Search results for: family physician program
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6733

Search results for: family physician program

883 An Investigative Study on the Use of Online Marketing Methods in Hungary

Authors: E. Happ, Zs. Ivancsone Horvath

Abstract:

With the development of the information technology, IT, sector, all industry of the world has a new path, dealing with digitalisation. Tourism is the most rapidly increasing industry in the world. Without digitalisation, tourism operators would not be competitive enough with foreign destinations or other experience-based service providers. Digitalisation is also necessary to enable organizations, which are interested in tourism to meet the growing expectations of consumers. With the help of digitalisation, tourism providers can also obtain information about tourists, changes in consumer behaviour, and the use of online services. The degree of digitalisation in tourism is different for different services. The research is based on a questionnaire survey conducted in 2018 in Hungary. The sample with more than 500 respondents was processed by the SPSS program, using a variety of analysis methods. The following two variables were observed from more aspects: frequency of travel and the importance of services related to online travel. With the help of these variables, a cluster analysis was performed among the participants. The sample can be divided into two groups using K-mean cluster analysis. Cluster ‘1’ is a positive group; they can be called the “most digital tourists.” They agree in most things, with low standard deviation, and for them, digitalisation is a starting point. To the members of Cluster ‘2’, digitalisation is important, too. The results show what is important (accommodation, information gathering) to them, but also what they are not interested in at all within the digital world (e.g., car rental or online sharing). Interestingly, there is no third negative cluster. This result (that there is no result) proves that tourism uses digitalisation, and the question is only the extent of the use of online tools and methods. With the help of the designed consumer groups, the characteristics of digital tourism segments can be identified. The help of different variables characterised these groups. One of them is the frequency of travel, where there is a significant correlation between travel frequency and cluster membership. The shift is clear towards Cluster ‘1’, which means, those who find services related to online travel more important, are more likely to travel as well. By learning more about digital tourists’ consumer behaviour, the results of this research can help the providers in what kind of marketing tools could be used to influence the consumer choices of the different consumer groups created using digital devices, furthermore how to conduct more detailed and effective marketing activities. The main finding of the research was that most of the people have digital tools which are important to be able to participate in e-tourism. Of these, mobile devices are increasingly preferred. That means the challenge for service providers is no longer the digital presence but having optimised application for different devices.

Keywords: cluster analysis, digital tourism, marketing tool, tourist behaviour

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882 Heuristic Approaches for Injury Reductions by Reduced Car Use in Urban Areas

Authors: Stig H. Jørgensen, Trond Nordfjærn, Øyvind Teige Hedenstrøm, Torbjørn Rundmo

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The aim of the paper is to estimate and forecast road traffic injuries in the coming 10-15 years given new targets in urban transport policy and shifts of mode of transport, including injury cross-effects of mode changes. The paper discusses possibilities and limitations in measuring and quantifying possible injury reductions. Injury data (killed and seriously injured road users) from six urban areas in Norway from 1998-2012 (N= 4709 casualties) form the basis for estimates of changing injury patterns. For the coming period calculation of number of injuries and injury rates by type of road user (categories of motorized versus non-motorized) by sex, age and type of road are made. A prognosticated population increase (25 %) in total population within 2025 in the six urban areas will curb the proceeded fall in injury figures. However, policy strategies and measures geared towards a stronger modal shift from use of private vehicles to safer public transport (bus, train) will modify this effect. On the other side will door to door transport (pedestrians on their way to/from public transport nodes) imply a higher exposure for pedestrians (bikers) converting from private vehicle use (including fall accidents not registered as traffic accidents). The overall effect is the sum of these modal shifts in the increasing urban population and in addition diminishing return to the majority of road safety countermeasures has also to be taken into account. The paper demonstrates how uncertainties in the various estimates (prediction factors) on increasing injuries as well as decreasing injury figures may partly offset each other. The paper discusses road safety policy and welfare consequences of transport mode shift, including reduced use of private vehicles, and further environmental impacts. In this regard, safety and environmental issues will as a rule concur. However pursuing environmental goals (e.g. improved air quality, reduced co2 emissions) encouraging more biking may generate more biking injuries. The study was given financial grants from the Norwegian Research Council’s Transport Safety Program.

Keywords: road injuries, forecasting, reduced private care use, urban, Norway

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881 A Study of School Meals: How Cafeteria Culture Shapes the Eating Habits of Students

Authors: Jillian Correia, Ali Sakkal

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Lunchtime can play a pivotal role in shaping student eating habits. Studies have previously indicated that eating a healthy meal during the school day can improve students’ well-being and academic performance, and potentially prevent childhood obesity. This study investigated the school lunch program in the United Kingdom in order to gain an understanding of the attitudes and beliefs surrounding school meals and the realities of student food patterns. Using a qualitative research methodology, this study was conducted in three primary and secondary school systems in London, United Kingdom. In depth interviews consisting of 14 headteachers, teachers, staff, and chefs and fieldwork observations of approximately 830 primary and secondary school students in the three schools’ cafeterias provided the data. The results of interview responses and fieldwork observation yielded the following set of themes: (a) school meals are publicly portrayed as healthful and nutritious, yet students’ eating habits do not align with this advertising, (b) the level of importance placed on school lunch varies widely among participants and generates inconsistent views concerning who is responsible (government, families, caterers, or schools) for students’ eating habits, (c) role models (i.e. teachers and chefs) present varying levels of interaction with students and conflicting approaches when monitoring students’ eating habits. The latter finding expanded upon Osowski, Göranzon, and Fjellström’s (2013) concept of teacher roles to formulate three education philosophies – the Removed Authority Role Model, the Accommodating Role Model, and the Social Educational Role Model – concluding that the Social Educational Role Model was the most effective at fostering an environment that encouraged healthy eating habits and positive behavior. For schools looking to cultivate strong relationships between students and teachers and facilitate healthier eating habits, these findings were used to construct three key recommendations: (1) elevate the lunch environment by encouraging proper dining etiquette, (2) get teachers eating at the table with students, and (3) shift the focus from monitoring behavior to a teacher-student dialogue centered on food awareness.

Keywords: food culture, eating habits, school meals, student behavior, education, food patterns, lunchtime

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880 L2 Exposure Environment, Teaching Skills, and Beliefs about Learners’ Out-of-Class Learning: A Survey on Teachers of English as a Foreign Language

Authors: Susilo Susilo

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In the process of foreign language acquisition, L2 exposure has been evidently assumed efficient for learners to help increase their proficiency. However, to get enough L2 exposure in the context of learning English as a foreign language is not as easy as that of the first language learning context. Therefore, beyond the classroom L2 exposure is helpful for EFL learners to achieve the language tasks. Alongside the rapid development of technology and media, English as a foreign language is virtually used in the social media of almost all regions, affecting the faces of Teaching English as a Foreign Language (TEFL). This different face of TEFL unavoidably intrigues teachers to treat their students differently in the classroom in order that they can put more effort in maximizing beyond-the-class learning to help improve their in-class achievements. The study aims to investigate: 1) EFL teachers’ teaching skills and beliefs about students’ out-of-class activities in different L2 exposure environments, and 2) the effect on EFL teachers’ teaching skills and beliefs about students’ out-of-class activities of different L2 exposure environments. This is a survey for 80 EFL teachers from Senior High Schools in three regions of two provinces in Indonesia. A questionnaire using a four-point Likert scale was distributed to the respondents to elicit data. The questionnaires were developed by reffering to the constructs of teaching skills (i.e. teaching preparation, teaching action, and teaching evaluation) and beliefs about out-of-class learning (i.e. setting, process and atmosphere), which have been taken from some expert definitions. The internal consistencies for those constructs were examined by using Cronbach Alpha. The data of the study were analyzed by using SPSS program, i.e. descriptive statistics and independent sample t-test. The standard for determining the significance was p < .05. The results revealed that: 1) teaching skills performed by the teachers of English as a foreign language in different exposure environments showed various focus of teaching skills, 2) the teachers showed various ways of beliefs about students’ out-of-class activities in different exposure environments, 3) there was a significant difference in the scores for NNESTs’ teaching skills in urban regions (M=34.5500, SD=4.24838) and those in rural schools (M=24.9500, SD=2.42794) conditions; t (78)=12.408, p = 0.000; and 4) there was a significant difference in the scores for NNESTs’ beliefs about students’ out-of-class activities in urban schools (M=36.9250, SD=6.17434) and those in rural regions (M=29.4250, SD=4.56793) conditions; t (78)=6.176, p = 0.000. These results suggest that different L2 exposure environments really do have effects on teachers’ teaching skills and beliefs about their students’ out-of-class learning.

