Search results for: maternal request for cesarean section

Authors: Mohammad Julhas Sujan, Md. Ferdous Alam

Abstract:

Maternal, neonatal, and child health (MNCH) holds one of the prime focuses in Bangladesh’s national healthcare system. To save the lives of mothers and children, knowing the stock of MNCH medicines in different healthcare facilities and when to replenish them are essential. A robust information system not only facilitates efficient management of the essential MNCH medicines but also helps effective allocation of scarce resources. In Bangladesh, Supply chain management of the 25-essential life-saving medicines are currently tracked and monitored via an electronic logistics management information system (eLMIS). Our aim was to conduct a cross-sectional study with a year (2020) worth of data from 24 districts of Bangladesh to evaluate how eLMIS is helping the Government and other stakeholders in efficient supply chain management. Data were collected from 4711 healthcare facilities ranging from primary to secondary levels within a district. About 90% (4143) are community clinics which are considered primary health care facilities in Bangladesh. After eLMIS implementation, the average reporting rate across the districts has been increased (> 97%). The month of stock (MOS) of zinc is an average 6 months compared to Inj. Magnesium Sulphate which will take 2.5 years to consume according to the current average monthly consumption (AMC). Due to first approaching expiry, Tab. Misoprostol, 7.1% Chlorhexidine and Inj. Oxytocin may become unusable. Moreover, Inj. Oxytocin is temperature sensitive and may reduce its efficacy if it is stocked for a longer period. In contrast, Zinc should be sufficiently stocked to prevent sporadic stockouts. To understand how data are collected, transmitted, processed, and aggregated for MNCH medicines in a faster and timely manner, an electronic logistics management information system (eLMIS) is necessary. We recommend the use of such a system in developing countries like Bangladesh for efficient supply chain management of essential MNCH medicines.

Keywords: adaption, eLMIS, MNCH, live-saving medicines

Procedia PDF Downloads 162

Authors: Amjaad Alsalamah, Liyakathunsia Syed

Abstract:

Transportation is an essential need for many people to go to their work, school, and home. In particular, the main common method inside many cities is to drive the car. Driving a car can be an easy job to reach the destination and load all stuff in a reasonable time. However, deciding to find a parking lot for a car can take a long time using the traditional system that can issue a paper ticket for each customer. The old system cannot guarantee a parking lot for all customers. Also, payment methods are not always available, and many customers struggled to find their car among a numerous number of cars. As a result, this research focuses on providing an online smart parking system in order to save time and budget. This system provides a flexible management system for both parking owner and customers by receiving all request via the online system and it gets an accurate result for all available parking and its location.

Keywords: smart parking system, IoT, tracking system, process model, cost, time

Procedia PDF Downloads 336

Authors: Palash Dey, Sudip Talukdar

Abstract:

In this work, a cross-breed approach is presented for obtaining both the amount of the damage intensity and location of damage existing in thin-walled members. This cross-breed approach is developed based on response surface methodology (RSM) and genetic algorithm (GA). Theoretical finite element (FE) model of cracked angle section thin walled curved beam has been linked to the developed approach to carry out trial experiments to generate response surface functions (RSFs) of free, forced and heterogeneous dynamic response data. Subsequently, the error between the computed response surface functions and measured dynamic response data has been minimized using GA to find out the optimum damage parameters (amount of the damage intensity and location). A single crack of varying location and depth has been considered in this study. The presented approach has been found to reveal good accuracy in prediction of crack parameters and possess great potential in crack detection as it requires only the current response of a cracked beam.

Keywords: damage parameters, finite element, genetic algorithm, response surface methodology, thin walled curved beam

Procedia PDF Downloads 248

Authors: Shu-Ling Wang

Abstract:

Background: Multiple studies showed early skin-to-skin contact (SSC) with mothers was beneficial to newborns such as breastfeeding and maternal childcare. In cases of newborns unable to have early SSC with mothers, fathers’ involvement could let early SSC continue without interruption. However, few studies had explored the effects of early SSC by fathers in comparison to early SSC with mothers. Paternal involvement of early SSC should be equally important in term of childcare and breastfeeding. The purpose of this study was to evaluate the efficacy of early SSC by fathers in particular in their support of breastfeeding. Methods: A quasi-experimental design was employed by the study. One hundred and forty-four father-infant pairs had participated the study, in which infants were assigned either to SSC with their fathers (n = 72) or to routine care (n = 72) as the control group. The study was conducted at a regional hospital in northern Taiwan. Participants included parents of both vaginal delivery (VD) and caesarean section birth (CS) infants. To be eligible for inclusion, infants must be over 37-week gestational ages. Data were collected twice: as pretest upon admission and as posttest with online questionnaire during first, second, and third postpartum months. The questionnaire included items for Breastfeeding Social Support, methods of feeding, and the mother-infant 24-hour rooming-in rate. The efficacy of early SSC with fathers was evaluated using the generalized estimating equation (GEE) modeling. Research Result: The primary finding was that SSC with fathers had positive impact on fathers’ support of breastfeeding. Analysis of the online questionnaire indicated that early SSC with fathers improved the support of breastfeeding than the control group (VD: t = -4.98, p < .001; CS: t = -2.37, p = .02). Analysis of mother-infant 24-hour rooming-in rate showed that SSC with fathers after CS had a positive impact on the rooming-in rate (χ² = 5.79, p = .02); however, with VD the difference between early SSC with fathers and the control group was insignificant (χ² = .23, p = .63). Analysis of the rate of exclusive breastfeeding indicated that early SSC with fathers had a higher rate than the control group during first three postpartum months for both delivery methods (VD: χ² = 12.51, p < .001 on 1st postpartum month, χ² = 8.13, p < .05 on 2nd postpartum month, χ² = 4.43, p < .05 on 3rd postpartum month; CS: χ² = 6.92, p < .05 on 1st postpartum month, χ² = 7.41, p < .05 on 2nd postpartum month, χ² = 6.24, p < .05 on 3rd postpartum month). No significant difference was found on the rate of exclusive breastfeeding with both methods of delivery between two groups during hospitalization. (VD: χ² =2 .00, p = .16; CS: χ² = .73, p = .39). Conclusion: Implementing early SSC with fathers has many benefits to both parents. The result of this study showed increasing fathers’ support of breastfeeding. This encourages our nursing personnel to focus the needs of father during breastfeeding, therefore further enhancing the quality of parental care, the rate and duration of breastfeeding.

