Search results for: federal rule of evidence
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5086

Search results for: federal rule of evidence

1336 The Role Previous Cytomegalovirus Infection in Subsequent Lymphoma Develompment

Authors: Amalia Ardeljan, Lexi Frankel, Divesh Manjani, Gabriela Santizo, Maximillian Guerra, Omar Rashid

Abstract:

Introduction: Cytomegalovirus (CMV) infection is a widespread infection affecting between 60-70% of people in industrialized countries. CMV has been previously correlated with a higher incidence of Hodgkin Lymphoma compared to noninfected persons. Research regarding prior CMV infection and subsequent lymphoma development is still controversial. With limited evidence, further research is needed in order to understand the relationship between previous CMV infection and subsequent lymphoma development. This study assessed the effect of CMV infection and the incidence of lymphoma afterward. Methods: A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th,10th codes, and Current Procedural Terminology (CPT) codes. These were used to identify lymphoma diagnosis in a previously CMV infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). A chi-squared test was used to assess statistical significance. Results: A total number of 14,303 patients was obtained in the CMV infected group as well as in the control population (matched by age range and CCI score). Subsequent lymphoma development was seen at a rate of 11.44% (1,637) in the CMV group and 5.74% (822) in the control group, respectively. The difference was statistically significant by p= 2.2x10-16, odds ratio = 2.696 (95% CI 2.483- 2.927). In an attempt to stratify the population by antiviral medication exposure, the outcomes were limited by the decreased number of members exposed to antiviral medication in the control population. Conclusion: This study shows a statistically significant correlation between prior CMV infection and an increased incidence of lymphoma afterward. Further exploration is needed to identify the potential carcinogenic mechanism of CMV and whether the results are attributed to a confounding bias.

Keywords: cytomegalovirus, lymphoma, cancer, microbiology

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1335 Changing Misconceptions in Heat Transfer: A Problem Based Learning Approach for Engineering Students

Authors: Paola Utreras, Yazmina Olmos, Loreto Sanhueza

Abstract:

This work has the purpose of study and incorporate Problem Based Learning (PBL) for engineering students, through the analysis of several thermal images of dwellings located in different geographical points of the Region de los Ríos, Chile. The students analyze how heat is transferred in and out of the houses and how is the relation between heat transfer and climatic conditions that affect each zone. As a result of this activity students are able to acquire significant learning in the unit of heat and temperature, and manage to reverse previous conceptual errors related with energy, temperature and heat. In addition, student are able to generate prototype solutions to increase thermal efficiency using low cost materials. Students make public their results in a report using scientific writing standards and in a science fair open to the entire university community. The methodology used to measure previous Conceptual Errors has been applying diagnostic tests with everyday questions that involve concepts of heat, temperature, work and energy, before the unit. After the unit the same evaluation is done in order that themselves are able to evidence the evolution in the construction of knowledge. As a result, we found that in the initial test, 90% of the students showed deficiencies in the concepts previously mentioned, and in the subsequent test 47% showed deficiencies, these percent ages differ between students who carry out the course for the first time and those who have performed this course previously in a traditional way. The methodology used to measure Significant Learning has been by comparing results in subsequent courses of thermodynamics among students who have received problem based learning and those who have received traditional training. We have observe that learning becomes meaningful when applied to the daily lives of students promoting internalization of knowledge and understanding through critical thinking.

Keywords: engineering students, heat flow, problem-based learning, thermal images

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1334 Occupational Exposure to Electromagnetic Fields Can Increase the Release of Mercury from Dental Amalgam Fillings

Authors: Ghazal Mortazavi, S. M. J. Mortazavi

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Electricians, power line engineers and power station workers, welders, aluminum reduction workers, MRI operators and railway workers are occupationally exposed to different levels of electromagnetic fields. Mercury is among the most toxic metals. Dental amalgam fillings cause significant exposure to elemental mercury vapour in the general population. Today, substantial evidence indicates that mercury even at low doses may lead to toxicity. Increased release of mercury from dental amalgam fillings after exposure to MRI or microwave radiation emitted by mobile phones has been previously shown by our team. Moreover, our recent studies on the effects of stronger magnetic fields entirely confirmed our previous findings. From the other point of view, we have also shown that papers which reported no increased release of mercury after MRI, may have some methodological flaws. Over the past several years, our lab has focused on the health effects of exposure of laboratory animals and humans to different sources of electromagnetic fields such as mobile phones and their base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons, and MRI. As a strong association between exposure to electromagnetic fields and mercury level has been found in our studies, our findings lead us to this conclusion that occupational exposure to electromagnetic fields in workers with dental amalgam fillings can lead to elevated levels of mercury. Studies which reported that exposure to mercury can be a risk factor of Alzheimer’s disease (AD) due to the accumulation of amyloid beta protein (Aβ) in the brain and those reported that long-term occupational exposure to high levels of electromagnetic fields can increase the risk of Alzheimer's disease and dementia in male workers support our concept and confirm the significant role of the occupational exposure to electromagnetic fields in increasing the mercury level in workers with amalgam fillings.

Keywords: occupational exposure, electromagnetic fields, workers, mercury release, dental amalgam, restorative dentistry

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1333 Hydrological Revival Possibilities for River Assi: A Tributary of the River Ganga in the Middle Ganga Basin

Authors: Anurag Mishra, Prabhat Kumar Singh, Anurag Ohri, Shishir Gaur

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Streams and rivulets are crucial in maintaining river networks and their hydrology, influencing downstream ecosystems, and connecting different watersheds of urban and rural areas. The river Assi, an urban river, once a lifeline for the locals, has degraded over time. Evidence, such as the presence of paleochannels and patterns of water bodies and settlements, suggests that the river Assi was initially an alluvial stream or rivulet that originated near Rishi Durvasha Ashram near Prayagraj, flowing approximately 120 km before joining the river Ganga at Assi ghat in Varanasi. Presently, a major challenge is that nearly 90% of its original channel has been silted and disappeared, with only the last 8 km retaining some semblance of a river. It is possible that initially, the river Assi branched off from the river Ganga and functioned as a Yazoo stream. In this study, paleochannels of the river Assi were identified using Landsat 5 imageries and SRTM DEM. The study employed the Normalized Difference Vegetation Seasonality Index (NDVSI) and Principal Component Analysis (PCA) of the Normalized Difference Vegetation Index (NDVI) to detect these paleochannels. The average elevation of the sub-basin at the Durvasha Rishi Ashram of river Assi is 96 meters, while it reduces to 80 meters near its confluence with the Ganga in Varanasi, resulting in a 16-meter elevation drop along its course. There are 81 subbasins covering an area of 83,241 square kilometers. It is possible that due to the increased resistance in the flow of river Assi near urban areas of Varanasi, a new channel, Morwa, has originated at an elevation of 87 meters, meeting river Varuna at an elevation of 79 meters. The difference in elevation is 8 meters. Furthermore, the study explored the possibility of restoring the paleochannel of the river Assi and nearby ponds and water bodies to improve the river's base flow and overall hydrological conditions.

