Search results for: young children

Authors: Gelareh Ghaderi

Abstract:

the overall objective of this study is to develop two alternative plans of spatial and infrastructural development for the Netwerkstad Twente (Twente region) until 2040 and to assess the impacts of those two alternative plans. This region is located on the eastern border of the Netherlands, and it comprises of five municipalities. Based on the strengths and opportunities of the five municipalities of the Netwerkstad Twente, and in order develop the region internationally, strengthen the job market and retain skilled and knowledgeable young population, two alternative visions have been developed; environmental oriented vision, and economical oriented vision. Environmental oriented vision is based mostly on preserving beautiful landscapes. Twente would be recognized as an educational center, driven by green technologies and environment-friendly economy. Market-oriented vision is based on attracting and developing different economic activities in the region based on visions of the five cities of Netwerkstad Twente, in order to improve the competitiveness of the region in national and international scale. On the basis of the two developed visions and strategies for achieving the visions, land use and infrastructural development are modeled and assessed. Based on the SWOT analysis, criteria were formulated and employed in modeling the two contrasting land use visions by the year 2040. Land use modeling consists of determination of future land use demand, assessment of suitability land (Suitability analysis), and allocation of land uses on suitable land. Suitability analysis aims to determine the available supply of land for future development as well as assessing their suitability for specific type of land uses on the basis of the formulated set of criteria. Suitability analysis was operated using CommunityViz, a Planning Support System application for spatially explicit land suitability and allocation. Netwerkstad Twente has highly developed transportation infrastructure, consists of highways network, national road network, regional road network, street network, local road network, railway network and bike-path network. Based on the assumptions of speed limitations on different types of roads provided, infrastructure accessibility level of predicted land use parcels by four different transport modes is investigated. For evaluation of the two development scenarios, the Multi-criteria Evaluation (MCE) method is used. The first step was to determine criteria used for evaluation of each vision. All factors were categorized as economical, ecological and social. Results of Multi-criteria Evaluation show that Environmental oriented cities scenario has higher overall score. Environment-oriented scenario has impressive scores in relation to economical and ecological factors. This is due to the fact that a large percentage of housing tends towards compact housing. Twente region has immense potential, and the success of this project will define the Eastern part of The Netherlands and create a real competitive local economy with innovations and attractive environment as its backbone.

Keywords: economical oriented vision, environmental oriented vision, infrastructure, land use, multi criteria assesment, vision

Procedia PDF Downloads 208

Authors: Gergely Horvath

Abstract:

The study analyzes the special provisions of the highest level of national agricultural legislation in the Fundamental Law of Hungary (25 April 2011) with descriptive, analytic and comparative methods. The agriculturally relevant articles of the constitution are very important, because –in spite of their high level of abstraction– they can determine and serve the practice comprehensively and effectively. That is why the objective of the research is to interpret the concrete sentences and phrases in connection with agriculture compared with the methods of some other relevant constitutions (historical-grammatical interpretation). The major findings of the study focus on searching for the appropriate provisions and approach capable of solving the problems of sustainable food production. The real challenge agricultural law must face with in the future is protecting or conserving its background and subjects: the environment, the ecosystem services and all the 'roots' of food production. In effect, agricultural law is the legal aspect of the production of 'our daily bread' from farm to table. However, it also must guarantee the safe daily food for our children and for all our descendants. In connection with sustainability, this unique, value-oriented constitution of an agrarian country even deals with uncustomary questions in this level of legislation like GMOs (by banning the production of genetically modified crops). The starting point is that the principle of public good (principium boni communis) must be the leading notion of the norm, which is an idea partly outside the law. The public interest is reflected by the agricultural law mainly in the concept of public health (in connection with food security) and the security of supply with healthy food. The construed Article P claims the general protection of our natural resources as a requirement. The enumeration of the specific natural resources 'which all form part of the common national heritage' also means the conservation of the grounds of sustainable agriculture. The reference of the arable land represents the subfield of law of the protection of land (and soil conservation), that of the water resources represents the subfield of water protection, the reference of forests and the biological diversity visualize the specialty of nature conservation, which is an essential support for agrobiodiversity. The mentioned protected objects constituting the nation's common heritage metonymically melt with their protective regimes, strengthening them and forming constitutional references of law. This regimes also mean the protection of the natural foundations of the life of the living and also the future generations, in the name of intra- and intergenerational equity.

Keywords: agricultural law, constitutional values, natural resources, sustainability

Procedia PDF Downloads 148

Authors: Carmen J. Savelli, Romy Conzade

Abstract:

Background: Access to sufficient amounts of safe and nutritious food is a basic human necessity, required to sustain life and promote good health. Food safety and food security are therefore inextricably linked, yet the importance of food safety in this relationship is often overlooked. Methodologies: A literature review and desk study were conducted to examine existing frameworks for discussing food security, especially from an international perspective, to determine the entry points for enhancing considerations for food safety in national and international policies. Major Findings: Food security is commonly understood as the state when all people at all times have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life. Conceptually, food security is built upon four pillars including food availability, access, utilization and stability. Within this framework, the safety of food is often wrongly assumed as a given. However, in places where food supplies are insufficient, coping mechanisms for food insecurity are primarily focused on access to food without considerations for ensuring safety. Under such conditions, hygiene and nutrition are often ignored as people shift to less nutritious diets and consume more potentially unsafe foods, in which chemical, microbiological, zoonotic and other hazards can pose serious, acute and chronic health risks. While food supplies might be safe and nutritious, if consumed in quantities insufficient to support normal growth, health and activity, the result is hunger and famine. Recent estimates indicate that at least 842 million people, or roughly one in eight, still suffer from chronic hunger. Even if people eat enough food that is safe, they will become malnourished if the food does not provide the proper amounts of micronutrients and/or macronutrients to meet daily nutritional requirements, resulting in under- or over-nutrition. Two billion people suffer from one or more micronutrient deficiencies and over half a billion adults are obese. Access to sufficient amounts of nutritious food is not enough. If food is unsafe, whether arising from poor quality supplies or inadequate treatment and preparation, it increases the risk of foodborne infections such as diarrhoea. 70% of diarrhoea episodes occurring annually in children under five are due to biologically contaminated food. Conclusions: An integrated approach is needed where food safety and nutrition are systematically introduced into mainstream food system policies and interventions worldwide in order to achieve health and development goals. A new framework, “Food for Health” is proposed to guide policy development and requires all three aspects of food security to be addressed in balance: sufficiency, nutrition and safety.

Keywords: food safety, food security, nutrition, policy

Procedia PDF Downloads 393

Authors: Mita Sirait

Abstract:

Everyday Jakarta produces 7,000 tons of solid waste and only about 5,200 tons delivered to landfill out of the city by 720 trucks, the rest are left yet manageable, as reported by Government of Clean Sector. CLEAN Jakarta Project is aimed at empowering community to achieve healthy environment for children and families in urban slum in Semper Barat and Penjaringan sub-district of North Jakarta that consisted of 20,584 people. The project applies Community Based Total Sanitation, an approach to empowering community to achieve total hygiene and sanitation behaviour by triggering activities. As regulated by Ministry of Health, it has 5 pillars: (1) open defecation free, (2) hand-washing with soaps, (3) drinking-water treatment, (4) solid-waste management and (5) waste-water management; and 3 strategic components: 1) demand creation, 2) supply creation and 3) enabling environment. Demand creation is generated by triggering community’s reaction to their daily sanitation habits by exposing them to their surrounding where they can see faeces, waste and other environmental pollutant to stimulate disgusting, embarrassing and responsibility sense. Triggered people then challenged to commit to improving their hygiene practice such as to stop littering and start waste separation. In order to support this commitment, and for supply creation component, the project initiated waste bank with community working group. It facilitated capacity-building trainings, waste bank system formulation and meetings with local authorities to solicit land permit and waste bank decree. As it is of a general banking system, waste bank has customer service, teller, manager, legal paper and provides saving book and money transaction. In 8 months, two waste banks have established with 148 customers, 17 million rupiah cash, and about 9 million of stored recyclables. Approximately 2.5 tons of 15-35 types of recyclable are managed in both waste banks per week. On enabling environment, the project has initiated sanitation working group in community and multi sectors government level, and advocated both parties. The former is expected to promote behaviour change and monitoring in the community, while the latter is expected to support sanitation with regulations, strategies, appraisal and awards; to coordinate partnering and networking, and to replicate best practices to other areas.

