Search results for: women history

Authors: Roya Vakili, Lekaa Elhajjmoussa, Barzin Omidi-Shal, Kim Blake

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Objective: The purpose of this case report is to highlight the successful treatment of a patient with Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness, (CHARGE syndrome) using a vagal nerve stimulator (VNS). Background: This is the first documented case report, to the authors' best knowledge, for a patient with CHARGE syndrome, epilepsy, autism, and postural orthostatic tachycardia syndrome (POTS) that was successfully treated with an implanted VNS therapeutic device. Methodology: The study is a case report. Results: This is the case of a 24-year-old female patient with CHARGE syndrome (non-random association of anomalies Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness) and several other comorbidities including refractory epilepsy, Patent Ductus Arteriosus (PDA) and POTS who had significant improvement of her symptoms after VNS implantation. She was a VNS candidate given her longstanding history of drug-resistant epilepsy and current disposition secondary to CHARGE syndrome. Prior to VNS implantation, she experienced three generalized seizures a year and daily POTS-related symptoms. She was having frequent lightheadedness and syncope spells due to a rapid heart rate and low blood pressure. The VNS device was set to detect a rapid heart rate and send appropriate stimulation anytime the heart rate exceeded 20% of the patient’s normal baseline. The VNS device demonstrated frequent elevated heart rates and concurrent VNS release every 8 minutes in addition to the programmed events. Following VNS installation, the patient became more active, alert, and communicative and was able to verbally communicate with words she was unable to say prior. Her GI symptoms also improved, as she was able to tolerate food better orally in addition to her G and J tube, likely another result of the vagal nerve stimulation. Additionally, the patient’s seizures and POTS-related cardiac events appeared to be well controlled. She had prolonged electroencephalogram (EEG) testing, showing no significant change in epileptiform activity. Improvements in the patient’s disposition are believed to be secondary to parasympathetic stimulation, adequate heart rate control, and GI stimulation, in addition to behavioral changes and other benefits via her implanted VNS. Conclusion: VNS showed promising results in improving the patient's quality of life and managing her diverse symptoms, including dysautonomia, POTs, gastrointestinal mobility, cognitive functioning as well seizure control.

Keywords: autism, POTs, CHARGE, VNS

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Authors: Irfan Khan, Chiemeka David Ekene Arize, Hilly Swami

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Mental health care access and stigma present global challenges, with disparities significantly influenced by economic, cultural, and societal factors. This paper focuses on the mental health care systems of South Asia and the United States, comparing how cultural norms, infrastructure, and policy affect mental health care accessibility and effectiveness in both regions. In South Asia, mental health care is hindered by a combination of underfunding, a critical shortage of professionals, and deeply ingrained cultural stigmas that deter help-seeking. Traditional beliefs often link mental disorders to supernatural causes, and women face additional barriers due to gender disparities. Despite recent policy reforms, implementation remains a challenge, particularly in rural areas. In contrast, the U.S. has a more developed healthcare infrastructure but continues to grapple with stigma, particularly within professional settings like law enforcement. Interventions such as the use of community health workers (CHWs) and collaborative care models have improved access, especially among underserved populations. However, the U.S. still faces disparities in care for minority groups, where cultural competence and stigma reduction are critical for improving outcomes. The paper’s comparative analysis identifies transferable strategies from the U.S. that could be adapted to South Asia’s context, such as integrating mental health care into primary care and using digital interventions to bridge the treatment gap in rural areas. Additionally, South Asia's community-centered approaches offer insights that could enhance the cultural adaptability of interventions in the U.S., particularly for ethnic minorities and immigrant populations. Through a systematic review, this paper examines intervention strategies, stigma, policy support, and the cultural and social determinants of mental health in both regions. The findings emphasize the need for culturally tailored mental health interventions and policy reforms that promote access and reduce stigma. Recommendations include enhancing public awareness, integrating mental health services into primary care, expanding community-based programs, and leveraging digital health interventions. This research contributes to the global discourse on mental health by highlighting culturally sensitive approaches that can be adapted to improve mental health care access and outcomes in both South Asia and the United States.

Keywords: mental health stigma South Asia, mental health care accessibility South Asia, cultural influences mental health South Asia, mental health interventions USA, cross-cultural mental health care

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Authors: Ana L. Gonzalez-Celis, Edgardo Ruiz-Carrillo, Karina Reyes-Jarquin, Margarita Chavez-Becerra

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Since recent decades, the aging has been viewed from a more positive perspective, where is not only about losses and damage, but also about being on a stage where you can enjoy life and live with well-being and quality of life. The challenge to feel better is to find those resources that seniors have. For that reason, psychological well-being has shown interest in the study of the affect and life satisfaction (hedonic well-being), while from a more recent tradition, focus on the development of capabilities and the personal growth, considering both as the main indicators of the quality of life. A resource that can be used in the later age is generativity, which refers to the ability of older people to develop and grow through activities that contribute with the improvement of the context in which they live and participate. In this way the generative interest is understood as a favourable attitude that contribute to the common benefit while strengthening and enriching the social institutions, to ensure continuity between generations and social development. On the other hand, generative behavior, differentiating from generative interest, is the expression of that attitude reflected in activities that make a social contribution and a benefit for generations to come. Hence the purpose of the research was to test if there is an association between the generative behaviour type and the psychological well-being with their dimensions. For this reason 188 Mexican adults from 60 to 94 years old (M = 69.78), 67% women, 33% men, completed two instruments: The Ryff’s Well-Being Scales to measure psychological well-being with 39 items with two dimensions (Hedonic and Eudaimonic well-being), and the Loyola’s Generative Behaviors Scale, grouped in five categories: Knowledge transmitted to the next generation, things to be remember, creativity, be productive, contribution to the community, and responsibility of other people. In addition, the socio-demographic data sheet was tested, and self-reported health status. The results indicated that the psychological well-being and its dimensions were significantly associated with the presence of generative behavior, where the level of well-being was higher when the frequency of some generative behaviour excelled; finding that the behavior with greater psychological well-being (M = 81.04, SD = 8.18) was "things to be remembered"; while with greater hedonic well-being (M = 73.39, SD = 12.19) was the behavior "responsibility of other people"; and with greater Eudaimonic well-being (M = 84.61, SD = 6.63), was the behavior "things to be remembered”. The most important findings highlight the importance of generative behaviors in adulthood, finding empirical evidence that the generativity in the last stage of life is associated with well-being. However, by finding differences in the types of generative behaviors at the level of well-being, is proposed the idea that generativity is not situated as an isolated construct, but needs other contextualized and related constructs that can simultaneously operate at different levels, taking into account the relationship between the environment and the individual, encompassing both the social and psychological dimension.

Keywords: eudaimonic well-being, generativity, hedonic well-being, Mexican elders, psychological well-being

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Authors: James Beauchemin

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Introduction: The incarceration of people with mental illness and substance use disorders is a major public health issue, with social, clinical, and economic implications. Yoga participation has been associated with numerous psychological benefits; however, there is a paucity of research examining impacts of yoga with incarcerated populations. The purpose of this study was to evaluate effectiveness of a six-week yoga intervention on several mental health-related variables, including emotion regulation, body awareness, and warnings of substance relapse among incarcerated females. Methods: This study utilized a pre-post, three-arm design, with participants assigned to intervention, therapeutic community, or general population groups. A between-groups analysis of covariance (ANCOVA) was conducted across groups to assess intervention effectiveness using the Difficulties in Emotion Regulation Scale (DERS), Scale of Body Connection (SBC), and Warnings of Relapse (AWARE) Questionnaire. Results: ANCOVA results for warnings of relapse (AWARE) revealed significant between-group differences F(2, 80) = 7.15, p = .001; np2 = .152), with significant pairwise comparisons between the intervention group and both the therapeutic community (p = .001) and the general population (p = .005) groups. Similarly, significant differences were found for emotional regulation (DERS) F(2, 83) = 10.521, p = .000; np2 = .278). Pairwise comparisons indicated a significant difference between the intervention and general population (p = .01). Finally, significant differences between the intervention and control groups were found for body awareness (SBC) F(2, 84) = 3.69, p = .029; np2 = .081). Between-group differences were clarified via pairwise comparisons, indicating significant differences between the intervention group and both the therapeutic community (p = .028) and general population groups (p = .020). Implications: Study results suggest that yoga may be an effective addition to integrative mental health and substance use treatment for incarcerated women, and contributes to increasing evidence that holistic interventions may be an important component for treatment with this population. Specifically, given the prevalence of mental health and substance use disorders, findings revealed that changes in body awareness and emotion regulation may be particularly beneficial for incarcerated populations with substance use challenges as a result of yoga participation. From a systemic perspective, this proactive approach may have long-term implications for both physical and psychological well-being for the incarcerated population as a whole, thereby decreasing the need for traditional treatment. By integrating a more holistic, salutogenic model that emphasizes prevention, interventions like yoga may work to improve the wellness of this population, while providing an alternative or complementary treatment option for those with current symptoms.

