Search results for: women roles
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4271

Search results for: women roles

431 The Recovery Experience Study of People with Bipolar Disorder

Authors: Sudkhanoung Ritruechai, Somrak Choovanichwong, Kruawon Tiengtom, Peanchanan Leeudomwong

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The purposes of this qualitative research were to study the recovery experience of people with bipolar disorder and also to propose a development approach to the Bipolar Friends Club. The participants were eight people with bipolar disorder for six to twenty years (four women and four men). They have been members of the Bipolar Friends Club for two to ten years. They have no mental symptoms in order to provide sufficient information about their recovery experiences and have returned to everyday life with their family, community, and work. The data were collected by doing an in-depth interview. Two interviews were done, each from 45-90 minutes and four to five weeks apart. The researcher sent the results of the preliminary data analysis to the participants two to three days beforehand. Confirmation of the results of the preliminary data analysis from the first interview was done at the second interview. The research study found that the participants had a positive experience of being a Bipolar Club member. The club continued its activities following Recovery Oriented Service: ROS to the participants. As a result, they recovered in eight areas as follows. 1) Intellectual: The wisdom of joining the group has brought knowledge and experiences from an exchange with others in self-care as well as a positive thinking in life. 2) Social: The participants have set up a group to take care of each other and to do activities which have brought warmth. Their social network which was normally little has also been increased. 3) Spiritual: The concept of religion has been used to lead the life of the participants. 4) Occupational: One participant is a student while the others do work. All of them have done well. 5) Environmental: The participants would be able to adapt to the environment and cope with their problems better. 6) Physical: Most female participants have difficulties with losing weight which leads them saying that they are ‘not fully recovered’. 7) Emotional: The participants feel calmer than before entering the club. They have also developed more tolerance to problems. 8) Financial: The participants would be able to control their spending by themselves and with the help of their family members. The people with bipolar disorder have suggested that the services of the club are perfect and should be continued. The results of the study encourage the Bipolar Friends Club, as well as other clubs/associations that support the recovery of patients. Consideration of the recovery has highlighted the need for ongoing and various life-enhancing programs for the caregivers and their loved ones with bipolar disorder. Then, they would be able to choose the program that suits their needs to improve their life.

Keywords: people with bipolar disorder, recovery, club, experience

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430 Experiences and Challenges of Menstruation Among Rural Schoolgirls in Ghana: A Case of Nadowli-Kaleo District in the Upper West Region of Ghana

Authors: Rosemond Mbii

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Menstruation is a critical topic. However normal menstruation is, it has become a determinant in the education of young women today. The research focuses on Breaking the silence and accessing menstrual hygiene management's challenges and experiences among rural schoolgirls in Ghana. The study's goal was to examine the menstrual hygiene practices of female students. Participants described their menstrual hygiene practices, their problems, and how they coped with their menstrual symptoms. The research used a qualitative technique through group interviews, personal interviews, and open-ended questionnaires since it is easier to understand a phenomenon from the subject's viewpoint. Sen's capacities approach and Feminist Political Ecology (FPE) were used to analyze the data. Menstruation was known to girls even before their menarche. A mother or grandmother, friends, and teachers were the primary sources of menstrual knowledge. The study also found that most girls use sanitary products made of fabrics, pads, and cotton during menstruation. Among the difficulties the girls faced, the study found were emotional upset, physical discomfort (cramps in the stomach, fatigue), embarrassment, and inadequate sanitation hygiene facilities. The girls wore many garments to avoid leaks; checked their skirts continuously, went to the bathroom with their friends to act as spics while they changed; sat differently on the chairs, and took medicine to reduce period discomfort. Introduction of a health care teacher who supplies sanitary products and medications to girls during school time. Euphemisms as a form of communication amongst girls were all coping mechanisms girls and the school developed. Another finding was that some girls continued to go to school even while having their periods, while others did not. Discomfort and menstruation cramps hampered class participation. In addition, the study revealed insufficient sanitation and hygiene for females to change sanitary products in private and manage menstrual hygiene comfortably.

Keywords: MHM (menstrual hygiene management), rural area, sanitation, menstruation, water, schoolgirl, rural area, sanitation, menstruation, water

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429 The Marriage of a Sui Juris Girl: Permission of Wali (Guardian) or Consent of Ward in the Context of Personal Law in Pakistan

Authors: Muhammad Farooq

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The present article explores the woman's consent as a paramount element in contracting a Muslim marriage. Also, whether permission of the wali (guardian) is a condition per se for a valid nikah (marriage deed) in the eye of law and Sharia. The researcher attempts to treat it through the related issues, inter alia; the marriage guardian, the women's legal capacity to give consent whether she is a virgin or nonvirgin and how that consent is to be given or may be understood. Does her laugh, tears or salience needs a legal interpretation as well as other female manifestations of emotion explained by the Muslim jurists? The silence of Muslim Family Law Ordinance 1961 (hereafter; MFLO 1961) in this regard and the likely reasons behind such silence is also inquired in brief. Germane to the theme, the various cases in which the true notion of woman's consent is interpreted by courts in Pakistan are also examined. In order to address the issue in hand, it is proposed to provide a brief overview of a few contemporary writers' opinions in which the real place of woman's consent in Muslim marriage is highlighted. Key to the idea of young Muslim woman's marriage, the doctrine of kafa'a (equality or suitability) between the man and woman is argued here to be grounded in the patriarchal and social norms. It is, therefore, concluded that such concept was the result of analogical reasoning and has less importance in the present time. As such it is not a valid factor in current scenarios to validate or invalidate marital bonds. A standard qualitative convention is used for this research. Among primary and secondary sources; for examples, Qur'an, Sunnah, Books, Scholarly articles, texts of law and case law is used to point out the researcher's view. In summation, the article is concluded with a bold statement that a young woman being a party to the contract, is absolutely entitled to 'full and free' consent for the Muslim marriage contract. It is the woman, an indispensable partaker and her consent (not the guardian' permission) that does validate or invalidate the said agreement in the eye of contemporary personal law and in Sharia.

Keywords: consent of woman, ejab (declaration), Nikah (marriage agreement), qabol (acceptance), sui juris (of age; independent), wali (guardian), wilayah (guardianship)

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428 Mobile Learning in Developing Countries: A Synthesis of the Past to Define the Future

Authors: Harriet Koshie Lamptey, Richard Boateng

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Mobile learning (m-learning) is a novel approach to knowledge acquisition and dissemination and is gaining global attention. Steady progress in wireless technologies and the portability of communication devices continue to broaden the scope and use of mobiles. With the convergence of Web functionality onto mobile platforms and the affordability and availability of mobile technology, m-learning has the potential of being the next prevalent channel of education in both formal and informal settings. There is substantive literature on developed countries but the state in developing countries (DCs) however appears vague. This paper is a synthesis of extant literature on mobile learning in DCs. The research interest is based on the fact that in DCs, mobile communication and internet connectivity are popular. However, its use in education is under explored. There are some reviews on the state, conceptualizations, trends and teacher education, but to the authors’ knowledge, no study has focused on mobile learning adoption and integration issues. This study examines issues and gaps associated with its adoption and integration in DCs higher education institutions. A qualitative build-up of literature was conducted using articles pooled from electronic databases (Google Scholar and ERIC). To enable criteria for inclusion and incorporate diverse study perspectives, search terms used were m-learning, DCs, higher education institutions, challenges, benefits, impact, gaps and issues. The synthesis revealed that though mobile technology has diffused globally, its pedagogical pursuit in DCs remains quite low. The absence of a mobile Web and the difficulty of resource conversion into mobile format due to lack of funding and technical competence is a stumbling block. Again, the lack of established design and implementation rules to guide the development of m-learning platforms in DCs is a hindrance. The absence of access restrictions on devices poses security threats to institutional systems. Negative perceptions that devices are taking over faculty roles lead to resistance in some situations. Resistance to change can be a hindrance to the acceptance and success of new systems. Lack of interest for m-learning is also attributed to lower technological literacy levels of the underprivileged masses. Scholarly works on m-learning in DCs is yet to mature. Most technological innovations are handed down from developed countries, and this constantly creates a lag for DCs. Lack of theoretical grounding was also identified which reduces the objectivity of study reports. The socio-cultural terrain of DCs results in societies with different views and needs that have been identified as a hindrance to research. Institutional commitment decisions, adequate funding for the necessary infrastructural development as well as multiple stakeholder participation is important for project success. Evidence suggests that while adoption decisions are readily made, successful integration of the concept for its full benefits to be realized is often neglected. Recommendations to findings were made to provide possible remedies to identified issues.

