Search results for: lower-body negative pressure
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8326

Search results for: lower-body negative pressure

2236 A Case of Mantle Cell Lymphoma Presenting With GI Symptoms and Noted to Have Extranodal Involvement of the Stomach and Colon on Presentation

Authors: Saba Amreen Syeda, Summaiah Asim, Syeda, Hafsa, Essam Quraishi

Abstract:

Mantle Cell Lymphoma (MCL) is a relatively uncommon type of lymphoma that comprises approximately 7 percent of non hodgkin's lymphomas (NHL), Classic MCL presents mostly in lymph nodes and occasionally in extranodal sites. About 26 % of MCL is present primarily in the Gastrointestinal tract. While both the upper GI tract and the lower GI tract could be involved, it is rare to present with concurrent upper and lower GI involvement with MCL. We present the case of a 51-year-old Asian Indian male that presented to our clinic with complaints of chronic diarrhea for the last one year, progressively worsening over the past three months. The Patient also reported black stool as well as bright red blood per rectum. Patient reported severe fatigue on minimal exertion. On a physical exam, the patient was noted to have matted lymphadenopathy in the neck. Patient was noted to be anemic with a hemoglobin to be 8 g/dl. Esophagogastroduodenoscopy and colonoscopy was performed. EGD showed a large 4 cm ulcer in the gastric antrum with thick heaped up edges. There was bleeding on contact. Colonoscopy showed a large 35 mm multilobulated polyp in the ascending colon, which was biopsied. The patient was also noted to have nodular proctitis in the mid rectum. This was localized and extended to about 5 cm. This area was biopsied as well. Biopsies from the stomach, colon, as well as the rectum, returned with findings of mantle cell lymphoma on pathology. Lymphoid cells in the biopsy were stained strongly positive for CD 20, cyclin D1, and CD 5. There was the absence of stain for CD 3 and CD 10. The IHC stain for CD 23 was negative. Biopsies from neck LAD were obtained and were also positive for MCL. The patient was referred to oncology for staging and treatment.

Keywords: mantle cell lymphoma, GI bleed, diarrhea, gastric ulcer, colon polyp

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2235 Physico-Chemical Characteristics and Possibilities of Utilization of Elbasan Thermal Waters

Authors: Elvin Çomo, Edlira Tako, Albana Hasimi, Rrapo Ormeni, Olger Gjuzi, Mirela Ndrita

Abstract:

In Albania, only low enthalpy geothermal springs and wells are known, the temperatures of some of them are almost at the upper limits of low enthalpy, reaching over 60°C. These resources can be used to improve the country's energy balance, as well as for profitable economic purposes. The region of Elbasan has the greatest geothermal energy potential in Albania. This bass is one of the most popular and used in our country. This area is a surface with a number of sources, located in the form of a chain, in the sector between Llixha and Hidraj and constitutes a thermo-mineral basin with stable discharge and high temperature. The sources of Elbasan Springs, with the current average flow of thermo mineral water of 12-18 l/s and its temperature 55-65oC, have specific reserves of 39.6 GJ/m2 and potential power to install 2760 kW. For the assessment of physico-chemical parameters and heavy metals, water samples were taken at 5 monitoring stations throughout the year 2022. The levels of basic parameters were analyzed using ISO, EU and APHA 21-th edition standard methods. This study presents the current state of the physico-chemical parameters of this thermal basin, the evaluation of these parameters for curative activities and for industrial processes, as well as the integrated utilization of geothermal energy. Possibilities for using thermomineral waters for heating homes in the area around them or even further, depending on the flow from the source or geothermal well. Sensitization of Albanian investors, medical research and the community for the high economic and curative effectiveness, for the integral use of geothermal energy in this area and the development of the tourist sector. An analysis of the negative environmental impact from the use of thermal water is also provided.

Keywords: geothermal energy, Llixha, physic-chemical parameters, thermal water

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2234 Characterization of Electrical Transport across Ultra-Thin SrTiO₃ and BaTiO₃ Barriers in Tunnel Junctions

Authors: Henry Navarro, Martin Sirena, Nestor Haberkorn

Abstract:

We report the electrical transport through voltage-current curves (I-V) in tunnels junction GdBa₂Cu₃O₇-d/ insulator/ GdBa₂Cu₃O₇-d, and Nb/insulator/ GdBa₂Cu₃O₇-d is analyzed using a conducting atomic force microscope (CAFM) at room temperature. The measurements were obtained on tunnel junctions with different areas (900 μm², 400 μm² and 100 μm²). Trilayers with GdBa₂Cu₃O₇-d (GBCO) as the bottom electrode, SrTiO₃ (STO) or BaTiO₃ (BTO) as the insulator barrier (thicknesses between 1.6 nm and 4 nm), and GBCO or Nb as the top electrode were grown by DC sputtering on (100) SrTiO₃ substrates. For STO and BTO barriers, asymmetric IV curves at positive and negative polarization can be obtained using electrodes with different work function. The main difference is that the BTO is a ferroelectric material, while in the STO the ferroelectricity can be produced by stress or deformation at the interfaces. In addition, hysteretic IV curves are obtained for BTO barriers, which can be ascribed to a combined effect of the FE reversal switching polarization and an oxygen vacancy migration. For GBCO/ BTO/ GBCO heterostructures, the IV curves correspond to that expected for asymmetric interfaces, which indicates that the disorder affects differently the properties at the bottom and top interfaces. Our results show the role of the interface disorder on the electrical transport of conducting/ insulator/ conduction heterostructures, which is relevant for different applications, going from resistive switching memories (at room temperature) to Josephson junctions (at low temperatures). The superconducting transition of the GBCO electrode was characterized by electrical transport using the 4-prong configuration with low density of topological defects and with Tc over liquid N₂ can be obtained for thicknesses of 16 nm, our results demonstrate that GBCO films with an average root-mean-square (RMS) smaller than 1 nm and areas (up 100 um²) free of 3-D topological defects can be obtained.