Keywords: belief about EFL out-of-class learning, L2 exposure environment, teachers of English as a foreign language, teaching skills

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879 Overcoming Mistrusted Masculinity: Analyzing Muslim Men and Their Aspirations for Fatherhood in Denmark

Authors: Anne Hovgaard Jorgensen

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This study investigates how Muslim fathers in Denmark are struggling to overcome notions of mistrust from teachers and educators. Starting from school-home-cooperation (parent conferences, school-home communication, etc.), the study finds that many Muslim fathers do not feel acknowledged as a resource in the upbringing of their children. To explain these experiences further, the study suggest the notion of ‘mistrusted masculinity’ to grasp the controlling image these fathers meet in various schools and child-care-institutions in the Danish Welfare state. The paper is based on 9 months of fieldwork in a Danish school, a social housing area and in various ‘father groups’ in Denmark. Additional, 50 interviews were conducted with fathers, children, mothers, schoolteachers, and educators. By using Connell's concepts 'hegemonic' and 'marginalized' masculinity as steppingstones, the paper argues that these concepts might entail a too static and dualistic picture of gender. By applying the concepts of 'emergent masculinity' and 'emergent fatherhood' the paper brings along a long needed discussion of how Muslim men in Denmark are struggling to overcome and change the controlling images of them as patriarchal and/or ignorant fathers regarding the upbringing of their children. As such, the paper shows how Muslim fathers are taking action to change this controlling image, e.g. through various ‘father groups’. The paper is inspired by the phenomenological notions of ‘experience´ and in the light of this notion, the paper tells the fathers’ stories about their upbringing of their children and aspirations for fatherhood. These stories share light on how these fathers take care of their children in everyday life. The study also shows that the controlling image of these fathers have affected how some Muslim fathers are actually being fathers. The study shows that fear of family-interventions from teachers or social workers e.g. have left some Muslim fathers in a limbo, being afraid of scolding their children, and being confused of ‘what good parenting in Denmark is’. This seems to have led to a more lassie fair upbringing than these fathers actually wanted. This study is important since anthropologists generally have underexposed the notion of fatherhood, and how fathers engage in the upbringing of their children. Over more, the vast majority of qualitative studies of fatherhood have been on white middleclass fathers, living in nuclear families. In addition, this study is crucial at this very moment due to the major refugee crisis in Denmark and in the Western world in general. A crisis, which has resulted in a vast number of scare campaigns against Islam from different nationalistic political parties, which enforces the negative controlling image of Muslim fathers.

Keywords: fatherhood, Muslim fathers, mistrust, education

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878 The Clash of the Clans in the British Divorce

Authors: Samuel Gary Beckton

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Ever since the Scottish Independence Referendum in 2014, there has been a threat of a second referendum. However, if there was another referendum and the majority favoured independence, it is highly likely to be by a small majority. In this paper, it will look into the hypothetical situation of what could have happened if Scotland had voted in favour of independence in 2014. If this occurred, there would be many Unionists within Scotland, including devoted supporters of the Better Together campaign. There was a possibility of some Scottish Unionists not willing to accept the result of the Referendum unchallenged and use their right of self-determination through the UN Charter for their region to remain within the United Kingdom. The Shetland and Orkney Islands contemplated of opting out of an independent Scotland in 2013. This caught the attention of some politicians and the media, via confirming the possibility of some form of partition in Scotland and could have gained extra attention if partition quickly became a matter of ‘need’ instead of ‘want’. Whilst some Unionists may have used petitions and formed pressure groups to voice their claims, others may have used more hard-line tactics to achieve their political objectives, including possible protest marches and acts of civil unrest. This could have possibly spread sectarian violence between Scottish Unionists and Nationalists. Glasgow has a serious issue of this kind of sectarianism, which has escalated in recent years. This is due to the number communities that have been established from Irish Immigrants, which maintain links with Northern Irish loyalists and republicans. Some Scottish Unionists not only have sympathy towards Northern Irish loyalists but actively participate with the paramilitary groups and gave support. Scottish loyalists could use these contacts to create their own paramilitary group(s), with aid from remaining UK (RUK) benefactors. Therefore, this could have resulted in the RUK facing a serious security dilemma, with political and ethical consequences to consider. The RUK would have the moral obligation to protect Scottish Unionists from persecution and recognise their right of self-determination, whilst ensuring the security and well-being of British citizens within and outside of Scotland. This work takes into consideration the lessons learned from the ‘Troubles’ in Northern Ireland. As an era of ‘Troubles’ could occur in Scotland, extending into England and Northern Ireland. This is due to proximity, the high number of political, communal and family links in Scotland to the RUK, and the delicate peace process within Northern Ireland which shares a similar issue. This paper will use British and Scottish Government documents prior to the Scottish referendum to argue why partition might happen and use cartography of maps of a potential partition plan for Scotland. Reports from the UK National Statistics, National Rail, and Ministry of Defence shall also be utilised, and use of journal articles that were covering the referendum.

Keywords: identity, nationalism, Scotland, unionism

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877 The Relationship between Vitamin D and Vitamin B12 Concentrations in Cataract Patients (Senile vs Diabetic)

Authors: Ali Showail Ali Alasmari

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Introduction: Cataract is the loss of transparency of the lens inside the eye. It is the most common cause of visual loss and blindness worldwide. This study provides a systemic review of the recent findings on the association of vitamin D, and vitamin B12, and their possible role in preventing cataracts in senile (S) and diabetic mellitus (DM) patient groups. Objective: This study was intended to establish and investigate if there is any role between vitamin D and vitamin B12? Secondly, the connection between serum level of vitamin D and vitamin B12 in cataract incidence senile (s) vs. diabetic mellitus (DM) cataract patient groups. Furthermore, to evaluate and analyze cataract occurrence regarding vitamin D and vitamin B12 levels with other risk factors. Finally, to evaluate lens opacities pre and post treatment with vitamin D and vitaminB12 linked to age and visual acuity loss in both senile(S) and diabetic mellitus (DM) cataract patients’ groups. Methods: This study conducted at the ophthalmology clinic at Muhyail General Hospital. Select a prospective case-control to study the effect of vitamin D and Vit B12 on senile(S) cataracts that caused by age and diabetic mellitus (DM)cataract patients; then we compare these two groups. This study prospectively enrolled a total of 50 samples, 25 with senile cataract and 25 with diabetic cataract, from ophthalmology clinic at Muhyail General Hospital. Measuring 25-hydroxy vitamin D and vitamin B12 level concentrations in the assigned samples. Analyses were performed using SAS (statistical analysis software) program. Results: The most important finding in this study was that the senile(s) cataract patients’ group greatly benefited by the combination therapy of vitamin D, and Vitamin B12 reached (28.5±1.50 and 521.1±21.10) respectively; on the contrary, the diabetic cataract patient group hardly shows any significant improvement (21.5 ± 1.00 and 197.2 ± 7.20) respectively. This is because of the Metformin, the first line drug for treating diabetes, has been reported to potentially decrease vitamin B-12 status. This epigenetic modification was correlated with the diabetic mellitus (DM) cataract patients’ group not responding. Vitamin B12 deficiency also leads to an impairment of the conversion of methylmalonyl-CoA to succinyl-CoA, which has been associated with insulin resistance. There was no significant difference between the age, body mass index (BMI), the mean of Vit-D pre-treatments, and the mean values of Hemoglobin A1C of both senile (S) and diabetic mellitus (DM) cataract patient groups. On other hand, there was a highly significant difference between the mean values of glucose levels in both senile (S) and diabetic mellitus (DM) cataract patient groups. Conclusion: Here we conclude that diabetic mellitus (DM) cataract patient group hardly benefited from this combination therapy vitamin D and vitamin B12; on the other hand senile patient group (s) benefited a lot from the therapy.

