Search results for: random differential inclusion
302 Genetic Screening of Sahiwal Bulls for Higher Fertility
Authors: Atul C. Mahajan, A. K. Chakravarty, V. Jamuna, C. S. Patil, Neeraj Kashyap, Bharti Deshmukh, Vijay Kumar
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The selection of Sahiwal bulls on the basis of dams best lactation milk yield under breeding programme in herd of the country neglecting fertility traits leads to deterioration in their performances and economy. The goal of this study was to explore polymorphism of CRISP2 gene and their association with semen traits (Post Thaw Motility, Hypo-osmotic Swelling Test, Acrosome Integrity, DNA Fragmentation and capacitation status), scrotal circumference, expected predicted difference (EPD) for milk yield and fertility. Sahiwal bulls included in present study were 60 bulls used in breeding programme as well as 50 young bulls yet to be included in breeding programme. All the Sahiwal bulls were found to be polymorphic for CRISP2 gene (AA, AG and GG) present within exon 7 to the position 589 of CRISP2 mRNA by using PCR-SSCP and Sequencing. Semen analysis were done on 60 breeding bulls frozen semen doses pertaining to four season (winter, summer, rainy and autumn). The scrotal circumference was measured from existing Sahiwal breeding bulls in the herd (n=47). The effect of non-genetic factors on reproduction traits were studied by least-squares technique and the significant difference of means between subclasses of season, period, parity and age group were tested. The data were adjusted for the significant non-genetic factors to remove the differential environmental effects. The adjusted data were used to generate traits like Waiting Period (WP), Pregnancy Rate (PR), Expected Predicted Difference (EPD) of fertility, respectively. Genetic and phenotypic parameters of reproduction traits were estimated. The overall least-squares means of Age at First Calving (AFC), Service Period (SP) and WP were estimated as 36.69 ± 0.18 months, 120.47 ± 8.98 days and 79.78 ± 3.09 days respectively. Season and period of birth had significant effect (p < 0.01) on AFC. AFC was highest during autumn season of birth followed by summer, winter and rainy. Season and period of calving had significant effect (p < 0.01) on SP and WP of sahiwal cows. The WP for Sahiwal cows was standardized based on four developed predicted model for pregnancy rate 42, 63, 84 and 105 days using all lactation records. The WP for Sahiwal cows were standardized as 42 days. A selection criterion was developed for Sahiwal breeding bulls and young Sahiwal bulls on the basis of EPD of fertility. The genotype has significant effect on expected predicted difference of fertility and some semen parameters like post thaw motility and HOST. AA Genotype of CRISP2 gene revealed better EPD for fertility than EPD of milk yield. AA genotype of CRISP2 gene has higher scrotal circumference than other genotype. For young Sahiwal bulls only AA genotypes were present with similar patterns. So on the basis of association of genotype with seminal traits, EPD of milk yield and EPD for fertility status, AA and AG genotype of CRISP2 gene was better for higher fertility in Sahiwal bulls.Keywords: expected predicted difference, fertility, sahiwal, waiting period
Procedia PDF Downloads 584301 Linguistic Competence Analysis and the Development of Speaking Instructional Material
Authors: Felipa M. Rico
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Linguistic oral competence plays a vital role in attaining effective communication. Since the English language is considered as universally used language and has a high demand skill needed in the work-place, mastery is the expected output from learners. To achieve this, learners should be given integrated differentiated tasks which help them develop and strengthen the expected skills. This study aimed to develop speaking instructional supplementary material to enhance the English linguistic competence of Grade 9 students in areas of pronunciation, intonation and stress, voice projection, diction and fluency. A descriptive analysis was utilized to analyze the speaking level of performance of the students in order to employ appropriate strategies. There were two sets of respondents: 178 Grade 9 students selected through a stratified sampling and chosen at random. The other set comprised English teachers who evaluated the usefulness of the devised teaching materials. A teacher conducted a speaking test and activities were employed to analyze the speaking needs of students. Observation and recordings were also used to evaluate the students’ performance. The findings revealed that the English pronunciation of the students was slightly unclear at times, but generally fair. There were lapses but generally they rated moderate in intonation and stress, because of other language interference. In terms of voice projection, students have erratic high volume pitch. For diction, the students’ ability to produce comprehensible language is limited, and as to fluency, the choice of vocabulary and use of structure were severely limited. Based on the students’ speaking needs analyses, the supplementary material devised was based on Nunan’s IM model, incorporating context of daily life and global work settings, considering the principle that language is best learned in the actual meaningful situation. To widen the mastery of skill, a rich learning environment, filled with a variety instructional material tends to foster faster acquisition of the requisite skills for sustained learning and development. The role of IM is to encourage information to stick in the learners’ mind, as what is seen is understood more than what is heard. Teachers say they found the IM “very useful.” This implied that English teachers could adopt the materials to improve the speaking skills of students. Further, teachers should provide varied opportunities for students to get involved in real life situations where they could take turns in asking and answering questions and share information related to the activities. This would minimize anxiety among students in the use of the English language.Keywords: diction, fluency, intonation, instructional materials, linguistic competence
Procedia PDF Downloads 241300 Participatory Monitoring Strategy to Address Stakeholder Engagement Impact in Co-creation of NBS Related Project: The OPERANDUM Case
Authors: Teresa Carlone, Matteo Mannocchi
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In the last decade, a growing number of International Organizations are pushing toward green solutions for adaptation to climate change. This is particularly true in the field of Disaster Risk Reduction (DRR) and land planning, where Nature-Based Solutions (NBS) had been sponsored through funding programs and planning tools. Stakeholder engagement and co-creation of NBS is growing as a practice and research field in environmental projects, fostering the consolidation of a multidisciplinary socio-ecological approach in addressing hydro-meteorological risk. Even thou research and financial interests are constantly spread, the NBS mainstreaming process is still at an early stage as innovative concepts and practices make it difficult to be fully accepted and adopted by a multitude of different actors to produce wide scale societal change. The monitoring and impact evaluation of stakeholders’ participation in these processes represent a crucial aspect and should be seen as a continuous and integral element of the co-creation approach. However, setting up a fit for purpose-monitoring strategy for different contexts is not an easy task, and multiple challenges emerge. In this scenario, the Horizon 2020 OPERANDUM project, designed to address the major hydro-meteorological risks that negatively affect European rural and natural territories through the co-design, co-deployment, and assessment of Nature-based Solution, represents a valid case study to test a monitoring strategy from which set a broader, general and scalable monitoring framework. Applying a participative monitoring methodology, based on selected indicators list that combines quantitative and qualitative data developed within the activity of the project, the paper proposes an experimental in-depth analysis of the stakeholder engagement impact in the co-creation process of NBS. The main focus will be to spot and analyze which factors increase knowledge, social acceptance, and mainstreaming of NBS, promoting also a base-experience guideline to could be integrated with the stakeholder engagement strategy in current and future similar strongly collaborative approach-based environmental projects, such as OPERANDUM. Measurement will be carried out through survey submitted at a different timescale to the same sample (stakeholder: policy makers, business, researchers, interest groups). Changes will be recorded and analyzed through focus groups in order to highlight causal explanation and to assess the proposed list of indicators to steer the conduction of similar activities in other projects and/or contexts. The idea of the paper is to contribute to the construction of a more structured and shared corpus of indicators that can support the evaluation of the activities of involvement and participation of various levels of stakeholders in the co-production, planning, and implementation of NBS to address climate change challenges.Keywords: co-creation and collaborative planning, monitoring, nature-based solution, participation & inclusion, stakeholder engagement
Procedia PDF Downloads 112299 Sensory Characteristics of White Chocolate Enriched with Encapsulated Raspberry Juice
Authors: Ivana Loncarevic, Biljana Pajin, Jovana Petrovic, Danica Zaric, Vesna Tumbas Saponjac, Aleksandar Fistes
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Chocolate is a food that activates pleasure centers in the human brain. In comparison to black and milk chocolate, white chocolate does not contain fat-free cocoa solids and thus lacks bioactive components. The aim of this study was to examine the sensory characteristics of enriched white chocolate with the addition of 10% of raspberry juice encapsulated in maltodextrins (denoted as encapsulate). Chocolate is primarily intended for enjoyment, and therefore, the sensory expectation is a critical factor for consumers when selecting a new type of chocolate. Consumer acceptance of chocolate depends primarily on the appearance and taste, but also very much on the mouthfeel, which mainly depends on the particle size of chocolate. Chocolate samples were evaluated by a panel of 8 trained panelists, food technologists, trained according to ISO 8586 (2012). Panelists developed the list of attributes to be used in this study: intensity of red color (light to dark); glow on the surface (mat to shiny); texture on snap (appearance of cavities or holes on the snap surface that are seen - even to gritty); hardness (hardness felt during the first bite of chocolate sample in half by incisors - soft to hard); melting (the time needed to convert solid chocolate into a liquid state – slowly to quickly); smoothness (perception of evenness of chocolate during melting - very even to very granular); fruitiness (impression of fruity taste - light fruity notes to distinct fruity notes); sweetness (organoleptic characteristic of pure substance or mixture giving sweet taste - lightly sweet to very sweet). The chocolate evaluation was carried out 24 h after sample preparation in the sensory laboratory, in partitioned booths, which were illuminated with fluorescent lights (ISO 8589, 2007). Samples were served in white plastic plates labeled with three-digit codes from a random number table. Panelist scored the perceived intensity of each attribute using a 7-point scale (1 = the least intensity and 7 = the most intensity) (ISO 4121, 2002). The addition of 10% of encapsulate had a big influence on chocolate color, where enriched chocolate got a nice reddish color. At the same time, the enriched chocolate sample had less intensity of gloss on the surface. The panelists noticed that addition of encapsulate reduced the time needed to convert solid chocolate into a liquid state, increasing its hardness. The addition of encapsulate had a significant impact on chocolate flavor. It reduced the sweetness of white chocolate and contributed to the fruity raspberry flavor.Keywords: white chocolate, encapsulated raspberry juice, color, sensory characteristics
