Search results for: tibetan people
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7130

Search results for: tibetan people

1760 Comparison of Marital Conflict Resolution Procedures and Parenting Styles between Nurses with Fixed and Rotating Shifts in Public Hospitals of Bandar Abbas, Iran

Authors: S. Abdolvahab Samavi, Kobra Hajializadeh, S. Abdolhadi Samavi

Abstract:

Nursing is a critical work that that can effect on the health of the society. A parenting style is a psychological construct demonstrating standard policies that parents use in their child rearing. The quality of parenting is more critical than the quantity spend with the child. Also, marital Conflict resolution is conceptualized as the methods and processes involved in facilitating the peaceful ending of conflict between couples. Both of these variables were affected by job status in nurses. Aim of this study was to compare the Marital Conflict Resolution and Parenting Styles between Nurses with fixed and rotating shifts in public hospitals of Bandar Abbas, Iran. Statistical population includes all married Nurses in hospitals of Bandar Abbas (900 Persons). For sample size estimation, the Morgan table was used, 270 people were selected by random sampling method. Conflict solution styles and Baumrind parenting styles questionnaire were used for collecting data about study variables. For analysis of data, descriptive and inferential statistics were used. Results showed there was significant difference between both groups in conflict solution styles. According to study results, nurses with fixed shifts had an effective conflict solution styles. Also, there was significant difference between both groups in Parenting Styles. According to study results, nurses with fixed shifts had an effective parenting style. Totally, results of this study showed that job status of nurses affected on Marital Conflict Resolution and Parenting Styles of nurses. Managers of health system should be consider these issues about work of nurses and if possible, married nurses employed at fixed day (vs. rotating) shift.

Keywords: marital conflict resolution procedures, parenting styles, nurses with fixed and rotating shifts, public hospitals

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1759 Aberrant Genome‐Wide DNA Methylation Profiles of Peripheral Blood Mononuclear Cells from Patients Hospitalized with COVID-19

Authors: Inam Ridha, Christine L. Kuryla, Madhuranga Thilakasiri Madugoda Ralalage Don, Norman J. Kleiman, Yunro Chung, Jin Park, Vel Murugan, Joshua LaBaer

Abstract:

To date, more than 275 million people worldwide have been diagnosed with COVID-19 and the rapid spread of the omicron variant suggests many millions more will soon become infected. Many infections are asymptomatic, while others result in mild to moderate illness. Unfortunately, some infected individuals exhibit more serious symptoms including respiratory distress, thrombosis, cardiovascular disease, multi-organ failure, cognitive difficulties, and, in roughly 2% of cases, death. Studies indicate other coronaviruses can alter the host cell's epigenetic profile and lead to alterations in the immune response. To better understand the mechanism(s) by which SARS-CoV-2 infection causes serious illness, DNA methylation profiles in peripheral blood mononuclear cells (PBMCs) from 90 hospitalized severely ill COVID-19 patients were compared to profiles from uninfected control subjects. Exploratory epigenome-wide DNA methylation analyses were performed using multiplexed methylated DNA immunoprecipitation (MeDIP) followed by pathway enrichment analysis. The findings demonstrated significant DNA methylation changes in infected individuals as compared to uninfected controls. Pathway analysis indicated that apoptosis, cell cycle control, Toll-like receptors (TLR), cytokine interactions, and T cell differentiation were among the most affected metabolic processes. In addition, changes in specific gene methylation were compared to SARS-CoV-2 induced changes in RNA expression using published RNA-seq data from 3 patients with severe COVID-19. These findings demonstrate significant correlations between differentially methylated and differentially expressed genes in a number of critical pathways.

Keywords: COVID19, epigenetics, DNA mathylation, viral infection

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1758 Local Identities to Global in the Centre of Isan, Thailand: Promoting Local Development and Community Participation

Authors: Thammanoon Raveepong, Craig Wheway

Abstract:

Originating from a multifaceted research project beginning with the opening of the Green Market at Ban Laow sub-district, Kosum Phisai, Mahasarakham with the support of Kosum Phisai Governor. The project involves key stakeholders related to villagers who have become involved with linking local identity to a more global identity to help ameliorate falling agricultural incomes and casualised work. There have been fifteen formal meetings involving local government stakeholders that took place at the local university, local schools, a public meeting at Ban-Don-Toom and Village meeting shelters. These events hosted 176 local stakeholders consisting of the District Governor, 7 Chairpersons/Heads of the District Development Council, a Health Promotion group, District retired government staff, 4 sub-district local government members, the City Development Council, 2 representatives from Mahasarakham Provincial Culture Council, 4 principles of all local schools, 11 village heads, 15 scholars form local and national universities, 132 villagers and 4 staff from public relation units. The goal of the project was to initiate a variety of local projects including promotion of Local healthy food, farm/homestay accommodation, local uniqueness, Travel guides (in book form and guide youths) and the proposed development of community tourism with the aim to utilise local people and activities to tap into the growing alternative tourism market. This paper aims to document the progress thus far, and the challenges presented working with local communities that have lacked expertise in linking to the global economy to derive economic benefits for their communities.

Keywords: Community-based tourism, community participation, local identity, mahasarakham province

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1757 Supportive Group Therapy: Its Effects on Depression, Self-Esteem and Quality of Life Among Institutionalized Elderly

Authors: Hannah Patricia S., Louise Margarrette R., Josking Oliver L., Denisse Katrina C., Justine Kali O.

Abstract:

Aims: In the Philippines, there has been an astronomical increase in the population of elderly sent to nursing home facilities which has been studied to induce despair and loss of self-worth. Nurses in institutionalized facilities generally care for the elderly. Although supportive group therapy has been explored to mend this psychological disparity, nursing research has limited published studies about this in the institutionalized setting. Hence, the study determined the effectiveness of supportive group therapy in depression, self-esteem and quality of life among institutionalized elderly. Methodology: A one-group pre-test-post-test design was conducted among 20-purposively selected institutionalized elderly after the Ethics Research Board approval. All eligible participants underwent the supportive group therapy after being subdivided into session groups. The Geriatric Depression Scale, which has a Cronbach’s alpha coefficient of 0.90; the Rosenberg Self-Esteem, which has a Cronbach’s alpha coefficient = 0.84; and the Older People Quality of Life, which has a Cronbach’s alpha coefficient =0.88, were utilized to measure depression, self-esteem, and quality of life, respectively. Descriptive statistics and Repeated Measures-Multivariate Analysis of Variance (RM-MANOVA) analyzed gathered data. Results: Results showed that the supportive group therapy significantly decreased post-test depression scores (F(1,19)=78.69,p=0.0001,partial η2=0.805), significantly improved post-test self-esteem score (F(1,19)=28.07,p=0.0001,partial η2=0.596), and significantly increased the post-test quality of life (F(1,19)=79.73,p=0.0001,partial η2=0.808) after the intervention has been rendered. Conclusion: Supportive group therapy is effective in alleviating depression and in improving self-esteem and quality of life among institutionalized elderly and can be utilized by nursing homes as an intervention to improve the over-all psychosocial status of elderly patients.