Keywords: cataract patients, senile, diabetes mellitus, vitamin B12, vitamin D, Muhyail General Hospital, Saudi Arabia

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876 Experiences of Community Midwives Receiving Helping Baby Breathe Training Through the Low Dose High-frequency Approach in Gujrat, Pakistan

Authors: Anila Naz, Arusa Lakhani, Kiran Mubeen, Yasmeen Amarsi

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Pakistan's neonatal mortality rate has the highest proportion in the South Asian region and it is higher in the rural areas as compared to the urban areas. Poor resuscitation techniques and lack of basic newborn resuscitation skills in birth attendants, are contributing factors towards neonatal deaths. Based on the significant outcomes of the Helping Baby Breath (HBB) training, a similar training was implemented for Community Midwives (CMWs) in a low resource setting in Gujrat, Pakistan, to improve their knowledge and skills. The training evaluation was conducted and participant feedback was obtained through both qualitative and quantitative methods. The findings of the quantitative assessment of the training evaluation will be published elsewhere. This paper presents the qualitative evaluation of the training. Objective: The objective of the study was to determine the perceptions of HBB trained CMWs about the effectiveness of the HBB training, and the challenges faced in the implementation of HBB skills for newborn resuscitation, at their work settings. The qualitative descriptive design was used in this study. The purposive sampling technique was chosen to recruit midwives and key informants as participants of the training. Interviews were conducted by using a semi-structured interview guide. The study included a total of five interviews: two focus group interviews for CMWs (10 in each group), and three individual interviews of key informants. The content analysis of the qualitative data yielded three themes: the effectiveness of training, challenges, and suggestions. The findings revealed that the HBB training was effective for the CMWs in terms of its usability, regarding improvement in newborn resuscitation knowledge and skills. Moreover, it enhanced confidence and satisfaction in CMWs. However, less volume of patients was a challenge for a few CMWs with regards to practicing their skills. Due to the inadequate number of patients and less opportunities of practice for several CMWs, they required such trainings frequently, in order to maintain their competency. The CMWs also recommended that HBB training should be part of the Midwifery program curriculum. Moreover, similar trainings were also recommended for other healthcare providers working in low resource settings, including doctors and nurses.

Keywords: neonatal resuscitation technique, helping baby breathe, community midwives, training evaluation

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875 KPI and Tool for the Evaluation of Competency in Warehouse Management for Furniture Business

Authors: Kritchakhris Na-Wattanaprasert

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The objective of this research is to design and develop a prototype of a key performance indicator system this is suitable for warehouse management in a case study and use requirement. In this study, we design a prototype of key performance indicator system (KPI) for warehouse case study of furniture business by methodology in step of identify scope of the research and study related papers, gather necessary data and users requirement, develop key performance indicator base on balance scorecard, design pro and database for key performance indicator, coding the program and set relationship of database and finally testing and debugging each module. This study use Balance Scorecard (BSC) for selecting and grouping key performance indicator. The system developed by using Microsoft SQL Server 2010 is used to create the system database. In regard to visual-programming language, Microsoft Visual C# 2010 is chosen as the graphic user interface development tool. This system consists of six main menus: menu login, menu main data, menu financial perspective, menu customer perspective, menu internal, and menu learning and growth perspective. Each menu consists of key performance indicator form. Each form contains a data import section, a data input section, a data searches – edit section, and a report section. The system generates outputs in 5 main reports, the KPI detail reports, KPI summary report, KPI graph report, benchmarking summary report and benchmarking graph report. The user will select the condition of the report and period time. As the system has been developed and tested, discovers that it is one of the ways to judging the extent to warehouse objectives had been achieved. Moreover, it encourages the warehouse functional proceed with more efficiency. In order to be useful propose for other industries, can adjust this system appropriately. To increase the usefulness of the key performance indicator system, the recommendations for further development are as follows: -The warehouse should review the target value and set the better suitable target periodically under the situation fluctuated in the future. -The warehouse should review the key performance indicators and set the better suitable key performance indicators periodically under the situation fluctuated in the future for increasing competitiveness and take advantage of new opportunities.

Keywords: key performance indicator, warehouse management, warehouse operation, logistics management

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874 Seismic Assessment of a Pre-Cast Recycled Concrete Block Arch System

Authors: Amaia Martinez Martinez, Martin Turek, Carlos Ventura, Jay Drew

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This study aims to assess the seismic performance of arch and dome structural systems made from easy to assemble precast blocks of recycled concrete. These systems have been developed by Lock Block Ltd. Company from Vancouver, Canada, as an extension of their currently used retaining wall system. The characterization of the seismic behavior of these structures is performed by a combination of experimental static and dynamic testing, and analytical modeling. For the experimental testing, several tilt tests, as well as a program of shake table testing were undertaken using small scale arch models. A suite of earthquakes with different characteristics from important past events are chosen and scaled properly for the dynamic testing. Shake table testing applying the ground motions in just one direction (in the weak direction of the arch) and in the three directions were conducted and compared. The models were tested with increasing intensity until collapse occurred; which determines the failure level for each earthquake. Since the failure intensity varied with type of earthquake, a sensitivity analysis of the different parameters was performed, being impulses the dominant factor. For all cases, the arches exhibited the typical four-hinge failure mechanism, which was also shown in the analytical model. Experimental testing was also performed reinforcing the arches using a steel band over the structures anchored at both ends of the arch. The models were tested with different pretension levels. The bands were instrumented with strain gauges to measure the force produced by the shaking. These forces were used to develop engineering guidelines for the design of the reinforcement needed for these systems. In addition, an analytical discrete element model was created using 3DEC software. The blocks were designed as rigid blocks, assigning all the properties to the joints including also the contribution of the interlocking shear key between blocks. The model is calibrated to the experimental static tests and validated with the obtained results from the dynamic tests. Then the model can be used to scale up the results to the full scale structure and expanding it to different configurations and boundary conditions.

Keywords: arch, discrete element model, seismic assessment, shake-table testing

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873 Effect of Male and Female Early Childhood Teacher's Educational Practices on Child' Social Adaptation

Authors: Therese Besnard

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Internationally in early childhood education (ECE), the great majority of teachers are women. Some groups believe that a greater male teacher presence in ECE would be beneficial for children, specifically for boys as it could offer a positive male model. It is a common belief that children would benefit from being exposed to both male and female models. Some believe that women are naturally better suited to offer quality care to young children comparatively to men. Some authors bring forth that after equivalent training, differences in the educational practices are purely individual and do not depend on the teacher’s gender. Others believe that a greater male presence in ECE would increase the risk of pedophilia or child abuse. The few scientific studies in this area suggest that differences could exist between male and female ECE teacher, in particular when it comes to play which is the mainstay of the ECE educational program. Male teachers describe themselves as being more playful and having a greater tendency to initiate physical and turbulent play comparatively to female teachers, who describe themselves as favoring games that are calmer and focused on social interaction. Observed directly, male teachers appear more actively engaged in play with children and propose more motor play than female teachers. Furthermore children who have both male and female teachers for one year show less behavior difficulties when compared to children with only female teachers. Despite a variety of viewpoints we don’t know if the educational practices of male ECE teachers, (emotional support, classroom organization or instructional support) are different than the educational practices of female teachers and if these practices are linked with children’s adaptation. This study compares the educational practices of 37 ECE teachers (57 % male) and analyses the link with children' social adaptation (n=221). Educational practices were assessed through observational measurements with the Classroom Assessment Scoring System (CLASS) in a natural class environment. Child social adaptation was assessed with the Social Competence and Behavior Evaluation (SCBE). Observational data reveals no differences between men's and women's scale of the CLASS. Results using Multilevel models analyses suggest that the ability to propose good classroom organization and give good instructional support are linked with better child' social adaptation, and that is always true for men and women teachers. The results are discussed on the basis of their potential impact on future educational interventions.