Keywords: yoga, mental health, incarceration, wellness

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Authors: Ye Sun, Han-Youl Lee, Kathy Musa-Veloso, Nabil Bosco

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Japan has been experiencing global ageing of population with the World’s leading life expectancy (80.8 y for men and 86.9 y for women) and among the lowest birth rate. Preventive nutrition-based approaches have been identified by the health authorities as one of the strategies to increase the healthy life expectancy and reduce the healthcare costs. However, the nutritional needs and status of the senior population have not been well characterized to provide targeted solutions. This study aims to describe the age- and gender-specific prevalence of inadequacy of macro- and micronutrients intake based on the latest Japan National Health and Nutrition Survey (JNHNS) 2014. JNHNS collected data on the consumption of foods and beverages using 1-day semi-weight household dietary record. Nutrient intake levels were then calculated using the Japanese standard tables of food composition. Where applicable, Japanese population-specific estimated average requirements (EAR) were used as a benchmark to determine the prevalence of potential nutrient intake inadequacy, and adequate intake (AI) were used for nutrients with no available EARs. In all, 3403 senior adults aged 60 y and above and 3324 young adults aged 19 to 59 y were included in the 2014 JNHNS. Age- and gender-specific differences were observed in the mean nutrient intakes as well as the prevalence of inadequacy. Among the 22 nutrients examined, the prevalence of inadequacy for iron, vitamin C, magnesium, potassium, and folic acid in the senior adults was significantly lower than young adults, suggesting potentially healthier dietary choices by the seniors. However, there was still a considerable proportion of seniors who did not meet the requirement for key nutrients like vitamin B1 (67%), calcium (57%), vitamin A (48%), magnesium (47%), vitamin E (44%), and vitamin B6 (41%). Inadequate nutrient intake is generally more prevalent among elderly males than females for many nutrients, with the exception of iron (prevalence of inadequacy: 21% versus 42%) which could partly be explained by the higher intake recommendations for the females. In conclusion, high prevalence of nutrient inadequacy exists in older adults, with a potentially worsened picture for men. Such inadequacies could have multiple health implications including physical frailty and mental health. Further study is warranted to investigate the food consumption patterns that could explain the observed nutrient inadequacies, and to eventually develop nutrition-based solutions tailored to the needs of specific subgroups of the population.

Keywords: ageing, national health and nutrition survey, nutrients, nutrition

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Authors: M. Ghasemi, S.Fazelifar

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Abstract Aim: Over-weight is not desirable and has implications for health and in the case of athletes affects performance. Exercise is a strategy used to counteract overweight owing to create a negative energy balance by increasing energy expenditure and influencing appetite regulating hormones. Interestingly, recent studies have revealed inhibitory effects of exercise on the hunger associated with these hormones in healthy subjects Neuropeptide Y(NPY) is a 36 amino acid protein that is a powerful stimulant appetite. NPY is an important central orexigenic hormone predominantly produced by the hypothalamus, and recently found to be secreted in adipose tissue. This neurotransmitter is secreted in the brain and autonomic nervous system. On the other hand, research has shown that thyme in addition to various properties, also affects the appetite. The purpose of this study was to determine Effects of eight weeks endurance training and thyme consumption on neuropeptide Y in untrained men. Methodology: 36 Healthy untrained men (mean body weight 78.25±3.2 kg, height 176±6.8 cm, age 34.32±4.54 years and BMI 29.1±4.3 kg/m2) voluntarily participated in this study . Subjects were randomly divided into four groups: 1. control, 2. Endurance training, 3. Thyme 4. Endurance training + Thyme. Amount of 10cc Blood sampling were obtained pre-test and post-test (after 8 weeks). The taken blood samples were centrifuged at 1500 × g for 15 min then plasma was stored at -20 °C until analysis. Endurance training consisted three session per week with 60% -75% of reserve heart rate for eight weeks. Exclusion criteria were history of gastrointestinal, endocrine, cardiovascular or psychological disease, and consuming any supplementation, alcohol and tobacco products. Descriptive statistics including means, standard deviations, and ranges were calculated for all measures. K-S test to determine the normality of the data and analysis of variance for repeated measures was used to analyze the data. A significant difference in the p<0/05 accepted. Results: Results showed that aerobic training significantly reduced body weight, body mass index, percent body fat, but significant increase observed in maximal oxygen consumption level (p ≤ 0/05). The neuropeptide Y levels were significantly increased after exercise. Analysis of data determined that there was no significant difference between the four groups. Conclusion: Appetite control plays a critical role in the competition between energy consumption and energy expenditure. The results of this study showed that endurance training and thyme consumption can be cause improvement in physiological parameters such as increasing aerobic capacity, reduction of fat mass and improve body composition in untrained men.

Keywords: Endurance training, neuropeptide Y, thyme, untrained men

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Authors: Elena Pucci, Margherita Tufarelli, Leonardo Giliberti

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As central for human and social development of the future, sustainability is becoming a recurring theme also in the fashion industry, where the need to explore new possible directions aimed at achieving sustainability goals and their communication is rising. Scholars have been devoted to the overall environmental impact of the textile and fashion industry, which, emerging as one of the world’s most polluting, today concretely assumes the need to take the path of sustainability in both products and production processes. Every day we witness the impact of our consumption, showing that the sustainability concept is as vast as complex: with a sometimes ambiguous definition, sustainability can concern projects, products, companies, sales, packagings, supply chains in relation to the actors proximity as well as traceability, raw materials procurement, and disposal. However, in its primary meaning, sustainability is the ability to maintain specific values and resources for future generations. The contribution aims to address sustainability in the fashion system as a layered problem that requires substantial changes at different levels: in the fashion product (materials, production processes, timing, distribution, and disposal), in the functioning of the system (life cycle, impact, needs, communication) and last but not least in the practice of fashion design which should conceive durable, low obsolescence and possibly demountable products. Moreover, consumers play a central role for the growing awareness, together with an increasingly strong sensitivity towards the environment and sustainable clothing. Since it is also a market demand, undertaking significant efforts to achieve total transparency and sustainability in all production and distribution processes is becoming fundamental for the fashion system. Sustainability is not to be understood as purely environmental but as the pursuit of collective well-being in relation to conscious production, human rights, and social dignity with the aim to achieve intelligent, resource, and environmentally friendly production and consumption patterns. Assuming sustainability as a layered problem makes the role of communication crucial to convey scientific or production specific content so that people can obtain and interpret information to make related decisions. Hence, if it is true that “what designers make becomes the future we inhabit'', design is facing great and challenging responsibility. The fashion industry needs a system of rules able to assess the sustainability of products, which is transparent and easily interpreted by consumers, identifying and enhancing virtuous practices. There are still complex and fragmented value chains that make it extremely difficult for brands and manufacturers to know the history of their products, to identify exactly where the risks lie, and to respond to the growing demand from consumers and civil society for responsible and sustainable production practices in the fashion industry.

Keywords: fashion design, fashion system, sustainability, communication, complexity

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Authors: Ofelia Loani Elvir Lazo, Roya Yumul, David Chernobylsky, Omar Durra

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Background: It is crucial to detect the patient’s existing anxiety to assist patients in a perioperative setting which is to be caused by the fear associated with surgical and anesthetic complications. However, the current gold standard for assessing patient anxiety, the STAI, is problematic to use in the preoperative setting, given the duration and concentration required to complete the 40-item questionnaire. Our primary aim in the study is to investigate the correlation of the Yumul Visual Facial Anxiety Scale (VFAS) and Numerical Verbal Rating Scale (NVRS) to State-Trait Anxiety Inventory (STAI) to determine the optimal anxiety scale to use in the perioperative setting. Methods: A clinical study of patients undergoing various surgeries was conducted utilizing each of the preoperative anxiety scales. Inclusion criteria included patients undergoing elective surgeries, while exclusion criteria included patients with anesthesia contraindications, inability to comprehend instructions, impaired judgement, substance abuse history, and those pregnant or lactating. 293 patients were analyzed in terms of demographics, anxiety scale survey results, and anesthesia data via Spearman Coefficients, Chi-Squared Analysis, and Fischer’s exact test utilized for comparative analysis. Results: Statistical analysis showed that VFAS had a higher correlation to STAI than NVRS (rs=0.66, p<0.0001 vs. rs=0.64, p<0.0001). The combined VFAS-Categorization Scores showed the highest correlation with the gold standard (rs=0.72, p<0.0001). Subgroup analysis showed similar results. STAI evaluation time (247.7 ± 54.81 sec) far exceeds VFAS (7.29 ± 1.61 sec), NVRS (7.23 ± 1.60 sec), and Categorization scales (7.29 ± 1.99 sec). Patients preferred VFAS (54.4%), Categorization (11.6%), and NVRS (8.8%). Anesthesiologists preferred VFAS (63.9%), NVRS (22.1%), and Categorization Scales (14.0%). Of note, the top five causes of preoperative anxiety were determined to be waiting (56.5%), pain (42.5%), family concerns (40.5%), no information about surgery (40.1%), or anesthesia (31.6%). Conclusıons: Both VFAS and Categorization tests also take significantly less time than STAI, which is critical in the preoperative setting. Combined VFAS-Categorization Score (VCS) demonstrates the highest correlation to the gold standard, STAI. Among both patients and anesthesiologists, VFAS was the most preferred scale. This forms the basis of the Yumul Faces Anxiety Scale, designed for quick quantization and assessment in the preoperative setting while maintaining a high correlation to the golden standard. Additional studies using the formulated Yumul Faces Anxiety Scale are merited.