Keywords: River Assi, small river restoration, paleochannel identification, remote sensing, GIS

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1332 Service Evaluation of Consent for Hand and Wrist Surgery and Formulation of Evidence-Based Guidelines

Authors: Parsa Keyvani, Alistair Phillips, David Warwick

Abstract:

Background: The current process for gaining patient consent for hand and wrist surgery at University Hospital Southampton (UHS) is paper-based and makes use of generic forms provided by the NHS and no patient information leaflet is available relating to hand and wrist surgery. Aims: To evaluate the process of obtaining clinical consent and suggest ways in which the service can be improved. Methods: A log-book review of four orthopaedic surgeons at UHS was carried out over a three-month period in order to identify the 10 most common types of elective hand and wrist surgeries performed. A literature review was carried out to identify the complications of these surgeries. The surgeries were then divided into 6 types: nerve, bone, ligament, joint, tendon and dupuytren’s surgery. A digitised consent form was created covering the complications of all 6 surgery types. Finally, the surgeons at the orthopaedic department of UHS were asked whether they prefer the old paper-based or the digitised consent form. Results: All of the surgeons felt that the procedure type-based form was easier to read, use and understand. Conclusion: This research highlights a number of problems related to the use of current NHS consent forms. The proposed solution is to use a set of digitised, procedure type-based consent forms. Digital consent forms can be filled in in advance and sent to the patient electronically along with any relevant information leaflets, thus giving them time to absorb the information and come up with any questions before they have their pre-procedure discussion with their doctor. This would allow the doctor to focus the consultation on the patient rather than writing out the consent form and would ultimately be a step forward in making the NHS a global digital leader and fully embrace the opportunity offered by technology.

Keywords: digitised consent form, elective surgery, hand surgery complications, informed consent, procedure type-based consent form

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1331 Glacier Dynamics and Mass Fluctuations in Western Himalayas: A Comparative Analysis of Pir-Panjal and Greater Himalayan Ranges in Jhelum Basin, India

Authors: Syed Towseef Ahmad, Fatima Amin, Pritha Acharya, Anil K. Gupta, Pervez Ahmad

Abstract:

Glaciers being the sentinels of climate change, are the most visible evidence of global warming. Given the unavailability of observed field-based data, this study has focussed on the use of geospatial techniques to obtain information about the glaciers of Pir-Panjal (PPJ) and the Great Himalayan Regions of Jhelum Basin (GHR). These glaciers need to be monitored in line with the variations in climatic conditions because they significantly contribute to various sectors in the region. The main aim of this study is to map the glaciers in the two adjacent regions (PPJ and GHR) in the north-western Himalayas with different topographies and compare the changes in various glacial attributes during two different time periods (1990-2020). During the last three decades, both PPJ as well as GHR regions have observed deglaciation of around 36 and 26 percent, respectively. The mean elevation of GHR glaciers has increased from 4312 to 4390 masl, while the same for PPJ glaciers has increased from 4085 to 4124 masl during the observation period. Using accumulation area ratio (AAR) method, mean mass balance of -34.52 and -37.6 cm.w.e was recorded for the glaciers of GHR and PPJ, respectively. The difference in areal and mass loss of glaciers in these regions may be due to (i) the smaller size of PPJ glaciers which are all smaller than 1 km² and are thus more responsive to climate change (ii) Higher mean elevation of GHR glaciers (iii) local variations in climatic variables in these glaciated regions. Time series analysis of climate variables indicates that both the mean maximum and minimum temperatures of Qazigund station (Tmax= 19.2, Tmin= 6.4) are comparatively higher than the Pahalgam station (Tmax= 18.8, Tmin= 3.2). Except for precipitation in Qazigund (Slope= - 0.3 mm a⁻¹), each climatic parameter has shown an increasing trend during these three decades, and with the slope of 0.04 and 0.03°c a⁻¹, the positive trend in Tmin (pahalgam) and Tmax (qazigund) are observed to be statistically significant (p≤0.05).

Keywords: glaciers, climate change, Pir-Panjal, greater Himalayas, mass balance

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1330 A Systematic Review of Patient-Reported Outcomes and Return to Work after Surgical vs. Non-surgical Midshaft Humerus Fracture

Authors: Jamal Alasiri, Naif Hakeem, Saoud Almaslmani

Abstract:

Background: Patients with humeral shaft fractures have two different treatment options. Surgical therapy has lesser risks of non-union, mal-union, and re-intervention than non-surgical therapy. These positive clinical outcomes of the surgical approach make it a preferable treatment option despite the risks of radial nerve palsy and additional surgery-related risk. We aimed to evaluate patients’ outcomes and return to work after surgical vs. non-surgical management of shaft humeral fracture. Methods: We used databases, including PubMed, Medline, and Cochrane Register of Controlled Trials, from 2010 to January 2022 to search for potential randomised controlled trials (RCTs) and cohort studies comparing the patients’ related outcome measures and return to work between surgical and non-surgical management of humerus fracture. Results: After carefully evaluating 1352 articles, we included three RCTs (232 patients) and one cohort study (39 patients). The surgical intervention used plate/nail fixation, while the non-surgical intervention used a splint or brace procedure to manage shaft humeral fracture. The pooled DASH effects of all three RCTs at six (M.D: -7.5 [-13.20, -1.89], P: 0.009) I2:44%) and 12 months (M.D: -1.32 [-3.82, 1.17], p:0.29, I2: 0%) were higher in patients treated surgically than in non-surgical procedures. The pooled constant Murley score at six (M.D: 7.945[2.77,13.10], P: 0.003) I2: 0%) and 12 months (M.D: 1.78 [-1.52, 5.09], P: 0.29, I2: 0%) were higher in patients who received non-surgical than surgical therapy. However, pooled analysis for patients returning to work for both groups remained inconclusive. Conclusion: Altogether, we found no significant evidence supporting the clinical benefits of surgical over non-surgical therapy. Thus, the non-surgical approach remains the preferred therapeutic choice for managing shaft humeral fractures due to its lesser side effects.

