Search results for: women labor participation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5127

Search results for: women labor participation

627 Utilization of Biodiversity of Peaces Herbals Used as Food and Treat the Path of Economic Phu Sing District in Sisaket Province Thailand

Authors: Nopparet Thammasaranyakun

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This research objects are: 1: To study the biodiversity of medicinal plants used for food and medicinal tourism economies along the Phu Sing district Sisaket province. 2: To study the use of medicinal plants used for food and medicinal tourism economies along the Phu Sing district Sisaket province. 3: To provide a database of information on biodiversity for food and medicinal plants and medicinal tourism economies along the Phu Sing district Sisaket province. 4: Learn to create a biodiversity of medicinal plants used as food and treatment by Journeys economic Phu Sing district Sisaket province Boundaries used in this study was the Phu Sing district. Population and Agricultural Development Center, rayong Mun due to the initiative for youth Local, Government Health officials, community leaders, teachers, students, schools, the local people and tourists. Sage wisdom to know the herbs and women's groups, OTOP Phu Sing district in SiisaKet province. By selecting the specific data that way. The process of participatory action research (PAR) is a community-based research. The method of collecting qualitative data. (Qualitative) tool is used from context, Community areas, interview and Taped recordings. Observation and focus group data was statistically analyzed using descriptive statistics (Descriptive Statistics). The results findings: 1- A study of the biodiversity of plants used for food and medicinal tourism economies along the Phu Sing district Sisaket province. Were used in the dry season and the rainy season find the medicinal plants of 251 species 41 types of drugs. 2- The study utilized medicinal plants used as food and the treatment of indigenous Phu Sing Sisaket province. Found 251 species have medicinal properties that are used for food and medicinal purposes 41 types of drugs. 3- Of the database technology of biodiversity for food and medicinal plants used by local treatment Phu Sing district Sisaket province. A data base of 251 medicinal species 41 types of drugs is used for food and medicinal properties Sisaket province. 4- learning the biodiversity of medicinal plants used for food and medicinal tourism economies along the Phu Sing district Sisaket province.

Keywords: utilization of biodiversity, peaces herbals, used as Food, Sing district, sisaket

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626 The Role of Demographics and Service Quality in the Adoption and Diffusion of E-Government Services: A Study in India

Authors: Sayantan Khanra, Rojers P. Joseph

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Background and Significance: This study is aimed at analyzing the role of demographic and service quality variables in the adoption and diffusion of e-government services among the users in India. The study proposes to examine the users' perception about e-Government services and investigate the key variables that are most salient to the Indian populace. Description of the Basic Methodologies: The methodology to be adopted in this study is Hierarchical Regression Analysis, which will help in exploring the impact of the demographic variables and the quality dimensions on the willingness to use e-government services in two steps. First, the impact of demographic variables on the willingness to use e-government services is to be examined. In the second step, quality dimensions would be used as inputs to the model for explaining variance in excess of prior contribution by the demographic variables. Present Status: Our study is in the data collection stage in collaboration with a highly reliable, authentic and adequate source of user data. Assuming that the population of the study comprises all the Internet users in India, a massive sample size of more than 10,000 random respondents is being approached. Data is being collected using an online survey questionnaire. A pilot survey has already been carried out to refine the questionnaire with inputs from an expert in management information systems and a small group of users of e-government services in India. The first three questions in the survey pertain to the Internet usage pattern of a respondent and probe whether the person has used e-government services. If the respondent confirms that he/she has used e-government services, then an aggregate of 15 indicators are used to measure the quality dimensions under consideration and the willingness of the respondent to use e-government services, on a five-point Likert scale. If the respondent reports that he/she has not used e-government services, then a few optional questions are asked to understand the reason(s) behind the same. Last four questions in the survey are dedicated to collect data related to the demographic variables. An indication of the Major Findings: Based on the extensive literature review carried out to develop several propositions; a research model is prescribed to start with. A major outcome expected at the completion of the study is the development of a research model that would help to understand the relationship involving the demographic variables and service quality dimensions, and the willingness to adopt e-government services, particularly in an emerging economy like India. Concluding Statement: Governments of emerging economies and other relevant agencies can use the findings from the study in designing, updating, and promoting e-government services to enhance public participation, which in turn, would help to improve efficiency, convenience, engagement, and transparency in implementing these services.

Keywords: adoption and diffusion of e-government services, demographic variables, hierarchical regression analysis, service quality dimensions

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625 Perception of Quality of Life and Self-Assessed Health in Patients Undergoing Haemodialysis

Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba

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Introduction: Despite the development of technologies and improvements in the interior of dialysis stations, dialysis remains an unpleasant procedure, difficult to accept by the patients (who undergo it 2 to 3 times a week, a single treatment lasting several hours). Haemodialysis is one of the renal replacement therapies, in Poland most commonly used in patients with chronic or acute kidney failure. Purpose: An attempt was made to evaluate the quality of life in haemodialysed patients using the WHOQOL-BREF questionnaire. Material and methods: The study covered 422 patients (200 women and 222 men, aged 60.5 ± 12.9 years) undergoing dialysis at three selected stations in Poland. The patients were divided into 2 groups, depending on the duration of their dialysis treatment. The evaluation was conducted with the WHOQOL-BREF questionnaire containing 26 questions analysing 4 areas of life, as well as the perception of the quality of life and health self-assessment. A 5-point scale is used to answer them. The maximum score in each area is 20 points. The results in individual areas have a positive direction. Results: In patients undergoing dialysis for more than 3 years, a reduction in the quality of life was found in the physical area and in their environment versus a group of patients undergoing dialysis for less than 3 years, where a reduced quality of life was found in the areas of social relations and mental well-being (p < 0.05). A significant correlation (p < 0.01) between the two groups was found in self-perceived general health, while no significant differences were observed in the general perception of the quality of life (p > 0.05). Conclusions: The study confirmed that in patients undergoing dialysis for more than three years, the quality of life is especially reduced in their environment (access to and quality of healthcare, financial resources, and mental and physical safety). The assessment of the quality of life should form a part of the therapeutic process, in which the role of the patient in chronic renal care should be emphasised, reflected in the quality of services provided by dialysis stations.

Keywords: haemodialysis, perception of quality of life, quality of services provided, dialysis station

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624 Validation of Nutritional Assessment Scores in Prediction of Mortality and Duration of Admission in Elderly, Hospitalized Patients: A Cross-Sectional Study

Authors: Christos Lampropoulos, Maria Konsta, Vicky Dradaki, Irini Dri, Konstantina Panouria, Tamta Sirbilatze, Ifigenia Apostolou, Vaggelis Lambas, Christina Kordali, Georgios Mavras

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Objectives: Malnutrition in hospitalized patients is related to increased morbidity and mortality. The purpose of our study was to compare various nutritional scores in order to detect the most suitable one for assessing the nutritional status of elderly, hospitalized patients and correlate them with mortality and extension of admission duration, due to patients’ critical condition. Methods: Sample population included 150 patients (78 men, 72 women, mean age 80±8.2). Nutritional status was assessed by Mini Nutritional Assessment (MNA full, short-form), Malnutrition Universal Screening Tool (MUST) and short Nutritional Appetite Questionnaire (sNAQ). Sensitivity, specificity, positive and negative predictive values and ROC curves were assessed after adjustment for the cause of current admission, a known prognostic factor according to previously applied multivariate models. Primary endpoints were mortality (from admission until 6 months afterwards) and duration of hospitalization, compared to national guidelines for closed consolidated medical expenses. Results: Concerning mortality, MNA (short-form and full) and SNAQ had similar, low sensitivity (25.8%, 25.8% and 35.5% respectively) while MUST had higher sensitivity (48.4%). In contrast, all the questionnaires had high specificity (94%-97.5%). Short-form MNA and sNAQ had the best positive predictive value (72.7% and 78.6% respectively) whereas all the questionnaires had similar negative predictive value (83.2%-87.5%). MUST had the highest ROC curve (0.83) in contrast to the rest questionnaires (0.73-0.77). With regard to extension of admission duration, all four scores had relatively low sensitivity (48.7%-56.7%), specificity (68.4%-77.6%), positive predictive value (63.1%-69.6%), negative predictive value (61%-63%) and ROC curve (0.67-0.69). Conclusion: MUST questionnaire is more advantageous in predicting mortality due to its higher sensitivity and ROC curve. None of the nutritional scores is suitable for prediction of extended hospitalization.