Keywords: developing countries, higher education institutions, mobile learning, literature review

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427 Observing Sustainability: Case Studies of Chandigarh Boutiques and Their Textile Waste Reuse

Authors: Prabhdip Brar

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Since the ancient times recycling, reusing and upcycling has been strongly practiced in India. However, previously reprocess was common due to lack of resources and availability of free time, especially with women who were homemakers. The upward strategy of design philosophy and drift of sustainability is sustainable fashion which is also termed eco fashion, the aspiration of which is to craft a classification which can be supported ad infinitum in terms of environmentalism and social responsibility. The viable approach of sustaining fashion is part of the larger trend of justifiable design where a product is generated and produced while considering its social impact to the environment. The purpose of this qualitative research paper is to find out if the apparel design boutiques in Chandigarh, (an educated fashion-conscious city) are contributing towards making conscious efforts with the re-use of environmentally responsive materials to rethink about eco-conscious traditional techniques and socially responsible approaches of the invention. Observation method and case studies of ten renowned boutiques of Chandigarh were conducted to find out about the creativity of their waste management and social contribution. Owners were interviewed with open-ended questions to find out their understanding of sustainability. This paper concludes that there are many sustainable ideas existing within India from olden times that can be incorporated into modern manufacturing techniques. The results showed all the designers are aware of sustainability as a concept. In all practical purposes, a patch of fabric is being used for bindings or one over the other as surface ornamentation techniques. Plain Fabrics and traditional prints and fabrics are valued more by the owners for using on other garments. Few of them sort their leftover pieces according to basic colors. Few boutique owners preferred donating it to Non-Government organizations. Still, they have enough waste which is not utilized because of lack of time and labor. This paper discusses how the Indian traditional techniques still derive influences though design and techniques, making India one of the contributing countries to the sustainability of fashion and textiles.

Keywords: eco-fashion textile, sustainable textiles, sustainability in india, waste management

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426 Evaluation of Non-Pharmacological Method-Transcervical Foley Catheter and Misoprostol to Intravaginal Misoprostol for Preinduction Cervical Ripening

Authors: Krishna Dahiya, Esha Charaya

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Induction of labour is a common obstetrical intervention. Around 1 in every 4 patient undergo induction of labour for different indications Purpose: To study the efficacy of the combination of Foley bulb and vaginal misoprostol in comparison to vaginal misoprostol alone for cervical ripening and induction of labour. Methods: A prospective randomised study was conducted on 150 patients with term singleton pregnancy admitted for induction of labour. Seventy-five patients were induced with both Foley bulb, and vaginal misoprostol and another 75 were given vaginal misoprostol alone for induction of labour. Both groups were then compared with respect to change in Bishop score, induction to the active phase of labour interval, induction delivery interval, duration of labour, maternal complications and neonatal outcomes. Data was analysed using statistical software SPSS version 11.5. Tests with P,.05 were considered significant. Results: The two groups were comparable with respect to maternal age, parity, gestational age, indication for induction, and initial Bishop scores. Both groups had a significant change in Bishop score (2.99 ± 1.72 and 2.17 ± 1.48 respectively with statistically significant difference (p=0.001 S, 95% C.I. -0.1978 to 0.8378). Mean induction to delivery interval was significantly lower in the combination group (11.76 ± 5.89 hours) than misoprostol group (14.54 ± 7.32 hours). Difference was of 2.78 hours (p=0.018,S, 95% CI -5.1042 to -0.4558). Induction to delivery interval was significantly lower in nulliparous women of combination group (13.64 ± 5.75 hours) than misoprostol group (18.4±7.09 hours), and the difference was of 4.76 hours (p=0.002, S, 95% CI 1.0465 to 14.7335). There was no difference between the groups in the mode of delivery, infant weight, Apgar score and intrapartum complications. Conclusion: From the present study it was concluded that addition of Foley catheter to vaginal misoprostol have the synergistic effect and results in early cervical ripening and delivery. These results suggest that the combination may be used to achieve timely and safe delivery in the presence of an unfavorable cervix. A combination of the Foley bulb and vaginal misoprostol resulted in a shorter induction-to-delivery time when compared with vaginal misoprostol alone without increasing labor complications.

Keywords: Bishop score, Foley catheter, induction of labor, misoprostol

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425 Impact of COVID-19 on Antenatal Care Provision at Public Hospitals in Ethiopia: A Mixed Method Study

Authors: Zemenu Yohannes

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Introduction: The pandemic overstretched the weak health systems in developing countries, including Ethiopia. This study aims to assess and explore the effect of COVID-19 on antenatal care (ANC) provision. Methods: A concurrent mixed methods study was applied. An interrupted time series design was applied for the quantitative study, and in-depth interviews were implemented for the qualitative research to explore maternity care providers' perceptions of ANC provision during COVID-19. We used routine monthly collected data from the health management information system (HMIS) in fifteen hospitals in the Sidama region, Ethiopia, from March 2019 to February 2020 (12 months) before COVID-19 and from March to August 2020 (6 months) during COVID-19. We imported data into STATA V.17 for analysis. ANC provision's mean monthly incidence rate ratio (IRR) was calculated using Poisson regression with a 95% confidence interval. The qualitative data were analysed using thematic analysis. Findings from quantitative and qualitative elements were integrated with a contiguous approach. Results: Our findings indicate the rate of ANC provision significantly decreased in the first six months of COVID-19. This study has three identified main themes: barriers to ANC provision, inadequate COVID-19 prevention approach, and delay in providing ANC. Conclusion and recommendation: Based on our findings, the pandemic affected ANC provision in the study area. The health bureau and stakeholders should take a novel and sustainable approach to prevent future pandemics. The health bureau and hospital administrators should establish a task force that relies on financial self-reliance to close gaps in future pandemics of medical supply shortages. Pregnant women should receive their care promptly from maternity care providers. In order to foster contact and avoid discrimination the future pandemics, hospital administrators should set up a platform for community members and maternity care providers.

Keywords: ANC provision, COVID-19, mixed methods study, Ethiopia

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424 Variation in Maternal Mortality in Sidama National Regional State, Southern Ethiopia: A Population Based Cross Sectional Household Survey

Authors: Aschenaki Zerihun Kea, Bernt Lindtjorn, Achamyelesh Gebretsadik, Sven Gudmund Hinderaker

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Introduction: Maternal mortality studies conducted at the national level do not provide the information needed for planning and monitoring health programs at lower administrative levels. The aim of this study was to measure maternal mortality, identify risk factors and district-level variations in Sidama National Regional State, southern Ethiopia. Methods: A cross sectional population-based survey was carried out in households where women reported pregnancy and birth outcomes in the past five years. The study was conducted in the Sidama National Regional State, southern Ethiopia, from July 2019 to May 2020. Multi-stage cluster sampling technique was employed. The outcome variable of the study was maternal mortality. Complex sample logistic regression analysis was applied to assess variables independently associated with maternal mortality. Results: We registered 10602 live births (LB) and 48 maternal deaths, yielding an overall maternal mortality ratio (MMR) of 419; 95% CI: 260-577 per 100,000 LB. Aroresa district had the highest MMR with 1142 (95% CI: 693-1591) per 100,000 LB. Leading causes of death were haemorrhage 21 (41%) and eclampsia 10 (27%). Thirty (59%) mothers died during labour, or within 24 hours after delivery, 25 (47%) died at home and 17 (38%) at a health facility. Mothers who did not have formal education had a higher risk of maternal death (AOR: 4.4; 95% CI: 1.7 – 11.0). The risk of maternal death was higher in districts with a low midwife-to-population ratio (AOR: 2.9; 95% CI: 1.0-8.9). Conclusion: The high maternal mortality with district-level variations in Sidama Region highlights the importance of improving obstetric care and employing targeted interventions in areas with high mortality rates. Due attention should be given to improving access to female education. Additional midwives have to be trained and deployed to improve maternal health services and consequently save the lives of mothers.

