Search results for: international maritime organization

Authors: Walid Al-Qerem, Ruba Zumot

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Background: The rise of obesity among children and adolescents remains a primary challenge for healthcare providers globally and in the Middle East. The aim of the present study is to determine the prevalence of obesity among 5-20 years old Jordanians based on CDC criteria. Method: A total of 5722 Jordanians (37% males; 63% females) aged 5-20 years data were retrieved from the Jordanian Ministry of Health electronic database (Hakeem). As per the CDC selection criteria, the chosen data pertains exclusively to healthy Jordanian children and adolescents who are medically sound, not suffering from health conditions, and not undergoing any treatments that could hinder normal growth patterns, such as severe infection, chronic kidney disease (CKD), Down’s syndrome, attention deficit hyperactivity disorder, cancer, heart disease, lung disease, cystic fibrosis, Crohn’s disease, type 1 diabetes, hormonal disturbances, any stress-related conditions, hormonal therapy such as corticosteroids, Growth hormones (GHS) or gonadotropin-releasing hormone agonists, insulin, and amphetamines or any other stimulants. In addition, participants with missing or invalid data values for anthropometric measurements were excluded from the study. Weight for age and body mass index for age were analyzed comparatively for Jordanian children and adolescents against the international growth standards. The Z-score for each record was computed based on CDC equations. As per CDC classifications, BMI for age percentiles, values ≥85th and < 95th are classified as overweight, and value at ≥ 95th is classified as obesity. Results: The average age of the evaluated sample was 12.33 ±4.39 years (10.79 ±3.39 for males and 13.23 ± 4.66 for females). The mean weight for males and females were 33.16±14.17 Kg and 133.54±17.17 cm for males, 43.86 ±18.82 Kg, and 142.19±18.35 for females, while for BMI the mean was for boys and girls 17.81±3.88 and 20.52±5.03 respectively. The results indicated that based on CDC criteria, 8.9% of males were classified as children/adolescents with overweight, and 9.7% were classified as children/adolescents with obesity, while in females, 17.8% were classified as children/adolescents with overweight and 10.2% were classified as children/adolescents with obesity. Discussion: The high prevalence of obesity reported in the present study emphasizes the importance of applying different strategies to prevent childhood obesity, including encouraging physical activity, promoting healthier food options, and behavioral changes. Conclusion: The results presented in this study indicated the high prevalence of overweight/obesity among Jordanian adolescents and children, which must be tagged by healthcare planners and providers.

Keywords: CDC, obesity, childhood, Jordan

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Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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Authors: Yongde Dai

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The recent Chinese military action blockbusters, notably known as, Wolf Warrior/Zhan Lang (2015), Operation Mekong/Mei gong he xing dong (2016), Warrior 2/Zhan Lang 2 (2017) and Operation Red Sea/Hong hai xing dong (2018), have achieved phenomenal box-office successes and in particular, Wolf Warrior 2 became China’s highest-grossing film of all time. However, their yearly presence tends to show a paradigmic shift from China’s primacy of wen manliness (soft) to wu masculinity (hard). With the increasing cinematic exposure of a more muscular image manifesting in both the Chinese heroic soldiers and China itself as a rising global power, the backlash of the Chinese public against the proliferation of the feminized masculinity influenced by the ‘pretty-boy’ pop-culture and China’s harder approach to the current Sino-US tensions have correspondingly emerged and continued to brew. Chinese masculinity imagined in these films is one of the key factors that enable a gendered interpretation of the correlation between the Chinese on-screen fantasy and off-screen reality, that is, China’s public and official discourse about the hegemonic masculinity and non-hegemonic masculinity as well as China’s international profile on cinematic appearance and in today’s Sino-US relation. By reading closely at the four megahits as visual-audio texts with Chinese masculinity studies by Kam Louie and Geng Song, this paper attempts to examine the Chinese construction of manliness with historical accounts and argue why and how the recurrent emphasis of hard/military masculinity (wu) on screen are viewed as China’s contemporary rewriting of the ‘sick-man’ history in the film form. Through this investigation, the paper finds that the rewriting of the ‘sick-man’ history in the cinematic world through heroic brawny soldiers comes to resonate a collective anxiety of China in countering the real-life increasing feminized masculinity on the public appearance, particularly on the male celebrities. In addition, the superpower fantasy about China illuminates a hypermasculine imaginary of China as a global rising power and this coincidently echoes China’s current tougher diplomatic strategy tackling the Sino-US trade war, South China sea dispute and Huawei-US lawsuits.

Keywords: Chinese masculinity, Chinese military action film, feminized masculinity, manhood and nationhood, sick man of Asia

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Authors: Ashti Morovati, Hushyar Azari, Bahram Pourghassem Gargari

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Objectives and goals: The prevalence of metabolic syndrome (MetS), as a major health burden for societies, is increasing. This clinical trial was conducted to evaluate the effects of CuEO supplementation on anthropometric indices, systolic and diastolic blood pressure, blood glucose level, insulin resistance and serum lipid level in patients suffering from MetS. Methods: This was a randomized, triple‐blind, placebo‐controlled clinical trial in which 56 patients with MetS aged 18–60 years who fulfilled the eligibility criteria were randomly allocated to an intervention or a control group. Inclusion criteria for the study were comprised of diagnosis of MetS according to the new International Federation of Diabetes. The exclusion criteria were defined as: taking herbal supplements, use of drugs having evident interaction with cumin such as anti‐depressant drugs, vitamin D, omega 3, selenium, zinc, smoking, pregnancy, or breastfeeding, suffering from cancer, having any history of gastrointestinal and hepatic, cardiovascular, thyroid and kidney disorders, and menopause. 75 mg CuEO or placebo soft gels were administered three times daily to the participants for eight weeks. The soft gel consumption was checked by asking the participants to bring the medication containers in the follow‐up visits at the 4th and the 8th weeks of the study. Data pertaining to blood pressure, height, weight, waist circumference, hip circumference and BMI, as well as food consumption were collected at the beginning and end of the study. Fasting blood samples ( glucose, triglyceride, total cholesterol, HDL-cholesterol and LDL-cholesterol) were obtained and biochemical measurements were assessed at the beginning and end of the study. Results: At eight weeks, a total of 44 patients completed this study. Except for diastolic blood pressure (DBP), the other assessed variables were not significantly different between the two groups. In intra group analysis, placebo and CuEO groups both had insignificant decrements in DBP (mean difference [MD] with 95% CI: −3.31 [−7.11, 0.47] and −1.77 [−5.95, 2.40] mmHg, respectively). However, DBP was significantly lower in CuEO compared with the placebo group at the end of study (81.41 ± 5.88 vs. 84.09 ± 5.54 mmHg, MD with 95% CI: −3.98 [−7.60, −0.35] mmHg, p < .05). Conclusions: The results of this study indicated that CuEO does not have any effect on MetS components, except for DBP in patients with MetS.

Keywords: blood pressure, fasting blood glucose, lipid profile, waist circumference

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Authors: Zainab Olabisi Tairu

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The human species is facing some of the most challenging issues encountered as civilization and development occurs. The most salient factors threatening all species globally are habitats loss and degradation, overexploitation, competition with unwanted invasive species, pollution, global climate and various individual lifestyles of indigenous species. In order to avoid or minimize the effect of our actions on the environment and to balance employee work life with their private life, Green Human Resource is important and must be practiced in every organization including Higher Learning Institutions. This study addressed Green HRM from an institutional perspective, University systems are involved in numerous and complex social, educational and extra-curricular activities. The University community must be challenged to rethink and re-construct their environmental policies and practices in order to contribute to sustainable development. Many institutions only look at sustainability from the technology improvement aspect and waste management. People are the principal actors for sustainability development at the institutional level. The aim of the study is to explore the concept of Green Human Resource Management at a case site. Divine Word University (DWU) an Institution of Higher Education that embraced the ‘Printing & Paper use Policy’, also commonly referred to as the ‘paperless policy’, the use of solar as an alternative source of energy, water conservation and improvement in internet technology (IT) with the aim of becoming a green institution in effort to help save the environment. This study used Participatory Action Research as the Overarching methodological framework and Egg of sustainability and Wellbeing as the theoretical perspective in analyzing the data, engaging Case study strategy and a mixed method design at DWU. Focus group interview were conducted with three departments at the University, semi-structure interviews with the senior managers, survey questionnaire administered to students and staff with a sample size of 176 participants, in addition, policy documents were also exploited as extra source of data. Waste management including e-waste appeared to be one of the main concerns at DWU. A vast majority of DWU staff and students expressed the need for their institution to do more on sustainability education. The findings revealed that members of the community are not fully integrated like the Egg of sustainability and wellbeing in order to achieve sustainable development goal. The concept of Green Human Resource Management in Universities lies with the idea that Universities must bear profound responsibilities to manage its stakeholders in an environmental friendly way. Human resource management can help local institutions to recognize the need for changes of lifestyle, production, consumption as well as the end product in order to combat or at least reduce human Induced which produce or aggravate it.