Keywords: shaft humeral fracture, surgical treatment, Patient-related outcomes, return to work, DASH

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1329 Challenges Associated with Recruitment of Professional Doctorate Degree Holders into Ghanaian Universities

Authors: Joseph E. Cobbinah, Abigail A. Aryeh-Adjei

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Over the years, entry into the academia in any Ghanaian university requires an advanced research degree, more preferably traditional doctorate (PhD or DPhil). It is however argued that PhD is more research intensive, so since university teaching involves a lot of research, those having traditional doctorate have good research background to teach in a university and are thus recruited as lecturers. However, in the last ten years, a reasonable number of academics enter Ghanaian universities with professional doctorate degrees, which hitherto was considered to be only suitable for industry, because it gives individuals with just basic research skills needed for professional practice, unlike the traditional PhD which is research intensive degree. Currently, there are a reasonable number of professional doctorate degree holders with qualifications like DBA, EdD, PsychD, DPharm, EngD, among others in various departments in many Ghanaian universities. Maybe, because such degree holders also use the title Dr, some university authorities put them at par with their counterparts with traditional doctorate, although some lecturers with PhD seem to look down upon those with traditional doctorate degrees and this has created some tension amongst those academics. This makes their promotions and holding of university academic positions very problematic in some ways. This paper therefore seeks to investigate the types of professional doctorate degree holders working as lecturers in some selected universities in Ghana and the challenges associated with their recruitment, acceptability and proper integration into universities’ teaching and learning. The paper adopted qualitative research methodology. In all, respondents from three state-owned and privately owned universities were involved in the study. Administrators, lecturers, heads of departments and deans of faculty were interviewed to assess the challenges associated with the recruitment of professional doctorate degree holders and any problems they face in the departments they work. It became evident that, although some lecturers enter the academia with professional doctorate degrees, their counterparts seem not to give them the recognition and respect they deserve. Although there is little or no evidence that professional doctorate degree holders are under performing, recruiting professional doctorate degree holders does not only become a challenge, but also their progression into the university’s promotion ladder become very slow compared to their counterparts with traditional PhD degrees.

Keywords: professional doctorate, academia, lecturers, Ghanaian universities, orate

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1328 Effects of Acupuncture Treatment in Gait Parameters in Parkinson's Disease

Authors: Catarina Isabel Ramos Pereira, Jorge Machado, Begona Alonso Criado, Maria João Santos

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Introduction: Gait disorders are one of the symptoms that have severe implications on the quality of life in Parkinson's disease (PD). Currently, there is no therapy to reverse or treat this condition. None of the drugs used in conventional medical treatment is entirely efficient, and all have a high incidence of side effects. Acupuncture treatment is believed to improve motor ability, but there is still little scientific evidence in individuals with PD. Aim: The aim of the study is to investigate the acute effect of acupuncture on gait parameters in Parkinson's disease. Methods: This is a randomized and controlled crossover study. The same individual patient was part of both the experimental (real acupuncture) and control group (false acupuncture/sham), and the sequence was randomized. Gait parameters were measured at two different moments, before and after treatment, using four force platforms as well as the collection of 3D markers positions taken by 11 cameras. Images were quantitatively analyzed using Qualisys Track Manager software that let us extract data related to the quality of gait and balance. Seven patients with the diagnosis of Parkinson's disease were included in the study. Results: Statistically significant differences were found in gait speed (p = 0.016), gait cadence (p = 0.006), support base width (p = 0.0001), medio-lateral oscillation (p = 0.017), left-right step length (p = 0.0002), and stride length: right-right (p = 0.0000) and left-left (p = 0.0018), time of left support phase (p = 0.029), right support phase (p = 0.025) and double support phase (p = 0.015), between the initial and final moments for the experimental group. Differences in right-left stride length were found for both groups. Conclusion: Our results show that acupuncture could enhance gait in Parkinson's disease patients. Deep research involving a larger number of volunteers should be accomplished to validate these encouraging findings.

Keywords: acupuncture, traditional Chinese medicine, Parkinson's disease, gait

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1327 The Conceptualization of Patient-Centered Care in Latin America: A Scoping Review

Authors: Anne Klimesch, Alejandra Martinez, Martin HäRter, Isabelle Scholl, Paulina Bravo

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Patient-centered care (PCC) is a key principle of high-quality healthcare. In Latin America, research on and promotion of PCC have taken place in the past. However, thorough implementation of PCC in practice is still missing. In Germany, an integrative model of patient-centeredness has been developed by synthesis of diverse concepts of PCC. The model could serve as a point of reference for further research on the implementation of PCC. However, it is predominantly based on research from Europe and North America. This scoping review, therefore, aims to accumulate research on PCC in Latin America in the past 15 years and analyse how PCC has been conceptualized. The resulting overview of PCC in Latin America will be a foundation for a subsequent study aiming at the adaptation of the integrative model of patient-centeredness to the Latin American health care context. Scientific databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, Web of Science, SCIELO, Redalyc.) will be searched, and reference and citation tracking will be performed. Studies will be included if they were carried out in Latin America, investigated PCC in any clinical and community setting (public and private), and were published in English, Spanish, French, or Portuguese since 2006. Furthermore, any theoretical framework or conceptual model to guide how PCC is conceptualized in Latin America will be included. Two reviewers will be responsible for the identification of articles, screening of records, and full-text assessment. The results of the scoping review will be used in the development of a mixed-methods study with the aim to understand the needs for PCC, as well as barriers and facilitators in Latin America. Based on the outcomes, the integrative model of PCC will be translated to Spanish and adapted to the Latin American context. The integrative model will enable the dissemination of the concept of PCC in Latin America and will provide a common ground for further research on the topic. The project will thereby make an important contribution to an evidence-based implementation of PCC in Latin America.

Keywords: conceptual framework, integrative model of PCC, Latin America, patient-centered care

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1326 A Comparison of Outcomes of Endoscopic Retrograde Cholangiopancreatography vs. Percutaneous Transhepatic Biliary Drainage in the Management of Obstructive Jaundice from Hepatobiliary Tuberculosis: The Philippine General Hospital Experience

Authors: Margaret Elaine J. Villamayor, Lobert A. Padua, Neil S. Bacaltos, Virgilio P. Bañez

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Significance: This study aimed to determine the prevalence of Hepatobiliary Tuberculosis (HBTB) with biliary obstruction and to compare the outcomes of ERCP versus PTBD in these patients. Methodology: This is a cross-sectional study involving patients from PGH who underwent biliary drainage from HBTB from January 2009 to June 2014. HBTB was defined as having evidence of TB (culture, smear, PCR, histology) or clinical diagnosis with the triad of jaundice, fever, and calcifications on imaging with other causes of jaundice excluded. The primary outcome was successful drainage and secondary outcomes were mean hospital stay and complications. Simple logistic regression was used to identify factors associated with success of drainage, z-test for two proportions to compare outcomes of ERCP versus PTBD and t-test to compare mean hospital stay post-procedure. Results: There were 441 patients who underwent ERCP and PTBD, 19 fulfilled the inclusion criteria. 11 underwent ERCP while 8 had PTBD. There were more successful cases in PTBD versus ERCP but this was not statistically significant (p-value 0.3615). Factors such as age, gender, location and nature of obstruction, vices, coexisting pulmonary or other extrapulmonary TB and presence of portal hypertension did not affect success rates in these patients. The PTBD group had longer mean hospital stay but this was not significant (p-value 0.1880). There were no complications reported in both groups. Conclusion: HBTB comprises 4.3% of the patients undergoing biliary drainage in PGH. Both ERCP and PTBD are equally safe and effective in the management of biliary obstruction from HBTB.

