Search results for: health indicators

Authors: Mitakshara Sharma, S. K. Nema, Sanjeev Narang

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Diabetes mellitus (DM) is a group of metabolic disorders characterized by metabolic abnormalities, chronic hyperglycaemia and long term macrovascular & microvascular complications. Vascular complications are due to platelet hyperactivity and dysfunction, increased inflammation, altered coagulation and endothelial dysfunction. Large proportion of patients with Type II DM suffers from preventable vascular angiopathies, and there is need to develop risk factor modifications and interventions to reduce impact of complications. These complications are attributed to platelet activation, recognised by increase in Platelet Volume Indices (PVI) including Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW). The current study is prospective analytical study conducted over 2 years. Out of 1100 individuals, 930 individuals fulfilled inclusion criteria and were segregated into three groups on basis of glycosylated haemoglobin (HbA1C): - (a) Diabetic, (b) Non-Diabetic and (c) Subjects with Impaired fasting glucose (IFG) with 300 individuals in IFG and non-diabetic groups & 330 individuals in diabetic group. Further, diabetic group was divided into two groups on the basis of presence or absence of known diabetes related vascular complications. Samples for HbA1c and PVI were collected using Ethylene diamine tetraacetic acid (EDTA) as anticoagulant and processed on SYSMEX-X-800i autoanalyser. The study revealed gradual increase in PVI from non-diabetics to IFG to diabetics. PVI were markedly increased in diabetic patients. MPV and PDW of diabetics, IFG and non diabetics were (17.60 ± 2.04)fl, (11.76 ± 0.73)fl, (9.93 ± 0.64)fl and (19.17 ± 1.48)fl, (15.49 ± 0.67)fl, (10.59 ± 0.67)fl respectively with a significant p value 0.00 and a significant positive correlation (MPV-HbA1c r = 0.951; PDW-HbA1c r = 0.875). MPV & PDW of subjects with diabetes related complications were higher as compared to those without them and were (17.51±0.39)fl & (15.14 ± 1.04)fl and (20.09 ± 0.98) fl & (18.96 ± 0.83)fl respectively with a significant p value 0.00. There was a significant positive correlation between PVI and duration of diabetes across the groups (MPV-HbA1c r = 0.951; PDW-HbA1c r = 0.875). However, a significant negative correlation was found between glycaemic levels and total platelet count (PC- HbA1c r =-0.164). This is multi-parameter and comprehensive study with an adequately powered study design. It can be concluded from our study that PVI are extremely useful and important indicators of impending vascular complications in all patients with deranged glycaemic control. Introduction of automated cell counters has facilitated the availability of PVI as routine parameters. PVI is a useful means for identifying larger & active platelets which play important role in development of micro and macro angiopathic complications of diabetes leading to mortality and morbidity. PVI can be used as cost effective markers to predict and prevent impending vascular events in patients with Diabetes mellitus especially in developing countries like India. PVI, if incorporated into protocols for management of diabetes, could revolutionize care and curtail the ever increasing cost of patient management.

Keywords: diabetes, IFG, HbA1C, MPV, PDW, PVI

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Authors: Magdalena Hasplova, Katerina Ivanova

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Perinatal palliative care is a relatively young and developing field that includes the care of a fetus or newborn with a life-threatening or limiting defect and his family. However, the training of midwives in perinatal palliative care is insufficient and midwives do not feel prepared for this aspect of their work. This fact can affect the barriers to communication with the mother or family of the endangered child. The main aim was to analyze the awareness of midwifery students on the issue of perinatal palliative care in the Czech Republic. Based on the analysis, draw attention to possible communication barriers that may be caused by insufficient information. The research was carried out using a qualitative method, the method of data collection was a semi-structured interview. Eleven female students took part in the research, and the respondents were selected using the Snowballing method. Some methods of grounded theory (open coding and category creation) were used to analyze the data. Based on the results of the research, questions were set in a questionnaire focused on communication barriers between mothers (family) and health care professionals in the care of newborns with life-threatening or limiting disabilities. Based on the analysis of data, categories 1 were determined. Knowledge of perinatal palliative care 2. Education 3. Practical experience 4. Readiness and concerns in the provision of perinatal palliative care 6. Supervision. The questions in the questionnaire were then derived taking into account the data obtained, and the operationalization of health literacy in the field of perinatal palliative care was performed. The analysis of the interviews revealed that the education of midwives in the Czech Republic in the issue of perinatal palliative care is not uniform. The research confirmed the insufficient knowledge and skills of midwifery students preparing to provide perinatal palliative care. Respondents reported feelings of unpreparedness in the areas of communication with a woman after perinatal loss, psychological support for a woman and her family, the care of a stillborn or dying child, or self-coping with death. The questions in the questionnaire then develop these areas. We assumed that by analyzing and interpreting the data obtained from our research, we will help to better understand the concerns and motivations of students in providing holistic perinatal palliative care. We came to the conclusion that it would be appropriate to set up a unified and comprehensive education on this issue in the Czech Republic. Healthcare professionals are in a unique position that can positively or negatively affect the intensity of perinatal loss. Already properly set up education of health professionals leads to overcoming barriers in communication between health professionals and the family, experiencing perinatal loss.

Keywords: midwife, perinatal loss, perinatal palliative care, communication, barriers, mothers, family

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Authors: Yula Milshteyn

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The present study focuses on the science of the “Soul” in Islamic Medieval Psychology.The main objective of the current essay is to analyze the concept of the “soul” in relation to “mental” disorders, in the philosophical psychology and medicinal treatise of Ibn Sina, a Muslim Persian physician-philosopher (known as Avicenna in the Western world) (981-1037 CE). The examination will concentrate on the nature of the soul, and the relationship of the soul to the body, as well as the manifestation of health and sickness in soul and body, The analysis draws on Avicenna’s Psychology (Kitab al-Najat or The Book of Salvation), Remarks and Admonitions (Al-isharat wa al-tanbihat), and the medical treatise – The Canon of Medicine (al-Qānūn fī al-Ṭibb). Avicenna’s psychology of the soul is primarily based on Aristotelian and Neo-platonic paradigms. For Avicenna, soul is a metaphysical, independent substance, which in modern terms implies independence of human consciousness from the material body. The soul however, is linked to the body and controls all its’ faculties or functions. It is suggested that in the specific case study of schizophrenia, it is a disorder pertained to both, soul and body and can be characterized as a multi-faceted neurobiological, physiological, psychological and metaphysical spiritual phenomenon.

