis approach. Both informal and professional caregivers worried about getting infected or infecting others with COVID-19, the consequences of the distancing measures, and quality of care. There was a general agreement that policy in the second wave was better informed compared to the first wave. At an organizational level, the policy was remarkably flexible. Recommendations were given for dementia care (need to offer meaningful activities, improve the organization of care, more support for informal caregivers), policy (national vs. locally organization, social isolation measures, visitor policy), and communication. Our study contributes to the foundation of future care decisions by (inter)national policymakers, politicians, and healthcare organizations during the course of the COVID-19 pandemic, underlining the need for balance between safety and autonomy for people with dementia.

Keywords: covid-19, dementia, home care, long-term care, policy

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Authors: Mei Lin, Lana Yj Liu, Thin Ngoc Pham

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Postgraduate taught (PGT) students’ learning strategies align with what the learning task constitutes and the environment that the task creates. Cognitively, they can discover new perspectives, challenge general assumptions, establish clear connections, and synthesise information. Metacognitively, their engagement is conducive to the development of planning, monitoring, and evaluating strategies. Given that there has been a lack of longitudinal insights into international PGT students’ experiences of the cognitive and metacognitive space created in the tasks, this paper presentation aims to fill the gaps by longitudinally exploring (1) the fundamentals of task designs to create cognitive and metacognitive space and (2) the opportunities and challenges of multicultural group discussions as a pedagogical approach for the implementation of cognitive and metacognitive space in the learning tasks. Data were collected from the two rounds of semi-structured interviews with 11 international PGT students in two programmes at a UK university -at the end of semester one and at the end of semester two. The findings show that the task designs, to create cognitive and metacognitive space, need to include four interconnected factors: clarity, relevance, motivation, and practicality. In addition, international PGT students perceived that they practised and developed their cognitive and metacognitive abilities while getting immersed in multicultural group discussions. The findings, from the learners’ point of view, make some pedagogy-related suggestions to the task designs at the master’s level, particularly how to engage students in learning during their transition into higher education in a different cultural setting.

Keywords: cognitive space, master students, metacognitive space, task design

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Authors: Sarah Holdren, Laura Crook, Anne Drapkin Lyerly

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Objective: The COVID-19 Pandemic has drawn new attention to long-existing bioethical questions around pregnancy, childbirth, and parenthood. Due to the increased risk of severe COVID-19, pregnant individuals may experience anxiety regarding medical decision-making. Especially in the case of hospital births, questions around the ethics of bringing healthy pregnant individuals into a high-risk environment for viral transmission illuminate gaps in the American maternal and child healthcare system. Limited research has sought to understand the experiences of those who gave birth outside hospitals during this time. This study aims to understand pregnant individuals’ conceptualization of risk during the COVID-19 pandemic. Methods: Individuals who gave birth after March 2020 were recruited through advertisements on social media. Participants completed a 1-hour semi-structured interview and a demographic questionnaire. Interviews were transcribed and coded by members of the research team using thematic narrative analysis. Results: A total of 18 participants were interviewed and completed the demographic questionnaire. The language of risk was utilized in birth narratives in three different ways, which highlighted the multileveled and nuanced ways in which risk is understood and mitigated by pregnant and birthing individuals. These included: 1. The risk of contracting COVID-19 before, during, and after birth, 2. The risk of birth complications requiring medical interventions dependent on selected birthing space (home, birthing center, hospital), and 3. The overall risk of creating life in the middle of a pandemic. The risk of contracting COVID-19 and risk of birth complications were often weighed in paradoxical ways throughout each individual’s pregnancy, while phrases such as “pandemic baby” and “apocalypse” appeared throughout narratives and highlighted the broader implications of pregnancy and childbirth during this momentous time. Conclusions: Healthcare professionals should consider the variety of ways that pregnant and birthing individuals understand the risk when counseling patients on healthcare decisions, especially during times of healthcare crisis such as COVID-19. Future work should look to understand how the language of risk fits into a broader understanding of the human experience of growing life in times of crisis.

Keywords: maternal and child health, thematic narrative analysis, COVID-19, risk mitigation

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Authors: Waleed Jarjoura

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In various cases of visual impairments, the individuals are referred to expert Ophthalmologists in order to establish a correct diagnosis. Children with visual-impairments confront various challenging experiences in life since early childhood throughout lifespan. In some cases, blind infants, especially due to congenital hydrocephalus, suffer from high intra-cranial pressure and, consequently, go through a ventriculo-peritoneal shunt surgery in order to limit the neurological symptoms or decrease the cognitive impairments. In this article, a detailed description of numerous crucial implications of the V/P shunt surgery, through the right posterior-inferior parieto-temporal cortex, on the observed preliminary capabilities that are pre-requisites for the acquisition of literacy skills in braille, basic Math competencies, braille printing which suggest Gerstmann syndrome in the blind. In addition, significant difficultiesorientation and mobility skills using the Cane, in general, organizational skills, and social interactions were observed. The primary conclusion of this report focuses on raising awareness among neuro-surgeons towards the need for alternative intracranial routes for V/P shunt implantation in blind infants that preserve the right posterior-inferior parieto-temporal cortex that is hypothesized to modulate the tactual-spatial cues in braille discrimination. A second conclusion targets educators and therapists that address the acquired dysfunctionsin blind individuals due to V/P shunt surgeries.

Keywords: congenital blindness, hydrocephalus, shunt surgery, spatial orientation

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Authors: Dina Siniora, Jasia Baig

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During the past few decades, the healthcare system has undergone profound changes in their healthcare decision-making competencies and moral aptitudes due to the vast advancement in technology, clinical skills, and scientific knowledge. Healthcare decision-making deals with morally contentious dilemmas ranging from illness, life and death judgments that require sensitivity and awareness towards the patient’s preferences while taking into consideration medicine’s abilities and boundaries. As the ever-evolving field of medicine continues to become more scientifically and morally multifarious; physicians and the hospital administrators increasingly rely on ethics committees to resolve problems that arise in everyday patient care. The role and latitude of responsibilities of ethics committees which includes being dispute intermediaries, moral analysts, policy educators, counselors, advocates, and reviewers; suggest the importance and effectiveness of a fully integrated committee. Despite achievements on Integrated Ethics and progress in standards and competencies, there is an imminent necessity for further improvement in quality within ethics consultation services in areas of credentialing, professionalism and standards of quality, as well as the quality of healthcare throughout the system. These concerns can be resolved first by collecting data about particular quality gaps and comprehend the level to which ethics committees are consistent with newly published ASBH quality standards. Policymakers should pursue improvement strategies that target both academic bioethics community and major stakeholders at hospitals, who directly influence ethics committees. This broader approach oriented towards education and intervention outcome in conjunction with preventive ethics to address disparities in quality on a systematic level. Adopting tools for improving competencies and processes within ethics consultation by implementing a credentialing process, upholding normative significance for the ASBH core competencies, advocating for professional Code of Ethics, and further clarifying the internal structures will improve productivity, patient satisfaction, and institutional integrity. This cannot be systemically achieved without a written certification exam for HCEC practitioners, credentialing and privileging HCEC practitioners at the hospital level, and accrediting HCEC services at the institutional level.

Keywords: ethics consultation, hospital, medical ethics, quality

Procedia PDF Downloads 189