Keywords: duration of admission, malnutrition, nutritional assessment scores, prognostic factors for mortality

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623 Making Unorganized Social Groups Responsible for Climate Change: Structural Analysis

Authors: Vojtěch Svěrák

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Climate change ethics have recently shifted away from individualistic paradigms towards concepts of shared or collective responsibility. Despite this evolving trend, a noticeable gap remains: a lack of research exclusively addressing the moral responsibility of specific unorganized social groups. The primary objective of the article is to fill this gap. The article employs the structuralist methodological approach proposed by some feminist philosophers, utilizing structural analysis to explain the existence of social groups. The argument is made for the integration of this framework with the so-called forward-looking Social Connection Model (SCM) of responsibility, which ascribes responsibilities to individuals based on their participation in social structures. The article offers an extension of this model to justify the responsibility of unorganized social groups. The major finding of the study is that although members of unorganized groups are loosely connected, collectively they instantiate specific external social structures, share social positioning, and the notion of responsibility could be based on that. Specifically, if the structure produces harm or perpetuates injustices, and the group both benefits from and possesses the capacity to significantly influence the structure, a greater degree of responsibility should be attributed to the group as a whole. This thesis is applied and justified within the context of climate change, based on the asymmetrical positioning of different social groups. Climate change creates a triple inequality: in contribution, vulnerability, and mitigation. The study posits that different degrees of group responsibility could be drawn from these inequalities. Two social groups serve as a case study for the article: first, the Pakistan lower class, consisting of people living below the national poverty line, with a low greenhouse gas emissions rate, severe climate change-related vulnerability due to the lack of adaptation measures, and with very limited options to participate in the mitigation of climate change. Second, the so-called polluter elite, defined by members' investments in polluting companies and high-carbon lifestyles, thus with an interest in the continuation of structures leading to climate change. The first identified group cannot be held responsible for climate change, but their group interest lies in structural change and should be collectively maintained. On the other hand, the responsibility of the second identified group is significant and can be fulfilled by a justified demand for some political changes. The proposed approach of group responsibility is suggested to help navigate climate justice discourse and environmental policies, thus helping with the sustainability transition.

Keywords: collective responsibility, climate justice, climate change ethics, group responsibility, social ontology, structural analysis

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622 Evaluation of the Impact of Neuropathic Pain on the Quality of Life of Patients

Authors: A. Ibovi Mouondayi, S. Zaher, R. Assadi, K. Erraoui, S. Sboul, J. Daoudim, S. Bousselham, K. Nassar, S. Janani

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Introduction: Neuropathic pain (NP) is chronic pain; it can be observed in a large number of clinical situations. This pain results from a lesion of the peripheral or central nervous system. It is a frequent reason for consultations in rheumatology. This pain being chronic, can become disabling for the patient, thereby altering his quality of life. Objective: The objective of this study was to evaluate the impact of neuropathic pain on the quality of life of patients followed-up for chronic neuropathic pain. Material and Method: This is a monocentric, cross-sectional, descriptive, retrospective study conducted in our department over a period of 19 months from October 2020 to April 2022. The missing parameters were collected during phone calls of the patients concerned. The diagnostic tool adopted was the DN4 questionnaire in the dialectal Arabic version. The impact of NP was assessed by the visual analog scale (VAS) on pain, sleep, and function. The impact of PN on mood was assessed by the hospital anxiety, and depression scale (HAD) score in the validated Arabic version. The exclusion criteria were patients followed up for depression and other psychiatric pathologies. Results: A total of 1528 patient data were collected; the average age of the patients was 57 years (standard deviation: 13 years) with extremes ranging from 17 years to 94 years, 91% were women and 9% men with a sex ratio man/woman equal to 0.10. 67% of our patients were married, and 63% of our patients were housewives. 43% of patients were followed-up for degenerative pathology. The NP was cervical radiculopathy in 26%, lumbosacral radiculopathy in 51%, and carpal tunnel syndrome in 20%. 23% of our patients had poor sleep quality, and 54% had average sleep quality. The pain was very intense in 5% of patients; 33% had severe pain, and 58% had moderate pain. The function was limited in 55% of patients. The average HAD score for anxiety and depression was 4.39 (standard deviation: 2.77) and 3.21 (standard deviation: 2.89), respectively. Conclusion: Our data clearly illustrate that neuropathic pain has a negative impact on the quality of sleep and function, as well as the mood of patients, thus influencing their quality of life.

Keywords: neuropathic pain, sleep, quality of life, chronic pain

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621 Designing a Socio-Technical System for Groundwater Resources Management, Applying Smart Energy and Water Meter

Authors: S. Mahdi Sadatmansouri, Maryam Khalili

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World, nowadays, encounters serious water scarcity problem. During the past few years, by advent of Smart Energy and Water Meter (SEWM) and its installation at the electro-pumps of the water wells, one had believed that it could be the golden key to address the groundwater resources over-pumping issue. In fact, implementation of these Smart Meters managed to control the water table drawdown for short; but it was not a sustainable approach. SEWM has been considered as law enforcement facility at first; however, for solving a complex socioeconomic problem like shared groundwater resources management, more than just enforcement is required: participation to conserve common resources. The well owners or farmers, as water consumers, are the main and direct stakeholders of this system and other stakeholders could be government sectors, investors, technology providers, privet sectors or ordinary people. Designing a socio-technical system not only defines the role of each stakeholder but also can lubricate the communication to reach the system goals while benefits of each are considered and provided. Farmers, as the key participators for solving groundwater problem, do not trust governments but they would trust a fair system in which responsibilities, privileges and benefits are clear. Technology could help this system remained impartial and productive. Social aspects provide rules, regulations, social objects and etc. for the system and help it to be more human-centered. As the design methodology, Design Thinking provides probable solutions for the challenging problems and ongoing conflicts; it could enlighten the way in which the final system could be designed. Using Human Centered Design approach of IDEO helps to keep farmers in the center of the solution and provides a vision by which stakeholders’ requirements and needs are addressed effectively. Farmers would be considered to trust the system and participate in their groundwater resources management if they find the rules and tools of the system fair and effective. Besides, implementation of the socio-technical system could change farmers’ behavior in order that they concern more about their valuable shared water resources as well as their farm profit. This socio-technical system contains nine main subsystems: 1) Measurement and Monitoring system, 2) Legislation and Governmental system, 3) Information Sharing system, 4) Knowledge based NGOs, 5) Integrated Farm Management system (using IoT), 6) Water Market and Water Banking system, 7) Gamification, 8) Agribusiness ecosystem, 9) Investment system.