Keywords: urban community, waste management, Jakarta, community based total sanitation (CBTS)

Procedia PDF Downloads 277

Authors: Alene Toulany, Elizabeth Dettmer, Seena Grewal, Kaley Roosen, Andrea Regina, Cathleen Steinegger, Kate Stadelman, Melissa Chambers, Lindsay Lochhead, Kelsey Gallagher, Alissa Steinberg, Andrea Leyser, Allison Lougheed, Jill Hamilton

Abstract:

Obesity and psychiatric disorders occur together so frequently that the combination has been coined an epidemic within an epidemic. Youth living with obesity are at increased risk for trauma, depression, anxiety and disordered eating. Although symptoms of binge eating disorder are common in paediatric obesity management programs, they are often not identified or addressed within treatment. At The Hospital for Sick Children (SickKids), a tertiary care paediatric hospital in Toronto, Canada, adolescents with obesity are treated in an interdisciplinary outpatient clinic (1-2 hours/week). This intensity of care is simply not enough to help these extremely complex patients. Existing day treatment programs for eating, and psychiatric disorders are not well suited for patients with obesity. In order to address this identified care gap, a unique collaboration was formed between the obesity, psychiatry, and eating disorder programs at SickKids in 2015. The aim of this collaboration was to provide an enhanced treatment arm to our general psychiatry day hospital program that addresses both the mental health issues and the lifestyle challenges common to youth with obesity and binge eating. The program is currently in year-one of a two-year pilot project and is designed for a length of stay of approximately 6 months. All youth participate in daily group therapy, academics, and structured mealtimes. The groups are primarily skills-based and are informed by cognitive/dialectical behavioural therapies. Weekly family therapy and individual therapy, as well as weekly medical appointments with a psychiatrist and a nurse, are provided. Youth in the enhanced treatment arm also receive regular sessions with a dietitian to establish normalized eating behaviours and monthly multifamily meal sessions to address challenges related to behaviour change and mealtimes in the home. Outcomes that will be evaluated include measures of mental health, anthropometrics, metabolic status, and healthcare satisfaction. At the end of the two years, it is expected that we will have had about 16 youth participants. This model of care delivery will be the first of its kind in Canada and is expected to inform future paediatric treatment practices.

Keywords: adolescent, binge eating, mental illness, obesity

Procedia PDF Downloads 329

Authors: M. Keršič, M. Lužnik, J. Lužnik

Abstract:

Cervical dilatation and membrane herniation before 26th week of gestation poses very high risk for extremely and very premature childbirth. Cerclage with mesh cap (mesh cerclage, MC) can greatly diminish this risk and provide additional positive effects. Between 2005 and 2014, MC has been performed in 9 patients with singleton pregnancies who had prolapsed membranes beyond external cervical/uterine os before 25th week of pregnancy (one in 29th). With patients in general anaesthesia, lithotomy and Trendelenburg position (about 25°) prolapsed membranes were repositioned in the uterine cavity, using tampon soaked in antiseptic solution (Skinsept mucosa). A circular, a type of purse-string suture (main band) with double string Ethilon 1 was applied at about 1 to 1.5 cm from the border of the external uterine os - 6 to 8 stitches were placed, so the whole external uterine os was encircled (modified McDonald). In the next step additional Ethilon 0 sutures were placed around all exposed parts of the main double circular suture and loosely tightened. On those sutures, round tailored (diameter around 6 cm) mesh (Prolene® or Gynemesh* PS) was attached. In all 9 cases, gestation was prolonged on average for 9 weeks and 4 days (67 days). In four cases maturity was achieved. Mesh was removed in 37th–38th week of pregnancy or if spontaneous labour began. In two cases, a caesarean section was performed because of breech presentation. In the first week after birth in 22nd week one new born died because of immaturity (premature birth was threatening in 18th week and then MC was placed). Ten years after first MC, 8 of 9 women with singleton pregnancy and MC performed have 8 healthy children from these pregnancies. Mesh cerclage successfully closed the opened cervical canal or uterine orifice and prevented further membrane herniation and membrane rupture. MC also provides a similar effect as with occluding the external os with suturing but without interrupting the way for excretion of abundant cervical mucus. The mesh also pulls the main circular band outwards and thus lowers the chance of suture cutting through the remaining cervix. MC prolonged gestation very successfully (mean for 9 weeks and 4 days) and thus increased possibility for survival and diminished the risk for complications in very early preterm delivered survivors in cases with cervical dilatation and membrane herniation before 26th week of gestation. Without action possibility to achieve at least 28th or 32nd week of gestation would be poor.

Keywords: cervical insufficiency, mesh cerclage, membrane protrusion, premature birth prevention, physical exam-indicated cerclage, rescue cerclage

Procedia PDF Downloads 168

Authors: Zohre Shahhosseini, Mehdi Pourasghar, AliReza Khalilian, Fariba Salehi

Abstract:

Objective: The prevalence of anxiety during pregnancy, particularly in developing countries, and its adverse effects on mother and baby, can make pregnancy unpleasant for pregnant women. The effect of anxiety during pregnancy on birth outcomes and children can be a justification for screening of anxious pregnant women in periodic pregnancy care and helping them. In this study, researchers have investigated effects and comparison of group counseling (Cognitive therapy) and interactive lectures on anxiety during pregnancy of primiparas. Methods: The population studied in this semi-experimental trail was nulliparous pregnant women with backgrounds in health care centers in Sari city .They were studied during a period of 3 months from early March to end May 2016. Sample size in this study was 91 patients, who were randomly assigned to three groups: group counseling, interactive lecture, and control group. Demographic questionnaire and Speilberger State –Trait Anxiety Inventory (SPAI) was completed for all three groups after obtaining letter of consent and completing the initial checklist. Then interventions included 4 sessions for group counseling and 4 sessions for interactive lecture which were implemented in two sessions a week. 4 weeks after interventions, Speilberger State – Trait Anxiety Inventory (SPAI), completed by both group counseling and interactive lectures groups again. In control group, the second questionnaire was also completed 4 weeks after completing the initial questionnaire. Data analysis was performed using spss software version 18. At first, the Kalmogorov-Smiranov test was carried out and then chi square tests, Independent t-test, paired t-test, ANOVA test, and Dunnett's post hoc test were applied. Results: Findings show that group counseling and interactive lecture with reducing state and trait anxiety in significant level of P=0/000 contribute to reduction of anxiety in nulliparous pregnant mothers. However, in this study, group counseling was more effective than an interactive lecture in reducing participants' anxiety, but this difference was not significant (P≥0/05). Conclusions: According to the results of this study, it is suggested that by screening of psychological - mental problems of pregnant women in periodic care during pregnancy be considered by revised prenatal care plans and creation of counseling and training units at health centers. Besides owing to the fact that both interactive lecture and group counseling method were effective in reducing anxiety, these methods should be used proportionate to situations and facilities.

Keywords: anxiety, group counseling, cognitive therapy, interactive lecture, nulliparous

Procedia PDF Downloads 274

Authors: M. Soubadra Devy, Savitha Swamy, Chethana V. Casiker

Abstract:

Sustainable smart cities are emerging as an important concept in response to the exponential rise in the world’s urbanizing population. While earlier, only technical, economic and governance based solutions were considered, more and more layers are being added in recent times. With the prefix of 'sustainability', solutions which help in judicious use of resources without negatively impacting the environment have become critical. We present a case study of Bangalore city which has transformed from being a garden city and pensioners' paradise to being an IT city with a huge, young population from different regions and diverse cultural backgrounds. This has had a big impact on the green spaces in the city and the biodiversity that they support, as well as on farming/gardening practices. Edible landscapes comprising farms lands, home gardens and neighbourhood parks (NPs henceforth) were examined. The land prices of areas having NPs were higher than those that did not indicate an appreciation of their aesthetic value. NPs were part of old and new residential areas largely managed by the municipality. They comprised manicured gardens which were similar in vegetation structure and composition. Results showed that NPs that occurred in higher density supported reasonable levels of biodiversity. In situations where NPs occurred in lower density, the presence of a larger green space such as a heritage park or botanical garden enhanced the biodiversity of these parks. In contrast, farm lands and home gardens which were common within the city are being lost at an unprecedented scale to developmental projects. However, there is also the emergence of a 'neo-culture' of home-gardening that promotes 'locovory' or consumption of locally grown food as a means to a sustainable living and reduced carbon footprint. This movement overcomes the space constraint by using vertical and terrace gardening techniques. Food that is grown within cities comprises of vegetables and fruits which are largely pollinator dependent. This goes hand in hand with our landscape-level study that has shown that cities support pollinator diversity. Maintaining and improving these man-made ecosystems requires analysing the functioning and characteristics of the existing structures of governance. Social network analysis tool was applied to NPs to examine relationships, between actors and ties. The management structures around NPs, gaps, and means to strengthen the networks from the current state to a near-ideal state were identified for enhanced services. Learnings from NPs were used to build a hypothetical governance structure and functioning of integrated governance of NPs and edible landscapes to enhance ecosystem services such as biodiversity support, food production, and aesthetic value. They also contribute to the sustainability axis of smart cities.