Keywords: sustainability, environmental management, higher education institutions, green human resource management

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Authors: Pillay J. D., D. De Wit, J. F. Ducray

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Field hockey is a popular international sport which is played in more than 100 countries across the world. Due to the nature of hockey, players repeatedly perform a combination of forward flexion and rotational movements of the spine in order to strike the ball. These movements have been shown to increase the risk of pain and injury to the lumbar spine. The aim of this study was to determine the prevalence and incidence of low back pain (LBP) in male adolescent field hockey players and the characteristics of LBP in terms of location, chronicity, disability, and treatment sought, as well as its association with selected risk factors. A survey was conducted on 112 male adolescent field hockey players in the eThekwini Municipality of KwaZulu-Natal, South Africa. The questionnaire contained sections on the demographics of participants, general characteristics of participants, health and lifestyle characteristics, low back pain patterns, treatment of low back pain, and the level of disability associated with LBP. The data were statistically analysed using IBM SPSS version 25 with statistical significance set at p-value <0.05. Descriptive statistics such as mean and standard deviation were used to summarise responses to continuous variables as appropriate. Categorical variables were described using frequency tables. Associations between risk factors and low back pain were tested using Pearson’s chi-square test and t-tests as appropriate. A total of 68 questionnaires were completed for analysis (67% participation rate); the period prevalence of LBP was 63.2% (35.0%:beginning of the season, 32.4%:mid-season, 22.1%: end of season). Incidence was 38.2%. The most common location for LBP was the middle low back region (39.5%), and the most common duration of pain was a few hours (32.6%). Most participants (79.1%) did not classify their pain as a disability, and only 44.2% of participants received medical treatment for their LBP. An interesting finding was the association between hydration and LBP (p = 0.050), i.e., those individuals who did not hydrate frequently during matches and training were significantly more likely to experience LBP. The results of this study, although limited to a select group of adolescents, showed a higher prevalence of LBP than that of previous studies. More importantly, even though most participants did not experience LBP classified as a disability, LBP still had a large impact on participants, as nearly half of the participants consulted with a medical professional for treatment. Need for the application of further strategies in the prevention and management of LBP in field hockey, such as adequate warm-up and cool-down, stretching exercises, rest between sessions, etc., are recommended as simple strategies to reduce LBP prevalence.

Keywords: adolescents, field hockey players, incidence, low back pain, prevalence, risk factors

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Authors: Sareh Edalati, Nasrin Omidvar, Arezoo Haghighian Roudsari, Delaram Ghodsi, Azizollaah Zargaran

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Background and aim: Improving consumer’s food choices and providing a healthy food environment by governments is one of the essential approaches to prevent non-communicable diseases and to fulfill the sustainable development goals (SDGs). The present study aimed to provide an analysis of the nutrition labeling policy as one of the main components of the healthy food environment to provide learning lessons for the country and other low and middle-income countries. Methods: Data were collected by reviewing documents and conducting semi-structured interviews with stakeholders. Respondents were selected through purposive and snowball sampling and continued until data saturation. MAXQDA software was used to manage data analysis. A deductive content analysis was used by applying the Kingdon multiple streams and the policy triangulation framework. Results: Iran is the first country in the Middle East and North Africa region, which has implemented nutrition traffic light labeling. The implementation process has gone through two phases: voluntary and mandatory. In the voluntary labeling, volunteer food manufacturers who chose to have the labels would receive an honorary logo and this helped to reduce the food-sector resistance gradually. After this phase, the traffic light labeling became mandatory. Despite these efforts, there has been poor involvement of media for public awareness and sensitization. Also, the inconsistency of nutrition traffic light colors which are based on food standard guidelines, lack of consistency between nutrition traffic light colors, the healthy/unhealthy nature of some food products such as olive oil and diet cola and the absence of a comprehensive evaluation plan were among the pitfalls and policy challenges identified. Conclusions: Strengthening the governance through improving collaboration within health and non-health sectors for implementation, more transparency of truthfulness of nutrition traffic labeling initiating with real ingredients, and applying international and local scientific evidence or any further revision of the program is recommended. Also, developing public awareness campaigns and revising school curriculums to improve students’ skills on nutrition label applications should be highly emphasized.

Keywords: nutrition labeling, policy analysis, food environment, Iran

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Authors: Nahela Nowshin, Rafia Sultana, Farzana Misha, Sabina F. Rashid

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Sexual and reproductive health and rights (SRHR) are currently an area of neglect for males (aged 15-24 years) in Bangladesh. The lack of focus on the male youth population has consequences not only for their own health and wellbeing, but the patriarchal structure of Bangladeshi society and socio-cultural norms mean that the male population’s SRH behavior can severely impact the lives of their female counterparts. A majority of sexual and reproductive health and rights-related research and interventions in the country are female-centric. Although the Government of Bangladesh has taken many initiatives to improve the SRHR of the general population, the male youth segment has not been prioritized in most of these interventions. There is an urgent need for male-youth-focused SRHR interventions in Bangladesh, but due to a lack of evidence-based research on this issue, there exist data gaps on how such interventions could be better designed and implemented. Therefore, to ascertain strategies for better program design and smoother implementation of male-youth-focused sexual and reproductive health and rights interventions, we carried out 25 key informant interviews with experts as well as focal persons involved in more than 20 ongoing and recently-ended SRHR-related interventions of national and international non-government organizations in which male youth were targeted or engaged. The results show that program implementers face several challenges at the field, organizational and policy levels. Some of the most common field challenges include high sensitivity to SRHR topics due to cultural reasons, difficulties in acquiring access to boys and young men due to their high mobility and engagement in labor for commercial purposes, as well as accessing them in hard-to-reach areas due to transportation and communication issues. Common organizational-level challenges include a lack of skilled manpower. Policy-level challenges include the prohibition of SRH service provision to unmarried adolescents and youth and lack of readiness of local governments to implement existing action plans. Some ways in which male-youth-focused SRHR interventions can be made more effective are through sensitization of service providers, awareness-raising at the community level to engage parents, advocacy to increase donor interest, and generating data on SRHR of male youth.