Keywords: thin film, sputtering, conductive atomic force microscopy, tunnel junctions

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2233 Enhancing Nursing Teams' Learning: The Role of Team Accountability and Team Resources

Authors: Sarit Rashkovits, Anat Drach- Zahavy

Abstract:

The research considers the unresolved question regarding the link between nursing team accountability and team learning and the resulted team performance in nursing teams. Empirical findings reveal disappointing evidence regarding improvement in healthcare safety and quality. Therefore, there is a need in advancing managerial knowledge regarding the factors that enhance constant healthcare teams' proactive improvement efforts, meaning team learning. We first aim to identify the organizational resources that are needed for team learning in nursing teams; second, to test the moderating role of nursing teams' learning resources in the team accountability-team learning link; and third, to test the moderated mediation model suggesting that nursing teams' accountability affects team performance by enhancing team learning when relevant resources are available to the team. We point on the intervening role of three team learning resources, namely time availability, team autonomy and performance data on the relation between team accountability and team learning and test the proposed moderated mediation model on 44 nursing teams (462 nurses and 44 nursing managers). The results showed that, as was expected, there was a positive significant link between team accountability and team learning and the subsequent team performance when time availability and team autonomy were high rather than low. Nevertheless, the positive team accountability- team learning link was significant when team performance feedback was low rather than high. Accordingly, there was a positive mediated effect of team accountability on team performance via team learning when either time availability or team autonomy were high and the availability of team performance data was low. Nevertheless, this mediated effect was negative when time availability and team autonomy were low and the availability of team performance data was high. We conclude that nurturing team accountability is not enough for achieving nursing teams' learning and the subsequent improved team performance. Rather there is need to provide nursing teams with adequate time, autonomy, and be cautious with performance feedback, as the latter may motivate nursing teams to repeat routine work strategies rather than explore improved ones.

Keywords: nursing teams' accountability, nursing teams' learning, performance feedback, teams' autonomy

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2232 Misconception on Multilingualism in Glorious Quran

Authors: Muhammed Unais

Abstract:

The holy Quran is a pure Arabic book completely ensured the absence of non Arabic term. If it was revealed in a multilingual way including various foreign languages besides the Arabic, it can be easily misunderstood that the Arabs became helpless to compile such a work positively responding to the challenge of Allah due to their lack of knowledge in other languages in which the Quran is compiled. As based on the presence of some non Arabic terms in Quran like Istabrq, Saradiq, Rabbaniyyoon, etc. some oriental scholars argued that the holy Quran is not a book revealed in Arabic. We can see some Muslim scholars who either support or deny the presence of foreign terms in Quran but all of them agree that the roots of these words suspected as non Arabic are from foreign languages and are assimilated to the Arabic and using as same in that foreign language. After this linguistic assimilation was occurred and the assimilated non Arabic words became familiar among the Arabs, the Quran revealed as using these words in such a way stating that all words it contains are Arabic either pure or assimilated. Hence the two of opinions around the authenticity and reliability of etymology of these words are right. Those who argue the presence of foreign words he is right by the way of the roots of that words are from foreign and those who argue its absence he is right for that are assimilated and changed as the pure Arabic. The possibility of multilingualism in a monolingual book is logically negative but its significance is being changed according to time and place. The problem of multilingualism in Quran is the misconception raised by some oriental scholars that the Arabs became helpless to compile a book equal to Quran not because of their weakness in Arabic but because the Quran is revealed in languages they are ignorant on them. Really, the Quran was revealed in pure Arabic, the most literate language of the Arabs, and the whole words and its meaning were familiar among them. If one become positively aware of the linguistic and cultural assimilation ever found in whole civilizations and cultural sets he will have not any question in this respect. In this paper the researcher intends to shed light on the possibility of multilingualism in a monolingual book and debates among scholars in this issue, foreign terms in Quran and the logical justifications along with the exclusive features of Quran.

Keywords: Quran, foreign Terms, multilingualism, language

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2231 Identity Formation of Mixed-Race Children in Japan

Authors: Shuko Takeshita

Abstract:

This study investigates the identity formation of mixed-race children in Japan. From the latter half of the 1980s to the mid-2000s, Japan experienced an 'intermarriage boom,' which was soon followed by a fairly significant number of children born to these unions. These children are now coming of age. Among mixed-race children, some embraced both cultural traditions, while others chose a monocultural path despite exposure to two cultural traditions as they grew up. What factors are involved in shaping the identity of mixed-race children? How does identity formation actually occur in these children? This study addresses these questions through an interview survey of 139 cross-cultural families since 1999, including 23 Pakistani-Japanese families, 20 Turkish-Japanese families, 26 families comprising other international Muslim husbands and Japanese wives, 33 Filipino-Japanese families, and 37 Brazilian-Japanese families. The results of this two-decade-long study reveal that in cases where one cannot tell at first glance that children are mixed race, there is a tendency for them to hide their mixed background due to fear of bullying at school, as well as for their parents to encourage them to do this. To pass as a Japanese is one strategy for avoiding discrimination and prejudice, and it can provide a measure of ethnic security or a way of coping with social intolerance. Certainly, among my informants, there are some children who were bullied or teased at school, and as a result, they stopped attending or transferred to other schools. But the mixed-race experience is not always a negative thing in Japan. There is clearly a double standard involved in that mixed-race children of a Caucasian parent are more readily accepted by society than those of a non-Caucasian parent. The perceived social status of mixed-race individuals is usually understood in relation to the hierarchical positionings of monoracial groups. Mixed-race children could be guaranteed the right to enjoy the benefit of maintaining and developing an identity as a Japanese, in addition to one more identity. We need to encourage a new awareness of the children as agents for a transition from a monocultural system to a multicultural system in Japanese society.

Keywords: identity formation, intermarriage, mixed race, multicultural children

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2230 Management Challenges and Product Quality of Fish Farms in Greece

Authors: S. Anastasiou, C. Nathanailides, S. Logothetis, G. Kanlis

Abstract:

The Greek aquaculture industry is second most important economic sector for the growth of the Greek Economy. The purpose of the present work is to present some data for the management challenges that the Aquaculture industry in Greece is currently facing. Currently the Greek aquaculture industry is going through a series of mergers and restructure. The financial status of the different aquaculture companies, the working conditions and management practices may vary according to lending exposure, market mix, company size, and technological parameters of the different fish farm units and rearing systems. Frequently, the aquaculture personnel are exposed to harsh environmental conditions and to occupational risk. Furthermore, there is pressure on the personnel of fish farms to constantly improve their production efficiency and to enhance their work skills to the new methods and practices which are adopted by the aquaculture industry. There is some data to suggest the existence of gender inequality in the workforce of Greek fish farms. Women are paid less, frequently absent higher managerial positions and most of the male workmates consider the job to harsh for women. Nevertheless, high level of job satisfaction was observed in both men and women. This high level of job satisfaction of the aquaculture personnel can be attributed, at least partially, to the nature of the work which has a very distinct working environment but most of the staff has very positive experiences with the interaction with their workmates and the satisfaction of being in a business which always exceeds its production target. Indeed, there is some evidence to suggest that the Greek aquaculture industry is always exceeding its production targets, while it is rapidly adopting and improving new technology, constantly improving of human resources management practices, which include constant training of the staff, very good communication channels between management and the personnel and reducing the risk of occupational hazard to the aquaculture personnel. All these parameters of management may have a determining role for the volume and quality of the production and future of this sector in Greece.