Keywords: numerical verbal anxiety scale, preoperative anxiety, state-trait anxiety inventory, visual facial anxiety scale

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Authors: Tom Turner

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The recent financial crisis in 2008 and the growing inequality in developed industrial societies would appear to present significant challenges to capitalism and the free market. Yet there have been few substantial mainstream political or economic challenges to the dominant capitalist and market paradigm to-date. There is no dearth of critical and theoretical (academic) analyses regarding the prevailing systems failures. Yet despite the growing inequality in the developed industrial societies and the financial crisis in 2008 few commentators have advocated the comprehensive socialization or state ownership of the means of production to our knowledge – a core principle of radical Marxism in the 19th and early part of the 20th century. Undoubtedly the experience in the Soviet Union and satellite countries in the 20th century has cast a dark shadow over the notion of centrally controlled economies and state ownership of the means of production. In this paper, we explore the history of a doctrine advocating the socialization or state ownership of the means of production that was central to Marxism and socialism generally. Indeed this doctrine provoked an intense and often acrimonious debate especially for left-wing parties throughout the 20th century. The debate within the political economy tradition has historically tended to divide into a radical and a revisionist approach to changing or reforming capitalism. The radical perspective views the conflict of interest between capital and labor as a persistent and insoluble feature of a capitalist society and advocates the public or state ownership of the means of production. Alternatively, the revisionist perspective focuses on issues of distribution rather than production and emphasizes the possibility of compromise between capital and labor in capitalist societies. Over the 20th century, the radical perspective has faded and even the social democratic revisionist tradition has declined in recent years. We conclude with the major challenges that confront both the radical and revisionist perspectives in the development of viable policy agendas in mature developed democratic societies. Additionally, we consider whether state ownership of the means of production still has relevance in the 21st century and to what extent state ownership is off the agenda as a political issue in the political mainstream in developed industrial societies. A central argument in the paper is that state ownership of the means of production is unlikely to feature as either a practical or theoretical solution to the problems of capitalism post the financial crisis among mainstream political parties of the left. Although the focus here is solely on the shifting views of the radical and revisionist socialist perspectives in the western European tradition the analysis has relevance for the wider socialist movement.

Keywords: sate ownership, ownership means of production, radicals, revisionists

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Authors: El Khaddam Safaa, Soulaymani Abdelmajid, Mokhtari Abdelghani, Ouammi Lahcen, Rachida Soulaymani-Beincheikh

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The poisonings represent a problem of health in the world and Morocco, The exact dimensions of this phenomenon are still poorly recorded that we see the lack of exhaustive statistical data. The objective of this retrospective study of a series of cases of the poisonings declared at the level of the region of Tadla-Azilal and collected by the Moroccan Poison Control and Pharmacovigilance Center. An epidemiological profile of the poisonings was to raise, to determine the risk factors influencing the vital preview of the poisoned And to follow the evolution of the incidence, the lethality, and the mortality. During the period of study, we collected and analyzed 9303 cases of poisonings by different incriminated toxic products with the exception of the scorpion poisonings. These poisonings drove to 99 deaths. The epidemiological profile which we raised, showed that the poisoned were of any age with an average of 24.62±16.61 years, The sex-ratio (woman/man) was 1.36 in favor of the women. The difference between both sexes is highly significant (χ2 = 210.5; p<0,001). Most of the poisoned which declared to be of urban origin (60.5 %) (χ2=210.5; p<0,001). Carbon monoxide was the most incriminated among the cases of poisonings (24.15 %), them putting in head, followed by some pesticides and farm produces (21.44 %) and food (19.95 %). The analysis of the risk factors showed that the grown-up patients whose age is between 20 and 74 years have twice more risk of evolving towards the death (RR=1,57; IC95 % = 1,03-2,38) than the other age brackets, so the male genital organ was the most exposed (explained) to the death that the female genital organ (RR=1,59; IC95 % = 1,07-2,38) The patients of rural origin had presented 5 times more risk (RR=4,713; IC95 % = 2,543-8,742). Poisoned by the mineral products had presented the maximum of risk on the vital preview death (RR=23,19, IC95 % = 2,39-224,1). The poisonings by pesticides produce a risk of 9 (RR=9,31; IC95 % = 6,10-14,18). The incidence was 3,3 cases of 10000 inhabitants, and the mortality was 0,004 cases of 1000 inhabitants (that is 4 cases by 1000 000 inhabitants). The rate of lethality registered annually was 10.6 %. The evolution of the indicators of health according to the years showed that the rate of statement measured by the incidence increased by a significant way. We also noted an improvement in the coverage which (who) ended up with a decrease in the rate of the lethality and the mortality during last years. The fight anti-toxic is a work of length time. He asks for a lot of work various levels. It is necessary to attack the delay accumulated by our country on the various legal, institutional and technical aspects. The ideal solution is to develop and to set up a national strategy.

Keywords: epidemiology, poisoning, risk factors, indicators of health, Tadla-Azilal grated by anti-toxic fight

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Authors: Oluwabori Emmanuel Olukoyejo, Ogra Victor Ogra, Bosede Amodu, Tewogbade Adeoye Adedeji

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Background: Disorders of thyroid function are the second most common endocrine disorders worldwide, with a direct relationship with metabolic bone diseases. These metabolic bone complications are often subtle but manifest as bone pains and an increased risk of fractures. The gold standard for diagnosis, Dual Energy X-ray Absorptiometry (DEXA), is limited in this environment due to unavailability, cumbersomeness and cost. However, bone biomarkers have shown prospects in assessing alterations in bone remodeling, which has not been studied in this environment. Aim: This study evaluates serum levels of bone-specific alkaline phosphatase (bone-specific ALP), osteopontin and osteoprotegerin biomarkers of bone turnover in patients with disorders of thyroid function. Methods: This is a cross-sectional study carried out over a period of one and a half years. Forty patients with thyroid dysfunctions, aged 20 to 50 years, and thirty-eight age and sex-matched healthy euthyroid controls were included in this study. Patients were further stratified into hyperthyroid and hypothyroid groups. Bone-specific ALP, osteopontin, and osteoprotegerin, alongside serum total calcium, ionized calcium and inorganic phosphate, were assayed for all patients and controls. A self-administered questionnaire was used to obtain data on sociodemographic and medical history. Then, 5 ml of blood was collected in a plain bottle and serum was harvested following clotting and centrifugation. Serum samples were assayed for B-ALP, osteopontin, and osteoprotegerin using the ELISA technique. Total calcium and ionized calcium were assayed using an ion-selective electrode, while the inorganic phosphate was assayed with automated photometry. Results: The hyperthyroid and hypothyroid patient groups had significantly increased median serum B-ALP (30.40 and 26.50) ng/ml and significantly lower median OPG (0.80 and 0.80) ng/ml than the controls (10.81 and 1.30) ng/ml respectively, p < 0.05. However, serum osteopontin in the hyperthyroid group was significantly higher and significantly lower in the hypothyroid group when compared with the controls (11.00 and 2.10 vs 3.70) ng/ml, respectively, p < 0.05. Both hyperthyroid and hypothyroid groups had significantly higher mean serum total calcium, ionized calcium and inorganic phosphate than the controls (2.49 ± 0.28, 1.27 ± 0.14 and 1.33 ± 0.33) mmol/l and (2.41 ± 0.04, 1.20 ± 0.04 and 1.15 ± 0.16) mmol/l vs (2.27 ± 0.11, 1.17 ± 0.06 and 1.08 ± 0.16) mmol/l respectively, p < 0.05. Conclusion: Patients with disorders of thyroid function have metabolic imbalances of all the studied bone markers, suggesting a higher bone turnover. The routine bone markers will be an invaluable tool for monitoring bone health in patients with thyroid dysfunctions, while the less readily available markers can be introduced as supplementary tools. Moreover, bone-specific ALP, osteopontin and osteoprotegerin were found to be the strongest independent predictors of metabolic bone markers’ derangements in patients with thyroid dysfunctions.