Keywords: supportive group therapy, institutionalized elderly, depression, self-esteem, quality of life

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1756 The Role of Metaphor in Communication

Authors: Fleura Shkëmbi, Valbona Treska

Abstract:

In elementary school, we discover that a metaphor is a decorative linguistic device just for poets. But now that we know, it's also a crucial tactic that individuals employ to understand the universe, from fundamental ideas like time and causation to the most pressing societal challenges today. Metaphor is the use of language to refer to something other than what it was originally intended for or what it "literally" means in order to suggest a similarity or establish a connection between the two. People do not identify metaphors as relevant in their decisions, according to a study on metaphor and its effect on decision-making; instead, they refer to more "substantive" (typically numerical) facts as the basis for their problem-solving decision. Every day, metaphors saturate our lives via language, cognition, and action. They argue that our conceptions shape our views and interactions with others and that concepts define our reality. Metaphor is thus a highly helpful tool for both describing our experiences to others and forming notions for ourselves. In therapeutic contexts, their shared goal appears to be twofold. The cognitivist approach to metaphor regards it as one of the fundamental foundations of human communication. The benefits and disadvantages of utilizing the metaphor differ depending on the target domain that the metaphor portrays. The challenge of creating messages and surroundings that affect customers' notions of abstract ideas in a variety of industries, including health, hospitality, romance, and money, has been studied for decades in marketing and consumer psychology. The aim of this study is to examine, through a systematic literature review, the role of the metaphor in communication and in advertising. This study offers a selected analysis of this literature, concentrating on research on customer attitudes and product appraisal. The analysis of the data identifies potential research questions. With theoretical and applied implications for marketing, design, and persuasion, this study sheds light on how, when, and for whom metaphoric communications are powerful.

Keywords: metaphor, communication, advertising, cognition, action

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1755 Potential Effects of Climate Change on Streamflow, Based on the Occurrence of Severe Floods in Kelantan, East Coasts of Peninsular Malaysia River Basin

Authors: Muhd. Barzani Gasim, Mohd. Ekhwan Toriman, Mohd. Khairul Amri Kamarudin, Azman Azid, Siti Humaira Haron, Muhammad Hafiz Md. Saad

Abstract:

Malaysia is a country in Southeast Asia that constantly exposed to flooding and landslide. The disaster has caused some troubles such loss of property, loss of life and discomfort of people involved. This problem occurs as a result of climate change leading to increased stream flow rate as a result of disruption to regional hydrological cycles. The aim of the study is to determine hydrologic processes in the east coasts of Peninsular Malaysia, especially in Kelantan Basin. Parameterized to account for the spatial and temporal variability of basin characteristics and their responses to climate variability. For hydrological modeling of the basin, the Soil and Water Assessment Tool (SWAT) model such as relief, soil type, and its use, and historical daily time series of climate and river flow rates are studied. The interpretation of Landsat map/land uses will be applied in this study. The combined of SWAT and climate models, the system will be predicted an increase in future scenario climate precipitation, increase in surface runoff, increase in recharge and increase in the total water yield. As a result, this model has successfully developed the basin analysis by demonstrating analyzing hydrographs visually, good estimates of minimum and maximum flows and severe floods observed during calibration and validation periods.

Keywords: east coasts of Peninsular Malaysia, Kelantan river basin, minimum and maximum flows, severe floods, SWAT model

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1754 Study of Mobile Game Addiction Using Electroencephalography Data Analysis

Authors: Arsalan Ansari, Muhammad Dawood Idrees, Maria Hafeez

Abstract:

Use of mobile phones has been increasing considerably over the past decade. Currently, it is one of the main sources of communication and information. Initially, mobile phones were limited to calls and messages, but with the advent of new technology smart phones were being used for many other purposes including video games. Despite of positive outcomes, addiction to video games on mobile phone has become a leading cause of psychological and physiological problems among many people. Several researchers examined the different aspects of behavior addiction with the use of different scales. Objective of this study is to examine any distinction between mobile game addicted and non-addicted players with the use of electroencephalography (EEG), based upon psycho-physiological indicators. The mobile players were asked to play a mobile game and EEG signals were recorded by BIOPAC equipment with AcqKnowledge as data acquisition software. Electrodes were places, following the 10-20 system. EEG was recorded at sampling rate of 200 samples/sec (12,000samples/min). EEG recordings were obtained from the frontal (Fp1, Fp2), parietal (P3, P4), and occipital (O1, O2) lobes of the brain. The frontal lobe is associated with behavioral control, personality, and emotions. The parietal lobe is involved in perception, understanding logic, and arithmetic. The occipital lobe plays a role in visual tasks. For this study, a 60 second time window was chosen for analysis. Preliminary analysis of the signals was carried out with Acqknowledge software of BIOPAC Systems. From the survey based on CGS manual study 2010, it was concluded that five participants out of fifteen were in addictive category. This was used as prior information to group the addicted and non-addicted by physiological analysis. Statistical analysis showed that by applying clustering analysis technique authors were able to categorize the addicted and non-addicted players specifically on theta frequency range of occipital area.

Keywords: mobile game, addiction, psycho-physiology, EEG analysis

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1753 The Effects of Damping Devices on Displacements, Velocities and Accelerations of Structures

Authors: Radhwane Boudjelthia

Abstract:

The most recent earthquakes occurred in the world have killed thousands of people and severe damage. For all the actors involved in the building process, the earthquake is the litmus test for construction. The goal we set ourselves is to contribute to the implementation of a thoughtful approach to the seismic protection of structures. For many engineers, the most conventional approach to protection works (buildings and bridges) the effects of earthquakes is to increase rigidity. This approach is not always effective, especially when there is a context that favors the phenomenon of resonance and amplification of seismic forces. Therefore, the field of earthquake engineering has made significant inroads, among others catalyzed by the development of computational techniques in computer form and the use of powerful test facilities. This has led to the emergence of several innovative technologies, such as the introduction of special devices insulation between infrastructure and superstructure. This approach, commonly known as "seismic isolation," to absorb the significant efforts without the structure is damaged and thus ensuring the protection of lives and property. In addition, the restraints to the construction by the ground shaking are located mainly at the supports. With these moves, the natural period of construction is increasing, and seismic loads are reduced. Thus, there is an attenuation of the seismic movement. Likewise, the insulation of the base mechanism may be used in combination with earthquake dampers in order to control the deformation of the insulation system and the absolute displacement of the superstructure located above the isolation interface. On the other hand, only can use these earthquake dampers to reduce the oscillation amplitudes and thus reduce seismic loads. The use of damping devices represents an effective solution for the rehabilitation of existing structures. Given all these acceleration reducing means considered passive, much research has been conducted for several years to develop an active control system of the response of buildings to earthquakes.