Keywords: aquaculture, fish quality, management, production targets

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2229 Adolescent Obesity Leading to Adulthood Cardiovascular Diseases among Punjabi Population

Authors: Manpreet Kaur, Badaruddoza, Sandeep Kaur Brar

Abstract:

The increasing prevalence of adolescent obesity is one of the major causes to be hypertensive in adulthood. Various statistical methods have been applied to examine the performance of anthropometric indices for the identification of adverse cardiovascular risk profile. The present work was undertaken to determine the significant traditional risk factors through principal component factor analysis (PCFA) among population based Punjabi adolescents aged 10-18 years. Data was collected among adolescent children from different schools situated in urban areas of Punjab, India. Principal component factor analysis (PCFA) was applied to extract orthogonal components from anthropometric and physiometric variables. Association between components were explained by factor loadings. The PCFA extracted four factors, which explained 84.21%, 84.06% and 83.15% of the total variance of the 14 original quantitative traits among boys, girls and combined subjects respectively. Factor 1 has high loading of the traits that reflect adiposity such as waist circumference, BMI and skinfolds among both sexes. However, waist circumference and body mass index are the indicator of abdominal obesity which increases the risk of cardiovascular diseases. The loadings of these two traits have found maximum in girls adolescents (WC=0.924; BMI=0.905). Therefore, factor 1 is the strong indicator of atherosclerosis in adolescents. Factor 2 is predominantly loaded with blood pressures and related traits (SBP, DBP, MBP and pulse rate) which reflect the risk of essential hypertension in adolescent girls and combined subjects, whereas, factor 2 loaded with obesity related traits in boys (weight and hip circumferences). Comparably, factor 3 is loaded with blood pressures in boys and with height and WHR in girls, while factor 4 contains high loading of pulse pressure among boys, girls and combined group of adolescents.

Keywords: adolescent obesity, cvd, hypertension, punjabi population

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2228 Numerical Investigation of Dynamic Stall over a Wind Turbine Pitching Airfoil by Using OpenFOAM

Authors: Mahbod Seyednia, Shidvash Vakilipour, Mehran Masdari

Abstract:

Computations for two-dimensional flow past a stationary and harmonically pitching wind turbine airfoil at a moderate value of Reynolds number (400000) are carried out by progressively increasing the angle of attack for stationary airfoil and at fixed pitching frequencies for rotary one. The incompressible Navier-Stokes equations in conjunction with Unsteady Reynolds Average Navier-Stokes (URANS) equations for turbulence modeling are solved by OpenFOAM package to investigate the aerodynamic phenomena occurred at stationary and pitching conditions on a NACA 6-series wind turbine airfoil. The aim of this study is to enhance the accuracy of numerical simulation in predicting the aerodynamic behavior of an oscillating airfoil in OpenFOAM. Hence, for turbulence modelling, k-ω-SST with low-Reynolds correction is employed to capture the unsteady phenomena occurred in stationary and oscillating motion of the airfoil. Using aerodynamic and pressure coefficients along with flow patterns, the unsteady aerodynamics at pre-, near-, and post-static stall regions are analyzed in harmonically pitching airfoil, and the results are validated with the corresponding experimental data possessed by the authors. The results indicate that implementing the mentioned turbulence model leads to accurate prediction of the angle of static stall for stationary airfoil and flow separation, dynamic stall phenomenon, and reattachment of the flow on the surface of airfoil for pitching one. Due to the geometry of the studied 6-series airfoil, the vortex on the upper surface of the airfoil during upstrokes is formed at the trailing edge. Therefore, the pattern flow obtained by our numerical simulations represents the formation and change of the trailing-edge vortex at near- and post-stall regions where this process determines the dynamic stall phenomenon.

Keywords: CFD, moderate Reynolds number, OpenFOAM, pitching oscillation, unsteady aerodynamics, wind turbine

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2227 Hybrid Energy System for the German Mining Industry: An Optimized Model

Authors: Kateryna Zharan, Jan C. Bongaerts

Abstract:

In recent years, economic attractiveness of renewable energy (RE) for the mining industry, especially for off-grid mines, and a negative environmental impact of fossil energy are stimulating to use RE for mining needs. Being that remote area mines have higher energy expenses than mines connected to a grid, integration of RE may give a mine economic benefits. Regarding the literature review, there is a lack of business models for adopting of RE at mine. The main aim of this paper is to develop an optimized model of RE integration into the German mining industry (GMI). Hereby, the GMI with amount of around 800 mill. t. annually extracted resources is included in the list of the 15 major mining country in the world. Accordingly, the mining potential of Germany is evaluated in this paper as a perspective market for RE implementation. The GMI has been classified in order to find out the location of resources, quantity and types of the mines, amount of extracted resources, and access of the mines to the energy resources. Additionally, weather conditions have been analyzed in order to figure out where wind and solar generation technologies can be integrated into a mine with the highest efficiency. Despite the fact that the electricity demand of the GMI is almost completely covered by a grid connection, the hybrid energy system (HES) based on a mix of RE and fossil energy is developed due to show environmental and economic benefits. The HES for the GMI consolidates a combination of wind turbine, solar PV, battery and diesel generation. The model has been calculated using the HOMER software. Furthermore, the demonstrated HES contains a forecasting model that predicts solar and wind generation in advance. The main result from the HES such as CO2 emission reduction is estimated in order to make the mining processing more environmental friendly.

Keywords: diesel generation, German mining industry, hybrid energy system, hybrid optimization model for electric renewables, optimized model, renewable energy

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2226 Hedonic Price Analysis of Consumer Preference for Musa spp in Northern Nigeria

Authors: Yakubu Suleiman, S. A. Musa

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The research was conducted to determine the physical characteristics of banana fruits that influenced consumer preferences for the fruit in Northern Nigeria. Socio-economic characteristics of the respondents were also identified. Simple descriptive statistics and Hedonic prices model were used to analyze the data collected for socio-economic and consumer preference respectively with the aid of 1000 structured questionnaires. The result revealed the value of R2 to be 0.633, meaning that, 63.3% of the variation in the banana price was brought about by the explanatory variables included in the model and the variables are: colour, size, degree of ripeness, softness, surface blemish, cleanliness of the fruits, weight, length, and cluster size of fruits. However, the remaining 36.7% could be attributed to the error term or random disturbance in the model. It could also be seen from the calculated result that the intercept was 1886.5 and was statistically significant (P < 0.01), meaning that about N1886.5 worth of banana fruits could be bought by consumers without considering the variables of banana included in the model. Moreover, consumers showed that they have significant preference for colours, size, degree of ripeness, softness, weight, length and cluster size of banana fruits and they were tested to be significant at either P < 0.01, P < 0.05, and P < 0.1 . Moreover, the result also shows that consumers did not show significance preferences to surface blemish, cleanliness and variety of the banana fruit as all of them showed non-significance level with negative signs. Based on the findings of the research, it is hereby recommended that plant breeders and research institutes should concentrate on the production of banana fruits that have those physical characteristics that were found to be statistically significance like cluster size, degree of ripeness,’ softness, length, size, and skin colour.