Keywords: maternal mortality variation, maternal death, Sidama, Ethiopia

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423 Association Type 1 Diabetes and Celiac Disease in Adult Patients

Authors: Soumaya Mrabet, Taieb Ach, Imen Akkari, Amira Atig, Neirouz Ghannouchi, Koussay Ach, Elhem Ben Jazia

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Introduction: Celiac disease (CD) and type 1 diabetes mellitus (T1D) are complex disorders with shared genetic components. The association between CD and T1D has been reported in many pediatric series. The aim of our study is to describe the epidemiological, clinical and evolutive characteristics of adult patients presenting this association. Material and Methods: This is a retrospective study including patients diagnosed with CD and T1D, explored in Internal Medicine, Gastroenterology and Endocrinology and Diabetology Departments of the Farhat Hached University Hospital, between January 2005 and June 2016. Results: Among 57 patients with CD, 15 patients had also T1D (26.3%). There are 11 women and 4 men with a median age of 27 years (16-48). All patients developed T1D prior to the diagnosis of CD with an average duration of 47 months between the two diagnosis (6 months-5 years). CD was revealed by recurrent abdominal pain in 11 cases, diarrhea in 10 cases, bloating in 8 cases, constipation in 6 cases and vomiting in 2 cases. Three patients presented cycle disorders with secondary amenorrhea in 2 patients. Anti-Endomysium, anti-transglutaminase and Anti-gliadin antibodies were positive respectively in 57, 54 and 11 cases. The biological tests revealed anemia in 10 cases, secondary to iron deficiency in 6 cases and folate and vitamin B12 deficiency in 4 cases, hypoalbuminaemia in 4 cases, hypocalcemia in 3 cases and hypocholesterolemia in 1 patient. Upper gastrointestinal endoscopy showed an effacement of the folds of the duodenal mucosa in 6 cases and a congestive duodenal mucosa in 3 cases. The macroscopic appearance was normal in the others cases. Microscopic examination showed an aspect of villous atrophy in 57 cases, which was partial in 10 cases and total in 47 cases. After an average follow-up of 3 years 2 months, the evolution was favorable in all patients under gluten-free diet with the necessity of less important doses of insulin in 10 patients. Conclusion: In our study, the prevalence of T1D in adult patients with CD was 26.3%. This association can be attributed to overlapping genetic HLA risk loci. In recent studies, the role of gluten as an important player in the pathogenesis of CD and T1D has been also suggested.

Keywords: celiac disease, gluten, prevalence, type 1 diabetes

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422 Cultural Orientation as a Moderator between Social Support Needs and Psychological Well-Being among Canadian University Students

Authors: Allison Streutker, Josephine Tan

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Universities across Canada have experienced unprecedented growth in international student enrollment from across the world. As cultural diversity in Canada and other countries increases, understanding the social support needs of all students is important for providing them with the assistance they need to thrive psychologically and academically. Those from individualistic cultural orientations tend to seek explicit social support, which involves expressly asking for assistance in times of stress. However, those from collectivistic cultural orientations are more likely to seek implicit social support, where encouragement is obtained from spending time among valued social groups without explicitly talking about problems. This study explored whether the relationship between the type of social support needs (implicit or explicit) and psychological and academic functioning might be moderated by cultural orientations (individualistic, collectivistic) among university students. Participants were 110 university students (70 women, 40 men; mean age = 24.8 years, SD = 6.6). They completed the Individualism and Collectivism Scale (ICS), Perceived Stress Scale (PSS), Interpersonal Support Evaluation List (ISEL) which assesses implicit and explicit social support, Satisfaction with Life Scale (SWLS), Scale of Positive and Negative Experience (SPANE) which yields positive and negative experience scores, Flourishing Scale (FS), and reported their grade point average (GPA) as a measure of academic performance. Moderated regression analysis demonstrated that, for those scoring lower on individualism, reporting lower level of implicit support predicted higher levels of perceived stress. For those scoring higher on individualism, lower levels of explicit social support predicted higher levels of perceived stress and a greater number of negative experiences. Generally, higher levels of implicit support were associated with greater satisfaction with life for all students, with the association becoming stronger among students with higher collectivism scores. No other significant findings were found. The results point to the value of considering the cultural orientations of students when designing programs to maintain and improve their sense of well-being.

Keywords: cultural orientation, social support, university students, well-being

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421 Correlation between Calpain 1 Expression and Proliferating/Apoptotic Index and Prognostic Factors in Triple Negative Breast Cancer

Authors: Shadia Al-Bahlani, Ruqaya Al-Rashdi, Shadia Al-Sinawi, Maya Al-Bahri

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Background: Breast cancer is the most common cancer in women worldwide. Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer, which is defined by the absence of Estrogen (ER), Progesterone (PR) and Human epidermal growth factor (Her-2) receptors. The calpain system plays an important role in many cellular processes including apoptosis, necrosis, cell signaling and proliferation. The role of clapins in pathogenesis and tumor progression has been studied in certain cancer types; however, its definite role is not yet established in breast cancer especially in the TNBC subtype. Objectives: This study aims to measure calpain-1 expression and correlate this measurement with the proliferating/apoptotic index as well with the prognostic factors in TNBC patients’ tissue. Materials and Methods: Thirty nine paraffin blocks from patients diagnosed with TNBC were used to measure the expression of calpain-1 and Ki-67 (proliferating marker) proteins using immunohistochemistry. Apoptosis was assessed morphological and biochemically using conventional Haematoxylin and Eosin (H&E) staining method and terminal deoxynucleotidyl transferase-mediate dUTP nick and labeling (TUNEL) assay respectively. Data was statistically analyzed using Pearson X2 test of association. Results: Calpain-1 content was visualized in the nucleus of the TNBC cells and its expression varied from low to high among the patients tissue. Calpain expression showed no significant correlation with the proliferating/apoptotic index as well with the clinicopathological variables. Apoptotic counts quantified by H&E staining showed significant association with the apoptotic TUNEL assay, validating both approaches. Conclusion: Although calpain-1 expression showed no significant association with the clinical outcome, its variable level of expression might indicate a hidden role in breast cancer tissue. Larger number of samples and different mode of assessments are needed to fully investigate such role. Exploring the involvement of calpain-1 in cancer progression might help in considering it as a biomarker of breast cancer.

Keywords: breast cancer, calpain, apoptosis, prognosis

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420 Organ Dose Calculator for Fetus Undergoing Computed Tomography

Authors: Choonsik Lee, Les Folio

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Pregnant patients may undergo CT in emergencies unrelated with pregnancy, and potential risk to the developing fetus is of concern. It is critical to accurately estimate fetal organ doses in CT scans. We developed a fetal organ dose calculation tool using pregnancy-specific computational phantoms combined with Monte Carlo radiation transport techniques. We adopted a series of pregnancy computational phantoms developed at the University of Florida at the gestational ages of 8, 10, 15, 20, 25, 30, 35, and 38 weeks (Maynard et al. 2011). More than 30 organs and tissues and 20 skeletal sites are defined in each fetus model. We calculated fetal organ dose-normalized by CTDIvol to derive organ dose conversion coefficients (mGy/mGy) for the eight fetuses for consequential slice locations ranging from the top to the bottom of the pregnancy phantoms with 1 cm slice thickness. Organ dose from helical scans was approximated by the summation of doses from multiple axial slices included in the given scan range of interest. We then compared dose conversion coefficients for major fetal organs in the abdominal-pelvis CT scan of pregnancy phantoms with the uterine dose of a non-pregnant adult female computational phantom. A comprehensive library of organ conversion coefficients was established for the eight developing fetuses undergoing CT. They were implemented into an in-house graphical user interface-based computer program for convenient estimation of fetal organ doses by inputting CT technical parameters as well as the age of the fetus. We found that the esophagus received the least dose, whereas the kidneys received the greatest dose in all fetuses in AP scans of the pregnancy phantoms. We also found that when the uterine dose of a non-pregnant adult female phantom is used as a surrogate for fetal organ doses, root-mean-square-error ranged from 0.08 mGy (8 weeks) to 0.38 mGy (38 weeks). The uterine dose was up to 1.7-fold greater than the esophagus dose of the 38-week fetus model. The calculation tool should be useful in cases requiring fetal organ dose in emergency CT scans as well as patient dose monitoring.

