Search results for: refugee status determination

Authors: Alla Ovsyannikova, Oksana Rymar, Elena Shakhtshneider, Mikhail Voevoda

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In Siberia endocrinologists increasingly noted young patients with the course of diabetes mellitus differing from 1 and 2 types. Therefore we did a molecular genetic study for this group of patients to verify the monogenic forms of diabetes mellitus in them and researched the characteristics of this pathology. When confirming the monogenic form of diabetes, we performed a correction therapy for many patients (transfer from insulin to tablets), prevented specific complications, examined relatives and diagnosed their diabetes at the preclinical stage, revealed phenotypic characteristics of the pathology which led to the high significance of this work. Materials and Methods: We observed 5 patients (4 families). We diagnosed MODY (Maturity Onset Diabetes of the Young) during the molecular genetic testing (direct automatic sequencing). All patients had a full clinical examination, blood samples for biochemical research, determination of C-peptide and TSH, antibodies to b-cells, microalbuminuria, abdominal ultrasound, heart and thyroid ultrasound, examination of ophthalmologist. Results: We diagnosed 3 rare types of MODY: two women had MODY8, one man – MODY6 and man and his mother - MODY12. Patients with types 8 and 12 had clinical features. Age of onset hyperglycemia ranged from 26 to 34 years. In a patient with MODY6 fasting hyperglycemia was detected during a routine examination. Clinical symptoms, complications were not diagnosed. The patient observes a diet. In the first patient MODY8 was detected during first pregnancy, she had itchy skin and mostly postprandial hyperglycemia. Upon examination we determined glycated hemoglobin 7.5%, retinopathy, non-proliferative stage, peripheral neuropathy. She uses a basic bolus insulin therapy. The second patient with MODY8 also had clinical manifestations of hyperglycemia (pruritus, thirst), postprandial hyperglycemia and diabetic nephropathy, a stage of microalbuminuria. The patient was diagnosed autoimmune thyroiditis. She used inhibitors of DPP-4. The patient with MODY12 had an aggressive course. In the detection of hyperglycemia he had complaints of visual impairment, intense headaches, leg cramps. The patient had a history of childhood convulsive seizures of non-epileptic genesis, without organic pathology, which themselves were stopped at the age of 12 years. When we diagnosed diabetes a patient was 28 years, he had hypertriglyceridemia, atherosclerotic plaque in the carotid artery, proliferative retinopathy (lacerocoagulation). Diabetes and early myocardial infarction were observed in three cases in family. We prescribe therapy with sulfonylureas and SGLT-2 inhibitors with a positive effect. At the patient's mother diabetes began at a later age (30 years) and a less aggressive course was observed. She also has hypertriglyceridemia and uses oral hypoglycemic drugs. Conclusions: 1) When young patients with hyperglycemia have extrapancreatic pathologies and diabetic complications with a short duration of diabetes we can assume they have one of type of MODY diabetes. 2) In patients with monogenic forms of diabetes mellitus, the clinical manifestations of hyperglycemia in each succeeding generation are revealed at an earlier age. Research had increased our knowledge of the monogenic forms of diabetes. The reported study was supported by RSCF, research project No. 14-15-00496-P.

Keywords: diabetes mellitus, MODY diabetes, monogenic forms, young patients

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Authors: Racheli Magnezi, Inbal Gazit, Michal Rassin, Joseph Barr, Orna Tal

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An effective process for transmitting patient critical information is essential for patient safety and for improving communication among healthcare staff. Previous studies have discussed handover tools such as SBAR (Situation, Background, Assessment, Recommendation) or SOFI (Short Observational Framework for Inspection). Yet, these formats lack flexibility, and require special training. In addition, nurses and physicians have different procedures for handing over information. The objectives of this study were to establish a universal, structured tool for handover, for both physicians and nurses, based on parameters that were defined as ‘important’ and ‘appropriate’ by the medical team, and to implement this tool in various hospital departments, with flexibility for each ward. A questionnaire, based on established procedures and on the literature, was developed to assess attitudes towards the most important information for effective handover between shifts (Cronbach's alpha 0.78). It was distributed to 150 senior physicians and nurses in 62 departments. Among senior medical staff, 12 physicians and 66 nurses responded to the questionnaire (52% response rate). Based on the responses, a handover form suitable for all hospital departments was designed and implemented. Important information for all staff included: Patient demographics (full name and age); Health information (diagnosis or patient complaint, changes in hemodynamic status, new medical treatment or equipment required); and Social Information (suspicion of violence, mental or behavioral changes, and guardianship). Additional information relevant to each unit included treatment provided, laboratory or imaging required, and change in scheduled surgery in surgical departments. ICU required information on background illnesses, Pediatrics required information on diet and food provided and Obstetrics required the number of days after cesarean section. Based on the model described, a flexible tool was developed that enables handover of both common and unique information. In addition, it includes general logistic information that must be transmitted to the next shift, such as planned disruptions in service or operations, staff training, etc. Development of a simple, clear, comprehensive, universal, yet flexible tool designed for all medical staff for transmitting critical information between shifts was challenging. Physicians and nurses found it useful and it was widely implemented. Ongoing research is needed to examine the efficiency of this tool, and whether the enthusiasm that accompanied its initial use is maintained.

Keywords: handover, nurses, hospital, critical information

Procedia PDF Downloads 249

Authors: Sarah Elshahat, Tina Moffat

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Suboptimal mental health is a considerable global public health challenge that leads to considerable inequalities worldwide. Newcomers are at elevated risk for developing mental health issues as a result of social exclusion, stigmatization, racism, unequal employment opportunities, and discrimination. The problem can be especially serious amongst Arabic-speaking immigrants and refugees (ASIR) whose mental wellness may have already been affected by exposure to political violence, persecution, hunger or war in their countries of origin. A scoping review was conducted to investigate pre- and post-migration mental health determinants amongst ASIR in North America (the U.S. and Canada), who are a rapidly growing population in both regions. Pertinent peer-reviewed papers and grey literature were located through a systematic search of five electronic databases (Medline, Embase, PsycINFO, Anthropology Plus, and Sociology Database). A stakeholder consultation was implemented to validate the analyzed findings of the included 44 studies. About 80% of the studies were carried out in the US, underscoring a lack of Canadian ASIR-mental health research. A gap in qualitative, mixed-method, and longitudinal research was detected, where approximately two-thirds of the studies adopted a cross-sectional method. Pre-migration determinants of mental health were related to the political unrest, violence and armed conflict in the Arab world, increasing post-traumatic stress disorder and psychological distress levels among ASIR. English language illiteracy and generational variations in acculturation patterns were major post-migration mental health triggering factors. Exposure to domestic violence, stigmatization, poverty, racialization, and harassment were significant post-migration mental health determinants that stem from social inequalities, triggering depression, and distress amongst ASIR. Family conflicts linked to child-rearing and gendered norms were considered as both pre- and post-migration mental health triggering factors. Most post-migration mental health protective factors were socio-culturally related and included the maintenance of positive ethnic identity, faith, family support, and community cohesion. Individual resilience, articulated as self-esteem and hope, was a significant negative predictor of depression and psychological distress among ASIR. Community-engaged, mixed-methods, and longitudinal studies are required to address the current gap in mental health research among ASIR in North America. A more thorough determination of potential mental health triggers and protective factors would help inform the development of mental wellness and resilience-promoting programs that are culturally sensitive to ASIR. On the policy level, the Health in All Policies framework of the World Health Organization can be potentially useful for addressing social and health inequalities among ASIR, reducing mental health challenges.

Keywords: depression, post-traumatic stress disorder, psychological distress, resilience

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Authors: Najeebullah Soomro, Habib Noorbhai, Mariam Soomro, Ross Sanders

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The demands on cricketers are increasing with more matches being played in a shorter period of time with a greater intensity. A ten year report on injury incidence for Australian elite cricketers between the 2000- 2011 seasons revealed an injury incidence rate of 17.4%.1. In the 2009–10 season, 24 % of Australian fast bowlers missed matches through injury. 1 Injury rates are even higher in junior cricketers with an injury incidence of 25% or 2.9 injuries per 100 player hours reported. 2 Traditionally, injury surveillance has relied on the use of paper based forms or complex computer software. 3,4 This makes injury reporting laborious for the staff involved. The purpose of this presentation is to describe a smartphone based mobile application as a means of improving injury surveillance in cricket. Methods: The researchers developed CricPredict mobile App for the Android platforms, the world’s most widely used smartphone platform. It uses Qt SDK (Software Development Kit) as IDE (Integrated Development Environment). C++ was used as the programming language with the Qt framework, which provides us with cross-platform abilities that will allow this app to be ported to other operating systems (iOS, Mac, Windows) in the future. The wireframes (graphic user interface) were developed using Justinmind Prototyper Pro Edition Version (Ver. 6.1.0). CricPredict enables recording of injury and training status conveniently and immediately. When an injury is reported automated follow-up questions include site of injury, nature of injury, mechanism of injury, initial treatment, referral and action taken after injury. Direct communication with the player then enables assessment of severity and diagnosis. CricPredict also allows the coach to maintain and track each player’s attendance at matches and training session. Workload data can also be recorded by either the player or coach by recording the number of balls bowled or played in a day. This is helpful in formulating injury rates and time lost due to injuries. All the data are stored at a secured password protected data server. Outcomes and Significance: Use of CricPredit offers a simple, user friendly tool for the coaching or medical staff associated with teams to predict, record and report injuries. This system will assist teams to capture injury data with ease thus allowing better understanding of injuries associated with cricket and potentially optimize the performance of such cricketers.

