Search results for: term creation
1729 Managing Pseudoangiomatous Stromal Hyperplasia Appropriately and Safely: A Retrospective Case Series Review
Authors: C. M. Williams, R. English, P. King, I. M. Brown
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Introduction: Pseudoangiomatous Stromal Hyperplasia (PASH) is a benign fibrous proliferation of breast stroma affecting predominantly premenopausal women with no significant increased risk of breast cancer. Informal recommendations for management have continued to evolve over recent years from surgical excision to observation, although there are no specific national guidelines. This study assesses the safety of a non-surgical approach to PASH management by review of cases at a single centre. Methods: Retrospective case series review (January 2011 – August 2016) was conducted on consecutive PASH cases. Diagnostic classification (clinical, radiological and histological), management outcomes, and breast cancer incidence were recorded. Results: 43 patients were followed up for median of 25 months (3-64) with 75% symptomatic at presentation. 12% of cases (n=5) had a radiological score (BIRADS MMG or US) ≥ 4 of which 3 were confirmed malignant. One further malignancy was detected and proven radiologically occult and contralateral. No patients were diagnosed with a malignancy during follow-up. Treatment evolved from 67% surgical in 2011 to 33% in 2016. Conclusions: The management of PASH has transitioned in line with other published experience. The preliminary findings suggest this appears safe with no evidence of missed malignancies; however, longer follow up is required to confirm long-term safety. Recommendations: PASH with suspicious radiological findings ( ≥ U4/R4) warrants multidisciplinary discussion for excision. In the absence of histological or radiological suspicion of malignancy, PASH can be safely managed without surgery.Keywords: benign breast disease, conservative management, malignancy, pseudoangiomatous stromal hyperplasia, surgical excision
Procedia PDF Downloads 1321728 Collaborative Governance to Foster Public Good: The Case of the Etorkizuna Eraikiz Initiative
Authors: Igone Guerra, Xabier Barandiaran
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The deep crisis (economic, social and cultural) in which Europe and Gipuzkoa, in the Basque Country (Spain), have been immersed in since 2008 forces governments to face a necessary transformation. These challenges demand different solutions and answers to meet the needs of the citizens. Adapting to continuous and sometimes abrupt changes in the social and political landscape requires an undeniable will to reinvent the way in which governments practice politics. This reinvention of government should help us build different organizations that, first, develop challenging public services, second, respond effectively to the needs of the citizens, and third, manage scarce resources, ultimately offering a contemporary concept of public value. In this context, the Etorkizuna Eraikiz initiative was designed to face the future challenges of the territory in a collaborative way. The aim of the initiative is to promote an alternative form of governance to generate common good and greater public value. In Etorkizuna Eraikiz democratic values, such as collaboration, participation, and accountability are prominent. This government approach is based on several features such as the creation of relational spaces to design and deliberate about the public politics or the promotion of a team-working approach, breaking down the silos between and within organizations, as an exercise in defining a shared vision regarding the Future of the Territory. A future in which the citizens are becoming actors in the problem-solving process and in the construction of a culture of participation and collective learning. In this paper, the Etorkizuna Eraikiz initiative will be presented (vision and methodology) as a model of a local approach to public policy innovation resulting in a way of governance that is more open and collaborative. Based on this case study, this paper explores the way in which collaborative governance leads to better decisions, better leadership, and better citizenry. Finally, the paper also describes some preliminary findings of this local approach, such as the level of knowledge of the citizenry about the projects promoted within Etorkizuna Eraikiz as well as the link between the challenges of the territory, as identified by the citizenry, and the political agenda promoted by the provincial government. Regarding the former, the Survey on the socio-political situation of Gipuzkoa showed that 27.9% of the respondents confirmed that they knew about the projects promoted within the initiative and gave it a mark of 5.71. In connection with the latter, over the last three years, 65 millions of euros have been allocated for a total of 73 projects that have covered socio-economic and political challenges such as aging, climate change, mobility, participation in democratic life, and so on. This governance approach of Etorkizuna Eraikiz has allowed the local government to match the needs of citizens to the political agenda fostering in this way a shared vision about the public value.Keywords: collaborative governance, citizen participation, public good, social listening, public innovation
Procedia PDF Downloads 1381727 Modification of Escherichia coli PtolT Expression Vector via Site-Directed Mutagenesis
Authors: Yakup Ulusu, Numan Eczacıoğlu, İsa Gökçe, Helen Waller, Jeremy H. Lakey
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Besides having the appropriate amino acid sequence to perform the function of proteins, it is important to have correct conformation after this sequence to process. To consist of this conformation depends on the amino acid sequence at the primary structure, hydrophobic interaction, chaperones and enzymes in charge of folding etc. Misfolded proteins are not functional and tend to be aggregated. Cysteine originating disulfide cross-links make stable this conformation of functional proteins. When two of the cysteine amino acids come side by side, disulfide bond is established that forms a cystine bridge. Due to this feature cysteine plays an important role on the formation of three-dimensional structure of many proteins. There are two cysteine amino acids (C44, C69) in the Tol-A-III protein. Unlike protein disulfide bonds from within his own, any non-specific cystine bridge causes a change in the three dimensional structure of the protein. Proteins can be expressed in various host cells as directly or fusion (chimeric). As a result of overproduction of the recombinant proteins, aggregation of insoluble proteins in the host cell can occur by forming a crystal structure called inclusion body. In general fusion proteins are produced for provide affinity tags to make proteins more soluble and production of some toxic proteins via fusion protein expression system like pTolT. Proteins can be modified by using a site-directed mutagenesis. By this way, creation of non-specific disulfide crosslinks can be prevented at fusion protein expression system via the present cysteine replaced by another amino acid such as serine, glycine or etc. To do this, we need; a DNA molecule that contains the gene that encodes for the target protein, required primers for mutation to be designed according to site directed mutagenesis reaction. This study was aimed to be replaced cysteine encoding codon TGT with serine encoding codon AGT. For this sense and reverse primers designed (given below) and used site-directed mutagenesis reaction. Several new copy of the template plasmid DNA has been formed with above mentioned mutagenic primers via polymerase chain reaction (PCR). PCR product consists of both the master template DNA (wild type) and the new DNA sequences containing mutations. Dpn-l endonuclease restriction enzyme which is specific for methylated DNA and cuts them to the elimination of the master template DNA. E. coli cells obtained after transformation were incubated LB medium with antibiotic. After purification of plasmid DNA from E. coli, the presence of the mutation was determined by DNA sequence analysis. Developed this new plasmid is called PtolT-δ.Keywords: site directed mutagenesis, Escherichia coli, pTolT, protein expression
Procedia PDF Downloads 3741726 Supply Network Design for Production-Distribution of Fish: A Sustainable Approach Using Mathematical Programming
Authors: Nicolás Clavijo Buriticá, Laura Viviana Triana Sanchez