Procedia PDF Downloads 160298 Negative Perceptions of Ageing Predicts Greater Dysfunctional Sleep Related Cognition Among Adults Aged 60+
Authors: Serena Salvi
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Ageistic stereotypes and practices have become a normal and therefore pervasive phenomenon in various aspects of everyday life. Over the past years, renewed awareness towards self-directed age stereotyping in older adults has given rise to a line of research focused on the potential role of attitudes towards ageing on seniors’ health and functioning. This set of studies has showed how a negative internalisation of ageistic stereotypes would discourage older adults in seeking medical advice, in addition to be associated to negative subjective health evaluation. An important dimension of mental health that is often affected in older adults is represented by sleep quality. Self-reported sleep quality among older adults has shown to be often unreliable when compared to their objective sleep measures. Investigations focused on self-reported sleep quality among older adults have suggested how this portion of the population would tend to accept disrupted sleep if believed to be up to standard for their age. On the other hand, unrealistic expectations, and dysfunctional beliefs towards sleep in ageing, might prompt older adults to report sleep disruption even in the absence of objective disrupted sleep. Objective of this study is to examine an association between personal attitudes towards ageing in adults aged 60+ and dysfunctional sleep related cognition. More in detail, this study aims to investigate a potential association between personal attitudes towards ageing, sleep locus of control and dysfunctional beliefs towards sleep among this portion of the population. Data in this study were statistically analysed in SPSS software. Participants were recruited through the online participants recruitment system Prolific. Inclusion of attention check questions throughout the questionnaire and consistency of responses were looked at. Prior to the commencement of this study, Ethical Approval was granted (ref. 39396). Descriptive statistics were used to determine the frequency, mean, and SDs of the variables. Pearson coefficient was used for interval variables, independent T-test for comparing means between two independent groups, analysis of variance (ANOVA) test for comparing the means in several independent groups, and hierarchical linear regression models for predicting criterion variables based on predictor variables. In this study self-perceptions of ageing were assessed using APQ-B’s subscales, while dysfunctional sleep related cognition was operationalised using the SLOC and the DBAS16 scales. Of the final subscales taken in consideration in the brief version of the APQ questionnaire, Emotional Representations (ER), Control Positive (PC) and Control and Consequences Negative (NC) have shown to be of particularly relevance for the remits of this study. Regression analysis show how an increase in the APQ-B subscale Emotional Representations (ER) predicts an increase in dysfunctional beliefs and attitudes towards sleep in this sample, after controlling for subjective sleep quality, level of depression and chronological age. A second regression analysis showed that APQ-B subscales Control Positive (PC) and Control and Consequences Negative (NC) were significant predictors in the change of variance of SLOC, after controlling for subjective sleep quality, level of depression and dysfunctional beliefs about sleep.Keywords: sleep-related cognition, perceptions of aging, older adults, sleep quality
Procedia PDF Downloads 103297 Driver of Migration and Appropriate Policy Concern Considering the Southwest Coastal Part of Bangladesh
Authors: Aminul Haque, Quazi Zahangir Hossain, Dilshad Sharmin Chowdhury
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The human migration is getting growing concern around the world, and recurrent disasters and climate change impact have great influence on migration. Bangladesh is one of the disaster prone countries that/and has greater susceptibility to stress migration by recurrent disasters and climate change. The study was conducted to investigate the factors that have a strong influence on current migration and changing pattern of life and livelihood means of the southwest coastal part of Bangladesh. Moreover, the study also revealed a strong relationship between disasters and migration and appropriate policy concern. To explore this relation, both qualitative and quantitative methods were applied to a questionnaire survey at household level and simple random sampling technique used in the sampling process along with different secondary data sources for understanding policy concern and practices. The study explores the most influential driver of migration and its relationship with social, economic and environmental drivers. The study denotes that, the environmental driver has a greater effect on the intention of permanent migration (t=1.481, p-value=0.000) at the 1 percent significance level. The significant number of respondents denotes that abrupt pattern of cyclone, flood, salinity intrusion and rainfall are the most significant environmental driver to make a decision on permanent migration. The study also found that the temporary migration pattern has 2-fold increased compared to last ten (10) years. It also appears from the study that environmental factors have a great implication on the changing pattern of the occupation of the study area and it has reported that about 76% of the respondent now in the changing modality of livelihood compare to their traditional practices. The study bares that the migration has foremost impact on children and women by increasing hardship and creating critical social security. The exposure-route of permanent migration is not smooth indeed, these migrations creating urban and conflict in Chittagong hill tracks of Bangladesh. The study denotes that there is not any safeguard of the stress migrant on existing policy and not have any measures for safe migration and resettlement rather considering the emergency response and shelter. The majority of (98%) people believes that migration is not to be the adoption strategies, but contrary to this young group of respondent believes that safe migration could be the adaptation strategy which could bring a positive result compare to the other resilience strategies. On the other hand, the significant number of respondents uttered that appropriate policy measure could be an adaptation strategy for being the formation of a resilient community and reduce the migration by meaningful livelihood options with appropriate protection measure.Keywords: environmental driver, livelihood, migration, resilience
Procedia PDF Downloads 263296 Assessing Children’s Probabilistic and Creative Thinking in a Non-formal Learning Context
Authors: Ana Breda, Catarina Cruz
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Daily, we face unpredictable events, often attributed to chance, as there is no justification for such an occurrence. Chance, understood as a source of uncertainty, is present in several aspects of human life, such as weather forecasts, dice rolling, and lottery. Surprisingly, humans and some animals can quickly adjust their behavior to handle efficiently doubly stochastic processes (random events with two layers of randomness, like unpredictable weather affecting dice rolling). This adjustment ability suggests that the human brain has built-in mechanisms for perceiving, understanding, and responding to simple probabilities. It also explains why current trends in mathematics education include probability concepts in official curriculum programs, starting from the third year of primary education onwards. In the first years of schooling, children learn to use a certain type of (specific) vocabulary, such as never, always, rarely, perhaps, likely, and unlikely, to help them to perceive and understand the probability of some events. These are keywords of crucial importance for their perception and understanding of probabilities. The development of the probabilistic concepts comes from facts and cause-effect sequences resulting from the subject's actions, as well as the notion of chance and intuitive estimates based on everyday experiences. As part of a junior summer school program, which took place at a Portuguese university, a non-formal learning experiment was carried out with 18 children in the 5th and 6th grades. This experience was designed to be implemented in a dynamic of a serious ice-breaking game, to assess their levels of probabilistic, critical, and creative thinking in understanding impossible, certain, equally probable, likely, and unlikely events, and also to gain insight into how the non-formal learning context influenced their achievements. The criteria used to evaluate probabilistic thinking included the creative ability to conceive events classified in the specified categories, the ability to properly justify the categorization, the ability to critically assess the events classified by other children, and the ability to make predictions based on a given probability. The data analysis employs a qualitative, descriptive, and interpretative-methods approach based on students' written productions, audio recordings, and researchers' field notes. This methodology allowed us to conclude that such an approach is an appropriate and helpful formative assessment tool. The promising results of this initial exploratory study require a future research study with children from these levels of education, from different regions, attending public or private schools, to validate and expand our findings.Keywords: critical and creative thinking, non-formal mathematics learning, probabilistic thinking, serious game
Procedia PDF Downloads 27295 An Observation Approach of Reading Order for Single Column and Two Column Layout Template
Authors: In-Tsang Lin, Chiching Wei