Keywords: breastfeeding, skin-to-skin contact, support of breastfeeding, rooming-in

Procedia PDF Downloads 215

Authors: M. Cabrera, W. Tizani, J. Ninic, F. Wang

Abstract:

Open section beam to concrete-filled tubular column structures has been increasingly utilized in construction over the past few decades due to their enhanced structural performance, as well as economic and architectural advantages. However, the use of this configuration in construction is limited due to the difficulties in connecting the structural members as there is no access to the inner part of the tube to install standard bolts. Blind-bolted systems are a relatively new approach to overcome this limitation as they only require access to one side of the tubular section to tighten the bolt. The performance of these connections in concrete-filled steel tubular sections remains uncharacterized due to the complex interactions between concrete, bolt, and steel section. Over the last years, research in structural performance has moved to a more sophisticated and efficient approach consisting of machine learning algorithms to generate metamodels. This method reduces the need for developing complex, and computationally expensive finite element models, optimizing the search for desirable design variables. Metamodels generated by a data fusion approach use numerical and experimental results by combining multiple models to capture the dependency between the simulation design variables and connection performance, learning the relations between different design parameters and predicting a given output. Fully characterizing this connection will transform high-rise and multistorey construction by means of the introduction of design guidance for moment-resisting blind-bolted connections, which is currently unavailable. This paper presents a review of the steps taken to develop metamodels generated by means of artificial neural network algorithms which predict the connection stress and stiffness based on the design parameters when using Extended Hollo-Bolt blind bolts. It also provides consideration of the failure modes and mechanisms that contribute to the deformability as well as the feasibility of achieving blind-bolted rigid connections when using the blind fastener.

Keywords: blind-bolted connections, concrete-filled tubular structures, finite element analysis, metamodeling

Procedia PDF Downloads 158

Authors: Joseph E. Estevez, Mahdi Ghazizadeh, James G. Ryan, Ajit D. Kelkar

Abstract:

Radiation shielding is an obstacle in long duration space exploration. Boron Nitride Nanotubes (BNNTs) have attracted attention as an additive to radiation shielding material due to B10’s large neutron capture cross section. The B10 has an effective neutron capture cross section suitable for low energy neutrons ranging from 10-5 to 104 eV and hydrogen is effective at slowing down high energy neutrons. Hydrogenated BNNTs are potentially an ideal nanofiller for radiation shielding composites. We use Molecular Dynamics (MD) Simulation via Material Studios Accelrys 6.0 to model the Young’s Modulus of Hydrogenated BNNTs. An extrapolation technique was employed to determine the Young’s Modulus due to the deformation of the nanostructure at its theoretical density. A linear regression was used to extrapolate the data to the theoretical density of 2.62g/cm3. Simulation data shows that the hydrogenated BNNTs will experience a 11% decrease in the Young’s Modulus for (6,6) BNNTs and 8.5% decrease for (8,8) BNNTs compared to non-hydrogenated BNNT’s. Hydrogenated BNNTs are a viable option as a nanofiller for radiation shielding nanocomposite materials for long range and long duration space exploration.

Keywords: boron nitride nanotube, radiation shielding, young modulus, atomistic modeling

Procedia PDF Downloads 297

Authors: Sabah Ben Fredj Melki, Yves Brygoo, Ahmed Mliki

Abstract:

A 700 pb PCR-derived DNA fragment was isolated from Aspergillus carbonarius, Aspergillus niger, and Aspergillus tubingensis using degenerated primers (LC1-LC2c) and two newly designed primer pairs (KSLB-LC6) for Aspergillus niger and (AFl1F-LC2) for Aspergillus tubingensis developed for the acyl transferase (AT) and the KS domains of fungal PKSs. DNA from the most of black Aspergillus species currently recognized was tested. Herein, we report on the identification and characterisation of a part of the novel putative OTA-polyketide synthase gene in A. carbonarius “ACPks”, A. niger “ANPks” and A. tubingenis “ATPks”. The sequences were aligned and analyzed using phylogenetic methods. Primers used in this study showed general applicability and other Aspergillus species belonging to section Nigri were successfully amplified especially in A. niger and A. tubingenis. The predicted amino acid sequences “ACPks” displayed 66 to 81% similarities to different polyketide synthase genes while “ANPks” similarities varied from 68 to 71% and “ATPks” were from 81 to 97%. The AT and the KS domains appeared to be specific for a particular type of fungal PKSs and were related to PKSs involved in different mycotoxin biosynthesis pathways, including ochratoxin A. The sequences presented in this work have a high utility for the discovery of novel fungal PKS gene clusters.

Keywords: Pks genes, OTA Biosynthesis, Aspergillus Nigri, sequence analysis

Procedia PDF Downloads 73

Authors: Zeinab. Shahrokhifar, Abolfazl Meshkini, Seyed Ali. Alavi

Abstract:

Considering the different dimensions of deprivation, housing supply is noted as a basic requirement in Iran after 1979 (coming to work of the new government). The government had built the constitution and obliged to meet this need in the form of five-year development programs in Iran’s provinces. This study focused on the adaptive analysis of housing policies in these five development programs in Kermanshah province located in western Iran. Our research is divided into two different analytical sections. In the first section, we collected the documentary information using approved plans and field studies. In the second section, a questionnaire was prepared and designed for the elite community (30) to support the documentary analysis. The results showed that various projects adopted in the form of strategic plans and implemented the policies included both quantitative and qualitative housing in Kermanshah province after 1979. The quality of housing, from the first to the fifth development plans has improved the situation in the housing indicators. The quantity of housing units for households has also been implemented through various policies that has desired results. The sequences of housing policies and plans do not overlap in the five development programs. According to the radar graph, the development programs overlapped in some policies, which shows the continuation of the previous policies, but this overlap is not perfect.

Keywords: law enforcement policy, housing policy, development programs, housing indicators, the city of Kermanshah

Procedia PDF Downloads 73

Authors: Kalbiye Konanc, Ergin Ozturk

Abstract:

To examine the effects of an ethanol liquid extract obtained from raw bee propolis (PE) on fattening performance and physiology such as vaccine-antibody relationship, microbial profile, immune status and some blood parameters of broiler chickens were used a total of 600 broiler (Ross 308) chicks, obtained from eggs of 288, 38-weeks-old broiler breeding. There were 6 groups: CC (Parent-Control and Offspring-Control, CP (Parent-Control and Offspring-propolis extract, Cip (Parent-Control and Offspring-in-ovo propolis extract), Cis (Parent-Control and Chickens-in-ovo saline), PeC (Parent-propolis extract and Offspring-Control), PeP (Parent-Propolis extract and Offspring-Propolis extract). Each group was consisted of 10 replications with 10 broiler offspring, and the experiment was lasted for 6 weeks with ethanol-extracted propolis concentration is 400 ppm/kg diet. While the highest feed consumptions at 0-21 days and 0-42 days were found in PeC, the best feed conversion ratio at 0-42 days was found in CP group. The live weight gains were found not to be different among the groups. The highest alanine aminotransferase activities were found in CC and CP and aspartate aminotransferase activities in PeP and PeC groups. The highest triglyceride and total antioxidant levels were found highest in CC and the highest total oxidant level in Cip group. IgA level in hatched eggs and IgM value after slaughtering were highest in Cip group. The best immune response was obtained for 21st day Newcastle Disease vaccine in CC and Cis groups and for 28th day Infectious Bursal Disease vaccine in CP group. The highest total aerobic microorganism and the lowest total fungi count were found in PeP group. In conclusion, it was determined that in-ovo propolis ethanol extract (Cip) increased the maternal antibody levels, that had not consistent effects on blood biochemical parameters except for triglyceride, that led to decrease in E. coli counts and that it can provide strong immune response against Infectious Bursal Disease.