Keywords: metabolic bone diseases, biomarker, bone turnover, hyperthyroid, hypothyroid, euthyroid

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Authors: Abdullah Mohammadi

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Years of prolong war in Afghanistan has led to one of the largest refugee and migrant populations in the contemporary world. During this continuous unrest which began in 1970s (by military coup, Marxist revolution and the subsequent invasion of USSR), over one-third of the population migrated to neighboring countries, especially Pakistan and Iran. After the Soviet Army withdrawal in 1989, a new wave of conflicts emerged between rival Afghan groups and this led to new refugees. Taliban period, also, created its own refugees. During all these years, I.R. of Iran has been one of the main destinations of Afghan refugees and migrants. At first, due to the political situation after Islamic Revolution, Iran government didn’t restrict the entry of Afghan refugees. Those who came first in Iran received ID cards and had access to education and healthcare services. But in 1990s, due to economic and social concerns, Iran’s policy towards Afghan refugees and migrants changed. The government has tried to identify and register Afghans in Iran and limit their access to some services and jobs. Unfortunately, there are few studies on Afghan refugees and migrants’ situation in Iran and we have a dim and vague picture of them. Of the few studies done on this group, none of them focus on the illegal Afghan migrants’ situation in Iran. Here, we tried to study the social and economic aspects of illegal Afghan migrants’ living in Iran. In doing so, we interviewed 24 illegal Afghan migrants in Iran. The method applied for analyzing the data is thematic analysis. For the interviews, we chose family heads (17 men and 7 women). According to the findings, illegal Afghan migrants’ socio-economic situation in Iran is very undesirable. Its main cause is the marginalization of this group which is resulted from government policies towards Afghan migrants. Most of the illegal Afghan migrants work in unskilled and inferior jobs and live in rent houses on the margins of cities and villages. None of them could buy a house or vehicle due to law. Based on their income, they form one of the lowest, unprivileged groups in the society. Socially, they face many problems in their everyday life: social insecurity, harassment and violence, misuse of their situation by police and people, lack of education opportunity, etc. In general, we may conclude that illegal Afghan migrant have little adaptation with Iran’s society. They face severe limitations compared to legal migrants and refugees and have no opportunity for upward social mobility. However, they have managed some strategies to face these difficulties including: seeking financial and emotional helps from family and friendship networks, sending one of the family members to third country (mostly to European countries), establishing self-administered schools for children (schools which are illegal and run by Afghan educated youth).

Keywords: illegal Afghan migrants, marginalization, social insecurity, upward social mobility

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Authors: Mark Darius Juszczak

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While epistemology, as a sub-field of philosophy, is generally concerned with theoretical questions about the nature of knowledge, the explosion in digital media technologies has resulted in an exponential increase in the storage and transmission of human information. That increase has resulted in a particular non-linear dynamic – digital epistemological functions are radically altering how and what we know. Neither the rate of that change nor the consequences of it have been well studied or taken into account in developing state-level strategies for epistemological functions. At the current time, US Federal policy, like that of virtually all other countries, maintains, at the national state level, clearly defined boundaries between various epistemological agencies - agencies that, in one way or another, mediate the functional use of knowledge. These agencies can take the form of patent and trademark offices, national library and archive systems, departments of education, departments such as the FTC, university systems and regulations, military research systems such as DARPA, federal scientific research agencies, medical and pharmaceutical accreditation agencies, federal funding for scientific research and legislative committees and subcommittees that attempt to alter the laws that govern epistemological functions. All of these agencies are in the constant process of creating, analyzing, and regulating knowledge. Those processes are, at the most general level, epistemological functions – they act upon and define what knowledge is. At the same time, however, there are no high-level strategic epistemological directives or frameworks that define those functions. The only time in US history where a proxy state-level epistemological strategy existed was between 1961 and 1969 when the Kennedy Administration committed the United States to the Apollo program. While that program had a singular technical objective as its outcome, that objective was so technologically advanced for its day and so complex so that it required a massive redirection of state-level epistemological functions – in essence, a broad and diverse set of state-level agencies suddenly found themselves working together towards a common epistemological goal. This paper does not call for a repeat of the Apollo program. Rather, its purpose is to investigate the minimum structural requirements for a national state-level epistemological strategy in the United States. In addition, this paper also seeks to analyze how the epistemological work of the multitude of national agencies within the United States would be affected by such a high-level framework. This paper is an exploratory study of this type of framework. The primary hypothesis of the author is that such a function is possible but would require extensive re-framing and reclassification of traditional epistemological functions at the respective agency level. In much the same way that, for example, DHS (Department of Homeland Security) evolved to respond to a new type of security threat in the world for the United States, it is theorized that a lack of coordination and alignment in epistemological functions will equally result in a strategic threat to the United States.

Keywords: strategic security, epistemological functions, epistemological agencies, Apollo program

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Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho

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Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.

Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function

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Authors: Jacqueline P. Davies

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Introduction: Student nurses must develop skills in observation, communication and reflection as well as public health knowledge from their first year of training. This paper will explain a method developed for students to collect their own findings about public health in urban areas. These areas are both rich in the history of old public health that informs the content of many traditional public health walks, but are also locations where new public health concerns about chronic disease are concentrated. The learning method explained in this paper enables students to collect their own data and write original work as first year students. Examples of their findings will be given. Methodology: In small groups, health care students are instructed to walk in neighbourhoods near to the hospitals they will soon attend as apprentice nurses. On their walks, they wander slowly, engage in conversations, and enter places open to the public. As they drift, they observe with all five senses in the real three dimensional world to collect data for their reflective accounts of old and new public health. They are encouraged to stop for refreshments and taste, as well as look, hear, smell, and touch while on their walk. They reflect as a group and later develop an individual reflective account in which they write up their deep reflections about what they observed on their walk. In preparation for their walk, they are encouraged to look at studies of quality of Life and other neighbourhood statistics as well as undertaking a risk assessment for their walk. Findings: Reflecting on their walks, students apply theoretical concepts around social determinants of health and health inequalities to develop their understanding of communities in the neighbourhoods visited. They write about the treasured historical architecture made of stone, bronze and marble which have outlived those who built them; but also how the streets are used now. The students develop their observations into thematic analyses such as: what we drink as illustrated by the empty coke can tossed into a now disused drinking fountain; the shift in home-life balance illustrated by streets where families once lived over the shop which are now walked by commuters weaving around each other as they talk on their mobile phones; and security on the street, with CCTV cameras placed at regular intervals, signs warning trespasses and barbed wire; but little evidence of local people watching the street. Conclusion: In evaluations of their first year, students have reported the health walk as one of their best experiences. The innovative approach was commended by the UK governing body of nurse education and it received a quality award from the nurse education funding body. This approach to education allows students to develop skills in the real world and write original work.

Keywords: education, innovation, nursing, urban

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Authors: Eumsin Payan

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The article desires the Association of Southeast Asian Nations (ASEAN) to take interest in the policies and give importance to India over other powerful countries in the World, including powerful countries in Asia, comprising of: People’s Republic of China (PRC), Russia, and India countries with the ability to drive the Asian continent, specifically, the ASEAN Economic Community (AEC). (Japan was incapable of stepping up to become the leader of ASEAN due to the fact that Japan has created “wounds” from military history with too many countries in Asia, including wounds from the Greater East Asia War, combining with economic problems Japan is currently facing and also several natural disasters, therefore Japan is not considered a good option of our era.) China appears to be an option that stands out, which could be seen through countless published articles in the general public. However, this article desires to propose India as an option to develop and drive the relationship between ASEAN countries in the future development of Computer Science Technology and allow India to be the leader in driving the Asian Economy in place of China and the United States. As for Russia, its location is distant and apart from South East Asia. Moreover, Russia does not give as much importance to ASEAN. In this light, the author perceives that India already has the “Look East” policy. Therefore, it would be simple for ASEAN to look back at India by simply starting cooperation through policies related to collaboration in the areas of computer science. In effect, this will continuously adjust and improve the relationship towards cooperation in the areas of economics, society, and culture. Referring to the above, the author suggests a word that could be used to call the relationship between India and ASEAN, INSEAN or IN-SEAN. Hereinafter, the author hopes that Thailand, in the position of one in the five founders of ASEAN, could become the leader or be the entity that pushes forward the ASEAN policies that will increase the importance of looking towards India. India is an emerging giant that has the ability to step up in Asia. With the proficient use of English, India is able to pass on the knowledge and drive the ASEAN’s Economic relationship better than China or Russia, as faced with higher language barriers. Moreover, India has cultivated democratic civilization from the colonization of the British Empire, similar to other nations of Southeast Asia, which are familiar with various heritage cultures that the British has brought them. The most important aspect in the author’s perspective is the fact that India is not aggressive and that they have courtesy. Through developing policies of the East through the “Look East” policy, it enabled India to establish a more smooth relationship with Asian countries comparing to China. China has imposed harsh policies towards democracy to the land above the South China Sea, which directly affect the ASEAN countries. From the above reasons, India, therefore, is an appropriate option in the establishment of a closer relationship with ASEAN, as the author has proposed relationship as INSEAN or IN-SEAN.