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Reading order is an important task in many digitization scenarios involving the preservation of the logical structure of a document. From the paper survey, it finds that the state-of-the-art algorithm could not fulfill to get the accurate reading order in the portable document format (PDF) files with rich formats, diverse layout arrangement. In recent years, most of the studies on the analysis of reading order have targeted the specific problem of associating layout components with logical labels, while less attention has been paid to the problem of extracting relationships the problem of detecting the reading order relationship between logical components, such as cross-references. Over 3 years of development, the company Foxit has demonstrated the layout recognition (LR) engine in revision 20601 to eager for the accuracy of the reading order. The bounding box of each paragraph can be obtained correctly by the Foxit LR engine, but the result of reading-order is not always correct for single-column, and two-column layout format due to the table issue, formula issue, and multiple mini separated bounding box and footer issue. Thus, the algorithm is developed to improve the accuracy of the reading order based on the Foxit LR structure. In this paper, a creative observation method (Here called the MESH method) is provided here to open a new chance in the research of the reading-order field. Here two important parameters are introduced, one parameter is the number of the bounding box on the right side of the present bounding box (NRight), and another parameter is the number of the bounding box under the present bounding box (Nunder). And the normalized x-value (x/the whole width), the normalized y-value (y/the whole height) of each bounding box, the x-, and y- position of each bounding box were also put into consideration. Initial experimental results of single column layout format demonstrate a 19.33% absolute improvement in accuracy of the reading-order over 7 PDF files (total 150 pages) using our proposed method based on the LR structure over the baseline method using the LR structure in 20601 revision, which its accuracy of the reading-order is 72%. And for two-column layout format, the preliminary results demonstrate a 44.44% absolute improvement in accuracy of the reading-order over 2 PDF files (total 18 pages) using our proposed method based on the LR structure over the baseline method using the LR structure in 20601 revision, which its accuracy of the reading-order is 0%. Until now, the footer issue and a part of multiple mini separated bounding box issue can be solved by using the MESH method. However, there are still three issues that cannot be solved, such as the table issue, formula issue, and the random multiple mini separated bounding boxes. But the detection of the table position and the recognition of the table structure are out of the scope in this paper, and there is needed another research. In the future, the tasks are chosen- how to detect the table position in the page and to extract the content of the table.Keywords: document processing, reading order, observation method, layout recognition
Procedia PDF Downloads 181294 Gandhi and the Judicial Discourse on Moral Rights
Authors: Sunayana Basu Mallik, Shishira Prakash
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The inclusion of Rights of Author (Moral and Personal Rights) resonate the century long battle of rights of authors, composers, performers across developed and developing countries (whether following civil law or common law systems). But, the juxtaposition of author’s special, moral, personal rights within the legislative framework of Copyright statutes (Indian Copyright Act, 1957, applicable statutes) underscores the foundational role of the right which goes to the root of the constitutional structure of India and philosophies of political and literary leaders like Mahatma Gandhi and Gurudeb Rabindranath Tagore. In the pre-independence era when the concept of moral rights was unknown to both England and India’s statutory laws, the strategic deployment method of Gandhi, his ideologies and thoughts scripted the concept of moral rights for authors/composers. The preservation of Rabindric Style (Characteristic Tagore’s vocal renditions) by Vishwabharati University (successor in interest for Tagore’s literary and musical compositions) prior to the Copyright Amendment of 1999 recognizing Author’s Special Rights in line with 6bis of Berne Convention invigorates the fact that the right existed intrinsically prior to the legislative amendment. The paper would in addition to the academic probe carry out an empirical enquiry of the institution’s (Navjivan Trust and Vishwa Bharati University’s) reasoning on the same. The judicial discourse and transforming constitutional ideals between 1950s till date in India alludes Moral Rights to be an essential legal right which have been reasoned by Indian Courts based on the underlying philosophies in culture, customs, religion wherein composers and literary figures have played key roles in enlightening and encouraging the members of society through their literary, musical and artistic work during pre-independence renaissance of India. The discourses have been influenced by the philosophies reflected in the preamble of the Indian constitution, ‘socialist, secular, democratic republic’ and laws of other civil law countries. Lastly, the paper would analyze the adjudication process and witness involvement in ascertaining violations of moral rights and further summarize the indigenous and country specific economic thoughts that often chisel decisions on moral rights of authors, composers, performers which sometimes intersect with author’s right of privacy and against defamation. The exclusivity contracts or other arrangements between authors, composers and publishing companies not only have an erosive effect on each thread of moral rights but irreparably dents factors that promote creativity. The paper would also be review these arrangements in view of the principles of unjust enrichment, unfair trade practices, anti-competitive behavior and breach of Section 27 (Restrain of Trade) of Indian Contract Act, 1857. The paper will thus lay down the three pillars on which author’s rights in India should namely rest, (a) political and judicial discourse evolving principles supporting moral rights of authors; (b) amendment and insertion of Section 57 of the Copyright Act, 1957; (c) overall constitutional framework supporting author’s rights.Keywords: copyright, moral rights, performer’s rights, personal rights
Procedia PDF Downloads 194293 Factors Associated with Treatment Adherence among Pulmonary Tuberculosis Patients in New Delhi
Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal
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Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis
Procedia PDF Downloads 200292 Role of Psychological Capital in Organizational and Personal Outcomes: An Exploratory Study of Medical Professionals in Pakistan
Authors: Shazia Almas, Jaffar Iqbal, Nazia Almas
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In most of the South Asian countries like Pakistan medical profession is one the most valued and respectful professions yet being a medical professional requires an enormous amount of responsibilities and work overload at the same time which possibly can be in contrast with family role of a doctor. Job and family are two primary spheres of a person's life no matter whatever the profession one adopts and the type of family one is running. There is a bi-directional relationship between job and family. The type and nature of work, time schedules, working shifts in medical profession are very demanding in the countries like Pakistan where number of patients is far more higher than the number of doctors available. The work life also have significant impact on family life and vice versa. Because of the sensitivity and interdependency of these relations, today’s overarching and competing demands remain dissatisfactory. The main objective of the current research is to investigate how interpersonal relationships affect work and work affects interpersonal relationships of medical professionals. In line with identifying these facts, the current study aimed to examine the predictive role of psychological capital (self-efficacy, hope, optimism, and resilience), in organizational outcome (job satisfaction) and personal outcome (family satisfaction) amongst male and medical professionals. A total of 350 participants from public and private sector hospitals of Pakistan were recruited through simple random and stratified sampling techniques, with age ranges from 26-50 years. The questionnaire including established and certified self-report measures of Psychological Capital Questionnaire, Job Satisfaction, and Family Satisfaction were adopted to collect the data. The reliability and validity of mentioned instruments were established through Cronbach’s alpha and factor analyses (exploratory and confirmatory) respectively using Structural Equation Modeling (SEM) by AMOS. The proposed hypotheses were tested using Pearson’s Correlation and Regression analyses for predicting effect whereas, t-Test was deployed to verify the difference between male and female health professionals. The results revealed that self-efficacy and optimism predicted job satisfaction while, self-efficacy, hope, and resilience predicted family satisfaction. Moreover, the results depicted significant gender differences in job satisfaction where females were higher on job satisfaction as compared to male medical professionals but no significant differences were observed in levels of family satisfaction between both genders. The study has implications for social, organizational and work policy designers. The study also paves for more researches with positive psychological approach to promote work-family harmony.Keywords: family satisfaction, job satisfaction, medical professionals, psychological capital
Procedia PDF Downloads 250291 An in silico Approach for Exploring the Intercellular Communication in Cancer Cells
Authors: M. Cardenas-Garcia, P. P. Gonzalez-Perez
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Intercellular communication is a necessary condition for cellular functions and it allows a group of cells to survive as a population. Throughout this interaction, the cells work in a coordinated and collaborative way which facilitates their survival. In the case of cancerous cells, these take advantage of intercellular communication to preserve their malignancy, since through these physical unions they can send signs of malignancy. The Wnt/β-catenin signaling pathway plays an important role in the formation of intercellular communications, being also involved in a large number of cellular processes such as proliferation, differentiation, adhesion, cell survival, and cell death. The modeling and simulation of cellular signaling systems have found valuable support in a wide range of modeling approaches, which cover a wide spectrum ranging from mathematical models; e.g., ordinary differential equations, statistical methods, and numerical methods– to computational models; e.g., process algebra for modeling behavior and variation in molecular systems. Based on these models, different simulation tools have been developed from mathematical ones to computational ones. Regarding cellular and molecular processes in cancer, its study has also found a valuable support in different simulation tools that, covering a spectrum as mentioned above, have allowed the in silico experimentation of this phenomenon at the cellular and molecular level. In this work, we simulate and explore the complex interaction patterns of intercellular communication in cancer cells using the Cellulat bioinformatics tool, a computational simulation tool developed by us and motivated by two key elements: 1) a biochemically inspired model of self-organizing coordination in tuple spaces, and 2) the Gillespie’s algorithm, a stochastic simulation algorithm typically used to mimic systems of chemical/biochemical reactions in an efficient and accurate way. The main idea behind the Cellulat simulation tool is to provide an in silico experimentation environment that complements and guides in vitro experimentation in intra and intercellular signaling networks. Unlike most of the cell signaling simulation tools, such as E-Cell, BetaWB and Cell Illustrator which provides abstractions to model only intracellular behavior, Cellulat is appropriate for modeling both intracellular signaling and intercellular communication, providing the abstractions required to model –and as a result, simulate– the interaction mechanisms that involve two or more cells, that is essential in the scenario discussed in this work. During the development of this work we made evident the application of our computational simulation tool (Cellulat) for the modeling and simulation of intercellular communication between normal and cancerous cells, and in this way, propose key molecules that may prevent the arrival of malignant signals to the cells that surround the tumor cells. In this manner, we could identify the significant role that has the Wnt/β-catenin signaling pathway in cellular communication, and therefore, in the dissemination of cancer cells. We verified, using in silico experiments, how the inhibition of this signaling pathway prevents that the cells that surround a cancerous cell are transformed.Keywords: cancer cells, in silico approach, intercellular communication, key molecules, modeling and simulation