Keywords: earthquake, building, seismic forces, displacement, resonance, response.

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1752 Modeling Socioeconomic and Political Dynamics of Terrorism in Pakistan

Authors: Syed Toqueer, Omer Younus

Abstract:

Terrorism, today, has emerged as a global menace with Pakistan being the most adversely affected state. Therefore, the motive behind this study is to empirically establish the linkage of terrorism with socio-economic (uneven income distribution, poverty and unemployment) and political nexuses so that a policy recommendation can be put forth to better approach this issue in Pakistan. For this purpose, the study employs two competing models, namely, the distributed lag model and OLS, so that findings of the model may be consolidated comprehensively, over the reference period of 1984-2012. The findings of both models are indicative of the fact that uneven income distribution of Pakistan is rather a contributing factor towards terrorism when measured through GDP per capita. This supports the hypothesis that immiserizing modernization theory is applicable for the state of Pakistan where the underprivileged are marginalized. Results also suggest that other socio-economic variables (poverty, unemployment and consumer confidence) can condense the brutality of terrorism once these conditions are catered to and improved. The rational of opportunity cost is at the base of this argument. Poor conditions of employment and poverty reduces the opportunity cost for individuals to be recruited by terrorist organizations as economic returns are considerably low and thus increasing the supply of volunteers and subsequently increasing the intensity of terrorism. The argument of political freedom as a means of lowering terrorism stands true. The more the people are politically repressed the more alternative and illegal means they will find to make their voice heard. Also, the argument that politically transitioning economy faces more terrorism is found applicable for Pakistan. Finally, the study contributes to an ongoing debate on which of the two set of factors are more significant with relation to terrorism by suggesting that socio-economic factors are found to be the primary causes of terrorism for Pakistan.

Keywords: terrorism, socioeconomic conditions, political freedom, distributed lag model, ordinary least square

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1751 Design and Assessment of Traffic Management Strategies for Improved Mobility on Major Arterial Roads in Lahore City

Authors: N. Ali, S. Nakayama, H. Yamaguchi, M. Nadeem

Abstract:

Traffic congestion is a matter of prime concern in developing countries. This can be primarily attributed due to poor design practices and biased allocation of resources based on political will neglecting the technical feasibilities in infrastructure design. During the last decade, Lahore has expanded at an unprecedented rate as compared to surrounding cities due to more funding and resource allocation by the previous governments. As a result of this, people from surrounding cities and areas moved to the Lahore city for better opportunities and quality of life. This migration inflow inherited the city with an increased population yielding the inefficiency of the existing infrastructure to accommodate enhanced traffic demand. This leads to traffic congestion on major arterial roads of the city. In this simulation study, a major arterial road was selected to evaluate the performance of the five intersections by changing the geometry of the intersections or signal control type. Simulations were done in two software; Highway Capacity Software (HCS) and Synchro Studio and Sim Traffic Software. Some of the traffic management strategies that were employed include actuated-signal control, semi-actuated signal control, fixed-time signal control, and roundabout. The most feasible solution for each intersection in the above-mentioned traffic management techniques was selected with the least delay time (seconds) and improved Level of Service (LOS). The results showed that Jinnah Hospital Intersection and Akbar Chowk Intersection improved 92.97% and 92.67% in delay time reduction, respectively. These results can be used by traffic planners and policy makers for decision making for the expansion of these intersections keeping in mind the traffic demand in future years.

Keywords: traffic congestion, traffic simulation, traffic management, congestion problems

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1750 Productivity, Phenolic Composition and Antioxidant Activity of Arrowroot (Maranta arundinacea)

Authors: Maira C. M. Fonseca, Maria Aparecida N. Sediyama, Rosana Goncalves R. das Dores, Sanzio Mollica Vidigal, Alberto C. P. Dias

Abstract:

Among Brazilian plant diversity, many species are used as food and considered minor crops (non-conventional plant foods) (NCPF). Arrowroot (Maranta arundinacea) is a NCPF from which starch is extracted from rhizome do not have gluten. Thus, arrowroot flower starch can be consumed by celiac people. Additional, some medicinal and functional proprieties are assigned to arrowroot leaves which currently are underutilized. In Brazil, it’s cultivated mainly by small scale farmers and there is no specific recommendation for fertilization. This work aimed to determinate the best fertilization for rhizome production and to verify its influence in phenolic composition and antioxidant activity of leaf extracts. Two arrowroot varieties, “Common” and “Seta”, were cultivated in organic system at state of Minas Gerais, Brazil, using cattle manure with three levels of nitrogen (N) (0, 300 and 900 kg N ha-1). The experiment design was in randomized block with four replicates. The highest production of rhizomes in both varieties, “Common” (38198.24 kg ha-1) and “Seta” (43567.71 kg ha-1), were obtained with the use of 300 kg N ha-1. With this fertilization, the total aerial part, petiole and leaf production in the varieties were respectively: “Common” (190.312 kg ha-1; 159.312 kg ha-1; 31.100 kg ha-1) and “Seta” (207.656 kg ha-1; 180.539 kg ha-1; 27.062 kg ha-1). Methanolic leaf extracts were analysed by HPLC-DAD. The major phenolic compounds found were caffeioylquinic acids, p-coumaric derivatives and flavonoids. In general, the production of these compounds significantly decreases with the increase levels of nitrogen (900 kg N ha-1). With 300 kg N ha-1 the phenolic production was similar to control. The antioxidant activity was evaluated using DPPH method and was detected around 60% of radical scavenging when 0.1 mg/mL of plant extracts were used. We concluded that fertilization with 300 kg N ha-1 increased arrowroot rhizome production, maintaining phenolic compounds yield at leaves.