Keywords: child social adaptation, early childhood education, educational practices, men teacher

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872 Validation of a Placebo Method with Potential for Blinding in Ultrasound-Guided Dry Needling

Authors: Johnson C. Y. Pang, Bo Peng, Kara K. L. Reeves, Allan C. L. Fud

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Objective: Dry needling (DN) has long been used as a treatment method for various musculoskeletal pain conditions. However, the evidence level of the studies was low due to the limitations of the methodology. Lack of randomization and inappropriate blinding is potentially the main sources of bias. A method that can differentiate clinical results due to the targeted experimental procedure from its placebo effect is needed to enhance the validity of the trial. Therefore, this study aimed to validate the method as a placebo ultrasound(US)-guided DN for patients with knee osteoarthritis (KOA). Design: This is a randomized controlled trial (RCT). Ninety subjects (25 males and 65 females) aged between 51 and 80 (61.26 ± 5.57) with radiological KOA were recruited and randomly assigned into three groups with a computer program. Group 1 (G1) received real US-guided DN, Group 2 (G2) received placebo US-guided DN, and Group 3 (G3) was the control group. Both G1 and G2 subjects received the same procedure of US-guided DN, except the US monitor was turned off in G2, blinding the G2 subjects to the incorporation of faux US guidance. This arrangement created the placebo effect intended to permit comparison of their results to those who received actual US-guided DN. Outcome measures, including the visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of pain, symptoms, and quality of life (QOL), were analyzed by repeated measures analysis of covariance (ANCOVA) for time effects and group effects. The data regarding the perception of receiving real US-guided DN or placebo US-guided DN were analyzed by the chi-squared test. The missing data were analyzed with the intention-to-treat (ITT) approach if more than 5% of the data were missing. Results: The placebo US-guided DN (G2) subjects had the same perceptions as the use of real US guidance in the advancement of DN (p<0.128). G1 had significantly higher pain reduction (VAS and KOOS-pain) than G2 and G3 at 8 weeks (both p<0.05) only. There was no significant difference between G2 and G3 at 8 weeks (both p>0.05). Conclusion: The method with the US monitor turned off during the application of DN is credible for blinding the participants and allowing researchers to incorporate faux US guidance. The validated placebo US-guided DN technique can aid in investigations of the effects of US-guided DN with short-term effects of pain reduction for patients with KOA. Acknowledgment: This work was supported by the Caritas Institute of Higher Education [grant number IDG200101].

Keywords: ultrasound-guided dry needling, dry needling, knee osteoarthritis, physiotheraphy

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871 Populism and National Unity: A Discourse Analysis of Poverty Eradication Strategies of Three Malaysian Prime Ministers

Authors: Khairil Ahmad, Jenny Gryzelius, Mohd Helmi Mohd Sobri

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With the waning support for centrist ‘third-way’ politics across the Western world, there has been an increase in political parties and individual candidates relying on populist political discourse and rhetoric in order to capitalize on the sense of frustration apparent within the electorate. What is of note is the divergence in the discourses employed. On the one hand, there is a polarization between a growing wave of populist right-wing parties and politicians, employing a mixture of economic populism with divisive nationalistic ideals such as restricted immigration, for example, the UK’s UKIP and Donald Trump in the US. On the other hand, there are resurgent, often grassroots-led, left-wing movements and politicians, such as Podemos in Spain and Jeremy Corbyn in the UK, focusing on anti-austerity measures and inclusive policies. In general, the concept of populism is often ascribed in a pejorative way. This is despite the success of populist left-wing governments across Latin America in recent times, especially in terms of reducing poverty. Nonetheless, recently, scholars such as Ernesto Laclau have tried to rethink populism as a social scientific concept which is essential in helping us make sense of contemporary political articulations. Using Laclau’s framework, this paper seeks to analyze poverty reduction policies in different iterations in the context of the tenures of three Prime Ministers of Malaysia. The first is Abdul Razak Hussein’s New Economic Policy, which focused on uplifting the economic position of Malaysia’s majority Malay population. The second is Mahathir Mohamad’s state-led neo-liberalization of the Malaysian economy, which focused on the creation of a core group of crony elites in order to spearhead economic development. The third is current Prime Minister Najib Razak’s targeted poverty eradication strategy through a focused program which directly provides benefits to recipients such as through direct cash transfers. The paper employs a discursive approach to trace elements of populism in these cases and highlight instances of how their strategies are articulated in ways that seek to appeal towards particular visions of national unity.

Keywords: discourse analysis, Malaysia, populism, poverty eradication

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870 Investigation of the Relationship between Digital Game Playing, Internet Addiction and Perceived Stress Levels in University Students

Authors: Sevim Ugur, Cemile Kutmec Yilmaz, Omer Us, Sevdenur Koksaldi

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Aim: This study aims to investigate the effect of digital game playing and Internet addiction on perceived stress levels in university students. Method: The descriptive study was conducted through face-to-face interview method with a total of 364 university students studying at Aksaray University between November 15 and December 30, 2017. The research data were collected using personal information form, a questionnaire to determine the characteristics of playing digital game, the Internet addiction scale and the perceived stress scale. In the evaluation of the data, Mann-Whitney U test was used for two-group comparison of the sample with non-normal distribution, Kruskal-Wallis H-test was used in the comparison of more than two groups, and the Spearman correlation test was used to determine the relationship between Internet addiction and the perceived stress level. Results: It was determined that the mean age of the students participated in the study was 20.13 ± 1.7 years, 67.6% was female, 35.7% was sophomore, and 62.1% had an income 500 TL or less. It was found that 83.5% of the students use the Internet every day and 70.6% uses the Internet for 5 hours or less per day. Of the students, 12.4% prefers digital games instead of spending time outdoors, 8% plays a game as the first activity in leisure time, 12.4% plays all day, 15.7% feels anger when he/she is prevented from playing, 14.8% prefers playing games to get away from his/her problems, 23.4% had his/her school achievement affected negatively because of game playing, and 8% argues with family members due to the time spent for gaming. Students who play games on the computer for a long time were found to feel back pain (30.8%), headache (28.6%), insomnia (26.9%), dryness and pain in the eyes (26.6%), pain in the wrist (21.2%), feeling excessive tension and anger (16.2%), humpback (12.9), vision loss (9.6%) and pain in the wrist and fingers (7.4%). In our study, students' Internet addiction scale mean score was found to be 45.47 ± 16.1 and mean perceived stress scale score was 28.56 ± 2.7. A significant and negative correlation (p=0.037) was found between the total score of the Internet addiction scale and the total score of the perceived stress scale (r=-0.110). Conclusion: It was found in the study that Internet addiction and perceived stress of the students were at a moderate level and that there was a negative correlation between Internet addiction and perceived stress levels. Internet addiction was found to increase with the increasing perceived stress levels of students, and students were found to have health problems such as back pain, dryness in the eyes, pain, insomnia, headache, and humpback. Therefore, it is recommended to inform students about different coping methods other than spending time on the Internet to cope with the stress they perceive.

Keywords: digital game, internet addiction, student, stress level

Procedia PDF Downloads 273
869 Psychological and Emotional Functioning of Elderly in Pakistan a Comparison in Punjab and Gilgit-Baltistan

Authors: Najma Najam, Rukhsana Kausar, Rabia Hussain Kanwal, Saira Batool, Anum Javed

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In Pakistan, elderly population though increasing but it has been neglected by the researchers and policy makers which resulted in compromised quality of life of the ageing population. Two regions, Punjab and Gilgit-Baltistan (GB) were selected for comparison as Lahore and Multan (Punjab) are highly urbanized, large cities whereas Gilgit and Skardu are remote and mountain bounded valleys in GB. This study focuses on psychological and emotional functioning of elderly and a series of measures translated and adapted in Urdu language was used to assess quality of life, psychological and mental well-being, actual and perceived social support, attachment patterns, forgiveness, affects, geriatric depression, and emotional disturbance patterns (depression, anxiety, and stress) in elderly. A gender-equated sample of 201 elderly participants, 93 from GB (60 from Gilgit, 33 from Skardu) and 108 from Punjab (61 from Lahore, 47 from Multan) with over 60 years age was collected from the multiethnic community of Punjab and GB through purposive convenient sampling technique. Findings revealed that elderly from Multan have better psychological and emotional functioning, higher levels of social support, tendency to forgive, better mental wellbeing and quality of life and lower levels of stress, anxiety, depression, negative affect and attachment avoidance and anxiety related to partner as compared to the elderly from Lahore. Furthermore, both elderly male of Gilgit & Skardu have adequate mental well-being including subjective well-being and psychological functioning which showed positive aspects of mental health but elderly female are more attached to their home and neighbourhood which shows their social and environmental mastery. Gilgiti elderly male reported more degree of positive affect such as enthusiasm, active, alertness, excitement and strong whereas among elderly from Skardu shows more negative affect i.e. aversive mood states, irritability, hostility, and general distress. The need of psychosocial therapy and family counseling for the elderly in urban areas has been identified, which can facilitate in reducing or preventing the depressive and stressful tendencies. The findings are expected to have implications for improving quality of life of the elderly, designing interventions, support system and rehabilitation services to help them. However, findings may attract attention of policy makers and researchers as currently this is the most neglected population in Pakistan.