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This research develops a productive context associated with the aquaculture industry in northern Tolima-Colombia, specifically in the town of Lerida. Strategic aspects of chain of fish Production-Distribution, especially those related to supply network design of an association devoted to cultivating, farming, processing and marketing of fish are addressed. This research is addressed from a special approach of Supply Chain Management (SCM) which guides management objectives to the system sustainability; this approach is called Sustainable Supply Chain Management (SSCM). The network design of fish production-distribution system is obtained for the case study by two mathematical programming models that aims to maximize the economic benefits of the chain and minimize total supply chain costs, taking into account restrictions to protect the environment and its implications on system productivity. The results of the mathematical models validated in the productive situation of the partnership under study, called Asopiscinorte shows the variation in the number of open or closed locations in the supply network that determines the final network configuration. This proposed result generates for the case study an increase of 31.5% in the partial productivity of storage and processing, in addition to possible favorable long-term implications, such as attending an agile or not a consumer area, increase or not the level of sales in several areas, to meet in quantity, time and cost of work in progress and finished goods to various actors in the chain.Keywords: Sustainable Supply Chain, mathematical programming, aquaculture industry, Supply Chain Design, Supply Chain Configuration
Procedia PDF Downloads 5391725 Role of Green Ecology in Business Development
Authors: Ashfaq Ahmed Kharal
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The study asserts that environment-friendly practices are increasingly being used by businesses throughout the world. Today, there is a great deal of interest in green management from both practitioners and academics. People expect managers to use resources intelligently and responsibly and to minimize the use of water, minerals, and other components in the finished products, as a crucial factor in this passion. The ethical or moral relevance of green management cannot be overstated. Employee Green Behavior (EGB) and environmental sustainability were shown to be significantly influenced by green human resource management (GHRM) in this study. Environmental issues, such as climate change, global warming, and resource conservation have a direct impact on business activities. The environment, society, and economy all suffer as a result of such obstacles. The depletion of natural resources needs immediate replenishment. As a result of government, non-governmental organizations (NGOs), environmental activists, and labor unions putting pressure on businesses and firms are now required to operate in ecologically responsible ways. Organizations are increasingly concerned about environmental sustainability in light of contemporary environmental circumstances and commercial marketplaces. Companies that emphasize long-term viability will benefit from integrating green employee behavior, green human resource management techniques, and environmental sustainability. Competition drives firms to respond to external causes, adapt, and evolve in response to changing conditions in the marketplace. Organizations develop strategic capabilities to transform their resources and acquire a competitive edge while implementing a business plan. The study of GHRM's function is being prioritized since environmental sustainability is becoming a more important strategic goal.Keywords: EGB, GHRM, environment sustainability, green ecology
Procedia PDF Downloads 1051724 Combained Cultivation of Endemic Strains of Lactic Acid Bacteria and Yeast with Antimicrobial Properties
Authors: A. M. Isakhanyan, F. N. Tkhruni, N. N. Yakimovich, Z. I. Kuvaeva, T. V. Khachatryan
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Introduction: At present, the simbiotics based on different genera and species of lactic acid bacteria (LAB) and yeasts are used. One of the basic properties of probiotics is presence of antimicrobial activity and therefore selection of LAB and yeast strains for their co-cultivation with the aim of increasing of the activity is topical. Since probiotic yeast and bacteria have different mechanisms of action, natural synergies between species, higher viability and increasing of antimicrobial activity might be expected from mixing both types of probiotics. Endemic strains of LAB Enterococcus faecium БТK-64, Lactobaccilus plantarum БТK-66, Pediococcus pentosus БТK-28, Lactobacillus rhamnosus БТK-109 and Kluyveromyces lactis БТX-412, Saccharomycopsis sp. БТX- 151 strains of yeast, with probiotic properties and hight antimicrobial activity, were selected. Strains are deposited in "Microbial Depository Center" (MDC) SPC "Armbiotechnology". Methods: LAB and yeast strains were isolated from different dairy products from rural households of Armenia. The genotyping by 16S rRNA sequencing for LAB and 26S RNA sequencing for yeast were used. Combined cultivation of LAB and yeast strains was carried out in the nutrient media on the basis of milk whey, in anaerobic conditions (without shaker, in a thermostat at 37oC, 48 hours). The complex preparations were obtained by purification of cell free culture broth (CFC) broth by the combination of ion-exchange chromatography and gel filtration methods. The spot-on-lawn method was applied for determination of antimicrobial activity and expressed in arbitrary units (AU/ml). Results. The obtained data showed that at the combined growth of bacteria and yeasts, the cultivation conditions (medium composition, time of growth, genera of LAB and yeasts) affected the display of antimicrobial activity. Purification of CFC broth allowed obtaining partially purified antimicrobial complex preparation which contains metabiotics from both bacteria and yeast. The complex preparation inhibited the growth of pathogenic and conditionally pathogenic bacteria, isolated from various internal organs from diseased animals and poultry with greater efficiency than the preparations derived individually alone from yeast and LAB strains. Discussion. Thus, our data shown perspectives of creation of a new class of antimicrobial preparations on the basis of combined cultivation of endemic strains of LAB and yeast. Obtained results suggest the prospect of use of the partially purified complex preparations instead antibiotics in the agriculture and for food safety. Acknowledgments: This work was supported by the RA MES State Committee of Science and Belarus National Foundation for Basic Research in the frames of the joint Armenian - Belarusian joint research project 13РБ-064.Keywords: co-cultivation, antimicrobial activity, biosafety, metabiotics, lactic acid bacteria, yeast
Procedia PDF Downloads 3391723 Effect of Various Durations of Type 2 Diabetes on Muscle Performance
Authors: Santosh Kumar Yadav, Shobha Keswani, Nishat Quddus, Sohrab Ahmad Khan, Zuheb Ahmad Shiddiqui, Varsha Chorsiya
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Introduction: Early onset diabetes is more aggressive than the late onset diabetes. Diabetic individual has a greater spectrum of life period to suffer from its damage, complications, and long-term disability. This study aimed at assessing knee joint muscle performance under various durations of diabetes. Method and Materials: A total of 30 diabetic subjects (18 male and 12 females) without diabetic neuropathy were included for the study. They were divided into three groups with 5 years, 10 years and 15 years of duration of disease each. Muscle performance was evaluated through strength and flexibility. Peak torque for quadriceps muscle was measured using isokinetic dynamometer. Flexibility for quadriceps and hamstring muscles were measured through Ducan’s Elys test and 90/90 test. Results: The result showed significant difference in muscle strength (p<0.05), flexibility (p≤0.05) between groups. Discussion: Optimal muscle strength and flexibility are vital for musculoskeletal health and functional independence. Conclusion: The reduced muscle performance and functional impairment in nonneuropathic diabetic patients suggest that other mechanism besides neuropathy that contribute to altered biomechanics. These findings of this study project early management of these altered parameters through disease-specific physical therapy and assessment-based intervention. Clinical Relevance: Managing disability is more costly than managing disease. Prompt and timely identification and management strategy can dramatically reduce the cost of care for diabetic patients.Keywords: muscle flexibility, muscle performance, muscle torque, type 2 diabetes
Procedia PDF Downloads 3281722 Community Perception towards the Major Drivers for Deforestation and Land Degradation of Choke Afro-alpine and Sub-afro alpine Ecosystem, Northwest Ethiopia
Authors: Zelalem Teshager