Keywords: Avicenna, canon of the medicine, mental disorders, psychology, schizophrenia, soul-body

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Authors: Stephanie Remedios, Linda Veronica Rios

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Background. Pediatric obesity is a serious health problem linked to multiple physical diseases and ailments, including diabetes, heart disease, and joint issues. While research has shown pediatric obesity can bring about an array of physical illnesses, it is less known how such a condition can affect children’s cognitive development. With childhood overweight and obesity prevalence rates on the rise, it is essential to understand the scope of their cognitive consequences. The present review of the literature tested the hypothesis that poor physical health, such as childhood obesity or malnutrition, negatively impacts a child’s cognitive development. Methodology. A systematic review was conducted to determine the relationship between poor physical health and lower cognitive functioning in children ages 4-16. Electronic databases were searched for studies dating back to ten years. The following databases were used: Science Direct, FIU Libraries, and Google Scholar. Inclusion criteria consisted of peer-reviewed academic articles written in English from 2012 to 2022 that analyzed the relationship between childhood malnutrition and obesity on cognitive development. A total of 17,000 articles were obtained, of which 16,987 were excluded for not addressing the cognitive implications exclusively. Of the acquired articles, 13 were retained. Results. Research suggested a significant connection between diet and cognitive development. Both diet and physical activity are strongly correlated with higher cognitive functioning. Cognitive domains explored in this work included learning, memory, attention, inhibition, and impulsivity. IQ scores were also considered objective representations of overall cognitive performance. Studies showed physical activity benefits cognitive development, primarily for executive functioning and language development. Additionally, children suffering from pediatric obesity or malnutrition were found to score 3-10 points lower in IQ scores when compared to healthy, same-aged children. Conclusion. This review provides evidence that the presence of physical activity and overall physical health, including appropriate diet and nutritional intake, has beneficial effects on cognitive outcomes. The primary conclusion from this research is that childhood obesity and malnutrition show detrimental effects on cognitive development in children, primarily with learning outcomes. Assuming childhood obesity and malnutrition rates continue their current trade, it is essential to understand the complete physical and psychological implications of obesity and malnutrition in pediatric populations. Given the limitations encountered through our research, further studies are needed to evaluate the areas of cognition affected during childhood.

Keywords: childhood malnutrition, childhood obesity, cognitive development, cognitive functioning

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Authors: Muhammad Afzal, Shahbaz Mushtaq, Duc-Anh-An-Vo, Kathryn Reardon Smith, Thanh Ma

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Climate change has become one of the most challenging environmental issues in the 21st century. Climate change-induced natural disasters, especially floods, are the major factors of livelihood vulnerability, impacting millions of individuals worldwide. Evaluating and mitigating the effects of floods requires an in-depth understanding of the relationship between vulnerability and livelihood capital assets. Using an integrated approach, sustainable livelihood framework, and system thinking approach, the study developed a conceptual model of a generalized livelihood system in District Rajanpur, Pakistan. The model visualizes the livelihood vulnerability system as a whole and identifies the key feedback loops likely to influence the livelihood vulnerability. The study suggests that such conceptual models provide effective communication and understanding tools to stakeholders and decision-makers to anticipate the problem and design appropriate policies. It can also serve as an evaluation technique for rural livelihood policy and identify key systematic interventions. The key finding of the study reveals that household income, health, and education are the major factors behind the livelihood vulnerability of the rural poor of District Rajanpur. The Pakistani government tried to reduce the livelihood vulnerability of the region through different income, health, and education programs, but still, many changes are required to make these programs more effective especially during the flood times. The government provided only cash to vulnerable and marginalized families through income support programs, but this study suggests that along with the cash, the government must provide seed storage facilities and access to crop insurance to the farmers. Similarly, the government should establish basic health units in villages and frequent visits of medical mobile vans should be arranged with advanced medical lab facilities during and after the flood.

Keywords: livelihood vulnerability, rural communities, flood, sustainable livelihood framework, system dynamics, Pakistan

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Authors: Anne Nattembo

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Cervical cancer remains a major public health problem in developing countries, especially in Africa. Effective cervical cancer prevention communication requires identification of behaviors, attitudes and increasing awareness of a given population; thus this study focused on investigating awareness, attitudes, and behavior among female university students towards cervical cancer messages. The study objectives sought to investigate the communication behavior of young adults towards cervical cancer, to understand female students recognition of cervical cancer as a problem, to identify the frames related to cervical cancer and their impact towards audience communication and participation behaviors, to identify the factors that influence behavioral intentions and level of involvement towards cervical cancer services and to make recommendations on how to improve cervical cancer communication towards female university students. The researcher obtained data using semi-structured interviews and focus group discussions targeting 90 respondents. The semi-structured in-depth interviews were carried out through one-on-one discussions basis using a set of prepared questions among 53 respondents. All interviews were audio-tape recorded. Each interview was directly typed into Microsoft Word. 4 focus group discussions were conducted with a total of 37 respondents; 2 female only groups with 10 respondents in one and 9 respondents in another, 1 mixed with 12 participants 5 of whom were male, and 1 male only group with 6 participants. The key findings show that the participants preferred to receive and access cervical cancer information from doctors although they were mainly receiving information from the radio. In regards to the type of public the respondents represent, majority of the respondents were non-publics in the sense that they did not have knowledge about cervical cancer, had low levels of involvement and had high constraint recognition their cervical cancer knowledge levels. The researcher identified the most salient audience frames among female university students towards cervical cancer and these included; death, loss, and fear. These frames did not necessarily make cervical cancer an issue of concern among the female university students but rather an issue they distanced themselves from as they did not perceive it as a risk. The study also identified the constraints respondents face in responding to cervical cancer campaign calls-to-action which included; stigma, lack of knowledge and access to services as well as lack of recommendation from doctors. In regards to sex differences, females had more knowledge about cervical cancer than the males. In conclusion the study highlights the importance of interpersonal communication in risk or health communication with a focus on health providers proactively sharing cervical cancer prevention information with their patients. Health provider’s involvement in cervical cancer is very important in influencing behavior and compliance of cervical cancer calls-to-action. The study also provides recommendations for designing effective cervical cancer campaigns that will positively impact on the audience such as packaging cervical cancer messages that also target the males as a way of increasing their involvement and more campaigns to increase awareness of cervical cancer as well as designing positive framed messages to counter the negative audience frames towards cervical cancer.