Keywords: computed tomography, fetal dose, pregnant women, radiation dose

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419 The Hierarchical Model of Fitness Services Quality Perception in Serbia

Authors: Mirjana Ilic, Dragan Zivotic, Aleksandra Perovic, Predrag Gavrilovic

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The service quality perception depends on many factors, such as the area in which the services are provided, socioeconomic status, educational status, experience, age and gender of consumers, as well as many others. For this reason, it is not possible to apply instrument for establishing the service quality perception that is developed in other areas and in other populations. The aim of the research was to form an instrument for assessing the quality perception in the field of fitness in Serbia. After analyzing the available literature and conducting a pilot research, there were 15 isolated areas in which it was possible to observe the service quality perception. The areas included: material and technical basis, secondary facilities, coaches, programs, reliability, credibility, security, rapid response, compassion, communication, prices, satisfaction, loyalty, quality outcomes and motives. These areas were covered by a questionnaire consisted of 100 items where the number of items varied from area to area from 3 up to 11. The questionnaire was administered to 350 subjects of both genders (174 men and 176 women) aged from 18 to 68 years, being beneficiaries of fitness services for at least 1 year. In each of the areas was conducted a factor analysis in its exploratory form by principal components method. The number of significant factors has been determined in accordance with the Kaiser Guttman criterion. The initial factor solutions were simplified using the Varimax rotation. Analyses per areas have produced from 1 to 4 factors. Afterward, the factor analysis of factor scores on the first principal component of each of the respondents in each of the analyzed area was performed, and the factor structure was obtained with four latent dimensions interpreted as offer, the relationship with the coaches, the experience of quality and the initial impression. This factor structure was analysed by hierarchical analysis of Oblique factors, which in the second order space produced single factor interpreted as a general factor of the service quality perception. The resulting questionnaire represents an instrument which can serve managers in the field of fitness to optimize the centers development, raising the quality of services in line with consumers needs and expectations.

Keywords: fitness, hierarchical model, quality perception, factor analysis

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418 Sufism and Social Justice: Embodied Love in Action

Authors: Nazal Abdul Nasar RP

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This paper explores the intersection of Sufism and social justice, examining how Sufi principles and practices inform and inspire activism, community engagement, and advocacy for human rights. Drawing on Islamic mystical texts, contemporary Sufi movements, and critical theory, this study argues that Sufism's emphasis on love, compassion, and unity provides a powerful framework for addressing systemic oppression and promoting collective liberation. Sufism, Islamic mysticism has long emphasized the importance of love, compassion, and unity. This paper explores how these principles can inform social justice work, particularly in the context of contemporary activism. Sufi teachings on ma'rifa (spiritual knowledge) emphasize the importance of spiritual awareness and self-reflection in social justice work. Fana (annihilation) informs strategies for addressing privilege and oppression by emphasizing ego annihilation and humility. Tawhid (unity) underlies efforts to build inclusive, equitable communities. Case studies of Sufi-inspired activism in the Middle East, North Africa, and South Asia demonstrate the potential of Sufi principles to inform social justice work. Examples include Sufi-led protests and grassroots organizing in Egypt and Turkey, Sufi women's empowerment initiatives in Morocco and Tunisia, and Sufi-inspired environmental activism in India and Pakistan. This research demonstrates the potential of Sufi principles to inform and inspire social justice activism. By embodying love, compassion, and unity, activists can address systemic oppression and promote collective liberation. The implications of this research include interfaith dialogue, community building, and activism. Future directions include integrating Sufi principles with critical theory, examining additional Sufi-inspired activism globally, and developing practical guidelines for Sufi-inspired social justice activism.

Keywords: sufism, social justice, islamic mysticism, ego annihilation, love, unity

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417 Automatic Processing of Trauma-Related Visual Stimuli in Female Patients Suffering From Post-Traumatic Stress Disorder after Interpersonal Traumatization

Authors: Theresa Slump, Paula Neumeister, Katharina Feldker, Carina Y. Heitmann, Thomas Straube

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A characteristic feature of post-traumatic stress disorder (PTSD) is the automatic processing of disorder-specific stimuli that expresses itself in intrusive symptoms such as intense physical and psychological reactions to trauma-associated stimuli. That automatic processing plays an essential role in the development and maintenance of symptoms. The aim of our study was, therefore, to investigate the behavioral and neural correlates of automatic processing of trauma-related stimuli in PTSD. Although interpersonal traumatization is a form of traumatization that often occurs, it has not yet been sufficiently studied. That is why, in our study, we focused on patients suffering from interpersonal traumatization. While previous imaging studies on PTSD mainly used faces, words, or generally negative visual stimuli, our study presented complex trauma-related and neutral visual scenes. We examined 19 female subjects suffering from PTSD and examined 19 healthy women as a control group. All subjects did a geometric comparison task while lying in a functional-magnetic-resonance-imaging (fMRI) scanner. Trauma-related scenes and neutral visual scenes that were not relevant to the task were presented while the subjects were doing the task. Regarding the behavioral level, there were not any significant differences between the task performance of the two groups. Regarding the neural level, the PTSD patients showed significant hyperactivation of the hippocampus for task-irrelevant trauma-related stimuli versus neutral stimuli when compared with healthy control subjects. Connectivity analyses revealed altered connectivity between the hippocampus and other anxiety-related areas in PTSD patients, too. Overall, those findings suggest that fear-related areas are involved in PTSD patients' processing of trauma-related stimuli even if the stimuli that were used in the study were task-irrelevant.

Keywords: post-traumatic stress disorder, automatic processing, hippocampus, functional magnetic resonance imaging

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416 Metoo in China: An Analysis of the Metoo Movement in China's Social Media

Authors: Xinrui Zhao

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Connective actions acquired a completely different outlook of a social movement which credited with the rapid developed of social media technologies. New social movements amalgamate and mobilize around hashtags, memes, and personalized action frames. In 2017, the #MeToo movements from America spread to a variety of countries as a hashtag on social media. It attempted to demonstrate the widespread prevalence of sexual assault and harassment movement. It also encouraged Chinese women to participate by devoting and contributing their voices and acts. Furthermore, China’s #MeToo movement shows certain characteristics which are strongly shaped by particular political and cultural backgrounds, that also need to be studied. This paper serves as supplementary materials of connective action studies by addressing the #MeToo movement issues in China, which is rarely mentioned previously in the literature, it also supports a view that suggests that ideological and cultural drivers both strategically contribute to personalized action frames. This paper combines textual analysis methods, collecting attached materials from search engines in China’s social media, portrays the structure of China’s #MeToo movements by showing prominent activists, scholars, organization and the public’s action frame in China’s social media(Weibo, wechat, zhihu, douban). In doing so, it seeks to find how China’s #MeToo movements are organized and reveal diversities of social action approaches among those three subjects, digs out the correlations of their actions related to different social media platforms. This analysis suggests that while facing the government's censorship and moral judgments from the public, China’s #MeToo movement combines with few influential sexual assault and harassment events and is lead by the prominent activists who also are the victims in the events. The debates and critiques among Chinese scholars concerned the outcomes and significance of China’s #MeToo movement are divided into sides. Organizations still show less power in participating China’s movement social media. Public’s participation is varied of platforms which hugely affected by their personal experiences and knowledge.