Keywords: antioxidant activity, non-conventional plants, organic fertilization, phenolic compounds

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1749 Effectiveness of Climate Smart Agriculture in Managing Field Stresses in Robusta Coffee

Authors: Andrew Kirabira

Abstract:

This study is an investigation into the effectiveness of climate-smart agriculture (CSA) technologies in improving productivity through managing biotic and abiotic stresses in the coffee agroecological zones of Uganda. The motive is to enhance farmer livelihoods. The study was initiated as a result of the decreasing productivity of the crop in Uganda caused by the increasing prevalence of pests, diseases and abiotic stresses. Despite 9 years of farmers’ application of CSA, productivity has stagnated between 700kg -800kg/ha/yr which is only 26% of the 3-5tn/ha/yr that CSA is capable of delivering if properly applied. This has negatively affected the incomes of the 10.6 million people along the crop value chain which has in essence affected the country’s national income. In 2019/20 FY for example, Uganda suffered a deficit of $40m out of singularly the increasing incidence of one pest; BCTB. The amalgamation of such trends cripples the realization of SDG #1 and #13 which are the eradication of poverty and mitigation of climate change, respectively. In probing CSA’s effectiveness in curbing such a trend, this study is guided by the objectives of; determining the existing farmers’ knowledge and perceptions of CSA amongst the coffee farmers in the diverse coffee agro-ecological zones of Uganda; examining the relationship between the use of CSA and prevalence of selected coffee pests, diseases and abiotic stresses; ascertaining the difference in the market organization and pricing between conventionally and CSA produced coffee; and analyzing the prevailing policy environment concerning the use of CSA in coffee production. The data collection research design is descriptive in nature; collecting data from farmers and agricultural extension workers in the districts of Ntungamo, Iganga and Luweero; each of these districts representing a distinct coffee agroecological zone. Policy custodian officers at district, cooperatives and at the crop’s overseeing national authority were also interviewed.

Keywords: climate change, food security, field stresses, Productivity

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1748 Inter-Communication-Management in Cases with Disabled Children (ICDC)

Authors: Dena A. Hussain

Abstract:

The objective of this project is to design an Information and Communication Technologies (ICT) tool based on a standardized platform to assist the work-integrated learning process of caretakers of disabled children. The tool should assist the intercommunication between caretakers and improve the learning process through knowledge bridging between all involved caretakers. Some children are born with disabilities while others have special needs after an illness or accident. Special needs children often need help in their learning process and require tools and services in a different way. In some cases the child has multiple disabilities that affect several capabilities in different ways. These needs are to be transformed into different learning techniques that the staff or personal (called caretakers in this project) caring for the child needs to learn and adapt. The caretakers involved are also required to learn new learning or training techniques and utilities specialized for the child’s needs. In many cases the number of people caring for the child’s development is rather large; the parents, specialist pedagogues, teachers, therapists, psychologists, personal assistants, etc. Each group of specialists has different objectives and in some cases the merge between theses specifications is very unique. This makes the synchronization between different caretakers difficult, resulting often in low level cooperation. By better intercommunication between professions both the child’s development could be improved but also the caretakers’ methods and knowledge of each other’s work processes and their own profession. This introduces a unique work integrated learning environment for all personnel involve, merging learning and knowledge in the work environment and at the same time assist the children’s development process. Creating an iterative process generates a unique learning experience for all involved. Using a work integrated platform will help encourage and support the process of all the teams involved in the process.We believe that working with children who have special needs is a continues learning/working process that is always integrated to achieve one main goal, which is to make a better future for all children.

Keywords: information and communication technologies (ICT), work integrated learning (WIL), sustainable learning, special needs children

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1747 An Analysis of the Dominance of Migrants in the South African Spaza and Retail market: A Relationship-Based Network Perspective

Authors: Meron Okbandrias

Abstract:

The South African formal economy is rule-based economy, unlike most African and Asian markets. It has a highly developed financial market. In such a market, foreign migrants have dominated the small or spaza shops that service the poor. They are highly competitive and capture significant market share in South Africa. This paper analyses the factors that assisted the foreign migrants in having a competitive age. It does that by interviewing Somali, Bangladesh, and Ethiopian shop owners in Cape Town analysing the data through a narrative analysis. The paper also analyses the 2019 South African consumer report. The three migrant nationalities mentioned above dominate the spaza shop business and have significant distribution networks. The findings of the paper indicate that family, ethnic, and nationality based network, in that order of importance, form bases for a relationship-based business network that has trust as its mainstay. Therefore, this network ensures the pooling of resources and abiding by certain principles outside the South African rule-based system. The research identified practises like bulk buying within a community of traders, sharing information, buying from a within community distribution business, community based transportation system and providing seed capital for people from the community to start a business is all based on that relationship-based system. The consequences of not abiding by the rules of these networks are social and economic exclusion. In addition, these networks have their own commercial and social conflict resolution mechanisms aside from the South African justice system. Network theory and relationship based systems theory form the theoretical foundations of this paper.

Keywords: migrant, spaza shops, relationship-based system, South Africa

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1746 Hybridization of Manually Extracted and Convolutional Features for Classification of Chest X-Ray of COVID-19

Authors: M. Bilal Ishfaq, Adnan N. Qureshi

Abstract:

COVID-19 is the most infectious disease these days, it was first reported in Wuhan, the capital city of Hubei in China then it spread rapidly throughout the whole world. Later on 11 March 2020, the World Health Organisation (WHO) declared it a pandemic. Since COVID-19 is highly contagious, it has affected approximately 219M people worldwide and caused 4.55M deaths. It has brought the importance of accurate diagnosis of respiratory diseases such as pneumonia and COVID-19 to the forefront. In this paper, we propose a hybrid approach for the automated detection of COVID-19 using medical imaging. We have presented the hybridization of manually extracted and convolutional features. Our approach combines Haralick texture features and convolutional features extracted from chest X-rays and CT scans. We also employ a minimum redundancy maximum relevance (MRMR) feature selection algorithm to reduce computational complexity and enhance classification performance. The proposed model is evaluated on four publicly available datasets, including Chest X-ray Pneumonia, COVID-19 Pneumonia, COVID-19 CTMaster, and VinBig data. The results demonstrate high accuracy and effectiveness, with 0.9925 on the Chest X-ray pneumonia dataset, 0.9895 on the COVID-19, Pneumonia and Normal Chest X-ray dataset, 0.9806 on the Covid CTMaster dataset, and 0.9398 on the VinBig dataset. We further evaluate the effectiveness of the proposed model using ROC curves, where the AUC for the best-performing model reaches 0.96. Our proposed model provides a promising tool for the early detection and accurate diagnosis of COVID-19, which can assist healthcare professionals in making informed treatment decisions and improving patient outcomes. The results of the proposed model are quite plausible and the system can be deployed in a clinical or research setting to assist in the diagnosis of COVID-19.