Keywords: cervical cancer communication, health communication, university students, risk communication

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Authors: Santosh B. Phad, Priyanka V. Janbandhu, Dhananjay W. Bansod

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Population Ageing is a growing concern for the social scientists. There is a higher level of aged male participation compared to elderly females. Now, the critical question is whether participation in work improves the quality of life among the elderly and the impact of working status on the mental well-being of the elderly. While examining these research questions, the present paper focuses on the workforce participation of the elderly and the reasons behind it, additionally, determines the association between employment status and the mental well-being of the elderly. The present study has a base of two data sources. First one is Census of India data, 2001 and 2011, and another one is – the Study on Global Ageing and Adult Health (SAGE), a survey conducted in 2007. To capture the trend of workforce participation elderly Census data is significant and to obtain other information associated with this issue the SAGE data is studied. The research piece consists of univariate and bivariate analysis along with some statistical methods like principal component analysis (PCA) and regression modeling – to investigate the association between workforce participation of elderly and subjective well-being (SWB). The results show that the percentage of elderly participating in the labor market is gradually reducing, but the share of working elderly has increased within the group of overall workers. i.e., the ratio of aged workers to non-aged workers is rising. The findings from survey data specify that there is a considerable share of the elderly in the labor market; three-fourths of the employed elderly enrolled the workforce unwillingly. They are in need of some earnings mainly to afford the medical expenses on their health or the health of their spouse, also to support their family members who are economically inactive. Apart from need, duration of working is another vital aspect for the elderly, whereas more than 80 percent of the elderly are working for six hours or more, and most of them engaged in self-employment. However, more than one-third of the working elderly falls into a negative cluster of the subjective well-being (SWB) index, and it is consistent with the result of the discriminant analysis. Here, the SWB index calculated from the 12 items and the reliability score of these items is 0.89.

Keywords: ageing, workforce, census of India, SAGE

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Authors: Herng-Sheng Lee, Chi-Yi Chen, Wan-Ting Huang, Li-Jen Chang, Solomon Chih-Cheng Chen, Hsin-Yi Yang

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A variety of gastrointestinal disorders, such as Crohn’s disease, ulcerative colitis, and coeliac disease, are recognized as risk factors for osteoporosis and osteoporotic fractures. One recent study suggests that individuals with irritable bowel syndrome (IBS) might also be at increased risk of osteoporosis and osteoporotic fractures. Up to now, the association between IBS and the risk of fractures at different anatomic sites occurrences is not completely clear. We conducted a population-based cohort analysis to investigate the fracture risk of IBS in comparison with non-IBS group. We identified 29,505 adults aged ≥ 20 years with newly diagnosed IBS using the Taiwan National Health Insurance Research Database in 2000-2012. A comparison group was constructed of patients without IBS who were matched according to gender and age. The occurrence of fracture was monitored until the end of 2013. We analyzed the risk of fracture events to occur in IBS by using Cox proportional hazards regression models. Patients with IBS had a higher incidence of osteoporotic fractures compared with non-IBS group (12.34 versus 9.45 per 1,000 person-years) and an increased risk of osteoporotic fractures (adjusted hazard ratio [aHR] = 1.27, 95 % confidence interval [CI] = 1.20 – 1.35). Site specific analysis showed that the IBS group had a higher risk of fractures for spine, forearm, hip and hand than did the non-IBS group. With further stratification for gender and age, a higher aHR value for osteoporotic fractures in IBS group was seen across all age groups in males, but seen in elderly females. In addition, female, elderly, low income, hypertension, coronary artery disease, cerebrovascular disease, and depressive disorders as independent osteoporotic fracture risk factors in IBS patients. The IBS is considered as a risk factor for osteoporotic fractures, particularly in female individuals and fracture sites located at the spine, forearm, hip and hand.

Keywords: irritable bowel syndrome, fracture, gender difference, longitudinal health insurance database, public health

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Authors: Luma Vaz, Marcio Port-Carvalho

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The main objective of this research was to study the basics aspects of the ecology of a group of capuchin monkeys (Cebus spp.), evaluating the risks that habit and food that is given by the visitors may cause to the people's health and animals welfare, also how to make proposals for mitigation and management guidelines. In order to do that, some aspects of the animal's ecology (such as diet, habitat range and habitat use) and activity patterns were studied. It was also measured the frequency of contact with visitors at the park using protocols for data collection. The behavioral categories of displacement and resting represent more than 80% of total activities, followed by feeding (13%) and others (6%). When compared to the studies in natural environment, the Cebus group studied has a small living area (1.7ha) occupying mostly the PEAL public area. The diversity of items offered by the visitors and the high frequency of contact closer than one meter suggests that using information and education campaigns must be a priority in the public program in PEAL in order to avoid future accidents and diseases transmissions.

Keywords: capuchin monkeys, Cebus, environmental education, public health, wildlife management

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Authors: Paolo Pilloni, Fabrizio Mulas, Salvatore Carta

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Nowadays, several research studies point up that an active lifestyle is essential for physical and mental health benefits. Mobile phones have greatly influenced people’s habits and attitudes also in the way they exercise. Our research work is mainly focused on investigating how to exploit mobile technologies to favour people’s exertion experience. To this end, we developed an exertion framework users can exploit through a real world mobile application, called BLINDED, designed to act as a virtual personal trainer to support runners during their trainings. In this work, inspired by both previous findings in the field of interaction design for people with visual impairments, feedback gathered from real users of our framework, and positive results obtained from two experimentations, we present some new interaction facilities we designed to enhance the interaction experience during a training. The positive obtained results helped us to derive some interaction design recommendations we believe will be a valid support for designers of future mobile systems conceived to be used in circumstances where there are limited possibilities of interaction.

Keywords: human computer interaction, interaction design guidelines, persuasive mobile technologies for sport and health

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Authors: Zachary Cooper-Baldock, Paulo E. Santos, Russell S. A. Brinkworth, Karl Sammut

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- In recent years, large unmanned underwater vehicles such as the Boeing Voyager and Anduril Ghost Shark have been developed. These vessels can be structured to contain onboard internal payload bays. These payload bays can serve a variety of purposes – including the launch and recovery (LAR) of smaller underwater vehicles. The LAR of smaller vessels is extremely important, as it enables transportation over greater distances, increased time on station, data transmission and operational safety. The larger vessel and its payload bay structure complicate the LAR of UUVs in contrast to static docks that are affixed to the seafloor, as they actively impact the local flow field. These flow field impacts require analysis to determine if UUV vessels can be safely launched and recovered inside the motherships. This research seeks to determine the hydrodynamic forces exerted on a vertically over-actuated, small, unmanned underwater vehicle (OUUV) during an internal LAR manoeuvre and compare this to an under-actuated vessel (UUUV). In this manoeuvre, the OUUV is navigated through the stern wake region of the larger vessel to a set point within the internal payload bay. The manoeuvre is simulated using ANSYS Fluent computational fluid dynamics models, covering the entire recovery of the OUUV and UUUV. The analysis of the OUUV is compared against the UUUV to determine the differences in the exerted forces. Of particular interest are the drag, pressure, turbulence and flow field effects exerted as the OUUV is driven inside the payload bay of the larger vessel. The hydrodynamic forces and flow field disturbances are used to determine the feasibility of making such an approach. From the simulations, it was determined that there was no significant detrimental physical forces, particularly with regard to turbulence. The flow field effects exerted by the OUUV are significant. The vertical thrusters exert significant wake structures, but their orientation ensures the wake effects are exerted below the UUV, minimising the impact. It was also seen that OUUV experiences higher drag forces compared to the UUUV, which will correlate to an increased energy expenditure. This investigation found no key indicators that recovery via a mothership payload bay was not feasible. The turbulence, drag and pressure phenomenon were of a similar magnitude to existing static and towed dock structures.