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The Choke Mountains have several endangered and endemic wildlife species and provide important ecosystem services. Despite their environmental importance, the Choke Mountains are found in dangerous conditions. This raised the need for an evaluation of the community's perception of deforestation and its major drivers and suggested possible solutions in the Choke Mountains of northwestern Ethiopia. For this purpose, household surveys, key informant interviews, and focus group discussions were used. A total sample of 102 informants was used for this survey. A purposive sampling technique was applied to select the participants for in-depth interviews and focus group discussions. Both qualitative and quantitative data analyses were used. Computation of descriptive statistics such as mean, percentages, frequency, tables, figures, and graphs was applied to organize, analyze, and interpret the study. This study assessed smallholder agricultural land expansion, Fuel wood collection, population growth; encroachment, free grazing, high demand of construction wood, unplanned resettlement, unemployment, border conflict, lack of a strong forest protecting system, and drought were the serious causes of forest depletion reported by local communities. Loss of land productivity, Soil erosion, soil fertility decline, increasing wind velocity, rising temperature, and frequency of drought were the most perceived impacts of deforestation. Most of the farmers have a holistic understanding of forest cover change. Strengthening forest protection, improving soil and water conservation, enrichment planting, awareness creation, payment for ecosystem services, and zero grazing campaigns were mentioned as possible solutions to the current state of deforestation. Applications of Intervention measures, such as animal fattening, beekeeping, and fruit production can contribute to decreasing the deforestation causes and improve communities’ livelihood. In addition, concerted efforts of conservation will ensure that the forests’ ecosystems contribute to increased ecosystem services. The major drivers of deforestation should be addressed with government intervention to change dependency on forest resources, income sources of the people, and institutional set-up of the forestry sector. Overall, further reduction in anthropogenic pressure is urgent and crucial for the recovery of the afro-alpine vegetation and the interrelated endangered wildlife in the Choke Mountains.Keywords: choke afro-alpine, deforestation, drivers, intervention measures, perceptions
Procedia PDF Downloads 541721 Exploring Challenges Faced by People Living with HIV/AIDS After Disclosure in Sub-Saharan Countries
Authors: Veliswa Nonfundo Hoho, Jabulani Gilford Kheswa
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HIV/AIDS has been a long-term condition worldwide, which does not only affect physical health but also causes psychological and social challenges in people living with this condition. In Sub-Saharan countries, namely; Nigeria, Uganda, Zimbabwe and South Africa, people living with HIV/AIDS come across different challenges especially after one has disclosed his/her status. They experience stigma and discrimination, isolation, lack of accessing and receiving treatment, lack of support and experience psychological distress. By using the evidence-based systematic review as a form of methodology, journal articles, dissertations, internet, and books were explored. This paper seeks to describe the challenges faced by people living with HIV/AIDS after disclosure, which forms a critical component of HIV/AIDS prevention and treatment interventions. The disclosure process model is used to underpin the study. This theory allows one to understand when and why interpersonal and verbal self-disclosure is beneficial for individuals who live with concealable stigmatized identities such as HIV/AIDS. Literature findings advocate that both negative and positive results were noted after disclosing one’s HIV status and psychosocial well-being of the majority of people living with HIV/AIDS also get affected especially in societies which subscribe HIV/AIDS pandemic to witchcraft. As for the infected homosexuals, research indicates that they suffer in silence and to cover their emotional emptiness due to ostracism, they often report low- self-efficacy with regard to condom use and become susceptible to reinfections which further place their lives at heightened risk for low immune system. In this regard, this paper challenges the policies which protect the dignity of people living with HIV/AIDS and calls for unity and financial support in favour of psychoeducational programmes and support groups aimed at curbing discrimination.Keywords: disclosure, discrimination, homosexuality, self-efficacy
Procedia PDF Downloads 2351720 Study of Microbial Diversity Associated with Tarballs and Their Exploitation in Crude Oil Degradation
Authors: Varsha Shinde, Belle Damodara Shenoy
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Tarballs are crude oil remnants found in oceans after long term weathering process and are a global concern since several decades as potential marine pollutant. Being complicated in structure microbial remediation of tarballs in natural environment is a slow process. They are rich in high molecular weight alkanes and poly aromatic hydrocarbons which are resistant to microbial attack and other environmental factors, therefore remain in environment for long time. However, it has been found that many bacteria and fungi inhabit on tarballs for nutrients and shelter. Many of them are supposed to be oil degraders, while others are supposed to be getting benefited by byproducts formed during hydrocarbon metabolism. Thus tarballs are forming special interesting ecological niche of microbes. This work aimed to study diversity of bacteria and fungi from tarballs and to see their potential application in crude oil degradation. The samples of tarballs were collected from Betul beach of south Goa (India). Different methods were used to isolate culturable fraction of bacteria and fungi from it. Those were sequenced for 16S rRNA gene and ITS for molecular level identification. The 16S rRNA gene sequence analysis revealed the presence of 13 bacterial genera/clades (Alcanivorax, Brevibacterium, Bacillus, Cellulomonas, Enterobacter, Klebsiella, Marinobacter, Nitratireductor, Pantoea, Pseudomonas, Pseudoxanthomonas, Tistrella and Vibrio), while the ITS sequence analysis placed the fungi in 8 diverse genera/ clades (Aspergillus, Byssochlamys, Monascus, Paecilomyces, Penicillium, Scytalidium/ Xylogone, Talaromyces and Trichoderma). All bacterial isolates were screened for oil degradation capacity. Potential strains were subjected to crude oil degradation experiment for quantification. Results were analyzed by GC-MS-MS.Keywords: bacteria, biodegradation, crude oil, diversity, fungi, tarballs
Procedia PDF Downloads 2211719 Plasma Engineered Nanorough Substrates for Stem Cells in vitro Culture
Authors: Melanie Macgregor-Ramiasa, Isabel Hopp, Patricia Murray, Krasimir Vasilev
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Stem cells based therapies are one of the greatest promises of new-age medicine due to their potential to help curing most dreaded conditions such as cancer, diabetes and even auto-immune disease. However, establishing suitable in vitro culture materials allowing to control the fate of stem cells remain a challenge. Amongst the factor influencing stem cell behavior, substrate chemistry and nanotopogaphy are particularly critical. In this work, we used plasma assisted surface modification methods to produce model substrates with tailored nanotopography and controlled chemistry. Three different sizes of gold nanoparticles were bound to amine rich plasma polymer layers to produce homogeneous and gradient surface nanotopographies. The outer chemistry of the substrate was kept constant for all substrates by depositing a thin layer of our patented biocompatible polyoxazoline plasma polymer on top of the nanofeatures. For the first time, protein adsorption and stem cell behaviour (mouse kidney stem cells and mesenchymal stem cells) were evaluated on nanorough plasma deposited polyoxazoline thin films. Compared to other nitrogen rich coatings, polyoxazoline plasma polymer supports the covalent binding of proteins. Moderate surface nanoroughness, in both size and density, triggers cell proliferation. In association with polyoxazoline coating, cell proliferation is further enhanced on nanorough substrates. Results are discussed in term of substrates wetting properties. These findings provide valuable insights on the mechanisms governing the interactions between stem cells and their growth support.Keywords: nanotopography, stem cells, differentiation, plasma polymer, oxazoline, gold nanoparticles
Procedia PDF Downloads 2801718 Theory of the Optimum Signal Approximation Clarifying the Importance in the Recognition of Parallel World and Application to Secure Signal Communication with Feedback
Authors: Takuro Kida, Yuichi Kida