Keywords: injury, cricket, surveillance, smartphones, mobile

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Authors: Abel Sichinava

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The need for organ transplantation is vigorously increasing worldwide. The numbers on the waiting lists grow, but the number of donors is not keeping up with the demand even though there is a legal possibility of decreasing the gap between the demand and supply. Most countries around the globe are facing an organ donation problem (living or deceased); however, the extent of the problem differs based on how well developed a country is. The determining issues seem to be centered on how aware the society is about the concept of organ donation, as well as cultural and religious factors. Even if people are aware of the benefits of organ donation, they may still have fears that keep them from being in complete agreement with the idea. Some believe that in the case of deceased organ donation: “the brain dead human body may recover from its injuries” or “the sick might get less appropriate treatment if doctors know they are potential donors.” In the case of living organ donations, people sometimes fear that after the donation, “it might reduce work efficiency, cause health deterioration or even death.” Another major obstacle in the organ shortage is a lack of a well developed ethical framework. In reality, there are truly an immense number of people on the waiting list, and they have only two options in order to receive a suitable organ. First is the legal way, which is to wait until their turn. Sadly, numerous patients die while on the waiting list before an appropriate organ becomes available for transplant. The second option is an illegal way: seeking an organ in a country where they can possibly get. To tell the truth, in people’s desire to live, they may choose the second option if their resources are sufficient. This process automatically involves “organ brokers.” These are people who get organs from vulnerable poor people by force or betrayal. As mentioned earlier, the high demand and low supply leads to human trafficking. The subject of the study was the large number of society from different backgrounds of their belief, culture, nationality, level of education, socio-economic status. The great majority of them interviewed online used “Google Drive Survey” and others in person. All statistics and information gathered from trusted sources annotated in the reference list and above mentioned considerable testimonies shared by the respondents are the fundamental evidence of a lack of the well developed ethical framework. In conclusion, the continuously increasing number of people on the waiting list and an irrelevant ethical framework, lead people to commit to atrocious, dehumanizing crimes. Therefore, world society should be equally obligated to think carefully and make vital decisions together for the advancement of an organ donations and its ethical framework.

Keywords: donation, ethical framwork, organ, transplant

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Authors: Maria Sciammarella, Uttam M. Shrestha, Youngho Seo, Grant T. Gullberg, Elias H. Botvinick

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Background: Myocardial perfusion imaging (MPI) is typically performed with static imaging protocols and visually assessed for perfusion defects based on the relative intensity distribution. Dynamic cardiac SPECT, on the other hand, is a new imaging technique that is based on time varying information of radiotracer distribution, which permits quantification of myocardial blood flow (MBF). In this abstract, we report a progress and current status of dynamic cardiac SPECT using conventional gamma camera (Infinia Hawkeye 4, GE Healthcare) for estimation of myocardial blood flow and coronary flow reserve. Methods: A group of patients who had high risk of coronary artery disease was enrolled to evaluate our methodology. A low-dose/high-dose rest/pharmacologic-induced-stress protocol was implemented. A standard rest and a standard stress radionuclide dose of ⁹⁹ᵐTc-tetrofosmin (140 keV) was administered. The dynamic SPECT data for each patient were reconstructed using the standard 4-dimensional maximum likelihood expectation maximization (ML-EM) algorithm. Acquired data were used to estimate the myocardial blood flow (MBF). The correspondence between flow values in the main coronary vasculature with myocardial segments defined by the standardized myocardial segmentation and nomenclature were derived. The coronary flow reserve, CFR, was defined as the ratio of stress to rest MBF values. CFR values estimated with SPECT were also validated with dynamic PET. Results: The range of territorial MBF in LAD, RCA, and LCX was 0.44 ml/min/g to 3.81 ml/min/g. The MBF between estimated with PET and SPECT in the group of independent cohort of 7 patients showed statistically significant correlation, r = 0.71 (p < 0.001). But the corresponding CFR correlation was moderate r = 0.39 yet statistically significant (p = 0.037). The mean stress MBF value was significantly lower for angiographically abnormal than that for the normal (Normal Mean MBF = 2.49 ± 0.61, Abnormal Mean MBF = 1.43 ± 0. 0.62, P < .001). Conclusions: The visually assessed image findings in clinical SPECT are subjective, and may not reflect direct physiologic measures of coronary lesion. The MBF and CFR measured with dynamic SPECT are fully objective and available only with the data generated from the dynamic SPECT method. A quantitative approach such as measuring CFR using dynamic SPECT imaging is a better mode of diagnosing CAD than visual assessment of stress and rest images from static SPECT images Coronary Flow Reserve.

Keywords: dynamic SPECT, clinical SPECT/CT, selective coronary angiograph, ⁹⁹ᵐTc-Tetrofosmin

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Authors: Kayliegh Richardson, Ana Speed

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The international campaign, '16 Days of Activism against Gender Based Violence', seeks to raise awareness and understanding of gender based violence in a variety of settings. The campaign requires its participants to join in for advancing the right to education and challenging violence, discrimination, and inequality and take into account intersections such as gender, race, ethnicity, religion, sexual orientation, socio-economic status and other social identifiers. The authors of this paper are both clinic supervisors at Northumbria University in Newcastle Upon Tyne, England. As part of their research project, the authors are going to ask final year students on the MLaw degree at Northumbria University to become involved in the campaign by participating in a variety of awareness-raising activities during the course of the 16 days, which runs from 27 November 2017 until 10 December 2017. As part of the campaign, the authors will be running the following activities for students to participate in 1. Documentary showing of Banaz, a love story followed by discussion group. 2. 16 blogs for 16 days. Students will contribute to our family law blog over the 16 days, with articles about gender based violence. 3. Guest lecture on domestic violence (potentially run by a domestic violence organisation) 4. Workshop by Professor Ruth Lewis who will be presenting her innovative research in gender based violence and online abuse. 5. Poster competition - the students are asked to submit a poster about the different forms of gender based violence or proposals for ending violence against women and girls. The research aims are to identify whether participation in the project: 1. increases the students' engagement with issues of gender justice 2. is an effective educational tool for raising the students' awareness and understanding of gender based violence in its many forms. 3. increases the students' understanding of the domestic and international framework for protecting victims (in particular women and children) of gender based violence. After the activities, an impartial, experienced researcher will be holding a focus group with volunteering students to discuss their experiences of participating in the activities and whether they felt that participation in the project achieved the aims set out above. This paper will discuss the activities undertaken by the students and will address the data gathered during the focus group. Finally, the authors will discuss their thoughts on whether awareness of gender-based violence and other international family law issues can be appropriately raised in an educational setting.