Keywords: human centered design, participatory management, smart energy and water meter (SEWM), social object, socio-technical system, water table drawdown

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620 Association of 1565C/T Polymorphism of Integrin Beta-3 (ITGB3) Gene and Increased Risk for Myocardial Infarction in Patients with Premature Coronary Artery Disease among Iranian Population

Authors: Mehrdad Sheikhvatan, Mohammad Ali Boroumand, Mehrdad Behmanesh, Shayan Ziaee

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Contradictory results have been obtained regarding the role of integrin, beta 3 (ITGB3) gene polymorphisms in occurrence of acute myocardial infarction (MI) in patients with coronary artery disease (CAD). Hence, we aimed to assess the association between 1565C/T polymorphism of ITGB3 gene and increased risk for acute MI in patients who suffered premature CAD in Iranian population. Our prospective study included 1000 patients (492 men and 508 women aged 21 to 55 years) referred to Tehran Heart center during a period of four years from 2008 to 2011 with the final diagnosis of premature CAD and classified into two groups with history of MI (n = 461) and without of MI (n = 539). The polymorphism variants were determined by PCR-RFLP technique by entering 10% of randomized samples and then genotyping of the polymorphism was also conducted by High Resolution Melting (HRM) method. Among study samples, 640 were followed with a median follow-up time 45.74 months for determining association of long-term major adverse cardiac events (MACE) and genotypes of polymorphisms. There was no significant difference in the frequency of 1565C/T polymorphism between the MI and non-MI groups. The frequency of wild genotype was 69.2% and 72.2%, the frequency of homozygous genotype was 21.3% and 18.4%, and the frequency of mutant genotype was 9.5% and 9.5%, respectively (p=0.505). Results were also similar when adjusted for covariates in a multivariate logistic regression model. No significant difference was also found in total-MACE free survival rate between the patients with different genotypes of 1565C/T polymorphism in both MI and non-MI group. The carriage of the 1565C/T polymorphism of ITGB3 gene seems unlikely to be a significant risk factor for the development of MI in Iranian patients with premature CAD. The presence of this ITGB3 gene polymorphism may not also predict long-term cardiac events.

Keywords: coronary artery disease, myocardial infarction, gene, integrin, beta 3, polymorphism

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619 Low Pertussis Vaccine Coverage Rates among Polish Nurses

Authors: Aneta Nitsch-Osuch, Sylwia Dyk, Izabela Gołebiak

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Background. Since 2014 the pertussis vaccine is recommended to Polish health care workers who have close contacts with infants. Although this recommendation is implemented into the National Immunization Programme, its realization has remained unknown. The Purpose: The aim of the study, conducted at the department of Social Medicine and Public Health (Medical University of Warsaw, Poland), was to describe a perception, knowledge and coverage rates regarding pertussis vaccination among nursing staff. According to the authors' knowledge, it was the first study related to this topic in our country. Material and Methods: A total number of 543 nurses who work at pediatric or neonatal wards was included into the study (501 women and 42 men), average age was 47 years. All nurses were asked to fulfill the anonymous survey, previously validated. Results: 1. Coverage rates: The analysis of results revealed that only 4% of responders reported they were vaccinated with Tdpa within past 10 years, while 8% declared they would plan the vaccine in the future. 35% of responders would consider the Tdpa vaccine whether there is some kind of the reimbursement. 2. Perception and knowledge of the disease and vaccination: The majority (82%) of nurses did not recognize pertussis as a re-emerging infectious disease. 54% of them believed that obligatory vaccinations in the childhood protect against the disease and the protection is a life-long one. Only 15% of nurses considered pertussis as a possible nosocomial infection. The current epidemiology of the disease was known to 6% of responders, while 24% of them were familiar with pertussis vaccination schedules for infants, children and adolescents, but only 9% of responders knew that adults older than 19 years are recommended to be vaccinated with Tdpa every 10 years. Many nurses (82%) would expect more educational activities related to pertussis and methods of its prophylaxis. Conclusions: The pertussis vaccine coverage rate among Polish nurses is extremely low. This is a result of not enough knowledge about the disease and its prevention. Educational activities addressed to health care workers and reimbursement of the pertussis vaccine are required to improve awareness and increase of vaccine coverage rates in the future.

Keywords: coverage, nurse, pertussis, vaccine

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618 Forensic Medical Capacities of Research of Saliva Stains on Physical Evidence after Washing

Authors: Saule Mussabekova

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Recent advances in genetics have allowed increasing acutely the capacities of the formation of reliable evidence in conducting forensic examinations. Thus, traces of biological origin are important sources of information about a crime. Currently, around the world, sexual offenses have increased, and among them are those in which the criminals use various detergents to remove traces of their crime. A feature of modern synthetic detergents is the presence of biological additives - enzymes. Enzymes purposefully destroy stains of biological origin. To study the nature and extent of the impact of modern washing powders on saliva stains on the physical evidence, specially prepared test specimens of different types of tissues to which saliva was applied have been examined. Materials and Methods: Washing machines of famous manufacturers of household appliances have been used with different production characteristics and advertised brands of washing powder for test washing. Over 3,500 experimental samples were tested. After washing, the traces of saliva were identified using modern research methods of forensic medicine. Results: The influence was tested and the dependence of the use of different washing programs, types of washing machines and washing powders in the process of establishing saliva trace and identify of the stains on the physical evidence while washing was revealed. The results of experimental and practical expert studies have shown that in most cases it is not possible to draw the conclusions in the identification of saliva traces on physical evidence after washing. This is a consequence of the effect of biological additives and other additional factors on traces of saliva during washing. Conclusions: On the basis of the results of the study, the feasibility of saliva traces of the stains on physical evidence after washing is established. The use of modern molecular genetic methods makes it possible to partially solve the problems arising in the study of unlaundered evidence. Additional study of physical evidence after washing facilitates detection and investigation of sexual offenses against women and children.

Keywords: saliva research, modern synthetic detergents, laundry detergents, forensic medicine

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617 'I Broke the Line Back to the Ancient Ones': Rethinking Intersectional Theory through Wounded Histories in Once Were Warriors (1994) and Whale Rider (2002).

Authors: Kerry Mackereth

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Kimberle Crenshaw’s theory of intersectionality has become immensely influential in the fields of women’s and gender studies. However, intersectionality’s widespread use among feminist scholars and activists has been accompanied by critiques of its reliance upon subject categorization. These critiques are of particular import when connected to Wendy Brown’s characterization of identity politics as static 'wounded attachments'. Together, these critiques show how the gridlock model proposed by intersectionality’s primary metaphor, the traffic accident at the intersection, is useful for identifying discrimination but not for remembering historical injustices or imagining feminist and anti-racist resistance. Through the lens of New Zealand Maori film, focusing upon Once Were Warriors (1994) and Whale Rider (2002), this article examines how wounded histories need not be passively reproduced by contemporaneously oppressed groups. Instead, the metaphor of the traffic intersection should be complemented by the metaphor of the wound. Against Brown’s characterization of wounded attachments as negative, static identities, Gloria Anzaldua’s account of the borderland between the United States and Mexico as “una herida abierta”, an open wound, offers an alternative reading of the wound. Through Anzaldua’s and Hortense Spillers’ political thought, the wound is reconceptualized as not only a site of suffering but also as a regenerative space. The coexistence of deterioration and regeneration at the site of the wound underpins the narrative arc of both Once Were Warriors and Whale Rider. In both films, the respective child protagonists attempt to reconcile the pain of wounded histories with the imagination of cultural regeneration. The metaphor of the wound thus serves as an alternative theoretical resource for mapping experiences of oppression, one that enriches feminist theory by balancing the remembrance of historical grievance with the forging of hopeful political projects.