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In this paper, it is shown a base of the new trend of algorithm mathematically that treats a historical reason of continuous discrimination in the world as well as its solution by introducing new concepts of parallel world that includes an invisible set of errors as its companion. With respect to a matrix operator-filter bank that the matrix operator-analysis-filter bank H and the matrix operator-sampling-filter bank S are given, firstly, we introduce the detail algorithm to derive the optimum matrix operator-synthesis-filter bank Z that minimizes all the worst-case measures of the matrix operator-error-signals E(ω) = F(ω) − Y(ω) between the matrix operator-input-signals F(ω) and the matrix operator-output-signals Y(ω) of the matrix operator-filter bank at the same time. Further, feedback is introduced to the above approximation theory, and it is indicated that introducing conversations with feedback do not superior automatically to the accumulation of existing knowledge of signal prediction. Secondly, the concept of category in the field of mathematics is applied to the above optimum signal approximation and is indicated that the category-based approximation theory is applied to the set-theoretic consideration of the recognition of humans. Based on this discussion, it is shown naturally why the narrow perception that tends to create isolation shows an apparent advantage in the short term and, often, why such narrow thinking becomes intimate with discriminatory action in a human group. Throughout these considerations, it is presented that, in order to abolish easy and intimate discriminatory behavior, it is important to create a parallel world of conception where we share the set of invisible error signals, including the words and the consciousness of both worlds.Keywords: matrix filterbank, optimum signal approximation, category theory, simultaneous minimization
Procedia PDF Downloads 1431717 Lower Limb Oedema in Beckwith-Wiedemann Syndrome
Authors: Mihai-Ionut Firescu, Mark A. P. Carson
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We present a case of inferior vena cava agenesis (IVCA) associated with bilateral deep venous thrombosis (DVT) in a patient with Beckwith-Wiedemann syndrome (BWS). In adult patients with BWS presenting with bilateral lower limb oedema, specific aetiological factors should be considered. These include cardiomyopathy and intraabdominal tumours. Congenital malformations of the IVC, through causing relative venous stasis, can lead to lower limb oedema either directly or indirectly by favouring lower limb venous thromboembolism; however, they are yet to be reported as an associated feature of BWS. Given its life-threatening potential, the prompt initiation of treatment for bilateral DVT is paramount. In BWS patients, however, this can prove more complicated. Due to overgrowth, the above-average birth weight can continue throughout childhood. In this case, the patient’s weight reached 170 kg, impacting on anticoagulation choice, as direct oral anticoagulants have a limited evidence base in patients with a body mass above 120 kg. Furthermore, the presence of IVCA leads to a long-term increased venous thrombosis risk. Therefore, patients with IVCA and bilateral DVT warrant specialist consideration and may benefit from multidisciplinary team management, with hematology and vascular surgery input. Conclusion: Here, we showcased a rare cause for bilateral lower limb oedema, respectively bilateral deep venous thrombosis complicating IVCA in a patient with Beckwith-Wiedemann syndrome. The importance of this case lies in its novelty, as the association between IVC agenesis and BWS has not yet been described. Furthermore, the treatment of DVT in such situations requires special consideration, taking into account the patient’s weight and the presence of a significant, predisposing vascular abnormality.Keywords: Beckwith-Wiedemann syndrome, bilateral deep venous thrombosis, inferior vena cava agenesis, venous thromboembolism
Procedia PDF Downloads 2351716 Sub-Chronic Exposure to Dexamethasone Impairs Cognitive Function and Insulin in Prefrontal Cortex of Male Wistar Rats
Authors: A. Alli-Oluwafuyi, A. Amin, S. M. Fii, S. O. Amusa, A. Imam, N. T. Asogwa, W. I. Abdulmajeed, F. Olaseinde, B. V. Owoyele
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Chronic stress or prolonged glucocorticoid administration impairs higher cognitive functions in rodents and humans. However, the mechanisms are not fully clear. Insulin and receptors are expressed in the brain and are involved in cognition. Insulin resistance accompanies Alzheimer’s disease and associated cognitive decline. The goal of this study was to evaluate the effects of sub-chronic administration of a glucocorticoid, dexamethasone (DEX) on behavior and biochemical changes in prefrontal cortex (PFC). Male Wistar rats were administered DEX (2, 4 & 8 mg/kg, IP) or saline for seven consecutive days and behavior was assessed in the following paradigms: “Y” maze, elevated plus maze, Morris’ water maze and novel object recognition (NOR) tests. Insulin, lactate dehydrogenase (LDH) and Superoxide Dismutase (SOD) activity were evaluated in homogenates of the prefrontal cortex. DEX-treated rats exhibited impaired prefrontal cortex function manifesting as reduced locomotion, impaired novel object exploration and impaired short- and long-term spatial memory compared to normal controls (p < 0.05). These effects were not consistently dose-dependent. These behavioral alterations were accompanied by a decrease in insulin concentration observed in PFC of 4 mg/kg DEX-treated rats compared to control (10μIU/mg vs. 50μIU/mg; p < 0.05) but not 2mg/kg. Furthermore, we report a modification of brain stress markers LDH and SOD (p > 0.05). These results indicate that prolonged activation of GCs disrupt prefrontal cortex function which may be related to insulin impairment. These effects may not be attributable to a non-specific elevation of oxidative stress in the brain. Future studies would evaluate mechanisms of GR-induced insulin loss.Keywords: dexamethasone, insulin, memory, prefrontal cortex
Procedia PDF Downloads 2841715 Entrepreneurial Resilience and Unemployment Curbing among Graduates. The Case of the Catholic University of Cameroon (CATUC) Bamenda, North West Region of Cameroon
Authors: Elizabeth Ankiambom Chiatii
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The effective participation of graduates as leaders in entrepreneurial resilience is a key driver to achieving sustainable job creation and curbing unemployment issues in the urban and rural communities of Cameroon. The unemployment problem is a global challenge in the Labour market, especially for youths graduating from universities. Statistics from the Cameroon National Institute of statistics indicate that the unemployment rate in the country increased to 3.9% in 2021 from 3.8% in 2020. One of the main causes of unemployment challenges and job hooping among university graduates is the high expectation for “white-collar jobs syndrome” as opposed to involvement in ‘blue-collar jobs’. In the recent years, the Catholic University of Cameroon has engaged its resources in problem and project based learning (PBL) approaches in order to enable the students at the end of their course work to be competent and resourceful in impacting their communities and the world at large. It is so encouraging to notice that most of our current and female ex-students have engaged as leaders in fostering entrepreneurial resilience through small and medium size ‘blue-collar’ enterprises like seamstresses or tailors, designers, catering services, poultry owners, traditional regalia designers, phone booth operators, farming (gardening) activities, saloon owners, wedding designers, restaurant operators and many other creative jobs where they also act as petty employers. A good number of them sponsor their university studies through these self-income generating activities. Part one of this paper centres on the introduction and background of study. Part two embodies some literature review in which we concentrate on some related conceptual issues. For example, we have some analogy of employment difficulties faced by the university graduates. Secondly, we will examine the details on entrepreneurial resilience within the context of Bamenda- Cameroon. Thirdly, we expound on the leadership role played by these graduates in building resilience as entrepreneurs stemming from their university training. The primary method of data collection is implemented, where questionnaires are distributed to at least 100 of these graduates engaged in building entrepreneurial resilience. The IVProbit regression analysis is used to determine the effect of these graduate participation as leader on entrepreneurial resilience. The results can contribute to the development of entrepreneurial resilience, and recommendations will be made to CATUC Bamenda, some communities and government leaders to enhance their policies to empower these young graduates in fostering these resourceful activities.Keywords: graduates entrepreneurial resilience, unemployment challenges, white-collar job syndrome, small and medium size blue-collar enterprises
Procedia PDF Downloads 641714 Chemical Technology Approach for Obtaining Carbon Structures Containing Reinforced Ceramic Materials Based on Alumina
Authors: T. Kuchukhidze, N. Jalagonia, T. Archuadze, G. Bokuchava