Keywords: gender based violence, clinical legal education, international family law, domestic abuse

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Authors: Ruth Hegarty, Noel Connaughton

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Sustainability reporting has become a priority for many global multinational companies. This is associated with ever-increasing expectations from key stakeholders for companies to be transparent about their strategies, activities and management with regard to sustainability issues. The Global Reporting Initiative (GRI) encourages reporters to only provide information on the issues that are really critical in order to achieve the organisation’s goals for sustainability and manage its impact on environment and society. A key challenge for most reporting organisations is how to identify relevant issues for sustainability reporting and prioritise those material issues in accordance with company and stakeholder needs. A recent study indicates that most of the largest companies listed on the world’s stock exchanges are failing to provide data on key sustainability indicators such as employee turnover, energy, greenhouse gas emissions (GHGs), injury rate, pay equity, waste and water. This paper takes an indepth look at the approaches used by a select number of international sustainability leader corporates to identify key sustainability issues. The research methodology involves performing a detailed analysis of the sustainability report content of up to 50 companies listed on the 2014 Dow Jones Sustainability Indices (DJSI). The most recent sustainability report content found on the GRI Sustainability Disclosure Database is then compared with 91 GRI Specific Standard Disclosures and a small number of GRI Standard Disclosures. Preliminary research indicates significant gaps in the information disclosed in corporate sustainability reports versus the indicator content specified in the GRI Content Index. The following outlines some of the key findings to date: Most companies made a partial disclosure with regard to the Economic indicators of climate change risks and infrastructure investments, but did not focus on the associated negative impacts. The top Environmental indicators disclosed were energy consumption and reductions, GHG emissions, water withdrawals, waste and compliance. The lowest rates of indicator disclosure included biodiversity, water discharge, mitigation of environmental impacts of products and services, transport, environmental investments, screening of new suppliers and supply chain impacts. The top Social indicators disclosed were new employee hires, rates of injury, freedom of association in operations, child labour and forced labour. Lesser disclosure rates were reported for employee training, composition of governance bodies and employees, political contributions, corruption and fines for non-compliance. The reporting on most other Social indicators was found to be poor. In addition, most companies give only a brief explanation on how material issues are defined, identified and ranked. Data on the identification of key stakeholders and the degree and nature of engagement for determining issues and their weightings is also lacking. Generally, little to no data is provided on the algorithms used to score an issue. Research indicates that most companies lack a rigorous and thorough methodology to systematically determine the material issues of sustainability reporting in accordance with company and stakeholder needs.

Keywords: identification of key stakeholders, material issues, sustainability reporting, transparency

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Authors: N. Gelovani, D. Ismailov, S. Bochorishvili

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Religious minorities of Georgia include Muslims. Their composition is sufficiently miscellaneous, enclosing both ethnical viewpoint and belonging to the inner Islamic denomination. A majority of Muslims represent Azerbaijanis, who chiefly live in Kvemo Kartli (Bolnisi, Gardabani, Dmanisi, Tetri Tskaro, Marneuli and Tsalka). The catalyst for researchers of Islamic History is the geopolitical interests of Georgia, centuries-old contacts with the Islamic world, the not entirely trivial portion of Islam confessor population, the increasing influence of the Islamic factor in current religious-political processes in the world, the elevating procedure of Muslim religious self-consciousness in the Post-Soviet states, significant challenges of international terrorism, and perspectives of rapid globalization. The rise in the level of religious identity of Muslim citizens of Georgia (first of all of those who are not ethnic Georgians) is noticeable. New mosques have been constructed and, sometimes, even young people are being sent to the religious educational institutions of Muslim countries to gain a higher Islamic education. At a time when gender studies are substantive, the goal of which is to eliminate gender-based discrimination and violence in societies, it is essential in Georgia to conduct researches around the concrete problem – Islamic tradition, woman and education in Georgia. A woman’s right to education is an important indicator of women’s general status in a society. The appropriate resources, innovative analysis of Georgian ethnological materials, and surveying of the population (quantitative and qualitative research reports, working papers), condition the success of these researches. In the presented work, interrelation matters of Islam, gender and education in contemporary Georgia by the example of the Azerbaijani population in Kvemo Kartli during period 1992-2016 are studied. We researched the history of Muslim religious education centers in Tbilisi and Kvemo Kartli (Bolnisi, Gardabani, Dmanisi, Tetri Tskaro, Marneuli and Tsalka) in 1992-2016, on the one hand, and the results of sociological interrogation, on the other. As a result of our investigation, we found that Azeri women in the Kvemo Kartli (Georgia) region mostly receive their education in Georgia and Azerbaijan. Educational and Cultural Institutions are inaccessible for most Azeri women. The main reasons are the absence of educational and religious institutions at their places of residence and state policies towards Georgia’s Muslims. 

Keywords: Islam, gender, Georgia, education

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Authors: T. Nguyen, H. Rennie, S. Vallance, M. Mackay

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Municipal Associations, also called Unions, Leagues or Federations of municipalities have been established worldwide to represent the interests and needs of urban governments in the face of increasing urban issues. In 2008, the Association of Cities of Vietnam (ACVN) joined the Asian Coalition of Community Action Program (ACCA program) and introduced the community-based upgrading approach to help Vietnamese cities to address urban upgrading issues. While this community-based upgrading approach has only been implemented in a small number of Vietnamese cities and its replication has faced certain challenges, it is worthy to explore insights on how the Association of cities of Vietnam played its role in implementing some reportedly successful projects. This paper responds to this inquiry and presents results extracted from the author’s PhD study that sets out with a general objective to critically examine how social capital dimensions (i.e., bonding, bridging and linking) were formed, mobilized and maintained in a local collective and community-based upgrading process. Methodologically, the study utilized the given general categorization of bonding, bridging and linking capitals to explore and confirm how social capital operated in the real context of a community-based upgrading process, particularly in the context of Vietnam. To do this, the study conducted two exploratory and qualitative case studies of housing projects in Friendship neighbourhood (Vinh city) and Binh Dong neighbourhood (Tan An city). This paper presents the findings of the Friendship neighbourhood case study, focusing on the role of the Vietnamese municipal association in forming, mobilizing and maintaining bonding, bridging and linking capital for a community-based upgrading process. The findings highlight the essential but uncertain role of ACVN - the organization that has a hybrid legitimacy status - in such a process. The results improve our understanding both practically and theoretically. Practically, the results offer insights into the performance of a municipal association operating in a transitioning socio-political context of Vietnam. Theoretically, the paper questions the necessity of categorizing social capital dimensions (i.e., bonding, bridging and linking) by suggesting a holistic approach of looking at social capital for urban governance issues within the Vietnamese context and perhaps elsewhere.

Keywords: bonding capital, bridging capital, municipal association, linking capital, social capital, housing upgrading

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Authors: Abouchouaib Belahmira, Joerg W. Schneider, Hafid Saber

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Continental sediments of the uppermost Carboniferous (late Pennsylvanian) El Menizla and Oued Issene formations of the Souss basin, Southwestern High Atlas Mountains, Morocco have yielded abundant well-preserved arthropods. The latter comprise freshwater and terrestrial elements, were found associated with plants, freshwater jellyfish and pelecypods. Arthropods are ubiquitous and typically restricted to the dominated lacustrine black shale taphofacies. The lithofacies interpretation and its correlation with the taphofacies led to the determination of the original depositional environment that was reconstructed as a fluvial-dominated with braided wide channel system and floodplain lakes to peat local backswamps sub-environments. The late Carboniferous fossiliferous strata have been correlated biostratigraphically with many other Pennsylvanian (Kasimovian/Gzhelian) deposits of North America and Europe on the basis of entomological studies. The faunal elements of the lentic biocoenosis of the Souss basin are depauperate, with the vagile forms slightly diverse than sessile ones. The prevailing groups are small shelly fauna, other habitat guild such as apterygotan Monura insect dasyleptids. The fossils recorded from the Souss basin includes crustaceans, of various sizes (µm- to mm) and morphologies, preservation state ranging from poorly preserved to rarely well-preserved specimens. Their remains sporadically found clustered and preserved as internal or external shell molds or steinkerns often disarticulated specimens. Ostracods as more likely Carbonita, their shells are preserved three-dimensionally. The clam shrimps conchostracans record of the Souss basin are often determined as pseudestherids and the Spinicaudatan leaiids. The moldic preservation is somewhat similar to pelecypods, they are known from internal casts or impressions. Monura insects are characterized by their low diversity, thus, only two species are known Dasyleptus lucasi Brongniart and Dasyleptus noli Rasnitsyn. The terrestrial component consists of pterygotan insects. They are diverse, significantly more frequent throughout the Souss basin fossil localities, numerically dominated by the members of Blattodea (cockroaches). The fossil record includes Blattodea, Protorthoptera, Diaphanopterodea, Ephemeroptera (mayfly) , Calneurodea, Grylloblattodea, Miomoptera and Palaeodictyoptera. Additionally, the composition of the preserved insect is mostly represented by completely isolated forewings, rare membranous hindwings, parts of the body or exceptionally preserved specimens, which may reflect a wide spectrum of taphonomic pathways. The steady increase in taxonomic diversity of fossil sites in the Souss basin, together with the taphonomic interpretation of arthropods assemblages, have contributed to provide a novel insight into the complex terrestrial ecosystem that thrived in this paleotropical key region during the late Pennsylvanian and additionally to understand climate-driven paleobiogeography and paleoecology of late Paleozoic non-marine arthropods.

Keywords: Souss, carboniferous, arthropods, taphonomy, paleoecology.