Keywords: gender theory, historical grievance, intersectionality, New Zealand film, postcolonialism

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616 Strategies for Improving and Sustaining Quality in Higher Education

Authors: Anshu Radha Aggarwal

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Higher Education (HE) in the India has experienced a series of remarkable changes over the last fifteen years as successive governments have sought to make the sector more efficient and more accountable for investment of public funds. Rapid expansion in student numbers and pressures to widen Participation amongst non-traditional students are key challenges facing HE. Learning outcomes can act as a benchmark for assuring quality and efficiency in HE and they also enable universities to describe courses in an unambiguous way so as to demystify (and open up) education to a wider audience. This paper examines how learning outcomes are used in HE and evaluates the implications for curriculum design and student learning. There has been huge expansion in the field of higher education, both technical and non-technical, in India during the last two decades, and this trend is continuing. It is expected that another about 400 colleges and 300 universities will be created by the end of the 13th Plan Period. This has lead to many concerns about the quality of education and training of our students. Many studies have brought the issues ailing our curricula, delivery, monitoring and assessment. Govt. of India, (via MHRD, UGC, NBA,…) has initiated several steps to bring improvement in quality of higher education and training, such as National Skills Qualification Framework, making accreditation of institutions mandatory in order to receive Govt. grants, and so on. Moreover, Outcome-based Education and Training (OBET) has also been mandated and encouraged in the teaching/learning institutions. MHRD, UGC and NBAhas made accreditation of schools, colleges and universities mandatory w.e.f Jan 2014. Outcome-based Education and Training (OBET) approach is learner-centric, whereas the traditional approach has been teacher-centric. OBET is a process which involves the re-orientation/restructuring the curriculum, implementation, assessment/measurements of educational goals, and achievement of higher order learning, rather than merely clearing/passing the university examinations. OBET aims to bring about these desired changes within the students, by increasing knowledge, developing skills, influencing attitudes and creating social-connect mind-set. This approach has been adopted by several leading universities and institutions around the world in advanced countries. Objectives of this paper is to highlight the issues concerning quality in higher education and quality frameworks, to deliberate on the various education and training models, to explain the outcome-based education and assessment processes, to provide an understanding of the NAAC and outcome-based accreditation criteria and processes and to share best-practice outcomes-based accreditation system and process.

Keywords: learning outcomes, curriculum development, pedagogy, outcome based education

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615 Poverty Reduction in European Cities: Local Governments’ Strategies and Programmes to Reduce Poverty; Interview Results from Austria

Authors: Melanie Schinnerl, Dorothea Greiling

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In the context of the 2020 strategy, poverty and its fight returned to the center of national political efforts. This served as motivation for an Austrian research grant-funded project to focus on the under-researched local government level with the aim to identify municipal best-practice cases and to derive policy implications for Austria. Designing effective poverty reduction strategies is a complex challenge which calls for an integrated multi-actor in approach. Cities are increasingly confronted to combat poverty, even in rich EU-member states. By doing so cities face substantial demographic, cultural, economic and social challenges as well as changing welfare state regimes. Furthermore, there is a low willingness of (right-wing) governments to support the poor. Against this background, the research questions are: 1. How do local governments define poverty? 2. Who are the main risk groups and what are the most pressing problems when fighting urban poverty? 3. What is regarded as successful anti-poverty initiatives? 4. What is the underlying welfare state concept? To address the research questions a multi-method approach was chosen, consisting of a systematic literature analysis, a comprehensive document analysis, and expert interviews. For interpreting the data the project follows the qualitative-interpretive paradigm. Municipal approaches for reducing poverty are compared based on deductive, as well as inductive identified criteria. In addition to an intensive literature analysis, interviews (40) were conducted in Austria since the project started in March 2018. From the other countries, 14 responses have been collected, providing a first insight. Regarding the definition of poverty the EU SILC-definition as well as counting the persons who receive need-based minimum social benefits, the Austrian form of social welfare, are the predominant approaches in Austria. In addition to homeless people, single-parent families, un-skilled persons, long-term unemployed persons, migrants (first and second generation), refugees and families with at least 3 children were frequently mentioned. The most pressing challenges for Austrian cities are: expected reductions of social budgets, a great insecurity of the central government's social policy reform plans, the growing number of homeless people and a lack of affordable housing. Together with affordable housing, old-age poverty will gain more importance in the future. The Austrian best practice examples, suggested by interviewees, focused primarily on homeless, children and young people (till 25). Central government’s policy changes have already negative effects on programs for refugees and elderly unemployed. Social Housing in Vienna was frequently mentioned as an international best practice case, other growing cities can learn from. The results from Austria indicate a change towards the social investment state, which primarily focuses on children and labour market integration. The first insights from the other countries indicate that affordable housing and labor market integration are cross-cutting issues. Inherited poverty and old-age poverty seems to be more pressing outside Austria.

Keywords: anti-poverty policies, European cities, empirical study, social investment

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614 Policy Initiatives That Increase Mass-Market Participation of Fuel Cell Electric Vehicles

Authors: Usman Asif, Klaus Schmidt

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In recent years, the development of alternate fuel vehicles has helped to reduce carbon emissions worldwide. As the number of vehicles will continue to increase in the future, the energy demand will also increase. Therefore, we must consider automotive technologies that are efficient and less harmful to the environment in the long run. Battery Electric Vehicles (BEVs) have gained popularity in recent years because of their lower maintenance, lower fuel costs, and lower carbon emissions. Nevertheless, BEVs show several disadvantages, such as slow charging times and lower range than traditional combustion-powered vehicles. These factors keep many people from switching to BEVs. The authors of this research believe that these limitations can be overcome by using fuel cell technology. Fuel cell technology converts chemical energy into electrical energy from hydrogen power and therefore serves as fuel to power the motor and thus replacing heavy lithium batteries that are expensive and hard to recycle. Also, in contrast to battery-powered electric vehicle technology, Fuel Cell Electric Vehicles (FCEVs) offer higher ranges and lower fuel-up times and therefore are more competitive with electric vehicles. However, FCEVs have not gained the same popularity as electric vehicles due to stringent legal frameworks, underdeveloped infrastructure, high fuel transport, and storage costs plus the expense of fuel cell technology itself. This research will focus on the legal frameworks for hydrogen-powered vehicles, and how a change in these policies may affect and improve hydrogen fueling infrastructure and lower hydrogen transport and storage costs. These policies may also facilitate reductions in fuel cell technology costs. In order to attain a better framework, a number of countries have developed conceptual roadmaps. These roadmaps have set out a series of objectives to increase the access of FCEVs to their respective markets. This research will specifically focus on policies in Japan, Europe, and the USA in their attempt to shape the automotive industry of the future. The researchers also suggest additional policies that may help to accelerate the advancement of FCEVs to mass-markets. The approach was to provide a solid literature review using resources from around the globe. After a subsequent analysis and synthesis of this review, the authors concluded that in spite of existing legal challenges that have hindered the advancement of fuel-cell technology in the automobile industry in the past, new initiatives that enhance and advance the very same technology in the future are underway.

Keywords: fuel cell electric vehicles, fuel cell technology, legal frameworks, policies and regulations

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613 Design and Implementation of an Affordable Electronic Medical Records in a Rural Healthcare Setting: A Qualitative Intrinsic Phenomenon Case Study

Authors: Nitika Sharma, Yogesh Jain

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Introduction: An efficient Information System helps in improving the service delivery as well provides the foundation for policy and regulation of other building blocks of Health System. Health care organizations require an integrated working of its various sub-systems. An efficient EMR software boosts the teamwork amongst the various sub-systems thereby resulting in improved service delivery. Although there has been a huge impetus to EMR under the Digital India initiative, it has still not been mandated in India. It is generally implemented in huge funded public or private healthcare organizations only. Objective: The study was conducted to understand the factors that lead to the successful adoption of an affordable EMR in the low level healthcare organization. It intended to understand the design of the EMR and address the solutions to the challenges faced in adoption of the EMR. Methodology: The study was conducted in a non-profit registered Healthcare organization that has been providing healthcare facilities to more than 2500 villages including certain areas that are difficult to access. The data was collected with help of field notes, in-depth interviews and participant observation. A total of 16 participants using the EMR from different departments were enrolled via purposive sampling technique. The participants included in the study were working in the organization before the implementation of the EMR system. The study was conducted in one month period from 25 June-20 July 2018. The Ethical approval was taken from the institute along with prior approval of the participants. Data analysis: A word document of more than 4000 words was obtained after transcribing and translating the answers of respondents. It was further analyzed by focused coding, a line by line review of the transcripts, underlining words, phrases or sentences that might suggest themes to do thematic narrative analysis. Results: Based on the answers the results were thematically grouped under four headings: 1. governance of organization, 2. architecture and design of the software, 3. features of the software, 4. challenges faced in adoption and the solutions to address them. It was inferred that the successful implementation was attributed to the easy and comprehensive design of the system which has facilitated not only easy data storage and retrieval but contributes in constructing a decision support system for the staff. Portability has lead to increased acceptance by physicians. The proper division of labor, increased efficiency of staff, incorporation of auto-correction features and facilitation of task shifting has lead to increased acceptance amongst the users of various departments. Geographical inhibitions, low computer literacy and high patient load were the major challenges faced during its implementation. Despite of dual efforts made both by the architects and administrators to combat these challenges, there are still certain ongoing challenges faced by organization. Conclusion: Whenever any new technology is adopted there are certain innovators, early adopters, late adopters and laggards. The same pattern was followed in adoption of this software. He challenges were overcome with joint efforts of organization administrators and users as well. Thereby this case study provides a framework of implementing similar systems in public sector of countries that are struggling for digitizing the healthcare in presence of crunch of human and financial resources.