Keywords: underwater vehicles, submarine, autonomous underwater vehicles, auv, computational fluid dynamics, flow fields, pressure, turbulence, drag

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Authors: Silas Webb, Joseph Hartland

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Background: Long-term retention of patients on ART has become a major health challenge in Sub-Saharan Africa (SSA). In 2010 a systematic review of 39 papers found that 30% of patients were no longer taking their ARTs two years after starting treatment. In the same review, it was noted that there was a paucity of data as to why patients become lost to follow-up (LTFU) in SSA. This project was performed in Mulanje Mission Hospital in Malawi as part of Swindon Academy’s Global Health eSSC. The HIV prevalence for Malawi is 10.3%, one of the highest rates in the world, however prevalence soars to 18% in the Mulanje. Therefore it is essential that patients at risk of being LTFU are identified early and managed appropriately to help them continue to participate in the service. Methodology: All patients on adult antiretroviral formulations at MMH, who were classified as ‘defaulters’ (patients missing a scheduled follow up visit by more than two months) over the last 12 months were included in the study. Demographic varibales were collected from Mastercards for data analysis. A comparison group of patients currently not lost to follow up was created by using all of the patients who attended the HIV clinic between 18th-22nd July 2016 who had never defaulted from ART. Data was analysed using the chi squared (χ²) test, as data collected was categorical, with alpha levels set at 0.05. Results: Overall, 136 patients had defaulted from ART over the past 12 months at MMH. Of these, 43 patients had missing Mastercards, so 93 defaulter datasets were analysed. In the comparison group 93 datasets were also analysed and statistical analysis done using Chi-Squared testing. A higher proportion of men in the defaulting group was noted (χ²=0.034) and defaulters tended to be younger (χ²=0.052). 94.6% of patients who defaulted were taking Tenofovir, Lamivudine and Efavirenz, the standard first line ART therapy in Malawi. The mean length of time on ART was 39.0 months (RR: -22.4-100.4) in the defaulters group and 47.3 months (RR: -19.71-114.23) in the control group, with a mean difference of 8.3 less months in the defaulters group (χ ²=0.056). Discussion: The findings in this study echo the literature, however this review expands on that and shows the demographic for the patient at most risk of defaulting and being LTFU would be: a young male who has missed more than 4 doses of ART and is within his first year of treatment. For the hospital, this data is important at it identifies significant areas for public health focus. For instance, fear of disclosure and stigma may be disproportionately affecting younger men, so interventions can be aimed specifically at them to improve their health outcomes. The mean length of time on medication was 8.3 months less in the defaulters group, with a p-value of 0.056, emphasising the need for more intensive follow-up in the early stages of treatment, when patients are at the highest risk of defaulting.

Keywords: anti-retroviral therapy, ART, HIV, lost to follow up, Malawi

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Authors: Vorapoj Promasatayaprot, Sumattana Glangkarn

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Background: Early childhood, the first five years of life, is a time of rapid cognitive, linguistic, social, emotional and motor development. This study was descriptive research which the main purpose of this research was to study early childhood development in Child Center of Local Government in order to emphasize the public citizen and communities participate in the Child Development Center. Method: The study designed was Action Research and divided into four steps consisted of (1) Planning (2) Acting (3) Observing and (4) Reflecting. This study was employed the areas and the subjects consisted of 10 committees of the Child Center in Thakhonyang municipality, Kantharawichai District, Maha Sarakham Province, Thailand and 50 representative parents by using the purposive sampling technique. The instrument used in this study were questionnaires. The data were analyzed using descriptive statistic; percentage, mean, standard deviation, maximum value, minimum, median. Qualitative data was collected using the observation and interview and was analysed by content analysis. Results: The results of this research were as follows: The promoting of early childhood development in child center at Thakhonyang Municipality, Kantharawichai District, Maha Sarakham Province, Thailand were 6 procedures ; (1) workshop participation (2) workshop in action plan (3) performing in action plan (4) following supervision (5) self – assessment (6) knowledge sharing seminar. The service model of the Local Fund Health Security in Thailand was passed the qualifications of local fund health security by 6 procedures to be the high potential local fund health security. Conclusion: The key success is that the commission will have to respond the performance at all process of plan to address the issue in the future. Factor of success is to community participate with transparent procedure. Coordination committee should manipulate the child center benefits among stake holders.

Keywords: child center, develop, early childhood development, local government, promote

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Authors: Sadra Abbasi

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The complex connection between psychological stress and the onset of different diseases has been an ongoing issue in the mental health field for a long time. Multiple studies have demonstrated that long-term stress can greatly heighten the likelihood of developing health issues like heart disease, cancer, arthritis, and severe depression. Recent research in cognitive science has provided insight into the intricate processes involved in posttraumatic stress disorder (PTSD), suggesting that distinct memory systems are accountable for both vivid reliving and normal autobiographical memories of traumatic incidents, as proposed by dual representation theory. This theory has important consequences for our comprehension of the neural mechanisms involved in fear and behavior related to threats, highlighting the amygdala-hippocampus-medial prefrontal cortex circuit as a crucial component in this process. This particular circuit, extensively researched in behavioral neuroscience, is essential for regulating the body's reactions to stress and trauma. This review will examine how incorporating a modern neuroscience viewpoint into an integrative case formulation offers a current way to comprehend the intricate connections among psychological stress, trauma, and disease.

Keywords: social, cognitive, stress, neuroscience, behavior, PTSD

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Authors: Daphne Alroy-Thiberge

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Trauma-impacted individuals present unique treatment challenges that include high reactivity, hyper-and hypo-arousal, poor adherence to therapy, as well as powerful transference and counter-transference experiences in therapy. This work provides an overview of the clinical tenets most often encountered in trauma-impacted individuals. Further, it provides readily applicable clinical techniques to optimize therapeutic rapport and facilitate accelerated positive mental health outcomes. Finally, integrated neuroscience and clinical evidence-based data are discussed to shed new light on crisis states in trauma-impacted individuals. This knowledge is utilized to provide effective and concrete interventions towards rapid and successful de-escalation of the impacted individual. A highly interactive, adult-learning-principles-based modality is utilized to provide an organic learning experience for participants. The information and techniques learned aim to increase clinical effectiveness, reduce staff injuries and burnout, and significantly enhance positive mental health outcomes and self-determination for the trauma-impacted individuals treated.