Keywords: biodiversity support, ecosystem services, edible green spaces, neighbourhood parks, sustainable smart city

Procedia PDF Downloads 120

Authors: Natalia V. Naryzhnaya, Alexandr V. Mukhomedzyanov, Ivan A. Derkachev, Boris K. Kurbatov, Leonid N. Maslov

Abstract:

Background: Techniques of adaptation to hypoxia and remote postconditioning (RPost) have great prospects for use in the clinic. However, recent studies have shown low efficacy of remote postconditioning in patients with AMI. We hypothesize that the reasons for this inefficiency may be metabolic disorders, which are very common, especially in patients with cardiovascular disease, and age of patients. The purpose of the study was to reveal the effectiveness of adaptation to chronic hypoxia and RPost. To determine the possible relationship between the decrease in the effectiveness of projective impacts and disorders of carbohydrate and lipid metabolism. Design: The study was carried out on Wistar rats 60 day old. MetS was induced by high-carbohydrate, high-fat diet (HСHFD). Modeling MS led to the formation of obesity, hypertension, impaired lipid and carbohydrate metabolism, hyperleptinemia, and moderate stress. Groups with adaptation to chronic hypoxia were subjected to hypoxia for 21 days at 12% O2 and 0.3% CO2 after complete of HСHFD. All animals were subjected to 45 min coronary occlusion and 120 min reperfusion. Groups with RPost, immediately after the end of ischemia, tourniquets were applied to the hind limbs in the area of the hip joint (3 times in the mode of 5 min ischemia, 5 min reperfusion). Results: RPost led to a twofold reduction of infarct size in rats with intact metabolism (р < 0.0001), while in rats with MetS, a decrease in infarct size during RPost was 25 % (p = 0.00003). A direct correlation was found between of infarct size during RPost and the serum leptin level of rats with MetC (r = 0.85). The presented data suggested that a decrease in the efficiency of remote postconditioning in rats with diet-induced metabolic syndrome depends on serum leptin. Chronic hypoxia resulted in a 38% reduced in infarct size in metabolically intact rats. The decrease of cardioprotection was observed in rats with chronic hypoxia and MetS. Infarct size showed a direct correlation with impaired glucose tolerance (AUC, glucose tolerance test, r = 0.034) and serum triglyceride levels (r = 0.39). Our study showed the dependence of cardioprotection in rats with metabolic syndrome during chronic hypoxia and DPost on opioids in the blood serum and myocardium, protein kinase C and NO synthase activity. Conclusion: The results obtained showed that the infarct-limiting efficiency of adaptation to hypoxia and remote postconditioning is reduced or completely absent in animals with metabolic syndrome. The increase in the infarction, in this case, directly depends on the disturbances in carbohydrate. lipid metabolism and opioids signaling. Funding: Investigation of effectiveness of chronic hypoxia at the metabolic syndrome was carried out within the support of Russian Science Foundation Grant 22-15-00048. Studies of the mechanisms of arterial hypertension in induced metabolic syndrome were carried out within the framework of the state assignment (122020300042-4). The work was performed using the Center for Collective Use "Medical Genomics".

Keywords: chronic hypoxia, opioids, remote postconditioning, metabolic syndrome

Procedia PDF Downloads 59

Authors: Gideon Nyuimbe Gasu

Abstract:

Sub Saharan Africa is at a critical point, experiencing rapid population growth, particularly in urban areas and young growing force. At the same time, the growing risk of catastrophic global climate change threatens to weaken food production system, increase intensity and frequency of drought, flood, and fires and undermine gains on development and poverty reduction. Although the region has the lowest per capital greenhouse gas emission level in the world, it will need to join global efforts to address climate change, including action to avoid significant increases and to encourage a green economy. Thus, there is a need for the concept of 'greening the economy' as was prescribed at Rio Summit of 1992. Renewable energy is one of the criterions to achieve this laudable goal of maintaining a green economy. There is need to address climate change while facilitating continued economic growth and social progress as energy today is critical to economic growth. Fossil fuels remain the major contributor of greenhouse gas emission. Thus, cleaner technologies such as carbon capture storage, renewable energy have emerged to be commercially competitive. This paper sets out to examine how to achieve a low carbon economy with minimal emission of carbon dioxide and other greenhouse gases which is one of the outcomes of implementing a green economy. Also, the paper examines the different renewable energy sources such as nuclear, wind, hydro, biofuel, and solar voltaic as a panacea to the looming climate change menace. Finally, the paper assesses the different renewable energy and energy efficiency as a propeller to generating new sources of income and jobs and in turn reduces carbon emission. The research shall engage qualitative, evaluative and comparative methods. The research will employ both primary and secondary sources of information. The primary sources of information shall be drawn from the sub Saharan African region and the global environmental organizations, energy legislation, policies and related industries and the judicial processes. The secondary sources will be made up of some books, journal articles, commentaries, discussions, observations, explanations, expositions, suggestions, prescriptions and other material sourced from the internet on renewable energy as a panacea to climate change. All information obtained from these sources will be subject to content analysis. The research result will show that the entire planet is warming as a result of the activities of mankind which is clear evidence that the current development is fundamentally unsustainable. Equally, the study will reveal that a low carbon development pathway in the sub Saharan African region should be embraced to minimize emission of greenhouse gases such as using renewable energy rather than coal, oil, and gas. The study concludes that until adequate strategies are devised towards the use of renewable energy the region will continue to add and worsen the current climate change menace and other adverse environmental conditions.

Keywords: carbon dioxide, climate change, legislation/law, renewable energy

Procedia PDF Downloads 205

Authors: Manasi Mahanty

Abstract:

In the current phase of globalization, the mobility of capital facilitates outsourcing and subcontracting of production processes to the developing economies for cheap and flexible labour force. In such process, the globalization of production networks operates at multi-locational points within the nation. Under the new quota regime in the globalization period, the Indian manufacturing exporters came under the influence of corporate buyers and large retailers from the importing countries. As part of such process, the garment manufacturing sector is expected to create huge employment opportunities and to expand the export market in the country. While following these, expectations, the apparel and garment industries mostly target to hire female migrant workers with a purpose of establishing more flexible industrial relations through the casual nature of employment contract. It leads to an increasing women’s participation in the labour market as well as the rise in precarious forms of female paid employment. In the context, the main objective of the paper is to understand the wider dynamics of globalization of production and its link with informalization, feminization of labour force and internal migration process of the country. For this purpose, the study examines the changing labour relations in the KINFRA Apparel Park at Kerala’s Special Economic Zone which operates under the scheme ‘Apparel Parks for Export’ (APE) of the Government of India. The present study was based on both quantitative and qualitative analysis. In the first, the secondary sources of data were collected from the source location (SEAM centre) and destination (KINFRA Park). The official figures and data were discussed and analyzed in order to find out the various dimensions of labour relations under globalization of production. In the second, the primary survey was conducted to make a comparative analysis of local and migrant female workers. The study is executed by taking 100 workers in total. The local workers comprised of 53% of the sample whereas the outside state workers were 47%. Even personal interviews with management staff, and workers were also made for collecting the information regarding the organisational structure, nature, and mode of recruitment, work environment, etc. The study shows the enormous presence of rural women migrant workers in KINFRA Apparel Park. A Public Private Partnership (PPP) arranged migration system is found as Skills for Employment in Apparel Manufacturing (SEAM) from where young women and girls are being sent to work in garment factories of Kerala’s KINFRA International Apparel Park under the guise of an apprenticeship based recruitment. The study concludes that such arrangements try to avoid standard employment relationships and strengthen informalization, casualization and contractualization of work. In this process, the recruitment of women migrant workers is to be considered as best option for the employers of private industries which could be more easily hired and fired.