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Authors: Amani Waheed, Mostafa Kofi, Shaymaa Attia, Soha Younis, Basma Abdel Hadi

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Background: Exposure to pesticides is one of the most important occupational risks among farmers in developing countries. Along with the wide use of pesticides in the world, the concerns over their health impacts are rapidly growing. Objective: To investigate thyroid and reproductive hormones and fasting blood glucose levels among farmers chronically exposed to pesticide from East Almnaif district, Ismailia governorate. Methods: An analytical cross-sectional study was conducted on 43 farmers with active involvement pesticides handling and 43 participants not occupationally exposed to pesticides as the control group. A structured interview questionnaire measuring the sociodemographic characteristics, pesticides exposure characteristics, and safety measures was used. General examination including measurements of height, weight, and blood pressure was done. Moreover, levels of plasma cholinesterase enzyme (PChE), glucose, as well as reproductive and thyroid hormones (TSH, T4, and testosterone) were determined. Results: There were no statistically significant differences between both groups regarding their age, educational level, smoking status, and body mass index. The mean duration of exposure was 20.60 11.06 years. Majority of farmers (76.7%) did not use any personal protective equipment (PPE) during pesticides handling. The mean systolic blood pressure among exposed farmers was greater (134.88 17.18 mm Hg) compared to control group (125 14.69 mm Hg) with statistically significant difference (p = 0.003). The mean diastolic blood pressure was higher (84.02 8.69 mm Hg) compared to control group (78.79 8.98 mm Hg) with statistically significant difference (p = 0.006). The pesticide exposed farmers had statistically significant lower level of PChE (3969.93 1841U/L) than control group (4879.29 1950.08 U/L). Additionally, TSH level was significantly higher in exposed farmers (median =1.39µIU/ml) compared to controls (median = 0.91 µIU/ml) (p=0.032). While, the exposed group had a lower T4 level (6.91 1.91 µg/dl) compared to the control group (7.79 2.10µg/dl), with the statistically significant difference between the two groups (p = 0.045). The exposed group had significantly lower level of testosterone hormone (median=3.37 ng/ml) compared to the control group (median= 6.22 ng/ml) (p=0.003). While, the exposed farmers had statistically insignificant higher level of fasting blood glucose (median =89 mg/dl) than the controls (median=88 mg/dl). Furthermore, farmers who did not use PPE had statistically significant lower level of T4 (6.57 1.81µg/dl) than farmers who used PPE during handling of pesticides (8.01 1.89 µg/dl). Conclusion: Chronic exposure to pesticides exerts disturbing action on reproductive function and thyroid function of the male farmers.

Keywords: chronic occupational pesticide exposure, Diabetes mellitus, male reproductive hormones, thyroid function

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Authors: Abdou Elhendy

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Numerous study have shown the efficacy of the percutaneous intervention (PCI) and coronary stenting in improving left ventricular function and relieving exertional angina. Furthermore, PCI remains the main line of therapy in acute myocardial infarction. Improvement of procedural techniques and new devices have resulted in an increased number of PCI in those with difficult and extensive lesions, multivessel disease as well as total occlusion. Immediate and late outcome may be compromised by acute thrombosis or the development of fibro-intimal hyperplasia. In addition, progression of coronary artery disease proximal or distal to the stent as well as in non-stented arteries is not uncommon. As a result, complications can occur, such as acute myocardial infarction, worsened heart failure or recurrence of angina. In a stent, restenosis can occur without symptoms or with atypical complaints rendering the clinical diagnosis difficult. Routine invasive angiography is not appropriate as a follow up tool due to associated risk and cost and the limited functional assessment. Exercise and pharmacologic stress testing are increasingly used to evaluate the myocardial function, perfusion and adequacy of revascularization. Information obtained by these techniques provide important clues regarding presence and severity of compromise in myocardial blood flow. Stress echocardiography can be performed in conjunction with exercise or dobutamine infusion. The diagnostic accuracy has been moderate, but the results provide excellent prognostic stratification. Adding myocardial contrast agents can improve imaging quality and allows assessment of both function and perfusion. Stress radionuclide myocardial perfusion imaging is an alternative to evaluate these patients. The extent and severity of wall motion and perfusion abnormalities observed during exercise or pharmacologic stress are predictors of survival and risk of cardiac events. According to current guidelines, stress echocardiography and radionuclide imaging are considered to have appropriate indication among patients after PCI who have cardiac symptoms and those who underwent incomplete revascularization. Stress testing is not recommended in asymptomatic patients, particularly early after revascularization, Coronary CT angiography is increasingly used and provides high sensitive for the diagnosis of coronary artery stenosis. Average sensitivity and specificity for the diagnosis of in stent stenosis in pooled data are 79% and 81%, respectively. Limitations include blooming artifacts and low feasibility in patients with small stents or thick struts. Anatomical and functional cardiac imaging modalities are corner stone for the assessment of patients after PCI and provide salient diagnostic and prognostic information. Current imaging techniques cans serve as gate keeper for coronary angiography, thus limiting the risk of invasive procedures to those who are likely to benefit from subsequent revascularization. The determination of which modality to apply requires careful identification of merits and limitation of each technique as well as the unique characteristic of each individual patient.

Keywords: coronary artery disease, stress testing, cardiac imaging, restenosis

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Authors: C. Virgilio, J. Carlier, P. Campistron, M. Toubal, P. Garnier, L. Broussous, V. Thomy, B. Nongaillard

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Wetting efficiency of microstructures or nanostructures patterned on Si wafers is a real challenge in integrated circuits manufacturing. In fact, bad or non-uniform wetting during wet processes limits chemical reactions and can lead to non-complete etching or cleaning inside the patterns and device defectivity. This issue is more and more important with the transistors size shrinkage and concerns mainly high aspect ratio structures. Deep Trench Isolation (DTI) structures enabling pixels’ isolation in imaging devices are subject to this phenomenon. While low-frequency acoustic reflectometry principle is a well-known method for Non Destructive Test applications, we have recently shown that it is also well suited for nanostructures wetting characterization in a higher frequency range. In this paper, we present a high-frequency acoustic reflectometry characterization of DTI wetting through a confrontation of both experimental and modeling results. The acoustic method proposed is based on the evaluation of the reflection of a longitudinal acoustic wave generated by a 100 µm diameter ZnO piezoelectric transducer sputtered on the silicon wafer backside using MEMS technologies. The transducers have been fabricated to work at 5 GHz corresponding to a wavelength of 1.7 µm in silicon. The DTI studied structures, manufactured on the wafer frontside, are crossing trenches of 200 nm wide and 4 µm deep (aspect ratio of 20) etched into a Si wafer frontside. In that case, the acoustic signal reflection occurs at the bottom and at the top of the DTI enabling its characterization by monitoring the electrical reflection coefficient of the transducer. A Finite Difference Time Domain (FDTD) model has been developed to predict the behavior of the emitted wave. The model shows that the separation of the reflected echoes (top and bottom of the DTI) from different acoustic modes is possible at 5 Ghz. A good correspondence between experimental and theoretical signals is observed. The model enables the identification of the different acoustic modes. The evaluation of DTI wetting is then performed by focusing on the first reflected echo obtained through the reflection at Si bottom interface, where wetting efficiency is crucial. The reflection coefficient is measured with different water / ethanol mixtures (tunable surface tension) deposited on the wafer frontside. Two cases are studied: with and without PFTS hydrophobic treatment. In the untreated surface case, acoustic reflection coefficient values with water show that liquid imbibition is partial. In the treated surface case, the acoustic reflection is total with water (no liquid in DTI). The impalement of the liquid occurs for a specific surface tension but it is still partial for pure ethanol. DTI bottom shape and local pattern collapse of the trenches can explain these incomplete wetting phenomena. This high-frequency acoustic method sensitivity coupled with a FDTD propagative model thus enables the local determination of the wetting state of a liquid on real structures. Partial wetting states for non-hydrophobic surfaces or low surface tension liquids are then detectable with this method.