Keywords: bee propolis, in-ovo feeding, immune parameters, poultry, maternal antibody, microorganisms

Procedia PDF Downloads 289

Authors: Tasnuba Binte Jamal, Khan Mahmud Amanat

Abstract:

Carbon Fiber-Reinforced Polymer (CFRP) composite materials have proven to have valuable properties and suitability to be used in the construction of new buildings and in upgrading the existing ones due to its effectiveness, ease of implementation and many more. In the present study, a numerical finite element investigation has been conducted using ANSYS 18.1 to study the behavior of square HSS AISC sections under eccentric compressive loading strengthened with CFRP materials. A three-dimensional finite element model for square HSS section using shell element was developed. Application of CFRP strengthening was incorporated in the finite element model by adding an additional layer of shell elements. Both material and geometric nonlinearities were incorporated in the model. The developed finite element model was applied to simulate experimental studies done by past researchers and it was found that good agreement exists between the current analysis and past experimental results, which established the acceptability and validity of the developed finite element model to carry out further investigation. Study was then focused on some selected non-compact AISC square HSS columns and the effects of number of CFRP layers, amount of eccentricities and cross-sectional geometry on the strength gain of those columns were observed. Load was applied at a distance equal to the column dimension and twice that of column dimension. It was observed that CFRP strengthening is comparatively effective for smaller eccentricities. For medium sized sections, strengthening tends to be effective at smaller eccentricities as well. For relatively large AISC square HSS columns, with increasing number of CFRP layers (from 1 to 3 layers) the gain in strength is approximately 1 to 38% to that of unstrengthened section for smaller eccentricities and slenderness ratio ranging from 27 to 54. For medium sized square HSS sections, effectiveness of CFRP strengthening increases approximately by about 12 to 162%. The findings of the present study provide a better understanding of the behavior of HSS sections strengthened with CFRP subjected to eccentric compressive load.

Keywords: CFRP strengthening, eccentricity, finite element model, square hollow section

Procedia PDF Downloads 144

Authors: Valentina Tereshkova

Abstract:

The paper shows how the relationship between international law and national sovereignty is viewed through the implementation of European Court of Human Right judgments. Methodology: Сonclusions are based on a survey of representatives of the legislative authorities and judges of the Krasnoyarsk region, the Rostov region, Sverdlovsk region and Tver region. The paper assesses the activities of the Russian Constitutional Court from 1998 to 2015 related to the establishment of the implementation mechanism and the Russian Constitutional Court judgments of 14.07.2015, № 21-P and of 19.04.2016, № 12-P where the Constitutional Court stated the impossibility of executing ECtHR judgments. I. Implementation of ECHR judgments by courts and other authorities. Despite the publication of the report of the RF Ministry of Justice on the implementation, we could not find any formal information on the Russian policy of the ECtHR judgment implementation. Using the results of the survey, the paper shows the effect of ECtHR judgments on law and legal practice in Russia. II. Implementation of ECHR judgments by Russian Constitutional Court. Russian Constitutional Court had implemented the ECtHR judgments. However, the Court determined on July, 14, 2015 its competence to consider the question of implementation of ECHR judgments. Then, it stated that the execution of the judgment [Anchugov and Gladkov case] was impossible because the Russian Constitution has the highest legal force on April, 19, 2016. Recently the CE Committee of Ministers asked Russia to provide ‘without further delay’ a compensation plan for the Yukos case. On November 11, 2016, Constitutional Court accepted a request from the Ministry of Justice to consider the possibility of execution of the ECtHR judgment in the Yukos case. Such a request has been made possible due to a lack of implementation mechanism. Conclusion: ECtHR judgments are as an effective tool to solve the structural problems of a legal system. However, Russian experts consider the ECHR as a tool of protection of individual rights. The paper shows link between the survey results and the absence of the implementation mechanism. New Article 104 par. 2 and Article 106 par. 2 of the Federal Law of the Constitutional Court are in conflict with international obligations of the Convention on the Law on Treaties 1969 and Article 46 ECHR. Nevertheless, a dialogue may be possible between Constitutional Court and the ECtHR. In its judgment [19.04.2016] the Constitutional Court determined that the general measures to ensure fairness, proportionality and differentiation of the restrictions of voting rights were possible in judicial practice. It also stated the federal legislator had the power ‘to optimize the system of Russian criminal penalties’. Despite the fact that the Constitutional Court presented the Görgülü case [Görgülü v Germany] as an example of non-execution of the ECtHR judgment, the paper proposes to draw on the experience of German Constitutional Court, which in the Görgülü case, on the one hand, stressed national sovereignty and, on the other hand, took advantage of this sovereignty, to resolve the issue in accordance with the ECHR.

Keywords: implementation of ECtHR judgments, sovereignty, supranational jurisdictions, principle of subsidiarity

Procedia PDF Downloads 194

Authors: Merve Ermis, Murat Yılmaz, Nihal Eratlı, Mehmet H. Omurtag

Abstract:

The static and dynamic analyses of hyperboloidal helix having the closed and the open square box sections are investigated via the mixed finite element formulation based on Timoshenko beam theory. Frenet triad is considered as local coordinate systems for helix geometry. Helix domain is discretized with a two-noded curved element and linear shape functions are used. Each node of the curved element has 12 degrees of freedom, namely, three translations, three rotations, two shear forces, one axial force, two bending moments and one torque. Finite element matrices are derived by using exact nodal values of curvatures and arc length and it is interpolated linearly throughout the element axial length. The torsional moments of inertia for close and open square box sections are obtained by finite element solution of St. Venant torsion formulation. With the proposed method, the torsional rigidity of simply and multiply connected cross-sections can be also calculated in same manner. The influence of the close and the open square box cross-sections on the static and dynamic analyses of hyperboloidal helix is investigated. The benchmark problems are represented for the literature.