Keywords: female migration, globalization, informalization, KINFRA apparel park

Procedia PDF Downloads 315

Authors: Sree Sanyal

Abstract:

Research in ageing often highlights the age-related health dimension more than the psycho-social characteristics of the elderly, which also influences and challenges the health outcomes. Multimorbidity is defined as the person having more than one chronic non-communicable diseases and their prevalence increases with ageing. The study aims to evaluate the influence of social ties on self-reported prevalence of multimorbidity (selected chronic non-communicable diseases) among the selected states of elderly population in India. The data is accessed from Building Knowledge Base on Population Ageing in India (BKPAI), collected in 2011 covering the self-reported chronic non-communicable diseases like arthritis, heart disease, diabetes, lung disease with asthma, hypertension, cataract, depression, dementia, Alzheimer’s disease, and cancer. The data of the above diseases were taken together and categorized as: ‘no disease’, ‘one disease’ and ‘multimorbidity’. The predicted variables were demographic, socio-economic, residential types, and the variable of social ties includes social support, social engagement, perceived support, connectedness, and importance of the elderly. Predicted probability for multiple logistic regression was used to determine the background characteristics of the old in association with chronic morbidities showing multimorbidity. The finding suggests that 24.35% of the elderly are suffering from multimorbidity. Research shows that with reference to ‘no disease’, according to the socio-economic characteristics of the old, the female oldest old (80+) from others in caste and religion, widowed, never had any formal education, ever worked in their life, coming from the second wealth quintile standard, from rural Maharashtra are more prone with ‘one disease’. From the social ties background, the elderly who perceives they are important to the family, after getting older their decision-making status has been changed, prefer to stay with son and spouse only, satisfied with the communication from their children are more likely to have less single morbidity and the results are significant. Again, with respect to ‘no disease’, the female oldest old (80+), who are others in caste, Christian in religion, widowed, having less than 5 years of education completed, ever worked, from highest wealth quintile, residing in urban Kerala are more associated with multimorbidity. The elderly population who are more socially connected through family visits, public gatherings, gets support in decision making, who prefers to spend their later years with son and spouse only but stays alone shows lesser prevalence of multimorbidity. In conclusion, received and perceived social integration and support from associated neighborhood in the older days, knowing about their own needs in life facilitates better health and wellbeing of the elderly population in selected states of India.

Keywords: morbidity, multi-morbidity, prevalence, social ties

Procedia PDF Downloads 100

Authors: Virany Diana, Martono Tri Utomo, Risa Etika

Abstract:

Background: Shock is one severe condition that can be a major cause of morbidity and mortality in the Neonatal Intensive Care Unit. Preterm infants are very susceptible to shock caused by many complications such as asphyxia, patent ductus arteriosus, intra ventricle haemorrhage, necrotizing enterocolitis, persistent pulmonal hypertension of the newborn, and septicaemia. Limited hemodynamic monitoring for early detection of shock causes delayed intervention and comprises the outcomes. Clinical parameters still used in neonatal shock detection, such as Capillary Refill Time, heart rate, cold extremity, and urine production. Blood pressure is most frequently used to evaluate preterm's circulation, but hypotension indicates uncompensated shock. Near-infrared spectroscopy (NIRS) is known as a noninvasive tool for monitoring and detecting the state of inadequate tissue perfusion. Muscle oxygen saturation shows decreased cardiac output earlier than systemic parameters of tissue oxygenation when cerebral regional oxygen saturation is still stabilized by autoregulation. However, to our best knowledge, until now, no study has analyzed the decrease of muscle oxygen regional saturation (mRSO₂) and the ratio of muscle and cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Purpose: The purpose of this study is to analyze the decrease of mRSO₂ and ratio of muscle to cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Patients and Methods: This cross-sectional study was conducted on preterm infants with 28-34 weeks gestational age, admitted to the NICU of Dr. Soetomo Hospital from November to January 2022. Patients were classified into two groups: shock and non-shock. The diagnosis of shock is based on clinical criteria (tachycardia, prolonged CRT, cold extremity, decreased urine production, and MAP Blood Pressure less than GA in weeks). Measurement of mRSO₂ and cRSO₂ by NIRS was performed by the doctor in charge when the patient came to NICU. Results: We enrolled 40 preterm infants. The initial conventional hemodynamic parameter as the basic diagnosis of shock showed significant differences in all variables. Preterm with shock had higher mean HR (186.45±1.5), lower MAP (29.8±2.1), and lower SBP (45.1±4.28) than non-shock children, and most had a prolonged CRT. The patients’ outcome was not a significant difference between shock and non-shock patients. The mean mRSO₂ in the shock and non-shock groups were 33,65 ± 11,32 vs. 69,15 ± 3,96 (p=0.001), and the mean ratio mRSO₂/cRSO₂ 0,45 ± 0,12 vs. 0,84 ± 0,43 (p=0,001), were significantly different. The mean cRSO₂ in the shock and non-shock groups were 71,60 ± 4,90 vs. 81,85 ± 7,85 (p 0.082), not significantly different. Conclusion: The decrease of mRSO₂ and ratio of mRSO₂/cRSO₂ can differentiate between shock and non-shock in the preterm infant when cRSO₂ is still normal.

Keywords: preterm infant, regional muscle oxygen saturation, regional cerebral oxygen saturation, NIRS, shock

Procedia PDF Downloads 64

Authors: Santhani M. Selveindran

Abstract:

Background: Natural disasters are traumatic global events that are becoming increasing more common, with significant psychosocial impact on survivors. This impact results not only in psychosocial distress but, for many, can lead to psychosocial disorders and chronic psychopathology. While there are currently available interventions that seek to prevent and treat these psychosocial sequelae, their effectiveness is uncertain. The evidence-base is emerging with more primary studies evaluating the effectiveness of various psychosocial interventions for survivors of natural disasters, which remains to be synthesized. Aim of Review: To identify, critically appraise and synthesize the current evidence-base on the effectiveness of psychosocial interventions in preventing or treating Post-Traumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD) and/or Generalized Anxiety Disorder (GAD) in adults and children who are survivors of natural disasters. Methods: A protocol was developed as a guide to carry out this review. A systematic search was conducted in eight international electronic databases, three grey literature databases, one dissertation and thesis repository, websites of six humanitarian and non-governmental organizations renowned for their work on natural disasters, as well as bibliographic and citation searching for eligible articles. Papers meeting the specific inclusion criteria underwent quality assessment using the Downs and Black checklist. Data were extracted from the included papers and analysed by way of narrative synthesis. Results: Database and website searching returned 3777 papers where 31 met the criteria for inclusion. Additional 2 papers were obtained through bibliographic and citation searching. Methodological quality of most papers was fair. Twenty-five studies evaluated psychological interventions, five, social interventions whereas three studies evaluated ‘mixed’ psychological and social interventions. All studies, irrespective of methodological quality, reported post-intervention reductions in symptom scores for PTSD, depression and/or anxiety and where assessed, reduced diagnosis of PTSD and MDD, and produced improvements in self-efficacy and quality of life. Statistically significant results were seen in 27 studies. However, three studies demonstrated that the evaluated interventions may not have been very beneficial. Conclusions: The overall positive results suggest that any psychosocial interventions are favourable and should be delivered to all natural disaster survivors, irrespective of age, country, and phase of disaster. Yet, heterogeneity and methodological shortcomings of the current evidence-base makes it difficult to draw definite conclusions needed to formulate categorical guidance or frameworks. Further, rigorously conducted research is needed in this area, although the feasibility of such, given the context and nature of the problem, is also recognized.

Keywords: psychosocial interventions, natural disasters, survivors, effectiveness

Procedia PDF Downloads 132

Authors: Willem J. A. Louw

Abstract:

The wave of new advanced computing technology that has been developed during the recent past has significantly changed the way we communicate, collaborate and collect information. It has created a new technology environment and paradigm in which our children and students grow-up and this impacts on their learning. Research confirmed that Generation Y students have a preference for learning in the new technology environment. The challenge or question is: How do we adjust our teaching and learning to make the most of these changes. The complexity of effective and efficient teaching and learning must not be underestimated and changes must be preceded by proper objective research to prevent any haphazard developments that could do more harm than benefit. A blended learning approach has been used in the Forestry department for a few numbers of years including the use of electronic-peer assisted learning (e-pal) in a fixed-computer set-up within a learning management system environment. It was decided to extend the investigation and do some exploratory research by using a range of different Tablet devices. For this purpose, learning activities or assignments were designed to cover aspects of communication, collaboration and collection of information. The Moodle learning management system was used to present normal module information, to communicate with students and for feedback and data collection. Student feedback was collected by using an online questionnaire and informal discussions. The research project was implemented in 2013, 2014 and 2015 amongst first and third-year students doing a forestry three-year technical tertiary qualification in commercial plantation management. In general, more than 80% of the students alluded to that the device was very useful in their learning environment while the rest indicated that the devices were not very useful. More than ninety percent of the students acknowledged that they would like to continue using the devices for all of their modules whilst the rest alluded to functioning efficiently without the devices. Results indicated that information collection (access to resources) was rated the highest advantageous factor followed by communication and collaboration. The main general advantages of using Tablets were listed by the students as being mobility (portability), 24/7 access to learning material and information of any kind on a user friendly device in a Wi-Fi environment, fast computing process speeds, saving time, effort and airtime through skyping and e-mail, and use of various applications. Ownership of the device is a critical factor while the risk was identified as a major potential constraint. Significant differences were reported between the different types and quality of Tablets. The preferred types are those with a bigger screen and the ones with overall better functionality and quality features. Tablets significantly increase the collaboration, communication and information collection needs of the students. It does, however, not replace the need of a computer/laptop because of limited storage and computation capacity, small screen size and inefficient typing.