Keywords: cross-sectional, hepatobiliary tuberculosis, obstructive jaundice, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage

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1325 Applied Canonical Correlation Analysis to Explore the Relationship between Resourcefulness and Quality of Life in Cancer Population

Authors: Chiou-Fang Liou

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Cancer has been one of the most life-threaten diseases worldwide for 30+ years. The influences of cancer illness include symptoms from cancer itself along with its treatments. The quality of life among patients diagnosed with cancer during cancer treatments has been conceptualized within four domains: Functional Well-Being, Social Well-Being, Physical Well-Being, and Emotional Well-Being. Patients with cancer often need to make adjustments to face all the challenges. The middle-range theory of Resourcefulness and Quality of life has been applied to explore factors contributing to cancer patients’ needs. Resourcefulness is defined as sets of skills that can be learned and consisted of Person and Social Resourcefulness. Empirical evidence also supported a possible relationship between Resourcefulness and Quality of Life. However, little is known about the extent to which the two concepts are related to each other. This study, therefore, applied a multivariate technique, Canonical Correlation Analysis, to identify the relationship between the two sets of variables with multi-dimensional measures, the Resourcefulness and Quality of Life in Cancer patients receiving treatments. After IRB approval, this multi-centered study took place at two medical centers in the Central Region of Taiwan. Sample A total of 186 patients with various cancer diagnoses and either receiving radiation therapy or chemotherapy consented to and answered questionnaires. The Import findings of the Generalized F test identified two typical sets with several linear relations and explained a total of 79.1% of the total variance. The first typical set found Personal Resourcefulness negatively related to Social Well-being, Functional being, Emotional Well-being, and Physical, in that order. The second typical set found Social Resourcefulness negatively related to Functional Well-being and Physical-being yet positively related to Social Well-being and Emotional Well-being. Discussion and Conclusion, The results of this presented study supported the statistically significant relationship between two sets of variables that are consistent with the theory. In addition, the results are considerably important in cancer patients receiving cancer treatments.

Keywords: cancer, canonical correlation analysis, quality of life, resourcefulness

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1324 Efficacy of Corticosteroids versus Placebo in Third Molar Surgery: A Systematic Review of Patient-Reported Outcomes

Authors: Parastoo Parhizkar, Jaber Yaghini, Omid Fakheran

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Background: Third molar surgery is often associated with postoperative problems which cause serious impediments on daily activities and quality of life. Steroidal anti-inflammatory drugs may decrease these common post-operative complications. The purpose of this review is evaluating the available evidence regarding the efficacy of corticosteroids used as adjunctive therapy for patients undergoing third molar surgery. Methods: PubMed, Google scholar, Scopus, web of science, clinicaltrials.gov, scirus.com, Cochrane central register for controlled trials, LILACS, OpenGrey, centerwatch, isrctn, who.int and ebsco were searched without restrictions regarding the year of publication. Randomized clinical trials assessing patient-reported outcomes in patients undergoing surgical therapy, were eligible for inclusion. Study quality was assessed using the CONSORT-checklist. No meta-analysis was performed. Results: A total of twelve Randomized Clinical Trials were included in this study. Methylprednisolone and Dexamethasone may decrease postoperative side effects such as pain, trismus and edema. Based on the results both of them could improve patients’ satisfaction, and there is no significant difference between these two types of corticosteroids regarding the patient centered outcomes (p > 0.05). Intralesional and intravenous injection of Dexamethasone showed an equivalent result, with statistically significant better results (P < 0.05) in comparison with the oral treatment. Conclusion: various types of corticosteroids can enhance the patient’s satisfaction following third molar surgery. However, there is no significant difference between Dexamethasone, Prednisolone and Methylprednisolone groups in this regard. Comparing the various administration routs, local injection of Dexamethasone is quite simple, painless and cost-effective adjunctive therapy with better drug efficacy.

Keywords: third molar surgery, corticosteroids, patient-reported outcomes, health related quality of life

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1323 The Effectiveness of Zinc Supplementation in Taste Disorder Treatment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Boshra Mozaffar, Arash Ardavani, Iskandar Idris

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Food taste and flavor affect food choice and acceptance, which are essential to maintain good health and quality of life. Reduced circulating zinc levels have been shown to adversely affect taste which can result in reduced appetite, weight loss and psychological problems, but the efficacy of Zinc supplementation to treat disorders of taste remains unclear. In this systematic review and meta-analysis, we aimed to examine the efficacy of zinc supplementation in the treatment of taste disorders. We searched four electronic bibliographical databases; Ovid MEDLINE, Ovid Embase, Ovid AMAD and PubMed. Article bibliographies were also searched, which yielded additional relevant studies. To facilitate the collection and identification of all available and relevant articles published before 7 December 2020, there were no restrictions on the publication date. We performed a systematic review and meta-analysis according to the PRISMA Statement. This review was registered at PROSPERO and given the identification number CRD42021228461. In total, we included 12 randomized controlled trials with 938 subjects. Intervention includes zinc (sulfate, gluconate, picolinate, polaprezinc and acetate); the pooled results of the meta-analysis indicate that improvements in taste disorder occurred more frequently in the intervention group compared to the control group (RR = 1.8; 95% CI:1.27 -2.57, p=0.009). The doses are equivalent to 17 mg- 86.7 mg of elemental zin for three to six months. Zinc supplementation is an effective treatment for taste disorders in patients with zinc deficiency or idiopathic taste disorders when given in high doses ranging from 68–86.7 mg/d for up to three months. However, we did not find sufficient evidence to determine the effectiveness of zinc supplementation in patients with taste disorders induced by chronic renal failure.

Keywords: taste change, taste disorder, zinc, zinc sulfate or Zn, deficiency, supplementation.

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1322 Interaction or Conflict: Addressing Modern Trans-Himalayan Pastoralism and Wildlife

Authors: Amit Kaushik

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Equus kiang kiang is an indigenous large-bodied herbivore species, and in India, it is restricted to limited geographies of Ladakh. One of such areas is the Tsokar Basin. With the rise in global pashmina demand, the livestock numbers have grown significantly. Previous studies have reported conflict between a nomadic pastoral community, the Changpas, and kiang. Absentee pastoralism (in lieu of pure pastoralism) and tourism are two major economic activities among the local people. However, the social, economic, political, and ecological changes are inevitable in such a contemporary system. The study examines several factors influencing the local pastoral economy and focuses on the presence of two non-human cohabitants, kiang, and the wolf. This study used semi-structured interviews and vehicle count method in four different seasons. The results show that people perceived kiang as a threat but also reveal a level of tolerance towards them. The locals predicted high kiang numbers ranging from 200-3000 in the basin and contrastingly ranked them behind wolves, which are very few in numbers. Due to a lack of scientific pieces of evidence, the kiang population status remains obscure, and local peoples’ concerns remain unaddressed. But how this competitive dysfunctionality does take place? On one side, the rural development or the animal husbandry department aims at developing the area by providing stall-feed and tourism, whereas, on another side, the wildlife department emphasizes wildlife conservation. Therefore, the managers and planners may need to be cautious about the local socio-ecological complexities and may require inter-departmental communications. The study concludes that an interdisciplinary inquiry may be an important tool in understanding such a precarious situation and may be used in the policy-making processes.