Keywords: psychological, emotional, aging, elderly, quality of life

Procedia PDF Downloads 512
868 Mothers’ Experiences of Continuing Their Pregnancy after Prenatally Receiving a Diagnosis of Down Syndrome

Authors: Sevinj Asgarova

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Within the last few decades, major advances in the field of prenatal testing have transpired yet little research regarding the experiences of mothers who chose to continue their pregnancies after prenatally receiving a diagnosis of Down Syndrome (DS) has been undertaken. Using social constructionism and interpretive description, this retrospective research study explores this topic from the point of view of the mothers involved and provides insight as to how the experience could be improved. Using purposive sampling, 23 mothers were recruited from British Columbia (n=11) and Ontario (n=12) in Canada. Data retrieved through semi-structured in-depth interviews were analyzed using inductive, constant comparative analysis, the major analytical techniques of interpretive description. Four primary phases emerged from the data analysis 1) healthcare professional-mothers communications, 2) initial emotional response, 3) subsequent decision-making and 4) an adjustment and reorganization of lifestyle to the preparation for the birth of the child. This study validates the individualized and contextualized nature of mothers’ decisions as influenced by multiple factors, with moral values/spiritual beliefs being significant. The mothers’ ability to cope was affected by the information communicated to them about their unborn baby’s diagnosis and the manner in which that information was delivered to them. Mothers used emotional coping strategies, dependent upon support from partners, family, and friends, as well as from other families who have children with DS. Additionally, they employed practical coping strategies, such as engaging in healthcare planning, seeking relevant information, and reimagining and reorganizing their lifestyle. Over time many families gained a sense of control over their situation and readjusted to the preparation for the birth of the child. Many mothers expressed the importance of maintaining positivity and hopefulness with respect to positive outcomes and opportunities for their children. The comprehensive information generated through this study will also provide healthcare professionals with relevant information to assist them in understanding the informational and emotional needs of these mothers. This should lead to an improvement in their practice and enhance their ability to intervene appropriately and effectively, better offering improved support to parents dealing with a diagnosis of DS for their child.

Keywords: continuing affected pregnancy, decision making, disability, down syndrome, eugenic social attitudes, inequalities, life change events, prenatal care, prenatal testing, qualitative research, social change, social justice

Procedia PDF Downloads 88
867 The Relationship of Depression Risk and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

Authors: Yu Chen Su

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Introduction: Gestational diabetes mellitus (GDM) refers to impaired glucose tolerance in pregnant women, impacting both the mother and newborn with short and long-term effects. It increases risks of preeclampsia, hypertension, type 2 diabetes, cesarean section, and preterm birth. GDM is associated with fetal macrosomia, shoulder dystocia, neonatal hypoglycemia, and future type 2 diabetes risk. A study on 6,421 pregnant women found 12% experienced high stress, linked to maladaptive coping and depressive emotions. Women with high-risk pregnancies may experience greater stress and depression. Research suggests GDM increases depression prevalence. A study on 632 Hispanic women with GDM showed severe stress and depression tendencies. Involving 95 women with GDM, 33.4% exhibited depression symptoms. Another study compared 180 GDM women to 186 with normal glucose levels, revealing higher depression levels in GDM women. They found GDM women were 1.85 times more likely to receive antidepressants during pregnancy and 1.69 times more likely to experience postpartum depression. Maternal stress and depressive symptoms during pregnancy are significant factors. Early identification by healthcare professionals can greatly benefit GDM women, their infants, and their families. Objectives: The purpose of this study was to investigate the association between gestational diabetes mellitus (GDM) and the risk of depression. Methods: This study reviewed and analyzed relevant literature on gestational diabetes mellitus (GDM) and depression in 6,876 patients. The literature search followed PRISMA guidelines and included databases like Embase, PubMed, MEDLINE, CINAHL, and Cochrane Library. Prospective or retrospective studies with relevant risk ratios and estimates were included, using a random-effects model for the analysis of depression risk correlation. Studies without depression data or relevant risks were excluded. The search period extended until October 2022. Results: Systematic review of 7 studies (6,876 participants) found a significant association (OR = 8.77, CI: 7.98-9.64, p < 0.05) between gestational diabetes mellitus (GDM) and higher depression risk compared to healthy pregnant women. Conclusions: Pregnancy is a significant life transition involving physiological, psychological, and social changes. Gestational diabetes poses challenges to women's physical and mental well-being. Sensitive healthcare professionals identifying issues early can greatly benefit women, babies, and the family.

Keywords: gestational diabetes, depression, systematic review, neta-analysis

Procedia PDF Downloads 57
866 Effects of the Affordable Care Act On Preventive Care Disparities

Authors: Cagdas Agirdas

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Background: The Affordable Care Act (ACA) requires non-grandfathered private insurance plans, starting with plan years on or after September 23rd, 2010, to provide certain preventive care services without any cost sharing in the form of deductibles, copayments or co-insurance. This requirement may affect racial and ethnic disparities in preventive care as it provides the largest copay reduction in preventive care. Objectives: We ask whether the ACA’s free preventive care benefits are associated with a reduction in racial and ethnic disparities in the utilization of four preventive services: cholesterol screenings, colonoscopies, mammograms, and pap smears. Methods: We use a data set of over 6,000 individuals from the 2009, 2010, and 2013 Medical Expenditure Panel Surveys (MEPS). We restrict our data set only to individuals who are old enough to be eligible for each preventive service. Our difference-in-differences logistic regression model classifies privately-insured Hispanics, African Americans, and Asians as the treatment groups and 2013 as the after-policy year. Our control group consists of non-Hispanic whites on Medicaid as this program already covered preventive care services for free or at a low cost before the ACA. Results: After controlling for income, education, marital status, preferred interview language, self-reported health status, employment, having a usual source of care, age and gender, we find that the ACA is associated with increases in the probability of the median, privately-insured Hispanic person to get a colonoscopy by 3.6% and a mammogram by 3.1%, compared to a non-Hispanic white person on Medicaid. Similarly, we find that the median, privately-insured African American person’s probability of receiving these two preventive services improved by 2.3% and 2.4% compared to a non-Hispanic white person on Medicaid. We do not find any significant improvements for any racial or ethnic group for cholesterol screenings or pap smears. Furthermore, our results do not indicate any significant changes for Asians compared to non-Hispanic whites in utilizing the four preventive services. These reductions in racial/ethnic disparities are robust to reconfigurations of time periods, previous diagnosis, and residential status. Conclusions: Early effects of the ACA’s provision of free preventive care are significant for Hispanics and African Americans. Further research is needed for the later years as more individuals became aware of these benefits.

Keywords: preventive care, Affordable Care Act, cost sharing, racial disparities

Procedia PDF Downloads 134
865 Barriers and Facilitators of Community Based Mental Health Intervention (CMHI) in Rural Bangladesh: Findings from a Descriptive Study

Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Sazzad Chowdhury, Sadia Chowdhury

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Access to mental health services in Bangladesh is a tale of urban privilege and rural struggle. Mental health services in the country are primarily centered in urban medical hospitals, with only 260 psychiatrists for a population of more than 162 million, while rural populations face far more severe and daunting challenges. In alignment with the World Health Organization's perspective on mental health as a basic human right and a crucial component for personal, community, and socioeconomic development; SAJIDA Foundation a value driven non-government organization in Bangladesh has introduced a Community Based Mental Health (CMHI) program to fill critical gaps in mental health care, providing accessible and affordable community-based services to protect and promote mental health, offering support for those grappling with mental health conditions. The CMHI programme is being implemented in 3 districts in Bangladesh, 2 of them are remote and most climate vulnerable areas targeting total 6,797 individual. The intervention plan involves a screening of all participants using a 10-point vulnerability assessment tool to identify vulnerable individuals. The assumption underlying this is that individuals assessed as vulnerable is primarily due to biological, psychological, social and economic factors and they are at an increased risk of developing common mental health issues. Those identified as vulnerable with high risk and emergency conditions will receive Mental Health First Aid (MHFA) and undergo further screening with GHQ-12 to be identified as cases and non-cases. The identified cases are then referred to community lay counsellors with basic training and knowledge in providing 4-6 sessions on problem solving or behavior activation. In situations where no improvement occurs post lay counselling or for individuals with severe mental health conditions, a referral process will be initiated, directing individuals to ensure appropriate mental health care. In our presentation, it will present the findings from 6-month pilot implementation focusing on the community-based screening versus outcome of the lay counseling session and barriers and facilitators of implementing community based mental health care in a resource constraint country like Bangladesh.