Keywords: tablets, teaching, blended learning, tablet quality

Procedia PDF Downloads 231

Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

Abstract:

Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

Procedia PDF Downloads 204

Authors: Charlotte K. Lee, Henrique R. N. Aguiar, Ralph Smith, James Baldock, Sam Botchey

Abstract:

Background: Femoral neck stress fractures (FNSF) are uncommon, making up 1 to 7.2% of stress fractures in healthy subjects. FNSFs are prevalent in young women, military recruits, endurance athletes, and individuals with energy deficiency syndrome or female athlete triad. Presentation is often non-specific and is often misdiagnosed following the initial examination. There is limited research addressing the return–to–activity time after FNSF. Previous studies have demonstrated prognostic time predictions based on various imaging techniques. Here, (1) OxSport clinic FNSF practice standards are retrospectively reviewed, (2) FNSF cohort demographics are examined, (3) Regression models were used to predict return–to–activity prognosis and consequently determine bone stress risk factors. Methods: Patients with a diagnosis of FNSF attending Oxsport clinic between 01/06/2020 and 01/01/2020 were selected from the Rheumatology Assessment Database Innovation in Oxford (RhADiOn) and OxSport Stress Fracture Database (n = 14). (1) Clinical practice was audited against five criteria based on local and National Institute for Health Care Excellence guidance, with a 100% standard. (2) Demographics of the FNSF cohort were examined with Student’s T-Test. (3) Lastly, linear regression and Random Forest regression models were used on this patient cohort to predict return–to–activity time. Consequently, an analysis of feature importance was conducted after fitting each model. Results: OxSport clinical practice met standard (100%) in 3/5 criteria. The criteria not met were patient waiting times and documentation of all bone stress risk factors. Importantly, analysis of patient demographics showed that of the population with complete bone stress risk factor assessments, 53% were positive for modifiable bone stress risk factors. Lastly, linear regression analysis was utilized to identify demographic factors that predicted return–to–activity time [R2 = 79.172%; average error 0.226]. This analysis identified four key variables that predicted return-to-activity time: vitamin D level, total hip DEXA T value, femoral neck DEXA T value, and history of an eating disorder/disordered eating. Furthermore, random forest regression models were employed for this task [R2 = 97.805%; average error 0.024]. Analysis of the importance of each feature again identified a set of 4 variables, 3 of which matched with the linear regression analysis (vitamin D level, total hip DEXA T value, and femoral neck DEXA T value) and the fourth: age. Conclusion: OxSport clinical practice could be improved by more comprehensively evaluating bone stress risk factors. The importance of this evaluation is demonstrated by the population found positive for these risk factors. Using this cohort, potential bone stress risk factors that significantly impacted return-to-activity prognosis were predicted using regression models.

Keywords: eating disorder, bone stress risk factor, femoral neck stress fracture, vitamin D

Procedia PDF Downloads 163

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

Abstract:

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

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

Procedia PDF Downloads 227

Authors: Ahlam Ali, Katrina Lappin, Jaine Blayney, Ken Mills

Abstract:

Leukaemia is the most frequently (30%) occurring type of paediatric cancer. Of these, approximately 80% are acute lymphoblastic leukaemia (ALL) with acute myeloid leukaemia (AML) cases making up the remaining 20% alongside other leukaemias. Unfortunately, children with AML do not have promising prognosis with only 60% surviving 5 years or longer. It has been highlighted recently the need for age-specific therapies for AML patients, with paediatric AML cases having a different mutational landscape compared with AML diagnosed in adult patients. Drug Repurposing is a recognized strategy in drug discovery and development where an already approved drug is used for diseases other than originally indicated. We aim to identify novel combination therapies with the promise of providing alternative more effective and less toxic induction therapy options. Our in-silico analysis highlighted ‘cell death and survival’ as an aberrant, potentially targetable pathway in paediatric AML patients. On this basis, 83 apoptotic inducing compounds were screened. A preliminary single agent screen was also performed to eliminate potentially toxic chemicals, then drugs were constructed into a pooled library with 10 drugs per well over 160 wells, with 45 possible pairs and 120 triples in each well. Seven cell lines were used during this study to represent the clonality of AML in paediatric patients (Kasumi-1, CMK, CMS, MV11-14, PL21, THP1, MOLM-13). Cytotoxicity was assessed up to 72 hours using CellTox™ Green reagent. Fluorescence readings were normalized to a DMSO control. Z-Score was assigned to each well based on the mean and standard deviation of all the data. Combinations with a Z-Score <2 were eliminated and the remaining wells were taken forward for further analysis. A well was considered ‘successful’ if each drug individually demonstrated a Z-Score <2, while the combination exhibited a Z-Score >2. Each of the ten compounds in one well (155) had minimal or no effect as single agents on cell viability however, a combination of two or more of the compounds resulted in a substantial increase in cell death, therefore the ten compounds were de-convoluted to identify a possible synergistic pair/triple combinations. The screen identified two possible ‘novel’ drug pairing, with BCL2 inhibitor ABT-737, combined with either a CDK inhibitor Purvalanol A, or AKT/ PI3K inhibitor LY294002. (ABT-737- 100 nM+ Purvalanol A- 1 µM) (ABT-737- 100 nM+ LY294002- 2 µM). Three possible triple combinations were identified (LY2409881+Akti-1/2+Purvalanol A, SU9516+Akti-1/2+Purvalanol A, and ABT-737+LY2409881+Purvalanol A), which will be taken forward for examining their efficacy at varying concentrations and dosing schedules, across multiple paediatric AML cell lines for optimisation of maximum synergy. We believe that our combination screening approach has potential for future use with a larger cohort of drugs including FDA approved compounds and patient material.

Keywords: AML, drug repurposing, ABT-737, apoptosis

Procedia PDF Downloads 176

Authors: Krystal Wang, Chongzheng Wei, Runsen Chen, Shufang Sun

Abstract:

Suicide is a global public mental health issue and is the tenth leading cause of death globally. Approximately 75% of suicides occur in low- and middle-income countries (LMIC). Compared to the general population, transgender and gender nonconforming (TGNC) young people have higher suicidal risks. Research has shown that the prevalence of suicidal behaviors among TGNC populations was high in both the United States and China. However, studies were mostly embedded within Western cultures. Limited data and research were available to assess suicidal behaviors among TGNC youth in LMIC countries and to consider various types of TGNC youth. The goal of the current project is to 1) investigate the prevalence of lifetime and past-year suicidal ideations, plans, and attempts among Chinese TGNC youth, 2) explore the relationship between gender identity and suicidal outcomes among TGNC youth in China, 3) identify individual, school, and family level risk and protective factors for suicidal behaviors. The study used data from a cross-sectional survey conducted by Beijing LGBTQ Center in 2021. The survey was the largest TGNC population study in China to understand the health conditions of TGNC individuals. Of the 7612 individuals who completed the survey, a total of 5632 youth (aged 10 to 19) was included in the final analysis. 2259 (40.11%) participants were categorized as transfeminine youth, 1034 (18.36%) as transmasculine youth, 1169 (20.76%) as nonbinary youth AFAB, 568 (10.09%) as nonbinary youth AMAB, 344 (6.11%) as questioning youth AFAB and 258 (4.58%) as questioning youth AMAB. Suicidal behaviors were assessed by asking about lifetime suicidal ideation and attempts, past 12 months suicidal ideation, plan and attempts, and suicidal methods. To achieve the aims, we conducted statistical analysis in Stata/SE 17.0 to 1) describe the prevalence of suicidal outcomes and 2) assess the relationship between gender identity and suicidal outcomes by performing crosstabs, bivariate and multivariate logistic regressions, and adjusting for covariates. The lifetime prevalence of suicidal ideations and attempts for the whole sample was 85.13% and 51.7%. Transfeminine youth had a significantly higher risk for lifetime suicidal ideations (Odds Ratios (OR) = 1.67, CI:1.28,2.18) and attempts than transmasculine youth (OR=1.66, CI: 1.35,2.03), adjusting for age and past year binge drinking, known risk factors of suicide behavior. Past-year prevalence of suicidal behaviors was also high among TGNC youth, with 75.69% in suicidal ideation, 88.77% in suicidal plans, and 57.96% in suicidal attempts. Transfeminine youth, among six subgroups, had the highest risk for past-year suicidal ideations and attempts compared to transmasculine youth. Non-binary youth, regardless of sex assigned at birth, also had a significantly higher risk for suicidal ideations. The prevalence of lifetime and past-year suicidal behaviors was alarming among TGNC youth in China. Among different categories of TGNC youth, transfeminine youth reported the most elevated suicidal risk. The findings indicated a compelling need for researchers and practitioners to address the mental health risks for this specific group and target interventions for TGNC youth in China.