Procedia PDF Downloads 249290 Measuring Digital Literacy in the Chilean Workforce
Authors: Carolina Busco, Daniela Osses
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The development of digital literacy has become a fundamental element that allows for citizen inclusion, access to quality jobs, and a labor market capable of responding to the digital economy. There are no methodological instruments available in Chile to measure the workforce’s digital literacy and improve national policies on this matter. Thus, the objective of this research is to develop a survey to measure digital literacy in a sample of 200 Chilean workers. Dimensions considered in the instrument are sociodemographics, access to infrastructure, digital education, digital skills, and the ability to use e-government services. To achieve the research objective of developing a digital literacy model of indicators and a research instrument for this purpose, along with an exploratory analysis of data using factor analysis, we used an empirical, quantitative-qualitative, exploratory, non-probabilistic, and cross-sectional research design. The research instrument is a survey created to measure variables that make up the conceptual map prepared from the bibliographic review. Before applying the survey, a pilot test was implemented, resulting in several adjustments to the phrasing of some items. A validation test was also applied using six experts, including their observations on the final instrument. The survey contained 49 items that were further divided into three sets of questions: sociodemographic data; a Likert scale of four values ranked according to the level of agreement; iii) multiple choice questions complementing the dimensions. Data collection occurred between January and March 2022. For the factor analysis, we used the answers to 12 items with the Likert scale. KMO showed a value of 0.626, indicating a medium level of correlation, whereas Bartlett’s test yielded a significance value of less than 0.05 and a Cronbach’s Alpha of 0.618. Taking all factor selection criteria into account, we decided to include and analyze four factors that together explain 53.48% of the accumulated variance. We identified the following factors: i) access to infrastructure and opportunities to develop digital skills at the workplace or educational establishment (15.57%), ii) ability to solve everyday problems using digital tools (14.89%), iii) online tools used to stay connected with others (11.94%), and iv) residential Internet access and speed (11%). Quantitative results were discussed within six focus groups using heterogenic selection criteria related to the most relevant variables identified in the statistical analysis: upper-class school students; middle-class university students; Ph.D. professors; low-income working women, elderly individuals, and a group of rural workers. The digital divide and its social and economic correlations are evident in the results of this research. In Chile, the items that explain the acquisition of digital tools focus on access to infrastructure, which ultimately puts the first filter on the development of digital skills. Therefore, as expressed in the literature review, the advance of these skills is radically different when sociodemographic variables are considered. This increases socioeconomic distances and exclusion criteria, putting those who do not have these skills at a disadvantage and forcing them to seek the assistance of others.Keywords: digital literacy, digital society, workforce digitalization, digital skills
Procedia PDF Downloads 67289 Investigating the Neural Heterogeneity of Developmental Dyscalculia
Authors: Fengjuan Wang, Azilawati Jamaludin
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Developmental Dyscalculia (DD) is defined as a particular learning difficulty with continuous challenges in learning requisite math skills that cannot be explained by intellectual disability or educational deprivation. Recent studies have increasingly recognized that DD is a heterogeneous, instead of monolithic, learning disorder with not only cognitive and behavioral deficits but so too neural dysfunction. In recent years, neuroimaging studies employed group comparison to explore the neural underpinnings of DD, which contradicted the heterogenous nature of DD and may obfuscate critical individual differences. This research aimed to investigate the neural heterogeneity of DD using case studies with functional near-infrared spectroscopy (fNIRS). A total of 54 aged 6-7 years old of children participated in this study, comprising two comprehensive cognitive assessments, an 8-minute resting state, and an 8-minute one-digit addition task. Nine children met the criteria of DD and scored at or below 85 (i.e., the 16th percentile) on the Mathematics or Math Fluency subtest of the Wechsler Individual Achievement Test, Third Edition (WIAT-III) (both subtest scores were 90 and below). The remaining 45 children formed the typically developing (TD) group. Resting-state data and brain activation in the inferior frontal gyrus (IFG), superior frontal gyrus (SFG), and intraparietal sulcus (IPS) were collected for comparison between each case and the TD group. Graph theory was used to analyze the brain network under the resting state. This theory represents the brain network as a set of nodes--brain regions—and edges—pairwise interactions across areas to reveal the architectural organizations of the nervous network. Next, a single-case methodology developed by Crawford et al. in 2010 was used to compare each case’s brain network indicators and brain activation against 45 TD children’s average data. Results showed that three out of the nine DD children displayed significant deviation from TD children’s brain indicators. Case 1 had inefficient nodal network properties. Case 2 showed inefficient brain network properties and weaker activation in the IFG and IPS areas. Case 3 displayed inefficient brain network properties with no differences in activation patterns. As a rise above, the present study was able to distill differences in architectural organizations and brain activation of DD vis-à-vis TD children using fNIRS and single-case methodology. Although DD is regarded as a heterogeneous learning difficulty, it is noted that all three cases showed lower nodal efficiency in the brain network, which may be one of the neural sources of DD. Importantly, although the current “brain norm” established for the 45 children is tentative, the results from this study provide insights not only for future work in “developmental brain norm” with reliable brain indicators but so too the viability of single-case methodology, which could be used to detect differential brain indicators of DD children for early detection and interventions.Keywords: brain activation, brain network, case study, developmental dyscalculia, functional near-infrared spectroscopy, graph theory, neural heterogeneity
Procedia PDF Downloads 53288 The Seller’s Sense: Buying-Selling Perspective Affects the Sensitivity to Expected-Value Differences
Authors: Taher Abofol, Eldad Yechiam, Thorsten Pachur
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In four studies, we examined whether seller and buyers differ not only in subjective price levels for objects (i.e., the endowment effect) but also in their relative accuracy given objects varying in expected value. If, as has been proposed, sellers stand to accrue a more substantial loss than buyers do, then their pricing decisions should be more sensitive to expected-value differences between objects. This is implied by loss aversion due to the steeper slope of prospect theory’s value function for losses than for gains, as well as by loss attention account, which posits that losses increase the attention invested in a task. Both accounts suggest that losses increased sensitivity to relative values of different objects, which should result in better alignment of pricing decisions to the objective value of objects on the part of sellers. Under loss attention, this characteristic should only emerge under certain boundary conditions. In Study 1 a published dataset was reanalyzed, in which 152 participants indicated buying or selling prices for monetary lotteries with different expected values. Relative EV sensitivity was calculated for participants as the Spearman rank correlation between their pricing decisions for each of the lotteries and the lotteries' expected values. An ANOVA revealed a main effect of perspective (sellers versus buyers), F(1,150) = 85.3, p < .0001 with greater EV sensitivity for sellers. Study 2 examined the prediction (implied by loss attention) that the positive effect of losses on performance emerges particularly under conditions of time constraints. A published dataset was reanalyzed, where 84 participants were asked to provide selling and buying prices for monetary lotteries in three deliberations time conditions (5, 10, 15 seconds). As in Study 1, an ANOVA revealed greater EV sensitivity for sellers than for buyers, F(1,82) = 9.34, p = .003. Importantly, there was also an interaction of perspective by deliberation time. Post-hoc tests revealed that there were main effects of perspective both in the condition with 5s deliberation time, and in the condition with 10s deliberation time, but not in the 15s condition. Thus, sellers’ EV-sensitivity advantage disappeared with extended deliberation. Study 3 replicated the design of study 1 but administered the task three times to test if the effect decays with repeated presentation. The results showed that the difference between buyers and sellers’ EV sensitivity was replicated in repeated task presentations. Study 4 examined the loss attention prediction that EV-sensitivity differences can be eliminated by manipulations that reduce the differential attention investment of sellers and buyers. This was carried out by randomly mixing selling and buying trials for each participant. The results revealed no differences in EV sensitivity between selling and buying trials. The pattern of results is consistent with an attentional resource-based account of the differences between sellers and buyers. Thus, asking people to price, an object from a seller's perspective rather than the buyer's improves the relative accuracy of pricing decisions; subtle changes in the framing of one’s perspective in a trading negotiation may improve price accuracy.Keywords: decision making, endowment effect, pricing, loss aversion, loss attention
Procedia PDF Downloads 344287 Comparative Study on Effectiveness and Safety of Oral Antidiabetic Medications in Patients with Type 2 Diabetes Mellitus in a Tertiary Care Hospital of Bangalore, South India - A Prospective Cohort Study
Authors: Shobha Rani R. Hiremath, Keerthana R., Madhuvan H. S.