Keywords: clinical competencies, crisis interventions, psychotherapy techniques, trauma informed care

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Authors: Ajit Kumar Yadav, Priyanka Yadav, F. Ram

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In present study is an effort to analyse the burden of diseases in the state. Disability Adjusted Life Years (DALY) is estimated non-communicable diseases. Multi-rounds (52nd, 60th and 71st round) of the National Sample Surveys (NSSO), conducted in 1995-96, 2004 and 2014 respectively, and Million Deaths Study (MDS) of 2001-03, 2006 and 2013-14 datasets are used. Descriptive and multivariate analyses are carried out to identify the determinants of different types of self-reported morbidity and DALY. The prevalence was higher for population aged 60 and above, among females, illiterates, and rich across the time period and for all the selected morbidities. The results were found to be significant at P<0.001. The estimation of DALY revealed that, the burden of communicable diseases was higher during infancy, noticeably among males than females in 2002. However, females aged 1-5 years were more vulnerable to report communicable diseases than the corresponding males. The age distribution of DALY indicates that individuals aged below 5 years and above 60 year were more susceptible to ill health. The growing incidence of non-communicable diseases especially among the older generations put additional burden on the health system in the state. The state has to grapple with the unsettled preventable infectious diseases in one hand and growing non-communicable in other hand.

Keywords: disease burden, non-communicable, communicable, India and region

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Authors: A. D'Alessandro, F. Ubertini, A. L. Materazzi

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In the field of civil engineering, Structural Health Monitoring is a topic of growing interest. Effective monitoring instruments permit the control of the working conditions of structures and infrastructures, through the identification of behavioral anomalies due to incipient damages, especially in areas of high environmental hazards as earthquakes. While traditional sensors can be applied only in a limited number of points, providing a partial information for a structural diagnosis, novel transducers may allow a diffuse sensing. Thanks to the new tools and materials provided by nanotechnology, new types of multifunctional sensors are developing in the scientific panorama. In particular, cement-matrix composite materials capable of diagnosing their own state of strain and tension, could be originated by the addition of specific conductive nanofillers. Because of the nature of the material they are made of, these new cementitious nano-modified transducers can be inserted within the concrete elements, transforming the same structures in sets of widespread sensors. This paper is aimed at presenting the results of a research about a new self-sensing nanocomposite and about the implementation of smart sensors for Structural Health Monitoring. The developed nanocomposite has been obtained by inserting multi walled carbon nanotubes within a cementitious matrix. The insertion of such conductive carbon nanofillers provides the base material with piezoresistive characteristics and peculiar sensitivity to mechanical modifications. The self-sensing ability is achieved by correlating the variation of the external stress or strain with the variation of some electrical properties, such as the electrical resistance or conductivity. Through the measurement of such electrical characteristics, the performance and the working conditions of an element or a structure can be monitored. Among conductive carbon nanofillers, carbon nanotubes seem to be particularly promising for the realization of self-sensing cement-matrix materials. Some issues related to the nanofiller dispersion or to the influence of the nano-inclusions amount in the cement matrix need to be carefully investigated: the strain sensitivity of the resulting sensors is influenced by such factors. This work analyzes the dispersion of the carbon nanofillers, the physical properties of the fresh dough, the electrical properties of the hardened composites and the sensing properties of the realized sensors. The experimental campaign focuses specifically on their dynamic characterization and their applicability to the monitoring of full-scale elements. The results of the electromechanical tests with both slow varying and dynamic loads show that the developed nanocomposite sensors can be effectively used for the health monitoring of structures.

Keywords: carbon nanotubes, self-sensing nanocomposites, smart cement-matrix sensors, structural health monitoring

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Authors: Ali Arazeem Abdullahi, Mariam Seedat-Khan, Bamidele S. Akanni

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Background: Like the rest of the world, cancer of the breast is a life-threatening disease to Nigerian women. The utilization of mammography is however very poor among the general population. Whereas, there strong indications that women who engage in the regular screening of breast cancer using mammography are more likely to have a lower risk of developing and dying from advanced breast cancer compared to unscreened women. This study examined knowledge of breast cancer and utilization of mammography among undergraduate female students at the University of Ilorin, Nigeria. Health Belief Model (HBM) was deployed to guide the conduct of the study. Method: Self-administered questionnaire was used to collect data from 292 undergraduate female students from the faculties of Social and Management Sciences of the University. A simple random sampling technique was used to select the respondents. Data was analyzed using both descriptive and inferential statistics. Results: The study found that apart from high knowledge of breast cancer and mammography, perceived threat, perceived susceptibility and perceived seriousness of breast cancer were equally high. However, the uptake of mammography was very poor largely due to perceived barriers including being single and young and poor history of breast cancer in families (cues to action). The test of hypotheses showed that there is a weak relationship of about 6.8% between knowledge of breast cancer and utilization of mammography (p-value= 0.244) at 0.05 level of significance. However, 64.4% of the respondents were willing to utilize mammography in the future if the opportunity arises. While the study found a significant statistical relationship between the perceived benefits of mammography and its utilization among the respondents, no significant statistical association was found between the socio-demographic characteristics of the respondents and the uptake of mammography. Recommendations: Findings highlight the need for health education interventions to promote breast cancer screening and the utilization mammography, while addressing barriers to the uptake of mammography among female undergraduate students of the University of Ilorin and Nigeria in general.

Keywords: cancer of the breast, mammography, female undergraduate students, health belief model, University of Ilorin

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Authors: Amy Williamson, Kerry Armstrong, Jason Edwards, Patricia Obst

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Australian national policy endorses a responsive approach to work health and safety (WHS) regulation, combining positive motivators (education and guidance), with compliance monitoring and enforcement to encourage and secure compliance with legislation. Despite theoretical support for responsive regulation, there is limited evidence regarding how to achieve best results in practice. Using positive psychology as a novel paradigm, this study aims to investigate how non-punitive regulatory interactions can be improved to further encourage regulatory compliance in the construction industry. As part of a larger project, semi-structured interviews were conducted with 35 inspectorate staff and 11 managers in the Australian (Queensland) construction industry. Using an inductive, grounded approach, an in-depth qualitative investigation was conducted to identify the positive psychological principles which underpin effective use of the non-punitive aspects of responsive regulation. Results highlighted the importance of effective engagement between inspectors and industry managers. This involved the need to interact cooperatively and encourage compliance with WHS legislation. Several strategies were identified that assisted regulatory interactions and the ability of inspectors to engage. The importance of communication and interpersonal skills was reported to be critical to any interaction, regardless of the nature of the visit and regulatory tools used. In particular, the use of clear and open communication fostered trust and rapport which facilitated more positive interactions. The importance of respect and empathy was also highlighted. The need for provision of guidance and direction on how to achieve compliance was also reported. This related to ensuring companies understand their WHS obligations, providing specific advice regarding how to rectify a breach and meet compliance requirements, and ensuring sufficient follow up to confirm that compliance is successfully achieved. In the absence of imminent risk, allowing companies the opportunity to comply before further action is taken was also highlighted. Increased proactive engagement with industry to educate and promote the vision of safety at work was also reported. Finally, provision of praise and positive feedback was reported to assist interactions and encourage the continuation of good practices. Evidence from positive psychology and organisational psychology was obtained to support the use of each strategy in practice. In particular, the area of positive leadership provided a useful framework to consider the factors and conditions that drive positive interactions within the context of work health and safety and the specific relationship between inspectors and industry managers. This study provides fresh insight into key psychological principles which support non-punitive regulatory interactions in the area of workplace health and safety. The findings of this research contribute to a better understanding of how inspectors can enhance the efficacy of their regulatory interactions to improve compliance with legislation. Encouraging and assisting compliance through effective non-punitive activity offers a sustainable pathway for promoting safety and preventing fatalities and injuries in the construction industry.