Keywords: community-based mental health, lay counseling, rural bangladesh, treatment gap

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864 Identifying and Understand Pragmatic Failures in Portuguese Foreign Language by Chinese Learners in Macau

Authors: Carla Lopes

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It is clear nowadays that the proper performance of different speech acts is one of the most difficult obstacles that a foreign language learner has to overcome to be considered communicatively competent. This communication presents the results of an investigation on the pragmatic performance of Portuguese Language students at the University of Macau. The research discussed herein is based on a survey consisting of fourteen speaking situations to which the participants must respond in writing, and that includes different types of speech acts: apology, response to a compliment, refusal, complaint, disagreement and the understanding of the illocutionary force of indirect speech acts. The responses were classified in a five levels Likert scale (quantified from 1 to 5) according to their suitability for the particular situation. In general terms, we can summarize that about 45% of the respondents' answers were pragmatically competent, 10 % were acceptable and 45 % showed weaknesses at socio-pragmatic competence level. Given that the linguistic deviations were not taken into account, we can conclude that the faults are of cultural origin. It is natural that in the presence of orthogonal cultures, such as Chinese and Portuguese, there are failures of this type, barely solved in the four years of the undergraduate program. The target population, native speakers of Cantonese or Mandarin, make their first contact with the English language before joining the Bachelor of Portuguese Language. An analysis of the socio - pragmatic failures in the respondents’ answers suggests the conclusion that many of them are due to the lack of cultural knowledge. They try to compensate for this either using their native culture or resorting to a Western culture that they consider close to the Portuguese, that is the English or US culture, previously studied, and also widely present in the media and on the internet. This phenomenon, known as 'pragmatic transfer', can result in a linguistic behavior that may be considered inauthentic or pragmatically awkward. The resulting speech act is grammatically correct but is not pragmatically feasible, since it is not suitable to the culture of the target language, either because it does not exist or because the conditions of its use are in fact different. Analysis of the responses also supports the conclusion that these students present large deviations from the expected and stereotyped behavior of Chinese students. We can speculate while this linguistic behavior is the consequence of the Macao globalization that culturally casts the students, makes them more open, and distinguishes them from the typical Chinese students.

Keywords: Portuguese foreign language, pragmatic failures, pragmatic transfer, pragmatic competence

Procedia PDF Downloads 195
863 Creatine Associated with Resistance Training Increases Muscle Mass in the Elderly

Authors: Camila Lemos Pinto, Juliana Alves Carneiro, Patrícia Borges Botelho, João Felipe Mota

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Sarcopenia, a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, currently affects over 50 million people and increases the risk of adverse outcomes such as physical disability, poor quality of life and death. The aim of this study was to examine the efficacy of creatine supplementation associated with resistance training on muscle mass in the elderly. A 12-week, double blind, randomized, parallel group, placebo controlled trial was conducted. Participants were randomly allocated into one of the following groups: placebo with resistance training (PL+RT, n=14) and creatine supplementation with resistance training (CR + RT, n=13). The subjects from CR+RT group received 5 g/day of creatine monohydrate and the subjects from the PL+RT group were given the same dose of maltodextrin. Participants were instructed to ingest the supplement on non-training days immediately after lunch and on training days immediately after resistance training sessions dissolved in a beverage comprising 100 g of maltodextrin lemon flavored. Participants of both groups undertook a supervised exercise training program for 12 weeks (3 times per week). The subjects were assessed at baseline and after 12 weeks. The primary outcome was muscle mass, assessed by dual energy X-ray absorptiometry (DXA). The secondary outcome included diagnose participants with one of the three stages of sarcopenia (presarcopenia, sarcopenia and severe sarcopenia) by skeletal muscle mass index (SMI), handgrip strength and gait speed. CR+RT group had a significant increase in SMI and muscle (p<0.0001), a significant decrease in android and gynoid fat (p = 0.028 and p=0.035, respectively) and a tendency of decreasing in body fat (p=0.053) after the intervention. PL+RT only had a significant increase in SMI (p=0.007). The main finding of this clinical trial indicated that creatine supplementation combined with resistance training was capable of increasing muscle mass in our elderly cohort (p=0.02). In addition, the number of subjects diagnosed with one of the three stages of sarcopenia at baseline decreased in the creatine supplemented group in comparison with the placebo group (CR+RT, n=-3; PL+RT, n=0). In summary, 12 weeks of creatine supplementation associated with resistance training resulted in increases in muscle mass. This is the first research with elderly of both sexes that show the same increase in muscle mass with a minor quantity of creatine supplementation in a short period. Future long-term research should investigate the effects of these interventions in sarcopenic elderly.

Keywords: creatine, dietetic supplement, elderly, resistance training

Procedia PDF Downloads 460
862 Urban Accessibility of Historical Cities: The Venetian Case Study

Authors: Valeria Tatano, Francesca Guidolin, Francesca Peltrera

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The preservation of historical Italian heritage, at the urban and architectural scale, has to consider restrictions and requirements connected with conservation issues and usability needs, which are often at odds with historical heritage preservation. Recent decades have been marked by the search for increased accessibility not only of public and private buildings, but to the whole historical city, also for people with disability. Moreover, in the last years the concepts of Smart City and Healthy City seek to improve accessibility both in terms of mobility (independent or assisted) and fruition of goods and services, also for historical cities. The principles of Inclusive Design have introduced new criteria for the improvement of public urban space, between current regulations and best practices. Moreover, they have contributed to transforming “special needs” into an opportunity of social innovation. These considerations find a field of research and analysis in the historical city of Venice, which is at the same time a site of UNESCO world heritage, a mass tourism destination bringing in visitors from all over the world and a city inhabited by an aging population. Due to its conformation, Venetian urban fabric is only partially accessible: about four thousand bridges divide thousands of islands, making it almost impossible to move independently. These urban characteristics and difficulties were the base, in the last 20 years, for several researches, experimentations and solutions with the aim of eliminating architectural barriers, in particular for the usability of bridges. The Venetian Municipality with the EBA Office and some external consultants realized several devices (e.g. the “stepped ramp” and the new accessible ramps for the Venice Marathon) that should determine an innovation for the city, passing from the use of mechanical replicable devices to specific architectural projects in order to guarantee autonomy in use. This paper intends to present the state-of-the-art in bridges accessibility, through an analysis based on Inclusive Design principles and on the current national and regional regulation. The purpose is to evaluate some possible strategies that could improve performances, between limits and possibilities of interventions. The aim of the research is to lay the foundations for the development of a strategic program for the City of Venice that could successfully bring together both conservation and improvement requirements.