Keywords: IN-SEAN, INSEAN, look west policy, look east policy, ASEAN, India

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Authors: Demelash Kassaye

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The Ethiopia case study reveals a unique model of community policing that has developed from a particular political context in which there is a history of violent political transition, a political structure characterized by ethnic federalism and a political ideology that straddles liberal capitalism and democracy on the one hand, and state-led development and centralized control on the other. The police see community policing as a way to reduce crime. Communities speak about community policing as an opportunity to take on policing responsibilities themselves. Both of these objectives are brought together in an overarching rhetoric of community policing as a way of ‘mobilizing for development’ – whereby the community cooperate with the police to reduce crime, which otherwise inhibits development progress. Community policing in Amhara has primarily involved the placement of Community Police Officers at the kebele level across the State. In addition, a number of structures have also been established in the community, including Advisory Councils, Conflict Resolving Committees, family police and the use of shoe shiner’s and other trade associations as police informants. In addition to these newly created structures, community policing also draws upon pre-existing customary actors, such as militia and elders. Conflict Resolving Committees, Community Police Officers and elders were reported as the most common first ports of call when community members experience a crime. The analysis highlights that the model of community policing in Amhara increased communities’ access to policing services, although this is not always attended by increased access to justice. Community members also indicate that public perceptions of the police have improved since the introduction of community policing, in part due to individual Community Police Officers who have, with limited resources, innovated some impressive strategies to improve safety in their neighborhoods. However, more broadly, community policing has provided the state with more effective surveillance of the population – a potentially oppressive function in the current political context. Ultimately, community policing in Amhara is anything but straightforward. It has been a process of attempting to demonstrate the benefits of newfound (and controversial) ‘democracy’ following years of dictatorship, drawing on generations of customary dispute resolution, providing both improved access to security for communities and an enhanced surveillance capacity for the state. For external actors looking to engage in community policing, this case study reveals the importance of close analysis in assessing potential merits, risks and entry points of programming. Factors found to be central in shaping the nature of community policing in the Amhara case include the structure of the political system, state-society relations, cultures dispute resolution and political ideology.

Keywords: community policing, community, militias, ethiopia

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Authors: JaeYoon Park

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The ability to communicate effectively across different cultures is a necessary skill in today’s increasingly globalized world. Intercultural communication competency (ICC) is a way of being that benefits all members of a society in their living, learning, and working environments as well as in the context of mediated communications. This study examines the effects of self-reflection processes on the improvement of intercultural communication skills focusing on college students at the University of Arkansas-Fort Smith. A total of sixty-nine students’ works were analyzed based on the data collected in the past three years (2016, 2017 and 2018). The students in the ‘Culture and Communication’ class, each spring, completed the Diversity Awareness Profile (DAP) survey as a pre- and post-test for the course. DAP is a self-assessment tool designed by Karen Stinson and widely used in college classes, companies, and organizations to evaluate an individual’s behaviors in various intercultural settings. It can assist individuals in becoming more aware of diversity issues and also provide a foundation for developing strategies for modifying any undesirable behavior they may discover in the assessment. In addition to the DAP surveys, the students also submitted self-reflection essays that discussed their own scores. The University of Arkansas-Fort Smith is a small regional university located in the Bible Belt of the United States. White, Christian, working-class students dominate its student population. The students, whose data were collected, were predominantly seniors in college majoring in either Media Communication or International Business. Approximately, 80% of the students increased their scores, and 42% of them moved forward to a new category. The findings also indicate that the students in the underrepresented groups (i.e., women, minority, and international students) show less change in their scores and behaviors than the rest of the students (i.e., white heterosexual male students). These findings, in most part, result from the fact that the underrepresented students were already aware of diversity and intercultural issues through their personal experiences before taking the class. The white heterosexual male students demonstrated the greatest improvements, judging from their DAP scores (pre- and post-tests) and self-reflection essays. Through the class assignments and discussions, which emphasized critical thinking and self-reflection, the latter group of students not only became more aware of the meaning of their own words and behaviors, but they were also able to develop greater proficiency in intercultural communication. This e-poster presentation will analyze the findings of this research data, and also discuss the pedagogical implications of such results.

Keywords: cross-cultural communication, diversity awareness survey, self-reflection, underrepresented students

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Authors: Jiabei Zhang

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Although adapted physical education (APE) teacher preparation programs are available in the nation, a consistent standards-based competency evaluation scale for preparing of qualified personnel for teaching children with disabilities in APE cannot be identified in the literature. The purpose of this study was to develop a standard-based competency evaluation scale for assessing qualifications for teaching children with disabilities in APE. Standard-based competencies were reviewed and identified based on research evidence documented as effective in teaching children with disabilities in APE. A standard-based competency scale was developed for assessing qualifications for teaching children with disabilities in APE. This scale included 20 standard-based competencies and a 4-point Likert-type scale for each standard-based competency. The first standard-based competency is knowledgeable of the causes of disabilities and their effects. The second competency is the ability to assess physical education skills of children with disabilities. The third competency is able to collaborate with other personnel. The fourth competency is knowledgeable of the measurement and evaluation. The fifth competency is to understand federal and state laws. The sixth competency is knowledgeable of the unique characteristics of all learners. The seventh competency is the ability to write in behavioral terms for objectives. The eighth competency is knowledgeable of developmental characteristics. The ninth competency is knowledgeable of normal and abnormal motor behaviors. The tenth competency is the ability to analyze and adapt the physical education curriculums. The eleventh competency is to understand the history and the philosophy of physical education. The twelfth competency is to understand curriculum theory and development. The thirteenth competency is the ability to utilize instructional designs and plans. The fourteenth competency is the ability to create and implement physical activities. The fifteenth competency is the ability to utilize technology applications. The sixteenth competency is to understand the value of program evaluation. The seventeenth competency is to understand professional standards. The eighteenth competency is knowledgeable of the focused instruction and individualized interventions. The nineteenth competency is able to complete a research project independently. The twentieth competency is to teach children with disabilities in APE independently. The 4-point Likert-type scale ranges from 1 for incompetent to 4 for highly competent. This scale is used for assessing if one completing all course works is eligible for receiving an endorsement for teaching children with disabilities in APE, which is completed based on the grades earned on three courses targeted for each standard-based competency. A mean grade received in three courses primarily addressing a standard-based competency will be marked on a competency level in the above scale. The level 4 is marked for a mean grade of A one receives over three courses, the level 3 for a mean grade of B over three courses, and so on. One should receive a mean score of 3 (competent level) or higher (highly competent) across 19 standard-based competencies after completing all courses specified for receiving an endorsement for teaching children with disabilities in APE. The validity, reliability, and objectivity of this standard-based competency evaluation scale are to be documented.