Keywords: EMR, healthcare technology, e-health, EHR

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612 Unpacking the Rise of Social Entrepreneurship over Sustainable Entrepreneurship among Sri Lankan Exporters in SMEs Sector: A Case Study in Sri Lanka

Authors: Amarasinghe Shashikala, Pramudika Hansini, Fernando Tajan, Rathnayake Piyumi

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This study investigates the prominence of the social entrepreneurship (SE) model over the sustainable entrepreneurship model among Sri Lankan exporters in the small and medium enterprise (SME) sector. The primary objective of this study is to explore how the unique socio-economic contextual nuances of the country influence this behavior. The study employs a multiple-case study approach, collecting data from thirteen SEs in the SME sector. The findings reveal a significant alignment between SE and the lifestyle of the people in Sri Lanka, attributed largely to its deep-rooted religious setting and cultural norms. A crucial factor driving the prominence of SE is the predominantly labor-intensive nature of production processes within the exporters of the SME sector. These processes inherently lend themselves to SE, providing employment opportunities and fostering community engagement. Further, SE initiatives substantially resonate with community-centric practices, making them more appealing and accessible to the local populace. In contrast, the findings highlight a dilemma between cost-effectiveness and sustainable entrepreneurship. Transitioning to sustainable export products and production processes is demanded by foreign buyers and acknowledged as essential for environmental stewardship, which often requires capital-intensive makeovers. This investment inevitably raises the overall cost of the export product, making it less competitive in the global market. Interestingly, the study notes a disparity between international demand for sustainable products and the willingness of buyers to pay a premium for them. Despite the growing global preference for eco-friendly options, the findings suggest that the additional costs associated with sustainable entrepreneurship are not adequately reflected in the purchasing behavior of international buyers. The abundance of natural resources coupled with a minimal occurrence of natural catastrophes renders exporters less environmentally sensitive. The absence of robust policy support for environmental preservation exacerbates this inclination. Consequently, exporters exhibit a diminished motivation to incorporate environmental sustainability into their business decisions. Instead, attention is redirected towards factors such as the local population's minimum standards of living, prevalent social issues, governmental corruption and inefficiency, and rural poverty. These elements impel exporters to prioritize social well-being when making business decisions. Notably, the emphasis on social impact, rather than environmental impact, appears to be a generational trend, perpetuating a focus on societal aspects in the realm of business. In conclusion, the manifestation of entrepreneurial behavior within developing nations is notably contingent upon contextual nuances. This investigation contributes to a deeper understanding of the dynamics shaping the prevalence of SE over sustainable entrepreneurship among Sri Lankan exporters in the SME sector. The insights generated have implications for policymakers, industry stakeholders, and academics seeking to navigate the delicate balance between socio-cultural values, economic feasibility, and environmental sustainability in the pursuit of responsible business practices within the export sector.

Keywords: small and medium enterprises, social entrepreneurship, Sri Lanka, sustainable entrepreneurship

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611 Designed Purine Molecules and in-silico Evaluation of Aurora Kinase Inhibition in Breast Cancer

Authors: Pooja Kumari, Anandkumar Tengli

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Aurora kinase enzyme, a protein on overexpression, leads to metastasis and is extremely important for women’s health in terms of prevention or treatment. While creating a targeted technique, the aim of the work is to design purine molecules that inhibit in aurora kinase enzyme and helps to suppress breast cancer. Purine molecules attached to an amino acid in DNA block protein synthesis or halt the replication and metastasis caused by the aurora kinase enzyme. Various protein related to the overexpression of aurora protein was docked with purine molecule using Biovia Drug Discovery, the perpetual software. Various parameters like X-ray crystallographic structure, presence of ligand, Ramachandran plot, resolution, etc., were taken into consideration for selecting the target protein. A higher negative binding scored molecule has been taken for simulation studies. According to the available research and computational analyses, purine compounds may be powerful enough to demonstrate a greater affinity for the aurora target. Despite being clinically effective now, purines were originally meant to fight breast cancer by inhibiting the aurora kinase enzyme. In in-silico studies, it is observed that purine compounds have a moderate to high potency compared to other molecules, and our research into the literature revealed that purine molecules have a lower risk of side effects. The research involves the design, synthesis, and identification of active purine molecules against breast cancer. Purines are structurally similar to the normal metabolites of adenine and guanine; hence interfere/compete with protein synthesis and suppress the abnormal proliferation of cells/tissues. As a result, purine target metastasis cells and stop the growth of kinase; purine derivatives bind with DNA and aurora protein which may stop the growth of protein or inhibits replication and stop metastasis of overexpressed aurora kinase enzyme.

Keywords: aurora kinases, in silico studies, medicinal chemistry, combination therapies, chronic cancer, clinical translation

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610 Bone Mineral Density in Long-Living Patients with Coronary Artery Disease

Authors: Svetlana V. Topolyanskaya, Tatyana A. Eliseeva, Olga N. Vakulenko, Leonid I. Dvoretski

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Introduction: Limited data are available on osteoporosis in centenarians. Therefore, we evaluated bone mineral density in long-living patients with coronary artery disease (CAD). Methods: 202 patients hospitalized with CAD were enrolled in this cross-sectional study. The patients' age ranged from 90 to 101 years. The majority of study participants (64.4%) were women. The main exclusion criteria were any disease or medication that can lead to secondary osteoporosis. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Results: Normal lumbar spine BMD was observed in 40.9%, osteoporosis – in 26.9%, osteopenia – in 32.2% of patients. Normal proximal femur BMD values were observed in 21.3%, osteoporosis – in 39.9%, and osteopenia – in 38.8% of patients. Normal femoral neck BMD was registered only in 10.4% of patients, osteoporosis was observed in 60.4%, osteopenia in 29.2%. Significant positive correlation was found between all BMD values and body mass index of patients (p < 0.001). Positive correlation was registered between BMD values and serum uric acid (p=0.0005). The likelihood of normal BMD values with hyperuricemia increased 3.8 times, compared to patients with normal uric acid, who often have osteoporosis (Odds Ratio=3.84; p = 0.009). Positive correlation was registered between all BMD values and body mass index (p < 0.001). Positive correlation between triglycerides levels and T-score (p=0.02), but negative correlation between BMD and HDL-cholesterol (p=0.02) were revealed. Negative correlation between frailty severity and BMD values (p=0.01) was found. Positive correlation between BMD values and functional abilities of patients assessed using Barthel index (r=0,44; p=0,000002) and IADL scale (r=0,36; p=0,00008) was registered. Fractures in history were observed in 27.6% of patients. Conclusions: The study results indicate some features of BMD in long-livers. In the study group, significant relationships were found between bone mineral density on the one hand, and patients' functional abilities on the other. It is advisable to further study the state of bone tissue in long-livers involving a large sample of patients.