Keywords: engagement, non-punitive approaches to compliance, positive interactions in the workplace, work health and safety compliance

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Authors: Iulianna Taritsa, Kuldeep Neote, Eric Fossel

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Lysosome-induced immunogenic cell death (LIICD) is a powerful mechanism of targeting cancer cells that kills circulating malignant cells and primes the host’s immune cells against future remission. Current immunotherapies for cancer are limited in preventing recurrence – a gap that can be bridged by training the immune system to recognize cancer neoantigens. Lysosomal leakage can be induced therapeutically to traffic antigens from dying cells to dendritic cells, which can later present those tumorigenic antigens to T cells. Previous research has shown that oxidative agents administered in the tumor microenvironment can initiate LIICD. We generated a fusion protein between an oxidative agent known as xanthine oxidase (XO) and a mini-antibody specific for EGFR/HER2-sensitive breast tumor cells. The anti-EGFR single domain antibody fragment is uniquely sourced from llama, which is functional without the presence of a light chain. These llama micro-antibodies have been shown to be better able to penetrate tissues and have improved physicochemical stability as compared to traditional monoclonal antibodies. We demonstrate that the fusion protein created is stable and can induce early markers of immunogenic cell death in an in vitro human breast cancer cell line (SkBr3). Specifically, we measured overall cell death, as well as surface-expressed calreticulin, extracellular ATP release, and HMGB1 production. These markers are consensus indicators of ICD. Flow cytometry, luminescence assays, and ELISA were used respectively to quantify biomarker levels between treated versus untreated cells. We also included a positive control group of SkBr3 cells dosed with doxorubicin (a known inducer of LIICD) and a negative control dosed with cisplatin (a known inducer of cell death, but not of the immunogenic variety). We looked at each marker at various time points after cancer cells were treated with the XO/antibody fusion protein, doxorubicin, and cisplatin. Upregulated biomarkers after treatment with the fusion protein indicate an immunogenic response. We thus show the potential for this fusion protein to induce an anticancer effect paired with an adaptive immune response against EGFR/HER2+ cells. Our research in human cell lines here provides evidence for the success of the same therapeutic method for patients and serves as the gateway to developing a new treatment approach against breast cancer.

Keywords: apoptosis, breast cancer, immunogenic cell death, lysosome

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Authors: Said Abdirasak Abidrahman, Ibrahim Mohamed

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Background: Urinary Tract Infections (UTIs) are the commonest infections described among diabetes mellitus patients. More often, empirical antimicrobial therapy is initiated before the laboratory results are made available with minimal treatment success. The knowledge of the etiology and antibiotic susceptibility patterns of the organisms causing urinary tract infections among diabetes mellitus patients remains scarce, despite its vitality. This study sought to determine the prevalence, bacteria species, and drug susceptibility patterns of common causes of urinary tract infections among diabetes mellitus patients attending Bosaso health centers. Materials and methods: We conducted a cross-sectional study involving adult diabetic patients at Bosaso health centers between the months of May and July 2020. Laboratory assay of mid-stream urine samples was done to isolate bacteria causes of UTIs. These were biochemically identified using Gram stain, Kligler iron agar (KIA), Indole test, citrate, urea, coagulase, catalase, motility agar, and lysine iron agar. Their antibiotic susceptibility pattern for the isolated organisms was made for Ampicillin 10μg, Ciprofloxacin 5μg, Cotrimoxazole 25μg, Gentamycin 10μg, Ceftriaxone 10μg, and determined using the Kirby Bauer Disc Diffusion method. Results: Of 177 participants, 69 (39.0%) were males and 108 (61.0%) were females. Their mean age was 33.1 years (range; 18-67 years). Of these, 14.7% (26/177) of the samples revealed significant growth (>= 105 CFU/mL) giving a prevalence of 14.9 % (95% CI: 10.6 to 16.3). The organisms isolated were Escherichia coli -50% (N=13), Klebsiella pneumonia 30.8% (N=8), Staphylococcus aureus 15.4% (N=4), and unidentified organism 3.8% (N=1), and these were associated with such socio-demographic factors like history of catheterization and sexual activity. Antibiotic susceptibility to the commonly used agents for treating UTIs indicated higher sensitivity to Gentamicin and Ceftriaxone.

Keywords: antimicrobials, bacteria, urinary tract infections, diabetes

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Authors: Monique Palma, Isabel Amaral

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This paper aims at mapping medical places in Oporto in the twentieth century in order to bring the urban history of medicine and healthcare in Portugal to a large audience, using Oporto as a case study. This analysis is consistent with the SDS's 2030 goals for policy guidance for heritage and development actors. As a result, it is critical to begin this research in order to place on the political agenda the preservation of Portuguese culture's history, memory, and heritage, particularly the medical culture, which is one of the most important drivers of civilizational development. To understand the evolution of medical care in urban history, we will conduct archive research (manuals, treatises, reports, periodic journals, newspapers, etc.) and interviews with key actors from medical institutions and medical museums. The findings of this study will be used to develop medical itineraries for inclusion in touristic agendas in Portugal and abroad, to include Portuguese medicine in global roadmaps, and to promote the preservation of the most iconic places of health care and medical heritage, as well as tools to promote social cohesion, dialogue among people, and "sense of place" globally.

Keywords: medical itineraries, history of medicine, urban history, Oporto

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Authors: Dina Alfreahat, Zoltan Sebestyen

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Safety is considered as one of the project’s success factors. Poor safety management may result in accidents that impact human, economic, and legal issues. Therefore, it is necessary to consider safety and health as a project success factor along with other project success factors, such as time, cost, and quality. Organizations have a knowledge deficit of the implementation of long-term safety practices, and due to cost control, safety problems tend to receive the least priority. They usually assume that safety management involves expenditures unrelated to production goals, thereby considering it unnecessary for profitability and competitiveness. The purpose of this study is to introduce, analysis and identify the correlation between the orientation of the public safety procedures of an organization and the public safety standards applied in the project. Therefore, the authors develop the process and collect the possible mathematical-statistical tools supporting the previously mentioned goal. The result shows that the adoption of management to safety is a major factor in implementing the safety standard in the project and thereby improving safety performance. It may take time and effort to adopt the mindset of safety orientation service development, but at the same time, the higher organizational investment in safety and health programs will contribute to the loyalty of staff to safety compliance.