Keywords: evaluation scale, teacher preparation, adapted physical education teachers, and children with disabilities

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Authors: Angela T. H. Kwan, Saman Arfaie, Joseph Therriault, Zahra Azizi, Firoza Z. Lussier, Cecile Tissot, Mira Chamoun, Gleb Bezgin, Stijn Servaes, Jenna Stevenon, Nesrine Rahmouni, Vanessa Pallen, Serge Gauthier, Pedro Rosa-Neto

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Alzheimer’s disease (AD) can be detected in living people using in vivo biomarkers of amyloid-β (Aβ) and tau, even in the absence of cognitive impairment during the preclinical phase. [¹⁸F]-MK-6420 is a high affinity positron emission tomography (PET) tracer that quantifies tau neurofibrillary tangles, but its ability to predict cognitive changes associated with early AD symptoms, such as memory decline, is unclear. Here, we assess the prognostic accuracy of baseline [18F]-MK-6420 tau PET for predicting longitudinal memory decline in asymptomatic elderly individuals. In a longitudinal observational study, we evaluated a cohort of cognitively normal elderly participants (n = 111) from the Translational Biomarkers in Aging and Dementia (TRIAD) study (data collected between October 2017 and July 2020, with a follow-up period of 12 months). All participants underwent tau PET with [¹⁸F]-MK-6420 and Aβ PET with [¹⁸F]-AZD-4694. The exclusion criteria included the presence of head trauma, stroke, or other neurological disorders. There were 111 eligible participants who were chosen based on the availability of Aβ PET, tau PET, magnetic resonance imaging (MRI), and APOEε4 genotyping. Among these participants, the mean (SD) age was 70.1 (8.6) years; 20 (18%) were tau PET positive, and 71 of 111 (63.9%) were women. A significant association between baseline Braak I-II [¹⁸F]-MK-6240 SUVR positivity and change in composite memory score was observed at the 12-month follow-up, after correcting for age, sex, and years of education (Logical Memory and RAVLT, standardized beta = -0.52 (-0.82-0.21), p < 0.001, for dichotomized tau PET and -1.22 (-1.84-(-0.61)), p < 0.0001, for continuous tau PET). Moderate cognitive decline was observed for A+T+ over the follow-up period, whereas no significant change was observed for A-T+, A+T-, and A-T-, though it should be noted that the A-T+ group was small.Our results indicate that baseline tau neurofibrillary tangle pathology is associated with longitudinal changes in memory function, supporting the use of [¹⁸F]-MK-6420 PET to predict the likelihood of asymptomatic elderly individuals experiencing future memory decline. Overall, [¹⁸F]-MK-6420 PET is a promising tool for predicting memory decline in older adults without cognitive impairment at baseline. This is of critical relevance as the field is shifting towards a biological model of AD defined by the aggregation of pathologic tau. Therefore, early detection of tau pathology using [¹⁸F]-MK-6420 PET provides us with the hope that living patients with AD may be diagnosed during the preclinical phase before it is too late.

Keywords: alzheimer’s disease, braak I-II, in vivo biomarkers, memory, PET, tau

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Authors: Ku Yu Yiu

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Writers have included the ugly in their works for centuries, but ugliness has often served merely as a contrast to bring out the beautiful, not having emerged as an independent aesthetic category until recent history. In the 1980s, China was going through a series of changes and transformations; the wounds and scars from the Cultural Revolution, a freer literary atmosphere then, and the introduction of Western thoughts into China gave rise to a trend of penning the ugly and the repulsive among writers. Such trend of utilizing 'Ugliness' as a theme of writing in Chinese literature is especially observed among Xianfeng writers (China’s pioneer writers or avant-garde writers). As a prominent Xianfeng writer, Su Tong (1963-) also incorporates ugliness into his novels: shoddy environment, degenerate and ruthless society, distorted and decadent humanity are part and parcel of his deliberate efforts of exploring and depicting the ugly aspects of the world. His full-length novel Rice, staging the appalling protagonist Five Dragons, is a prime example. In fact, all characters in Rice exhibit Ugliness but Five Dragons’s turning into a figure of ugly spite is the most thorough and complete, making Rice a masterpiece of Su Tong’s art in projecting the Ugliness embedded in society and human nature. Approaching Rice from the angle of the aesthetics of the Ugly and selecting Five Dragons as the subject of close reading and analysis, this paper offers insights into both Su Tong’s distinct style of foregrounding and unfolding Ugliness in his novel and the workings of such text when he deploys the Ugly as a center component of his writing. In addition to citing from the discussion of Rice by literary critics and the author himself, this paper also presents textual evidence and analyzes the imageries/motifs and calculated vocabulary/narration employed by Su Tong to illustrate how Five Dragons' extreme behaviors and psychological states are integral to the plot and ultimately to the manifestation of ugliness as the novel’s theme. This study reveals that although the psyche and doings of Five Dragons and other 'ugly' characters are, as the author once stated, imagined products of the writer Su Tong himself, Rice sheds light onto the ugly aspects of life in China in 1920s-30s. Three aspects of Ugliness are identified and discussed in the paper. Lastly, this paper also suggests some effects of Su Tong’s exploration of Ugliness in Rice, proposing that the portrayal of Ugliness per se is not the ends of Su Tong’s mastery of the aesthetics of the Ugly but rather a means to making his writing transcend from provoking spontaneous moral judgment in readers on the doings of Five Dragons to prompting readers to ponder on philosophical questions such as how humanity can still be possible when an individual confronts the dark sides of a self, a society, and his/her fate.

Keywords: aesthetics, Rice, Su Tong, Ugly

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Authors: Alan Ruiz-Padilla, Brando Villalobos-Villalobos, Yeniley Ruiz-Noa, Claudia Mendoza-Macías, Claudia Palafox-Sánchez, Miguel Marín-Rosales, Álvaro Cruz, Rubén Rangel-Salazar

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Introduction: In patients with rheumatoid arthritis, resistance or poor response to disease modifying antirheumatic drugs (DMARD) may be a reflection of the increase in g-P. The expression of g-P may be important in mediating the effluence of DMARD from the cell. In addition, P-glycoprotein is involved in the transport of cytokines, IL-1, IL-2 and IL-4, from normal lymphocytes activated to the surrounding extracellular matrix, thus influencing the activity of RA. The involvement of P-glycoprotein in the transmembrane transport of cytokines can serve as a modulator of the efficacy of DMARD. It was shown that a number of lymphocytes with glycoprotein P activity is increased in patients with RA; therefore, P-glycoprotein expression could be related to the activity of RA and could be a predictor of poor response to therapy. Objective: To evaluate in RA patients, if the G2677T/A MDR1 polymorphisms is associated with differences in the rate of therapeutic response to disease-modifying antirheumatic agents in patients with rheumatoid arthritis. Material and Methods: A prospective cohort study was conducted. Fifty seven patients with RA were included. They had an active disease according to DAS-28 (score >3.2). We excluded patients receiving biological agents. All the patients were followed during 6 months in order to identify the rate of therapeutic response according to the American College of Rheumatology (ACR) criteria. At the baseline peripheral blood samples were taken in order to identify the G2677T/A MDR1 polymorphisms using PCR- Specific allele. The fragment was identified by electrophoresis in polyacrylamide gels stained with ethidium bromide. For statistical analysis, the genotypic and allelic frequencies of MDR1 gene polymorphism between responders and non-responders were determined. Chi-square tests as well as, relative risks with 95% confidence intervals (95%CI) were computed to identify differences in the risk for achieving therapeutic response. Results: RA patients had a mean age of 47.33 ± 12.52 years, 87.7% were women with a mean for DAS-28 score of 6.45 ± 1.12. At the 6 months, the rate of therapeutic response was 68.7 %. The observed genotype frequencies were: for G/G 40%, T/T 32%, A/A 19%, G/T 7% and for A/A genotype 2%. Patients with G allele developed at 6 months of treatment, higher rate for therapeutic response assessed by ACR20 compared to patients with others alleles (p=0.039). Conclusions: Patients with G allele of the - G2677T/A MDR1 polymorphisms had a higher rate of therapeutic response at 6 months with DMARD. These preliminary data support the requirement for a deep evaluation of these and other genotypes as factors that may influence the therapeutic response in RA.