Keywords: child and adolescent mental health, gender minority health, cross-cultural perspective, preventing suicide in youth

Procedia PDF Downloads 54

Authors: Bruno RamaëL, GwenaëL Page, Catherine Knopf-Lenoir, Olivier Baledent, Anne-Virginie Salsac

Abstract:

No routine technique currently exists for clinicians to measure the mechanical properties of vascular walls non-invasively. Most of the data available in the literature come from traction or dilatation tests conducted ex vivo on native blood vessels. The objective of the study is to develop a non-invasive characterization technique based on Magnetic Resonance Imaging (MRI) measurements of the deformation of vascular walls under pulsating blood flow conditions. The goal is to determine the mechanical properties of the vessels by inverse analysis, coupling imaging measurements and numerical simulations of the fluid-structure interactions. The hyperelastic properties are identified using Solidworks and Ansys workbench (ANSYS Inc.) solving an optimization technique. The vessel of interest targeted in the study is the common carotid artery. In vivo MRI measurements of the vessel anatomy and inlet velocity profiles was acquired along the facial vascular network on a cohort of 30 healthy volunteers: - The time-evolution of the blood vessel contours and, thus, of the cross-section surface area was measured by 3D imaging angiography sequences of phase-contrast MRI. - The blood flow velocity was measured using a 2D CINE MRI phase contrast (PC-MRI) method. Reference arterial pressure waveforms were simultaneously measured in the brachial artery using a sphygmomanometer. The three-dimensional (3D) geometry of the arterial network was reconstructed by first creating an STL file from the raw MRI data using the open source imaging software ITK-SNAP. The resulting geometry was then transformed with Solidworks into volumes that are compatible with Ansys softwares. Tetrahedral meshes of the wall and fluid domains were built using the ANSYS Meshing software, with a near-wall mesh refinement method in the case of the fluid domain to improve the accuracy of the fluid flow calculations. Ansys Structural was used for the numerical simulation of the vessel deformation and Ansys CFX for the simulation of the blood flow. The fluid structure interaction simulations showed that the systolic and diastolic blood pressures of the common carotid artery could be taken as reference pressures to identify the mechanical properties of the different arteries of the network. The coefficients of the hyperelastic law were identified using Ansys Design model for the common carotid. Under large deformations, a stiffness of 800 kPa is measured, which is of the same order of magnitude as the Young modulus of collagen fibers. Areas of maximum deformations were highlighted near bifurcations. This study is a first step towards patient-specific characterization of the mechanical properties of the facial vessels. The method is currently applied on patients suffering from facial vascular malformations and on patients scheduled for facial reconstruction. Information on the blood flow velocity as well as on the vessel anatomy and deformability will be key to improve surgical planning in the case of such vascular pathologies.

Keywords: identification, mechanical properties, arterial walls, MRI measurements, numerical simulations

Procedia PDF Downloads 302

Authors: Edna Negron-Martinez

Abstract:

Our time's global challenges and trends —like those associated with climate change, demographics displacements, growing health inequalities, and increasing burden of diseases— have complex connections to the determinants of health. Information on the burden of disease causes and prevention is fundamental for public health actions, like preparedness and responses for disasters, and recovery resources after the event. For instance, there is an increasing consensus about key findings of the effects and connections of the global burden of disease, as it generates substantial healthcare costs, consumes essential resources and prevents the attainment of optimal health and well-being. The goal of this research endeavor is to promote a comprehensive understanding of the connections between social, environmental, and economic influences on health. These connections are illustrated by pulling from clearly the core curriculum of multidisciplinary areas —as urban design, energy, housing, and economy— as well as in the health system itself. A systematic review of primary and secondary data included a variety of issues as global health, natural disasters, and critical pollution impacts on people's health and the ecosystems. Environmental health is challenged by the unsustainable consumption patterns and the resulting contaminants that abound in many cities and urban settings around the world. Poverty, inadequate housing, and poor health are usually linked. The house is a primary environmental health context for any individual and especially for more vulnerable groups; such as children, older adults and those who are sick. Nevertheless, very few countries show strong decoupling of environmental degradation from economic growth, as indicated by a recent 2017 Report of the World Bank. Worth noting, the environmental fraction of the global burden of disease in a 2016 World Health Organization (WHO) report estimated that 12.6 million global deaths, accounting for 23% (95% CI: 13-34%) of all deaths were attributable to the environment. Among the environmental contaminants include heavy metals, noise pollution, light pollution, and urban sprawl. Those key findings make a call to the significance to urgently adopt in a global scale the United Nations post-2015 Sustainable Development Goals (SDGs). The SDGs address the social, environmental, and economic factors that influence health and health inequalities, advising how these sectors, in turn, benefit from a healthy population. Consequently, more actions are necessary from an inter-sectoral and systemic paradigm to enforce an integrated sustainability policy implementation aimed at the environmental, social, and economic determinants of health.

Keywords: building capacity for workforce development, ecological and environmental health effects of pollution, public health education, sustainability

Procedia PDF Downloads 89

Authors: Caitlin Bailey, Marian Frattarola Saulino, Beth Steinberg

Abstract:

Today, virtually all programs offered to people with intellectual and developmental disabilities tout themselves as person-centered, community-based and inclusive, yet there is a vast range in type and quality of services that use these similar descriptors. The issue is exacerbated by the fields’ measurement practices around quality, inclusion, independent living, choice and person-centered outcomes. For instance, community inclusion for people with disabilities is often measured by the number of times person steps into his or her community. These measurement approaches set standards for quality too low so that agencies supporting group home residents to go bowling every week can report the same outcomes as an agency that supports one person to join a book club that includes people based on their literary interests rather than disability labels. Ultimately, lack of delineation in measurement contributes to the confusion between face value “quality” and true quality services and supports for many people with disabilities and their families. This exploratory study adopts alternative approaches to quality measurement including co-production methods and systems theoretical framework in order to identify the factors that 1) lead to high-quality supports and, 2) differentiate high-quality services. Project researchers have partnered with community practitioners who are all committed to providing quality services and supports but vary in the degree to which they are actually able to provide them. The study includes two parts; first, an online survey distributed to more than 500 agencies that have demonstrated commitment to providing high-quality services; and second, four in-depth case studies with agencies in three United States and Israel providing a variety of supports to children and adults with disabilities. Results from both the survey and in-depth case studies were thematically analyzed and coded. Results show that there are specific factors that differentiate service quality; however meaningful quality measurement practices also require that researchers explore the contextual factors that contribute to quality. These not only include direct services and interactions, but also characteristics of service users, their environments as well as organizations providing services, such as management and funding structures, culture and leadership. Findings from this study challenge researchers, policy makers and practitioners to examine existing quality service standards and measurements and to adopt alternate methodologies and solutions to differentiate and scale up evidence-based quality practices so that all people with disabilities have access to services that support them to live, work, and enjoy where and with whom they choose.