Keywords: analysis, consumers, preference, variables

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2225 Sublethal Effects of Thiamethoxam-Lambda Cyhalothrin on the Life Table Parameters and Population Projection of Trialeurodes vaporariorum (Hemiptera: Aleyrodidae) and Its Parasitoid, Encarsia formosa (Hymenoptera: Aphelinidae)

Authors: Sevda Ddras, Fariba Mehrkhou, Remzi Atlihan, Maryam Fourouzan

Abstract:

The greenhouse whitefly, Trialeurodes vaporariorum Westwood (Hemiptera: Aleyrodidae), is one of the most important pest on vegetables and ornamental host plants. In this research, the sub-lethal concentration (LC30) of thiamethoxam-lambda cyhalothrin (TLC) on the biological properties, life table parameters and population projection of T. vaporarium and its parasitoid, Encarsia formosa Gahan, were studied at controlled condition (25 ±5 ℃, R.H. 60 ±10 % and a photoperiod of 16:8 h (L:D). Bioassays were conducted by dipping tomato leaves containing third instar nymphs of the whitefly T. vaporariorum, in the obtained LC30 concentration of eforia. The life table data were analyzed using the computer program TWOSEX–MSChart based on the age-stage, two-sex life table theory. The results showed that, usage of sublethal concentration of TLC effected the biological properties and population growth parameters of greenhouse whitefly by shortening the developmentl time, adult longevity, decreasing the fecundity and population growth paramters. Also, the LC30 concentration of TLC had negative effects on life history and life table parameters of E.formosa. The obtained results illustrated that the sublethal concentration of TLC resulted in prolonging of developmental time, decreasing of adult longevity, survival rate and population growth parameters of E.formosa. Additionally, the population projection results were accordance with the population growth rate of either greenhouse whitefly or E.formosa. We conclude that, TLC should not be used in integrated pest management programs where E. formosa exists.

Keywords: greenhouse whitefly, Encarsia formosa, thiamethoxam-lambda cyhalothrin, population projection, life table parameters

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2224 Preference Heterogeneity as a Positive Rather Than Negative Factor towards Acceptable Monitoring Schemes: Co-Management of Artisanal Fishing Communities in Vietnam

Authors: Chi Nguyen Thi Quynh, Steven Schilizzi, Atakelty Hailu, Sayed Iftekhar

Abstract:

Territorial Use Rights for Fisheries (TURFs) have been emerged as a promising tool for fisheries conservation and management. However, illegal fishing has undermined the effectiveness of TURFs, profoundly degrading global fish stocks and marine ecosystems. Conservation and management of fisheries, therefore, largely depends on effectiveness of enforcing fishing regulations, which needs co-enforcement by fishers. However, fishers tend to resist monitoring participation, as their views towards monitoring scheme design has not been received adequate attention. Fishers’ acceptability of a monitoring scheme is likely to be achieved if there is a mechanism allowing fishers to engage in the early planning and design stages. This study carried out a choice experiment with 396 fishers in Vietnam to elicit fishers’ preferences for monitoring scheme and to estimate the relative importance that fishers place on the key design elements. Preference heterogeneity was investigated using a Scale-Adjusted Latent Class Model that accounts for both preference and scale variance. Welfare changes associated with the proposed monitoring schemes were also examined. It is found that there are five distinct preference classes, suggesting that there is no one-size-fits-all scheme well-suited to all fishers. Although fishers prefer to be compensated more for their participation, compensation is not a driving element affecting fishers’ choice. Most fishers place higher value on other elements, such as institutional arrangements and monitoring capacity. Fishers’ preferences are driven by their socio-demographic and psychological characteristics. Understanding of how changes in design elements’ levels affect the participation of fishers could provide policy makers with insights useful for monitoring scheme designs tailored to the needs of different fisher classes.

Keywords: Design of monitoring scheme, Enforcement, Heterogeneity, Illegal Fishing, Territorial Use Rights for Fisheries

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2223 Reduced Lung Volume: A Possible Cause of Stuttering

Authors: Shantanu Arya, Sachin Sakhuja, Gunjan Mehta, Sanjay Munjal

Abstract:

Stuttering may be defined as a speech disorder affecting the fluency domain of speech and characterized by covert features like word substitution, omittance and circumlocution and overt features like prolongation of sound, syllables and blocks etc. Many etiologies have been postulated to explain stuttering based on various experiments and research. Moreover, Breathlessness has also been reported by many individuals with stuttering for which breathing exercises are generally advised. However, no studies reporting objective evaluation of the pulmonary capacity and further objective assessment of the efficacy of breathing exercises have been conducted. Pulmonary Function Test which evaluates parameters like Forced Vital Capacity, Peak Expiratory Flow Rate, Forced expiratory flow Rate can be used to study the pulmonary behavior of individuals with stuttering. The study aimed: a) To identify speech motor & physiologic behaviours associated with stuttering by administering PFT. b) To recognize possible reasons for an association between speech motor behaviour & stuttering severity. In this regard, PFT tests were administered on individuals who reported signs and symptoms of stuttering and showed abnormal scores on Stuttering Severity Index. Parameters like Forced Vital Capacity, Forced Expiratory Volume, Peak Expiratory Flow Rate (L/min), Forced Expiratory Flow Rate (L/min) were evaluated and correlated with scores of Stuttering Severity Index. Results showed significant decrease in the parameters (lower than normal scores) in individuals with established stuttering. Strong correlation was also found between degree of stuttering and the degree of decrease in the pulmonary volumes. Thus, it is evident that fluent speech requires strong support of lung pressure and requisite volumes. Further research in demonstrating the efficacy of abdominal breathing exercises in this regard is needed.

Keywords: forced expiratory flow rate, forced expiratory volume, forced vital capacity, peak expiratory flow rate, stuttering

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2222 The Impact of Geophagia on the Iron Status of Black South African Women