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BACKGROUND: Type 2 Diabetes is a chronic health condition where the body cannot effectively use the insulin it produces, leading to elevated blood sugar levels It is often associated with lifestyle factors and insulin resistance. Globally, diabetes is on the rise, with urban areas like Bangalore seeing a surge due to lifestyle changes, stress, and dietary habits. To manage diabetes effectively, over 50 medications are available, each serving to regulate blood sugar through different mechanisms. This reflects the complex and individualized nature of diabetes treatment. Given the increase in medications for Type 2 diabetes mellitus, it is important to evaluate their effectiveness and safety so that clinicians can make informed choices while treating their patients. OBJECTIVES: To evaluate the effectiveness of various anti-diabetic medications used in the hospital in Type 2 diabetes patients by monitoring their HbA1c levels. To assess the safety of these medications by monitoring Adverse drug reactions if any. METHODOLOGY Design : Prospective Cohort study, Study period: 8 months, Sample Size: 100 patients, Inclusion Criteria: Patients above 18 years of both genders who were diagnosed with T2DM and who were prescribed oral hypoglycaemic agents. Exclusion Criteria: Diabetic patients with hepatic/renal failure, patients prescribed with insulin /not prescribed with OHAs and patients who were terminally ill, pregnant and lactating patients. Source of Data: Prescriptions, lab reports, ECG reports. Data collection forms were used to collect data which consisted of patient demographic details, drugs prescribed, laboratory investigations such as HbA1C, FBS, PPBS , ECG and any ADRs experienced. Data was collected at baseline, 3 months, and 6 months. It was statistically analyzed using SPSS (version 26) software. RESULTS: Greater number of patients (46%) were in the age group of greater than 61 years. 43 patients had no co-morbidities whereas 51 patients had Hypertension as the co morbidity. Basically 5 Drug combinations were prescribed as follows. Combination 1: Tablet Metformin HCL + Glimepiride (500, 2 mg) : 1-0-1, Combination 2: Tablet Sitagliptin + Metformin HCL (50, 500 mg) : 1-0-1, Combination 3: Tablet Vildagliptin + Metformin HCL (50, 500 mg): 1-0-1, Combination 4: Tablet Voglibose+ Glimepiride+ Metformin HCL (0.2 ,2 ,500mg): : 1-0-1, Combination 5: Tablet Voglibose+ Glimepiride+ Metformin HCL (0.2, 2 ,500mg): : 1-0-1 and T. Sitagliptin +Metformin HCL (50, 500 mg): 0-1-0. Combination 5 (Voglibose, Glimepiride, Metformin, Sitagliptin) was most effective in reducing HbA1c levels, showing a significant decrease (-0.00682, p = 0.001), followed by Combinations 4 and 3. However, Combination 5 also had the highest incidence of gastrointestinal side effects (72.7%) and ECG abnormalities (27.3%). Combination 1 (Metformin + Glimepiride) had the highest occurrence of hypoglycemia due to Glimepiride's insulin-stimulating effects. Weight loss was most notable in Combination 5, affecting 36.36% of patients. CONCLUSION: The enhanced effectiveness of Combinations 3, 4, and 5 suggests that a multi-drug approach that incorporates different mechanisms of action is more effective in managing HbA1c levels in patients with diabetes. Adverse effect profiles should be considered for personalized treatment strategies.Keywords: type 2 diabetes, safety, oral anti diabetic medications, effectiveness
Procedia PDF Downloads 9286 The Effect of Mindfulness Meditation on Pain, Sleep Quality, and Self-Esteem in Patients Receiving Hemodialysis in Jordan
Authors: Hossam N. Alhawatmeh, Areen I. Albustanji
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Hemodialysis negatively affects physical and psychological health. Pain, poor sleep quality, and low self-esteem are highly prevalent among patients with end-stage renal disease (ESRD) who receive hemodialysis, significantly increasing mortality and morbidity of those patients. Mind-body interventions (MBI), such as mindfulness meditation, have been recently gaining popularity that improved pain, sleep quality, and self-esteem in different populations. However, to our best knowledge, its effects on these health problems in patients receiving hemodialysis have not been studied in Jordan. Thus, the purpose of the study was to examine the effect of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESR receiving hemodialysis in Jordan. An experimental repeated-measures, randomized, parallel control design was conducted on (n =60) end-stage renal disease patients undergoing hemodialysis between March and June 2023 in the dialysis center at a public hospital in Jordan. Participants were randomly assigned to the experimental (n =30) and control groups (n =30) using a simple random assignment method. The experimental group practiced mindfulness meditation for 30 minutes three times per week for five weeks during their hemodialysis treatments. The control group's patients continued to receive hemodialysis treatment as usual for five weeks during hemodialysis sessions. The study variables for both groups were measured at baseline (Time 0), two weeks after intervention (Time 1), and at the end of intervention (Time 3). The numerical rating scale (NRS), the Rosenberg Self-Esteem Scale (RSES-M), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure pain, self-esteem, and sleep quality, respectively. SPSS version 25 was used to analyze the study data. The sample was described by frequency, mean, and standard deviation as an appropriate. The repeated measures analysis of variance (ANOVA) tests were run to test the study hypotheses. The results of repeated measures ANOVA (within-subject) revealed that mindfulness meditation significantly decrease pain by the end of the intervention in the experimental group. Additionally, mindfulness meditation improved sleep quality and self-esteem in the experimental group, and these improvements occurred significantly after two weeks of the intervention and at the end of the intervention. The results of repeated measures ANOVA (within and between-subject) revealed that the experimental group, compared to the control group, experienced lower levels of pain and higher levels of sleep quality and self-esteem over time. In conclusion, the results provided substantial evidence supporting the positive impacts of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESRD undergoing hemodialysis. These results highlight the potential of mindfulness meditation as an adjunctive therapy in the comprehensive care of this patient population. Incorporating mindfulness meditation into the treatment plan for patients receiving hemodialysis may contribute to improved well-being and overall quality of life.Keywords: hemodialysis, pain, sleep quality, self-esteem, mindfulness
Procedia PDF Downloads 86285 Reducing Road Traffic Accident: Rapid Evidence Synthesis for Low and Middle Income Countries
Authors: Tesfaye Dagne, Dagmawit Solomon, Firmaye Bogale, Yosef Gebreyohannes, Samson Mideksa, Mamuye Hadis, Desalegn Ararso, Ermias Woldie, Tsegaye Getachew, Sabit Ababor, Zelalem Kebede
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Globally, road traffic accident (RTA) is causing millions of deaths and injuries every year. It is one of the leading causes of death among people of all age groups and the problem is worse among young reproductive age group. Moreover the problem is increasing with an increasing number of vehicles. The majority of the problem happen in low and middle income countries (LMIC), even if the number of vehicles in these countries is low compared to their population. So, the objective of this paper is to summarize the best available evidence on interventions that can reduce road traffic accidents in low and middle income countries (LMIC). Method: A rapid evidence synthesis approach adapted from the SURE Rapid Response Service was applied to search, appraise and summarize the best available evidence on effective intervention in reducing road traffic injury. To answer the question under review, we searched for relevant studies from databases including PubMed, the Cochrane Library, TRANSPORT, Health system evidence, Epistemonikos, and SUPPORT summary. The following key terms were used for searching: Road traffic accident, RTA, Injury, Reduc*, Prevent*, Minimiz*, “Low and middle-income country”, LMIC. We found 18 articles through a search of different databases mentioned above. After screening for the titles and abstracts of the articles, four of them which satisfy the inclusion criteria were included in the final review. Then we appraised and graded the methodological quality of systematic reviews that are deemed to be highly relevant using AMSTAR. Finding: The identified interventions to reduce road traffic accidents were legislation and enforcement, public awareness/education, speed control/ rumble strips, road improvement, mandatory motorcycle helmet, graduated driver license, street lighting. Legislation and Enforcement: Legislation focusing on mandatory motorcycle helmet usage, banning cellular phone usage when driving, seat belt laws, decreasing the legal blood alcohol content (BAC) level from 0.06 g/L to 0.02 g/L bring the best result where enforcement is there. Public Awareness/Education: focusing on seat belt use, child restraint use, educational training in health centers and schools/universities, and public awareness with media through the distribution of videos, posters/souvenirs, and pamphlets are effective in the short run. Speed Control: through traffic calming bumps, or speed bumps, rumbled strips are effective in reducing accidents and fatality. Mandatory Motorcycle Helmet: is associated with reduction in mortality. Graduated driver’s license (GDL): reduce road traffic injury by 19%. Street lighting: is a low-cost intervention which may reduce road traffic accidents.Keywords: evidence synthesis, injury, rapid review, reducing, road traffic accident
Procedia PDF Downloads 164284 Oat Bran Associated with Nutritional Counseling in Treating Obesity and Other Risk Factors for Cardiovascular Disease
Authors: Simone Raimondi De Souza, Glaucia Maria Moraes De Oliveira, Ronir Raggio Luiz, Glorimar Rosa
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Introduction: Obesity is among the main risk factors for cardiovascular disease (CVD). Genesis is multifactorial, including genetic, hormonal and environmental factors disorders, among which inadequate feeding pattern, for which nutritional counseling strategies have proven effective. The consumption of beta-glucans (soluble fibers that reportedly promote satiety) present in oat bran can be an effective strategy for preventing and treating obesity. Other benefits have been observed with oat bran consumption, such as reduction of hypercholesterolemia and hyperglycemia, two other risk factors for CVD. Objectives: To analyze the effect of oat bran consumption associated with nutritional counseling in reducing body mass index (BMI), blood cholesterol, glucose profile, waist and neck circumference in obese individuals, and to evaluate the change in eating pattern. Methods: clinical trial, randomized, double-blind, placebo-controlled, lasting 90 days with adults of both genders, with BMI ≥30kg/m2. The study was approved by the Ethics in Research involving human beings in a public institute of cardiology, in Rio de Janeiro, Brazil. Individuals were invited to participate and accepted formally by signing the Terms of Consent. Participants were randomized into oat bran group (gOB) or placebo group (gPCB) and received, respectively: morning prepared consisting of 40g oat bran, 30g of skimmed milk powder and 1g sweetener sucralose; refined flour 40g rice, 30g of milk powder and 1g sweetener sucralose. The Ten Steps to Healthy Eating, of Brazilian Ministry of Health were used to support the nutritional counseling. Variables analyzed: gender; age; BMI, waist circumference (WC) neck circumference (NC); systolic blood pressure (SBP); diastolic blood pressure (DBP); food consumption, total cholesterol (TC), LDL-cholesterol (LDL-c), HDL-cholesterol (HDL-c), non-HDL cholesterol (nHDLc), triglycerides (TG), fasting glucose (FG), fasting insulin (FI) and HOMA-IR. Dietary intake was assessed by 24-hour dietary recall. The Diet Quality Index revised for the Brazilian population (IQD-R) assessed quality of feeding pattern. Statistical analyzes were performed using SPSS version 21, considering statistically significant p-value less than 0.05. Results: A total of 38 participants were included, age = 50 ± 7,6years, 63% women. 19 subjects were placed in gOB and 19 in gPCB. After intervention, statistically significant reductions were observed in the following parameters: in gOB: IQD-R, TC, LDL-c, nHDL-c, FI, SBP, DBP, BMI, WC, NC; in gPCB: IQD-R, LDL-c, SBP, DBP, BMI, WC, NC. No statistically significant differences were observed in the results between groups. Conclusion: Our results reinforce nutritional counseling as important strategy for prevention and treatment of obesity and suggest that inclusion of oat bran in daily diet can bring additional benefits controlling risk factors for CVD. More studies are needed to establish all benefits of oat bran to human health as well as the ideal daily dose for consumption.Keywords: oat bran, cardiovascular disease, nutritional counseling, obesity