Keywords: Bangladesh, intervention, male, SRHR

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Authors: Qi En Han, Si En Wai, Eugene Quek

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As one of the two Academic Medical Centres (AMCs) in Singapore, SingHealth Duke-NUS AMC strives to improve patients’ lives through excellent clinical care, research and education. These efforts are enhanced with the establishment of Academic Clinical Programmes (ACPs). Each ACP brings together specialists in a particular discipline from different institutions to maximize the power of shared knowledge and resources. Initiated by Surgery ACP, the student research mentorship programme is a programme designed to facilitate engagement between medical students and the surgical faculty. The programme offers mentors not only the opportunity to supervise research but also to nurture future clinician scientists. In turn, medical students acquire valuable research experience which may be useful in their future careers. The programme typically lasts one year, depending on the students’ commitment. Surgery ACP matches students’ research interests with the mentor's area of expertise whenever possible. Surgery ACP organizes informal tea sessions to bring students and prospective mentors together. Once a match is made, the pair is required to submit a project proposal which includes the title, proposed start and end dates, ethical and biosafety considerations and project details. The mentees either think of their own research question with guidance from the mentors or join an existing project. The mentees may participate in data collection, data analysis, manuscript writing and conference presentation. The progress of each research project is monitored through half-yearly progress report. The mentees report problems encountered or changes made to existing proposal on top of the progress made. A total of 18 mentors were successfully paired with 36 mentees since 2013. Currently, there are 23 on-going and 13 completed projects. The mentees are encouraged to present their projects at conferences and to publish in peer-reviewed journals. Six mentees have presented their completed projects at local or international conferences and one mentee has her work published. To further support student research, Surgery ACP organized a Research Day in 2015 to recognize their research efforts and to showcase their wide-range of research. Surgery ACP recognizes that early exposure of medical students to research is important in developing them into clinician scientists. As interest in research take time to develop and are usually realized during various research attachments, it is crucial that programmes such as the student research mentorship programme exist. Surgery ACP will continue to build on this programme.

Keywords: academic clinical programme, clinician scientist, medical student, mentoring

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Authors: Athanasia Chatzifotiou, Karen Tait

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Eco-school is an international initiative that offers schools the opportunity to develop practices on education for sustainable development (EfSD). Such practices need to focus on nine areas, namely: energy, water, biodiversity, school grounds, healthy living, transport, litter, waste and global citizenship. Acquiring the green flag status is the ultimate stage (silver and bronze are the other two) that is awarded by a committee external to the school and it lasts for two years. Our project focused on two such primary schools that had acquired the green flag status. The aim of our project is to describe the schools’ approach of becoming an eco-school, the practitioners’ role in promoting the values and principles of such endeavors, thus identifying the impact of EfSD. We chose the eco-schools initiative as it gives a clear and straightforward way to identify a school with an interest in EfSD. The project is important because even though EfSD attracts high attention in rhetoric, there is evidence indicating that EfSD may be neglected in practice. This paper presents part of a bigger project that aims to compare how primary schools and early years settings have approached EfSD via the eco-school initiative in the North East of England. This is a qualitative project that used a case study design to focus on the practices of two particular primary schools to gain a green flag status. A semi-structured interview was used with the lead teachers/practitioners of the schools; an audit was also conducted as part of a tour of the schools’ premises highlighting the initiatives, curriculum work, projects undertaken as well as resources available to school. A content analysis of the interview transcripts was conducted with the creation of response categories and response narratives by the two researchers first working individually and then collaboratively; the findings of the project reflected issues that concerned: a) pupils’ cognitive, physical and socio-emotional development, b) the wider community and c) the lead practitioners’ role and status in school. In relation to EfSD, our findings indicated that its impact upon these two eco-schools was rather minimal; a mismatch was identified between the eco-school practices and a holistic understanding of issues that EfSD aims to achieve. This mismatch between eco-school practices and EfSD is discussed with regard to: a) pupils’ understanding of the sustainability dimension in the topics they addressed; and b) teachers’ knowledge of sustainability and willingness to keep on such work in schools.

Keywords: eco-schools, environment, primary schools, sustainability education

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Authors: Sengul Celik, Alper Ketenci

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In Turkish Constitution about health care in Article 56, it is said that: everyone has the right to live in a healthy and balanced environment. It is the duty of the state and citizens to improve the environment, protect environmental health, and prevent environmental pollution. The state ensures that everyone lives their lives in physical and mental health; it organizes the planning and service of health institutions from a single source in order to realize cooperation by increasing savings and efficiency in human and substance power. The state fulfills this task by utilizing and supervising health and social institutions in the public and private sectors. General health insurance can be established by law for the widespread delivery of health services. To have health care is one of the basic rights of patients. After the coupe attempt in July 2016, the Government of Turkey has announced a state of emergency and issued lots of emergency decrees. By these emergency decrees, lots of people were dismissed from their jobs and lost their some basic social rights. The violations occur in social life. One of the most common observations is the discrimination by government in health care system. This study aims to put forward the violation of human rights in health care system in Turkey due to their discriminated position by an emergency decree. The study is a case study that is based on nine interviews with the people or relatives of people who lost their jobs by an emergency decree in Turkey. In this study, no personally identifiable information was obtained for the safety of individuals. Also no distinctive questions regarding the identity of individuals were asked. The interviews are obtained through internet call applications. The data were analyzed through the requirements of regular health care system in Turkey. The interviews expose that the people or the relatives of people lost their right to have regular health care. They have to pay extra amount both in clinical services and in medication treatment. The patient right to quality medical care without prejudice is violated. It was assessed that the people who are involved in emergency decree and their relatives are discriminated by government and deprived of regular medical care and supervision. Although international legal arrangements and legal responsibilities of the state have been put forward by Article 56, they are violated in practice. To prevent these kinds of violations, some measures should be taken against the deprivation in health care system especially towards the discriminated people by an emergency decree.

Keywords: emergency decree in Turkey, health care, discriminated people, patients rights

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Authors: Alina Murtishcheva

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The development of an effective system of administrative supervision is a prerequisite for the functioning of local self-government on the basis of the rule of law. Administrative supervision of local self-government is of particular importance in the EU countries due to the influence of integration processes. The central authorities act on the international level; however, subnational authorities also have to implement European legislation in order to strengthen integration. Therefore, the central authority, being the connecting link between supranational and subnational authorities, should bear responsibility, including financial responsibility, for possible mistakes of subnational authorities. Consequently, the state should have sufficient mechanisms of control over local and regional authorities in order to correct their mistakes. At the same time, the control mechanisms do not deny the autonomy of local self-government. The paper analyses models of administrative supervision of local self-government in Ukraine, Poland, Lithuania, Belgium, Great Britain, Italy, and France. The research methods used in this paper are theoretical methods of analysis of scientific literature, constitutions, legal acts, Congress of Local and Regional Authorities of the Council of Europe reports, and constitutional court decisions, as well as comparative and logical analysis. The legislative basis of administrative supervision was scrutinized, and the models of administrative supervision were classified, including a priori control and ex-post control or their combination. The advantages and disadvantages of these models of administrative supervision are analysed. Compliance with Article 8 of the European Charter of Local Self-Government is of great importance for countries achieving common goals and sharing common values. However, countries under study have problems and, in some cases, demonstrate non-compliance with provisions of Article 8. Such non-conformity as the endorsement of a mayor by the Flemish Government in Belgium, supervision with a view to expediency in Great Britain, and the tendency to overuse supervisory power in Poland are analysed. On the basis of research, the tendencies of administrative supervision of local authorities’ activities in selected European countries are described. Several recommendations for Ukraine as a country that had been granted the EU candidate status are formulated. Having emphasised its willingness to become a member of the European community, Ukraine should not only follow the best European practices but also avoid the mistakes of countries that have long-term experience in developing the local self-government institution. This project has received funding from the Research Council of Lithuania (LMTLT), agreement № P-PD-22-194

Keywords: administrative supervision, decentralisation, legality, local authorities, local self-government

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Authors: María de los Ángeles Cerda González, Itzel Arriaga Hurtado, Pascacio José Martínez Pichardo

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In México, the recognition of refugee condition is a fundamental right which, as host State, has the obligation of respect, protect, and fulfill to the foreigners – where we can find the figure of immigrants in irregular situation-, that cannot return to their country of origin for humanitarian reasons. The recognition of the refugee condition as a fundamental right in the Mexican law system proceeds under these situations: 1. The immigrant applies for the refugee condition, even without the necessary proving elements to accredit the humanitarian character of his departure from his country of origin. 2. The immigrant does not apply for the recognition of refugee because he does not know he has the right to, even if he has the profile to apply for. 3. The immigrant who applies fulfills the requirements of the administrative procedure and has access to the refugee recognition. Of the three situations above, only the last one is contemplated for the national indexes of the status refugee; and the first two prove the inefficiency of the governmental system viewed from its lack of sensibility consequence of the no education in human rights matter and which results in the legal vulnerability of the immigrants in irregular situation because they do not have access to the procuration and administration of justice. In the aim of determining the causes and consequences of the no recognition of the refugee status, this investigation was structured from a systemic analysis which objective is to show the advances in Central American humanitarian emergency investigation, the Mexican States actions to protect, respect and fulfil the fundamental right of refugee of immigrants in irregular situation and the social and legal vulnerabilities suffered by Central Americans in Mexico. Therefore, to achieve the deduction of the legal nature of the humanitarian emergency from the Human Rights as a branch of the International Public Law, a conceptual framework is structured using the inductive deductive method. The problem statement is made from a legal framework to approach a theoretical scheme under the theory of social systems, from the analysis of the lack of communication of the governmental and normative subsystems of the Mexican legal system relative to the process undertaken by the Central American immigrants to achieve the recognition of the refugee status as a human right. Accordingly, is determined that fulfilling the obligations of the State referent to grant the right of the recognition of the refugee condition, would mean a guideline for a new stage in Mexican Law, because it would enlarge the constitutional benefits to everyone whose right to the recognition of refugee has been denied an as consequence, a great advance in human rights matter would be achieved.