Authors: A van Onselen, C. M. Walsh, F. J. Veldman, C. Brand

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Objectives: To determine the nutritional status and risk factors associated with women practicing geophagia in QwaQwa, South Africa. Materials and Methods: An observational epidemiological study design was adopted which included an exposed (geophagia) and non-exposed (control) group. A food frequency questionnaire, anthropometric measurements and blood sampling were applied to determine nutritional status of participants. Logistic regression analysis was performed in order to identify factors that were likely to be associated with the practice of geophagia. Results: The mean total energy intake for the geophagia group (G) and control group(C) were 10324.31 ± 2755.00 kJ and 10763.94 ± 2556.30 kJ respectively. Both groups fell within the overweight category according to the mean body mass index (BMI) of each group (G= 25.59 kg/m2; C= 25.14 kg/m2). The mean serum iron levels of the geophagia group (6.929 μmol/l) were significantly lower than that of the control group (13.75 μmol/l) (p = 0.000). Serum transferrin (G=3.23g/l; C=2.7054g/l) and serum transferrin saturation (G=8.05%; C=18.74%) levels also differed significantly between groups (p=0.00). Factors that were associated with the practice of geophagia included haemoglobin (Odds ratio (OR):14.50), serum-iron (OR: 9.80), serum-ferritin (OR: 3.75), serum-transferrin (OR: 6.92) and transferrin saturation (OR: 14.50). A significant negative association (p=0.014) was found between women who were wage-earners and those who were not wage-earners and the practice of geophagia (OR: 0.143; CI: 0.027; 0.755). These findings seem to indicate that a permanent income may decrease the likelihood of practising geophagia. Key findings: Geophagia was confirmed to be a risk factor for iron deficiency in this community. The significantly strong association between geophagia and iron deficiency emphasizes the importance of identifying the practice of geophagia in women, especially during their child bearing years. Further research to establish whether the practice of geophagia is a cause of iron-deficiency, or whether it is the consequence thereof, would give a clearer view on how to recognise and treat the condition.

Keywords: geophagia, iron deficiency anaemia, dietary intake, anthropometry

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2221 Design and Fabrication of Stiffness Reduced Metallic Locking Compression Plates through Topology Optimization and Additive Manufacturing

Authors: Abdulsalam A. Al-Tamimi, Chris Peach, Paulo Rui Fernandes, Paulo J. Bartolo

Abstract:

Bone fixation implants currently used to treat traumatic fractured bones and to promote fracture healing are built with biocompatible metallic materials such as stainless steel, cobalt chromium and titanium and its alloys (e.g., CoCrMo and Ti6Al4V). The noticeable stiffness mismatch between current metallic implants and host bone associates with negative outcomes such as stress shielding which causes bone loss and implant loosening leading to deficient fracture treatment. This paper, part of a major research program to design the next generation of bone fixation implants, describes the combined use of three-dimensional (3D) topology optimization (TO) and additive manufacturing powder bed technology (Electron Beam Melting) to redesign and fabricate the plates based on the current standard one (i.e., locking compression plate). Topology optimization is applied with an objective function to maximize the stiffness and constraint by volume reductions (i.e., 25-75%) in order to obtain optimized implant designs with reduced stress shielding phenomenon, under different boundary conditions (i.e., tension, bending, torsion and combined loads). The stiffness of the original and optimised plates are assessed through a finite-element study. The TO results showed actual reduction in the stiffness for most of the plates due to the critical values of volume reduction. Additionally, the optimized plates fabricated using powder bed techniques proved that the integration between the TO and additive manufacturing presents the capability of producing stiff reduced plates with acceptable tolerances.

Keywords: additive manufacturing, locking compression plate, finite element, topology optimization

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2220 Psychological Well Being of Female Prisoners

Authors: Sujata Gupta Kedar, J. N. Tulika

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Early researchers suggested that imprisonment had negative psychological and physical effects on its inmates, leading to psychological deterioration. The term “prisons” in the Consensus Statement of WHO is intended to denote, as those institutions which hold people who have been sentenced to a period of imprisonment by the courts for offences against the law. Thus “prisons” if local circumstances justify it, may also be taken to include secure institutions holding on a compulsory basis on any of the following categories of people: remand prisoners; civil prisoners; juvenile detainees; immigration detainees; some categories of mentally disordered patients; asylum seekers; refugees; people detained pending expulsion, deportation, exile, exclusion or any other form of compulsory transfer to other countries or areas of the country; people detained in police cells; and any other compulsorily detained group. Prisons are aimed to cure the criminal and their behavior but their records are not encouraging. Instead the imprisonment affects all prisoners in different way. From withstanding the shock of entry to the new culture, which is very different from their own, prisoners must try to determine how to spend the time in prison, since the hours appears to be endless in prisons. There is also the fear of deterioration. This article aims to provide an overview of the psychological well being of female prisoners in the prison environment in five areas- satisfaction, efficiency, sociability, mental health and interpersonal relations. Research was done on two different types of imprisonment- under trial prisoner and convict. Total sample included 22 female prisoners of Nagaon Special Jail of Assam. The instrument used for the study was based on Psychological Well Being Scale. Statistical analysis was done with t-test and one way anova test. The result demonstrated that there is no significant difference in the psychological wellbeing of female prisoners in the prison and that there is no significant difference in the psychological well being of different types of female prisoners involved in different crimes but there is significant difference in the mental health of the female prisoners in prison.

Keywords: psychological effect, female prisoners, prison, well being of prisoners

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2219 Reallocation of Bed Capacity in a Hospital Combining Discrete Event Simulation and Integer Linear Programming

Authors: Muhammed Ordu, Eren Demir, Chris Tofallis

Abstract:

The number of inpatient admissions in the UK has been significantly increasing over the past decade. These increases cause bed occupancy rates to exceed the target level (85%) set by the Department of Health in England. Therefore, hospital service managers are struggling to better manage key resource such as beds. On the other hand, this severe demand pressure might lead to confusion in wards. For example, patients can be admitted to the ward of another inpatient specialty due to lack of resources (i.e., bed). This study aims to develop a simulation-optimization model to reallocate the available number of beds in a mid-sized hospital in the UK. A hospital simulation model was developed to capture the stochastic behaviours of the hospital by taking into account the accident and emergency department, all outpatient and inpatient services, and the interactions between each other. A couple of outputs of the simulation model (e.g., average length of stay and revenue) were generated as inputs to be used in the optimization model. An integer linear programming was developed under a number of constraints (financial, demand, target level of bed occupancy rate and staffing level) with the aims of maximizing number of admitted patients. In addition, a sensitivity analysis was carried out by taking into account unexpected increases on inpatient demand over the next 12 months. As a result, the major findings of the approach proposed in this study optimally reallocate the available number of beds for each inpatient speciality and reveal that 74 beds are idle. In addition, the findings of the study indicate that the hospital wards will be able to cope with 14% demand increase at most in the projected year. In conclusion, this paper sheds a new light on how best to reallocate beds in order to cope with current and future demand for healthcare services.