Keywords: coexistence, human-livestock-wildlife interactions, interdisciplinary approach, kiang, policymaking, tsokar.

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1321 Harmful Algal Blooming Micro-Algae in Kenya’s Coastal Waters

Authors: Nancy Awuor Oduor, Nils Moosdorf

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Harmful Algal Blooms (HABs) are a threat to coastal water quality, marine biodiversity, and human health. The attention on HABs and associated phycotoxins is still very low in tropical coastal developing countries despite the high dependence of local communities on coastal and marine resources for food and livelihoods and the growing evidence of the global increase in HABs frequency, toxicity, and geographical expansion. Lack of HABs monitoring thus creates a high risk of exposure due to uncertainty. This study assessed the spatial and temporal variability and effects of potential HAB-forming species in Kenya’s coastal waters. The preliminary results from 463 sampled collected over a series of 10 coastal surveys conducted over 267 Km of Kenya’s coastline between August 2021 and July 2022 revealed the presence of 87 potential algal blooming species belonging to 47 genera dominated by species capable of producing toxins, causing physical harm and high biomass at 41, 31 and 21 % respectively. The taxonomic composition was also dominated by dinoflagellates at 47%, followed by diatoms, cyanobacteria, and silicoflagellates at 39, 12, and 2%, respectively. About 92 % of the toxin-producing species were established in the creek waters. However, there were no significant variations established in species richness between the dry and wet seasons. Paralytic Shellfish Poisoning (PSP) toxin-producing dinoflagellates Alexandrium spp., Aphanizomenon spp., Gonyaulax spp., Gymnodinium spp., and Brachydinium capitatum, and Amnesic Shellfish Poisoning (ASP) Toxin producing diatoms Amphora spp., Nitzschia spp. and Pseudo-nitzschia spp. Frequented the area in low cell densities ranging between 5 and 1500 cells/L. However, no domoic acid (DA) and saxitoxins (SXTs) were detected during the July surveys. This does not mean that the toxins are absent in the area, and longer studies are recommended.

Keywords: harmful algal blooms, phycotoxins, saxitoxin, domoic acid, Kenya

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1320 A Modified Open Posterior Approach for the Fixation of Posterior Cruciate Ligament Tibial Avulsion Fractures

Authors: Babak Mirzashahi, Arvin Najafi, Pejman Mansouri, Mahmoud Farzan

Abstract:

Background: The most effective treatment of posterior cruciate ligament (PCL) tears and the consequence of untreated PCL injuries remain controversial. Objectives: The aim of this study is to assess outcomes of fixation of tibial posterior cruciate ligament (PCL) avulsion fractures via a modified technique. Patients and Methods: From January, 2009 to March, 2012, there were 45 cases of PCL tibial avulsion fractures that were referred to our hospital and were managed through a modified open posterior approach. Fixation of Tibial PCL avulsion fractures were fixed by means of a lag screw and washer placed through our modified open posterior approach. Range of motion was begun on the first postoperative day. Clinical stability, range of motion, gastrocnemius muscle strength, radiographic investigation, and patient’s overall quality of life was analyzed at final follow up visit. Results: The average of overall musculoskeletal functional evaluation scores was 15 (range 3–35). All patients achieved union of their fracture and had clinically stable knees at the latest follow-up. The mean preoperative Lysholm score for 15 knees was 62 ± 8 (range, 50-75); the mean postoperative Lysholm score was 92± 7 (range, 75-101). A significant difference in Lysholm scores between preoperative and final follow-up evaluations was found (P < .05). At first-year follow-up, 42 (93%) patients revealed a difference of less than 10 mm in thigh circumference between their injured and healthy knees. Conclusions: The management of displaced large PCL avulsion fractures with placement of a cancellous lag screw with washer by means of the modified open posterior approach leads to satisfactory clinical, radiographic, and functional results and reduces the operation time and less blood loss. Level of evidence: IV.

Keywords: posterior cruciate ligament, tibial fracture, lysholm knee score, patient outcome assessment

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1319 Empirical Analysis of Forensic Accounting Practices for Tackling Persistent Fraud and Financial Irregularities in the Nigerian Public Sector

Authors: Sani AbdulRahman Bala

Abstract:

This empirical study delves into the realm of forensic accounting practices within the Nigerian Public Sector, seeking to quantitatively analyze their efficacy in addressing the persistent challenges of fraud and financial irregularities. With a focus on empirical data, this research employs a robust methodology to assess the current state of fraud in the Nigerian Public Sector and evaluate the performance of existing forensic accounting measures. Through quantitative analyses, including statistical models and data-driven insights, the study aims to identify patterns, trends, and correlations associated with fraudulent activities. The research objectives include scrutinizing documented fraud cases, examining the effectiveness of established forensic accounting practices, and proposing data-driven strategies for enhancing fraud detection and prevention. Leveraging quantitative methodologies, the study seeks to measure the impact of technological advancements on forensic accounting accuracy and efficiency. Additionally, the research explores collaborative mechanisms among government agencies, regulatory bodies, and the private sector by quantifying the effects of information sharing on fraud prevention. The empirical findings from this study are expected to provide a nuanced understanding of the challenges and opportunities in combating fraud within the Nigerian Public Sector. The quantitative insights derived from real-world data will contribute to the refinement of forensic accounting strategies, ensuring their effectiveness in addressing the unique complexities of financial irregularities in the public sector. The study's outcomes aim to inform policymakers, practitioners, and stakeholders, fostering evidence-based decision-making and proactive measures for a more resilient and fraud-resistant financial governance system in Nigeria.

Keywords: fraud, financial irregularities, nigerian public sector, quantitative investigation

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1318 Autism Management in Ghana: Comparative Analyses of Creative Art forms

Authors: Edwina Owusu Panin, Kwame Baah Owusu Panin

Abstract:

This abstract intends to demonstrate multiple strategies of autism management in Ghana by exploring the possibilities. The advantages of adopting creative art forms as a therapeutic method. Autism is a developmental disorder that includes social interaction, communication, and repetitive behaviours. In Ghana, as in many other countries, there is a rising demand for effective intervention and support for people with autism and their families. Creative arts such as music, dance, drama and visual arts have shown promise in promoting communication, social interaction and inclusion of people with autism. These art forms provide alternative channels for self-expression and can be powerful tools for autistic people to interact with the world, their friends and families around them. Creative art forms interventions have been found to improve social skills, improve emotion regulation, promote creativity and increase self-confidence in people with autism. This study examines existing programs and interventions in Ghana involving creative art forms for people with autism through a comparative analysis. It explores the different approaches, methods and results of these interventions. By comparing and evaluating these programs, the study aims to identify best practices, challenges and areas for development in managing autism through the creative arts in Ghana. Although many schools and rehabilitation centres employ various forms in therapeutic approaches for autism. There is no comparative analysis of which type of autism and which creative art forms is suitable. The results of this study will contribute to the development of evidence-based practices for the management of autism in Ghana. It provides valuable information about the effectiveness of creative arts interventions and helps inform policy makers, educators, therapists and other stakeholders involved in autism support. Ultimately, the goal is to improve the well-being and quality of life of people with autism in Ghana and their families by promoting inclusive and accessible interventions that harness the power of creative art forms.