Procedia PDF Downloads 231283 Restructurasation of the Concept of Empire in the Social Consciousness of Modern Americans
Authors: Maxim Kravchenko
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The paper looks into the structure and contents of the concept of empire in the social consciousness of modern Americans. To construct the model of this socially and politically relevant concept we have conducted an experiment with respondents born and living in the USA. Empire is seen as a historic notion describing such entities as the British empire, the Russian empire, the Ottoman empire and others. It seems that the democratic regime adopted by most countries worldwide is incompatible with imperial status of a country. Yet there are countries which tend to dominate in the contemporary world and though they are not routinely referred to as empires, in many respects they are reminiscent of historical empires. Thus, the central hypothesis of the study is that the concept of empire is cultivated in some states through the intermediary of the mass media though it undergoes a certain transformation to meet the expectations of a democratic society. The transformation implies that certain components which were historically embedded in its structure are drawn to the margins of the hierarchical structure of the concept whereas other components tend to become central to the concept. This process can be referred to as restructuration of the concept of empire. To verify this hypothesis we have conducted a study which falls into two stages. First we looked into the definition of empire featured in dictionaries, the dominant conceptual components of empire are: importance, territory/lands, recognition, independence, authority/power, supreme/absolute. However, the analysis of 100 articles from American newspapers chosen at random revealed that authors rarely use the word «empire» in its basic meaning (7%). More often «empire» is used when speaking about countries, which no longer exist or when speaking about some corporations (like Apple or Google). At the second stage of the study we conducted an associative experiment with the citizens of the USA aged 19 to 45. The purpose of the experiment was to find out the dominant components of the concept of empire and to construct the model of the transformed concept. The experiment stipulated that respondents should give the first association, which crosses their mind, on reading such stimulus phrases as “strong military”, “strong economy” and others. The list of stimuli features various words and phrases associated with empire including the words representing the dominant components of the concept of empire. Then the associations provided by the respondents were classified into thematic clusters. For instance, the associations to the stimulus “strong military” were compartmentalized into three groups: 1) a country with strong military forces (North Korea, the USA, Russia, China); 2) negative impression of strong military (war, anarchy, conflict); 3) positive impression of strong military (peace, safety, responsibility). The experiment findings suggest that the concept of empire is currently undergoing a transformation which brings about a number of changes. Among them predominance of positively assessed components of the concept; emergence of two poles in the structure of the concept, that is “hero” vs. “enemy”; marginalization of any negatively assessed components.Keywords: associative experiment, conceptual components, empire, restructurasation of the concept
Procedia PDF Downloads 313282 Effect of Rapeseed Press Cake on Extrusion System Parameters and Physical Pellet Quality of Fish Feed
Authors: Anna Martin, Raffael Osen
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The demand for fish from aquaculture is constantly growing. Concurrently, due to a shortage of fishmeal caused by extensive overfishing, fishmeal substitution by plant proteins is getting increasingly important for the production of sustainable aquafeed. Several research studies evaluated the impact of plant protein meals, concentrates or isolates on fish health and fish feed quality. However, these protein raw materials often require elaborate and expensive manufacturing and their availability is limited. Rapeseed press cake (RPC) – a side product of de-oiling processes – exhibits a high potential as a plant-based fishmeal alternative in fish feed for carnivorous species due to its availability, low costs and protein content. In order to produce aquafeed with RPC, it is important to systematically assess i) inclusion levels of RPC with similar pellet qualities compared to fishmeal containing formulations and ii) how extrusion parameters can be adjusted to achieve targeted pellet qualities. However, the effect of RPC on extrusion system parameters and pellet quality has only scarcely been investigated. Therefore, the aim of this study was to evaluate the impact of feed formulation, extruder barrel temperature (90, 100, 110 °C) and screw speed (200, 300, 400 rpm) on extrusion system parameters and the physical properties of fish feed pellets. A co-rotating pilot-scale twin screw extruder was used to produce five iso-nitrogenous feed formulations: a fish meal based reference formulation including 16 g/100g fishmeal and four formulations in which fishmeal was substituted by RPC to 25, 50, 75 or 100 %. Extrusion system parameters, being product temperature, pressure at the die, specific mechanical energy (SME) and torque, were monitored while samples were taken. After drying, pellets were analyzed regarding to optical appearance, sectional and longitudinal expansion, sinking velocity, bulk density, water stability, durability and specific hardness. In our study, the addition of minor amounts of RPC already had high impact on pellet quality parameters, especially on expansion but only marginally affected extrusion system parameters. Increasing amounts of RPC reduced sectional expansion, sinking velocity, bulk density and specific hardness and increased longitudinal expansion compared to a reference formulation without RPC. Water stability and durability were almost not affected by RPC addition. Moreover, pellets with rapeseed components showed a more coarse structure than pellets containing only fishmeal. When the adjustment of barrel temperature and screw speed was investigated, it could be seen that the increase of extruder barrel temperature led to a slight decrease of SME and die pressure and an increased sectional expansion of the reference pellets but did almost not affect rapeseed containing fish feed pellets. Also changes in screw speed had little effects on the physical properties of pellets however with raised screw speed the SME and the product temperature increased. In summary, a one-to-one substitution of fishmeal with RPC without the adjustment of extrusion process parameters does not result in fish feed of a designated quality. Therefore, a deeper knowledge of raw materials and their behavior under thermal and mechanical stresses as applied during extrusion is required.Keywords: extrusion, fish feed, press cake, rapeseed
Procedia PDF Downloads 148281 Role of Indigenous Women in Securing Sustainable Livelihoods in Western Himalayan Region, India
Authors: Haresh Sharma, Jaimini Luharia
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The ecology in the Western Himalayan region transforms with the change in altitude. This change is observed in terms of topography, species of flora and fauna and the quality of the soil. The current study focuses on women of indigenous communities of Pangi Valley, which is located in the state of Himachal Pradesh, India. The valley is bifurcated into three different areas –Saichu, Hudan Bhatori, and Sural Bhatori valleys. It is one of the most remote, rugged and difficult to access tribal regions of Chamba district. The altitude of the valley ranges from 2,000 m to 6,000 m above sea level. The Pangi valley is inhabited by ‘Pangwals’ and ‘Bhots’ tribes of the Himalayas who speak their local tribal language called’ Pangwali’. The valley is cut-off from the mainland due to heavy snow and lack of proper roads during peak winters. Due to difficult geographical location, the daily lives of the people are constantly challenged, and they are most of the times deprived of benefits targeted through government programs. However, the indigenous communities earn their livelihood through livestock and forest-based produce while some of them migrate to nearby places for better work. The current study involves snowball sampling methodology for data collection along with in-depth interviews of women members of Self-Help Groups and women farmers. The findings reveal that the lives of these indigenous communities largely depend on forest-based products. So, it creates all the more significance of enhancing, maintaining, and consuming natural resources sustainably. Under such circumstances, the women of the community play a significant role of guardians in conservation and protection of the forests. They are the custodians of traditional knowledge of environment conservation practices that have been followed for many years in the region. The present study also sought to establish a relationship between some of the development initiatives undertaken by the women in the valley that stimulate sustainable mountain economy and conservation practices. These initiatives include cultivation of products like hazelnut, ‘Gucchi’ rare quality mushroom, medicinal plants exclusively found in the region, thereby promoting long term sustainable conservation of agro-biodiversity of the Western Himalayan region. The measures taken by the community women are commendable as they ensure access and distribution of natural resources as well as manage them for future generations. Apart from this, the tribal women have actively formed Self-Help Groups promoting financial inclusion through various activities that augment ownership and accountability towards the overall development of the communities. But, the results also suggest that there’s not enough recognition given to women’s role in forests conservation practices due to several local socio-political reasons. There are not enough research studies done on communities of Pangi Valley due to inaccessibility created out of lack of proper roads and other resources. Also, there emerged a need to concretize indigenous and traditional knowledge of conservation practices followed by women in the community.Keywords: forest conservation, indigenous community women, sustainable livelihoods, sustainable development, poverty alleviation, Western Himalayas
Procedia PDF Downloads 120280 Method of Nursing Education: History Review
Authors: Cristina Maria Mendoza Sanchez, Maria Angeles Navarro Perán