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The growing scientific-technological progress in modern civilization causes actuality of producing construction materials which can successfully work in conditions of high temperature, radiation, pressure, speed, and chemically aggressive environment. Such extreme conditions can withstand very few types of materials and among them, ceramic materials are in the first place. Corundum ceramics is the most useful material for creation of constructive nodes and products of various purposes for its low cost, easy accessibility to raw materials and good combination of physical-chemical properties. However, ceramic composite materials have one disadvantage; they are less plastics and have lower toughness. In order to increase the plasticity, the ceramics are reinforced by various dopants, that reduces the growth of the cracks. It is shown, that adding of even small amount of carbon fibers and carbon nanotubes (CNT) as reinforcing material significantly improves mechanical properties of the products, keeping at the same time advantages of alundum ceramics. Graphene in composite material acts in the same way as inorganic dopants (MgO, ZrO2, SiC and others) and performs the role of aluminum oxide inhibitor, as it creates shell, that gives possibility to reduce sintering temperature and at the same time it acts as damper, because scattering of a shock wave takes place on carbon structures. Application of different structural modification of carbon (graphene, nanotube and others) as reinforced material, gives possibility to create multi-purpose highly requested composite materials based on alundum ceramics. In the present work offers simplified technology for obtaining of aluminum oxide ceramics, reinforced with carbon nanostructures, during which chemical modification with doping carbon nanostructures will be implemented in the process of synthesis of final powdery composite – Alumina. In charge doping carbon nanostructures connected to matrix substance with C-O-Al bonds, that provide their homogeneous spatial distribution. In ceramic obtained as a result of consolidation of such powders carbon fragments equally distributed in the entire matrix of aluminum oxide, that cause increase of bending strength and crack-resistance. The proposed way to prepare the charge simplifies the technological process, decreases energy consumption, synthesis duration and therefore requires less financial expenses. In the implementation of this work, modern instrumental methods were used: electronic and optical microscopy, X-ray structural and granulometric analysis, UV, IR, and Raman spectroscopy.Keywords: ceramic materials, α-Al₂O₃, carbon nanostructures, composites, characterization, hot-pressing
Procedia PDF Downloads 1191713 Improving Self-Administered Medication Adherence for Older Adults: A Systematic Review
Authors: Mathumalar Loganathan, Lina Syazana, Bryony Dean Franklin
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Background: The therapeutic benefit of self-administered medication for long-term use is limited by an average 50% non-adherence rate. Patient forgetfulness is a common factor in unintentional non-adherence. With a growing ageing population, strategies to improve self-administration of medication adherence are essential. Our aim was to review systematically the effects of interventions to optimise self-administration of medication. Method: Database searched were MEDLINE, EMBASE, PsynINFO, CINAHL from 1980 to 31 October 2013. Search terms included were ‘self-administration’, ‘self-care’, ‘medication adherence’, and ‘intervention’. Two independent reviewers undertook screening and methodological quality assessment, using the Downs and Black rating scale. Results: The search strategy retrieved 6 studies that met the inclusion and exclusion criteria. Three intervention strategies were identified: self-administration medication programme (SAMP), nursing education and medication packaging (pill calendar). A nursing education programme focused on improving patients’ behavioural self-management of drug prescribing. This was the most studied area and three studies highlighting an improvement in self-administration of medication. Conclusion: Results are mixed and there is no one interventional strategy that has proved to be effective. Nevertheless, self-administration of medication programme seems to show most promise. A multi-faceted approach and clearer policy guideline are likely to be required to improve prescribing for these vulnerable patients. Mixed results were found for SAMP. Medication packaging (pill calendar) was evaluated in one study showing a significant improvement in self-administration of medication. A meta-analysis could not be performed due to heterogeneity in the outcome measures.Keywords: self-administered medication, intervention, prescribing, older patients
Procedia PDF Downloads 3231712 Legal Considerations in Fashion Modeling: Protecting Models' Rights and Ensuring Ethical Practices
Authors: Fatemeh Noori
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The fashion industry is a dynamic and ever-evolving realm that continuously shapes societal perceptions of beauty and style. Within this industry, fashion modeling plays a crucial role, acting as the visual representation of brands and designers. However, behind the glamorous façade lies a complex web of legal considerations that govern the rights, responsibilities, and ethical practices within the field. This paper aims to explore the legal landscape surrounding fashion modeling, shedding light on key issues such as contract law, intellectual property, labor rights, and the increasing importance of ethical considerations in the industry. Fashion modeling involves the collaboration of various stakeholders, including models, designers, agencies, and photographers. To ensure a fair and transparent working environment, it is imperative to establish a comprehensive legal framework that addresses the rights and obligations of each party involved. One of the primary legal considerations in fashion modeling is the contractual relationship between models and agencies. Contracts define the terms of engagement, including payment, working conditions, and the scope of services. This section will delve into the essential elements of modeling contracts, the negotiation process, and the importance of clarity to avoid disputes. Models are not just individuals showcasing clothing; they are integral to the creation and dissemination of artistic and commercial content. Intellectual property rights, including image rights and the use of a model's likeness, are critical aspects of the legal landscape. This section will explore the protection of models' image rights, the use of their likeness in advertising, and the potential for unauthorized use. Models, like any other professionals, are entitled to fair and ethical treatment. This section will address issues such as working conditions, hours, and the responsibility of agencies and designers to prioritize the well-being of models. Additionally, it will explore the global movement toward inclusivity, diversity, and the promotion of positive body image within the industry. The fashion industry has faced scrutiny for perpetuating harmful standards of beauty and fostering a culture of exploitation. This section will discuss the ethical responsibilities of all stakeholders, including the promotion of diversity, the prevention of exploitation, and the role of models as influencers for positive change. In conclusion, the legal considerations in fashion modeling are multifaceted, requiring a comprehensive approach to protect the rights of models and ensure ethical practices within the industry. By understanding and addressing these legal aspects, the fashion industry can create a more transparent, fair, and inclusive environment for all stakeholders involved in the art of modeling.Keywords: fashion modeling contracts, image rights in modeling, labor rights for models, ethical practices in fashion, diversity and inclusivity in modeling
Procedia PDF Downloads 771711 Developing Confidence of Visual Literacy through Using MIRO during Online Learning
Authors: Rachel S. E. Lim, Winnie L. C. Tan