Keywords: accessibility of historical cities, historical heritage preservation, inclusive design, technological and social innovation

Procedia PDF Downloads 261
861 Comparison of Cardiovascular and Metabolic Responses Following In-Water and On-Land Jump in Postmenopausal Women

Authors: Kuei-Yu Chien, Nai-Wen Kan, Wan-Chun Wu, Guo-Dong Ma, Shu-Chen Chen

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Purpose: The purpose of this study was to investigate the responses of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), rating of perceived exertion (RPE) and lactate following continued high-intensity interval exercise in water and on land. The results of studies can be an exercise program design reference for health care and fitness professionals. Method: A total of 20 volunteer postmenopausal women was included in this study. The inclusion criteria were: duration of menopause > 1 year; and sedentary lifestyle, defined as engaging in moderate-intensity exercise less than three times per week, or less than 20 minutes per day. Participants need to visit experimental place three times. The first time visiting, body composition was performed and participant filled out the questionnaire. Participants were assigned randomly to the exercise environment (water or land) in second and third time visiting. Water exercise testing was under water of trochanter level. In continuing jump testing, each movement consisted 10-second maximum volunteer jump for two sets. 50% heart rate reserve dynamic resting (walking or running) for one minute was within each set. SBP, DBP, HR, RPE of whole body/thigh (RPEW/RPET) and lactate were performed at pre and post testing. HR, RPEW, and RPET were monitored after 1, 2, and 10 min of exercise testing. SBP and DBP were performed after 10 and 30 min of exercise testing. Results: The responses of SBP and DBP after exercise testing in water were higher than those on land. Lactate levels after exercise testing in water were lower than those on land. The responses of RPET were lower than those on land post exercise 1 and 2 minutes. The heart rate recovery in water was faster than those on land at post exercise 5 minutes. Conclusion: This study showed water interval jump exercise induces higher cardiovascular responses with lower RPE responses and lactate levels than on-land jumps exercise in postmenopausal women. Fatigue is one of the major reasons to obstruct exercise behavior. Jump exercise could enhance cardiorespiratory fitness, the lower-extremity power, strength, and bone mass. There are several health benefits to the middle to older adults. This study showed that water interval jumping could be more relaxed and not tried to reach the same land-based cardiorespiratory exercise intensity.

Keywords: interval exercise, power, recovery, fatigue

Procedia PDF Downloads 396
860 The Millennium Development Goals and Algerian Economic Policy: Some Evidences

Authors: Abdelkader Guendouz, Fatima Zohra Adel

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Even if both the economic and the human development are an axial pillar in its global policy, Algerian government seems to be more and more engaged in the international context aiming to reach of the so called millennium development goals, and this since its beginning. By looking closely at the Algerian economic policy, it is easy to mention the existence of several programs in which both economic and social realisations including among others, poverty reduction, enhancement of education level and conditions, woman statute and gender equity amelioration targets. The efforts of Algerian government in the field of these targets had been acheminated through three main plans, which are: -PSRE (Plan de Soutien à la Relance Economique), for the period of 2001 to 2004, initiated with about 7 billion US dollar, had been focused on three objectives, namely, poverty reduction, job creation and regional equilibrium with rural areas revitalization. -PCSC (le Programme complémentaire de soutien à la croissance économique), for the period of 2005 to 2009, with a starting funding of 114 billion US dollar. This program aims to develop public services and supporting public investments, especially in which concerns social infrastructures. Now, and at the end of the maturity of the MDGs agenda, an important question is to be asked: what are the main realizations regarding these MDGs? In order to answer this question, the present paper tries to examine the Algerian economic policy (but also the social one) by considering the MDGs challenges, for the period from 2000 to 2010, but also until 2015. This examination is focused on three main targets, namely poverty, education, and health. Firstly, statistical assessment for the Algerian economic and social situation shows that almost all MDGs had been reached during the period of 2000 to 2009 and it continues to maintain and improve them. This observation can be endorsed by invoking some achievements. Starting by the reduction of poverty, the proportion of population living with less than 1 US dollar per a day passed from 8.0 % in 2000 to 0.5 % in 2009, and 0.3 % in 2015. For education sphere, the enrolment ratio of six-year child, which is the most significant index for school attendance, is about 98 % for 2009 against 93 % in 1999, and only 43 % in 1966. Concluding with health care and relevant services; the Algerian government has accomplished big steps in providing easy access to this sector for the population. Moreover, the percentage of assisted accouchement had been raised from 91.2 % in 2000 to 97.2 % in 2009.

Keywords: Algerian economic policy, MDGs, poverty, education, health

Procedia PDF Downloads 238
859 Adequacy of Antenatal Care and Its Relationship with Low Birth Weight in Botucatu, São Paulo, Brazil: A Case-Control Study

Authors: Cátia Regina Branco da Fonseca, Maria Wany Louzada Strufaldi, Lídia Raquel de Carvalho, Rosana Fiorini Puccini

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Background: Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. The purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil. Methods: A case-control study was conducted in Botucatu, São Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the official medical records of pregnant women). The study population consisted of two groups, each with 860 newborns. The case group comprised newborns weighing less than 2,500 grams, while the control group comprised live newborns weighing greater than or equal to 2,500 grams. Adequacy of ANC was evaluated according to three measurements: 1. Adequacy of the number of ANC visits adjusted to gestational age; 2. Modified Kessner Index; and 3. Adequacy of ANC laboratory studies and exams summary measure according to parameters defined by the Ministry of Health in the Program for Prenatal and Birth Care Humanization. Results: Analyses revealed that LBW was associated with the number of ANC visits adjusted to gestational age (OR = 1.78, 95% CI 1.32-2.34) and the ANC laboratory studies and exams summary measure (OR = 4.13, 95% CI 1.36-12.51). According to the modified Kessner Index, 64.4% of antenatal visits in the LBW group were adequate, with no differences between groups. Conclusions: Our data corroborate the association between inadequate number of ANC visits, laboratory studies and exams, and increased risk of LBW newborns. No association was found between the modified Kessner Index as a measure of adequacy of ANC and LBW. This finding reveals the low indices of coverage for basic actions already well regulated in the Health System in Brazil. Despite the association found in the study, we cannot conclude that LBW would be prevented only by an adequate ANC, as LBW is associated with factors of complex and multifactorial etiology. The results could be used to plan monitoring measures and evaluate programs of health care assistance during pregnancy, at delivery and to newborns, focusing on reduced LBW rates.

Keywords: low birth weight, antenatal care, prenatal care, adequacy of health care, health evaluation, public health system

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858 Establishment of Nursing School in the Backward Region of Nepal

Authors: Shyam lamsal

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Introduction: Karnali Academy of Health Sciences (KAHS) has been established in 2011, by an Act of parliament of Nepal, in Jumla, to provide health services in easy way in backward areas, to produce skilled health professionals & conduct research. The backward areas mentioned in act of KAHS are Humla, Jumla, Kalikot, Dolpa, Mugu districts of Karnali zone, Jajarkot district of Bheri zone & Bajura, Baghang & Achham districts of Seti zone in Nepal occupying around 25 % of the total national geography. Backward area of Nepal is specific to having worst health indicators with life expectancy (47 years), HDI (0.35), Literacy rate (58%), global acute malnutrition (13%), crude birth rate (33.6), crude death rate (9.6), Total fertility rate (4.2), infant mortality rate (61.5 per 1000 live births), under five mortality rate (59 per 1000 live births) and maternal mortality ratio (400 per 1000 live births). History of health facilities in backward region: All the nine districts of this region have a district hospital with very few grass root level health manpower. Government of Nepal regularly deploys one or two medical officers to each district who generally are not regular to their care. Jumla district itself was having one medical officer before the establishment of KAHS. Development activities: Establishment of 100 bedded specialty teaching hospital with 10 medical officers and five specialists, accredited its own nursing school for running diploma nursing programme, started “Karnali health survey” which covers 55 thousand households of backward region, started community care and school health camps, planning phase completed for 300 bedded teaching hospital construction. Future Plan: Expansion of the teaching hospital to 300 beds within 3 years, start health assistant and bachelor midwifery course in 2015 AD, start bachelor in laboratory and bachelor in public health course in 2016 AD and start MBBS course in 2018 AD. Deploy the medical officers and family physicians to all the district hospitals within 3 years. KAHS provides reservation up to 45% students from backward region with the commitment to stay for at least five years of their service period. Conclusion: This institution may be the example for the rest of the world in providing nursing care, education in remote areas as well as the best model for nursing manpower retention in remote areas of developing countries.