Keywords: hyperboloidal helix, squared cross section, thin walled cross section, torsional rigidity

Procedia PDF Downloads 377

Authors: Peter Winzer, Erik Massarczyk

Abstract:

Experts, enterprises and operators expect that the bandwidth request will increase up to rates of 100 to 1,000 Mbps within several years. Therefore the most important question is, which technology shall satisfy the future consumer broadband demands. Currently the consensus is, that the fiber technology has the best technical characteristics to achieve such the high bandwidth rates. But fiber technology is so far very cost-intensive and resource consuming. To avoid these investments, operators are concentrating to upgrade the existing copper and hybrid fiber coax infrastructures. This work presents a comparison of the copper and fiber technologies including an overview about the current German broadband market. Both technologies are reviewed in the terms of demand, willingness to pay and economic efficiency in connection with the technical characteristics.

Keywords: broadband customer demand, fiber development, g.fast, vectoring, willingness to pay for broadband services

Procedia PDF Downloads 469

Authors: Ziba Khalili, Mohsen Sheikholeslami, Ladan Momayez

Abstract:

Combining the photovoltaic/thermal (PVT) systems with a thermoelectric (TE) module can raise energy yields since the TE module boosts the system's energy conversion efficiency. In the current study, a PVT system integrated with a TE module was designed and simulated in ANSYS Fluent 19.2. A copper heat transfer tube (HTT) was employed for cooling the photovoltaic (PV) cells. Four different shapes of HTT cross-section, i.e., circular, square, elliptical, and triangular, with equal cross-section areas were investigated. Also, the influence of Cu-Al2O3/water hybrid nanofluid (0.024% volume concentration), fluid inlet velocity (uᵢ ), and amount of solar radiation (G), on the PV temperature (Tₚᵥ) and system performance were investigated. The ambient temperature (Tₐ), wind speed (u𝓌), and fluid inlet temperature (Tᵢ), were considered to be 25°C, 1 m/s, and 27°C, respectively. According to the obtained data, the triangular case had the greatest impact on reducing the compared to other cases. In the triangular case, examination of the effect of hybrid nanofluid showed that the use of hybrid nanofluid at 800 W/m2 led to a reduction of the TPV by 0.6% compared to water, at 0.19 m/s. Moreover, the thermal efficiency ( ) and the overall electrical efficiency (nₜ) of the system improved by 0.93% and 0.22%, respectively, at 0.19 m/s. In a triangular case where G and were 800 W/m2 and 19 m/s, respectively, the highest amount of, thermal power (Eₜ), and, were obtained as 72.76%, 130.84 W and 12.03%, respectively.

Keywords: electrical performance, photovoltaic/thermal, thermoelectric, hybrid nanofluid, thermal efficiency

Procedia PDF Downloads 78

Authors: Krishna Dahiya, Esha Charaya

Abstract:

Induction of labour is a common obstetrical intervention. Around 1 in every 4 patient undergo induction of labour for different indications Purpose: To study the efficacy of the combination of Foley bulb and vaginal misoprostol in comparison to vaginal misoprostol alone for cervical ripening and induction of labour. Methods: A prospective randomised study was conducted on 150 patients with term singleton pregnancy admitted for induction of labour. Seventy-five patients were induced with both Foley bulb, and vaginal misoprostol and another 75 were given vaginal misoprostol alone for induction of labour. Both groups were then compared with respect to change in Bishop score, induction to the active phase of labour interval, induction delivery interval, duration of labour, maternal complications and neonatal outcomes. Data was analysed using statistical software SPSS version 11.5. Tests with P,.05 were considered significant. Results: The two groups were comparable with respect to maternal age, parity, gestational age, indication for induction, and initial Bishop scores. Both groups had a significant change in Bishop score (2.99 ± 1.72 and 2.17 ± 1.48 respectively with statistically significant difference (p=0.001 S, 95% C.I. -0.1978 to 0.8378). Mean induction to delivery interval was significantly lower in the combination group (11.76 ± 5.89 hours) than misoprostol group (14.54 ± 7.32 hours). Difference was of 2.78 hours (p=0.018,S, 95% CI -5.1042 to -0.4558). Induction to delivery interval was significantly lower in nulliparous women of combination group (13.64 ± 5.75 hours) than misoprostol group (18.4±7.09 hours), and the difference was of 4.76 hours (p=0.002, S, 95% CI 1.0465 to 14.7335). There was no difference between the groups in the mode of delivery, infant weight, Apgar score and intrapartum complications. Conclusion: From the present study it was concluded that addition of Foley catheter to vaginal misoprostol have the synergistic effect and results in early cervical ripening and delivery. These results suggest that the combination may be used to achieve timely and safe delivery in the presence of an unfavorable cervix. A combination of the Foley bulb and vaginal misoprostol resulted in a shorter induction-to-delivery time when compared with vaginal misoprostol alone without increasing labor complications.

Keywords: Bishop score, Foley catheter, induction of labor, misoprostol

Procedia PDF Downloads 306

Authors: A. T. Laiche, M. L. Tlil, Benine B., S. Bechoua

Abstract:

The aim of this study is to isolate and select, from camel milk from El-Oued region in Algeria, a strains of lactic acid bacteria and possessing probiotic properties ; and to evaluate their potential effect on intestinal disorders in Wistar ratsmThe results relating to the selection of probiotic strains confirms that the Thermophilic streptococcus exhibits the best probiotic activity performance, with a resistance important to different degrees of pH and to bile salts, and a remarkable antibacterial activity and resistance to antibiotics compared to the other four isolated strains. In the in vivo study, diseases are induced in rats at the level of the digestive system, it was reported that the administration of Escherichia coli and castor oil caused an intestinal disorders. The microscopic observation of the histological section of the intestine showed a damaged intestinal structure and some symptoms of its irritation, including a decrease in the height of the villi and the presence of others destroyed cells, and after treatment with Streptococcus thermophilus, the microscopic observation of the cut of the histological section of the intestine showed almost complete disappearance of the mentioned symptoms, The dosage of the hematological parameters by complete blood count (CBC) is in agreement with the results of the histological sections.