Keywords: central American immigrants in irregular situation, humanitarian emergency, human rights, refugee

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Authors: Diego Caballero Vélez

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In 1997 the Schengen Convention was incorporated in the mainstream of EU law by the Amsterdam Treaty. It came into effect in 1999 with the abolition of internal border controls in the EU, a milestone in the European integration project. In the meantime, due to the Yugoslav wars, nearly 700,000 asylum applications were filed in the European countries provoking a major refugee crisis. During this period, the opening of Eastern Europe fostered more cooperation and policy-making at the EU level in migration issues. Currently, a similar migratory crisis is taking place in Europe. The Syrian war has caused the most massive influx of immigrants in Europe since World War II. Nevertheless, the EU is adopting different migration policies from those implemented during the Yugoslav migration crisis. The current crisis has not led to a common European position but national responses have been offered on migration policies and responsibility for border security and asylum-seekers. A lot of factors can explain this change from a cooperation scenario to a no cooperation one, such as the economic crisis, but this research is focused on the premise that 'threat perception' lies at the core of some states grand strategies towards migration and it also influences in multilateral or unilateral responses. Migration rests at the nexus of three dimensions of security, including geopolitical interests, material production, and internal security. According to some scholars, migration policy is an 'integral instrument' of state grand strategy in that context. Political integration at the EU might be altered with the emergence of existential threats. In other words, some areas of the European cooperation can be transformed when a 'critical juncture' occurs, for instance a migration crisis. In that instance, Member states could see migration as a matter of threat that modifies their national interests and willingness to embrace international cooperation. This research will focus on EU Member states´ perceptions of the 90´s migration crisis and the current one. The goal is to evaluate to what extent the perceptions of threat are one of the main factors for explaining the transition from a cooperation scenario to a no-cooperation one in European asylum and security policies. To analyze threat perception in both migration crisis, some relevant Member states are treated as cases of study and a comparative analysis is carried out based on public opinion polls, public and policy discourse in migration, voting practices and deconstruction of the migration policies themselves both at EU level and a national one.

Keywords: cooperation, migration crisis, national responses, threat perception

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Authors: Orkide Donma, Mustafa M. Donma

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Obesity is a low-grade inflammatory disease and may lead to health problems such as hypertension, dyslipidemia, diabetes. It is also associated with important risk factors for cardiovascular diseases. This requires the detailed evaluation of obesity, particularly in children. The aim of this study is to enlighten the potential associations between lipid ratios and obesity indices and to introduce those with discriminating features among children with obesity and metabolic syndrome (MetS). A total of 408 children (aged between six and eighteen years) participated in the scope of the study. Informed consent forms were taken from the participants and their parents. Ethical Committee approval was obtained. Anthropometric measurements such as weight, height as well as waist, hip, head, neck circumferences and body fat mass were taken. Systolic and diastolic blood pressure values were recorded. Body mass index (BMI), diagnostic obesity notation model assessment index-II (D2 index), waist-to-hip, head-to-neck ratios were calculated. Total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDLChol), low-density lipoprotein cholesterol (LDLChol) analyses were performed in blood samples drawn from 110 children with normal body weight, 164 morbid obese (MO) children and 134 children with MetS. Age- and sex-adjusted BMI percentiles tabulated by World Health Organization were used to classify groups; normal body weight, MO and MetS. 15^th-to-85^th percentiles were used to define normal body weight children. Children, whose values were above the 99th percentile, were described as MO. MetS criteria were defined. Data were evaluated statistically by SPSS Version 20. The degree of statistical significance was accepted as p≤0.05. Mean±standard deviation values of BMI for normal body weight children, MO children and those with MetS were 15.7±1.1, 27.1±3.8 and 29.1±5.3 kg/m², respectively. Corresponding values for the D2 index were calculated as 3.4±0.9, 14.3±4.9 and 16.4±6.7. Both BMI and D2 index were capable of discriminating the groups from one another (p≤0.01). As far as other obesity indices were considered, waist-to hip and head-to-neck ratios did not exhibit any statistically significant difference between MO and MetS groups (p≥0.05). Diagnostic obesity notation model assessment index-II was correlated with the triglycerides-to-HDL-C ratio in normal body weight and MO (r=0.413, p≤0.01 and r=0.261, (p≤0.05, respectively). Total cholesterol-to-HDL-C and LDL-C-to-HDL-C showed statistically significant differences between normal body weight and MO as well as MO and MetS (p≤0.05). The only group in which these two ratios were significantly correlated with waist-to-hip ratio was MetS group (r=0.332 and r=0.334, p≤0.01, respectively). Lack of correlation between the D2 index and the triglycerides-to-HDL-C ratio was another important finding in MetS group. In this study, parameters and ratios, whose associations were defined previously with increased cardiovascular risk or cardiac death have been evaluated along with obesity indices in children with morbid obesity and MetS. Their profiles during childhood have been investigated. Aside from the nature of the correlation between the D2 index and triglycerides-to-HDL-C ratio, total cholesterol-to-HDL-C as well as LDL-C-to- HDL-C ratios along with their correlations with waist-to-hip ratio showed that the combination of obesity-related parameters predicts better than one parameter and appears to be helpful for discriminating MO children from MetS group.

Keywords: children, lipid ratios, metabolic syndrome, obesity indices

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Authors: Ahmed Slami, Med El Amine Brixi Nigassa, Nassima Labdelli, Sofiane Soulimane, Arnaud Pothier

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Many people suffer from diabetes, a disease marked by abnormal levels of sugar in the blood; 285 million people have diabetes, 6.6% of the world adult population (in 2010), according to the International Diabetes Federation. Insulin medicament is invented to be injected into the body. Generally, the injection requires the patient to do it manually. However, in many cases he will be unable to inject the drug, saw that among the side effects of hyperglycemia is the weakness of the whole body. The researchers designed a medical device that injects insulin too autonomously by using micro-pumps. Many micro-pumps of concepts have been investigated during the last two decades for injecting molecules in blood or in the body. However, all these micro-pumps are intended for slow infusion of drug (injection of few microliters by minute). Now, the challenge is to develop micro-pumps for fast injections (1 microliter in 10 seconds) with accuracy of the order of microliter. Recently, studies have shown that only piezoelectric actuators can achieve this performance, knowing that few systems at the microscopic level were presented. These reasons lead us to design new smart microsystems injection drugs. Therefore, many technological advances are still to achieve the improvement of materials to their uses, while going through their characterization and modeling action mechanisms themselves. Moreover, it remains to study the integration of the piezoelectric micro-pump in the microfluidic platform features to explore and evaluate the performance of these new micro devices. In this work, we propose a new micro-pump model based on piezoelectric actuation with a new design. Here, we use a finite element model with Comsol software. Our device is composed of two pumping chambers, two diaphragms and two actuators (piezoelectric disks). The latter parts will apply a mechanical force on the membrane in a periodic manner. The membrane deformation allows the fluid pumping, the suction and discharge of the liquid. In this study, we present the modeling results as function as device geometry properties, films thickness, and materials properties. Here, we demonstrate that we can achieve fast injection. The results of these simulations will provide quantitative performance of our micro-pumps. Concern the spatial actuation, fluid rate and allows optimization of the fabrication process in terms of materials and integration steps.