Keywords: wetting, acoustic reflectometry, gigahertz, semiconductor

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Authors: Hacer Kobya Bulut, Ilknur Kahriman, Birsel C. Demirbag

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Introduction and Purpose: The lives of children with cancer are affected by long term hospitalizations in a negative way due to complications arising from diagnosis or treatment. However, the children's parents are known to have difficulties in meeting their children’s needs and providing home care after cancer treatment or during remission process. Supporting these children and their parents by giving a planned discharge training starting from the hospital and home care leads to reducing hospital applications, hospitalizations, hospital costs, shortening the length of hospital stay and increasing the satisfaction of the children with cancer and their families. This study was conducted to investigate the status of children and their parents' unplanned application to hospital and re-hospitalization. Methods: The study was carried out with 65 children with hematological malignancy in 0-17 age group and their families in a hematology clinic and polyclinic of a university hospital in Trabzon. Data were collected with survey methodology between August-November, 2015 through face to face interview using numbers, percentage and chi-square test in the evaluation. Findings: Most of the children were leukemia (90.8%) and 49.2% had been ill over 13 months. Few of the parents (32.3%) stated that they had received discharge and home care training (24.6%) but most of them (69.2%) found themselves enough in providing home care. Very few parents (6.2%) received home care training after their children being discharged and the majority of parents (61.5%) faced difficulties in home care and had no one to call around them. The parents expressed that in providing care to their children with hematological malignance, they faced difficulty in feeding them (74.6%), explaining their disease (50.0%), giving their oral medication (47.5%), providing hygiene (43.5%) and providing oral care (39.3%). The question ‘What are the emergency situations in which you have to bring your children to a doctor immediately?' was replied as fever (89.2%), severe nausea and vomiting (87.7%), hemorrhage (86.2%) and pain (81.5%). The study showed that 50.8% of the children had unplanned applications to hospitals and 33.8% of them identified as unplanned hospitalization and the first causes of this were fever and pain. The study showed that the frequency of applications (%78.8) and hospitalizations (%81.8) was higher for boys and a statistically significant difference was found between gender and unplanned applications (X=4.779; p=0.02). Applications (48.5%) and hospitalizations (40.9%) were found lower for the parents who had received hospital discharge training, and a significant difference was determined between receiving training and unplanned hospitalizations (X=8.021; p=0.00). Similarly, applications (30.3%) and hospitalizations (40.9%) was found lower for the ones who had received home care training, and a significant difference was determined between receiving home care training and unplanned hospitalizations (X=4.758; p=0.02). Conclusion: It was found out that caregivers of children with cancer did not receive training related to home care and complications about treatment after discharging from hospital, so they faced difficulties in providing home care and this led to an increase in unplanned hospital applications and hospitalizations.

Keywords: cancer, children, unplanned application, unplanned hospitalization

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Authors: Adepoju A. A., Raufu M. O., Ganiyu M. O., Olawuyi S. O., Olalere J. O., Ogunkunle A. A.

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This study investigated the effects of social safety nets on food security among farming households in Southwest Nigeria. The study used a multistage sampling technique, purposively selecting two states from southwest Nigeria, Oyo and Ogun as the study area with eight Agricultural Development Programme (ADP) agricultural zones. The Local Government Areas (LGAs) were stratified into urban and rural LGAs. Sixteen villages from Oyo and 12 villages from Ogun were randomly selected from the rural LGAs using a proportionate to-size sampling, resulting in 472 respondents, with 271 and 201 from Oyo and Ogun states, respectively. The data was analyzed using descriptive statistics like mean, standard deviation, frequency and percentages, while logistic regression analysis examines the association between independent variables and dependent variables. The study found that poverty reduction, social empowerment, food security palliative, microcredit, and agricultural empowerment are the most prevalent social safety nets among farming households. School feed programs are the most prevalent form of poverty reduction, while training for empowerment improves wellbeing. Food item distribution is the most beneficial for food security and wellbeing. Self-empowerment-based micro-credit support is the most effective, while Anchor Borrower's project is the most beneficial for agricultural empowerment. The study found that 62.68% of the variance in food security status is explained by independent variables. females farmers have a 56% higher likelihood of being food secure than their male counterparts. An additional increase in age decreases the likelihood of being food secure by 6%. Married individuals have a 58% lower likelihood of being food secure compared to singles, possibly due to increased financial responsibilities. A larger household size increases the likelihood of being food secure by 3.41%. Larger households may benefit from economies of scale or shared resources and social safety net programs. Engagement in farming as a primary occupation increases the likelihood of being food secure by 62%. The study further reveals that participation in poverty reduction and microcredit programs significantly increases the likelihood of food security by 30,069% and 135.48%, respectively. The study therefore recommends expanding school feed programs, improving empowerment training, strengthening food distribution, promoting micro-credit, supporting agricultural empowerment, and addressing gender disparities in social safety net programs.

Keywords: poverty reduction, food distribution, micro-credit, household well-being

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Authors: R. O. Babatunde, O. M. Igbalajobi, F. Matambalya

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Moderate economic growth in developing and emerging countries has led to improvement in the food consumption and nutrition situation in the last two decades. Nevertheless, about 870 million people, with a quarter of them from Sub-Saharan Africa, are still suffering from hunger worldwide. As part of measures to reduce the widespread poverty and hunger, cash transfer programmes are now being implemented in many countries of the world. While nationwide cash transfer schemes are few in Sub-Saharan Africa generally, the available ones are more concentrated in East and Southern Africa. Much of the available literature on social protection had focused on the poverty impact of cash transfer schemes at the household level, with the larger proportion originating from Latin America. On the contrary, much less empirical studies have been conducted on the poverty impact of cash transfer in Sub-Saharan Africa, let alone on the food security and nutrition impact. To fill this gap in knowledge, this paper examines the impact of cash transfer on food security in Nigeria. As a case study, the paper analysed the Ekiti State Cash Transfer Scheme (ECTS). ECTS is an unconditional transfer scheme which was established in 2011 to directly provide cash transfer to elderly persons aged 65 years and above in Ekiti State of Nigeria. Using survey data collected in 2013, we analysed the impact of the scheme on food availability and dietary diversity of the beneficiary households. Descriptive and Propensity Score Matching (PSM) techniques were used to estimate the Average Treatment Effect (ATE) and Average Treatment Effect on the Treated (ATT) among the beneficiary and control groups. Thereafter, a model to test for the impact of participation in the cash transfer scheme on calorie availability and dietary diversity was estimated. The results indicate that while households in the sample are clearly vulnerable, there were statistically significant differences between the beneficiary and control groups. For instance, monthly expenditure, calorie availability and dietary diversity were significantly larger among the beneficiary and consequently, the prevalence and depth of hunger were lower in the group. Econometric results indicate that the cash transfer has a positive and significant effect on food availability and dietary diversity in the households. Expanding the coverage of the present scheme to cover all eligible households in the country and incorporating cash transfer into a comprehensive hunger reduction policy will make it to have a greater impact at improving food security among the most vulnerable households in the country.

Keywords: calorie availability, cash transfers, dietary diversity, propensity score matching

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Authors: Wisdom Robert Duruji, Moses Kanayochukwu Ifoh, Efeoghene Edward Esiemunobo

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This study examines the impact of natural and artificial disasters, lackadaisical and semantic approach in risk management, and mitigation implication for sustainable development goals in Nigeria, from 2009 to 2022. The study utilizes a range of research methods to achieve its objectives. These include literature review, website knowledge, Google search, news media information, academic journals, field-work and on-site observations. These diverse methods allow for a comprehensive analysis on the impact and the implications being study. The study finds that paradigm shift from remediating seismic, flooding, environmental pollution and degradation natural disasters by Nigeria Emergency Management Agency (NEMA), to political and charity organization; has plunged risk reduction strategies to embezzling opportunities. However, this lackadaisical and semantic approach in natural disaster mitigation, invariably replicates artificial disasters in Nigeria through: Boko Haram terrorist organization, Fulani herdsmen and farmers conflicts, political violence, kidnapping for ransom, ethnic conflicts, Religious dichotomy, insurgency, secession protagonists, unknown-gun-men, and banditry. This study also, finds that some Africans still engage in self-imposed slavery through human trafficking, by nefariously stow-away to Europe; through Libya, Sahara desert and Mediterranean sea; in search for job opportunities, due to ineptitude in governance by their leaders; a perilous journey that enhanced artificial disasters in Nigeria. That artificial disaster fatality in Nigeria increased from about 5,655 in 2009 to 114,318 in 2018; and to 157,643 in 2022. However, financial and material loss of about $9.29 billion was incurred in Nigeria due to natural disaster, while about $70.59 billion was accrued due to artificial disaster; from 2009 to 2018. Although disaster risk mitigation and politics can synergistically support sustainable development goals; however, they are different entities, and need for distinct separations in Nigeria, as in reality and perception. This study concluded that referendum should be conducted in Nigeria, to ascertain its current status as a nation. Therefore it is recommended that Nigerian governments should refine its naturally endowed crude oil locally; to end fuel subsidy scam, corruption and poverty in Nigeria!