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Visual literacy is about making meaning through the interaction of images, words, and sounds. Graphic communication students typically develop visual literacy through critique and production of studio-based projects for their portfolios. However, the abrupt switch to online learning during the COVID-19 pandemic has made it necessary to consider new strategies of visualization and planning to scaffold teaching and learning. This study, therefore, investigated how MIRO, a cloud-based visual collaboration platform, could be used to develop the visual literacy confidence of 30 diploma in graphic communication students attending a graphic design course at a Singapore arts institution. Due to COVID-19, the course was taught fully online throughout a 16-week semester. Guided by Kolb’s Experiential Learning Cycle, the two lecturers developed students’ engagement with visual literacy concepts through different activities that facilitated concrete experiences, reflective observation, abstract conceptualization, and active experimentation. Throughout the semester, students create, collaborate, and centralize communication in MIRO with infinite canvas, smart frameworks, a robust set of widgets (i.e., sticky notes, freeform pen, shapes, arrows, smart drawing, emoticons, etc.), and powerful platform capabilities that enable asynchronous and synchronous feedback and interaction. Students then drew upon these multimodal experiences to brainstorm, research, and develop their motion design project. A survey was used to examine students’ perceptions of engagement (E), confidence (C), learning strategies (LS). Using multiple regression, it¬ was found that the use of MIRO helped students develop confidence (C) with visual literacy, which predicted performance score (PS) that was measured against their application of visual literacy to the creation of their motion design project. While students’ learning strategies (LS) with MIRO did not directly predict confidence (C) or performance score (PS), it fostered positive perceptions of engagement (E) which in turn predicted confidence (C). Content analysis of students’ open-ended survey responses about their learning strategies (LS) showed that MIRO provides organization and structure in documenting learning progress, in tandem with establishing standards and expectations as a preparatory ground for generating feedback. With the clarity and sequence of the mentioned conditions set in place, these prerequisites then lead to the next level of personal action for self-reflection, self-directed learning, and time management. The study results show that the affordances of MIRO can develop visual literacy and make up for the potential pitfalls of student isolation, communication, and engagement during online learning. The context of how MIRO could be used by lecturers to orientate students for learning in visual literacy and studio-based projects for future development are discussed.Keywords: design education, graphic communication, online learning, visual literacy
Procedia PDF Downloads 1121710 Computerized Cognitive Training and Psychological Resiliency among Adolescents with Learning Disabilities
Authors: Verd Shomrom, Gilat Trabelsi
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The goal of the study was to examine the effects of Computerized Cognitive Training (CCT) with and without cognitive mediation on Executive Function (EF) (planning and self- regulation) and on psychological resiliency among adolescents with Attention Deficits Hyperactive Disorder (ADHD) with or without Learning Disabilities (LD). Adolescents diagnosed with Attention Deficit Disorder and / or Learning Disabilities have multidimensional impairments that result from neurological damage. This work explored the possibility of influencing cognitive aspects in the field of Executive Functions (specifically: patterns of planning and self-regulation) among adolescents with a diagnosis of Attention Deficit Disorder and / or Learning Disabilities who study for a 10-12 grades. 46 adolescents with ADHD and/or with LD were randomly applied to experimental and control groups. All the participants were tested (BRC- research version, Resiliency quaternaries) before and after the intervention: mediated/ non-mediated Computerized Cognitive Training (MINDRI). The results indicated significant effects of cognitive modification in the experimental group, between pre and post Phases, in comparison to control group, especially in self- regulation (BRC- research version, Resiliency quaternaries), and on process analysis of Computerized Cognitive Training (MINDRI). The main conclusion was that even short- term mediation synchronized with CCT could greatly enhance the performance of executive functions demands. Theoretical implications for the positive effects of MLE in combination with CCT indicate the ability for cognitive change. The practical implication is the awareness and understanding of efficient intervention processes to enhance EF, learning awareness, resiliency and self-esteem of adolescents in their academic and daily routine.Keywords: attention deficits hyperactive disorder, computerized cognitive training, executive function, mediated learning experience, learning disabilities
Procedia PDF Downloads 1531709 The Invisible Labour of Informal Care: Parentified Caregiving in David Chariandy's Soucouyant
Authors: Walter Rafael Ramos Villanueva
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The overwhelming majority of scholarship on David Chariandy’s novel Soucouyant focuses on how Adele’s dementia represents the preservation of “cultural memory” and the perniciousness of “historical trauma.” However, by metaphorizing Adele’s mental condition, these critics risk treating her dementia as mostly figurative, and they thus elide a more detailed discussion of the literal ramifications of her dementia diagnosis. To move beyond these readings, then, my paper will approach Adele’s disorder as a literal medical condition and explore how her caregiving needs affect not only her but also those around her. Soucouyant subverts traditional caregiving narratives by depicting the difficult and typically invisible labour of informal caregiving that is undertaken by the families and friends of those who are ill or otherwise disabled. Because Adele’s family is unable to access proper public healthcare resources within the community, the burden of care falls upon the protagonist and his brother, who become “parentified children.” Parentified children, according to Nancy D. Chase, are “parents to their parents, and fulfill this role at the expense of their own developmentally appropriate needs and pursuits.” The novel provides a depiction of informal caregiving that is multi-faceted and asks us to question why is it exactly that we place the burden of care on those who are not equipped to handle such pressures instead of putting the onus on the government and the public healthcare system to take care of its most vulnerable members. Ageing Studies scholar Larry Polvika notes that although policymakers often offer “pious expressions of appreciation” and acknowledge that informal caregiving is “the backbone of our long-term care system,” governmental support for these caregivers remains inadequate. It is my belief that, by showcasing the struggles of informal caregivers, Chariandy’s text combats this dangerous and empty political rhetoric.Keywords: caregiving, dementia, literature, parentified children
Procedia PDF Downloads 1741708 Unravelling Cross-Commodity Price Transmission Dynamics between Coastal and Freshwater Fish Species in Bangladesh: A Structural VAR Analysis
Authors: Farhana Arefeen Mila, Luis Emilio Morales, Nam Hoang, Sujana Adapa, Garry Griffith
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This study investigates the existence of price transmission asymmetries and imperfections among the coastal and freshwater fish species in Bangladesh. Using a Structural Vector Autoregression (SVAR) model, we explore how price changes in one fish species impact the prices of others in the retail market. Monthly data from the Department of Agricultural Marketing (DAM) covering the period from 2012 to 2023 was analyzed. Price series were detrended using the Hodrick-Prescott filter, and unit root tests confirmed stationarity after detrending. The findings indicate that there are significant interdependencies and asymmetries in price transmission, particularly the strong influence of Hilsha on the broader fish market. Hilsha’s price shocks generate immediate responses across other species, reflecting its cultural and economic importance. Silver Pomfret demonstrates some independence but is still affected by broader market fluctuations, particularly those involving Hilsha. Meanwhile, Rohu and Catla exhibit high interdependence, where price changes in one species closely impact the other, underscoring their substitutable nature in consumer preferences. These findings emphasize the need for joint interventions and market monitoring to stabilize prices effectively. Stakeholders are encouraged to monitor Hilsha’s market, consider coordinated interventions for Rohu and Catla, and establish data-sharing partnerships to enhance market stability. Additionally, promoting consumer awareness of price trends and sustainable practices can further support market resilience and long-term sustainability in the fisheries sector.Keywords: price transmission, cross commodity, fish, Bangladesh, CCF, SVAR, IRF
Procedia PDF Downloads 121707 Mindfulness and Mental Resilience Training for Pilots: Enhancing Cognitive Performance and Stress Management
Authors: Nargiza Nuralieva