Keywords: connective action, China, MeToo movement, social media

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415 Gender-based Violence and Associated Factors among Private College Female Students in Harar City, Ethiopia, Jan 2023

Authors: Taju Abdela Mohammed

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Introduction: There has been a rise in awareness of violence against young women and girls, particularly when it occurs in educational environments. Gender-based violence in schools is a significant barrier. Therefore, it would be a threat to the achievement of the sustainable development goals, strive for gender equality in all our programs, right from the planning stages, to make sure we are as equitable as possible. Research on the causes, attitudes, and perceptions of gender-based violence was scant. Furthermore, there aren't many studies done on female students attending private colleges. Thus, the purpose of this study is to evaluate the frequency of gender-based violence and related variables among female students attending private colleges in Harar City, Ethiopia. Methodology: A facility-based mixed method concurrent triangulation study design was conducted among 500 randomly selected Private college female students in Harar City. Self-administered questionnaire and an in-depth interview were used to collect the data. The collected data were cleaned and analyzed using a statistical package for social science. Descriptive statistics were conducted and the results were reported using frequency, and percentile. Bivariate logistic regression was performed to identify associated factors. Adjusted odds ratios with 95% confidence intervals and p values < 0.05 were used to explain statistically significant associations. Thematic analysis was used to manually translate, transcribe, and analyze qualitative data. Result: The study showed the prevalence of gender-based violence was 338 (67.6%) (CI 0.432–0.721) Private college female students in Harar city Administration. Age less than 20 years and 20–24 years, [AOR = 0.21, 95% CI (0.03–0.81)] and [AOR = 0.12, 95% CI (0.03–0.51)], tight family control, [AOR = 5.12, 95% CI (1.43–6.9)], Witnessed father abuse mother at childhood; [AOR = 4.04, 95% CI (1.36–12.1)], had drunkenness female or boyfriend; [AOR = 2.12, 95% CI (1.60–14.05)] had significant association with gender-based violence. Conclusion: Our study shows the prevalence of gender-based violence among Private college female students is significant. This is due to the fact that gender-based violence, such as school dropout, unintended pregnancy, abortion, STDs, and psychological disorders, is abandoning young girls' lives and lowering their productivity.

Keywords: female students, gender-violence, harar, Ethiopia

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414 Empirical Study of Innovative Development of Shenzhen Creative Industries Based on Triple Helix Theory

Authors: Yi Wang, Greg Hearn, Terry Flew

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In order to understand how cultural innovation occurs, this paper explores the interaction in Shenzhen of China between universities, creative industries, and government in creative economic using the Triple Helix framework. During the past two decades, Triple Helix has been recognized as a new theory of innovation to inform and guide policy-making in national and regional development. Universities and governments around the world, especially in developing countries, have taken actions to strengthen connections with creative industries to develop regional economies. To date research based on the Triple Helix model has focused primarily on Science and Technology collaborations, largely ignoring other fields. Hence, there is an opportunity for work to be done in seeking to better understand how the Triple Helix framework might apply in the field of creative industries and what knowledge might be gleaned from such an undertaking. Since the late 1990s, the concept of ‘creative industries’ has been introduced as policy and academic discourse. The development of creative industries policy by city agencies has improved city wealth creation and economic capital. It claims to generate a ‘new economy’ of enterprise dynamics and activities for urban renewal through the arts and digital media, via knowledge transfer in knowledge-based economies. Creative industries also involve commercial inputs to the creative economy, to dynamically reshape the city into an innovative culture. In particular, this paper will concentrate on creative spaces (incubators, digital tech parks, maker spaces, art hubs) where academic, industry and government interact. China has sought to enhance the brand of their manufacturing industry in cultural policy. It aims to transfer the image of ‘Made in China’ to ‘Created in China’ as well as to give Chinese brands more international competitiveness in a global economy. Shenzhen is a notable example in China as an international knowledge-based city following this path. In 2009, the Shenzhen Municipal Government proposed the city slogan ‘Build a Leading Cultural City”’ to show the ambition of government’s strong will to develop Shenzhen’s cultural capacity and creativity. The vision of Shenzhen is to become a cultural innovation center, a regional cultural center and an international cultural city. However, there has been a lack of attention to the triple helix interactions in the creative industries in China. In particular, there is limited knowledge about how interactions in creative spaces co-location within triple helix networks significantly influence city based innovation. That is, the roles of participating institutions need to be better understood. Thus, this paper discusses the interplay between university, creative industries and government in Shenzhen. Secondary analysis and documentary analysis will be used as methods in an effort to practically ground and illustrate this theoretical framework. Furthermore, this paper explores how are creative spaces being used to implement Triple Helix in creative industries. In particular, the new combination of resources generated from the synthesized consolidation and interactions through the institutions. This study will thus provide an innovative lens to understand the components, relationships and functions that exist within creative spaces by applying Triple Helix framework to the creative industries.

Keywords: cultural policy, creative industries, creative city, triple Helix

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413 Safety Profile of Anti-Retroviral Medicine in South Africa Based on Reported Adverse Drug Reactions

Authors: Sarah Gounden, Mukesh Dheda, Boikhutso Tlou, Elizabeth Ojewole, Frasia Oosthuizen

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Background: Antiretroviral therapy (ART) has been effective in the reduction of mortality and resulted in an improvement in the prognosis of HIV-infected patients. However, treatment with antiretrovirals (ARVs) has led to the development of many adverse drug reactions (ADRs). It is, therefore, necessary to determine the safety profile of these medicines in a South African population in order to ensure safe and optimal medicine use. Objectives: The aim of this study was to quantify ADRs experienced with the different ARVs currently used in South Africa, to determine the safety profile of ARV medicine in South Africa based on reported ADRs, and to determine the ARVs with the lowest risk profile based on specific patient populations. Methodology: This was a quantitative study. Individual case safety reports for the period January 2010 – December 2013 were obtained from the National Pharmacovigilance Center; these reports contained information on ADRs, ARV medicine, and patient demographics. Data was analysed to find associations that may exist between ADRs experienced, ARV medicines used and patient demographics. Results: A total of 1916 patient reports were received of which 1534 met the inclusion criteria for the study. The ARV with the lowest risk of ADRs were found to be lamivudine (0.51%, n=12), followed by lopinavir/ritonavir combination (0.8%, n=19) and abacavir (0.64%, n=15). A higher incidence of ADRs was observed in females compared to males. The age group 31–50 years and the weight group 61–80 kg had the highest incidence of ADRs reported. Conclusion: This study found that the safest ARVs to be used in a South African population are lamivudine, abacavir, and the lopinavir/ritonavir combination. Gender differences play a significant role in the occurrence of ADRs and both anatomical and physiological differences account for this. An increased BMI (body mass index) in both men and women showed an increase in the incidence of ADRs associated with ARV therapy.

Keywords: adverse drug reaction, antiretrovirals, HIV/AIDS, pharmacovigilance, South Africa

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412 Effects of Abiotic Stress on the Phytochemical Content and Bioactivity of Pistacia lentiscus L.

Authors: S. Mamoucha, N. Tsafantakis, Α. Ioannidis, S. Chatzipanagiotou, C. Nikolaou, L. Skaltsounis, N. Fokialakis, N. Christodoulakis

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Introduction: Plant secondary metabolites (SM) can be grouped into three chemically distinct groups: terpenes, phenolics, and nitrogen-containing compounds. For many years the adaptive significance of SM was unknown. They were thought to be functionless end-products. Currently it is accepted that many secondary metabolites (also known as natural products) have important ecological roles in plants. For instance, they serve as attractants (odor, color, taste) for pollinators and seed-dispersing animals. Moreover, they protect plants from herbivores, microbial pathogens and from environmental stress (high and low temperatures, drought, alkalinity, salinity, radiation etc). It is well known that both biotic and abiotic stress often increase the accumulation of SM. The local climatic conditions, seasonal changes, external factors such as light, temperature, humidity affect the biosynthesis and composition of secondary metabolites. A well known dioecious evergreen plant, Pistacia lentiscus L. (mastic tree), was selected in order to study the metabolic variations occur in response to the different climate conditions, due to the seasonal variation and its effect on the biosynthesis of bioactive compounds. Materials-methods: Young and mature leaves were collected in January and July 2014, dried and extracted by accelerated solvent extraction (Dionex ASE™ 350) using solvents of increased polarity (DCM, MeOH, and H2O). GC-MS and UHPLC-HRMS analysis were carried out in order to define the nature and the relative abundance of SM. The antibacterial activity was evaluated by using the Agar Disc Diffusion Assay against ATCC and clinical isolates strains: Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, Streptococcus mutans and Klebsiella pneumoniae. All tests were carried out in duplicate and the average radii of the inhibition zones were calculated for each extract. Results: According to the phytochemical profile obtained from each extract, the biosynthesis of SM varied both qualitatively and quantitatively under the two different types of seasonal stress. With exception of the biologically inactive nonpolar DCM extract of July, all extracts inhibited the growth of most of the investigated microorganisms. A clear positive correlation has been observed between the relative abundance of SM and the bioactivity of the DCM extracts of January and July. Observed changes during phytochemical analysis were mainly focused on the triterpenoid content. On the other hand, the bioactivity of the polar extracts (MeOH and H2O) of January and July resulted practically invariable against most of the microorganisms, besides the significant variation of the SM content due to the seasonal variation. Conclusion: Our results clearly confirmed the hypothesis of abiotic stress as an important regulating factor that significantly affects the biosynthesis of secondary metabolites and thus the presence of bioactive compounds. Acknowledgment: This work was supported by IKY - State Scholarship Foundation, Athens, Greece.