Keywords: autism, therapeutic, creative art, art form

Procedia PDF Downloads 76
1317 Salient Beliefs regarding Alcohol Reduction and Cessation among Thai Teenagers

Authors: Panrapee Suttiwan, Rewadee Watakakosol Arunya Tuicomepee, Sakkaphat T. Ngamake

Abstract:

Alcohol consumption ranks among the top six of health-risk behaviors that lead to disability and death among Thai teenagers. Underage drinkers have higher health risks than their non-drinking peers do. This study, therefore, aimed to explore salient beliefs of Thai teenagers with alcohol reduction and cessation based on the Theory of Planned Behaviour theoretical framework. Participants were 225 high-school and vocational school students, most of whom (60.9%) consumed alcohol almost daily (5-6 times / week), and one-third of whom (33.8%) reported habitual moderate drink. The average age was 16.5 (SD = 0.9), and the average age of the first use of alcohol was 13.7 (SD = 2.2). Instrument was an open-ended questionnaire that elicited beliefs about having alcohol reduction / cessation in the past 12 months. Findings revealed salient benefit beliefs of alcohol reduction / cessation among the teens such as improved physical and mental health, accident and violence avoidance, less sexual risks, money and time saving, better academic performance, and improved relationships. In contrast, the teens identified several disadvantage beliefs such as deteriorating health, social awkwardness, lack of little fun, excitement, and experience, physical uneasiness, stress, and lack of self-confidence. Salient normative groups for alcohol reduction / cessation included parents, elder relatives, siblings, close friends, teachers, boy / girlfriends, and seniors / juniors at school. Situations influencing alcohol reduction / cessation included quarrels with boy / girlfriends, family conflicts, peer pressure, partying and socializing, festive holidays and anniversary celebration, and visiting entertainment places, etc. This study provides empirical evidence that help to identify normative attitudes towards alcohol reduction / cessation and may thus be an important knowledge for public health campaigns seeking to reduce alcohol consumption in this population.

Keywords: alcohol consumption reduction, cessation, salient belief, Thai teenagers

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1316 Host Cell Membrane Lipid Rafts Are Required for Influenza A Virus Adsorption to Host Cell Surface

Authors: Dileep K. Verma, Sunil K. Lal

Abstract:

Influenza still remains one of the most challenging diseases posing significant threat to public health causing seasonal epidemics and pandemics. Previous studies suggest that influenza hemagglutinin is essential for viral attachment to host sialic acid receptors and concentrate in lipid rafts for efficient viral fusion. Studies also reported selective nature of Influenza virus to utilize rafts micro-domain for efficient virus assembly and budding. However, the detailed mechanism of Influenza A Virus (IAV) binding to host cell membrane and entry inside the host remains elusive. In the present study, we investigated if host membrane lipid rafts play any significant role in early life cycle events of influenza A virus. Role of host lipid rafts was studied using raft disruption method by extraction of cholesterol and Methyl-β-Cyclodextrin was used to remove membrane cholesterol. We observed co-localization of Influenza A Virus to lipid rafts by visualization of known lipid raft marker GM1 on host cell membrane. Co-localization suggest direct involvement of these micro-domain in initiation of IAV life cycle. We found significant reduction in influenza A virus adsorption in raft disrupted target host cells indicating poor binding and attachment in absence of coherent membrane rafts. Taken together, the results of present study provide evidence for critical involvement of host lipid rafts and its constituents in adsorption process of Influenza A Virus and suggests crucial involvement in other early events of IAV life cycle. The present study opens a new domain to study influenza virus-host interaction and to combat flu at the very early steps of viral life cycle.

Keywords: lipid raft, adsorption, cholesterol, methyl-β-cyclodextrin, GM1

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1315 Attraction and Identification of Early Scavenger Insects on Shaded and Sunny Liver Baits in a Saharian Region of South-Central Algeria

Authors: A. M. Taleb, A. G. Tail, A. F. Kara, B. B. Djedouani, C. T. Moussa

Abstract:

Forensic entomology is the use of insects to aid legal investigations. The main purpose of forensic entomology is to establish the postmortem interval (PMI). In order to estimate the PMI, a forensic entomologist compares the case data with certain reference information relevant to the particular location and time of year. This reference information, including the local distribution of species, are not available in Algeria. Therefore, experiments need to be conducted to provide references for entomological evidence. The objective of this study was to identify the necrophagous flies species which arrive first to carrion using liver baits in Ghardaia, South Algeria. The study was carried out during the spring season in the palmeral of Beni Isguen, Ghardaia which is well known by its hot arid climate. The experiment site (32°28’0’’ N, 3°42’0’’ E), is situated at an altitude of about 526 metres above mean sea level. On April the 4th, 2014, a number of three replicates of liver baited traps were placed in the shade and other three baits were exposed to the sun. Flying insects and larvae were captured and identified. After few minutes, flies invaded the traps which were exposed to the sun. In contrast, no flies were observed in the other traps. A total number of fourty five (45) adult specimens belonging to three taxa were identified: Calliphora vicina (Robineau-Desvoidy, 1830) (Diptera, Calliphoridae) (51.11 %), Lucilia sericata (Meigen, 1826) (Diptera, Calliphoridae) (33.33 %) and Sarcophaga africa (Wiedemann, 1824) (Diptera: Sarcophagidae) (15.55 %). Six hundred and three (603) maggots belonging to two taxa were identified: Calliphora vicina (76.28 %) and Lucilia sericata (23.71 %). The data obtained from this study provides baseline information regarding the carrion fauna of this area. It will also form a basis for similar studies in different geographical and climatological regions of Algeria.

Keywords: forensic entomology, liver baits, necrophagous fly, Ghardaia, South Algeria

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1314 River Catchment’s Demography and the Dynamics of Access to Clean Water in the Rural South Africa

Authors: Yiseyon Sunday Hosu, Motebang Dominic Vincent Nakin, Elphina N. Cishe

Abstract:

Universal access to clean and safe drinking water and basic sanitation is one of the targets of the 6th Sustainable Development Goals (SDGs). This paper explores the evidence-based indicators of Water Rights Acts (2013) among households in the rural communities in the Mthatha River catchment of OR Tambo District Municipality of South Africa. Daily access to minimum 25 litres/person and the factors influencing clean water access were investigated in the catchment. A total number of 420 households were surveyed in the upper, peri-urban, lower and coastal regions of Mthatha Rivier catchment. Descriptive and logistic regression analyses were conducted on the data collected from the households to elicit vital information on domestic water security among rural community dwellers. The results show that approximately 68 percent of total households surveyed have access to the required minimum 25 litre/person/day, with 66.3 percent in upper region, 76 per cent in the peri-urban, 1.1 percent in the lower and 2.3 percent in the coastal regions. Only 30 percent among the total surveyed households had access to piped water either in the house or public taps. The logistic regression showed that access to clean water was influenced by lack of water infrastructure, proximity to urban regions, daily flow of pipe-borne water, household size and distance to public taps. This paper recommends that viable integrated rural community-based water infrastructure provision strategies between NGOs and local authority and the promotion of point of use (POU) technologies to enhance better access to clean water.