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The study delves into assessing the influence of mindfulness and mental resilience training on the cognitive performance and stress management of pilots. Employing a meticulous literature search across databases such as Medline and Google Scholar, the study used specific keywords to target a wide array of studies. Inclusion criteria were stringent, focusing on peer-reviewed studies in English that utilized designs like randomized controlled trials, with a specific interest in interventions related to mindfulness or mental resilience training for pilots and measured outcomes pertaining to cognitive performance and stress management. The initial literature search identified a pool of 123 articles, with subsequent screening resulting in the exclusion of 77 based on title and abstract. The remaining 54 articles underwent a more rigorous full-text screening, leading to the exclusion of 41. Additionally, five studies were selected from the World Health Organization's clinical trials database. A total of 11 articles from meta-analyses were retained for examination, underscoring the study's dedication to a meticulous and robust inclusion process. The interventions varied widely, incorporating mixed approaches, Cognitive behavioral Therapy (CBT)-based, and mindfulness-based techniques. The analysis uncovered positive effects across these interventions. Specifically, mixed interventions demonstrated a Standardized Mean Difference (SMD) of 0.54, CBT-based interventions showed an SMD of 0.29, and mindfulness-based interventions exhibited an SMD of 0.43. Long-term effects at a 6-month follow-up suggested sustained impacts for both mindfulness-based (SMD: 0.63) and CBT-based interventions (SMD: 0.73), albeit with notable heterogeneity.Keywords: mindfulness, mental resilience, pilots, cognitive performance, stress management
Procedia PDF Downloads 541706 Formulation of Highly Dosed Drugs Using Different Granulation Techniques: A Comparative Study
Authors: Ezeddin Kolaib
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Paracetamol tablets and cimetidine tablets were prepared by single-step granulation/tabletting and by compression after high shear granulation. The addition of PVP (polyvinylpyrrolidone) was essential for single-step granulation/tabletting of formulation containing high concentrations of paracetamol or cimetidine. Paracetamol tablets without and with PVP obtained by single-step granulation/tabletting exhibited a significantly higher tensile strength, a significantly lower disintegration time, a lower friability and a faster dissolution compared to those prepared by compression after high shear granulation. Cimetidine tablets with PVP obtained by single-step granulation/tabletting exhibited a significantly lower tensile strength, a significantly lower disintegration time and a faster dissolution compared to those prepared by compression after high shear granulation. Single-step granulation/tabletting allowed to produce tablets containing up to 80% paracetamol or cimetidine with a dissolution profile complying with the USP requirements. For pure paracetamol or pure cimetidine the addition of crospovidone as a disintegrant was required to obtain a dissolution profile that complied with the pharmacopoeial requirements. Long term and accelerated stability studies of paracetamol tablets produced by single-step granulation/tabletting over a period of one year showed no significant influence on the tablet tensile strength, friability and dissolution. Although a significant increase of the disintegration time was observed, it remained below 10 min. These results indicated that single-step granulation/tabletting could be an efficient technique for the production of highly dosed drugs such as paracetamol and cimetidine.Keywords: single-step granulation/tabletting, twin screw extrusion, high shear granulation, high dosage drugs, paracetamol, cimetidine
Procedia PDF Downloads 2951705 The Impact of Restricting Product Availability on the Purchasing of Lower Sugar Biscuits in UK Convenience Stores
Authors: Hannah S. Waldron
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Background: The government has proposed sugar reduction targets in an effort to tackle childhood obesity, focussing on those of low socioeconomic status (SES). Supermarkets are a key location for reducing the amount of sugar purchased, but success so far in this environment has been limited. Building on previous research, this study will assess the impact of restricting the availability of higher sugar biscuits as a strategy to encourage lower sugar biscuit purchasing, and whether the effects vary by customer SES. Method: 14 supermarket convenience stores were divided between control (n=7) and intervention (n=7) groups. In the intervention stores, biscuits with sugar above the government’s target (26.2g/100g) were removed from sale and replaced with lower sugar ( < 26.2g sugar/100g) alternatives. Sales and customer demographic information were collected using loyalty card data and point-of-sale transaction data for 8-weeks pre and post the intervention for lower sugar biscuits, total biscuits, alternative higher sugar products, and all products. Results were analysed using three-way and two-way mixed ANOVAs. Results: The intervention resulted in a significant increase in lower sugar biscuit purchasing (p < 0.001) and a significant decline in overall biscuit sales (p < 0.001) between the time periods compared to control stores. Sales of higher sugar products and all products increased significantly between the two time periods in both the intervention and control stores (p < 0.05). SES showed no significant effect on any of the reported outcomes (p > 0.05). Conclusion: Restricting the availability of higher sugar products may be a successful strategy for encouraging lower sugar purchasing across all SES groups. However, larger-scale interventions are required in additional categories to assess the long term implications for both consumers and retailers.Keywords: biscuits, nudging, sugar, supermarket
Procedia PDF Downloads 1051704 Potential of Croatia as an Attractive Tourist Destination for the Russian Market
Authors: Maja Martinovic, Valentina Zarkovic, Hrvoje Maljak
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Europe is one of the most popular tourist destinations in the world, in which tourism occupies a significant place among the most relevant economic activities, and this applies to the Republic of Croatia as well. Based on this study, the authors intended to encourage and support the creation of an effective tourism policy in Croatia that would be based on the profiling of certain target groups. Another objective was to compare the results obtained from the customer analysis with the market analysis of the tourism industry in Croatia. The objective is to adapt the current tourist offer according to the identified needs and expectations of a particular tourist group in order to increase the attractiveness of Croatia as a tourist destination and motivate greater attendance of the targeted tourist groups. The current research was oriented towards the Russian market as the target group. Therefore, the authors wanted to encourage a discussion on how to attract more Russian guests. Consequently, the intention of the research was a detailed analysis of Russian tourists, in order to gain a better understanding of their travelling motives and tendencies. Furthermore, attention was paid to the expectations of Russian customers and to compare them with the Croatian tourist offer, and to determine whether there is a possibility for an overlap. The method used to obtain the information required was a survey conducted among Russian citizens about their travelling habits. The research was carried out on the basis of 166 participants of different age, gender, profession and income group. The sampling and distribution of the survey took place between May and July 2016. The results provided from the research indicate that Croatian tourism has certain unrealized potential considering the popularization of Croatia as a tourist destination, and there is a capacity for increasing the revenues within the group of Russian tourists. Such a conclusion is based on the fact that the Croatian tourist offer and the preferences of the Russian guests are compatible, i.e. they overlap in many aspects. The results demonstrate that beautiful nature, cultural and historical heritage as well as the sun and sea, play a leading role in attracting more Russian tourists. It is precisely these elements that form the three pillars of the Croatian tourist offer. On the other hand, the profiling revealed that the most desirable destinations for the Russian guests are Italy and Spain, both of which provide the same main tourist attractions as Croatia. Therefore, the focus of the strategic ideas given in the paper shifted to other tourism segments, such as type of accommodation, sales channels, travel motives, additional offer and seasonality etc., in order to gain advantage in the Russian market, the Mediterranean region and tourism in general. The purpose of the research is to serve as a foundation for analysing the attractiveness of the other tourist destinations in the Russian market, as well as to be a general basis for a more detailed profiling of the various specific target groups of the Russian and other tourist groups.Keywords: Croatia, Russian market, target groups, tourism, tourist destination