Keywords: antibacterial screening, phytochemical profile, Pistacia lentiscus, abiotic stress

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411 A Case-Series Analysis of Tuberculosis in Patients at Internal Medicine Department

Authors: Cherif Y., Ghariani R., Derbal S., Farhati S., Ben Dahmen F., Abdallah M.

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Introduction: Tuberculosis (TBC) is a frequent infection and is still a major public health problem in Tunisia. The aim of this work is to focus on diagnostic and therapeutic characteristics of TBC in patients referred to our internal medicine department. Patients and Methods: The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2016 to December 2019, collecting patients with latent or patent TBC. Twenty-eight medical records of adults diagnosed with TBC were reviewed. Results: Twenty-eight patients, including 18 women and 10 men, were diagnosed with TBC. Their mean age is 48 years (range: 22-78 years). Five patients have a medical history of diabetes mellitus, 1 patient was followed for systemic lupus erythematosus treated with corticosteroids and immunosuppressant drugs, and another was treated with corticosteroids for Mac Duffy syndrome. The TBC is latent in 12 cases and patent in 16 cases. The most common symptoms were fever and weight loss and were found in 10 cases, a cough in 2 cases, sputum in 3 cases, lymph nodes in 4 cases, erythema nodosum in 2 cases, and neurological signs in 3 cases. Lymphopenia is noticed in 3 cases and a biological inflammatory syndrome in 18 of the cases. The purified protein derivate reaction was positive in 17 cases, anergic in 3 cases, negative in 5 cases, and not done in 3 cases. The acid-fast bacilli stain culture was strongly positive in one patient. The histopathological study was conclusive in 11 patients and showed granulomatosis with caseous necrosis. TBC was pulmonary in 7 patients, lymph node in 7 cases, peritoneal in 7 cases, digestive in 1 case, neuromeningeal in 3 cases, and thyroïd in 1 case. Seven patients had multifocal TBC. All the patients received anti-tuberculosis treatment with a mean duration of 8 months with no failure or relapse with an average follow-up time of 10.58 months. Conclusion: Diagnosis and management of TBC remain essential to avoid serious complications. The survey is necessary to ensure timely detection and treatment of infected adults to decrease its incidence. The best treatment remains preventive through vaccination and improving social and economic conditions.

Keywords: tuberculosis, infection, autoimmune disease, granulomatosis

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410 Leader Self-sacrifice in Sports Organizations

Authors: Stefano Ruggieri, Rubinia C. Bonfanti

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Research on leadership in sports organizations has proved extremely fruitful in recent decades, favoring the growing and diffusion of figures such as mental coaches, trainers, etc. Recent scholarly attention on organizations has been directed towards the phenomenon of leader self-sacrifice, wherein leaders who display such behavior are perceived by their followers as more effective, charismatic, and legitimate compared to those who prioritize self-interest. This growing interest reflects the importance of leaders who prioritize the collective welfare over personal gain, as they inspire greater loyalty, trust, and dedication among their followers, ultimately fostering a more cohesive and high-performing team environment. However, there is limited literature on the mechanisms through which self-sacrifice influences both group dynamics (such as cohesion and team identification) and individual factors (such as self-competence). The aim of the study is to analyze the impact of the leader self-sacrifice on cohesion, team identification and self-competence. Team identification is a crucial determinant of individual identity, delineated by the extent to which a team member aligns with a specific organizational team rather than broader social collectives. This association motivates members to synchronize their actions with the collective interests of the group, thereby fostering cohesion among its constituents, and cultivating a shared sense of purpose and unity within the team. In the domain of team sports, particularly soccer and water polo, two studies involving 447 participants (men = 238, women = 209) between 22 and 35 years old (M = 26.36, SD = 5.51) were conducted. The first study employed a correlational methodology to investigate the predictive capacity of self-sacrifice on cohesion, team identification, self-efficacy, and self-competence. The second study utilized an experimental design to explore the relationship between team identification and self-sacrifice. Together, these studies provided comprehensive insights into the multifaceted nature of leader self-sacrifice and its profound implications for group cohesion and individual well-being within organizational settings. The findings underscored the pivotal role of leader self-sacrifice in not only fostering stronger bonds among team members but also in enhancing critical facets of group dynamics, ultimately contributing to the overall effectiveness and success of the team.

Keywords: cohesion, leadership, self-sacrifice, sports organizations, team-identification

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409 Fathers’ Depression and its Relationship with Mothers’ Depression During Postpartum Period

Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

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Fathers are at risk of depression during the postpartum period. Some studies have been reported maternal depression is the key predictor of paternal postpartum depression (PPD). This study aimed to estimate the prevalence and predictors of parental PPD and its association with maternal PPD. In a cross-sectional study, via a stratified random and convenience sampling method, participants referring to health centers during 2-8 weeks postpartum were recruited from March to October 2017. Paternal PPD and its relation to maternal PPD and other related factors were assessed using multiple logistic regression. Participants were 591 literate couples who referred to Mazandaran province primary health centers during to study period. Couples were screened for depression using Edinburgh Postnatal Depression Scale (EPDS). Fathers provided information on socio-demographic characteristics, life events, neonatal stressor, perceived stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), and general health status using General Health Questionnaire (GHQ) as well. Data on mothers ‘demographic characteristics and obstetrics factors was also gathered. Overall, 93 fathers (15.7%) and 188 mothers (31.8%) reported depressive symptoms above the cut-off EPDS score of 12. In the multiple logistic regression model, older age [OR=1.20, (95%CI: 1.05- 1.36)], maternal depressive symptoms [OR=1.15, (95%CI: 1.04-1.27)], higher GHQ scores [OR=1.21, (95%CI: 1.11-1.33)] and increased recent life events [OR=1.42, (95%CI: 1.01-1.2.00)] were related to paternal PPD. A significant inverse association was found between number of children and paternal PPD [OR=0.20, (95%CI: 0.07-0.53)]. Depressive symptoms, especially in first-time fathers following the birth of a child, are not uncommon. Maternal depressive symptoms and paternal well-being were strong predictors of parental PPD. Creating opportunities for men to access special health care services, parental education to help adapting to parenthood, screening programs, and psychiatric/psychosocial interventions to decrease the suffering of depression for both depressed parents are recommended.

Keywords: depression, men, postpartum, risk factors, women

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408 Development of an Improved Paradigm for the Tourism Sector in the Department of Huila, Colombia: A Theoretical and Empirical Approach

Authors: Laura N. Bolivar T.

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The tourism importance for regional development is mainly highlighted by the collaborative, cooperating and competitive relationships of the involved agents. The fostering of associativity processes, in particular, the cluster approach emphasizes the beneficial outcomes from the concentration of enterprises, where innovation and entrepreneurship flourish and shape the dynamics for tourism empowerment. Considering the department of Huila, it is located in the south-west of Colombia and holds the biggest coffee production in the country, although it barely contributes to the national GDP. Hence, its economic development strategy is looking for more dynamism and Huila could be consolidated as a leading destination for cultural, ecological and heritage tourism, if at least the public policy making processes for the tourism management of La Tatacoa Desert, San Agustin Park and Bambuco’s National Festival, were implemented in a more efficient manner. In this order of ideas, this study attempts to address the potential restrictions and beneficial factors for the consolidation of the tourism sector of Huila-Colombia as a cluster and how could it impact its regional development. Therefore, a set of theoretical frameworks such as the Tourism Routes Approach, the Tourism Breeding Environment, the Community-based Tourism Method, among others, but also a collection of international experiences describing tourism clustering processes and most outstanding problematics, is analyzed to draw up learning points, structure of proceedings and success-driven factors to be contrasted with the local characteristics in Huila, as the region under study. This characterization involves primary and secondary information collection methods and comprises the South American and Colombian context together with the identification of involved actors and their roles, main interactions among them, major tourism products and their infrastructure, the visitors’ perspective on the situation and a recap of the related needs and benefits regarding the host community. Considering the umbrella concepts, the theoretical and the empirical approaches, and their comparison with the local specificities of the tourism sector in Huila, an array of shortcomings is analytically constructed and a series of guidelines are proposed as a way to overcome them and simultaneously, raise economic development and positively impact Huila’s well-being. This non-exhaustive bundle of guidelines is focused on fostering cooperating linkages in the actors’ network, dealing with Information and Communication Technologies’ innovations, reinforcing the supporting infrastructure, promoting the destinations considering the less known places as well, designing an information system enabling the tourism network to assess the situation based on reliable data, increasing competitiveness, developing participative public policy-making processes and empowering the host community about the touristic richness. According to this, cluster dynamics would drive the tourism sector to meet articulation and joint effort, then involved agents and local particularities would be adequately assisted to cope with the current changing environment of globalization and competition.