Keywords: corruption, crude oil, environmental risk analysis, Nigeria, referendum, terrorism

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Authors: I. Gupta, N. Setia

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Introduction. Buyer conduct is a progression of practices or examples that buyers pursue before making a buy. It begins when the shopper ends up mindful of a need or wish for an item, at that point finishes up with the buying exchange. Business visionaries can't generally simply shake hands with their intended interest group people and become more acquainted with them. Research is often necessary, so every organization primarily involves doing continuous research to understand and satisfy consumer needs pattern. Aims and Objectives: The aim of the present study is to examine the different behaviors of the consumer, including pre-purchase, purchase, and post-purchase behavior. Materials and Methods: In order to get results, face to face interview held with 80 people which comprise a larger part of female individuals having upper as well as middle-class status. The prime source of data collection was primary. However, the study has also used the theoretical contribution of many researchers in their respective field. Results: Majority of the respondents were females (70%) from the age group of 20-50. The collected data was analyzed through hypothesis testing statistical techniques such as correlation analysis, single regression analysis, and ANOVA which has rejected the null hypothesis that there is no relation between researching the consumer behavior at different stages and organizational performance. The real finding of this study is that simply focusing on the buying part isn't enough to gain profits and fame, however, understanding the pre, buy and post-buy behavior of consumer performs a huge role in organization success. The outcomes demonstrated that the organization, which deals with the three phases of research of purchasing conduct is able to establish a great brand image as compare to their competitors. Alongside, enterprises can observe customer conduct in a considerably more proficient manner. Conclusion: The analyses of consumer behavior presented in this study is an attempt to understand the factors affecting consumer purchasing behavior. This study has revealed that those corporations are more successful, which work on understanding buying behavior instead to just focus on the selling products. As a result, organizations perform good and grow rapidly because consumers are the one who can make or break the company. The interviews that were conducted face to face, clearly revealed that those organizations become at top-notch whom consumers are satisfied, not just with product but also with services of the company. The study is not targeting the particular class of audience; however, it brings out benefits to the masses, in particular to business organizations.

Keywords: consumer behavior, pre purchase, post purchase, consumer satisfaction

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Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Obada Ahmad Al Jayyousi, Ihdaa Mahmoud Bani Khalaf, Eman E. Alshial

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Background: Bipolar disorder, formerly known as manic depression, is a mental health status that leads to extreme mood swings that include emotional lows (depression) and highs (mania or hypomania). This systematic review and meta-analysis aimed to assess the safety and efficacy of lithium versus valproate among bipolar patients. Methods: A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until June 2022. Studies comparing lithium versus valproate among bipolar patients were selected for the analysis, and all relevant outcomes were pooled in the meta-analysis using Review Manager Software. Results: 11 Randomized Clinical Trials were included in this meta-analysis with a total of 4159 patients. Our meta showed that lithium was superior to valproate in terms of Young Mania Rating Scale (YMRS) (MD = 0.00 with 95% CI, (-0.55 – 0.55; I2 = 0%), P = 1.00). The results of the Hamilton Depression Rating Scale (HDRS) showed that the overall effect favored the valproate treated group (MD = 1.41 with 95% CI, (-0.15 – 2.67; I2 = 0%), P = 0.03). Concerning the results of the Montgomery-Asberg Depression Rating Scale (MADRS), the results showed that the lithium was superior to valproate (MD = 0.03 with 95% CI, (-0.80 to 0.87; I2 = 40%), P = 0.94). In terms of the sexual side effect, we found that the valproate was superior to lithium (RR 1.19 with 95% CI, (0.74 to 1.91; I2 = 0%), P = 0.47). The lithium-treated group was superior in comparison to valproate treated group in terms of Abnormal Involuntary Movement Scale (AIMS) (MD = -0.03 with 95% CI (-0.38 to 0.32; I2 = 0%), P = 0.87). The lithium was more favorable in terms of Simpson-Agnes scale (MD = -0.40 with 95% CI, (-0.86 to 0.06; I2 = 0%), P = 0.09). The results of the Barnes akathisia scale showed that the overall effect of the valproate was more favorable in comparison to lithium (MD = 0.05 with 95% CI, (-0.12 to 0.22; I2 = 0%), P = 0.57). Conclusion: Our study revealed that on the scales of efficacy Lithium treated group surpassed Valproate treated group in terms of Young Mania Rating Scale (YMRS), Abnormal Involuntary Movement Scale (AIMS) and Simpson-Agnes scale, but valproate surpassed it in Barnes Akathisia scale. Furthermore, on the scales of depression Hamilton Depression Rating Scale (HDRS) showed that the overall effect favored Valproate treated group, but Lithium surpassed valproate in terms of Montgomery-Asberg Depression Rating Scale (MADRS). Valproate surpassed Lithium in terms of sexual side effects.

Keywords: bipolar, mania, bipolar-depression, sexual dysfunction, sexual side effects, treatment

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Authors: Aamir Shahzad, Mao-Gang He

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Currently, dusty plasmas motivated the researchers' widespread interest. Since the last two decades, substantial efforts have been made by the scientific and technological community to investigate the transport properties and their nonlinear behavior of three-dimensional and two-dimensional nonideal complex (dusty plasma) liquids (NICDPLs). Different calculations have been made to sustain and utilize strongly coupled NICDPLs because of their remarkable scientific and industrial applications. Understanding of the thermophysical properties of complex liquids under various conditions is of practical interest in the field of science and technology. The determination of thermal conductivity is also a demanding question for thermophysical researchers, due to some reasons; very few results are offered for this significant property. Lack of information of the thermal conductivity of dense and complex liquids at different parameters related to the industrial developments is a major barrier to quantitative knowledge of the heat flux flow from one medium to another medium or surface. The exact numerical investigation of transport properties of complex liquids is a fundamental research task in the field of thermophysics, as various transport data are closely related with the setup and confirmation of equations of state. A reliable knowledge of transport data is also important for an optimized design of processes and apparatus in various engineering and science fields (thermoelectric devices), and, in particular, the provision of precise data for the parameters of heat, mass, and momentum transport is required. One of the promising computational techniques, the homogenous nonequilibrium molecular dynamics (HNEMD) simulation, is over viewed with a special importance on the application to transport problems of complex liquids. This proposed work is particularly motivated by the FIRST TIME to modify the problem of heat conduction equations leads to polynomial velocity and temperature profiles algorithm for the investigation of transport properties with their nonlinear behaviors in the NICDPLs. The aim of proposed work is to implement a NEMDS algorithm (Poiseuille flow) and to delve the understanding of thermal conductivity behaviors in Yukawa liquids. The Yukawa system is equilibrated through the Gaussian thermostat in order to maintain the constant system temperature (canonical ensemble ≡ NVT)). The output steps will be developed between 3.0×105/ωp and 1.5×105/ωp simulation time steps for the computation of λ data. The HNEMD algorithm shows that the thermal conductivity is dependent on plasma parameters and the minimum value of lmin shifts toward higher G with an increase in k, as expected. New investigations give more reliable simulated data for the plasma conductivity than earlier known simulation data and generally the plasma λ0 by 2%-20%, depending on Γ and κ. It has been shown that the obtained results at normalized force field are in satisfactory agreement with various earlier simulation results. This algorithm shows that the new technique provides more accurate results with fast convergence and small size effects over a wide range of plasma states.

Keywords: molecular dynamics simulation, thermal conductivity, nonideal complex plasma, Poiseuille flow

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Authors: Mariia Karizhenskaia, Tanvi Nandani, Ali Tafazoli Moghadam

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Hospice palliative care (HPC) is one of the most complicated philosophies of care in which physical, social/cultural, and spiritual aspects of human life are intermingled with an undeniably significant role in every aspect. Among these dimensions of care, culture possesses an outstanding position in the process and goal determination of HPC. This study shows the importance of cultural elements in the establishment of effective and optimized structures of HPC in the Canadian healthcare environment. Our systematic search included Medline, Google Scholar, and St. Lawrence College Library, considering original, peer-reviewed research papers published from 1998 to 2023 to identify recent national literature connecting culture and palliative care delivery. The most frequently presented feature among the articles is the role of culture in the efficiency of the HPC. It has been shown frequently that including the culturespecific parameters of each nation in this system of care is vital for its success. On the other hand, ignorance about the exclusive cultural trends in a specific location has been accompanied by significant failure rates. Accordingly, implementing a culture-wise adaptable approach is mandatory for multicultural societies. The following outcome of research studies in this field underscores the importance of culture-oriented education for healthcare staff. Thus, all the practitioners involved in HPC will recognize the importance of traditions, religions, and social habits for processing the care requirements. Cultural competency training is a telling sample of the establishment of this strategy in health care that has come to the aid of HPC in recent years. Another complexity of the culturized HPC nowadays is the long-standing issue of racialization. Systematic and subconscious deprivation of minorities has always been an adversity of advanced levels of care. The last part of the constellation of our research outcomes is comprised of the ethical considerations of culturally driven HPC. This part is the most sophisticated aspect of our topic because almost all the analyses, arguments, and justifications are subjective. While there was no standard measure for ethical elements in clinical studies with palliative interventions, many research teams endorsed applying ethical principles for all the involved patients. Notably, interpretations and projections of ethics differ in varying cultural backgrounds. Therefore, healthcare providers should always be aware of the most respectable methodologies of HPC on a case-by-case basis. Cultural training programs have been utilized as one of the main tactics to improve the ability of healthcare providers to address the cultural needs and preferences of diverse patients and families. In this way, most of the involved health care practitioners will be equipped with cultural competence. Considerations for ethical and racial specifications of the clients of this service will boost the effectiveness and fruitfulness of the HPC. Canadian society is a colorful compilation of multiple nationalities; accordingly, healthcare clients are diverse, and this divergence is also translated into HPC patients. This fact justifies the importance of studying all the cultural aspects of HPC to provide optimal care on this enormous land.