Keywords: co-production, inclusion, independent living, quality measurement, quality supports

Procedia PDF Downloads 374

Authors: Selin Top, Raul Marcos, M. Sinan Bilgili

Abstract:

Although there have been several studies related to collection, temporary storage, handling and disposal of solid wastes generated by hospitals, there are only a few studies related to liquid wastes generated by hospitals or hospital wastewaters. There is an important amount of water consumptions in hospitals. While minimum domestic water consumption per person is 100 L/day, water consumption per bed in hospitals is generally ranged between 400-1200 L. This high amount of consumption causes high amount of wastewater. The quantity of wastewater produced in a hospital depends on different factors: bed numbers, hospital age, accessibility to water, general services present inside the structure (kitchen, laundry, laboratory, diagnosis, radiology, and air conditioning), number and type of wards and units, institution management policies and awareness in managing the structure in safeguarding the environment, climate and cultural and geographic factors. In our country, characterization of hospital wastewaters conducted by classical parameters in a very few studies. However, as mentioned above, this type of wastewaters may contain different compounds than domestic wastewaters. Hospital Wastewater (HWW) is wastewater generated from all activities of the hospital, medical and non medical. Nowadays, hospitals are considered as one of the biggest sources of wastewater along with urban sources, agricultural effluents and industrial sources. As a health-care waste, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components due to using disinfectants, pharmaceuticals, radionuclides and solvents making not suitable the connection of hospital wastewater to the municipal sewage network. These characteristics may represent a serious health hazard and children, adults and animals all have the potential to come into contact with this water. Therefore, the treatment of hospital wastewater is an important current interest point to focus on. This paper aims to approach on the investigation of hospital wastewater treatment by membrane systems. This study aim is to determined hospital wastewater’s characterization and also evaluates the efficiency of hospital wastewater treatment by high pressure filtration systems such as ultrafiltration (UF). Hospital wastewater samples were taken directly from sewage system from Şişli Etfal Training and Research Hospital, located in the district of Şişli, in the European part of Istanbul. The hospital is a 784 bed tertiary care center with a daily outpatient department of 3850 patients. Ultrafiltration membrane is used as an experimental treatment and the influence of the pressure exerted on the membranes was examined, ranging from 1 to 3 bar. The permeate flux across the membrane was observed to define the flooding membrane points. The global COD and BOD5 removal efficiencies were 54% and 75% respectively for ultrafiltration, all the SST removal efficiencies were above 90% and a successful removal of the pathological bacteria measured was achieved.

Keywords: hospital wastewater, membrane, ultrafiltration, treatment

Procedia PDF Downloads 281

Authors: Rupali Bhatia, Deepthi Nair, Geetika Khanna, Seema Singhal

Abstract:

Introduction: Genital tract tuberculosis is a chronic disease (caused by reactivation of organisms from systemic distribution of Mycobacterium tuberculosis) that often presents with low grade symptoms and non-specific complaints. Patients with genital tuberculosis are usually young women seeking workup and treatment for infertility. Infertility is the commonest presentation due to involvement of the fallopian tubes, endometrium and ovarian damage with poor ovarian volume and reserve. The diagnosis of genital tuberculosis is difficult because of the fact that it is a silent invader of genital tract. Since tissue cannot be obtained from fallopian tubes, the diagnosis is made by isolation of bacilli from endometrial tissue obtained by endometrial biopsy curettage and/or aspiration. Problems are associated with sampling technique as well as diagnostic modality due to lack of adequate sample volumes and the segregation of the sample for various diagnostic tests resulting in non-uniform distribution of microorganisms. Moreover, lack of an efficient sampling technique universally applicable for all specific diagnostic tests contributes to the diagnostic challenges. Endometrial sampling plays a key role in accurate diagnosis of female genital tuberculosis. It may be done by 2 methods viz. endometrial curettage and endometrial aspiration. Both endometrial curettage and aspirate have their own limitations as curettage picks up strip of the endometrium from one of the walls of the uterine cavity including tubal osteal areas whereas aspirate obtains total tissue with exfoliated cells present in the secretory fluid of the endometrial cavity. Further, sparse and uneven distribution of the bacilli remains a major factor contributing to the limitations of the techniques. The sample that is obtained by either technique is subjected to histopathological examination, AFB staining, culture and PCR. Aim: Comparison of the sampling techniques viz. endometrial biopsy curettage and endometrial aspiration using different laboratory methods of histopathology, cytology, microbiology and molecular biology. Method: In a hospital based observational study, 75 Indian females suspected of genital tuberculosis were selected on the basis of inclusion criteria. The women underwent endometrial tissue sampling using Novaks biopsy curette and Karmans cannula. One part of the specimen obtained was sent in formalin solution for histopathological testing and another part was sent in normal saline for acid fast bacilli smear, culture and polymerase chain reaction. The results so obtained were correlated using coefficient of correlation and chi square test. Result: Concordance of results showed moderate agreement between both the sampling techniques. Among HPE, AFB and PCR, maximum sensitivity was observed for PCR, though the specificity was not as high as other techniques. Conclusion: Statistically no significant difference was observed between the results obtained by the two sampling techniques. Therefore, one may use either EA or EB to obtain endometrial samples and avoid multiple sampling as both the techniques are equally efficient in diagnosing genital tuberculosis by HPE, AFB, culture or PCR.

Keywords: acid fast bacilli (AFB), histopatholgy examination (HPE), polymerase chain reaction (PCR), endometrial biopsy curettage

Procedia PDF Downloads 309

Authors: Mohsina Aktar, Bishawjit Mallick

Abstract:

Bangladesh faces the multidimensional manifestations of climate change e.g. flood, cyclone, sea level rise, drainage congestion, salinity, etc. This study aimed at to find out the community’s perception of the perceived impact of climate change on their wetland resource based livelihood, to analyze their present livelihood scenario and to find out required institutional setup to strengthen present livelihood scenario. Therefore, this study required both quantitative analysis like quantification of wetland resources, occupation, etc. and also exploratory information like policy and institutional reform. For quantitative information 200 questionnaire survey and in some cases observation survey and for socially shareable qualitative and quantitative issues case study and focus group discussion were conducted. In-Depth interview was conducted for socially non-shareable qualitative issues. The overall findings of this study have been presented maintaining a sequence- perception about climate change effect, livelihood scenario and required institutional support of the wetland community. Flood has been ranked where cyclone effect is comparatively less disastrous in this area. Heavy rainfall comes after the cyclone. Female members responded almost same about the ranking and effects of frequently occurred and devastating effects of climate change. People are much more aware of the impact of climate change. Training of Care in RVCC project helps to increase their knowledge level. If the level of education can be increased, people can fight against calamity and poverty with more confidence. People seem to overcome the problems of water logging and thus besides involving in Hydroponics (33.3%) as prime occupation in monsoon; they are also engaged in other business related activities. January to May is the low-income season for the farmers. But some people don’t want to change their traditional occupation and their age is above 45. The young earning member wants to utilize their lean income period by alternative occupation. People who do not have own land and performing water transportation or other types of occupation are now interested about Hydroponics. People who give their land on rent are now thinking about renting their land in monsoon as through that they can earn a sound amount rather than get nothing. What they require is just seed, training, and capital. Present marketing system faces the problem of communication. So this sector needed to be developed. Involvement of women in income earning activity is very low (5.1%), and 100% women are housewives. They became inferior due to their educational level and dominance of their husband. Only one NGO named BCAS (Bangladesh Center for Advanced Studies) has been found engage training facilities and advocacy for this purpose. Upazilla agricultural extension office like other GO remains inactive to give support the community for extension and improvement of Hydroponics agriculture. If the community gets proper support and inspiration, they can fight against crisis of low-income and climate change, with the Hydroponics cultivation system successfully.

Keywords: wetland community, hydroponics, climate change adaptation, livelihood

Procedia PDF Downloads 251

Authors: Khaled Alabduljabbar

Abstract:

Background: Benign, isolated, recurrent sixth nerve palsy is very rare in children. Here we report a case of recurrent abducens nerve palsy with no obvious etiology. It is a diagnosis of exclusion. A recurrent benign form of 6th nerve palsy, a rarer still palsy, has been described in the literature, and it is of most likely secondary to inflammatory causes, e.g, following viral and bacterial infections. Purpose: To present a case of 14 months old girl with recurrent attacks of isolated left sixth cranial nerve palsy following upper respiratory tract infection. Observation: The patient presented to opthalmology clinic with sudden onset of inward deviation (esotropia) of the left eye with a compensatory left face turn one week following signs of upper respiratory tract infection. Ophthalmological examination revealed large angle esotropia of the left eye in primary position, with complete limitation of abduction of the left eye, no palpebral fissure changes, and abnormal position of the head (left face turn). Visual acuity was normal, and no significant refractive error on cycloplegic refraction for her age. Fundus examination was normal with no evidence of papilledema. There was no relative afferent pupillary defect (RAPD) and no anisocoria. Past medical history and family history were unremarkable, with no history of convulsion attacks or head trauma. Additional workout include CBC. Erythrocyte sedimentation rate, Urgent magnetic resonance imaging (MRI), and angiography of the brain were performed and demonstrated the absence of intracranial and orbital lesions. Referral to pediatric neurologist was also done and concluded no significant finding. The patient showed improvement of the left sixth cranial nerve palsy and left face turn over a period of two months. Seven months since the first attack, she experienced a recurrent attack of left eye esotropia with left face turn concurrent with URTI. The rest of eye examination was again unremarkable. CT scan and MRI scan of brain and orbit were performed and showed only signs of sinusitis with no intracranial pathology. The palsy resolved spontaneously within two months. A third episode of left 6th nerve palsy occurred 6 months later, whichrecovered over one month. Examination and neuroimagingwere unremarkable. A diagnosis of benign recurrent left 6th cranial nerve palsy was made. Conclusion: Benign sixth cranial nerve palsy is always a diagnosis of exclusion given the more serious and life-threatening alternative causes. It seems to have a good prognosis with only supportive measures. The likelihood of benign 6th cranial nerve palsy to resolve completely and spontaneously is high. Observation for at least 6 months without intervention is advisable.