Keywords: camel milk, probiotic, pathogenic bacteria, intestinal disorders, lactic acid bacteria

Procedia PDF Downloads 158

Authors: Kristin Murray

Abstract:

The proposed paper exams prologues in 20th and 21st century American literature in order to show how Native American writer Tommy Orange’s Prologue in his 2018 novel There, Thereis different. In an interview about his 2018 novel There, There, explains he feels “a kind of burden to catch the general reader up with what really happened, because history has got it so wrong and still continue to” (Laubernds). Orange, thus, includes a “Prologue” in his novel to do this work, catching readers upon Native Americans and their history. Prologues are usually from the narrator’s voice, a character’s voice, or even from a fictionalized version of the author, but the tone of Orange’s “Prologue” is that of a non-fictional first-person essayist. Examining prologues in American literature posits Orange’s prologue outside the norm. This paper also examines other introductory sections, the preface, in particular. The research and examination reveal that Orange is adding his personal voice in the Prologue to the multiple narratorsof the novel, and his is the voice of a writer who knows that his audience comes to his novel with a plethora of misinformation. The truths he tells are horrifying and hopeful. He tells of Thanksgiving as a “land deal” and a “successful massacre,” but he also tellsreaders how urban Indians have found a sense of the land, even through concrete. Native American writers contributed and still contribute to the genre of autobiography in ways that have changed our understanding of this genre. This examination of Orange’s Prologue reveals the new and unexpected way to view this often under-examined introductory section, the prologue.

Keywords: native american literature, prologues, prefaces, 20th century american literature

Procedia PDF Downloads 181

Authors: Khulud Alhussain, Anna Gavine, Stephen Macgillivray, Sushila Chowdhry

Abstract:

Background: Estimates show that by the year 2030, mental illness will account for more than half of the global economic burden, second to non-communicable diseases. Often, the perinatal period is characterised by psychological ambivalence and a mixed anxiety-depressive condition. Maternal mental disorder is associated with perinatal anxiety and depression and affects breastfeeding behaviors. Studies also indicate that maternal mental health can considerably influence a baby's health in numerous aspects and impact the newborn health due to lack of adequate breastfeeding. However, studies reporting factors associated with breastfeeding behaviors are predominantly quantitative. Therefore, it is not clear what literature is available to understand the factors affecting breastfeeding and perinatal women’s perspectives and experiences. Aim: This review aimed to explore the perceptions and experiences of women with perinatal anxiety and depression, as well as how these experiences influence their breastfeeding behaviours. Methods: A systematic literature review of qualitative studies in line with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). Four electronic databases (CINAHL, PsycINFO, Embase, and Google Scholar) were explored for relevant studies using a search strategy. The search was restricted to studies published in the English language between 2000 and 2022. Findings from the literature were screened using a pre-defined screening criterion and the quality of eligible studies was appraised using the Walsh and Downe (2006) checklist. Findings were extracted and synthesised based on Braun and Clark. The review protocol was registered on PROSPERO (Ref: CRD42022319609). Result: A total of 4947 studies were identified from the four databases. Following duplicate removal and screening 16 studies met the inclusion criteria. The studies included 87 pregnant and 302 post-partum women from 12 countries. The participants were from a variety of economic, regional, and religious backgrounds, mainly from the age of 18 to 45 years old. Three main themes were identified: Barriers to breastfeeding, breastfeeding facilitators, emotional disturbance, and breastfeeding. Seven subthemes emerged from the data: expectation versus reality, uncertainly about maternal competencies, body image and breastfeeding, lack of sufficient breastfeeding support for family and caregivers’ support, influences positive breastfeeding practices, breastfeeding education, and causes of mental strain among breastfeeding women. Breastfeeding duration is affected in women with mental health disorders, irrespective of their desire to breastfeed. Conclusion: There is significant empirical evidence that breastfeeding behaviour and perinatal mental disturbance are linked. However, there is a lack of evidence to apply the findings to Saudi women due to lack of empirical qualitative information. To improve the psychological well-being of mothers, it is crucial to explore and recognise any concerns with their mental, physical, and emotional well-being. Therefore, robust research is needed so that breastfeeding intervention researchers and policymakers can focus on specifically what needs to be done to help mentally distressed perinatal women and their new-born.

Keywords: pregnancy, perinatal period, anxiety, depression, emotional disturbance, breastfeeding

Procedia PDF Downloads 99

Authors: Jiyoung Kim, Chae Weon Chung

Abstract:

Labor pain is one of the most common concerns of pregnant women, thus women are in need of possible options they could take to control the pain. So, this study aimed to explore maternal perception of epidural anesthesia and to compare the childbirth outcomes according to the use of epidural anesthesia. For this descriptive study, women who were over 36 weeks of pregnancy were recruited from an out-patient obstetric clinic in a public hospital in Seoul. Women were included in the study if agreed to participate, were pregnant singleton, without pregnancy complication, and expecting a natural birth. Data collection was done twice, the first one at the prenatal care visit and the second one at an in-patient ward on 2nd day postpartum. The instrument of the beliefs about epidural anesthesia, one item of asking intention to use epidural anesthesia, demographics, and obstetrical characteristics were incorporated into a questionnaire. One nurse researcher performed data collection with the structured questionnaire after the approval of the institutional review board. At the initial data collection 133 women were included, while 117 were retained at the second point after excluded 13 women due to the occurrence of complications. Analyses were done by chi-square, t-test, and ANOVA using the SPSS program. Women were aged 32.5 years old, 22.2% were over 35 years old. The average gestational age was 38.5 weeks, and 67.5% were nulliparous. Out of 38 multiparous women, 20 women (52.6%) had received epidural anesthesia in the previous delivery. At the initial interview, 62.6% (n=73) of women wanted to receive epidural anesthesia while 22.4% answered not decided and 15.4% did not want to take the procedure. However, there were changes in proportions between women’s intention to take it and actual procedures done, particularly, two-thirds of women (n=26) who had been undecided were found to receive epidural anesthesia during labor. There was a significant difference in the perception of epidural anesthesia measured before delivery between women who received and not received it (t=3.68, p < .001). Delivery outcomes were statistically different between the two groups in delivery mode (chi-square=8.64, p=.01), O₂ supply during labor (chi-square =5.01, p=.03), duration of 2nd stage of labor (t=3.70, p < .001), and arterial cord blood pH (t=2.64, p=.01). Interestingly, there was no difference in labor pain perceived between women with and without epidural anesthesia. Considering the preference and use of epidural anesthesia, health professionals need to assess coping ability of women undergoing delivery and to provide accurate information about pain control to support their decision making and eventually to enhance delivery outcomes for mothers and neonates.