Keywords: cultural competence, end-of-life care, hospice, palliative care

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Authors: Erimias Firre

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This study is situated within the religio-cultural milieu of Coptic Orthodox Christians of the Tigrinya ethnic group in Eritrea. With this ethnic group being conservative and traditionally bound, extended family structures dissected along various clans and expansive community networks are the distinguishing mark of its members. Notably, Coptic Tigrinya constitutes the largest percentage of all Christian denominations in Eritrea. As religious, cultural beliefs, rituals and teachings permeate in all aspects of social life, a distinct worldview and traditionalized health and illness conceptualization are common. Accordingly, this study argues that religio-culturally bound illness ideologies immensely determine the perception, help seeking behavior and healing preference of Coptic Tigrinya in Eritrea. The study bears significance in the sense that it bridges an important knowledge gap, given that it is ethno-linguistically (within the Tigrinya ethnic group), spatially (central region of Eritrea) and religiously (Coptic Christianity) specific. The conceptual framework guiding this research centered on the social determinants of mental health, and explores through the lens of critical theory how existing systems generate social vulnerability and structural inequality, providing a platform to reveal how the psychosocial model has the capacity to emancipate and empower those with mental disorders to live productive and meaningful lives. A case study approach was employed to explore the interrelationship between religio-cultural beliefs and practices and perception of common mental disorders of depression, anxiety, bipolar affective, schizophrenia and post-traumatic stress disorders and the impact of these perceptions on people with those mental disorders. Purposive sampling was used to recruit 41 participants representing seven diverse cohorts; people with common mental disorders, family caregivers, general community members, ex-fighters , priests, staff at St. Mary’s and Biet-Mekae Community Health Center; resulting in rich data for thematic analysis. Findings highlighted current religio-cultural perceptions, causes and treatment of mental disorders among Coptic Tigrinya result in widespread labelling, stigma and discrimination, both of those with mental disorders and their families. Traditional healing sources are almost exclusively tried, sometimes for many years, before families and sufferers seek formal medical assessment and treatment, resulting difficult to treat illness chronicity. Service gaps in the formal medical system result in the inability to meet the principles enshrined in the WHO Mental Health Action Plan 2013-2020 to which the Eritrean Government is a signatory. However, the study found that across all participant cohorts, there was a desire for change that will create a culture whereby those with mental disorders will have restored hope, connectedness, healing and self-determination.

Keywords: Coptic Tigrinya, mental disorders, psychosocial model social integration and recovery, traditional healing

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Authors: Harini Atturu, Divyani Byagari, Bindhu Rani Thumkunta, Sahitya Bammidi, Manasa Badveli

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Introduction: Biological, psychological and social domains influence the outcomes of pregnancy. The COVID19 pandemic had a significant effect on the psychological and social domains of pregnant women all over the world. Everyone has inherent coping mechanisms which ultimately determine the actual impact of such external stimulus on outcomes of pregnancy. This study aims to understand the coping strategies used by pregnant women to overcome the psychological impact of the first wave of the COVID 19 pandemic. Methods: Institutional ethics permission was sought. All pregnant women attending antenatal clinics in the institution during September 2020 were included in the study. Brief-COPE, a self-rated questionnaire, was provided to understand the coping strategies used by them. The Questionnaire consists of 28 questions that fall into 14 themes. These 14 themes were mapped into four domains consisting of Approaching coping (APC) styles, Avoidant Coping (AVC) styles, Humor and Religion. The results were analyzed using univariate and multivariate analysis. Factor analysis was performed to identify themes that are most frequently used. Results: 162 pregnant women were included in the study. The majority of the women were aged between 18 and 30 (90.1%). 60.9% of the respondents were having their first pregnancy and were in the 2nd trimester (59.6%). The majority of them were living in the city (74%), belonged to the middle class (77.6%) and were not working (70.1%). 56 respondents (34.6%) reported that they had contact with suspected or Covid positive patients. Many were worried that their pregnancy might be complicated (43%), their baby may contract COVID (45%) and their family members could get COVID during the hospital visits for antenatal check-ups. 33.6% of women admitted missing their regular antenatal check-ups because of the above concerns. All respondents used various coping strategies to overcome the psychological impact of COVID 19. Out of the 4 coping strategies, participants scored high on Religion with a mean of 5.471.45 followed by Approaching Coping (APC) styles (5.131.25), Humor (4.592.07) and Avoidant Coping (AVC) styles (4.130.88). Religion as a coping strategy scored high for all respondents irrespective of age, parity, trimester, social and employment status. Exploratory Factor analysis revealed two cluster groups that explained 68% of the variance, with Component 1 contributing to 58.9% and component 2 contributing 9.13% of the variance. Humor, Acceptance, Planning, and Religion were the top 4 factors that showed strong loadings. Conclusion: Most of the pregnant women were worried about the negative impact of COVID 19 on the outcomes of their pregnancy. Religion and Approaching coping styles seem to be the predominant coping strategies used by them. Interventionists and policymakers should consider these factors while providing support to such women.

Keywords: coping strategies, pregnancy, COVID-19, brief-COPE

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Authors: Golnoush Rostami, Farzam Kharvari

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In recent years, developments in the field of architectural education have resulted in a shift from conventional teaching methods to alternative state-of-the-art approaches in teaching methods and strategies. Criticism in architecture has been a key player both in the profession and education, but it has been mostly offered by renowned individuals. Hence, not only students or other professionals but also critics themselves may not have the option to experience buildings and rely on available 2D materials, such as images and plans, that may not result in a holistic understanding and evaluation of buildings. On the other hand, immersive environments provide students and professionals the opportunity to experience buildings virtually and reflect their evaluation by experiencing rather than judging based on 2D materials. Therefore, the aim of this study is to compare the effect of experiencing buildings in immersive environments and 2D drawings, including images and plans, on architecture criticism and architectural education. As a result, three buildings that have parametric brick facades were studied through 2D materials and in Unreal Engine v. 24 as an immersive environment among 22 architecture students that were selected using convenient sampling and were divided into two equal groups using simple random sampling. This study used mixed methods, including quantitative and qualitative methods; the quantitative section was carried out by a questionnaire, and deep interviews were used for the qualitative section. A questionnaire was developed for measuring three constructs, including privacy regulation based on Altman’s theory, the sufficiency of illuminance levels in the building, and the visual status of the view (visually appealing views based on obstructions that may have been caused by facades). Furthermore, participants had the opportunity to reflect their understanding and evaluation of the buildings in individual interviews. Accordingly, the collected data from the questionnaires were analyzed using independent t-test and descriptive analyses in IBM SPSS Statistics v. 26, and interviews were analyzed using the content analysis method. The results of the interviews showed that the participants who experienced the buildings in the immersive environment were able to have a thorough and more precise evaluation of the buildings in comparison to those who studied them through 2D materials. Moreover, the analyses of the respondents’ questionnaires revealed that there were statistically significant differences between measured constructs among the two groups. The outcome of this study suggests that integrating immersive environments into the profession and architectural education as an effective and efficient tool for architecture criticism is vital since these environments allow users to have a holistic evaluation of buildings for vigorous and sound criticism.