Keywords: osteoporosis, bone mineral density, centenarians, coronary artery disease

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609 Examining the Contemporary Relevance of Mahatma Gandhi’s Thought: A Bulwark against Terrorism

Authors: Jayita Mukhopadhyay

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Even though more than six decades has passed since the death of India’s iconic thinker and mass leader Mahatma Gandhi, the world besieged by terrorism may still take a leaf out of his philosophical discourse on non-violence and attempt to turn his theory into praxis to save mankind. The greatest soul world has ever produced, a man of divine fire, an apostle of peace and non-violence, a revolutionary, a visionary, a social reformer and deliverer of the downtrodden, Father of the nation, these and numerous other epithets have been used by eminent personalities and scholars while describing Mahatma Gandhi. Gandhi was a relentless fighter and mass mobiliser who awakened a sleeping giant, the common men and women of India, shook them out of their docile, fatalistic mould, invigorated them with his doctrine of ahimsa and satyagraha (non violence and strict adherence to truth), instilled in them nationalist zeal and patriotic fervour and turned them into determined, steadfast freedom fighters. Under his leadership, the national liberation movement got a new life and ultimately succeeded in ending the era of foreign domination. And he did all these while resisting a natural tendency of his people to respond violently to unspeakable violence and atrocities unleashed by the colonial British administration desperate to keep India in its empire. In this paper, an attempt will be made to unravel Gandhi’s elucidation of the concept of non-violent resistance, along with non-cooperation and civil disobedience and their actual application through political practices which succeeded in capturing the imagination of not only India’s teeming millions but the entire world. The methodology of analytical study will be used as Gandhi’s own writings and those by noted scholars on Gandhi will be examined extensively to establish contemporary relevance of his thought, his invaluable guidelines about how to cope with poverty, inequality, exploitation, repression and marginalization of some sections of society and resultant radicalization of some disturbed members of human race, the very conditions which spawn terrorism in today’s world.

Keywords: India, non cooperation, non violence, terrorism

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608 Exploring the Practices of Global Citizenship Education in Finland and Scotland

Authors: Elisavet Anastasiadou

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Global citizenship refers to an economic, social, political, and cultural interconnectedness, and it is inextricably intertwined with social justice, respect for human rights, peace, and a sense of responsibility to act on a local and global level. It aims to be transformative, enhance critical thinking and participation with pedagogical approaches based on social justice and democracy. The purpose of this study is to explore how Global Citizenship Education (GCE) is presented and implemented in two educational contexts, specifically in the curricula and pedagogical practices of primary education in Finland and Scotland. The impact of GCE is recognized as means for further development by institution such as and Finnish and Scottish curricula acknowledge the significance of GCE, emphasizing the student's ability to act and succeed in diverse and global communities. This comparative study should provide a good basis for further developing teaching practices based on informed understanding of how GCE is constrained or enabled from two different perspectives, extend the methodological applications of Practice Architectures and provide critical insights into GCE as a theoretical notion adopted by national and international educational policy. The study is directly connected with global citizenship aiming at future and societal change. The empirical work employs a multiple case study approach, including interviews and analysis of existing documents (textbook, curriculum). The data consists of the Finnish and Scottish curriculum. A systematic analysis of the curriculum in relation to GCE will offer insights into how the aims of GCE are presented and framed within the two contexts. This will be achieved using the theory of Practice Architectures. Curricula are official policy documentations (texts) that frame and envisage pedagogical practices. Practices, according to the theory of practice architectures, consist of sayings, doings, and relatings. Hence, even if the text analysis includes the semantic space (sayings) that are prefigured by the cultural-discursive arrangements and the relating prefigured by the socio-political arrangements, they will inevitably reveal information on the (doings) prefigured by the material-economic arrangements, as they hang together in practices. The results will assist educators in making changes to their teaching and enhance their self-conscious understanding of the history-making significance of their practices. It will also have a potential reform and focus on educationally relevant to such issues. Thus, the study will be able to open the ground for interventions and further research while it will consider the societal demands of a world in change.

Keywords: citizenhsip, curriculum, democracy, practices

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607 Elevated Creatinine Clearance and Normal Glomerular Filtration Rate in Patients with Systemic Lupus erythematosus

Authors: Stoyanka Vladeva, Elena Kirilova, Nikola Kirilov

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Background: The creatinine clearance is a widely used value to estimate the GFR. Increased creatinine clearance is often called hyperfiltration and is usually seen during pregnancy, patients with diabetes mellitus preceding the diabetic nephropathy. It may also occur with large dietary protein intake or with plasma volume expansion. Renal injury in lupus nephritis is known to affect the glomerular, tubulointerstitial, and vascular compartment. However high creatinine clearance has not been found in patients with SLE, Target: Follow-up of creatinine clearance values in patients with systemic lupus erythematosus without history of kidney injury. Material and methods: We observed the creatinine, creatinine clearance, GFR and dipstick protein values of 7 women (with a mean age of 42.71 years) with systemic lupus erythematosus. Patients with active lupus have been monthly tested in the period of 13 months. Creatinine clearance has been estimated by Cockcroft-Gault Equation formula in ml/sec. GFR has been estimated by MDRD formula (The Modification of Diet in renal Disease) in ml/min/1.73 m2. Proteinuria has been defined as present when dipstick protein > 1+.Results: In all patients without history of kidney injury we found elevated creatinine clearance levels, but GFRremained within the reference range. Two of the patients were in remission while the other five patients had clinically and immunologically active Lupus. Three of the patients had a permanent presence of high creatinine clearance levels and proteinuria. Two of the patients had periodically elevated creatinine clearance without proteinuria. These results show that kidney disturbances may be caused by the vascular changes typical for SLE. Glomerular hyperfiltration can be result of focal segmental glomerulosclerosis caused by a reduction in renal mass. Probably lupus nephropathy is preceded not only by glomerular vascular changes, but also by tubular vascular changes. Using only the GFR is not a sufficient method to detect these primary functional disturbances. Conclusion: For early detection of kidney injury in patients with SLE we determined that the follow up of creatinine clearance values could be helpful.

Keywords: systemic Lupus erythematosus, kidney injury, elevated creatinine clearance level, normal glomerular filtration rate

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606 A Review of the Effects of Exercise in Preventing Migraine Headaches

Authors: Afsaneh Soltani, Zahra Mohajer

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Migraine is one of the most common chronic neurological diseases. Migraines affect different aspects of life. Severe migraine headaches lead to dysfunction, a reduced presence at work, and decreased ability to think and make decisions. Non-pharmacological treatments play a very important role in controlling and preventing migraine headaches. A healthy lifestyle helps control migraine headaches. Migraine headaches can be reduced by following these steps: Avoiding stress, eating regularly and avoiding hunger and thirst, avoiding stimulants such as chocolate, caffeine, and cigarettes, following a regular bedtime routine, or avoiding sleep deprivation. Exercise a lot, and do regular exercise (and prevent obesity). Non-pharmacological treatment is especially important in pregnant women and children because in these cases, medical treatments are not preferred due to the many side effects. Exercise is one of the most effective and uncomplicated non-pharmacological alternatives in the treatment of migraine headaches. Exercising for episodic migraines is a safe, effective, and promising complementary treatment option. Numerous studies have shown that aerobic exercise reduces the severity and duration of migraine headaches. Effective aerobic exercise includes cycling and brisk walking. Exercise improves the quality of life and reduces the use of medication in people with migraines. Patients who exercise have fewer migraine days, resulting in better personal, social, and occupational performance. Several studies have shown that pain intensity and frequency in patients who exercise regularly decreased significantly after exercise compared to controls who did not exercise. According to a study, regular exercise reduces the levels of interleukins, especially IL-12P70, which reduces anxiety and reduces the number of days of migraine in patients. An article has shown that endurance exercise reduces the number of migraine days and also increases cerebrovascular health in migraine patients. According to studies, the minimum duration of exercise to achieve a positive effect of exercise in patients with migraine is 3 months (12 weeks) and 40 minutes three times a week.