Keywords: innovative strategy, local development, network of tourism actors, tourism cluster

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407 Nursing Experience in Caring for a Patient with Terminal Gastric Cancer and Abdominal Aortic Aneurysm

Authors: Pei-Shan Liang

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Objective: This article explores the nursing experience of caring for a patient with terminal gastric cancer complicated by an abdominal aortic aneurysm. The patient experienced physical discomfort due to the disease, initially unable to accept the situation, leading to anxiety, and eventually accepting the need for surgery. Methods: The nursing period was from June 6 to June 10, 2024. Through observation, direct care, conversations, and physical assessments, and using Gordon's eleven functional health patterns for a one-on-one holistic assessment, interdisciplinary team meetings were held with the critical care team and family. Three nursing health issues were identified: pain related to the disease and invasive procedures, anxiety related to uncertainty about disease recovery, and decreased cardiac tissue perfusion related to hemodynamic instability. Results: Open communication techniques and empathetic care were employed to establish a trusting nurse-patient relationship, and patient-centered nursing interventions were developed. Pain was assessed using a 10-point pain scale, and pain medications were adjusted by a pharmacist. Initially, Fentanyl 500mcg with pump run at 1ml/hr was administered, later changed to Ultracet 37.5mg/325mg, 1 tablet every 6 hours orally, reducing the pain score to 3. Lavender aromatherapy and listening to crystal music were used as distractions to alleviate pain, allowing the patient to sleep uninterrupted for at least 7 hours. The patient was encouraged to express feelings and fears through LINE messages or drawings, and a psychologist was invited to provide support. Family members were present at least twice a day for over an hour each time, reducing psychological distress and uncertainty about the prognosis. According to the Beck Anxiety Inventory, the anxiety score dropped from 17 (moderate anxiety) to 6 (no anxiety). Focused nursing care was implemented with close monitoring of vital signs maintaining systolic blood pressure between 112-118 mmHg to ensure adequate myocardial perfusion. The patient was encouraged to get out of bed for postoperative rehabilitation and to strengthen cardiopulmonary function. A chest X-ray showed no abnormalities, and breathing was smooth with Triflow use, maintaining at least 5 seconds with 2 balls four times a day, and SpO2 >96%. Conclusion: The care process highlighted the importance of addressing psychological care in addition to maintaining life when the patient’s condition changes. The presence of family often provided the greatest source of comfort for the patient, helping to reduce anxiety and pain. Nurses must play multiple roles, including advocate, coordinator, educator, and consultant, using various communication techniques and fostering hope by listening to and accepting the patient’s emotional responses. It is hoped that this report will provide a reference for clinical nursing staff and contribute to improving the quality of care.

Keywords: intensive care, gastric cancer, aortic aneurysm, quality of care

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406 Revenge: Dramaturgy and the Tragedy of Jihad

Authors: Myriam Benraad

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On 5 July 2016, just days before the bloody terrorist attack on the Promenade des Anglais in Nice, the Al-Hayat media centre, one of the official propaganda branches of the Islamic State, broadcast a French nasheed which paid tribute to the Paris and Brussels attacks of November 2015 and March 2016. Entitled 'My Revenge', the terrorist anthem was of rare vehemence. It mentioned, sequentially, 'huddled bodies', in a reference to the civilian casualties of Western air strikes in the Iraqi-Syrian zone, 'explosive belts', 'sharp knives', 'large-calibre weapons' as well as 'localised targets'. France was accused of bearing the responsibility for the wave of attacks on its territory since the Charlie Hebdo massacre of January 2015 due to its 'ruthless war' against the Muslim world. Evoking an 'old aggression' and the 'crimes and spoliations' of which France has made itself guilty, the jihadist hymn depicted the rebirth of the caliphate as 'laudable revenge'. The notion of revenge has always been central to contemporary jihadism, understood both as a revolutionary ideology and a global militant movement. In recent years, the attacks carried out in Europe and elsewhere in the world have, for most, been claimed in its name. Whoever says jihad, says drama, yet few studies, if any, have looked at its dramatic and emotional elements, most notably its tragic vengefulness. This seems all the more astonishing that jihad is filled with drama; it could even be seen as a drama in its own right. The jihadists perform a script and take on roles inspired by their respective group’s culture (norms, values, beliefs, and symbols). The militants stage and perform such a script for a designated audience, either partisan, sympathising or hostile towards them and their cause. This research paper will examine the dramaturgy of jihadism and in particular, the genre that best characterises its violence: revenge tragedy. Theoretically, the research will rely on the tools of social movement theory and the sociology of emotions. Methodologically, it will draw from dramaturgical analysis and a combination of qualitative and quantitative tools to attain valuable observations of a number of developments, trends, and patterns. The choice has been made to focus mainly – however not exclusively – on the attacks which have taken place since 2001 in the European Union and more specific member states that have been significantly hit by jihadist terrorism. The research looks at a number of representative longitudinal samples identifying continuities and discontinuities, similarities, but also substantial differences. The preliminary findings tend to establish the relevance and validity of this approach in helping make better sense of sensitisation, mobilisation, and survival dynamics within jihadist groups, and motivations among individuals who have embraced violence. Besides, they illustrate their pertinence for counterterrorism policymakers and practitioners. Through drama, jihadist groups ensure the unceasing regeneration of their militant cause as well as their legitimation among their partisans. Without drama, and without the spectacular ideological staging of reality, they would not be able to maintain their attraction potential and power of persuasion.

Keywords: Jihadism, dramaturgy, revenge, tragedy

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405 Evaluation of Methods for Simultaneous Extraction and Purification of Fungal and Bacterial DNA from Vaginal Swabs

Authors: Vanessa De Carvalho, Chad MacPherson, Julien Tremblay, Julie Champagne, Stephanie-Anne Girard

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Background: The interactions between bacteria and fungi in the human vaginal microbiome are fundamental to the concept of health and disease. The means by which the microbiota and mycobiota interact is still poorly understood and further studies are necessary to properly characterize this complex ecosystem. The aim of this study was to select a DNA extraction method capable of recovering high qualities of fungal and bacterial DNA from a single vaginal swab. Methods: 11 female volunteers ( ≥ 20 to < 55 years old) self-collected vaginal swabs in triplicates. Three commercial extraction kits: Masterpure Yeast Purification kit (Epicenter), PureLink™ Microbiome DNA Purification kit (Invitrogen), and Quick-DNA™ Fecal/Soil Microbe Miniprep kit (Zymo) were evaluated on the ability to recover fungal and bacterial DNA simultaneously. The extraction kits were compared on the basis of recovery, yield, purity, and the community richness of bacterial (16S rRNA - V3-V4 region) and fungal (ITS1) microbiota composition by Illumina MiSeq amplicon sequencing. Results: Recovery of bacterial DNA was achieved with all three kits while fungal DNA was only consistently recovered with Masterpure Yeast Purification kit (yield and purity). Overall, all kits displayed similar microbiota profiles for the top 20 OTUs; however, Quick-DNA™ Fecal/Soil Microbe Miniprep kit (Zymo) showed more species richness than the other two kits. Conclusion: In the present study, Masterpure Yeast purification kit proved to be a good candidate for purification of high quality fungal and bacterial DNA simultaneously. These findings have potential benefits that could be applied in future vaginal microbiome research. Whilst the use of a single extraction method would lessen the burden of multiple swab sampling, decrease laboratory workload and off-set costs associated with multiple DNA extractions, thoughtful consideration must be taken when selecting an extraction kit depending on the desired downstream application.