Keywords: COMSOL software, piezoelectric, micro-pump, microfluidic

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Authors: Seyeon Lee, Suyeon Lee, Julia Rogers

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This research investigates and records post-flood and typhoon conditions of low income housing in the Thua Thien Hue Province, Vietnam; area prone to extreme flooding in Central Vietnam. The cost of rebuilding houses after flood and typhoon has been always a burden for low income households. These costs often lead to the elimination of essential construction practices for disaster resistance. Despite relief efforts from international non-profit organizations and Vietnam government, the impacts of flood and typhoon damages to residential construction has been reoccurring to the same neighborhood annually. Notwithstanding its importance, this topic has not been systematically investigated. The study is limited to assistance provided to low income households documenting existing conditions of low income homes impacted by post flood and typhoon conditions in the Thua Thien Hue Province. The research identifies leading causes of the building failure from the natural disasters. Relief efforts and progress made since the last typhoon is documented. The quality of construction and repairs are assessed based on Home Builders Guide to Coastal Construction by Federal Emergency Management Agency. Focus group discussions and individual interviews with local residents from four different communities were conducted to get incites on repair effort by the non-profit organizations and Vietnam government, and their needs post flood and typhoon. The findings from the field study informed that many of the local people are now aware of the importance of improving housing conditions as one of the key coping strategies to withstand flood and typhoon events as it makes housing and community more resilient to future events. While there has been a remarkable improvement of housing and infrastructure with the support from the local government as well as the non-profit organizations, many households in the study areas are found to still live in weak and fragile housing conditions without gaining access to the aid to repair and strengthen the houses. Given that the major immediate recovery action taken by the local people tends to focus on repairing damaged houses, and on this ground, low-income households spend a considerable amount of their income on housing repair, providing proper and applicable construction practices will not only improve the housing condition, but also contribute to reducing poverty in Vietnam.

Keywords: disaster coping mechanism, housing welfare, low-income housing, recovery reduction

Procedia PDF Downloads 254

Authors: Samuel Holder

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Mass incarceration in the United States is a human rights issue, not merely a civil rights problem. It is a human rights problem not only because the United States has a high rate of incarceration, but more importantly because of who is jailed, for what purpose they are jailed and, ultimately, the manner in which they are jailed. To sustain the scale of the criminal justice system, one of the darker policies involves a multi-tiered strategy of fee- and fine-collection, targeting, usually, the most vulnerable and poor, many of whom run into the law via small offenses that do not rise to the level of felonies. This paper advances the notion that this debt collection-to-incarceration pipeline is tantamount to a modern-day debtors’ prison system. This article seeks to confront the thorny issue of incarceration via criminal justice debt from a human rights and cause-lawyering position. It will argue that a two-pronged cause-lawyering strategy: the first focused on traditional litigation along constitutional grounds, and the second, an advocacy approach rooted in grassroots campaigns, designed to shift the normative operation and understanding of the rights of marginalized and racialized offenders. Ultimately, the argument suggests that this approach will be effective in combatting the (often highly privatized) criminal justice debt system and bring the roles of 'incapacitation, rehabilitation, deterrence, and retribution' back into the criminal justice legal conversation. Part I contextualizes and historicizes the role of fees, penalties, and fines in American criminal justice. Part II examines the emergence of private industry in the criminal justice system, and its role in the acceleration of profit-driven criminal justice debt collection and incarceration. Part III addresses the failures of the federal and state law and legislation in combatting predatory incarceration and debt collection in the criminal justice system, particularly as waged against the indigent and/or ethnically or racially marginalized. Part IV examines the potential for traditional cause-lawyering litigation along constitutional grounds, using case studies across contexts for illustration. Finally, Part V will review the radical cause-lawyer’s role in the normative struggle in redefining prisoners’ rights and the rights of the marginalized (and racialized) as they intersect at the crossroads of criminal justice debt. This paper will conclude with recommendations for litigation and advocacy, drawing on hypotheses advanced, and informed by case studies from a variety of both national and international jurisdictions.

Keywords: cause-lawyering, criminal justice debt, human rights, judicial fees

Procedia PDF Downloads 147

Authors: Fatma Ahmed, Heba Mostafa, Bassem Ramdan, Azza El-Soussi

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Background: World Health Organization stated that by 2020 cardiac disease will be the number one cause of death worldwide and estimates that 25 million people per year will suffer from heart disease. Cardiac surgery is considered an effective treatment for severe forms of cardiovascular diseases that cannot be treated by medical treatment or cardiac interventions. In spite of the benefits of cardiac surgery, it is considered a major stressful experience for patients who are candidate for surgery. Prehabilitation can decrease incidences of postoperative complications as it prepares patients for surgical stress through enhancing their defenses to meet the demands of surgery. When patients anticipate the postoperative sequence of events, they will prepare themselves to act certain behaviors, identify their roles and actively participate in their own recovery, therefore, anxiety levels are decreased and functional capacity is enhanced. Prehabilitation programs can comprise interventions that include physical exercise, psychological prehabilitation, nutritional optimization and risk factor modification. Physical exercises are associated with improvements in the functioning of the various physiological systems, reflected in increased functional capacity, improved cardiac and respiratory functions and make patients fit for surgical intervention. Prehabilitation programs should also prepare patients psychologically in order to cope with stress, anxiety and depression associated with postoperative pain, fatigue, limited ability to perform the usual activities of daily living through acting in a healthy manner. Notwithstanding the benefits of psychological preparations, there are limited studies which investigated the effect of psychological prehabilitation to confirm its effect on psychological, quality of life and physiological outcomes of patients who had undergone cardiac surgery. Aim of the study: The study aims to determine the effect of prehabilitation interventions on outcomes of patients undergoing cardiac surgeries. Methods: Quasi experimental study design was used to conduct this study. Sixty eligible and consenting patients were recruited and divided into two groups: control and intervention group (30 participants in each). One tool namely emotional, physiological, clinical, cognitive and functional capacity outcomes of prehabilitation intervention assessment tool was utilized to collect the data of this study. Results: Data analysis showed significant improvement in patients' emotional state, physiological and clinical outcomes (P < 0.000) with the use of prehabilitation interventions. Conclusions: Cardiac prehabilitation in the form of providing information about surgery, circulation exercise, deep breathing exercise, incentive spirometer training and nutritional education implemented daily by patients scheduled for elective open heart surgery one week before surgery have been shown to improve patients' emotional state, physiological and clinical outcomes.

Keywords: emotional recovery, clinical recovery, coronary artery bypass grafting patients, prehabilitation

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Authors: Şule Yanık, Emel Ertürk-Mustul, Zerrin Turan, Hasan Gürgür

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It is known that there are policies that will support the early special education (ESE) for children requiring special care including the children with hearing loss (CHL) in many countries that give importance to early childhood (0-6 years) education, accordingly ESE services have been gradually increasing and these services provide positive contributions to the child and family. These services begin with medical diagnostics, provision of the use of assistive technologies for hearing and the orientation of children towards early education program (EEP) for the CHL. In 0-3 years of age EEP, education and support services are provided to the children and their families. In 3-6 years of age, children are supported in a pre-school education program (PSE) in which their peers and teachers are present. Therefore, the children with hearing loss and their families are going through a series of medical, educational and social transition process after diagnosed with hearing loss. Depending on their age and development, CHL also go through a transition period from hospital to home, from home to EEP and from EEP to PSE. It is seen that there is no legal regulation regarding the transition process in Turkey and hence different processes have been carried out in the transition process from EEP to PSE. The aim of this study is to reveal the problems confronted by the CHL during the transition period from EEP to PSE and the solution proposals for these problems. In this study, a document review was made by reviewing the national and international studies about transition processes of the CHL in Turkey from EEP to PSE. Accordingly, in the study carried out in two stages, firstly, a review of the body of literature was performed by creating key words related to the subject. Secondly, the problems confronted by the CHL in Turkey during the transition period from EEP to PSE and the solution proposals for these problems were demonstrated by analyzing the obtained data. According to the body of literature, it is seen that there are no laws concerning the transition processes of the children who require special care including the CHL in Turkey from EEP (sending) to PSE (receiving), and correspondingly numerous problems have been experienced during the transition period. It seems that the EEP adopts family-centered approaches for strengthening the families of the CHL. However, PSE program aims to prepare the children to school life by focusing on their social and academical development rather with the adoption of children-centered approaches. Therefore, while the families feel an inseparable part of the team in EEP, they indicated that they felt like a stranger in the school team after their children have started to PSE. Therefore, families find the transition processes worrisome and state that they are not satisfied with the process. We discovered that in the process of transition from EEP to PSE, families are not informed, there is a limited number of PSE options available, children cannot adapt to the new educational environment and cannot benefit from the existing PSE.