Keywords: project management perspective, safety orientation, safety performance, safety standards

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Authors: Fiorenza Misale

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The painful phenomenon of so-called white deaths and accidents at work, unfortunately, is always current. The key is to act on the culture of security through effective measures of attitudes and behaviors that go far beyond the knowledge and the know-how. It is necessary that there is an ‘introjection’ of safety culture through the conscious involvement of all workers. The legislation on work safety identifies the main tool to promote the culture of safety at work and prevention within the workplace. In law the term education is used to distinguish itself from the information with which they will simply theoretically transmit, and from the training with which they will provide the practical skills. The new decree fact fills several gaps in previous legislation and stresses the importance of training in the workplace, that is, the main activity through which it is possible to achieve the active participation of all workers in the company’s prevention system. This system is built only through the dissemination of risk information, the circulation of information, comparison and dialogue between all actors involved that are the necessary elements for a correct transmission of the culture of worker safety. Training activity should put the focus on work experience in order to bring out all the knowledge needed to identify and assess the risks in the work place, and especially the action to eliminate or control them, integrating, when necessary, the missing knowledge. In addition to traditional training and information systems can be utilized for the purpose of training that are able to affect both one emotionally and aesthetically, team-theatre is one of them. Among the methods of company theater that can be used in work safety we have: Lesson show, theater workshop, improvised theater, forum theater, theater playback. The theater can represent a complementary approach to traditional training and give information on safety measures, demonstrating that there are more engaging outreach tools. Team-theatre allows identification with the characters, a transmission of emotions and moods and it is through the staging of a story that the individual processes new information. It’ also s a means of experiential training that allows you to work with your mind, body, emotions.The aim of one work is the use of corporate theater on the personnel working in the health sector. Through a questionnaire we are able to analyze the knowledge of occupational safety and current risks; in particular in health care which is to be administered before and after the play.

Keywords: theater, training, occupational health, safety

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Authors: Brianna M. Soule, Jesslyn A. Bryk-Lucy, Linda M. Ritchie

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Colic, defined as abdominal pain in the horse, has several known predisposing factors. Decreased water intake has been shown to predispose equines to impaction colic. The objective of this study was to determine if offering flavored water (sweet feed or banana extract) would increase voluntary water intake in horses to serve as an assessable, noninvasive method for farm managers, veterinarians, or owners to decrease the risk of impaction colic. An a priori power analysis, which was conducted using G*Power version 3.1.9.7, indicated that the minimum sample size required to achieve 80% power for detecting a large effect at a significance level of α = .05 was 19 horses for a one-way repeated measures ANOVA with three treatment levels and assuming a non-sphericity correction of ε=0.5. After a three-day control period, 21 horses were randomly divided into two sequences and offered either banana or sweet feed flavored water. Horses always had a bucket of unflavored water available. A repeated measure study design was used to measure water consumption of each horse over a 62-hour period. A one-way repeated measures ANOVA was conducted to determine whether there were statistically significant differences among the means for the three-day average water intake (ml/kg). Although not statistically significant (F(2, 38) = 1.28, p = .290, partial η2 = .063), the three-day average water intake was largest for banana flavored water (M = 53.51, SD = 9.25 ml/kg), followed by sweet feed (M = 52.93, SD = 11.99 ml/kg), and, finally, unflavored water (M = 50.40, SD = 10.82 ml/kg). Paired-samples t-tests were used to determine whether there was a statistically significant difference between the three-day average water intake (ml/kg) for flavored versus unflavored water. The average unflavored water intake (M = 29.3 ml/kg, SD = 8.9) over the measurement period was greater than the banana flavored water (M = 27.7 ml/kg, SD = 9.8), but the average consumption of the sweet feed flavored water (M = 30.4 ml/kg, SD = 14.6) was greater than unflavored water (M = 24.3 ml/kg, SD = 11.4). None of these differences in average intake were statistically significant (p > .244). Future research is warranted to determine if other flavors significantly increase voluntary water intake in horses.

Keywords: colic, equine, equine science, water intake, flavored water, horses, equine management, equine health, horse health, horse health care management, colic prevention

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Authors: Fangting Gao

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Ozone acts as an atmospheric shield, protecting organisms from ultraviolet radiation by absorbing it. Currently, a large amount of international environmental epidemiology has confirmed that short- and long-term exposure to ozone has significant effects on population health. Near-surface ozone, as a secondary pollutant in the atmosphere, not only negatively affects the production activities of living organisms but also damages ecosystems and affects climate change to some extent. In this paper, using the hour-by-hour ozone observations given by ground meteorological stations in four cities, namely Beijing, Kunming, Xining, and Guangzhou, from 2015 to 2017, the number of days of exceedance and the long-term change characteristics of ozone are analyzed by using the time series analysis method. On this basis, the effects of changes in meteorological conditions on ozone concentration were discussed in conjunction with the same period of meteorological data, and the similarities and differences of near-surface ozone in different cities were comparatively analyzed to establish a relevant quantitative model of near-surface ozone. This study found that ozone concentrations were highest during the summer months of the year, that ozone concentrations were strongly correlated with meteorological conditions, and that none of the four cities had ozone concentrations that reached the threshold for causing disease.

Keywords: ozone, meteorological conditions, pollution, health

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Authors: Deepa Shokeen, Bani Tamber Aeri

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Food environments are believed to play a significant role in the obesity epidemic and robust research methods are required to establish which factors or aspects of the food environment are relevant to food choice and to adiposity. The relationship between the food environment and obesity is complex. While there is little research linking food access with obesity as an outcome measure in any age group, with the help of this article we will try to understand the relationship between what we eat and the environmental context in which these food choices are made. Methods: A literature search of studies published between January 2000 and December 2013 was undertaken on computerized medical, social science, health, nutrition and education databases including Google, PubMed etc. Reports of organisations such as World Health Organisation (WHO), Centre for Chronic Disease Control (CCDC) were studied to project the data. Results: Studies show that food environments play a significant role in the obesity epidemic and robust research methods are required to establish which factors or aspects of the food environment are relevant to food choice and to adiposity. Evidence indicates that the food environment may help explain the obesity and cardio-metabolic risk factors among young adults. Conclusion: Cardiovascular disease is the ever growing chronic disease, the incidence of which will increase markedly in the coming decades. Therefore, it is the need of the hour to assess the prevalence of various risk factors that contribute to the incidence of cardiovascular diseases especially in the work environment. Research is required to establish how different environments affect different individuals as individuals interact with the environment on a number of levels. We need to ascertain the impact of selected food and nutrition environments (Information, organization, community, consumer) on food choice and dietary intake of the working adults as it is important to learn how these food environments influence the eating perceptions and health behaviour of the adults.