Keywords: COVID-19, feature engineering, artificial neural networks, radiology images

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1745 Exploring the Concerns and Practices Associated with Organ Transplantation in the Context of Muslims in Pakistan from an Anthropological Perspective

Authors: Qurratulain Faheem

Abstract:

The human body often serves as a reference point to analyse the notions of self and society. Situating on Merleau-Ponty and Bourdieu theories of embodiments, this research explores the notions around the human body and its influence on the ethical considerations in regards to organ transplantation among the Muslim communities in Pakistan. The context of Pakistan makes an intriguing case study as cadaveric organ transplantation is not in practise. Whereas living organ transplantation is commonly is practised between family members only. These contradictory practices apparently rests on the ideologies around the human body and religious beliefs as well the personal judgements and authority of healthcare professionals. This research is a year-long ethnographic study carried out as part of doctoral studies. An anthropological approach towards organ transplantation in Pakistan brought forward various socio-cultural notions around the human body and selfhood that serve as a framework around biomedical ethical issues in various societies. Further, it surface the contradictions and issues associated with organ transplantation that makes it a dilemma situated in a nexus of various socio-cultural and political factors rather seeing it as an isolated health concern. This research is a novel study on the subject of organ transplantation in the context of Pakistan but also put forward ethnographic data that could serve as a reference in other religious societies. Further, the ethnographic data bring forward experiences and stories of organ receivers, organ donors, religious leaders, healthcare professionals, and the general public, which aspire to encourage biomedical ethicists and social-scientists to consider ethnography as a research methodology and rely upon people’s lived experiences while establishing policies and practices around biomedical ethical issues.

Keywords: Gender, organ transplantation, muslims, pakistan, organ donation, bioethics, culture and religion, gender

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1744 Speech Anxiety in Higher Education Students-Retention of an Ancestral Trait: A Study into the Students' Perspective of Communication Anxiety with Suggestions on How to Minimise Student Distress

Authors: Paul D. Facey, Claire Morgan

Abstract:

Speech anxiety is thought to be deep-seated within the human evolutionary lineage.As a result, almost all people display high levels of anxiety when asked to communicate in front of an audience.However, proficiency in oral communication is considered as an essential skill for a graduate career and significant emphasis is placed on developing these skills in many degree programs.Because of this, many degree schemes incorporate some form of assessed dialogic presentation. Yet, a student’s anxiety over public speaking, especially if severe, can be so great that at worst it can cause the student to withdraw from their study. This study investigated how students perceive their own levels of anxiety when faced with public speaking using the Personal Report of Public Speaking Anxiety (PRPSA) questionnaire developed by McCroskey. Additionally, students were asked to provide examples of adjustments that could be implemented that they felt would alleviate some/all of their anxiety. The results of the study indicated that the majority of the students experienced a moderate level of anxiety. However, further analysis showed that of those who were in the moderate anxiety’ group, 43% fell into the higher range suggesting that overall more students experience higher levels of anxiety when faced with public speaking than maybe first envisaged. Thus, it is essential that steps are taken to address student anxiety in order that students engage with presentations, are motivated and encouraged and do not avoid such assignments. The feedback from our students indicated a need to implement systematic desensitization programs where students learn to overcome their anxiety through a series of sessions that gradually increase their anxiety levels. Furthermore, these sessions should be run in parallel with skills sessions in order for students to be better prepared and allow self-reflection and self-analysis.This study highlights the paucity of these sessions on many degree schemes and suggests that they should form an integral part of a students’ early academic learning.

Keywords: student anxiety, communication anxiety, public speaking, higher education, desensitisation

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1743 Exploring Individual Decision Making Processes and the Role of Information Structure in Promoting Uptake of Energy Efficient Technologies

Authors: Rebecca J. Hafner, Daniel Read, David Elmes

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The current research applies decision making theory in order to address the problem of increasing uptake of energy-efficient technologies in the market place, where uptake is currently slower than one might predict following rational choice models. Specifically, in two studies we apply the alignable/non-alignable features effect and explore the impact of varying information structure on the consumers’ preference for standard versus energy efficient technologies. As researchers in the Interdisciplinary centre for Storage, Transformation and Upgrading of Thermal Energy (i-STUTE) are currently developing energy efficient heating systems for homes and businesses, we focus on the context of home heating choice, and compare preference for a standard condensing boiler versus an energy efficient heat pump, according to experimental manipulations in the structure of prior information. In Study 1, we find that people prefer stronger alignable features when options are similar; an effect which is mediated by an increased tendency to infer missing information is the same. Yet, in contrast to previous research, we find no effects of alignability on option preference when options differ. The advanced methodological approach used here, which is the first study of its kind to randomly allocate features as either alignable or non-alignable, highlights potential design effects in previous work. Study 2 is designed to explore the interaction between alignability and construal level as an explanation for the shift in attentional focus when options differ. Theoretical and applied implications for promoting energy efficient technologies are discussed.

Keywords: energy-efficient technologies, decision-making, alignability effects, construal level theory, CO2 reduction

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1742 Social Networks in a Communication Strategy of a Large Company

Authors: Kherbache Mehdi

Abstract:

Within the framework of the validation of the Master in business administration marketing and sales in INSIM institute international in management Blida, we get the opportunity to do a professional internship in Sonelgaz Enterprise and a thesis. The thesis deals with the integration of social networking in the communication strategy of a company. The problematic is: How communicate with social network can be a solution for companies? The challenges stressed by this thesis were to suggest limits and recommendations to Sonelgaz Enterprise concerning social networks. The whole social networks represent more than a billion people as a potential target for the companies. Thanks to research and a qualitative approach, we have identified tree valid hypothesis. The first hypothesis allows confirming that using social networks cannot be ignored by any company in its communication strategy. However, the second hypothesis demonstrates that it’s necessary to prepare a strategy that integrates social networks in the communication plan of the company. The risk of this strategy is very limited because failure on social networks is not a restraint for the enterprise, social networking is not expensive and, a bad image which could result from it is not as important in the long-term. Furthermore, the return on investment is difficult to evaluate. Finally, the last hypothesis shows that firms establish a new relation between consumers and brands thanks to the proximity allowed by social networks. After the validation of the hypothesis, we suggested some recommendations to Sonelgaz Enterprise regarding the communication through social networks. Firstly, the company must use the interactivity of social network in order to have fruitful exchanges with the community. We also recommended having a strategy to treat negative comments. The company must also suggest delivering resources to the community thanks to a community manager, in order to have a good relation with the community. Furthermore, we advised using social networks to do business intelligence. Sonelgaz Enterprise can have some creative and interactive contents with some amazing applications on Facebook for example. Finally, we recommended to the company to be not intrusive with “fans” or “followers” and to be open to all the platforms: Twitter, Facebook, Linked-In for example.