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Introduction: Nursing as a profession, from its initial formation and after its development in practice, has been built and identified mainly from its technical competence and professionalization within the positivist approach of the XIX century that provides a conception of the disease built on the basis of to the biomedical paradigm, where the care provided is more focused on the physiological processes and the disease than on the suffering person understood as a whole. The main issue that is in need of study here is a review of the nursing profession's history to get to know how the nursing profession was before the XIX century. It is unclear if there were organizations or people with knowledge about looking after others or if many people survived by chance. The holistic care, in which the appearance of the disease directly affects all its dimensions: physical, emotional, cognitive, social and spiritual. It is not a concept from the 21st century. It is common practice, most probably since established life in this world, with the final purpose of covering all these perspectives through quality care. Objective: In this paper, we describe and analyze the history of education in nursing learning in terms of reviewing and analysing theoretical foundations of clinical teaching and learning in nursing, with the final purpose of determining and describing the development of the nursing profession along the history. Method: We have done a descriptive systematic review study, doing a systematically searched of manuscripts and articles in the following health science databases: Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL. The selection of articles has been made according to PRISMA criteria, doing a critical reading of the full text using the CASPe method. A compliment to this, we have read a range of historical and contemporary sources to support the review, such as manuals of Florence Nightingale and John of God as primary manuscripts to establish the origin of modern nursing and her professionalization. We have considered and applied ethical considerations of data processing. Results: After applying inclusion and exclusion criteria in our search, in Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL, we have obtained 51 research articles. We have analyzed them in such a way that we have distinguished them by year of publication and the type of study. With the articles obtained, we can see the importance of our background as a profession before modern times in public health and as a review of our past to face challenges in the near future. Discussion: The important influence of key figures other than Nightingale has been overlooked and it emerges that nursing management and development of the professional body has a longer and more complex history than is generally accepted. Conclusions: There is a paucity of studies on the subject of the review to be able to extract very precise evidence and recommendations about nursing before modern times. But even so, as more representative data, an increase in research about nursing history has been observed. In light of the aspects analyzed, the need for new research in the history of nursing emerges from this perspective; in order to germinate studies of the historical construction of care before the XIX century and theories created then. We can assure that pieces of knowledge and ways of care were taught before the XIX century, but they were not called theories, as these concepts were created in modern times.Keywords: nursing history, nursing theory, Saint John of God, Florence Nightingale, learning, nursing education
Procedia PDF Downloads 112279 A Case Study Demonstrating the Benefits of Low-Carb Eating in an Adult with Latent Autoimmune Diabetes Highlights the Necessity and Effectiveness of These Dietary Therapies
Authors: Jasmeet Kaur, Anup Singh, Shashikant Iyengar, Arun Kumar, Ira Sahay
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Latent autoimmune diabetes in adults (LADA) is an irreversible autoimmune disease that affects insulin production. LADA is characterized by the production of Glutamic acid decarboxylase (GAD) antibodies, which is similar to type 1 diabetes. Individuals with LADA may eventually develop overt diabetes and require insulin. In this condition, the pancreas produces little or no insulin, which is a hormone used by the body to allow glucose to enter cells and produce energy. While type 1 diabetes was traditionally associated with children and teenagers, its prevalence has increased in adults as well. LADA is frequently misdiagnosed as type 2 diabetes, especially in adulthood when type 2 diabetes is more common. LADA develops in adulthood, usually after age 30. Managing LADA involves metabolic control with exogenous insulin and prolonging the life of surviving beta cells, thereby slowing the disease's progression. This case study examines the impact of approximately 3 months of low-carbohydrate dietary intervention in a 42-year-old woman with LADA who was initially misdiagnosed as having type 2 diabetes. Her c-peptide was 0.13 and her HbA1c was 9.3% when this trial began. Low-carbohydrate interventions have been shown to improve blood sugar levels, including fasting, post-meal, and random blood sugar levels, as well as haemoglobin levels, blood pressure, energy levels, sleep quality, and satiety levels. The use of low-carbohydrate dietary intervention significantly reduces both hypo- and hyperglycaemia events. During the 3 months of the study, there were 2 to 3 hyperglycaemic events owing to physical stress and a single hypoglycaemic event. Low-carbohydrate dietary therapies lessen insulin dose inaccuracy, which explains why there were fewer hyperglycaemic and hypoglycaemic events. In three months, the glycated haemoglobin (HbA1c) level was reduced from 9.3% to 6.3%. These improvements occur without the need for caloric restriction or physical activity. Stress management was crucial aspect of the treatment plan as stress-induced neuroendocrine hormones can cause immunological dysregulation. Additionally, supplements that support immune system and reduce inflammation were used as part of the treatment during the trial. Long-term studies are needed to track disease development and corroborate the claim that such dietary treatments can prolong the honeymoon phase in LADA. Various factors can contribute to additional autoimmune attacks, so measuring c-peptide is crucial on a regular basis to determine whether insulin levels need to be adjusted.Keywords: autoimmune, diabetes, LADA, low_carb, nutrition
Procedia PDF Downloads 38278 Assessment of the Growth Enhancement Support Scheme in Adamawa State, Nigeria
Authors: Oto J. Okwu, Ornan Henry, Victor A. Otene
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The agricultural sector contributes a great deal to the sustenance of Nigeria’s food security and economy, with an attendant impact on rural development. In spite of the relatively high number of farmers in the country, self-sufficiency in food production is still a challenge. Farmers are faced with myriad problems which hinder their production efficiency, one of which is their access to agricultural inputs required for optimum production. To meet the challenges faced by farmers, the government at the federal level has come up with many agricultural policies, one of which is the Agricultural Transformation Agenda (ATA). The Growth Enhancement Support Scheme (GESS) is one of the critical components of ATA, which is aimed at ensuring the effective distribution of agricultural inputs delivered directly to farmers, and at a regulated cost. After about 8 years of launching this policy, it will be necessary to carry out an assessment of GESS and determine the impact it has made on rural farmers with respect to their access to farm inputs. This study was carried out to assess the Growth Enhancement Support Scheme (GESS) in Adamawa State, Nigeria. Crop farmers who registered under the GESS in Adamawa State, Nigeria, formed the population for the study. Primary data for the study were obtained through a survey, and the use of a structured questionnaire. A sample size of 167 respondents was selected using multi-stage, purposive, and random sampling techniques. The validity and reliability of the research instrument (questionnaire) were obtained through pilot testing and test-retest method, respectively. The objectives of the study were to determine the difference in the level of access to agricultural inputs before and after GESS, determine the difference in cost of agricultural inputs before and after GESS, and to determine the challenges faced by rural farmers in accessing agricultural inputs through GESS. Both descriptive and inferential statistics were used in analyzing the collected data. Specifically, Mann-Whitney, student t-test, and factor analysis were used to test the stated hypotheses. Research findings revealed there was a significant difference in the level of access to farm inputs after the introduction of GESS (Z=14.216). Also, there was a significant difference in the cost of agro-inputs after the introduction of GESS (Pr |T| > |t|= 0.0000). The challenges faced by respondents in accessing agro-inputs through GESS were administrative and technical in nature. Based on the findings of the research, it was recommended that efforts be made by the government to sustain the GESS, as it has significantly improved the level of farmers’ access to agricultural inputs and has reduced the cost of agro-inputs, while administrative challenges faced by the respondents in accessing inputs be addressed by the government, and extension agents assist the farmers to overcome the technical challenges they face in accessing inputs.Keywords: agricultural policy, agro-inputs, assessment, growth enhancement support scheme, rural farmers
Procedia PDF Downloads 109277 Population Growth as the Elephant in the Room: Teachers' Perspectives and Willingness to Incorporate a Controversial Environmental Sustainability Issue in their Teaching
Authors: Iris Alkaher, Nurit Carmi
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It is widely agreed among scientists that population growth (PG) is a major factor that drives the global environmental crisis. Many researchers recognize that explicitly addressing the impact of PG on the environment and human quality of life through education systems worldwide could play a significant role in improving understanding regarding the links between rapid PG and environmental degradation and changing perceptions, attitudes, and behaviors concerning the necessity to reduce the fertility rate. However, the issue of PG is still rarely included in schools' curricula, mainly because of its complexity and controversiality. This study aims to explore the perspectives of teachers with an academic background in environmental and sustainability education (ESEteachers) and teachers with no such background (non-ESE teachers) regarding PG as an environmental risk. The study also explores the teachers’ willingness to include PG in their teaching and identifies what predicts their inclusion of it. In this mixed-methods research study, data were collected using questionnaires and interviews. The findings portray a complex picture concerning the debate aboutPG as a major factor that drives the global environmental crisis in the Israeli context. Consistent with other countries, we found that the deep-rooted pronatalist culture in the Israeli society, as well as a robust national pronatalist agenda and policies, have a tremendous impact on the education system. Therefore, we found that an academic background in ESE had a limited impact on teachers' perceptions concerning PG as a problem and on their willingness to include it in their teaching and discuss its controversiality. Teachers' attitudes related to PG demonstrated social, cultural, and politically oriented disavowal justification regarding the negative impacts of rapid PG, identified in the literature as population-skepticism and population-fatalism. Specifically, factors such as the ongoing Israeli-Palestinian conflict, the Jewish anxiety of destruction, and the religious command to“be fruitful and multiply”influenced the perceptions of both ESE and non-ESE teachers. While these arguments are unique to the Israeli context, pronatalist policies are international. In accordance with the pronatalist policy, we also found that the absence of PG from both school curricula and the Israeli public discourse was reported by ESE and non-ESE teachers as major reasons for their disregarding PG in their teaching. Under these circumstances, the role of the education system to bring the population question to the front stage in Israel and elsewhere is more challenging. To encourage science and social studies teachers to incorporate the controversial issue of PG in their teaching and successfully confront dominant pronatalist cultures, they need strong and ongoing scaffolding and support. In accordance with scientists' agreement regarding the role of PG as a major factor that drives the global environmental crisis, we call on stakeholders and policymakers in the education system to bring the population debate into schools' curricula, the sooner, the better. And not only as part of human efforts to mitigate environmental degradation but also to use this controversial topic as a platform for shaping critical learners and responsible and active citizens who are tolerant of different people’s opinions.Keywords: population growth, environmental and sustainability education, controversial environmental sustainability issues, pronatalism