Keywords: early education program, early special education, children with hearing loss, transition

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Authors: Mclee Kerolle

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For more than 50 years, the state of Hawaii has had the beginnings of a burgeoning commercial aerospace presence statewide. While Hawaii provides the aerospace industry with unique assets concerning geographic location, lack of range safety issues and other factors critical to aerospace development, Hawaii’s strategy and commitment for aerospace have been unclear. For this reason, this paper presents a comparative analysis of Hawaii’s space sector with two of the world’s leading space sectors, Colorado and the Netherlands, in order to provide a strategic plan that establishes a firm position going forward to support Hawaii’s aerospace development statewide. This plan will include financial and other economic incentives legislatively supported by the State to help grow and diversify Hawaii’s aerospace sector. The first part of this paper will examine the business model adopted by the Colorado Space Coalition (CSC), a group of industry stakeholders working to make Colorado a center of excellence for aerospace, as blueprint for growth in Hawaii’s space sector. The second section of this paper will examine the business model adopted by the Netherlands Space Business Incubation Centre (NSBIC), a European Space Agency (ESA) affiliated program that offers business support for entrepreneurs to turn space-connected business ideas into commercial companies. This will serve as blueprint to incentivize space businesses to launch and develop in Hawaii. The third section of this paper will analyze the current policies both CSC, and NSBIC implores to promote industry expansion and legislative advocacy. The final section takes the findings from both space sectors and applies their most adaptable features to a Hawaii specific space business model that takes into consideration the unique advantage and disadvantages found in developing Hawaii’s space sector. The findings of this analysis will show that the development of a strategic plan based on a comparative analysis that creates high technology jobs and new pathways for a trained workforce in the space sector, as well as elicit state support and direction, will achieve the goal of establishing Hawaii as a center of space excellence. This analysis will also serve as a signal to the federal, private sector and international community that Hawaii is indeed serious about developing its’ aerospace industry. Ultimately this analysis and subsequent aerospace development plan will serve as a blueprint for the benefit of all space-faring nations seeking to develop their space sectors.

Keywords: Colorado, Hawaii, Netherlands, space policy

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Authors: Swati Arun

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The present paper argues that Balance of Power (BOP) needs to conjugate with certain contingencies like geography. It is evident that sea powers (‘insular’ for better clarity) are not balanced (if at all) in the same way as land powers. Its apparent that artificial insularity that the US has achieved reduces the chances of balancing (constant) and helps it maintain preponderance (variable). But how precise is this approach in assessing the dynamics between China’s rise and reaction of other powers and US. The ‘evolved’ theory can be validated by putting China and US in the equation. Systemic Relation between the nations was explained through the Balance of Power theory much before the systems theory was propounded. The BOP is the crux of functionality of ‘power relation’ dynamics which has played its role in the most astounding ways leading to situations of war and peace. Whimsical; but true that, the BOP has remained a complicated and indefinable concepts since Hans. Morganthau to Kenneth Waltz. A challenge of the BOP, however remains; “ that it has too many meanings”. In the recent times it has become evident that the myriad of expectations generated by BOP has not met the practicality of the current world politics. It is for this reason; the BoP has been replaced by Preponderance Theory (PT) to explain prevailing power situation. PT does provide an empirical reasoning for the success of this theory but fails in a abstract logical reasoning required for making a theory universal. Unipolarity clarifies the current system as one where balance of power has become redundant. It seems to reach beyond the contours of BoP, where a superpower does what it must to remain one. The centrality of this arguments pivots around - an exception, every time BOP fails to operate, preponderance of power emerges. PT does not sit well with the primary logic of a theory because it works on an exception. The evolution of such a pattern and system where BOP fails and preponderance emerges is absent. The puzzle here is- if BOP really has become redundant or it needs polishing. The international power structure changed from multipolar to bipolar to unipolar. BOP was looked at to provide inevitable logic behind such changes and answer the dilemma we see today- why US is unchecked, unbalanced? But why was Britain unchecked in 19th century and why China was unbalanced in 13th century? It is the insularity of the state that makes BOP reproduce “imbalance of power”, going a level up from off-shore balancer. This luxury of a state to maintain imbalance in the region of competition or threat is the causal relation between BOP’s and geography. America has applied imbalancing- meaning disequilibrium (in its favor) to maintain the regional balance so that over time the weaker does not get stronger and pose a competition. It could do that due to the significant parity present between the US and the rest.

Keywords: balance of power, china, preponderance of power, US

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Authors: Nino Damenia

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The agricultural sector plays an important role in the development of Georgia's economy, it contributes to employment and food security. It faces various types of risks that may lead to heavy financial losses. Agricultural insurance is one of the means of combating agricultural risks. The paper discusses the agricultural insurance experience of those countries (European countries and the USA) that have successfully implemented the agricultural insurance program. Analysis of international cases shows that a well-designed and implemented agri-insurance system can bring significant benefits to farmers, insurance companies and the economy as a whole. In the background of all this, the Government of Georgia recognized the importance of agro-insurance and took important steps for its development. In 2014, in cooperation with insurance companies, an agro-insurance program was introduced, the purpose of which is to increase the availability of insurance for farmers and stimulate the agro-insurance market. Despite such a step forward, challenges remain such as awareness of farmers, insufficient infrastructure for data collection and risk assessment, involvement of insurance companies and other important factors. With the support of the government and stakeholders, it is possible to overcome the existing challenges and establish a strong and effective agro-insurance system. Objectives. The purpose of the research is to analyze the development trends of the agricultural insurance market, to identify the main factors affecting its growth, and to further develop recommendations for development prospects for Georgia. Methodologies. The research uses mixed methods, which combine qualitative and quantitative research techniques. The qualitative method includes the study of the literature of Georgian and foreign economists, which allows us to get acquainted with the challenges, opportunities, legislative and regulatory frameworks of agricultural insurance. Quantitative analysis involves collecting data from stakeholders and then analyzing it. The paper also uses the methods of synthesis, comparison and statistical analysis of the agricultural insurance market in Georgia, Europe and the USA. Conclusions. As the main results of the research, we can consider that the analysis of the insurance market has been made and its main functions have been identified; The essence, features and functions of agricultural insurance are analyzed; European and US agricultural insurance market is researched; The stages of formation and development of the agricultural insurance market of Georgia are studied, its importance for the agricultural sector of Georgia is determined; The role of the state for the development of agro-insurance is analyzed and development prospects are established based on the study of the current trends of the agro-insurance market of Georgia.