Keywords: domestic water, household technology, water security, rural community

Procedia PDF Downloads 353
1313 Comparison of Deep Brain Stimulation Targets in Parkinson's Disease: A Systematic Review

Authors: Hushyar Azari

Abstract:

Aim and background: Deep brain stimulation (DBS) is regarded as an important therapeutic choice for Parkinson's disease (PD). The two most common targets for DBS are the subthalamic nucleus (STN) and globus pallidus (GPi). This review was conducted to compare the clinical effectiveness of these two targets. Methods: A systematic literature search in electronic databases: Embase, Cochrane Library and PubMed were restricted to English language publications 2010 to 2021. Specified MeSH terms were searched in all databases. Studies which evaluated the Unified Parkinson's Disease Rating Scale (UPDRS) III were selected by meeting the following criteria: (1) compared both GPi and STN DBS; (2) had at least three months follow-up period; (3)at least five participants in each group; (4)conducted after 2010. Study quality assessment was performed using the Modified Jadad Scale. Results: 3577 potentially relevant articles were identified, of these, 3569 were excluded based on title and abstract, duplicate and unsuitable article removal. Eight articles satisfied the inclusion criteria and were scrutinized (458 PD patients). According to Modified Jadad Scale, the majority of included studies had low evidence quality which was a limitation of this review. 5 studies reported no statistically significant between-group difference for improvements in UPDRS ш scores. At the same time, there were some results in terms of pain, action tremor, rigidity, and urinary symptoms, which indicated that STN DBS might be a better choice. Regarding the adverse effects, GPi was superior. Conclusion: It is clear that other larger randomized clinical trials with longer follow-up periods and control groups are needed to decide which target is more efficient for deep brain stimulation in Parkinson’s disease and imposes fewer adverse effects on the patients. Meanwhile, STN seems more reasonable according to the results of this systematic review.

Keywords: brain stimulation, globus pallidus, Parkinson's disease, subthalamic nucleus

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1312 A Qualitative Study of Parents' Recommendations for Improving the Notification Process and Communication between Health Professionals and Families for New Diagnosis of Cystic Fibrosis

Authors: Mohammad S. Razai, Jan Williams, Rachel Nestel, Dermot Dalton

Abstract:

Purpose: This descriptive qualitative study aimed to obtain parents recommendations for improving the notification process and communication of positive newborn screening result for cystic fibrosis (CF). Methods: Thematic analysis of semi-structured open-ended interviews with 11 parents of 7 children with confirmed diagnosis of CF between 2 months — 2 years of age. Results: Parents preferred face to face disclosure of positive NBS results by a pediatrician with CF professional qualification. They trusted a pediatrician more than any other professional in providing accurate, credible and comprehensive information about the diagnosis and its implications. Parents recommended that health professionals be knowledgeable and provide clear, succinct and understandable information. Providers should also explore parents concerns and acknowledge feelings and emotions. Most parents reported that they preferred to be notified immediately as soon as the results were available. Several parents preferred to be told once the diagnosis was certain. Most parents regarded open access to CF team as the most significant part of care coordination. In addition to health professionals, most parents used internet as an important source of information, interaction and exchange of experiences. Most parents also used social networking sites such as Facebook groups and smart phone apps. Conclusion: This study provides significant new evidence from parental perspective in emphasizing the pivotal role of good communication skills deployed by a knowledgeable CF specialist in person. Parents use of social media and internet has replaced some traditional methods of information exchange and may reduce the need for professional input for newly diagnosed CF patients.

Keywords: care coordination, cystic fibrosis, newborn screening, notification process, parental preferences, professional-paren communication

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1311 Regression of Fibrosis by Apigenin in Thioacetamide-Induced Liver Fibrosis Rat Model through Suppression of HIF-1/FAK Pathway

Authors: Hany M. Fayed, Rehab F. Abdel-Rahman, Alyaa F. Hessin, Hanan A. Ogaly, Gihan F. Asaad, Abeer A. A. Salama, Sahar Abdelrahman, Mahmoud S. Arbid, Marwan Abd Elbaset Mohamed

Abstract:

Liver fibrosis is a serious global health problem that occurs as a result of a variety of chronic liver disorders. Apigenin, a flavonoid found in many plants, has several pharmacological properties. The aim of this study was to evaluate the antifibrotic efficacy of apigenin (APG) against experimentally induced hepatic fibrosis in rats via using thioacetamide (TAA) and to explore the possible underlying mechanisms. TAA (100 mg/kg, i.p.) was given three times each week for two weeks to induce liver fibrosis. After TAA injections, APG was given orally (5 and 10 mg/kg) daily for two weeks. Biochemical, molecular, histological and immunohistochemical analyses were performed on blood and liver tissue samples. The functioning of the liver, oxidative stress, inflammation, and liver fibrosis indicators were all evaluated. The findings showed that TAA markedly increased the activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), as well as the levels of malondialdehyde (MDA), focal adhesion kinase (FAK), hypoxia-inducible factor-1 (HIF-1), nuclear factor-κB (NF-κB), transforming growth factor-beta (TGF-β), tumor necrosis factor-alpha (TNF-α) and interleukin-1β (IL-1β) with a reduction in albumin, total protein, A/G ratio, GSH content and interleukin-10 (IL-10). Moreover, TAA elevated the content of collagen I, α -smooth muscle actin (α-SMA), and hydroxyproline in the liver. The treatment with APG in a dose-dependent manner has obviously prevented these alterations and amended the harmful effects induced by TAA. The histopathological and immunohistochemical observations supported this biochemical evidence. The higher dose of APG produced the most significant antifibrotic effect. As a result of these data, APG appears to be a promising antifibrotic drug and could be used as a new herbal medication or dietary supplement in the future for the treatment of liver fibrosis. This effect might be related to the inhibition of the HIF-1/FAK signaling pathway.