Procedia PDF Downloads 101276 An Integrated Framework for Wind-Wave Study in Lakes
Authors: Moien Mojabi, Aurelien Hospital, Daniel Potts, Chris Young, Albert Leung
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The wave analysis is an integral part of the hydrotechnical assessment carried out during the permitting and design phases for coastal structures, such as marinas. This analysis aims in quantifying: i) the Suitability of the coastal structure design against Small Craft Harbour wave tranquility safety criterion; ii) Potential environmental impacts of the structure (e.g., effect on wave, flow, and sediment transport); iii) Mooring and dock design and iv) Requirements set by regulatory agency’s (e.g., WSA section 11 application). While a complex three-dimensional hydrodynamic modelling approach can be applied on large-scale projects, the need for an efficient and reliable wave analysis method suitable for smaller scale marina projects was identified. As a result, Tetra Tech has developed and applied an integrated analysis framework (hereafter TT approach), which takes the advantage of the state-of-the-art numerical models while preserving the level of simplicity that fits smaller scale projects. The present paper aims to describe the TT approach and highlight the key advantages of using this integrated framework in lake marina projects. The core of this methodology is made by integrating wind, water level, bathymetry, and structure geometry data. To respond to the needs of specific projects, several add-on modules have been added to the core of the TT approach. The main advantages of this method over the simplified analytical approaches are i) Accounting for the proper physics of the lake through the modelling of the entire lake (capturing real lake geometry) instead of a simplified fetch approach; ii) Providing a more realistic representation of the waves by modelling random waves instead of monochromatic waves; iii) Modelling wave-structure interaction (e.g. wave transmission/reflection application for floating structures and piles amongst others); iv) Accounting for wave interaction with the lakebed (e.g. bottom friction, refraction, and breaking); v) Providing the inputs for flow and sediment transport assessment at the project site; vi) Taking in consideration historical and geographical variations of the wind field; and vii) Independence of the scale of the reservoir under study. Overall, in comparison with simplified analytical approaches, this integrated framework provides a more realistic and reliable estimation of wave parameters (and its spatial distribution) in lake marinas, leading to a realistic hydrotechnical assessment accessible to any project size, from the development of a new marina to marina expansion and pile replacement. Tetra Tech has successfully utilized this approach since many years in the Okanagan area.Keywords: wave modelling, wind-wave, extreme value analysis, marina
Procedia PDF Downloads 84275 A Versatile Data Processing Package for Ground-Based Synthetic Aperture Radar Deformation Monitoring
Authors: Zheng Wang, Zhenhong Li, Jon Mills
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Ground-based synthetic aperture radar (GBSAR) represents a powerful remote sensing tool for deformation monitoring towards various geohazards, e.g. landslides, mudflows, avalanches, infrastructure failures, and the subsidence of residential areas. Unlike spaceborne SAR with a fixed revisit period, GBSAR data can be acquired with an adjustable temporal resolution through either continuous or discontinuous operation. However, challenges arise from processing high temporal-resolution continuous GBSAR data, including the extreme cost of computational random-access-memory (RAM), the delay of displacement maps, and the loss of temporal evolution. Moreover, repositioning errors between discontinuous campaigns impede the accurate measurement of surface displacements. Therefore, a versatile package with two complete chains is developed in this study in order to process both continuous and discontinuous GBSAR data and address the aforementioned issues. The first chain is based on a small-baseline subset concept and it processes continuous GBSAR images unit by unit. Images within a window form a basic unit. By taking this strategy, the RAM requirement is reduced to only one unit of images and the chain can theoretically process an infinite number of images. The evolution of surface displacements can be detected as it keeps temporarily-coherent pixels which are present only in some certain units but not in the whole observation period. The chain supports real-time processing of the continuous data and the delay of creating displacement maps can be shortened without waiting for the entire dataset. The other chain aims to measure deformation between discontinuous campaigns. Temporal averaging is carried out on a stack of images in a single campaign in order to improve the signal-to-noise ratio of discontinuous data and minimise the loss of coherence. The temporal-averaged images are then processed by a particular interferometry procedure integrated with advanced interferometric SAR algorithms such as robust coherence estimation, non-local filtering, and selection of partially-coherent pixels. Experiments are conducted using both synthetic and real-world GBSAR data. Displacement time series at the level of a few sub-millimetres are achieved in several applications (e.g. a coastal cliff, a sand dune, a bridge, and a residential area), indicating the feasibility of the developed GBSAR data processing package for deformation monitoring of a wide range of scientific and practical applications.Keywords: ground-based synthetic aperture radar, interferometry, small baseline subset algorithm, deformation monitoring
Procedia PDF Downloads 161274 In-Flight Aircraft Performance Model Enhancement Using Adaptive Lookup Tables
Authors: Georges Ghazi, Magali Gelhaye, Ruxandra Botez
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Over the years, the Flight Management System (FMS) has experienced a continuous improvement of its many features, to the point of becoming the pilot’s primary interface for flight planning operation on the airplane. With the assistance of the FMS, the concept of distance and time has been completely revolutionized, providing the crew members with the determination of the optimized route (or flight plan) from the departure airport to the arrival airport. To accomplish this function, the FMS needs an accurate Aircraft Performance Model (APM) of the aircraft. In general, APMs that equipped most modern FMSs are established before the entry into service of an individual aircraft, and results from the combination of a set of ordinary differential equations and a set of performance databases. Unfortunately, an aircraft in service is constantly exposed to dynamic loads that degrade its flight characteristics. These degradations endow two main origins: airframe deterioration (control surfaces rigging, seals missing or damaged, etc.) and engine performance degradation (fuel consumption increase for a given thrust). Thus, after several years of service, the performance databases and the APM associated to a specific aircraft are no longer representative enough of the actual aircraft performance. It is important to monitor the trend of the performance deterioration and correct the uncertainties of the aircraft model in order to improve the accuracy the flight management system predictions. The basis of this research lies in the new ability to continuously update an Aircraft Performance Model (APM) during flight using an adaptive lookup table technique. This methodology was developed and applied to the well-known Cessna Citation X business aircraft. For the purpose of this study, a level D Research Aircraft Flight Simulator (RAFS) was used as a test aircraft. According to Federal Aviation Administration the level D is the highest certification level for the flight dynamics modeling. Basically, using data available in the Flight Crew Operating Manual (FCOM), a first APM describing the variation of the engine fan speed and aircraft fuel flow w.r.t flight conditions was derived. This model was next improved using the proposed methodology. To do that, several cruise flights were performed using the RAFS. An algorithm was developed to frequently sample the aircraft sensors measurements during the flight and compare the model prediction with the actual measurements. Based on these comparisons, a correction was performed on the actual APM in order to minimize the error between the predicted data and the measured data. In this way, as the aircraft flies, the APM will be continuously enhanced, making the FMS more and more precise and the prediction of trajectories more realistic and more reliable. The results obtained are very encouraging. Indeed, using the tables initialized with the FCOM data, only a few iterations were needed to reduce the fuel flow prediction error from an average relative error of 12% to 0.3%. Similarly, the FCOM prediction regarding the engine fan speed was reduced from a maximum error deviation of 5.0% to 0.2% after only ten flights.Keywords: aircraft performance, cruise, trajectory optimization, adaptive lookup tables, Cessna Citation X
Procedia PDF Downloads 264273 Survival Analysis after a First Ischaemic Stroke Event: A Case-Control Study in the Adult Population of England.
Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski
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Stroke is associated with a significant risk of morbidity and mortality. There is scarcity of research on the long-term survival after first-ever ischaemic stroke (IS) events in England with regards to effects of different medical therapies and comorbidities. The objective of this study was to model the all-cause mortality after an IS diagnosis in the adult population of England. Using a retrospective case-control design, we extracted the electronic medical records of patients born prior to or in year 1960 in England with a first-ever ischaemic stroke diagnosis from January 1986 to January 2017 within the Health and Improvement Network (THIN) database. Participants with a history of ischaemic stroke were matched to 3 controls by sex and age at diagnosis and general practice. The primary outcome was the all-cause mortality. The hazards of the all-cause mortality were estimated using a Weibull-Cox survival model which included both scale and shape effects and a shared random effect of general practice. The model included sex, birth cohort, socio-economic status, comorbidities and medical therapies. 20,250 patients with a history of IS (cases) and 55,519 controls were followed up to 30 years. From 2008 to 2015, the one-year all-cause mortality for the IS patients declined with an absolute change of -0.5%. Preventive treatments to cases increased considerably over time. These included prescriptions of statins and antihypertensives. However, prescriptions for antiplatelet drugs decreased in the routine general practice since 2010. The survival model revealed a survival benefit of antiplatelet treatment to stroke survivors with hazard ratio (HR) of 0.92 (0.90 – 0.94). IS diagnosis had significant interactions with gender and age at entry and hypertension diagnosis. IS diagnosis was associated with high risk of all-cause mortality with HR= 3.39 (3.05-3.72) for cases compared to controls. Hypertension was associated with poor survival with HR = 4.79 (4.49 - 5.09) for hypertensive cases relative to non-hypertensive controls, though the detrimental effect of hypertension has not reached significance for hypertensive controls, HR = 1.19(0.82-1.56). This study of English primary care data showed that between 2008 and 2015, the rates of prescriptions of stroke preventive treatments increased, and a short-term all-cause mortality after IS stroke declined. However, stroke resulted in poor long-term survival. Hypertension, a modifiable risk factor, was found to be associated with poor survival outcomes in IS patients. Antiplatelet drugs were found to be protective to survival. Better efforts are required to reduce the burden of stroke through health service development and primary prevention.Keywords: general practice, hazard ratio, health improvement network (THIN), ischaemic stroke, multiple imputation, Weibull-Cox model.
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