Keywords: pharmacogenetics, MDR1, P-glycoprotein, therapeutic response, rheumatoid arthritis

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Authors: P. H. G. J. Pushpakumara, Andrew Dawson

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Introduction: Deliberate self harm (DSH) is a major public health problem globally. Suicide rates of Sri Lanka are being among the highest national rates in the world, since 1950. Previous DSH is the most important independent predictor of repetition. The estimated 1 year non-fatal repeat self-harm rate was 16.3%. Asian countries had considerably lower rate, 10.0%. Objectives: To calculate incidence of deliberate self-poisoning (DSP) and suicides, repetition rate of DSP in Kurunegala District (KD). To determine the pattern of repeated DSP in KD. Methods: Study had two components. In the first component, demographic and event related details of, DSP admission in 46 hospitals and suicides in 28 police stations of KD were collected for 3 years from January 2011. Demographic details of cohort of DSP patients admitted to above hospitals in 2011 were linked with hospital admissions and police records of next two years period from the index admission. Records were screened for links with high sensitivity using the computer then did manual matching which would have been much more specific. In the second component, randomly selected DSP patients (n=438), who admitted to main referral centre which receives 60% of DSP cases of the district, were interviewed to assess life-time repetition. Results: There were 16,993 DSP admissions and 1078 suicides for the three year period. Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011, 2012 and 2013. Average male to female ratio for suicide incidences was 5.5. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population. Male incidences were slightly greater than the female incidences, male: female ratio was 1.1:1. Highest age standardized male and female incidence was reported in 20-24 years age group, 769.6/100,000, and 15-19 years age group 1304.0/100,000. Male to female ratio of the incidence increased with the age. There were 318 (179 male and 139 female) patients attempted DSH within two years. Female repetitive patients were ounger compared to the males, p < 0.0001, median age: males 28 and females 19 years. 290 (91.2%) had only one repetitive attempt, 24 (7.5%) had two, 3 (0.9%) had three and one (0.3%) had four in that period. One year repetition rate was 5.6 and two year repetition rate was 7.9%. Average intervals between indexed events and first repetitive DSP events were 246.8 (SD:223.4) and 238.5 (SD:207.0) days among males and females. One fifth of first repetitive events occurred within first two weeks in both males and females. Around 50% of males and females had the second event within 28 weeks. Within the first year of the indexed event, around 70% had the second event. First repetitive event was fatal for 28 (8.8%) individuals. Ages of those who died, mean 49.7 years (SD:15.3), were significantly higher compared to those who had non-fatal outcome, p<0.0001. 9.5% had life time history of DSH attempts. Conclusions: Both, DSP and suicide incidences were very high in KD. However, repetition rates were lesser compared regional values. Prevention of repetition alone may not produce significant impact on prevention of DSH.

Keywords: deliberate self-harm, incidence, repetition, Sri Lanka, suicide

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Authors: Catarina Cruz, Ana Breda

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In the early years, until the children’s entrance at the elementary school, they are stimulated by their educators, through rich and attractive contexts, to explore and develop skills in different domains, from the socio-emotional to the cognitive. Many of these contexts trigger real or imaginary situations, familiar or not, through resources or pedagogical practices that incite children's curiosity, questioning, expression of ideas or emotions, social interaction, among others. Later, when children enter at the elementary school, their activity at school becomes more focused on developing skills in the cognitive domain, namely acquiring learning from different subject areas, such as Mathematics, Natural Sciences, History, among others. That is, to ensure that children develop the standardized learning recommended in the guiding curriculum documents, they spend part of their time applying formulas, memorizing information, following instructions, and so on, and in this way not much time is left to listen children, to learn about their interests and likes, as well as their perspective and questions about the surround world. In Elementary School, especially in the 1st Cycle, children are naturally curious, however, sometimes this skill is subtly conditioned by adults. Curious children learn more, since they have an intrinsic desire to know more, especially about what is unknown. When children think on subjects or themes that they are interested in or curious about, they attribute more meaning to this learning and retain it for longer. Therefore, it is important to approach subjects in the classroom that seduce or captivate children's attention, trigger them curiosity, and allow to hear their ideas. There are several resources, strategies and pedagogical practices to awaken children's curiosity, to explore their knowledge, to understand their perspectives and their way of thinking, to know a little more about their personality and to provide space for dialogue. The storytelling, its narrative’s exploration and interpretation is one of those pedagogical practices. Children’s literature, about real or imaginary subjects, stimulate children’s insights supported into their experiences, emotions, learnings and personality, and promote opportunities for children express freely their feelings and thoughts. This work focuses on a session developed with children in the 3rd year of schooling, from a Portuguese 1st Cycle Basic School, in which the story "From the Outside In and From the Inside Out" was presented. The story’s presentation was mainly centred on children’s activity, who read excerpts and interpreted/explored them through a dialogue led by one of the authors. The study presented here intends to show an example of how an exploration of a children's story can trigger ideas, thoughts, emotions or attitudes in children in the 3rd year of elementary school. To answer the research question, this work aimed to: identify ideas, thoughts, emotions or attitudes that emerged from the exploration of story; analyse aspects of the story and the orchestration/conduction of dialogue with/between children that facilitated or inhibited the emergence of ideas, thoughts, emotions or attitudes by children,

Keywords: storytelling, children’s perspectives, soft skills, non-formal learning contexts, orchestration

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Authors: Andrew Kipp

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Student absenteeism is harmful to both the school and the absentee student. One approach to improving student absenteeism is targeting contextual factors within the students’ learning environment. However, contemporary literature has not taken an ecological agency approach to understanding student absenteeism. Ecological agency is a theoretical framework that magnifies the interplay between the environment and the actions of people within the environment. To elaborate, the person’s personal history and aspirations and the environmental conditions provide potential outlets or restrictions to their intended action. The framework provides the unique perspective of understanding absentee students’ decision-making through the affordances and constraints found in their learning environment. To that effect, the study was guided by the question, “Why do absentee students decide to engage in absenteeism in a suburban Kansas school?” A case study methodology was used to answer the research question. Four suburban, Kansas high school absentee students in the 2020-2021 school year were selected for the study. The fall 2020 semester was in a remote learning setting, and the spring 2021 semester was in an in-person learning setting. The study captured their decision-making with respect to school attendance throughsemi-structured interviews, prolonged observations, drawings, and concept maps. The data was analyzed through thematic analysis. The findings revealed that peer socialization opportunities, methods of instruction, shifts in cultural beliefs due to COVID-19, manifestations of anxiety and lack of space to escape their anxiety, social media bullying, and the inability to receive academic tutoring motivated the participants’ daily decision to either attend or miss school. The findings provided a basis to improve several institutional and classroom practices. These practices included more student-led instruction and less teacher-led instruction in both in-person and remote learning environments, promoting socialization through classroom collaboration and clubs based on emerging student interests, reducing instances of bullying through prosocial education, safe spaces for students to escape the classroom to manage their anxiety, and more opportunities for one-on-one tutoring to improve grades. The study provides an example of using the ecological agency approach to better understand the personal and environmental factors that lead to absenteeism. The study also informs educational policies and classroom practices to better promote student attendance. Further research should investigate other school contexts using the ecological agency theoretical framework to better understand the influence of the school environment on student absenteeism.

Keywords: student absenteeism, ecological agency, classroom practices, educational policy, student decision-making

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Authors: Rudainah Alkhazam, Özlem Yaşar Uğurlu

Abstract:

Immigrant entrepreneurship arises from the start of entrepreneurial activity by immigrants in the country they relocate to. The future prosperity and stability of the refugee-hosting countries depends on the mutual social and economic benefits between the residents and the refugees. Syrian refugees and workers in host countries necessitate efforts to assist their residents and refugees in meeting their daily needs, contributing lawfully to local and possibly regional economies through trade, and instilling hope in their future. This study investigates the effects of Syrian refugee entrepreneurs on host communities' business sectors, focusing on Turkey. Specifically, we examine entrepreneurship in general and its role in the country's economy. Because Turkey is the most popular resettlement destination for Syrian refugees, this study will shed light on the challenges of successful migrant entrepreneurship in Turkey and their role in the business sector. The research relies on a mixed-method approach which helps identify recurring themes, favorable results, and conflicting results across methods, allowing us to draw accurate conclusions. The study will adopt a quantitative method in collecting numerical data from Syrian refugees in Turkey. The self-administered survey would be translated into Arabic to ensure that the respondents understood the questions and possible replies. The research will use survey questionnaires to gather the majority of the data. These surveys would have closed-ended questions with nominal ratio and Likert scales. The data will be analyzed using linear regression and the Statistical Package for Social Sciences (SPSS) to ascertain the role of Syrian entrepreneurs in the business sectors of Turkey. The research will use the findings to make future recommendations. Syrian entrepreneurs, among the migrant entrepreneurs, contribute to the labor market, the majority of whom are young people. This research noted the significant participation of Syrian immigrant women in the entrepreneurship sector. The previous experience of Syrians in the field of trade and running their own business plays a vital role in the success of their business in the host countries. The study shows that Syrian entrepreneurs could integrate effectively into the various Turkish business sectors and could rely on themselves, open and manage their projects, and market them in the Turkish market. Syrian entrepreneurs consider that the investment and labor laws, commercial arrangements, and facilities for obtaining financial resources in Turkey need to be more flexible and available to immigrant entrepreneurs.