Keywords: bed occupancy rate, bed reallocation, discrete event simulation, inpatient admissions, integer linear programming, projected usage

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2218 Analysis of Extreme Case of Urban Heat Island Effect and Correlation with Global Warming

Authors: Kartikey Gupta

Abstract:

Global warming and environmental degradation are at their peak today, with the years after 2000A.D. giving way to 15 hottest years in terms of average temperatures. In India, much of the standard temperature measuring equipment are located in ‘developed’ urban areas, hence showing us an incomplete picture in terms of the climate across many rural areas, which comprises most of the landmass. This study showcases data studied by the author since 3 years at Vatsalya’s Children’s village, in outskirts of Jaipur, Rajasthan, India; in the midst of semi-arid topography, where consistently huge temperature differences of up to 15.8 degrees Celsius from local Jaipur weather only 30 kilometers away, are stunning yet scary at the same time, encouraging analysis of where the natural climatic pattern is heading due to rapid unrestricted urbanization. Record-breaking data presented in this project enforces the need to discuss causes and recovery techniques. This research further explores how and to what extent we are causing phenomenal disturbances in the natural meteorological pattern by urban growth. Detailed data observations using a standardized ambient weather station at study site and comparing it with closest airport weather data, evaluating the patterns and differences, show striking differences in temperatures, wind patterns and even rainfall quantity, especially during high-pressure zone days. Winter-time lows dip to 8 degrees below freezing with heavy frost and ice, while only 30 kms away minimum figures barely touch single-digit temperatures. Human activity is having an unprecedented effect on climatic patterns in record-breaking trends, which is a warning of what may follow in the next 15-25 years for the next generation living in cities, and a serious exploration into possible solutions is a must.

Keywords: climate change, meteorology, urban heat island, urbanization

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2217 Microthermometry of Carbonated Rocks of the Hondita-Lomagorda Formations, the Tiger Cave Sector, Municipality of Yaguara, Colombia

Authors: Camila Lozano-Vivas, Camila Quevedo-Villamil, Ingrid Munoz-Quijano, Diego Loaiza

Abstract:

Colombia's limited oil reserves make the finding of new fields of extraction or the potentiate of the existing ones a more important task to do every day; the exploration projects that allow to have a better knowledge of the oil basins are essential. The upper Magdalena Valley basin - VSM, whose reserves are limited, has been one of the first basins for the exploration and production of hydrocarbons in Colombia. The Hondita and Lomagorda formations were deposited in the Late Cretaceous Middle Albian to the Coniacian and are characterized by being the hydrocarbon-generating rocks in the VSM basin oil system along with the Shale de Bambucá; therefore multiple studies have been made. In the oil industry, geochemical properties are used to understand the origin, migration, accumulation, and alteration of hydrocarbons and, in general, the evolution of the basin containing them. One of the most important parameters to understand this evolution is the formation temperature of the oil system. For this reason, a microthermometric study of fluid inclusions was carried out to recognize formation temperatures and to determine certain basic physicochemical variables, homogenization temperature, pressure, density and salinity of the fluid at the time of entrapment, providing evidence on the history of different events in different geological environments in the evolution of a sedimentary basin. Prior to this study, macroscopic and microscopic petrographic analyses of the samples collected in the field were performed. The results of the mentioned properties of the fluid inclusions in the different samples analyzed have salinities ranging from 20.22% to 26.37% eq. by weight NaCl, similar densities found in the ranges of 1.05 to 1.16 g/cc and an average homogenization temperature at 142.92°C, indicating that, at the time of their entanglement, the rock was in the window of generation of medium hydrocarbons –light with fragile characteristics of the rock that would make it useful to treat them as naturally fractured reservoirs.

Keywords: homogenization temperature, fluid inclusions, microthermometry, salinity

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2216 Determining Cellular Biomarkers Sensitive to Low Damaging Exposure

Authors: Svetlana Guryeva, Inna Kornienko, Elena Petersen

Abstract:

At present, translational medicine is a rapidly developing branch of biomedicine. The main idea of translational medicine is a practical application of fundamental research. One of the possible applications for translational medicine is researching therapies that improve human age-related organism condition. To fill the gap between experiments and clinical practice, it is necessary to create the standardized system for the investigation of different effects on cellular aging models. In this study, primary human fibroblasts derived from patients of different ages were used as a cellular aging model. The senescence-associated β-galactosidase activity, lipofuscin, γ-H2AX, the reactive oxygen species level, and cell death markers (annexin V/propidium iodide) were used as biomarkers of the cell functional state. The effects of damaging exposures (oxidative stress and heat shock), potential positive factors (metformin and acetaminophen), and their combinations were investigated using the described biomarkers. Oxidative stress and heat shock caused the increase in the levels of all biomarkers, and only the cells from young patients partly coped with stress 3 days after the exposures. Metformin improved the state of pretreatment cells from young and old patients. The acetaminophen did not show significant changes in the biomarker levels compare to the action of metformin. This study proved the opportunity to develop a standardized screening system based on biomarkers of the cell functional state to identify potential positive or negative effects of some physical and chemical exposures. Moreover, such a system can be useful for the aims of regenerative medicine to determine the effect of cell pretreatment before transplantation.

Keywords: biomarkers, primary fibroblasts, regenerative medicine, senescence, test system, translational medicine

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2215 Mitigation of Profitable Problems: Level of Hotel Quality Management Program and Environmental Management Practices Towards Performance

Authors: Siti Anis Nadia Abu Bakar, Vani Tanggamani

Abstract:

Over recent years, the quality and environmental management practices are the necessary tasks in hospitality industry in order to provide high quality services, a comfortable and safe environment for occupants as well as innovative nature and shareholders' satisfaction, its environmental and social added value sustainable. Numerous studies have observed and measured quality management program (QMProg) and environmental management practices (EMPrac) independently. This paper analyzed the level of QMProg, and EMPrac in hospitality industry, particularly on hotel performance, specifically in the context of Malaysia as hotel industry in Malaysia has contributed tremendously to the development in the Malaysia tourism industry.The research objectives are; (1) to analyze how the level of QMProg influences on firm performance; (2) to investigate the level of EMPrac and its influence on firm performance. This paper contributes to the literature by providing added-value to the service industry strategic decision-making processes by helping to predict the varying impacts of positive and negative corporate social responsibility (CSR) activities on financial performance in their respective industries. Further, this paper also contributes to develop more applicable CSR strategies. As a matter of fact, the findings of this paper has contributed towards an integrated management system that will assist a firm in implementation of their environmental strategy by creating a higher level of accountability for environmental performance. The best results in environmental systems have instigated managers to explore more options when dealing with problems, especially problems involving the reputation of their hotel. In conclusion, the results of the study infer that the best CSR strategies of the quality and environmental management practices influences hotel performance.