Keywords: food environment, prevalence, cardiovascular disease, India, worksite, risk factors

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Authors: Osayomwanbor E. Oghama, John O. Olomukoro

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The school environment, apart from home, is probably the most important indoor environment for children. Children spend as much as 80-90% of their indoor time either at school or at home; an average of 35 - 40 hours per week in schools, hence are at the risk of indoor air pollutants such as volatile organic compounds (VOCs). Concentrations of VOCs vary widely but are generally higher indoors than outdoors. This research was, therefore, carried out to evaluate the levels of VOCs in secondary school classrooms in Benin City, Edo State. Samples were obtained from a total of 18 classrooms in 6 secondary schools. Samples were collected 3 times from each school and from 3 different classrooms in each school using Draeger ORSA 5 tubes. Samplers were left to stay for a school-week (5 days). The VOCs detected and analyzed were benzene, ethlybenzene, isopropylbenzene, naphthalene, n-butylbenzene, n-propylbenzene, toluene, m-xylene, p-xylene, o-xylene, styrene, chlorobenzene, chloroform, 1,2-dichloropropane, 2,2-dichloropropane, tetrachloroethane, tetrahydrofuran, isopropyl acetate, α-pinene, and camphene. The results showed that chloroform, o-xylene, and styrene were the most abundant while α-pinene and camphene were the least abundant. The health risk assessment was done in terms of carcinogenic (CRI) and non-carcinogenic risks (THR). The CRI values of the schools ranged from 1.03 × 10-5 to 1.36 × 10-5 μg/m³ (a mean of 1.16 × 10-5 μg/m³) with School 6 and School 3 having the highest and lowest values respectively. The THR values of the study schools ranged from 0.071-0.086 μg/m³ (a mean of 0.078 μg/m³) with School 3 and School 2 having the highest and lowest values respectively. The results show that all the schools pose a potential carcinogenic risks having CRI values greater than the recommended limit of 1 × 10-6 µg/m³ and no non-carcinogenic risk having THR values less than the USEPA hazard quotient of 1 µg/m³. It is recommended that school authorities should ensure adequate ventilation in their schools, supplementing natural ventilation with mechanical sources, where necessary. In addition, indoor air quality should be taken into consideration in the design and construction of classrooms.

Keywords: carcinogenic risk indicator, health risk, indoor air, non-carcinogenic risk indicator, secondary schools, volatile organic compounds

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Authors: Baikuntha Prasad Acharya, Elizabeth Halpenny

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Small tourism enterprises (STEs) are primary providers of services and attractions in many destinations of less developed countries; they are considered the lifeblood of tourism sector. Furthermore, in rural community destinations of such countries including Nepal, STEs are regarded as alternative tools for advancing economic and sociocultural transformations. Many families in rural Nepali destinations are venturing into small tourism entrepreneurship so that their poverty can be reduced and they can live a sustained life. Most these communities are utilizing their lifestyles and natural and cultural heritages as tourism attractions. This study aimed to understand the sustainability of the STEs in rural destinations by synthesizing observations from Ghalegaon and Ghandruk of the Annapurna Conservation Area in western Nepal. Ghalegaon has community-based homestays and Ghandruk has independently owned and operated small tourism businesses such as cafes, tea houses, lodges, guest houses, and hotels, etc. The community-based homestays of Ghalegaon are compared with the independently owned and operated STEs of Ghandruk. The data were collected through multiple sources: 1) survey of tourists (n=112) and households (n=191); 2) interviews (n=14) with the locals, 3) group discussions (n=10) with different local groups including that of regional tourism players, experts and policy makers, 4) observations, and 5) document analysis. The STEs of both communities were first analyzed by understanding their level of sustainability as businesses, and then were explored how they were impacting on respective communities’ sustainability. The survey indicators and guidelines for interviews and group discussions were adapted to the Nepalese context based on four pillars of sustainability: economic, social, cultural and environmental; an additional dimension of management was also included, particularly for the STEs. The findings have shown a weaker economic and management dimensions of Ghalegaon’s Homestay than that of Ghandruk’s STEs. Some interesting social complexities of rural tourism and entrepreneurship were also revealed. This study’s findings do not much resonate to what Nepal government’s current rural tourism strategies that have been envisioned and prioritized for, particularly that the rural homestay tourism opportunities enhance inclusiveness of women and other deprived communities by spreading the benefits to the grassroots level. The study has highlighted several important applied implications to the local tourism management committees, tourism operators and associations, and regional and national tourism authorities. Further studies are advisable in other similar contexts in Nepal and in other countries to see whether there are variances in the findings.

Keywords: Nepal, rural tourism communities, small tourism enterprises, sustainability

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Authors: Marcelo T. Okano, Oduvaldo Vendrametto, Osmildo S. Santos, Marcelo E. Fernandes, Heide Landi

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Teaching of entrepreneurship and innovation in Brazilian universities has increased in recent years due to several factors such as the emergence of disciplines like biotechnology increased globalization reduced basic funding and new perspectives on the role of the university in the system of knowledge production Innovation is increasingly seen as an evolutionary process that involves different institutional spheres or sectors in society Entrepreneurship is a milestone on the road towards economic progress, and makes a huge contribution towards the quality and future hopes of a sector, economy or even a country. Entrepreneurship is as important in small and medium-sized enterprises (SMEs) and local markets as in large companies, and national and international markets, and is just as key a consideration for public companies as or private organizations. Entrepreneurship helps to encourage the competition in the current environment that leads to the effects of globalization. There is an increasing tendency for government policy to promote entrepreneurship for its apparent economic benefit. Accordingly, governments seek to employ entrepreneurship education as a means to stimulate increased levels of economic activity. Entrepreneurship education and training (EET) is growing rapidly in universities and colleges throughout the world, and governments are supporting it both directly and through funding major investments in advice-provision to would-be entrepreneurs and existing small businesses. The Triple Helix of university–industry–government relations is compared with alternative models for explaining the current research system in its social contexts. Communications and negotiations between institutional partners generate an overlay that increasingly reorganizes the underlying arrangements. To achieve the objective of this research was a survey of the literature on the entrepreneurship and innovation and then a field research with 100 students of Fatec. To collect the data needed for analysis, we used the exploratory research of a qualitative nature. We asked to respondents what degree of knowledge over ten related to entrepreneurship and innovation topics, responses were answered in a Likert scale with 4 levels, none, small, medium and large. We can conclude that the terms such as entrepreneurship and innovation are known by most students because the university propagates them across disciplines, lectures, and institutes innovation. The more specific items such as canvas and Design thinking model are unknown by most respondents. The importance of the University in teaching innovation and entrepreneurship in the transmission of this knowledge to the students in order to equalize the knowledge. As a future project, these items will be re-evaluated to create indicators for measuring the knowledge level.

Keywords: Brazilian universities, entrepreneurship, innovation, entrepreneurship, globalization

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