Keywords: exercise, headache, migraine, physical activity

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605 The Efficacy of Pre-Hospital Packed Red Blood Cells in the Treatment of Severe Trauma: A Retrospective, Matched, Cohort Study

Authors: Ryan Adams

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Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.

Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine

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604 Nutritional Impact in Patients Who Underwent Sleeve-Type Bariatric Surgery

Authors: Melissa Mattos, Camila Lima, Ibraim Castro, Augusto Carioca, Saulo Magalhães, Paula Freitas, Keciany Oliveira

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Obesity is a chronic, multifactorial, relapsing disease that has increased dramatically over the years. Its control is considered a public health issue, and more and more treatments and interventions are being studied to reduce its prevalence. When interventions in lifestyle and the use of drugs do not generate lasting results, bariatric procedures emerge as a resource for obesity control. The main guidelines for the treatment of obesity emphasize the need for pre-procedure and post-procedure nutritional monitoring to avoid nutritional deficiencies that may occur. The individual who undergoes bariatric surgery needs to understand the changes that will be necessary for life in view of the intense anatomical and metabolic changes that result from surgical techniques. To assess the nutritional profile of patients who undergo bariatric surgery, we analyzed data from the medical records of all people who underwent sleeve-type bariatric surgery from January to June 2022 at a clinic in the City of Fortaleza. 38 patients were analyzed, 32 women and 6 men in the pre-surgical period, 6 and 12 months after surgery. The data showed an average weight loss of 24.45% at 6 months and 30.85% at 12 months, with a reduction of 21.32% and 30.41%, respectively, in the fat percentage, also indicating that 13.15% used drugs for weight loss during this period, leading to reflection on the isolated long-term efficacy of bariatric surgery, requiring multidisciplinary follow-up for a change in lifestyle. Only 12 individuals, corresponding to 31.57%, reached eutrophic BMI 12 months after surgery, 20 individuals remained overweight, corresponding to 52.63% of the sample, and 6 individuals (15.78%) remained in the BMI obese class I. As for body composition, there was a 52.39% reduction in fat mass and a 12.82% reduction in muscle mass, and 21% of individuals underwent cholecystectomy. Sleeve-type bariatric surgery promoted significant weight loss after 1 year of the procedure, with a reduction in body fat percentage and fat mass. Most patients were still overweight and had a significant reduction in muscle mass.

Keywords: bariatric surgery, sleeve gastrectomy, obesity, sleeve

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603 Understanding the First Mental Breakdown from the Families’ Perspective Through Metaphors

Authors: Eli Buchbinder

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Introduction. Language is the basis to our experience as human being. We use language in describing our experiences and construct meaning and narratives from experiences. Metaphors are a valuable linguistic tool commonly use. Metaphors link two domains that are ordinarily not related. Metaphors achieve simultaneously multi-level integration: abstract and concrete, rational and imaginative, familiar and the unfamiliar, conscious and preconscious/unconscious. As such, metaphors epistemological and ontological tool that are important in social work in every field and domain. Goals and Methods The presentation’s aim is to validate the value of metaphors through the first psychiatric breakdown is a traumatic for families. The presentation is based on two pooled qualitative studies. The first study focused on 12 spouses: 7 women and 5 men, between the ages of 22 and 57, regarding their experiences and meanings of the first psychiatric hospitalization of their partners diagnosed with affective disorders. The second study focused on 10 parents, between the ages of 47 and 62, regarding their experiences and meanings following their child's first psychotic breakdown during young adulthood. Results Two types of major metaphors evolved from the interviews in farming the trauma of the first mental breakdown. The first mode - orientation (spatial) metaphors, reflect symbolic expression of the loss of a secure base, represented in the physical environment, e.g., describing hospitalization as "falling into an abyss." The second mode- ontological metaphors, reflect how parents and spouses present their traumatic experiences of hospitalization in terms of discrete, powerful and coherent entities, e.g., describing the first hospitalization as "swimming against the tide." The two metaphors modes reflect the embodiment of the unpredictability, being mired in distress, shock, intense pain and the experience the collapse of continuity on the life course and cuts off the experience of control. Conclusions Metaphors are important and powerful guide in assessing individuals and families’ phenomenological reality. As such, metaphors are useful for understanding and orientated therapeutic intervening, in the studies above, with the first psychiatric hospitalization experienced, as well as in others social workers’ interventions.

Keywords: first mental breakdown, metaphors, family perspective, qualitative research

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602 Prevalence of Elder Abuse and Effects of Social Factors on It

Authors: Ezat Vahidian, Babak Eshrati

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Introduction: Elder abuse, a very complex issue with diverse definitions and names, has been very slow to capture the public eye and public policy since it is manifested at many levels. It requires the involvement of different types of professionals. While elder abuse is not a new phenomenon, the speed of population ageing world-wide is likely to lead to an increase in its incidence and prevalence. Elder abuse has devastating consequences for older persons such as poor quality of life, psychological distress, and loss of property and security. It is also associated with increased mortality and morbidity. Elder abuse is a problem that manifests itself in both rich and poor countries and at all levels of society. Purpose: The purpose of this study is to determine the prevalence of elder abuse and effects of social factor on it in Markazi Province. Materials and methods: The society of the study was all of the elders in Markazi Province that were available by geographical address in the table of rural and urban household societies. The study was cross sectional and multi phases in sampling the first one was classification according rural and urban area and the second one was cluster sampling with equal cluster. Estimation of samples were 472 persons and increased by design effect to 1110 persons. Collection data was done by questionnaire and analyzed by SPSS and chi 2 exam. Results: This study showed 70 persons were abused (42/8% male and 57/2% female) mean of ages was 74/7 years. 64% were marred and 31% were widows. There were not any significant meaningful association between elder abuse and area of living (pv=0.299),occupation (p.v=0.104), education (pv=0.358) and age (P.value=0.104) there were significant meaningful association between physical impairment (pv=0.08), and movement impairment (P.value=0.008). Conclusion: Results verify that maltreatment occurred in the aged persons. Analysis of data indicated that elder abuse exist in every socioeconomic group with any context of education in urban area and rural area and in men and women. Prevalence of elder abuse was 6.3% (70 persons) that verify the data of developed countries with limited sample.

Keywords: elder abuse, education, occupation, area of living

Procedia PDF Downloads 387
601 Blockchain Platform Configuration for MyData Operator in Digital and Connected Health

Authors: Minna Pikkarainen, Yueqiang Xu

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The integration of digital technology with existing healthcare processes has been painfully slow, a huge gap exists between the fields of strictly regulated official medical care and the quickly moving field of health and wellness technology. We claim that the promises of preventive healthcare can only be fulfilled when this gap is closed – health care and self-care becomes seamless continuum “correct information, in the correct hands, at the correct time allowing individuals and professionals to make better decisions” what we call connected health approach. Currently, the issues related to security, privacy, consumer consent and data sharing are hindering the implementation of this new paradigm of healthcare. This could be solved by following MyData principles stating that: Individuals should have the right and practical means to manage their data and privacy. MyData infrastructure enables decentralized management of personal data, improves interoperability, makes it easier for companies to comply with tightening data protection regulations, and allows individuals to change service providers without proprietary data lock-ins. This paper tackles today’s unprecedented challenges of enabling and stimulating multiple healthcare data providers and stakeholders to have more active participation in the digital health ecosystem. First, the paper systematically proposes the MyData approach for healthcare and preventive health data ecosystem. In this research, the work is targeted for health and wellness ecosystems. Each ecosystem consists of key actors, such as 1) individual (citizen or professional controlling/using the services) i.e. data subject, 2) services providing personal data (e.g. startups providing data collection apps or data collection devices), 3) health and wellness services utilizing aforementioned data and 4) services authorizing the access to this data under individual’s provided explicit consent. Second, the research extends the existing four archetypes of orchestrator-driven healthcare data business models for the healthcare industry and proposes the fifth type of healthcare data model, the MyData Blockchain Platform. This new architecture is developed by the Action Design Research approach, which is a prominent research methodology in the information system domain. The key novelty of the paper is to expand the health data value chain architecture and design from centralization and pseudo-decentralization to full decentralization, enabled by blockchain, thus the MyData blockchain platform. The study not only broadens the healthcare informatics literature but also contributes to the theoretical development of digital healthcare and blockchain research domains with a systemic approach.