Keywords: epidural anesthesia, delivery outcomes, labor pain, perception

Procedia PDF Downloads 153

Authors: Kevin Klein-Cardeña

Abstract:

For Julia Kristeva, contra Lacan, the instinctive body refuses to go away within discourse. Neither is the pre-Oedipal stage of maternal fusion vanquished by the emergence of language and with it, the law of the father. On the contrary, Kristeva argues, the pre-symbolic ambivalently haunts the society of speech, simultaneously animating and threatening the very foundations of signification. Kristeva invents the term “the semiotic” to refer to this continual breaking-through of the material unconscious onto the scene of meaning. This presentation examines Kristeva’s semiotic as a theoretical gesture that itself is a disruption of discourse, re-presenting the ‘return of the repressed’ body in theory—-the breaking-through of the unconscious onto the science of meaning. Faced with linguistic theories concerned with abstract sign-systems as well as Lacanian doctrine privileging the linguistic sign unequivocally over the bodily drive, Kristeva’s theoretical corpus issues the message of a psychic remainder that disrupts with a view toward replenishing theoretical accounts of language and sense. Reviewing Semiotic challenge across these two levels (the sense and science of language), the presentation suggests that Kristeva’s offerings constitute a coherent gestalt, providing an account of the feminist nature of her dual intervention. In contrast to other feminist critiques, Kristeva’s gesture hinges on its restoration of the maternal contribution to subjectivity. Against the backdrop of ‘phallogocentric’ and ‘necrophilic’ theories that strip language of a subject and strip the subject of a body, Kristeva recasts linguistic study through a metaphor of life and birthing. Yet the semiotic fragments the subject it produces, dialoguing with an unconscious curtailed by but also exceeding the symbolic order of signification. Linguistics, too, becomes fragmented in the same measure as it is more meaningfully renewed by its confrontation with the semiotic body. It is Kristeva’s own body that issues this challenge, on both sides of the boundary between the theory and the theorized. The Semiotic becomes comprehensible as a project unified by its concern to disrupt and rehabilitate language, the subject, and the scholarly discourses that treat them.

Keywords: Julia kristeva, the Semiotic, french feminism, psychoanalysic theory, linguistics

Procedia PDF Downloads 75

Authors: G. Wimmers

Abstract:

The University of Northern British Columbia needed a new laboratory building for the Master of Engineering in Integrated Wood Design Program and its new Civil Engineering Program. Since the University is committed to reducing its environmental footprint and because the Master of Engineering Program is actively involved in research of energy efficient buildings, the decision was made to request the energy efficiency of the Passive House Standard in the Request for Proposals. The building is located in Prince George in Northern British Columbia, a city located at the northern edge of climate zone 6 with an average low between -8 and -10.5 in the winter months. The footprint of the building is 30m x 30m with a height of about 10m. The building consists of a large open space for the shop and laboratory with a small portion of the floorplan being two floors, allowing for a mezzanine level with a few offices as well as mechanical and storage rooms. The total net floor area is 1042m² and the building’s gross volume 9686m³. One key requirement of the Passive House Standard is the airtight envelope with an airtightness of < 0.6 ach@50Pa. In the past, we have seen that this requirement can be challenging to reach for industrial buildings. When testing for air tightness, it is important to test in both directions, pressurization, and depressurization, since the airflow through all leakages of the building will, in reality, happen simultaneously in both directions. A specific detail or situation such as overlapping but not sealed membranes might be airtight in one direction, due to the valve effect, but are opening up when tested in the opposite direction. In this specific project, the advantage was the overall very compact envelope and the good volume to envelope area ratio. The building had to be very airtight and the details for the windows and doors installation as well as all transitions from walls to roof and floor, the connections of the prefabricated wall panels and all penetrations had to be carefully developed to allow for maximum airtightness. The biggest challenges were the specific components of this industrial building, the large bay door for semi-trucks and the dust extraction system for the wood processing machinery. The testing was carried out in accordance with EN 132829 (method A) as specified in the International Passive House Standard and the volume calculation was also following the Passive House guideline resulting in a net volume of 7383m3, excluding all walls, floors and suspended ceiling volumes. This paper will explore the details and strategies used to achieve an airtightness of 0.07 ach@50Pa, to the best of our knowledge the lowest value achieved in North America so far following the test protocol of the International Passive House Standard and discuss the crucial steps throughout the project phases and the most challenging details.

Keywords: air changes, airtightness, envelope design, industrial building, passive house

Procedia PDF Downloads 148

Authors: Stacy Jarvis

Abstract:

Databases such as JSTOR, RILM and WorldCat have been the main source and storage of literature in the music orb. The Reference Index to Music Literature is a bibliographic database of over 2.6 million citations to writings about music from over 70 countries. The Research Institute produces RILM for the Study of Music at the University of Buffalo. JSTOR is an e-library of academic journals, books, and primary sources. Database JSTOR helps scholars find, utilise, and build upon a vast range of literature through a powerful teaching and research platform. Another database, WorldCat, is the world's biggest library catalogue, assisting scholars in finding library materials online. An evaluation of these databases in the music sphere is conducted by looking into the description and intended use and finding similarities and differences among them. Through comparison, it is found that these aim to serve different purposes, though they have the same goal of providing and storing literature. Also, since each database has different parts of literature that it majors on, the intended use of the three databases is evaluated. This can be found in the description, scope, and intended uses section. These areas are crucial to the research as it addresses the functional or literature differences among the three databases. It is also found that these databases have different quantitative potentials. This is determined by addressing the year each database began collecting literature and the number of articles, periodicals, albums, conference proceedings, music, dissertations, digital media, essays collections, journal articles, monographs, online resources, reviews, and reference materials that can be found in each one of them. This can be found in the sections- description, scope and intended uses and the importance of the database in identifying literature on different topics. To compare the delivery of services to the users, the importance of databases in identifying literature on different topics is also addressed in the section -the importance of databases in identifying literature on different topics. Even though these databases are used in research, they all have disadvantages and advantages. This is addressed in the sections on advantages and disadvantages. This will be significant in determining which of the three is the best. Also, it will help address how the shortcomings of one database can be addressed by utilising two databases together while conducting research. It is addressed in the section- a combination of RILM and JSTOR. All this information revolves around the idea that a huge amount of quantitative and qualitative data can be found in the presented databases on music and digital content; however, each of the given databases has a different construction and material features contributing to the musical scholarship in its way.