Keywords: social network, buzz, communication, consumer, return on investment, internet users, web 2.0, Facebook, Twitter, interaction

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1741 The Basics of Cognitive Behavioral Family Therapy and the Treatment of Various Physical and Mental Diseases

Authors: Mahta Mohamadkashi

Abstract:

The family is the most important source of security and health for the people of the society, and at the same time, it is the main field of creating all kinds of social and psychological problems. On the one hand, a family is a natural group with many goals and roles that are important and necessary for all family members. On the other hand, the family is a strong and organized group that recruits the therapist because of the goals that are concealed in its policy and procedures. The relationship between the environment and the family background with mental illnesses has been the focus of various researchers for a long time, and the research and experiments that have been conducted to show that the functioning of the family is related to the mental health of the members of the family. Currently, several theoretical perspectives with different approaches seek to explain and resolve psychological problems and family conflicts that can be mentioned. This research aims to investigate "cognitive-behavioral family therapy" by using the "family therapy" research method which is included the descriptive-analytical method and the method of collecting library information, with special reliance on Persian and Latin books and articles. for considering one of the important approaches of family therapy that we are going which have been known as data and its conditions that also includes requirements and limitations. For this purpose, in the beginning, brief background and introduction about family and family therapy are going to describe, and then the basics of cognitive-behavioral family therapy and the implementation process and various techniques of this approach can go through a big discussion. After that, we will apply this approach in the treatment of various physical and mental diseases in the form of related research, and we will examine the ups and downs of the implementation procedures, limitations, and future directions in this field. In general, This study emphasizes the role of the family system in the occurrence of psychological diseases and disorders and also validates the role of the family system in the treatment of those diseases and disorders. Also, cognitive-behavioral family therapy has been approved as an effective treatment approach for a variety of mental disorders.

Keywords: cognitive-behavioral, family, family therapy, cognitive-behavioral family therapy

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1740 Disentangling an Ethnographic Study of the Imagined Inca: How the Yale-Peruvian Expedition of 1911 Created an Inca Heritage

Authors: Charlotte Williams

Abstract:

Yale University Professor Hiram Bingham’s discovery of Machu Picchu in 1911 spurred an international interest in the Inca Empire, and with it, a dispute with the Peruvian government over who had rightful jurisdiction and curatorship over Inca history. By 2011, the Peruvian government initiated a legal battle for the return of artifacts that Bingham had removed from Machu Picchu, successfully returning them not to the site of Machu Picchu, but to Cusco, employing the rationale that the ancient Inca capital housed descendants of the Inca empire. This conflation of the past and present can be traced to a largely unanalyzed study that accompanied Bingham’s expedition: an ethnographic analysis of Inca descendants, which at the time portrayed indigenous Peruvian Andean peoples as remnants of a lost civilization, using Cusco as an assumed repository for people with 'Inca' characteristics. This study draws from the original Yale Peruvian Expedition archives, the Cusco Library archives, and in-depth interviews with curators of the Inca Museum and Machu Picchu Museum to analyze both the political conflict that emerged as a reaction to the ethnographic study, and how the study articulated with an inflating tourism market attempting to define what it meant to be Inca to an international public. The construction of the modern Inca as both directors of tourism management and purveyors of their archaeological material culture points to a unique case in which modern Peruvian citizens could claim heritage to an Inca past despite a lack of recognition as a legally defined group. The result has far-reaching implications, since Bingham’s artifacts returned not necessarily to a traditional nation-state, but to an imagined one, broadening the conditions under which informal repatriations can occur.

Keywords: archaeology of memory, imagined communities, Incanismo, repatriation

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1739 Socio-Economic and Environmental Impact of Urban Sprawl: A Case Study Adigrat City, Tigray, Ethiopia

Authors: Fikre Belay Tekulu

Abstract:

This thesis presents the socio-economic and environmental impacts of urban sprawl in the case of Adigrat city, Tigray Region, Ethiopia. The main objective of this research is to assess major causes, trends and socio-economic and environmental impacts of the urban sprawl of Adigrat city. The study employed both quantitative and qualitative methods as questionnaires, interviews and observation used for data collection. Simple random sampling has been used to select the participants. The land use and land cover change for agricultural land and forest and grassland resource analysis is done with the aid of GIS. Urban sprawl is mainly caused by the rapid population growth, increase in the living and property cost in the core of the city, land demand and land speculation and the growth of transport and an increase in income of people and demand of more living space. The study indicates 15726.24 hectares (515.49 per cent) of new land added to the city jurisdiction from its adjacent Gantafeshum Wereda between 1986 and 2018. The population of Adigrat city increased by 9.045 per cent per year, while the city expanded 16.01 per cent per annum and the LCR was 0.0233 hectares per person between 1986 and 2018.Built-up area increased by 35.27 per cent per annum, while agricultural land, forests and grassland cover decreased by 1.68 per cent and 1.26 per cent per annum respectively in the last thirty three years. This rapid growth of urban sprawl brought social-economic and environmental change in the city that has been observed by the city residents. Therefore, the city administration should need strong, integrated, effective and efficient work, with its neighbor rural area and also done timely preparation, implementation, supervision, and evaluation of the structural plan of the city to bring out sustainable development of the city.

Keywords: cause, , trends, urban sprawl, land use land cover, GIS

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1738 Outbreak of Cholera, Jalgaon District, Maharastra, 2013

Authors: Yogita Tulsian, A. Yadav

Abstract:

Background: India reports 3,600 cholera cases annually. In August 2013, a cholera outbreak was reported in Jalgaon district, Maharashtra state. We sought to describe the epidemiological characteristics,identify risk factors, and recommend control measures. Methods: We collected existing stool and water testing laboratory results, and conducted a1: 1 matched case-control study. A cholera case was defined as a resident of Vishnapur or Malapur villagewith onset of acute watery diarrhea on/ after 1-July-2013. Controls were matched by age, gender and village and had not experienced any diarrhea for 3 months. We collected socio-demographic characteristics, clinical presentation, and food/travel/water exposure history and conducted conditional logistic regression. Results: Of 50 people who met the cholera case definition, 40 (80%) were from Vishnapur village and 30 (60%) were female. The median age was 8.5 years (range; 0.3-75). Twenty (45%) cases were hospitalized, twelve (60%) with severe dehydration. Three of five stool samples revealed Vibrio cholerae 01 El Tor, Ogawa and samples from 7 of 14 Vishnapur water sources contained fecal coliforms. Cases from Vishnapur were significantly more likely to drink from identified contaminated water sources (matched odds ratio (MOR) 3.5; 95% confidence interval (CI): 1-13), or from a river/canal (MOR=18.4;95%CI: 2-504). Cases from Malapur were more likely to drink from a river/canal (MOR=6.2; 95%CI: 0.6-196). Cases from both villages were significantly more likely to visit the forest (MOR 6.3; 95%CI: 2-30) or another village (MOR 3.5; 95%CI; 0.9-17). Conclusions: This outbreak was caused by Vibrio cholerae, likely through contamination of water in Vishnapur village and/or through drinking river/canal water. We recommended safe drinking water for forest visitors and all residents of these villages and use of regular water testing.