Keywords: 6th nerve pasy, abducens nerve pasy, recurrent nerve palsy, cranial nerve palsy

Procedia PDF Downloads 69

Authors: Laura E. Hall, Joel Monárrez-Espino, Luz María Tejada Tayabas

Abstract:

College students are at risk of weight gain and poor dietary habits, and health behaviours established during this period have been shown to track into midlife. They may therefore be an important target group for health promotion strategies, yet there is a lack of literature regarding dietary intakes and associated factors in this group, particularly in middle-income countries such as Mexico. The aim of this exploratory research was to describe and compare reported dietary intakes among nursing and nutrition college students at two public universities in Mexico, and to explore the relationship between demographic, behavioural and other health-related factors and the risk of low diet quality. Mexican college students (n=444) majoring in nutrition or nursing at two urban universities completed questionnaires regarding dietary and health-related behaviours and risks. Dietary intake was assessed via 24-hour recall. Weight, height and abdominal circumference were measured. Descriptive statistics were reported and nutrient intakes were compared between colleges and study tracks using Student’s t tests, odds ratios and Pearson chi square tests. Two dietary quality scores were constructed to explore the relationship between demographic, behavioural and other health-related factors and the diet quality scores using binary logistic regression. Analysis was performed using SPSS statistics, with differences considered statistically significant at p<0.05. The response rate to the survey was 91%. When macronutrients were considered as a percentage of total energy, the majority of students had protein intakes within recommended ranges, however one quarter of students had carbohydrate and fat intakes exceeding recommended levels. Three quarters had fibre intakes that were below recommendations. More than half of the students reported intakes of magnesium, zinc, vitamin A, folate and vitamin E that were below estimated average requirements. Students studying nutrition reported macronutrient and micronutrient intakes that were more compliant with recommendations compared to nursing students, and students studying in central-north Mexico were more compliant than those studying in southeast Mexico. Breakfast skipping (Adjusted Odds Ratio (OR) = 5.3; 95% Confidence Interval (CI) = 1.2-22.7), risk of anxiety (OR = 2.3; CI = 1.3-4.4), and university location (OR = 1.6; CI = 1.03-2.6) were associated with a greater risk of having a low macronutrient score. Caloric intakes <1800kcal (OR = 5.8; CI = 3.5-9.7), breakfast skipping (OR = 3.7; CI = 1.4-10.3), vigorous exercise ≤1h/week (OR = 2.6; CI = 1.3-5.2), soda consumption >250mls/day (OR = 2.0; CI = 1.2-3.3), unhealthy diet perception (OR = 1.9; CI = 1.2-3.0), and university location (OR = 1.8; CI = 1.1-2.8) were significantly associated with greater odds of having a low micronutrient score. College students studying nursing and nutrition did not report ideal diets, and these students should not be overlooked in public health interventions. Differences in dietary intakes between universities and study tracks were evident, with more favourable profiles evident in nutrition compared to nursing, and North-central compared to Southeast students. Further, demographic, behavioural and other health-related factors were associated with diet quality scores, warranting further research.

Keywords: college student, diet quality, nutrient intake, young adult

Procedia PDF Downloads 435

Authors: Matias Hargreaves, Martin Del Valle, Diego Rodriguez, Riveros Jose Luis

Abstract:

Trough years, all kind of social development projects have tried to solve social problems such as hunger, poverty, malnutrition, food insecurity, among others, with poor success. Both private and state initiatives have invested resources in several countries and communities. Nevertheless, most of these initiatives are scientific or external developers-centered, with a lack of local participation. This compromises the sustainability of any intervention and also leads to a poor empowerment of local community. The participatory approach aims to rescue and enhance the local knowledge since it recognizes that this kind of problems are better known by native actors. The objective of the study was to describe the role played by the community empowerment on food security improvement in the NGO “O Viveiro” (15°43'37.77"S; 32°46'27.53"E) and Barrio Broma village (15°43'58.78"S; 32°46'7.27"E) in Chitima, Mozambique. A center for training in goat livestock and orchard was build. A community orchard was co-constructed between foreign technicians and local actors. The prototype was installed in February, 2016 by the technician team and local community with 16 m2 as a nursery garden. Two orchard workshops were conducted in order to design a sustainable productive model which mixes both local and technological approaches. Two goat meat workshops were conducted in order to describe local methods and train the community to conduce their own techniques with high sanitary and productive standards. Technician team stayed in Mozambique until May, 2016. The quorum for the orchard workshops was 20 and 14 persons respectively, which represents 100% and 70%of the total requested quorum (20). For the goat meat workshops were 4 and 5 persons, which representa80% and 100% of the total requested quorum (5). Until August, 2016, the orchard is 3.219 m2 and it grows several vegetables as beans, chili pepper, garlic, onion, tomatoes, lettuce, sweet potato, yuca potato, cabbage, eggplant, papaya trees, mango, and cassava. The process of increasing in size and diversification of vegetables grown was led entirely by the local community. In connection with this, the local community started to harvest and began to sell the vegetable products at the local market. At the meat goat workshops, local participants rescued a local knowledge by describing and practicing a traditional way to process goat meat by drying it outdoors and then doing a smoked treatment. This information might contribute to describe the level of empowerment of this community, and thus give evidence of acceptance of foreign intervention for improving their own proceedings and traditions.

Keywords: children malnutrition, food security, Local community, participatory approach

Procedia PDF Downloads 257

Authors: Abiola O. Temitayo-Oboh, Olugbenga L. Abodunrin, Wasiu O. Adebimpe, Micheal C. Asuzu

Abstract:

Introduction: Many women who are sexually active would prefer to avoid becoming pregnant but are not using any method of contraception. These women are considered to have an unmet need for contraception. In an ideal situation, all women who want to space or limit their births and are exposed to the risk of conception would use some kind of conception; in practice, however, some women fail to use contraception which put them at risk of having mistimed or unwanted births, induced abortion, or maternal death. This study, therefore, aimed to assess the determinants of unmet need for contraception among currently married women in rural and urban communities of Osun State, South-West Nigeria. Methods: This was an analytical cross-sectional comparative study, which was carried out among currently married women. Three hundred and twenty respondents each were selected for the rural and urban groups from four Local Government Areas using multi-stage sampling technique. Data were collected using a pre-tested semi-structured interviewer-administered questionnaire and focus group discussion (FGD) guide; data analysis was done with Statistical Package for Social Sciences (SPSS) version 17.0 and detailed content analysis method respectively. Statistical analysis of the difference between proportions was done by the use of the Chi-square test and T-test was used to compare the means of the continuous variables. The study also utilized descriptive, bivariate and multivariate analytical techniques to examine the effect of some variables on unmet need. Level of statistical significance was set at p-value < 0.05 for all values. Results: Two hundred and ninety-six (92.5%) of the rural and 306 (95.6%) of the urban study population had heard of contraception, 365 (57.0 %) of the total respondents had good knowledge [162 (50.6 %) for rural respondents and 203 (63.4 %) for urban respondents]. This difference was statistically significant (p < 0.001). Five hundred and twenty-one (81.4%) respondents had a positive attitude towards contraception [243 (75.9%) in the rural and 278 (86.9%) in the urban area], and the difference was also statistically significant (p < 0.001). Only 47 (14.7%) and 59 (18.4%) of rural and urban women were current contraceptive users respectively. The total unmet need for contraception among rural women was 138 (43.1%) of which 82 (25.6%) was for spacing and 56 (17.5%), for limiting. While the total unmet need for contraception among urban women was 145 (45.3%) of which 96 (30.0%) was for spacing and 49 (15.3%) for limiting. Number of living children, knowledge of contraceptive methods, discussion with health workers about family planning, couples discussion about family planning and availability of family planning services were found to be predictors of women’s unmet need for contraception (p < 0.05). Conclusion: It is, therefore, recommended that there is need to intensify reproductive health education in bridging the knowledge gap, improving attitude and modifying practices regarding use of contraception in Nigeria. Hence, this will help to enhance the utilization of family planning services among Nigerian women.

Keywords: contraception, married women, Nigeria, rural, urban, unmet need

Procedia PDF Downloads 174