Keywords: RILM, JSTOR, WorldCat, database, literature, research

Procedia PDF Downloads 83

Authors: Qurat-ul-Ain, Humaira Mehmood

Abstract:

Background: HIV infection (a global pandemic) in pregnant women has turn out to be an emerging aspect of public health because of its role in the spread of HIV infection, predominantly among children. Aim: The aim was to analyze the trends of diagnosis with respect to gestational age and an overview of the mode of delivery over ten years. Methods: A retrospective data collection from clinical records of diagnosed HIV infected pregnant females attended at HIV antenatal clinic (special clinic), at Pakistan Institute of Medical Sciences, Islamabad, for various complaints during the period of 10 years from February 2007 to December 2016 was done. Results: A total of 113 pregnancies were reported with HIV infection in 10 years. Cases diagnosed at the 1st trimester (1-12 weeks) of pregnancy were (50.4%, 57/113), at the 2nd trimester (13-26 weeks) were (24.8%, 28/113), at the 3rd trimester (27-40+ weeks) were (24.7%, 28/113). Most deliveries were by caesarean section (53.1%, 60/113), elective caesarean sections were (58.3%, 35/60) and emergency caesarean sections were (41.6%,25/60). Vaginal deliveries were (26.5%, 30/113). Reported miscarriages were (17.7%, 20/113). Conclusion: At 1st trimester, 50% of the females were diagnosed with HIV infection, and 50% remained undiagnosed at their 1st trimester. Routine antenatal HIV testing throughout the country is vastly needed for timely diagnoses and prompt treatment(antiretroviral therapy), to suppress the virus, to reduce the risk of spread of HIV infection, to plan elective caesarean section delivery and to prevent mother-to-child transmission.

Keywords: gestational age, HIV infection, mode of delivery, pregnancy

Procedia PDF Downloads 124

Authors: Andreea Halunga, Chris D. Orme, Takashi Yamagata

Abstract:

This paper proposes a heteroskedasticity-robust Breusch-Pagan test of the null hypothesis of zero cross-section (or contemporaneous) correlation in linear panel-data models, without necessarily assuming independence of the cross-sections. The procedure allows for either fixed, strictly exogenous and/or lagged dependent regressor variables, as well as quite general forms of both non-normality and heteroskedasticity in the error distribution. The asymptotic validity of the test procedure is predicated on the number of time series observations, T, being large relative to the number of cross-section units, N, in that: (i) either N is fixed as T→∞; or, (ii) N²/T→0, as both T and N diverge, jointly, to infinity. Given this, it is not expected that asymptotic theory would provide an adequate guide to finite sample performance when T/N is "small". Because of this, we also propose and establish asymptotic validity of, a number of wild bootstrap schemes designed to provide improved inference when T/N is small. Across a variety of experimental designs, a Monte Carlo study suggests that the predictions from asymptotic theory do, in fact, provide a good guide to the finite sample behaviour of the test when T is large relative to N. However, when T and N are of similar orders of magnitude, discrepancies between the nominal and empirical significance levels occur as predicted by the first-order asymptotic analysis. On the other hand, for all the experimental designs, the proposed wild bootstrap approximations do improve agreement between nominal and empirical significance levels, when T/N is small, with a recursive-design wild bootstrap scheme performing best, in general, and providing quite close agreement between the nominal and empirical significance levels of the test even when T and N are of similar size. Moreover, in comparison with the wild bootstrap "version" of the original Breusch-Pagan test our experiments indicate that the corresponding version of the heteroskedasticity-robust Breusch-Pagan test appears reliable. As an illustration, the proposed tests are applied to a dynamic growth model for a panel of 20 OECD countries.

Keywords: cross-section correlation, time-series heteroskedasticity, dynamic panel data, heteroskedasticity robust Breusch-Pagan test

Procedia PDF Downloads 432

Authors: Yelda Yenel, Orkut Acele

Abstract:

In a media-saturated world, celebrities have become ubiquitous figures, encountered both in public spaces and within the privacy of our homes, seamlessly integrating into daily life. From Alexander the Great to contemporary media personalities, the image of celebrity has persisted throughout history, manifesting in various forms and contexts. Over time, as the relationship between society and the market evolved, so too did the roles and behaviors of celebrities. These transformations offer insights into the cultural climate, revealing shifts in habits and worldviews. In Türkiye, the emergence of private television channels brought an influx of celebrities into everyday life, making them a pervasive part of daily routines. To understand modern celebrity culture, it is essential to examine the ideological functions of media within political, economic, and social contexts. Within this framework, celebrities serve as both reflections and creators of cultural values and, at times, act as intermediaries, offering insights into the society of their era. Starting its broadcasting life in 1992 with religious films and religious conversation, Türkiye Newspaper, Radio, Television channel (TGRT) later changed its appearance, slogan, and the celebrities it featured in response to the political atmosphere. Celebrities played a critical role in transforming from the existing slogan 'Peace has come to the screen' to 'Watch and see what will happen”. Celebrities hold significant roles in society, and their images are produced and circulated by various actors, including media organizations and public relations teams. Understanding these dynamics is crucial for analyzing their influence and impact. This study aims to explore Turkish society in the 1990s, focusing on TGRT and its visual and discursive characteristics regarding celebrity figures such as Seda Sayan. The first section examines the historical development of celebrity culture and its transformations, guided by the conceptual framework of celebrity studies. The complex and interconnected image of celebrity, as introduced by post-structuralist approaches, plays a fundamental role in making sense of existing relationships. This section traces the existence and functions of celebrities from antiquity to the present day. The second section explores the economic, social, and cultural contexts of 1990s Türkiye, focusing on the media landscape and visibility that became prominent in the neoliberal era following the 1980s. This section also discusses the political factors underlying TGRT's transformation, such as the 1997 military memorandum. The third section analyzes TGRT as a case study, focusing on its significance as an Islamic television channel and the shifts in its public image, categorized into two distinct periods. The channel’s programming, which aligned with Islamic teachings, and the celebrities who featured prominently during these periods became the public face of both TGRT and the broader society. In particular, the transition to a more 'secular' format during TGRT's second phase is analyzed, focusing on changes in celebrity attire and program formats. This study reveals that celebrities are used as indicators of ideology, benefiting from this instrumentalization by enhancing their own fame and reflecting the prevailing cultural hegemony in society.