Keywords: backward area, nursing school

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857 Early Childhood Education and Learning Outcomes in Lower Primary Schools, Uganda

Authors: John Acire, Wilfred Lajul, Ogwang Tom

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Using a qualitative research technique, this study investigates the influence of Early Childhood Education (ECE) on learning outcomes in lower primary schools in Gulu City, Uganda. The study, which is based on Vygotsky's sociocultural theory of human learning, fills gaps in the current literature on the influence of ECE on learning outcomes. The aims of the study include analyzing the state of learning outcomes, investigating ECE practices, and determining the influence of these practices on learning outcomes in lower primary schools. The findings highlight the critical significance of ECE in promoting children's overall development. Nursery education helps children improve their handwriting, reading abilities, and general cognitive development. Children who have received nursery education have improved their abilities to handle pencils, form letters, and engage in social interactions, highlighting the significance of fine motor skills and socializing. Despite the good elements, difficulties in implementing ECE practices were found, such as differences in teaching styles, financial limits, and potential weariness due to prolonged school hours. The study suggests focused interventions to improve the effectiveness of ECE practices, ensure their connection with educational goals and maximize their influence on children's development. The study's findings show that respondents agree on the importance of nursery education in supporting holistic development, socialization, language competency, and conceptual comprehension. Challenges in nursery education, such as differences in teaching techniques and insufficient resources, highlight the need for comprehensive measures to address these challenges. Furthermore, parental engagement in home learning activities was revealed as an important factor affecting early education outcomes. Children who were engaged at home performed better in lower primary, emphasizing the value of a supportive family environment. Finally, the report suggests measures to enhance parental participation, changes in teaching methods through retraining, and age-appropriate enrolment. Future studies might concentrate on the involvement of parents, ECE policy practice, and the influence of ECE teachers on lower primary school learning results. These ideas are intended to help create a more favorable learning environment by encouraging holistic development and preparing children for success in succeeding academic levels.

Keywords: early childhood education, learning outcomes in lower primary schools, early childhood education practices, how ECE practices influence learning outcomes in lower primary schools

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856 DPAGT1 Inhibitors: Discovery of Anti-Metastatic Drugs

Authors: Michio Kurosu

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Alterations in glycosylation not only directly impact cell growth and survival but also facilitate tumor-induced immunomodulation and eventual metastasis. Identification of cell type-specific glycoconjugates (tumor markers) has led to the discovery of new assay systems for certain cancers via immunodetection reagents. N- and O-linked glycans are the most abundant forms of glycoproteins. Recent studies of cancer immunotherapy are based on the immunogenicity of truncated O-glycan chains (e.g., Tn, sTn, T, and sLea/x). The prevalence of N-linked glycan changes in the development of tumor cells is known; however, therapeutic antibodies against N-glycans have not yet been developed. This is due to the lack of specificity of N-linked glycans between normal/healthy and cancer cells. Abnormal branching of N-linked glycans has been observed, particularly in solid cancer cells. While the discovery of drug-like glycosyltransferase inhibitors that block the biosynthesis of specific branching has a very low likelihood of success, altered glycosylation levels can be exploited by suppressing N-glycan biosynthesis through the inhibition of dolichyl-phosphate N-acetylglucosaminephosphotransferase1 (DPAGT1) activity. Inhibition of DPAGT1 function leads to changes of O-glycosylation on proteins associated with mitochondria and zinc finger binding proteins (indirect effects). On the basis of dynamic crosstalk between DPAGT1 and Snail/Slung/ZEB1 (a family of transcription factors that promote the repression of the adhesion molecules), we have developed pharmacologically acceptable selective DPAGT1 inhibitors. Tunicamycin kills a wide range of cancer and healthy cells in a non-selective manner. In sharp contrast, our DPAGT1 inhibitors display strong cytostatic effects against 16 solid cancers, which require the overexpression of DPAGT1 in their progression but do not affect the cell viability of healthy cells. The identified DPAGT1 inhibitors possess impressive anti-metastatic ability in various solid cancer cell lines and induce their mitochondrial structural changes, resulting in apoptosis. A prototype DPAGT1 inhibitor, APPB has already been proven to shrink solid tumors (e.g., pancreatic cancers, triple-negative breast cancers) in vivo while suppressing metastases and has strong synergistic effects when combined with current cytotoxic drugs (e.g., paclitaxel). At this conference, our discovery of selective DPAGT1 inhibitors with drug-like properties and proof-of-pharmaceutical concept studies of a novel DPAGT1 inhibitor are presented.

Keywords: DPAGT1 inhibitors, anti-metastatic drugs, natural product based drug designs, cytostatic effects

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855 Effective Learning and Testing Methods in School-Aged Children

Authors: Farzaneh Badinlou, Reza Kormi-Nouri, Monika Knopf, Kamal Kharrazi

Abstract:

When we teach, we have two critical elements at our disposal to help students: learning styles as well as testing styles. There are many different ways in which educators can effectively teach their students; verbal learning and experience-based learning. Lecture as a form of verbal learning style is a traditional arrangement in which teachers are more active and share information verbally with students. In experienced-based learning as the process of through, students learn actively through hands-on learning materials and observing teachers or others. Meanwhile, standard testing or assessment is the way to determine progress toward proficiency. Teachers and instructors mainly use essay (requires written responses), multiple choice questions (includes the correct answer and several incorrect answers as distractors), or open-ended questions (respondents answers it with own words). The current study focused on exploring an effective teaching style and testing methods as the function of age over school ages. In the present study, totally 410 participants were selected randomly from four grades (2ⁿᵈ, 4ᵗʰ, 6ᵗʰ, and 8ᵗʰ). Each subject was tested individually in one session lasting around 50 minutes. In learning tasks, the participants were presented three different instructions for learning materials (learning by doing, learning by observing, and learning by listening). Then, they were tested via different standard assessments as free recall, cued recall, and recognition tasks. The results revealed that generally students remember more of what they do and what they observe than what they hear. The age effect was more pronounced in learning by doing than in learning by observing, and learning by listening, becoming progressively stronger in the free-recall, cued-recall, and recognition tasks. The findings of this study indicated that learning by doing and free recall task is more age sensitive, suggesting that both of them are more strategic and more affected by developmental differences. Pedagogically, these results denoted that learning by modeling and engagement in program activities have the special role for learning. Moreover, the findings indicated that the multiple-choice questions can produce the best performance for school-aged children but is less age-sensitive. By contrast, the essay as essay can produce the lowest performance but is more age-sensitive. It will be very helpful for educators to know that what types of learning styles and test methods are most effective for students in each school grade.

Keywords: experience-based learning, learning style, school-aged children, testing methods, verbal learning

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854 Investigating the Effect of Plant Root Exudates and of Saponin on Polycyclic Aromatic Hydrocarbons Solubilization in Brownfield Contaminated Soils

Authors: Marie Davin, Marie-Laure Fauconnier, Gilles Colinet

Abstract:

In Wallonia, there are 6,000 estimated brownfields (rising to over 3.5 million in Europe) that require remediation. Polycyclic Aromatic Hydrocarbons (PAHs) are a class of recalcitrant carcinogenic/mutagenic organic compounds of major concern as they accumulate in the environment and represent 17% of all encountered pollutants. As an alternative to environmentally aggressive, expensive and often disruptive soil remediation strategies, a lot of research has been directed to developing techniques targeting organic pollutants. The following experiment, based on the observation that PAHs soil content decreases in the presence of plants, aimed at improving our understanding of the underlying mechanisms involved in phytoremediation. It focusses on plant root exudates and whether they improve PAHs solubilization, which would make them more available for bioremediation by soil microorganisms. The effect of saponin, a natural surfactant found in some plant roots such as members of the Fabaceae family, on PAHs solubilization was also investigated as part of the implementation of the experimental protocol. The experiments were conducted on soil collected from a brownfield in Saint-Ghislain (Belgium) and presenting weathered PAHs contamination. Samples of soil were extracted with different solutions containing either plant root exudates or commercial saponin. Extracted PAHs were determined in the different aqueous solutions using High-Performance Liquid Chromatography and Fluorimetric Detection (HPLC-FLD). Both root exudates of alfalfa (Medicago sativa L.) or red clover (Trifolium pratense L.) and commercial saponin were tested in different concentrations. Distilled water was used as a control. First of all, results show that PAHs are more extracted using saponin solutions than distilled water and that the amounts generally rise with the saponin concentration. However, the amount of each extracted compound diminishes as its molecular weight rises. Also, it appears that passed a certain surfactant concentration, PAHs are less extracted. This suggests that saponin might be investigated as a washing agent in polluted soil remediation techniques, either for ex-situ or in-situ treatments, as an alternative to synthetic surfactants. On the other hand, preliminary results on experiments using plant root exudates also show differences in PAHs solubilization compared to the control solution. Further results will allow discussion as to whether or not there are differences according to the exudates provenance and concentrations.

Keywords: brownfield, Medicago sativa, phytoremediation, polycyclic aromatic hydrocarbons, root exudates, saponin, solubilization, Trifolium pratense

Procedia PDF Downloads 234