Keywords: apigenin, FAK, HIF-1, liver fibrosis, rat, thioacetamide

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1310 Traumatic Chiasmal Syndrome Following Traumatic Brain Injury

Authors: Jiping Cai, Ningzhi Wangyang, Jun Shao

Abstract:

Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality that leads to structural and functional damage in several parts of the brain, such as cranial nerves, optic nerve tract or other circuitry involved in vision and occipital lobe, depending on its location and severity. As a result, the function associated with vision processing and perception are significantly affected and cause blurred vision, double vision, decreased peripheral vision and blindness. Here two cases complaining of monocular vision loss (actually temporal hemianopia) due to traumatic chiasmal syndrome after frontal head injury were reported, and were compared the findings with individual case reports published in the literature. Reported cases of traumatic chiasmal syndrome appear to share some common features, such as injury to the frontal bone and fracture of the anterior skull base. The degree of bitemporal hemianopia and visual loss acuity have a variable presentation and was not necessarily related to the severity of the craniocerebral trauma. Chiasmal injury may occur even in the absence bony chip impingement. Isolated bitemporal hemianopia is rare and clinical improvement usually may not occur. Mechanisms of damage to the optic chiasm after trauma include direct tearing, contusion haemorrhage and contusion necrosis, and secondary mechanisms such as cell death, inflammation, edema, neurogenesis impairment and axonal damage associated with TBI. Beside visual field test, MRI evaluation of optic pathways seems to the strong objective evidence to demonstrate the impairment of the integrity of visual systems following TBI. Therefore, traumatic chiasmal syndrome should be considered as a differential diagnosis by both neurosurgeons and ophthalmologists in patients presenting with visual impairment, especially bitemporal hemianopia after head injury causing frontal and anterior skull base fracture.

Keywords: bitemporal hemianopia, brain injury, optic chiasma, traumatic chiasmal syndrome.

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1309 Resistances among Sexual Offenders on Specific Stage of Change

Authors: Chang Li Yu

Abstract:

Resistances commonly happened during sexual offenders treatment program (SOTP), and removing resistances was one of the treatment goals on it. Studies concerning treatment effectiveness relied on pre- and post-treatment evaluations, however, no significant difference on resistance revealed after treatment, and the above consequences generally contributed to the low motivation for change instead. Therefore, the aim of this study was to investigate the resistance across each stage of change among sexual offenders (SO). The present study recruited prisoned SO in Taiwan, excluding those with literacy difficulties; finally, 272 participants were included. Of all participants completed revised version of URICA (University of Rhode Island Change Assessment) and resistance scale specifically for SO. The former included four stages of change: pre-contemplation (PC), contemplation (C), action (A), and maintain (M); the later composed eight types of resistance: system blaming, victims blaming, problems with treatment alliance, social justification, hopelessness, isolation, psychological reactance, and passive reactance. Both of the instruments were with well reliability and validity. Descriptive statistics and ANOVA were performed. All of 272 participants, age under 25 were 18(6.6%), 25-39 were 133(48.9%), 40-54 were 102(37.5%), and age over 55 were 19(7.0%); college level and above were 53(19.5%), high school level were 110(40.4%), and under high school level were 109(40.1%); first offended were 117(43.0%), and recidivist were 23(8.5%). Further deleting data with missing values and invalid questionnaires, SO with stage of change on PC were 43(18.9%), C were 109(47.8%), A were 70(30.7%), and on M were 6(2.6%). One-way ANOVA showed significant differences on every kind of resistances, excepting isolation and passive reactance. Post-hoc analysis showed that SO with different stages had their main resistance. There are two contributions to the present study. First, this study provided a clinical and theoretical measurement of evaluation that was never used in the past. Second, this study used an evidence-based methodology to prove a clinical perspective differed from the past, suggesting that resistances to treatment on SO appear the whole therapeutic process, when SO progress into the next stage of change, clinicians have to deal with their main resistance for working through the therapy.

Keywords: resistance, sexual offenders treatment program (SOTP), motivation for change, prisoned sexual offender

Procedia PDF Downloads 245
1308 Legal Theories Underpinning Access to Justice for Victims of Sexual Violence in Refugee Camps in Africa

Authors: O. E. Eberechi, G. P. Stevens

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Legal theory has been referred to as the explanation of why things do or do not happen. It also describes situations and why they ensue. It provides a normative framework by which things are regulated and a foundation for the establishment of legal mechanisms/institutions that can bring about a desired change in a society. Furthermore, it offers recommendations in resolving practical problems and describes what the law is, what the law ought to be and defines the legal landscape generally. Some legal theories provide a universal standard, e.g. human rights, while others are capable of organizing and streamlining the collective use, and, by extension, bring order to society. Legal theory is used to explain how the world works and how it does not work. This paper will argue for the application of the principles of legal theory in the achievement of access to justice for female victims of sexual violence in refugee camps in Africa through the analysis of legal theories underpinning the access to justice for these women. It is a known fact that female refugees in camps in Africa often experience some form of sexual violation. The perpetrators of these incidents may never be apprehended, prosecuted, convicted or sentenced. Where prosecution does occur, the perpetrators are either acquitted as a result of poor investigation, inept prosecution, a lack of evidence, or the case may be dismissed owing to tardiness on the part of the prosecutor, which accounts for the culture of impunity in refugee camps. In other words, victims do not have access to the justice that could ameliorate the plight of the victims. There is, thus, a need for a legal framework that will facilitate access to justice for these victims. This paper will start with an introduction, and be followed by the definition of legal theory, its functions and its application in law. Secondly, it will provide a brief explanation of the problems faced by female refugees who are victims of sexual violence in refugee camps in Africa. Thirdly, it will embark on an analysis of theories which will be a help to an understanding of the precarious situation of female refugees, why they are violated, the need for access to justice for these victims, and the principles of legal theory in its usefulness in resolving access to justice for these victims.

Keywords: access to justice, underpinning legal theory, refugee, sexual violence

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1307 Assessing the Macroeconomic Effects of Fiscal Policy Changes in Egypt: A Bayesian Structural Vector Autoregression Approach

Authors: Walaa Diab, Baher Atlam, Nadia El Nimer

Abstract:

Egypt faces many obvious economic challenges, and it is so clear that a real economic transformation is needed to address those problems, especially after the recent decisions of floating the Egyptian pound and the gradual subsidy cuts that are trying to meet the needed conditions to get the IMF support of (a £12bn loan) for its economic reform program. Following the post-2008 revival of the interest in the fiscal policy and its vital role in speeding up or slowing down the economic growth. Here comes the value of this paper as it seeks to analyze the macroeconomic effects of fiscal policy in Egypt by applying A Bayesian SVAR Approach. The study uses the Bayesian method because it includes the prior information and no relevant information is omitted and so it is well suited for rational, evidence-based decision-making. Since the study aims to define the effects of fiscal policy shocks in Egypt to help the decision-makers in determining the proper means to correct the structural problems in the Egyptian economy, it has to study the period of 1990s economic reform, but unfortunately; the available data is on an annual frequency. Thus, it uses annual time series to study the period 1991: 2005 And quarterly data over the period 2006–2016. It uses a set of six main variables includes government expenditure and net tax revenues as fiscal policy arms affecting real GDP, unemployment, inflation and the interest rate. The study also tries to assess the 'crowding out' effects by considering the effects of government spending and government revenue shocks on the composition of GDP, namely, on private consumption and private investment. Last but not least the study provides its policy implications regarding the needed role of fiscal policy in Egypt in the upcoming economic reform building on the results it concludes from the previous reform program.

Keywords: fiscal policy, government spending, structural vector autoregression, taxation

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