Keywords: cholera, case control study, contaminated water, river

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1737 Literature as a Strategic Tool to Conscientise Africans: An Attempt by Postcolonial Writers and Critics to Reverse the Socio-Economics Imbalances of Colonialism

Authors: Lutendo Nendauni

Abstract:

Colonialism breaks things, colonisers exploded native cultural solidarity, producing the spiritual confusion, psychic wounding, and economic exploitation of a new and dominated ‘other’. Colonialism as the cultural and economic exploitation began when the West defended in their seizure of foreign territories for the exploitation of its natural resources; this resulted in brutal socio-economic imbalances. The Western profited at the detriment of the weak Africa. However, colonialism has since passed, but the effects are still evident culturally, socially, and economically. This paper explored how postcolonial writers and critics attempt to reverse the socio-economic imbalances resulting from the fragmentation of colonialism, with a focus on the play 'I will Marry When I Want' by Ngugi wa Thiong’o and Ngugi wa Mirii, as a primary text. Using qualitative discourse-textual analysis as the research methodology, the researcher purposively extracts discourse segments from the text for analysis and interpretation. The findings reveal that Postcolonial critics and writers attempt to reverse the socio-economic effects of colonialism through various counter discourses; their literature is concerned with the destruction of colonised identity, the search for this identity, and its assertion. It is manifest in the text that writers offer corrective views about Africans; they stress that they write their literary texts to conscientise their fellow Africans. Postcolonial writers and critics argue that language is a carrier of culture and that the only way to break free from colonial influence is by not adopting a foreign language. They further through their poems, novels, plays, and music strategically shine the spotlight on the previously nameless and destitute people so that they can develop the human spirit’s desire to overcome defeat, socio-political deprivation, and isolation.

Keywords: colonialism, postcoloniality, critics, socio-economic imbalances

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1736 Effect of Zidovudine on Hematological and Virologic Parameters among Female Sex Workers Receiving Antiretroviral Therapy (ART) in North-Western Nigeria

Authors: N. M. Sani, E. D. Jatau, O. S. Olonitola, M. Y. Gwarzo, P. Moodley, N. S. Mujahid

Abstract:

Haemoglobin (HB) indicates anaemia level and by extension may reflect the nutritional level and perhaps the immunity of an individual. Some antiretroviral drugs like zidovudine are known to cause anaemia in People living with HIV/AIDS (PLWHA). A cross-sectional study using demographic data and blood specimen from 218 female commercial sex workers attending antiretroviral therapy (ART) clinics was conducted between December 2009 and July 2011 to assess the effect of zidovudine on haematologic and RNA viral load of female sex workers receiving antiretroviral treatment in north-western Nigeria. Anaemia is a common and serious complication of both HIV infection and its treatment. In the setting of HIV infection, anaemia has been associated with decreased quality of life, functional status, and survival. Antiretroviral therapy, particularly the highly active antiretroviral therapy (HAART), has been associated with a decrease in the incidence and severity of anaemia in HIV-infected patients who have received a HAART regimen for at least 1 year. In this study, result has shown that out of 218 patients, 26 with haemoglobin count between 5.1–10 g/dl were observed to have the highest viral load count of 300,000–350,000 copies/ml. It was also observed that most patients (190) with HB of 10.1–15.0 g/dl had viral load count of 200,000–250,000 copies/ml. An inverse relationship therefore exists, i.e. the lower the haemoglobin level, the higher the viral load count, even though the test statistics did not show any significance between the two (P=0.206). This shows that multivariate logistic regression analysis demonstrated that anaemia was associated with a CD4+ cell count below 50/µL in female sex workers with a viral load above 100,000 copies/mL who use zidovudine. Severe anaemia was less prevalent in this study population than in historical comparators; however, mild to moderate anaemia rates remain high. The study, therefore, recommends that hematological and virologic parameters be monitored closely in patients receiving first line ART regimen.

Keywords: anaemia, female sex worker, haemoglobin, Zidovudine

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1735 Dynamics of Soil Fertility Management in India: An Empirical Analysis

Authors: B. Suresh Reddy

Abstract:

The over dependence on chemical fertilizers for nutrient management in crop production for the last few decades has led to several problems affecting soil health, environment and farmers themselves. Based on the field work done in 2012-13 with 1080 farmers of different size-classes in semi-arid regions of Uttar Pradesh, Jharkhand and Madhya Pradesh states of India, this paper reveals that the farmers in semi-arid regions of India are actively managing soil fertility and other soil properties through a wide range of practices that are based on local resources and knowledge. It also highlights the socio-economic web woven around these soil fertility management practices. This study highlights the contribution of organic matter by traditional soil fertility management practices in maintaining the soil health. Livestock has profound influence on the soil fertility enhancement through supply of organic manure. Empirical data of this study has clearly revealed how farmers’ soil fertility management options are being undermined by government policies that give more priority to chemical fertiliser-based strategies. Based on the findings it is argued that there should be a 'level playing field' for both organic and inorganic soil fertility management methods by promoting and supporting farmers in using organic methods. There is a need to provide credit to farmers for adopting his choice of soil fertility management methods which suits his socio-economic conditions and that best suits the long term productivity of soils. The study suggests that the government policies related to soil fertility management must be enabling, creating the conditions for development based more on locally available resources and local skills and knowledge. This will not only keep Indian soils in healthy condition but also support the livelihoods of millions of people, especially the small and marginal farmers.