Keywords: celebrity culture, media, neoliberalism, TGRT

Procedia PDF Downloads 30

Authors: Amy Claridge, Tishra Beeson

Abstract:

Background: Maternal depression is a serious health concern impacting between 10-16% of birthing persons. It is associated with difficulty in emotional interaction and the formation of attachment bonds between parent and infant. Longitudinally, maternal depression can have severe, lasting impacts on both parent and child, increasing the risk for mental, social, and physical health issues. Rates of prenatal depression have been higher among individuals who were pregnant during the first year of the COVID-19 pandemic. Pregnant persons are considered a high-risk group for poor clinical outcomes from COVID-19 infection and may also have faced or continue to face additional stressors such as financial burdens, loss of income or employment, and the benefits accompanying employment, especially among those in the United States (U.S.). It is less clear whether individuals who gave birth during the pandemic continue to experience high levels of depressive symptoms or whether symptoms have been reduced as a pandemic response has shifted. The current study examined longitudinal reports of depressive symptoms among individuals in the U.S. who gave birth between March 2020 and September 2021. Methods: This mixed-method study involved surveys and interviews with birthing persons (18-45 years old) in their third trimester of pregnancy and at 8 weeks postpartum. Participants also completed a follow-up survey at 12-18 months postpartum. Participants were recruited using convenience methods via an online survey. Survey participants included 242 U.S. women who self-reported depressive symptoms (10-item Edinburgh Postnatal Depression Scale) at each data collection wave. A subset of 23 women participated in semi-structured prenatal and 8-week postpartum qualitative interviews. Follow-up interviews are currently underway and will be integrated into the presentation. Preliminary Results: Prenatal depressive symptoms were significantly positively correlated to 8-week and 12-18-month postpartum depressive symptoms. Participants who reported clinical levels of depression prenatally were 3.29 times (SE = .32, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Those who reported clinical depression at 8-weeks postpartum were 6.52 times (SE = .41, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Participants who gave birth earlier in the pandemic reported significantly higher prenatal (t(103) = 2.84, p < .01) and 8-week postpartum depressive symptoms (t(126) = 3.31, p < .001). Data from qualitative interviews contextualize the findings. Participants reported negative emotions during pregnancy, including sadness, grief, and anxiety. They attributed this in part to their experiences of pregnancy during the pandemic and uncertainty related to the birth experience and postpartum period. Postpartum interviews revealed some stressors specific to childbirth during the COVID-19 pandemic; however, most women reflected on positive experiences of birth and postpartum. Conclusions: Taken together, findings reveal a pattern of persistent depressive symptoms among U.S. parents who gave birth during the pandemic. Depressive symptoms are of significant concern for the health of parents and children, and the findings of this study suggest a need for continued mental health intervention for parents who gave birth during the pandemic. Policy and practice implications will be discussed.

Keywords: maternal mental health, perinatal depression, postpartum depression, covid-19 pandemic

Procedia PDF Downloads 77

Authors: Madeleine Elder, Aye Htun

Abstract:

Background: Myiasis is the parasitic infestation of body tissues by fly larvae. It predominantly occurs in poor socioeconomic regions of tropical and subtropical countries where it is associated with poor hygiene and sanitation. Cutaneous and wound myiasis are the most common presentations whereas urogenital myiasis is rare, with few reported cases. Case: a 26-year-old primiparous woman with a low-risk pregnancy presented to the emergency department at 37+3-weeks’ gestation after passing a 2cm black larva during micturition, with 2 weeks of mild vulvar pruritus and dysuria. She had travelled to India 9-months prior. Examination of the external genitalia showed small white larvae over the vulva and anus and a mildly inflamed introitus. Speculum examination showed infiltration into the vagina and heavy white discharge. High vaginal swab reported Candida albicans. Urine microscopy reported bacteriuria with Enterobacter cloacae. Urine parasite examination showed myiasis caused by Clogmia albipunctata species of fly larvae from the family Psychodidae. Renal tract ultrasound and inflammatory markers were normal. Infectious diseases, urology and paediatric teams were consulted. The woman received treatment for her urinary tract infection (which was likely precipitated by bladder irritation from local parasite infestation) and vaginal candidiasis. She underwent daily physical removal of parasites with cleaning, speculum examination and removal, and hydration to promote bladder emptying. Due to the risk of neonatal exposure, aspiration pneumonitis and facial infestation, the woman was steroid covered and proceeded to have an elective caesarean section at 38+3-weeks’ gestation, with delivery of a healthy infant. She then proceeded to have a rigid cystoscopy and washout, which was unremarkable. Placenta histopathology revealed focal eosinophilia in keeping with the history of maternal parasites. Conclusion: Urogenital myiasis is very rare, especially in the developed world where it is seen in returned travellers. Treatment may include systemic therapy with ivermectin and physical removal of parasites. During pregnancy, physical removal is considered the safest treatment option, and discussion around the timing and mode of delivery should consider the risk of harm to the foetus.

Keywords: urogenital myiasis, parasitic infection, infection in pregnancy, returned traveller

Procedia PDF Downloads 127

Authors: J. E. Appel, R. N. Bouwmeester, L. Crombach, K. Georgieva, N. O’Shea, T. I. van Rijssel, L. Wingens

Abstract:

The Netherlands has a unique and progressive euthanasia law. Even people with advanced neurodegenerative diseases, like dementia, can request euthanasia when an Advanced Euthanasia Directive (AED) was written. Although the law sets some guidelines, in practice many complexities occur. Especially doctors experience difficult situations, as they have to decide whether euthanasia is justified. Research suggests that this leads to an emotional burden for them, due to feelings of isolation, fear of prosecution, as well as pressures from patient, family, or society. Existing literature, however, failed to address problems arising in dementia cases in particular, as well as possible sources of support. In order to investigate these issues, semi-structured in-depth interviews with 20 Dutch general practitioners and elderly care physicians will be conducted. Results are expected to be obtained by the end of December 2017.

Keywords: dementia, euthanasia, general practitioners, elderly care physicians, palliative care

Procedia PDF Downloads 213

Authors: Jitendra Aswani

Abstract:

In the first section of this study, impact of Global Financial Crisis (GFC) on the synchronization of fourteen Asian Stock Markets (ASM’s) of countries like Hong Kong, India, Thailand, Singapore, Taiwan, Pakistan, Bangladesh, South Korea, Malaysia, Indonesia, Japan, China, Philippines and Sri Lanka, has been analysed using the network science and its metrics like degree of node, clustering coefficient and network density. Then in the second section of this study by introducing the US stock market in existing network and developing a Minimum Spanning Tree (MST) spread of crisis from the US stock market to Asian Stock Markets (ASM) has been explained. Data used for this study is adjusted the closing price of these indices from 6th January, 2000 to 15th September, 2013 which further divided into three sub-periods: Pre, during and post-crisis. Using network analysis, it is found that Asian stock markets become more interdependent during the crisis than pre and post crisis, and also Hong Kong, India, South Korea and Japan are systemic important stock markets in the Asian region. Therefore, failure or shock to any of these systemic important stock markets can cause contagion to another stock market of this region. This study is useful for global investors’ in portfolio management especially during the crisis period and also for policy makers in formulating the financial regulation norms by knowing the connections between the stock markets and how the system of these stock markets changes in crisis period and after that.

Keywords: global financial crisis, Asian stock markets, network science, Kruskal algorithm

Procedia PDF Downloads 424

Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

Abstract:

Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

Procedia PDF Downloads 228