Keywords: agricultural insurance, agriculture, agricultural insurance program, risk

Procedia PDF Downloads 37

Authors: Priyoth Kittiteerasack, Alana Steffen, Alicia K. Matthews

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Depression is a leading cause of the worldwide burden of disability and disease burden. Notably, lesbian, gay, bisexual, and transgender (LGBT) populations are more likely to be a high-risk group for depression compared to their heterosexual and cisgender counterparts. To date, little is known about the rates and predictors of depression among Thai LGBT populations. As such, the purpose of this study was to: 1) measure the prevalence of depression among a diverse sample of Thai LGBT adults and 2) determine the influence of minority stress variables (discrimination, victimization, internalized homophobia, and identity concealment), general stress (stress and loneliness), and coping strategies (problem-focused, avoidance, and seeking social support) on depression outcomes. This study was guided by the Minority Stress Model (MSM). The MSM posits that elevated rates of mental health problems among LGBT populations stem from increased exposures to social stigma due to their membership in a stigmatized minority group. Social stigma, including discrimination and violence, represents unique sources of stress for LGBT individuals and have a direct impact on mental health. This study was conducted as part of a larger descriptive study of mental health among Thai LGBT adults. Standardized measures consistent with the MSM were selected and translated into the Thai language by a panel of LGBT experts using the forward and backward translation technique. The psychometric properties of translated instruments were tested and acceptable (Cronbach’s alpha > .8 and Content Validity Index = 1). Study participants were recruited using convenience and snowball sampling methods. Self-administered survey data were collected via an online survey and via in-person data collection conducted at a leading Thai LGBT organization. Descriptive statistics and multivariate analyses using multiple linear regression models were conducted to analyze study data. The mean age of participants (n = 411) was 29.5 years (S.D. = 7.4). Participants were primarily male (90.5%), homosexual (79.3%), and cisgender (76.6%). The mean score for depression of study participant was 9.46 (SD = 8.43). Forty-three percent of LGBT participants reported clinically significant levels of depression as measured by the Beck Depression Inventory. In multivariate models, the combined influence of demographic, stress, coping, and minority stressors explained 47.2% of the variance in depression scores (F(16,367) = 20.48, p < .001). Minority stressors independently associated with depression included discrimination (β = .43, p < .01) victimization (β = 1.53, p < .05), and identity concealment (β = -.54, p < .05). In addition, stress (β = .81, p < .001), history of a chronic disease (β = 1.20, p < .05), and coping strategies (problem-focused coping β = -1.88, p < .01, seeking social support β = -1.12, p < .05, and avoidance coping β = 2.85, p < .001) predicted depression scores. The study outcomes emphasized that minority stressors uniquely contributed to depression levels among Thai LGBT participants over and above typical non-minority stressors. Study findings have important implications for nursing practice and the development of intervention research.

Keywords: depression, LGBT, minority stress, sexual and gender minority, Thailand

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Authors: Kangana Sengar, Sanjay Deb, Ramesh Dawar

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Introduction: Ki-67 can be a useful marker in determining proliferative activity in patients with multiple myeloma (MM). However, using Ki-67 alone results in the erroneous inclusion of non-myeloma cells leading to false high counts. We have used Dual IHC (immunohistochemistry) staining with Ki-67 and CD138 to enhance specificity in assessing proliferative activity of bone marrow plasma cells. Aims and objectives: To estimate the proportion of proliferating (Ki-67 expressing) plasma cells in patients with MM and correlation of Ki-67 with other known prognostic parameters. Materials and Methods: Fifty FFPE (formalin fixed paraffin embedded) blocks of trephine biopsies of cases diagnosed as MM from 2010 to 2015 are subjected to H & E staining and Dual IHC staining for CD 138 and Ki-67. H & E staining is done to evaluate various histological parameters like percentage of plasma cells, pattern of infiltration (nodular, interstitial, mixed and diffuse), routine parameters of marrow cellularity and hematopoiesis. Clinical data is collected from patient records from Medical Record Department. Each of CD138 expressing cells (cytoplasmic, red) are scored as proliferating plasma cells (containing a brown Ki¬67 nucleus) or non¬proliferating plasma cells (containing a blue, counter-stained, Ki-¬67 negative nucleus). Ki-67 is measured as percentage positivity with a maximum score of hundred percent and lowest of zero percent. The intensity of staining is not relevant. Results: Statistically significant correlation of Ki-67 in D-S Stage (Durie & Salmon Stage) I vs. III (p=0.026) and ISS (International Staging System) Stage I vs. III (p=0.019), β2m (p=0.029) and percentage of plasma cells (p < 0.001) is seen. No statistically significant correlation is seen between Ki-67 and hemoglobin, platelet count, total leukocyte count, total protein, albumin, S. calcium, S. creatinine, S. LDH, blood urea and pattern of infiltration. Conclusion: Ki-67 index correlated with other known prognostic parameters. However, it is not determined routinely in patients with MM due to little information available regarding its relevance and paucity of studies done to correlate with other known prognostic factors in MM patients. To the best of our knowledge, this is the first study in India using Dual IHC staining for Ki-67 and CD138 in MM patients. Routine determination of Ki-67 will help to identify patients who may benefit with more aggressive therapy. Recommendation: In this study follow up of patients is not included, and the sample size is small. Studying with larger sample size and long follow up is advocated to prognosticate Ki-67 as a marker of survival in patients with multiple myeloma.

Keywords: bone marrow, dual IHC, Ki-67, multiple myeloma

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Authors: A. S. V. Carvalho, J. Luis, L. S. O. Pires, J. M. Oliveira

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Additive manufacturing technologies (AM) experienced a remarkable growth in the latest years due to the development and diffusion of a wide range of three-dimensional (3D) printing techniques. Nowadays we can find techniques available for non-industrial users, like fused filament fabrication, but techniques like 3D printing, polyjet, selective laser sintering and stereolithography are mainly spread in the industry. Robocasting (R3D) shows a great potential due to its ability to shape materials with a wide range of viscosity. Industrial porcelain compositions showing different rheological behaviour can be prepared and used as candidate materials to be processed by R3D. The use of this AM technique in industry is very residual. In this work, a specific porcelain composition with suitable rheological properties will be processed by R3D, and a systematic study of the printing parameters tuning will be shown. The porcelain composition was formulated based on an industrial spray dried porcelain powder. The powder particle size and morphology was analysed. The powders were mixed with water and an organic binder on a ball mill at 200 rpm/min for 24 hours. The batch viscosity was adjusted by the addition of an acid solution and mixed again. The paste density, viscosity, zeta potential, particle size distribution and pH were determined. In a R3D system, different speed and pressure settings were studied to access their impact on the fabrication of porcelain models. These models were dried at 80 °C, during 24 hours and sintered in air at 1350 °C for 2 hours. The stability of the models, its walls and surface quality were studied and their physical properties were accessed. The microstructure and layer adhesion were observed by SEM. The studied processing parameters have a high impact on the models quality. Moreover, they have a high impact on the stacking of the filaments. The adequate tuning of the parameters has a huge influence on the final properties of the porcelain models. This work contributes to a better assimilation of AM technologies in ceramic industry. Acknowledgments: The RoboCer3D project – project of additive rapid manufacturing through 3D printing ceramic material (POCI-01-0247-FEDER-003350) financed by Compete 2020, PT 2020, European Regional Development Fund – FEDER through the International and Competitive Operational Program (POCI) under the PT2020 partnership agreement.