Keywords: immersive environments, architecture criticism, architectural education, occupant-centric evaluation, pre-occupancy evaluation

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Authors: Alena Cejkova, Martina Paldrychova, Jana Michailidu, Olga Matatkova, Jan Masak

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Increasing the resistance of pathogenic microorganisms to many antibiotics is a serious threat to the treatment of infectious diseases and cleaning medical instruments. It should be added that the resistance of microbial populations growing in biofilms is often up to 1000 times higher compared to planktonic cells. Biofilm formation in a number of microorganisms is largely influenced by the quorum sensing regulatory mechanism. Finding external factors such as natural substances or physical processes that can interfere effectively with quorum sensing signal molecules should reduce the ability of the cell population to form biofilm and increase the effectiveness of antibiotics. The present work is devoted to the effect of chitosan as a representative of natural substances with anti-biofilm activity and non- thermal plasma (NTP) alone or in combination with polymyxin B on biofilm formation of Pseudomonas aeruginosa. Particular attention was paid to the influence of these agents on the level of quorum sensing signal molecules (acyl-homoserine lactones) during planktonic and biofilm cultivations. Opportunistic pathogenic strains of Pseudomonas aeruginosa (DBM 3081, DBM 3777, ATCC 10145, ATCC 15442) were used as model microorganisms. Cultivations of planktonic and biofilm populations in 96-well microtiter plates on horizontal shaker were used for determination of antibiotic and anti-biofilm activity of chitosan and polymyxin B. Biofilm-growing cells on titanium alloy, which is used for preparation of joint replacement, were exposed to non-thermal plasma generated by cometary corona with a metallic grid for 15 and 30 minutes. Cultivation followed in fresh LB medium with or without chitosan or polymyxin B for next 24 h. Biofilms were quantified by crystal violet assay. Metabolic activity of the cells in biofilm was measured using MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) colorimetric test based on the reduction of MTT into formazan by the dehydrogenase system of living cells. Activity of N-acyl homoserine lactones (AHLs) compounds involved in the regulation of biofilm formation was determined using Agrobacterium tumefaciens strain harboring a traG::lacZ/traR reporter gene responsive to AHLs. The experiments showed that both chitosan and non-thermal plasma reduce the AHLs level and thus the biofilm formation and stability. The effectiveness of both agents was somewhat strain dependent. During the eradication of P. aeruginosa DBM 3081 biofilm on titanium alloy induced by chitosan (45 mg / l) there was an 80% decrease in AHLs. Applying chitosan or NTP on the P. aeruginosa DBM 3777 biofilm did not cause a significant decrease in AHLs, however, in combination with both (chitosan 55 mg / l and NTP 30 min), resulted in a 70% decrease in AHLs. Combined application of NTP and polymyxin B allowed reduce antibiotic concentration to achieve the same level of AHLs inhibition in P. aeruginosa ATCC 15442. The results shown that non-thermal plasma and chitosan have considerable potential for the eradication of highly resistant P. aeruginosa biofilms, for example on medical instruments or joint implants.

Keywords: anti-biofilm activity, chitosan, non-thermal plasma, opportunistic pathogens

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Authors: Teodorica G. Ani

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Economic activity requires an encouraging regulatory environment and effective rules that are transparent and accessible to all. The World Bank has been publishing the annual Doing Business reports since 2004 to investigate the scope and manner of regulations that enhance business activity and those that constrain it. A streamlined business environment supporting the development of competitive small and medium enterprises (SMEs) may expand employment opportunities and improve the living conditions of low income households. Asia has emerged as one of the most attractive markets in the world. Economies in East Asia and the Pacific were among the most active in making it easier for local firms to do business. The study aimed to describe the ease of doing business and its effect to economic growth among selected economies in Asia for the year 2014. The study covered 29 economies in East Asia, Southeast Asia, South Asia and Middle Asia. Ease of doing business is measured by the Doing Business indicators (DBI) of the World Bank. The indicators cover ten aspects of the ease of doing business such as starting a business, dealing with construction permits, getting electricity, registering property, getting credit, protecting investors, paying taxes, trading across borders, enforcing contracts and resolving insolvency. In the study, Gross Domestic Product (GDP) was used as the proxy variable for economic growth. Descriptive research was the research design used. Graphical analysis was used to describe the income and doing business among selected economies. In addition, multiple regression was used to determine the effect of doing business to economic growth. The study presented the income among selected economies. The graph showed China has the highest income while Maldives produces the lowest and that observation were supported by gathered literatures. The study also presented the status of the ten indicators of doing business among selected economies. The graphs showed varying trends on how easy to start a business, deal with construction permits and to register property. Starting a business is easiest in Singapore followed by Hong Kong. The study found out that the variations in ease of doing business is explained by starting a business, dealing with construction permits and registering property. Moreover, an explanation of the regression result implies that a day increase in the average number of days it takes to complete a procedure will decrease the value of GDP in general. The research proposed inputs to policy which may increase the awareness of local government units of different economies on the simplification of the policies of the different components used in measuring doing business.

Keywords: doing business, economic growth, gross domestic product, Asia

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Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

Abstract:

Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

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Authors: Anietie J. Atangwho, Udeme E. Asibong, Item J. Atangwho, Ndifreke E. Udonwa

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Diabesity, a syndrome where diabetes and obesity occur simultaneously in a single patient, has emerged as a recent challenge to the medical world and is already at epidemic proportion in some countries. Therefore, this study aimed to determine the prevalence of diabesity among adult patients attending the General Outpatient clinic of three healthcare facilities in Calabar in a bid to improve healthcare delivery to patients at risk. A cross-sectional descriptive study design was employed using a mixed method approach that comprised quantitative and qualitative components i.e., Focused Group Discussion (FGD) and Key Informant Interview (KII). One hundred and ninety (190) participants aged 18 to 72 years and body mass index (BMI) ≥ 30kg/m2 were recruited as the study population for the quantitative study using systematic random sampling technique and analysed using SPSS version 25. The qualitative component performed 4 FGDs and 3 KIIs. Results of sociodemographic variables showed respondents aged 35 – 44 as highest in number (37.3%). Of this number, 83.7% were females, 76.8% married, and 3.7% earned USD1,110.00 monthly. Whereas majority of the participants (65.8 %) were within class 1 obesity, only 38% considered themselves obese. Diabesity occurrence was found to be 12.6% (i.e. BMI ≥ 30 to 45.2kg/m2 vs FBS ≥ 7.0 – 14.8mmo/l), with 38% of them being previously undiagnosed. About 48.4 % of the respondents ate two meals only per day; with 90.5% eating between meals. Snacking was predominant, mostly pastries (67.9%), with 58.9% taking cola drinks alongside. Sixty-one percent participated in one form of exercise or the other, with walking/trekking as the most common; 34.4 % had no regular exercise schedule. Only about 39.5% of the participants spent less than an hour on devices like phone, television, and laptops. Additionally, previously known and newly diagnosed hypertensive patients were 27.9% and 7.2%, respectively. Qualitative assessment with KII and FGDs showed eating unhealthy diets and lack of exercise as major factors responsible for diabesity. The bivariate analysis revealed significant association between diabesity with marital status and hypertension (p = 0.007 and p = 0.005, respectively). Also, positive association with diabesity were eating snacking (p = 0.017) and number of times a respondent snacks per day (p = 0.035). Overall, the study has revealed the occurrence of diabesity in Calabar at 12.6 % of the study population, with 38 % of them previously undiagnosed; it identified unhealthy diets and lack of exercise as causative factors as well as hypertension as snacking associatory indicators of diabesity.

Keywords: diabesity, obesity, diabetes, unhealthy diet

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Authors: R. L. P. de Lima, F. C. B. Boogaard, D. Setyo Rini, P. Arisandi, R. E. de Graaf-Van Dinther

Abstract:

Water quality in many Asian countries is very poor due to inefficient solid waste management, high population growth and the lack of sewage and purification systems for households and industry. A consortium of Indonesian and Dutch organizations has begun a large-scale international research project to evaluate and propose solutions to face the surface water pollution challenges in Brantas Basin, Indonesia (East Java: Malang / Surabaya). The first phase of the project consisted in a baseline study to assess the current status of surface water bodies and to determine the ambitions and strategies among local stakeholders. This study was conducted with high participatory / collaborative and knowledge sharing objectives. Several methods such as using mobile sensors (attached to boats or underwater drones), test strips and mobile apps, bio-monitoring (sediments), ecology scans using underwater cameras, or continuous / static measurements, were applied in different locations in the regions of the basin, at multiple locations within the water systems (e.g. spring, upstream / downstream of industry and urban areas, mouth of the Surabaya River, groundwater). Results gave an indication of (reference) values of basic water quality parameters such as turbidity, electrical conductivity, dissolved oxygen or nutrients (ammonium / nitrate). An important outcome was that collecting random samples may not be representative of a body of water, given that water quality parameters can vary widely in space (x, y, and depth) and time (day / night and seasonal). Innovative / dynamic monitoring methods (e.g. underwater drones, sensors on boats) can contribute to better understand the quality of the living environment (water, ecology, sediment) and factors that affect it. The field work activities, in particular, underwater drones, revealed potential as awareness actions as they attracted interest from locals and local press. This baseline study involved the cooperation with local managing organizations with Dutch partners, and their willingness to work together is important to ensure participatory actions and social awareness regarding the process of adaptation and strengthening of regulations, or for the construction of facilities such as sewage.

Keywords: water quality monitoring, pollution, underwater drones, social awareness

Procedia PDF Downloads 192