Keywords: corporate social responsibility (CSR), environmental management practices (EMPrac), performance (PERF), quality management program (QMProg)

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2214 The Battle between French and English in the Algerian University: Ideological and Pedagogical Stakes

Authors: Taoufik Djennane

Abstract:

Algeria is characterized by a fragmented language education policy. While pre-university education is entirely conducted in Arabic, higher education remains linguistically divided, with some fields offered in Arabic and others exclusively based on French. Within this linguistic policy, English remains far behind French. However, there has been a significant shift in the state’s linguistic orientation since the social riot of March 2019, known as El-Hirak, which ousted away the ex-president. Since then, social calls were voiced to get rid of French, and English started to receive an unprecedented political push. The historical decision only came at the beginning of the academic year 2023-2024 when the ministry of higher education imposed English as medium of instruction (hereafter EMI), especially in scientific and technological fields. As such, this paper considered this abrupt switch in the medium of instruction and its effects on the community of teachers. Building on a socio-psychological approach, teachers’ attitudes towards EMI were measured. Data were collected using classroom observation, semi-structured interviews and a survey. The results showed that a clear majority of teachers hold negative attitudes towards EMI. The point is that they are linguistically incompetent, and they are not ready yet to deliver content subjects in a language they have no, or little, command of. The study showed the importance of considering attitudes in the ‘policy-formation’ stage before the ‘implementation’ stage. The findings also proved that teachers are not passive bystanders; they can rather be the final arbiters imposing themselves as policy-makers resisting ministerial instructions through their linguistic practices inside the classroom which only acknowledge French. The study showed the necessity to avoid sudden switch and opt for gradual change, without putting aside those who are directly concerned with political/pedagogical measures (teachers, learners, etc).

Keywords: micro planning, EMI, language education policy, agency

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2213 Developing a Research Culture in the Faculty of Engineering and Information Technology at the Central University of Technology, Free State: Implications for Knowledge Management

Authors: Mpho Agnes Mbeo, Patient Rambe

Abstract:

The thirteenth year of the Central University of Technology, Free State’s (CUT) transition from a vocational and professional training orientation institution (i.e. a technikon) into a university with a strong research focus has neither been a smooth nor an easy one. At the heart of this transition was the need to transform the psychological faculties of academic and research staffs compliment who were accustomed to training graduates for industrial placement. The lack of a culture of research that fully embraces a strong ethos of conducting world-class research needed to be addressed. The induction and socialisation of academic staff into the development and execution of cutting-edge research also required the provision of research support and the creation of a conducive academic environment for research, both for emerging and non-research active academics. Drawing on ten cases, comprising four heads of departments, three prolific established researchers, and three emerging researchers, this study explores the challenges faced in establishing a strong research culture at the university. Furthermore, it gives an account of the extent to which the current research interventions have addressed the perceivably “missing research culture”, and the implications of these interventions for knowledge management. Evidence suggests that the endowment of an ideal institutional research environment (comprising strong internet networks, persistent connectivity on and off campus), research peer mentorship, and growing publication outputs should be matched by a coherent research incentive culture and strong research leadership. This is critical to building new knowledge and entrenching knowledge management founded on communities of practice and scholarly networking through the documentation and communication of research findings. The study concludes that the multiple policy documents set for the different domains of research may be creating pressure on researchers to engage research activities and increase output at the expense of research quality.

Keywords: Central University of Technology, performance, publication, research culture, university

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2212 Effect of Modification and Expansion on Emergence of Cooperation in Demographic Multi-Level Donor-Recipient Game

Authors: Tsuneyuki Namekata, Yoko Namekata

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It is known that the mean investment evolves from a very low initial value to some high level in the Continuous Prisoner's Dilemma. We examine how the cooperation level evolves from a low initial level to a high level in our Demographic Multi-level Donor-Recipient situation. In the Multi-level Donor-Recipient game, one player is selected as a Donor and the other as a Recipient randomly. The Donor has multiple cooperative moves and one defective move. A cooperative move means the Donor pays some cost for the Recipient to receive some benefit. The more cooperative move the Donor takes, the higher cost the Donor pays and the higher benefit the Recipient receives. The defective move has no effect on them. Two consecutive Multi-level Donor-Recipient games, one as a Donor and the other as a Recipient, can be viewed as a discrete version of the Continuous Prisoner's Dilemma. In the Demographic Multi-level Donor-Recipient game, players are initially distributed spatially. In each period, players play multiple Multi-level Donor-Recipient games against other players. He leaves offspring if possible and dies because of negative accumulated payoff of him or his lifespan. Cooperative moves are necessary for the survival of the whole population. There is only a low level of cooperative move besides the defective move initially available in strategies of players. A player may modify and expand his strategy by his recent experiences or practices. We distinguish several types of a player about modification and expansion. We show, by Agent-Based Simulation, that introducing only the modification increases the emergence rate of cooperation and introducing both the modification and the expansion further increases it and a high level of cooperation does emerge in our Demographic Multi-level Donor-Recipient Game.

Keywords: agent-based simulation, donor-recipient game, emergence of cooperation, spatial structure, TFT, TF2T

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2211 A Study on the Impact of Covid-19 on Primary Healthcare Workers in Ekiti State, South-West Nigeria

Authors: Adeyinka Adeniran, Omowunmi Bakare, Esther Oluwole, Florence Chieme, Temitope Durojaiye, Modupe Akinyinka, Omobola Ojo, Babatunde Olujobi, Marcus Ilesanmi, Akintunde Ogunsakin

Abstract:

Introduction: Globally, COVID-19 has greatly impacted the human race physically, socially, mentally, and economically. However, healthcare workers seemed to bear the greatest impact. The study, therefore, sought to assess the impact of COVID-19 on the primary healthcare workers in Ekiti, South-west Nigeria. Methods: The study was a cross-sectional descriptive study using a quantitative data collection method of 716 primary healthcare workers in Ekiti state. Respondents were selected using an online convenience sampling method via their social media platforms. Data was collected, collated, and analyzed using SPSS version 25 software and presented as frequency tables, mean and standard deviation. Bivariate and multivariate analyses were conducted using a t-test, and the level of statistical significance was set at p<0.05. Results: Less than half (47.1%) of respondents were between 41-50 age group and a mean age of 44.4+6.4SD. A majority (89.4%) were female, and almost all (96.2%) were married. More than (90%) had ever heard of Coronavirus, and (85.8%) had to spend more money on activities of daily living such as transportation (90.1%), groceries (80.6%), assisting relations (95.8%) and sanitary measures (disinfection) at home (95.0%). COVID-19 had a huge negative impact on about (89.7%) of healthcare workers, with a mean score of 22+4.8. Conclusion: COVID-19 negatively impacted the daily living and professional duties of primary healthcare workers, which reflected their psychological, physical, social, and economic well-being. Disease outbreaks are unlikely to disappear in the near future. Hence, global proactive interventions and homegrown measures should be adopted to protect healthcare workers and save lives.