Keywords: livestock, organic matter, small farmers, soil fertility

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1734 The Impact of Selected Personality Skills on Intercultural Interaction and Communication of Students of Social Pedagogy in the Czech Republic

Authors: Irena Balaban Cakirpaloglu, Karla Hrbackova

Abstract:

This paper focuses on the issue of intercultural competencies of university students who are preparing to work in assisting professions. In recent years, the Czech Republic has become a major destination for many people from different cultural environments, and there is a growing need for workers in assisting professions to be able to respond flexibly and adequately to the changing living conditions of multicultural coexistence. The main objective of this study is to analyse the preparedness of students in assisting professions in relation to intercultural competencies. Intercultural competences include several essential skills for working successfully with diversity. Taking into account the main objective of this research, a pilot study was conducted among students of Social Pedagogy at the Faculty of Humanities at Tomas Bata University in Zlin in the academic year 2017/2018. The research sample consisted of 116 students. To obtain the data, we used the Cross-Cultural Adaptability Inventory (CCAI) by Kelley and Meyers. The inventory maps strengths and weaknesses in 4 skill areas: Emotional Resilience, Flexibility/Openness, Perceptual Acuity and Personal Autonomy. This inventory also examines individual ability to succeed in intercultural interaction and communication. The results obtained from the survey were statistically processed and analysed using the relevant statistical methods. The results of the survey point to the fact that students of social pedagogy achieve average to below average results in individual skill areas. At the same time, significant differences have been detected among the students with work experience in multicultural environment and those with no experience.

Keywords: cross–cultural adaptability inventory, diversity, intercultural competences, students of social pedagogy

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1733 The Potential of Kepulauan Seribu as Marine-Based Eco-Geotourism Site: The Study of Carbonate Platform as Geotourism Object in Kepulauan Seribu, Jakarta

Authors: Barry Majeed, Eka Febriana, Seto Julianto

Abstract:

Kepulauan Seribu National Parks is a marine preservation region in Indonesia. It is located in 5°23' - 5°40' LS, 106°25' - 106°37' BT North of Jakarta City. Covered with area 107,489 ha, Kepulauan Seribu has a lot of tourism spots such as cluster islands, fringing reef and many more. Kepulauan Seribu is also nominated as Strategic Tourism Region In Indonesia (KSPN). So, these islands have a lot of potential sides more than preservation function as a national park, hence the development of sustainable geotourism. The aim of this study is for enhancing the development of eco-geotourism in Kepulauan Seribu. This study concern for three main aspect of eco-geotourism such as tourism, form and process. Study for the tourism aspect includes attractions, accommodations, tours, activities, interpretation, and planning & management in Kepulauan Seribu. Study for the form aspect focused on the carbonate platform situated between two islands. Primarily in carbonate reef such as head coral, branchy coral, platy coral that created the carbonate sequence in Kepulauan Seribu. Study for the process aspect primarily discussed the process of forming of carbonate from carbonate factory later becomes Kepulauan Seribu. Study for the regional geology of Kepulauan Seribu has been conducted and suggested that Kepulauan Seribu lithologies are mainly quarternary limestone. In this study, primary data was taken from an observation of quarternary carbonate platform between two islands from Hati Island, Macan Island, Bulat Island, Ubi Island and Kelapa Island. From this observation, the best routes for tourist have been made from Island to Island. Qualitative methods such as depth interview to the local people in purposive sampling also have been made. Finally, this study also giving education about geological site – carbonate sequence - in Kepulauan Seribu for the local wisdom so that this study can support the development of sustainable eco-geotourism in Kepulauan Seribu.

Keywords: carbonate factory, carbonate platform, geotourism, Kepulauan Seribu

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1732 Assessing the Accessibility to Primary Percutaneous Coronary Intervention

Authors: Tzu-Jung Tseng, Pei-Hsuen Han, Tsung-Hsueh Lu

Abstract:

Background: Ensuring patients with ST-elevation myocardial infarction (STEMI) access to hospitals that could perform percutaneous coronary intervention (PCI) in time is an important concern of healthcare managers. One commonly used the method to assess the coverage of population access to PCI hospital is the use GIS-estimated linear distance (crow's fly distance) between the district centroid and the nearest PCI hospital. If the distance is within a given distance (such as 20 km), the entire population of that district is considered to have appropriate access to PCI. The premise of using district centroid to estimate the coverage of population resident in that district is that the people live in the district are evenly distributed. In reality, the population density is not evenly distributed within the administrative district, especially in rural districts. Fortunately, the Taiwan government released basic statistical area (on average 450 population within the area) recently, which provide us an opportunity to estimate the coverage of population access to PCI services more accurate. Objectives: We aimed in this study to compare the population covered by a give PCI hospital according to traditional administrative district versus basic statistical area. We further examined if the differences between two geographic units used would be larger in a rural area than in urban area. Method: We selected two hospitals in Tainan City for this analysis. Hospital A is in urban area, hospital B is in rural area. The population in each traditional administrative district and basic statistical area are obtained from Taiwan National Geographic Information System, Ministry of Internal Affairs. Results: Estimated population live within 20 km of hospital A and B was 1,515,846 and 323,472 according to traditional administrative district and was 1,506,325 and 428,556 according to basic statistical area. Conclusion: In urban area, the estimated access population to PCI services was similar between two geographic units. However, in rural areas, the access population would be overestimated.

Keywords: accessibility, basic statistical area, modifiable areal unit problem (MAUP), percutaneous coronary intervention (PCI)

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1731 Health and the Politics of Trust: Multi-Drug-Resistant Tuberculosis in Kathmandu

Authors: Mattia Testuzza

Abstract:

Public health is a social endeavour, which involves many different actors: from extremely stratified, structured health systems to unofficial networks of people and knowledge. Health and diseases are an intertwined individual and social experiences. Both patients and health workers navigate this public space through relations of trust. Trust in healthcare goes from the personal trust between a patient and her/his doctor to the trust of both the patient and the health worker in the medical knowledge and the healthcare system. Trust it is not a given, but it is continuously negotiated, given and gained. The key to understand these essential relations of trust in health is to recognise them as a social practice, which therefore implies agency and power. In these terms, health is constantly public and made public, as trust emerges as a meaningfully political phenomenon. Trust as a power relation can be observed at play in the implementation of public health policies such as the WHO’s Directly-Observed Theraphy Short-course (DOTS), and with the increasing concern for drug-resistance that tuberculosis pose, looking at the role of trust in the healthcare delivery system and implementation of public health policies becomes significantly relevant. The ethnographic fieldwork was carried out in four months through observation of the daily practices at the National Tuberculosis Center of Nepal, and semi-structured interviews with MultiDrug-Resistant Tuberculosis (MDR-TB) patients at different stages of the treatment, their relatives, MDR-TB specialised nurses, and doctors. Throughout the research, the role which trust plays in tuberculosis treatment emerged as one fundamental ax that cuts through all the different factors intertwined with drug-resistance development, unfolding a tension between the DOTS policy, which undermines trust, and the day-to-day healthcare relations and practices which cannot function without trust. Trust also stands out as a key component of the solutions to unforeseen issues which develop from the overall uncertainty of the context - for example, political instability and extreme poverty - in which tuberculosis treatment is carried out in Nepal.

Keywords: trust, tuberculosis, drug-resistance, politics of health

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