Keywords: bacterial vaginosis, DNA extraction, microbiota, mycobiota, vagina, vulvovaginal candidiasis, women’s health

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404 The Communicational Behaviors of the Nurses Towards 'Crying Patient'

Authors: Hacer Kobya Bulut, Kıymet Yeşilçiçek Çalık, Birsel Canan Demirbağ, Hacer Erdöl, Songül Aktaş

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Introduction: As an expression of an emotion which always exists in life, crying is regarded as one of the problematic behaviors of patients by nurses. Towards such patients, nurses may exhibit emotional and behavioral reactions such as feeling helpless, anger, indifferent, defense, and opposition. However crying either meets a need, reduces the tension to cope with problems or helps patient to gain strength. Therefore, nurses must accept that crying is a normal mechanism that reduces emotional tension and should approach a crying patient accordingly. Objective: This study was carried out to evaluate the communicational behaviors of the nurses towards ‘crying patient’. Methods: This descriptive study was conducted with the nurses working at a university hospital in a city in the Eastern Black Sea in June-September 2015. The entire universe was tried to be reached without sampling. 90% of the population was reached and the study was completed with 309 nurses who volunteered to participate in the study. Data were collected through a questionnaire which was prepared reviewing the literature by researchers. Data were evaluated in SPSS analysis program using percentages, numbers and chi-square test with the 95% confidence interval and p <0.05significance level. Findings: The findings showed that the average age of nurses was 31.52 ± 7.96, work experience was 10:09 ± 7.69 and only 22.7% had training about ‘approach to crying patient’ during their education. 97.1% of the nurses often faced with crying patients in their professional lives, 62.8% stated that they faced crying women patients. When they see crying patients, 84.8% of the nurses ‘do not want the patient to cry’, 80.9% wonder ‘why they are crying’, % 79.6 ‘feel uneasiness’,% 79.3 ‘feel sorry’ and 41.4% ‘ feel helpless’. The question ‘Why do you think the patient is crying?’ was answered by 93.5% nurses as ‘they are suffering’, by 86.1% ‘they are helpless’, 80.9% ‘they are sad’, 79.6% ‘they need help’, 54.4% ‘because they feel inadequate,’ and 44.7% ‘they fail to control their crying behavior. ‘How do you approach to your patient when she/he is crying?’ question was answered by 82.5% of nurses as ‘I would console’, 77.3% as ‘I would ask the reason’, 63.1% as ‘I would try to stop her from crying’ all of which are actually inappropriate nursing approaches. However, 92.2% of the nurses stated that ‘I do not judge the crying patient’, ‘87.1% said ‘I allocate time to crying patients’ and 85.8% said ‘ I ask patient whether they want to cry alone’. The study showed that educational background and work experience of the nurses affected the appropriate approach to crying patients (P <0.05). Conclusion: As a result of the study, it was found out that nurses do not want patients to cry, so they exhibit inappropriate approach such as consoling the patients and they have difficulty in approaching crying patients.

Keywords: approach to patient, communication, crying patient, nurse, Turkey

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403 Re-Framing Resilience Turn in Risk and Management with Anti-Positivistic Perspective of Holling's Early Work

Authors: Jose CanIzares

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In the last decades, resilience has received much attention in relation to understanding and managing new forms of risk, especially in the context of urban adaptation to climate change. There are abundant concerns, however, on how to best interpret resilience and related ideas, and on whether they can guide ethically appropriate risk-related or adaptation efforts. Narrative creation and framing are critical steps in shaping public discussion and policy in large-scale interventions, since they favor or inhibit early decision and interpretation habits, which can be morally sensitive and then become persistent on time. This article adds to such framing process by contesting a conventional narrative on resilience and offering an alternative one. Conventionally, present ideas on resilience are traced to the work of ecologist C. S. Holling, especially to his article Resilience and Stability in Ecosystems. This article is usually portrayed as a contribution of complex systems thinking to theoretical ecology, where Holling appeals to resilience in order to challenge received views on ecosystem stability and the diversity-stability hypothesis. In this regard, resilience is construed as a “purely scientific”, precise and descriptive concept, denoting a complex property that allows ecosystems to persist, or to maintain functions, after disturbance. Yet, these formal features of resilience supposedly changed with Holling’s later work in the 90s, where, it is argued, Holling begun to use resilience as a more pragmatic “boundary term”, aimed at unifying transdisciplinary research about risks, ecological or otherwise, and at articulating public debate and governance strategies on the issue. In the conventional story, increased vagueness and degrees of normativity are the price to pay for this conceptual shift, which has made the term more widely usable, but also incompatible with scientific purposes and morally problematic (if not completely objectionable). This paper builds on a detailed analysis of Holling’s early work to propose an alternative narrative. The study will show that the “complexity turn” has often entangled theoretical and pragmatic aims. Accordingly, Holling’s primary aim was to fight what he termed “pathologies of natural resource management” or “pathologies of command and control management”, and so, the terms of his reform of ecosystem science are partly subordinate to the details of his proposal for reforming the management sciences. As regards resilience, Holling used it as a polysemous, ambiguous and normative term: sometimes, as an instrumental value that is closely related to various stability concepts; other times, and more crucially, as an intrinsic value and a tool for attacking efficiency and instrumentalism in management. This narrative reveals the limitations of its conventional alternative and has several practical advantages. It captures well the structure and purposes of Holling’s project, and the various roles of resilience in it. It helps to link Holling’s early work with other philosophical and ideological shifts at work in the 70s. It highlights the currency of Holling’s early work for present research and action in fields such as risk and climate adaptation. And it draws attention to morally relevant aspects of resilience that the conventional narrative neglects.

Keywords: resilience, complexity turn, risk management, positivistic, framing

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402 The Incidence of Cardiac Arrhythmias Using Trans-Telephonic, Portable Electrocardiography Recorder, in Out-Patients Faculty of Medicine Ramathibodi Hospital

Authors: Urasri Imsomboon, Sopita Areerob, Kanchaporn Kongchauy, Tuchapong Ngarmukos

Abstract:

Objective: The Trans-telephonic Electrocardiography (ECG) monitoring is used to diagnose of infrequent cardiac arrhythmias and improve outcome of early detection and treatment on suspected cardiac patients. The objectives of this study were to explore incidence of cardiac arrhythmia using Trans-Telephonic and to explore time to first symptomatic episode and documented cardiac arrhythmia in outpatients. Methods: Descriptive research study was conducted between February 1, 2016, and December 31, 2016. A total of 117 patients who visited outpatient clinic were purposively selected. Research instruments in this study were the personal data questionnaire and the record form of incidence of cardiac arrhythmias using Trans-Telephonic ECG recorder. Results: A total of 117 patients aged between 15-92 years old (mean age 52.7 ±17.1 years), majority of studied sample was women (64.1%). The results revealed that 387 ECGs (Average 2.88 ECGs/person, SD = 3.55, Range 0 – 21) were sent to Cardiac Monitoring Center at Coronary Care Unit. Of these, normal sinus rhythm was found mostly 46%. Top 5 of cardiac arrhythmias were documented at the time of symptoms: sinus tachycardia 43.5%, premature atrial contraction 17.7%, premature ventricular contraction 14.3%, sinus bradycardia 11.5% and atrial fibrillation 8.6%. Presenting symptom were tachycardia 94%, palpitation 83.8%, dyspnea 51.3%, chest pain 19.6%, and syncope 14.5%. Mostly activities during symptom were no activity 64.8%, sleep 55.6% and work 25.6%.The mean time until the first symptomatic episode occurred on average after 6.88 ± 7.72 days (median 3 days). The first documented cardiac arrhythmia occurred on average after 9 ± 7.92 days (median 7 day). The treatments after patients known actual cardiac arrhythmias were observe themselves 68%, continue same medications 15%, got further investigations (7 patients), and corrected causes of cardiac arrhythmias via invasive cardiac procedures (5 patients). Conclusion: Trans-telephonic: portable ECGs recorder is effective in the diagnosis of suspected symptomatic cardiac arrhythmias in outpatient clinic.

Keywords: cardiac arrhythmias, diagnosis, outpatient clinic, trans-telephonic: portable ECG recorder

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