Keywords: Covid-19, health workforce, primary health care, health systems, depression

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2210 Tax System Reform in Nepal: Analysis of Contemporary Issues, Challenges, and Ways Forward

Authors: Dilliram Paudyal

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The history of taxation in Nepal dates back to antiquity. However, the modern tax system gained its momentum after the establishment of democracy in 1951, which initially focused only land tax and tariff on foreign trade. In the due time, several taxes were introduced, such as direct taxes, indirect taxes, and non-taxes. However, the tax structure in Nepal is heavily dominated by indirect taxes that contribute more than 60 % of the total revenue. The government has been mobilizing revenues through a series of tax reforms during the Tenth Five-year Plan (2002 – 2007) and successive Three-year Interim Development Plans by introducing several tax measures. However, these reforms are regressive in nature, which does not lead the overall economy towards short-run stability as well as in the long run development. Based on the literature review and discussion among government officials and few taxpayers individually and groups, this paper aims to major issues and challenges that hinder the tax reform effective in Nepal. Additionally, this paper identifies potential way and process of tax reform in Nepal. The results of the study indicate that transparency in a major problem in Nepalese tax system in Nepal, where serious structural constraints with administrative and procedural complexities envisaged in the Income Tax Act and taxpayers are often unaware of the specific size of tax which is to comply them. Some other issues include high tax rate, limited tax base, leakages in tax collection, rigid and complex Income Tax Act, inefficient and corrupt tax administration, limited potentialities of direct taxes and negative responsiveness of land tax with higher administrative costs. In the context, modality of tax structure and mobilize additional resources is to be rectified on a greater quantum by establishing an effective, dynamic and highly power driven Autonomous Revenue Board.

Keywords: corrupt, development, inefficient, taxation

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2209 Management of Nutritional Strategies in Prevention of Autism Before and During Pregnancy

Authors: Maryam Ghavam Sadri, Kimia Moiniafshari

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Objectives: Autism is a neuro-developmental disorder that has negative effects on verbal, mental and behavioral development. Studies have shown the role of a maternal dietary pattern before and during pregnancy. The relation of exerting of nutritional management programs in prevention of Autism has been approved. This review article has been made to investigate the role of nutritional management strategies before and during pregnancy in the prevention of Autism. Methods: This review study was accomplished by using the keywords related to the topic, 67 articles were found (2000-2015) and finally 20 article with criteria such as including maternal lifestyle, nutritional deficiencies and Autism prevention were selected. Results: Maternal dietary pattern and health before and during pregnancy have important roles in the incidence of Autism. Studies have suggested that high dietary fat intake and obesity can increase the risk of Autism in offspring. Maternal metabolic condition specially gestational diabetes (GDM) (p-value < 0.04) and folate deficiency (p-value = 0.04) is associated with risk of Autism. Studies have shown that folate intake in mothers with autistic children is less than mothers who have typically developing children (TYP) (p-value<0.01). As folate is an essential micronutrient for fetus mental development, consumption of average 600 mcg/day especially in P1 phase of pregnancy results in significant reduction in incidence of Autism (OR:1.53, 95%CI=0.42-0.92, p-value = 0.02). furthermore, essential fatty acid deficiency especially omega-3 fatty acid increases the rate of Autism and consumption of supplements and food sources of omega-3 can decrease the risk of Autism up to 34% (RR=1.53, 95%CI=1-2.32). Conclusion: regards to nutritional deficiency and maternal metabolic condition before and during pregnancy in prevalence of Autism, carrying out the appropriate nutritional strategies such as well-timed folate supplementation before pregnancy and healthy lifestyle adherence for prevention of metabolic syndrome (GDM) seems to help Autism prevention.

Keywords: autism, autism prevention, dietary inadequacy, maternal lifestyle

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2208 A Study of the Disorders of Sexual Functioning in Women with Type 2 Diabetes Mellitus in a Tertiary Care Hospital in India

Authors: Mehak Nagpal, T. S. Sathyanarayan Rao

Abstract:

Background: Sexual functioning is a neglected aspect of health in women with diabetes, though it contributes greatly towards quality of life and feeling of wellbeing. Also women with DM are at higher risk than men of developing sexual dysfunction and depression. Materials and Methods: Cross-sectional comparison study. Sample size: 100 previously diagnosed type 2DM patients attending Outpatient Diabetic Clinic at Medicine department JSS Hospital Mysore; aged 20-65 years and 60 normal healthy female subjects for Control group. Data was collected with ethical approval over a period of 2 years. Tools Used: 1) Hamilton Depression Rating Scale (HAMD – 17 item) 2) Female Sexual Functioning Index (FSFI) 3) Arizona Sexual Experience Scale (ASEX-F) for female-for screening. 4) The Appraisal of Diabetes Scale (ADS). Results: Statistically significant differences were observed in prevalence rate and severity of depression between diabetic group (45% vs 11% syndromal depression) and controls. Depression scores correlated significantly with glycaemic control, adherence to treatment, BMI and the cognitive appraisal of diabetes. There was significantly greater impairment in the sexual functioning of women with type 2 diabetes mellitus as compared to controls; both prevalence (62% vs 38.3%) and severity (p value < 0.01). Arousal (74.2% vs 53.3%), Desire (76.3% vs 50%) and Satisfaction (76.7% vs 63.7%) were most affected and 64.5% were affected in 2 or more domains. A negative illness appraisal on ADS correlated significantly with poor glycaemic control, higher rates of depression and also more severe female sexual dysfunction (p value < 0.05). Conclusion: Diabetes specific factors that correlated significantly with FSD in this study included the psychological appraisal of diabetes, duration of diabetes, presence of complications and BMI.

Keywords: depression, female sexual dysfunction, India, type 2 diabetes mellitus

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2207 The Biopsychosocial Effects of Amputation on Transtibial Amputees in Kwazulu-Natal

Authors: Riyona Chetty, Raisuyah Bhagwan, Nalini Govender

Abstract:

Background: A myriad of physical, psychosocial, and environmental sequelae are associated with limb loss. However, there is a paucity of empirical South African data, which focuses on these sequelae, how they interface with the amputee’s quality of life as well as the challenges they experience following amputation. Objective: This study sought to explore the biopsychosocial effects of amputation and how amputation affected the quality of life of transtibial amputees. Setting: Participants were recruited from a medical facility, under the KwaZulu-Natal Department of Health in South Africa. Methods: A qualitative approach guided this study. Data was collected using one-on-one interviews with 14 unilateral transtibial amputees. Data was analysed thematically. Results: Five broad themes emerged from the inquiry, which captured amputees’ experiences of phantom limb pain, body image disturbances, and their challenges related to adapting to daily activities. Participants also expressed the salience of familial support as well as the importance of psychological interventions to cope. Conclusion: The findings suggested that support networks and professional psychological intervention are imperative in facilitating successful adjustment to the amputation experience. Raising awareness of limb loss in both, rural and urban settings may help reduce the stigma attached to it. Contribution: Quality of life comprises several domains, namely physical, psychological, environmental, and social albeit limited local and international data exists regarding the environmental and social effects. This study brought to the fore the positive and negative effects of amputation in each domain, as well as various strategies that facilitate successful adjustment to amputation.

Keywords: amputation, quality of life, biopsychosocial, phantom limb pain, body image, support

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