Keywords: blockchain, health data, platform, action design

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600 Building Environmental Citizenship in Spain: Urban Movements and Ecologist Protest in Las Palmas De Gran Canaria, 1970-1983

Authors: Juan Manuel Brito-Diaz

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The emergence of urban environmentalism in Spain is related to the processes of economic transformation and growing urbanization that occurred during the end of the Franco regime and the democratic transition. This paper analyzes the urban environmental mobilizations and their impacts as relevant democratizing agents in the processes of political change in cities. It’s an under-researched topic and studies on environmental movements in Spain have paid little attention to it. This research takes as its starting point the close link between democratization and environmentalism, since it considers that environmental conflicts are largely a consequence of democratic problems, and that the impacts of environmental movements are directly linked to the democratization. The study argues that the environmental movements that emerged in Spain at the end of the dictatorship and the democratic transition are an important part of the broad and complex associative fabric that promoted the democratization process. The research focuses on investigating the environmental protest in Las Palmas de Gran Canaria—the most important city in the Canary Islands—between 1970 and 1983, concurrently with the last local governments of the dictatorship and the first democratic city councils. As it is a case study, it opens up the possibility to ask multiple specific questions and assess each of the responses obtained. Although several research methodologies have been applied, such as the analysis of historical archives documentation or oral history interviews, mainly a very widespread methodology in the sociology of social movements, although very little used by social historians, has been used: the Protest Event Analysis (PEA). This methodology, which consists of generating a catalog of protest events by coding data around previously established variables, has allowed me to map, analyze and interpret the occurrence of protests over time and space, and associated factors, through content analysis. For data collection, news from local newspapers have provided a large enough sample to analyze the properties of social protest -frequency, size, demands, forms, organizers, etc.—and relate them to another type of information related to political structures and mobilization repertoires, encouraging the establishment of connections between the protest and the political impacts of urban movements. Finally, the study argues that the environmental movements of this period were essential to the construction of the new democratic city in Spain, not only because they established the issues of sustainability and urban environmental justice on the public agenda, but also because they proposed that conflicts derived from such matters should ultimately be resolved through public deliberation and citizen participation.

Keywords: democratization, environmental movements, political impacts, social movements

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599 Role of Indigenous Peoples in Climate Change

Authors: Neelam Kadyan, Pratima Ranga, Yogender

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Indigenous people are the One who are affected by the climate change the most, although there have contributed little to its causes. This is largely a result of their historic dependence on local biological diversity, ecosystem services and cultural landscapes as a source of their sustenance and well-being. Comprising only four percent of the world’s population they utilize 22 percent of the world’s land surface. Despite their high exposure-sensitivity indigenous peoples and local communities are actively responding to changing climatic conditions and have demonstrated their resourcefulness and resilience in the face of climate change. Traditional Indigenous territories encompass up to 22 percent of the world’s land surface and they coincide with areas that hold 80 percent of the planet’s biodiversity. Also, the greatest diversity of indigenous groups coincides with the world’s largest tropical forest wilderness areas in the Americas (including Amazon), Africa, and Asia, and 11 percent of world forest lands are legally owned by Indigenous Peoples and communities. This convergence of biodiversity-significant areas and indigenous territories presents an enormous opportunity to expand efforts to conserve biodiversity beyond parks, which tend to benefit from most of the funding for biodiversity conservation. Tapping on Ancestral Knowledge Indigenous Peoples are carriers of ancestral knowledge and wisdom about this biodiversity. Their effective participation in biodiversity conservation programs as experts in protecting and managing biodiversity and natural resources would result in more comprehensive and cost effective conservation and management of biodiversity worldwide. Addressing the Climate Change Agenda Indigenous Peoples has played a key role in climate change mitigation and adaptation. The territories of indigenous groups who have been given the rights to their lands have been better conserved than the adjacent lands (i.e., Brazil, Colombia, Nicaragua, etc.). Preserving large extensions of forests would not only support the climate change objectives, but it would respect the rights of Indigenous Peoples and conserve biodiversity as well. A climate change agenda fully involving Indigenous Peoples has many more benefits than if only government and/or the private sector are involved. Indigenous peoples are some of the most vulnerable groups to the negative effects of climate change. Also, they are a source of knowledge to the many solutions that will be needed to avoid or ameliorate those effects. For example, ancestral territories often provide excellent examples of a landscape design that can resist the negatives effects of climate change. Over the millennia, Indigenous Peoples have developed adaptation models to climate change. They have also developed genetic varieties of medicinal and useful plants and animal breeds with a wider natural range of resistance to climatic and ecological variability.

Keywords: ancestral knowledge, cost effective conservation, management, indigenous peoples, climate change

Procedia PDF Downloads 663
598 Caregivers Burden: Risk and Related Psychological Factors in Caregivers of Patients with Parkinson’s Disease

Authors: Pellecchia M. T., Savarese G., Carpinelli L., Calabrese M.

Abstract:

Introduction: Parkinson's disease (PD) is characterized by a progressive loss of autonomy which undoubtedly has a significant impact on the quality of life of caregivers, and parents are the main informal caregivers. Caring for a person with PD is associated with an increased risk of psychiatric morbidity and persistent anxiety-depressive distress. The aim of the study is to investigate the burden on caregivers of patients with PD, through the use of multidimensional scales and to identify their personological and environmental determinants. Methods: The study has been approved by the Ethic Committee of the University of Salerno and informed consent for participation to the study was obtained from patients and their caregivers. The study was conducted at the Neurology Department of the A.O.U. "San Giovanni di Dio and Ruggi D’Aragona" of Salerno between September 2020 and May 2021. Materials: The questionnaires used were: a) Caregiver Burden Inventory - CBI a questionnaire of 24 items that allow identifying five sub-categories of burden (objective, psychological, physical, social, emotional); b) Depression Anxiety Stress Scales Short Version - DASS-21 questionnaire consisting of 21 items and valid in examining three distinct but interrelated areas (depression, anxiety and stress); c) Family Strain Questionnaire Short Form - FSQ-SF is a questionnaire of 30 items grouped in areas of increasing psychological risk (OK, R, SR, U); d) Zarit Caregiver Burden Inventory - ZBI, consisting of 22 items based on the analysis of two main factors: personal stress and pressure related to his role; e) Life Satisfaction, a single item that aims to evaluate the degree of life satisfaction in a global way using a 0-100 Likert scale. Findings: N ° 29 caregivers (M age = 55.14, SD = 9.859; 69% F) participated in the study. 20.6% of the sample had severe and severe burden (CBI score = M = 26.31; SD = 22.43) and 13.8% of participants had moderate to severe burden (ZBI). The FSQ-SF highlighted a minority of caregivers who need psychological support, in some cases urgent (Area SR and Area U). The DASS-21 results show a prevalence of stress-related symptoms (M = 10.90, SD = 10.712) compared to anxiety (M = 7.52, SD = 10.752) and depression (M = 8, SD = 10.876). There are significant correlations between some specific variables and mean test scores: retired caregivers report higher ZBI scores (p = 0.423) and lower Life Satisfaction levels (p = -0.460) than working caregivers; years of schooling show a negative linear correlation with the ZBI score (p = -0.491). The T-Test indicates that caregivers of patients with cognitive impairment are at greater risk than those of patients without cognitive impairment. Conclusions: It knows the factors that affect the burden the most would allow for early recognition of risky situations and caregivers who would need adequate support.

Keywords: anxious-depressive axis, caregivers’ burden, Parkinson’ disease, psychological risks

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