Keywords: entrepreneurship, immigration, Syrian, Turkey, refugees, investors, socio-economic benefits, unemployment

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Authors: Ruchirat Patanathabutr

Abstract:

This applied research has adopted descriptive social science research methodology to interpret, analyze and assess the data and used descriptive analysis to present the research results. The objective of this research is to investigate the behaviors and opinions on the service and construction of cable car system at the Upper Esaan Wild Animal Adventure Park (Khon Kaen – Udon Thani) in Khao Suan Kwang District, Khon Kaen Province (Khon Kaen Zoo) of people in the local and distant communities as well as the service users. The research results have revealed that the main target group is the residents in the upper northeastern region of Thailand, especially those who have resided in the immediate vicinity of the cable car project and in nearby districts for more than 10 years. They are men and women at the age of 20-60 with high school diploma and higher levels of education, working as traders/entrepreneurs, government officers/state enterprise employees, and freelancers/self-employed, with the average monthly income of no more than 30,000 baht. Khon Kaen Zoo should improve its 4 organizational images as a tourist attraction, an animal display enclosure, an educational institution and as a provincial symbol; however, the zoo should mainly be presented as an important tourist attraction. The service should focus on maintaining the service standards in both the animal display area and the ocean park. The attention should also be directed at the types and numbers of animals, service quality, service fee, convenient access and transportation, promotions and the standards of other services. Regarding the community involvement in the cable car system construction project, it is strongly agreed that there should be a cable car service between the animal display area and the ocean park and a round-trip ticket should cost 20 baht, 50 baht or 100 baht, respectively. Khon Kaen Zoo or responsible entity must provide related groups of people, such as people in the local and distant communities as well as the service users, with accurate information about the community management guidelines. This is because the community opinions have showed the uncertainty about the cable car system construction at Khon Kaen Zoo and the 4 principles of management, including planning, organizing, leading and controlling, are indicated as uncertain as there is no statistically significant difference at 0.05. In addition, the social, economic, and environmental impacts of the cable car system construction at Khon Kaen Zoo on the communities must be considered carefully.

Keywords: community opinion, cable car system, Khon Kaen Zoo, Thailand

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Authors: Norhayati Ayob, Shamsu Mohamad

Abstract:

This paper aims to provide an initial background of the process of making traditional ceramic pottery, focusing on the materials and the influence of culture heritage. Ceramic pottery is one of the hallmarks of Sabah’s heirloom, not only use as cooking and storage containers but also closely linked with folk cultures and heritage. The Bajau Laut ethnic community of Semporna or better known as the Sea Gypsies, mostly are boat dwellers and work as fishermen in the coast. This ethnic community is famous for their own artistic traditional heirloom, especially the traditional hand-made clay stove called Lapohan. It is found that in the daily life of Bajau Laut community, Lapohan (clay stove) is used to prepare the meal and as a food warmer while they are at the sea. Besides, Lapohan pottery conveys symbolic meaning of natural objects, which portrays the identity, and values of Bajau Laut community. It is acknowledged that the basic process of making potterywares was much the same for people all across the world, nevertheless, it is crucial to consider that different ethnic groups may have their own styles and choices of raw materials. Furthermore, it is still unknown why and how the Bajau Laut ethnic of Semporna get started making their own pottery and to survive until today by heavily depending on the raw materials available in Semporna. In addition, the emergent problem faced by the pottery maker in Sabah is the absence of young successor to continue the heirloom legacy. Therefore, this research aims to explore the traditional pottery making in Sabah, by investigating the background history of Lapohan pottery and to propose the classification of Lapohan based on design and motifs of traditional pottery that will be recognised throughout the study. It is postulated that different techniques and forms of making traditional pottery may produce different types of pottery in terms of surface decoration, shape, and size that portrays different cultures. This study will be conducted at Selakan Island, Semporna, which is the only location that still has Lapohan making. This study is also based on the chronological process of making pottery and taboos of the process of preparing the clay, forming, decoration technique, motif application and firing techniques. The relevant information for the study will be gathered from field study, including observation, in-depth interview and video recording. In-depth interviews will be conducted with several potters and the conversation and pottery making process will be recorded in order to understand the actual process of making Lapohan. The findings hope to provide several types of Lapohan based on different designs and cultures, for example, the one with flat-shape design or has round-shape on the top of clay stove will be labeled with suitable name based on their culture. In conclusion, it is hoped that this study will contribute to conservation for traditional pottery making in Sabah as well as to preserve their culture and heirloom for future generations.

Keywords: Bajau Laut, culture, Lapohan, traditional pottery

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Authors: Halimat M. Ajose-Adeogun, Zaynab A. Bello

Abstract:

Artificial Intelligence (AI) and Natural Language Processing (NLP) have transformed computer language comprehension, allowing computers to comprehend spoken and written language with human-like cognition. NLP, a multidisciplinary area that combines rule-based linguistics, machine learning, and deep learning, enables computers to analyze and comprehend human language. NLP applications in medicine range from tackling issues in electronic health records (EHR) and psychiatry to improving diagnostic precision in orthopedic surgery and optimizing clinical procedures with novel technologies like chatbots. The technology shows promise in a variety of medical sectors, including quicker access to medical records, faster decision-making for healthcare personnel, diagnosing dysplasia in Barrett's esophagus, boosting radiology report quality, and so on. However, successful adoption requires training for healthcare workers, fostering a deep understanding of NLP components, and highlighting the significance of validation before actual application. Despite prevailing challenges, continuous multidisciplinary research and collaboration are critical for overcoming restrictions and paving the way for the revolutionary integration of NLP into medical practice. This integration has the potential to improve patient care, research outcomes, and administrative efficiency. The research methodology includes using NLP techniques for Sentiment Analysis and Emotion Recognition, such as evaluating text or audio data to determine the sentiment and emotional nuances communicated by users, which is essential for designing a responsive and sympathetic chatbot. Furthermore, the project includes the adoption of a Personalized Intervention strategy, in which chatbots are designed to personalize responses by merging NLP algorithms with specific user profiles, treatment history, and emotional states. The synergy between NLP and personalized medicine principles is critical for tailoring chatbot interactions to each user's demands and conditions, hence increasing the efficacy of mental health care. A detailed survey corroborated this synergy, revealing a remarkable 20% increase in patient satisfaction levels and a 30% reduction in workloads for healthcare practitioners. The poll, which focused on health outcomes and was administered to both patients and healthcare professionals, highlights the improved efficiency and favorable influence on the broader healthcare ecosystem.

Keywords: natural language processing, artificial intelligence, healthcare communication, electronic health records, patient care

Procedia PDF Downloads 76

Authors: Sachil Kumar, Anoop K.Verma, Uma Shankar Singh

Abstract:

It’s extremely important to study postmortem interval in different causes of death since it assists in a great way in making an opinion on the exact cause of death following such incident often times. With diligent knowledge of the interval one could really say as an expert that the cause of death is not feigned hence there is a great need in evaluating such death to have been at the CRIME SCENE before performing an autopsy on such body. The approach described here is based on analyzing the degradation or proteolysis of a cardiac protein in cases of deaths due to burn as a marker of time since death. Cardiac tissue samples were collected from (n=6) medico-legal autopsies, (Department of Forensic Medicine and Toxicology), King George’s Medical University, Lucknow India, after informed consent from the relatives and studied post-mortem degradation by incubation of the cardiac tissue at room temperature (20±2 OC) for different time periods (~7.30, 18.20, 30.30, 41.20, 41.40, 54.30, 65.20, and 88.40 Hours). The cases included were the subjects of burn without any prior history of disease who died in the hospital and their exact time of death was known. The analysis involved extraction of the protein, separation by denaturing gel electrophoresis (SDS-PAGE) and visualization by Western blot using cTnT specific monoclonal antibodies. The area of the bands within a lane was quantified by scanning and digitizing the image using Gel Doc. As time postmortem progresses the intact cTnT band degrades to fragments that are easily detected by the monoclonal antibodies. A decreasing trend in the level of cTnT (% of intact) was found as the PM hours increased. A significant difference was observed between <15 h and other PM hours (p<0.01). Significant difference in cTnT level (% of intact) was also observed between 16-25 h and 56-65 h & >75 h (p<0.01). Western blot data clearly showed the intact protein at 42 kDa, three major (28 kDa, 30kDa, 10kDa) fragments, three additional minor fragments (12 kDa, 14kDa, and 15 kDa) and formation of low molecular weight fragments. Overall, both PMI and cardiac tissue of burned corpse had a statistically significant effect where the greatest amount of protein breakdown was observed within the first 41.40 Hrs and after it intact protein slowly disappears. If the percent intact cTnT is calculated from the total area integrated within a Western blot lane, then the percent intact cTnT shows a pseudo-first order relationship when plotted against the time postmortem. A strong significant positive correlation was found between cTnT and PM hours (r=0.87, p=0.0001). The regression analysis showed a good variability explained (R2=0.768) The post-mortem Troponin-T fragmentation observed in this study reveals a sequential, time-dependent process with the potential for use as a predictor of PMI in cases of burning.

Keywords: burn, degradation, postmortem interval, troponin-T

Procedia PDF Downloads 449