Procedia PDF Downloads 3221703 Parasagittal Approach to Lumbar Epidural Steroid Injections: A Cost-Effectiveness Analysis
Authors: K. D. Candido, A. Lissounov, I. Knezevic, N. Knezevic
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Background: The most commonly performed pain procedures in the USA is Lumbar Epidural Steroid Injections (LESI). There are three main types of these procedures: transforaminal (TF), interlaminar (IL) and caudal injections. It is expected for TF injections to have better outcomes than IL injections, based on the recently published systematic review. The studies presented in that review used a midline IL approach, but those with parasagittal IL approach were not taken into consideration. Our aim is to emphasize the efficacy of the lateral parasagittal (paramedian) IL approach in this review. Methods: We included five studies in this systematic review, which compared Parasagittal-IL (PIL) with either Midline-IL (MIL) or TF LESI. Total of 296 patients who had undergone different types of LESI were observed across the five studies, and the average pain and functional improvements were calculated and compared among groups. Results: Pain and function improvements with PIL approach is superior on 12 months follow up to MIL approach (53.4% vs. 14.7%) and (55% vs. 27.7%), respectively. A 12 months follow-up results between PIL and TF shows a near equivalent effectiveness for pain (58.9% vs. 63.2%) and function improvement (47.3% vs. 48.1%). An average follow-up of 17.1 days have shown better short-term pain relief for PIL than TF approach (45.8% vs. 19.2%), respectively. Number of repeated injections is lower for PIL injections than MIL. Number of weeks between 1st and 2nd injections: PIL averaged 15.8 weeks and MIL averaged 9.7 weeks. Third LESI injection is more common in TF group (30%) than PIL group (18.8%). Conclusion: Higher complication rates are associated with TF injections for which FDA7 issued an official warning. We have recorded better outcomes in pain and function improvement of Parasagittal-IL LESI as compared to midline-IL injection, in the presented systematic review. Parasagittal and TF injections have equivalent efficacy in Pain and Function improvements thus we advocate for Parasagittal-IL approach consideration as an alternative for TF injections.Keywords: parasagital approach, lumbar, back pain, epidural steroid injection
Procedia PDF Downloads 1741702 ESG and Corporate Financial Performance: Empirical Evidence from Vietnam’s Listed Construction Companies
Authors: My Linh Hoang, Van Dung Hoang
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Environmental, Social, and Governance (ESG) factors have become a focus for companies globally, as businesses are now focusing on long-term sustainable goals rather than only operating for the goals of profit maximization. According to recent research, in several countries, companies have shown positive results in their financial performance by improving their ESG performance. The construction industry is one of the most crucial components of social and economic development; as a result, considerations for ESG factors are becoming more and more essential for companies in this sector. In Vietnam, the construction industry has been growing rapidly in recent years; however, it has yet to be discussed and studied extensively in Vietnam how ESG factors create impacts on corporate financial performance in general and construction corporations’ financial performance in particular. This research aims to examine the relationship between ESG factors and financial indicators in construction companies from 2011 to 2021 through panel data analysis of 75 listed construction companies in Vietnam and to provide insights into how these companies can better integrate ESG considerations into their operations to enhance their financial performance. The data was analyzed through 3 main methods: descriptive statistics, correlation coefficient analysis applied to all dependent, explanatory and control variables, and panel data analysis method. In panel data analysis, the study uses the fixed effects model (FEM) and random effects model (REM). The Hausman test will be used to select which model is suitable to be used. The findings indicate that maintaining a strong commitment to ESG principles can have a positive impact on financial performance. Finally, FGLS estimation will be performed when the problem of autocorrelation and variable variance appears in the model. This is significant for all parties involved, including investors, company managers, decision-makers, and industry regulators.Keywords: ESG, financial performance, construction company, Vietnam
Procedia PDF Downloads 901701 Service Provision in 'the Jungle': Describing Mental Health and Psychosocial Support Offered to Residents of the Calais Camp
Authors: Amy Darwin, Claire Blacklock
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Background: Existing literature about delivering evidence-based mental health and psychosocial support (MHPSS) in emergency settings is limited. It is difficult to monitor and evaluate the approach to MHPSS in informal refugee camps such as ‘The Jungle’ in Calais, where there are multiple service providers and where the majority of providers are volunteers. AIM: To identify experiences of MHPSS delivery by service providers in an informal camp environment in Calais, France and describe MHPSS barriers and opportunities in this type of setting. Method: Qualitative semi-structured interviews were conducted with 13 individuals from different organisations offering MHPSS in Calais and analysed using conventional content analysis. Results: Unsafe, uncertain and unsanitary conditions in the camp meant MHPSS was difficult to implement, and such conditions contributed to the poor mental health of the residents. The majority of MHPSS was offered by volunteers who lacked resources and training, and there was no overall official camp leadership which meant care was poorly coordinated and monitored. Strong relationships existed between volunteers and camp residents, but volunteers felt frustrated that they could not deliver the kind of MHPSS that they felt residents required. Conclusion: While long-term volunteers had built supportive relationships with camp residents, lack of central coordination and leadership of MHPSS services and limited access to trained professionals made implementation of MHPSS problematic. Similarly, the camp lacked the necessary infrastructure to meet residents’ basic needs. Formal recognition of the camp, and clear central leadership were identified as necessary steps to improving MHPSS delivery.Keywords: calais, mental health, refugees, the jungle, MHPSS
Procedia PDF Downloads 2491700 Eco-Cities in Challenging Environments: Pollution As A Polylemma in The Uae
Authors: Shaima A. Al Mansoori
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Eco-cities have become part of the broader and universal discourse and embrace of sustainable communities. Given the ideals and ‘potential’ benefits of eco-cities for people, the environment and prosperity, hardly can an argument be made against the desirability of eco-cities. Yet, this paper posits that it is necessary for urban scholars, technocrats and policy makers to engage in discussions of the pragmatism of implementing the ideals of eco-cities, for example, from the political, budgetary, cultural and other dimensions. In the context of such discourse, this paper examines the feasibility of one of the cardinal principles and goals of eco-cities, which is the reduction or elimination of pollution through various creative and innovative initiatives, in the UAE. This paper contends and argues that, laudable and desirable as this goal is, it is a polylemma and, therefore, overly ambitious and practically unattainable in the UAE. The paper uses the mixed method research strategy, in which data is sourced from secondary and general sources through desktop research, from public records in governmental agencies, and from the conceptual academic and professional literature. Information from these sources will be used, first, to define and review pollution as a concept and multifaceted phenomenon with multidimensional impacts. Second, the paper will use society’s five goal clusters as a framework to identify key causes and impacts of pollution in the UAE. Third, the paper will identify and analyze specific public policies, programs and projects that make pollution in the UAE a polylemma. Fourth, the paper will argue that the phenomenal rates of population increase, urbanization, economic growth, consumerism and development in the UAE make pollution an inevitable product and burden that society must live with. This ‘reality’ makes the goal and desire of pollution-free cities pursuable but unattainable. The paper will conclude by identifying and advocating creative and innovative initiatives that can be taken by the various stakeholders in the country to reduce and mitigate pollution in the short- and long-term.Keywords: goal clusters, pollution, polylemma, sustainable communities
Procedia PDF Downloads 385