Keywords: additive manufacturing, porcelain, robocasting, R3D

Procedia PDF Downloads 146

Authors: Maike Andresen, Georg Dochtmann

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Due to political, social, and societal changes in labor organization, top-sharing, defined as job-sharing in leading positions, becomes more important in HRM. German companies are looking for practical and economically meaningful solutions that allow to enduringly increase women’s ratio in management, not only because of a recently implemented quota. Furthermore, supporting employees in achieving work-life balance is perceived as an important goal for a sustainable HRM to gain competitive advantage. Top-sharing is seen as being suitable to reach both goals. To evaluate determinants leading to effective top-sharing, a case study of a newly implemented top-sharing tandem in a large German enterprise was conducted over a period of 15 months. In this company, a full leadership position was split into two 60%-part-time positions held by an experienced female leader in her late career and a female college who took over her first leadership position (mid-career). We assumed a person-person fit in terms of a match of the top sharing partners’ personality profiles (Big Five) and their leadership motivations to be important prerequisites for an effective collaboration between them. We evaluated the person-person fit variables once before the tandem started to work. Both leaders were expected to learn from each other (mentoring, competency development). On an operational level, they were supposed to lead together the same employees in an effective manner (leader-member exchange), presupposing an effective cooperation between both (handing over information). To see developments over time, these processes were evaluated three times over the span of the project. Top-Sharing and the underlined processes are expected to positively influence the tandem’s performance which has been evaluated twice, at the beginning and the end of the project, to assess its development over time as well. The evaluation of the personality and the basic motives suggests that both executives can be a successful top-sharing tandem. The competency evaluations (supervisor as well as self-assessment) increased over the time span. Although the top sharing tandem worked on equal terms, they implemented rather classical than peer-mentoring due to different career ambitions of the tandem partners. Thus, opportunities were not used completely. Team-member exchange scores proved the good cooperation between the top-sharers. Although the employees did not evaluate the leader-member-exchange between them and the two leaders of the tandem homogeneously, the top-sharing tandem itself did not have the impression that the employees’ task performance depended on whom of the tandem was responsible for the task. Furthermore, top-sharing did not negatively influence the performance of both leaders. During qualitative interviews with the top-sharers and their team, we found that the top-sharers could focus more easily on their tasks. The results suggest positive outcomes of top-sharing (e.g. competency improvement, learning from each other through mentoring). Top-Sharing does not hamper performance. Thus, further research and practical implementations are suggested. As part-time jobs are still more often a female solution to increase their work-life- and work-family-balance, top-sharing may be a suitable solution to increase the woman’s ratio in leadership positions as well as to sustainable increase work-life-balance of executives.

Keywords: mentoring, part-time leadership, top-sharing, work-life-balance

Procedia PDF Downloads 243

Authors: Jubaida Gulshan Ara, Zebun Nasreen Ahmed

Abstract:

Urban flood and drought has been a major problem of Dhaka city, particularly in recent years. Continuous increase of the city built up area, and limiting rainwater infiltration zone, are thought to be the main causes of the problem. Proper rainwater management, even at the individual plot level, might bring significant improvement in this regard. As residential use pattern occupies a significant portion of the city surface, the scope of rainwater harvesting (RWH) in residential buildings can be investigated. This paper reports on a research which explored the scope of rainwater harvesting in residential plots, with multifamily apartment buildings, in Dhaka city. The research investigated the basics of RWH, contextual information, i.e., hydro-geological, meteorological data of Dhaka city and the rules and legislations for residential building construction. The study also explored contemporary rainwater harvesting practices in the local and international contexts. On the basis of theoretical understanding, 21 sample case-studies, in different phases of construction, were selected from seven different categories of plot sizes, in different residential areas of Dhaka city. Primary data from the 21 case-study buildings were collected from a physical survey, from design drawings, accompanied by a questionnaire survey. All necessary secondary data were gathered from published and other relevant sources. Collected primary and secondary data were used to calculate and analyze the RWH needs for each case study, based on the theoretical understanding. The main findings have been compiled and compared, to observe residential development trends with regards to building rainwater harvesting system. The study has found that, in ‘Multifamily Apartment Building’ of Dhaka city, storage, and recharge structure size for rainwater harvesting, increases along with occupants’ number, and with the increasing size of the plot. Hence, demand vs. supply ratio remains almost the same for different sizes of plots, and consequently, the size of the storage structure increases significantly, in large-scale plots. It has been found that rainwater can meet only 12%-30% of the total restricted water demand of these residential buildings of Dhaka city. Therefore, artificial groundwater recharge might be the more suitable option for RWH, than storage. The study came up with this conclusion that, in multifamily residential apartments of Dhaka city, artificial groundwater recharge might be the more suitable option for RWH, than storing the rainwater on site.

Keywords: Dhaka city, rainwater harvesting, residential plots, urban flood

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Authors: Tammy Wee, Detlev Remy, Arif Perdana

Abstract:

In the recent years, data analytics has become the buzzword in the hospitality industry. The hospitality industry is another example of a data-rich industry that has yet fully benefited from the insights of data analytics. Effective use of data analytics can change how hotels operate, market and position themselves competitively in the hospitality industry. However, at the moment, the data obtained by individual hotels remain under-utilized. This research is a preliminary research on data analytics in the hospitality industry, using an in-depth face-to-face interview on one hotel as a start to a multi-level research. The main case study of this research, hotel A, is a chain brand of international hotel that has been systematically gathering and collecting data on its own customer for the past five years. The data collection points begin from the moment a guest book a room until the guest leave the hotel premises, which includes room reservation, spa booking, and catering. Although hotel A has been gathering data intelligence on its customer for some time, they have yet utilized the data to its fullest potential, and they are aware of their limitation as well as the potential of data analytics. Currently, the utilization of data analytics in hotel A is limited in the area of customer service improvement, namely to enhance the personalization of service for each individual customer. Hotel A is able to utilize the data to improve and enhance their service which in turn, encourage repeated customers. According to hotel A, 50% of their guests returned to their hotel, and 70% extended nights because of the personalized service. Apart from using the data analytics for enhancing customer service, hotel A also uses the data in marketing. Hotel A uses the data analytics to predict or forecast the change in consumer behavior and demand, by tracking their guest’s booking preference, payment preference and demand shift between properties. However, hotel A admitted that the data they have been collecting was not fully utilized due to two challenges. The first challenge of using data analytics in hotel A is the data is not clean. At the moment, the data collection of one guest profile is meaningful only for one department in the hotel but meaningless for another department. Cleaning up the data and getting standards correctly for usage by different departments are some of the main concerns of hotel A. The second challenge of using data analytics in hotel A is the non-integral internal system. At the moment, the internal system used by hotel A do not integrate with each other well, limiting the ability to collect data systematically. Hotel A is considering another system to replace the current one for more comprehensive data collection. Hotel proprietors recognized the potential of data analytics as reported in this research, however, the current challenges of implementing a system to collect data come with a cost. This research has identified the current utilization of data analytics and the challenges faced when it comes to implementing data analytics.

Keywords: data analytics, hospitality industry, customer relationship management, hotel marketing

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Authors: Maria Klitgaard Christensen, Carmen Lim, Sukanta Saha, Danielle Cannon, Finley Prentis, Oleguer Plana-Ripoll, Natalie Momen, Kim Moesgaard Iburg, John J. McGrath

Abstract:

Introduction: About a third of the world’s population will develop a mental disorder over their lifetime. Having a mental disorder is a huge burden in health loss and cost for the individual, but also for society because of treatment cost, production loss and caregivers’ cost. The objective of this study is to synthesize the international published literature on the economic burden of mental disorders. Methods: Systematic literature searches were conducted in the databases PubMed, Embase, Web of Science, EconLit, NHS York Database and PsychInfo using key terms for cost and mental disorders. Searches were restricted to 1980 until May 2019. The inclusion criteria were: (1) cost-of-illness studies or cost-analyses, (2) diagnosis of at least one mental disorder, (3) samples based on the general population, and (4) outcome in monetary units. 13,640 publications were screened by their title/abstract and 439 articles were full-text screened by at least two independent reviewers. 112 articles were included from the systematic searches and 31 articles from snowball searching, giving a total of 143 included articles. Results: Information about diagnosis, diagnostic criteria, sample size, age, sex, data sources, study perspective, study period, costing approach, cost categories, discount rate and production loss method and cost unit was extracted. The vast majority of the included studies were from Western countries and only a few from Africa and South America. The disorder group most often investigated was mood disorders, followed by schizophrenia and neurotic disorders. The disorder group least examined was intellectual disabilities, followed by eating disorders. The preliminary results show a substantial variety in the used perspective, methodology, costs components and outcomes in the included studies. An online tool is under development enabling the reader to explore the published information on costs by type of mental disorder, subgroups, country, methodology, and study quality. Discussion: This is the first systematic review synthesizing the economic cost of mental disorders worldwide. The paper will provide an important and comprehensive overview over the economic burden of mental disorders, and the output from this review will inform policymaking.

Keywords: cost-of-illness, health economics, mental disorders, systematic review

Procedia PDF Downloads 107