Search results for: Jordanian men and women’s health

Authors: Baikuntha Prasad Acharya, Elizabeth Halpenny

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Small tourism enterprises (STEs) are primary providers of services and attractions in many destinations of less developed countries; they are considered the lifeblood of tourism sector. Furthermore, in rural community destinations of such countries including Nepal, STEs are regarded as alternative tools for advancing economic and sociocultural transformations. Many families in rural Nepali destinations are venturing into small tourism entrepreneurship so that their poverty can be reduced and they can live a sustained life. Most these communities are utilizing their lifestyles and natural and cultural heritages as tourism attractions. This study aimed to understand the sustainability of the STEs in rural destinations by synthesizing observations from Ghalegaon and Ghandruk of the Annapurna Conservation Area in western Nepal. Ghalegaon has community-based homestays and Ghandruk has independently owned and operated small tourism businesses such as cafes, tea houses, lodges, guest houses, and hotels, etc. The community-based homestays of Ghalegaon are compared with the independently owned and operated STEs of Ghandruk. The data were collected through multiple sources: 1) survey of tourists (n=112) and households (n=191); 2) interviews (n=14) with the locals, 3) group discussions (n=10) with different local groups including that of regional tourism players, experts and policy makers, 4) observations, and 5) document analysis. The STEs of both communities were first analyzed by understanding their level of sustainability as businesses, and then were explored how they were impacting on respective communities’ sustainability. The survey indicators and guidelines for interviews and group discussions were adapted to the Nepalese context based on four pillars of sustainability: economic, social, cultural and environmental; an additional dimension of management was also included, particularly for the STEs. The findings have shown a weaker economic and management dimensions of Ghalegaon’s Homestay than that of Ghandruk’s STEs. Some interesting social complexities of rural tourism and entrepreneurship were also revealed. This study’s findings do not much resonate to what Nepal government’s current rural tourism strategies that have been envisioned and prioritized for, particularly that the rural homestay tourism opportunities enhance inclusiveness of women and other deprived communities by spreading the benefits to the grassroots level. The study has highlighted several important applied implications to the local tourism management committees, tourism operators and associations, and regional and national tourism authorities. Further studies are advisable in other similar contexts in Nepal and in other countries to see whether there are variances in the findings.

Keywords: Nepal, rural tourism communities, small tourism enterprises, sustainability

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Authors: Thilini Kananke

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Culinary herbs have long been considered as significant dietary sources of many potential health-promoting compounds. The present research focused on analysis of antimicrobial, antioxidant and physicochemical properties in selected four culinary herbs namely Murraya koenigii (Curry leaves), Pandanus amaryllifolius (Pandan leaves), Cymbopogon citrates (Lemon grass leaves), and Mentha Piperita (Minchi leaves) obtained from several market sites in Ratnapura District, Sri Lanka. The antimicrobial activity of ethanolic, chloroform and distilled water extracts of culinary herbs were evaluated against the strains of Staphylococcus aureus, Salmonella typhi and Shigella spp. Total phenolic content and the radical scavenging activity (using DPPH assay) of culinary herbs were determined. Four heavy metals (Cu, Cd, Pb and Fe) were analyzed in the selected culinary herbs using the atomic absorption spectroscopy (AAS). Proximate compositions of the selected herbs were analyzed using AOAC official methods. Antimicrobial activity of all selected culinary herbs showed relativity high inhibition zones against S. aureus. Pandan leaves showed the least antimicrobial activity against selected bacterial strains compared with other culinary herbs. Both the highest radical scavenging activity (lower IC50 value) and the total phenolic content (25.57 ±3.54µg GAE/100g) were reported in Mentha piperita extract. The highest concentrations of Cu, Fe and Cd were reported in Curry leaves (29.15 mg/kg), Lemon grass leaves (257.98 mg/kg) and Pandan leaves (6.05 mg/kg) respectively. The heavy metal contents detected in all culinary herbs were below the permitted limits set by WHO/FAO, except Cd. The highest moisture (85.00±0.00%) and fiber (10.66± 2.00%) contents were found in Pandan leaves, while the highest protein (8.94±0.29%), fat (12.3± 2.52%) and ash (3.50± 0.17%) contents were reported in curry leaves. The information obtained from this study highlights the importance of further investigation of other antioxidant, antimicrobial and health promoting compounds of culinary herbs available in Sri Lanka for a detailed comparison.

Keywords: antimicrobial, antioxidant, culinary herbs, proximate analysis

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Authors: Erica Cochran Hameen, Bobuchi Ken-Opurum, Shalini Priyadarshini, Berangere Lartigue, Sadhana Anath-Pisipati

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School districts throughout the United States are constantly seeking measures to improve test scores, reduce school absenteeism and improve indoor environmental quality. It is imperative to identify key building investments which will provide the largest benefits to schools in terms of improving the aforementioned factors. This study uses Analysis of Variance (ANOVA) tests to statistically evaluate the impact of a school building’s mechanical and plumbing characteristics on a child’s educational performance. The educational performance is measured via three indicators, i.e. test scores, suspensions, and absenteeism. The study investigated 125 New York City school facilities to determine the potential correlations between 50 mechanical and plumbing variables and the performance indicators. Key findings from the tests revealed that elementary schools with pneumatic systems in “good” condition have 48.8% lower percentages of students scoring at the minimum English Language Arts (ELA) competency level compared with those with no pneumatic system. Additionally, elementary schools with “unit heaters/cabinet heaters” in “good to fair” conditions have 1.1% higher attendance rates compared to schools with no “unit heaters/cabinet heaters” or those in inferior condition. Furthermore, elementary schools with air conditioning have 0.6% higher attendance rates compared to schools with no air conditioning, and those with interior floor drains in “good” condition have 1.8% higher attendance rates compared to schools with interior drains in inferior condition.

Keywords: academic attendance and performance, mechanical and plumbing systems, schools, student health

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Authors: Priyanka Bhowmik, Subrata Majumdar, Debprasad Chattopadhyay

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Background: Cervical cancer is the third major cause of cancer in women and the second most frequent cause of cancer related deaths causing 300,000 deaths annually worldwide. Evasion of immune response by Human Papilloma Virus (HPV), the key contributing factor behind cancer and pre-cancerous lesions of the uterine cervix, makes immunotherapy a necessity to treat this disease. Objective: A Heat killed fraction of Mycobacterium indicus pranii (MIP), a non-pathogenic Mycobacterium has been shown to exhibit cytotoxic effects on different cancer cells, including human cervical carcinoma cell line HeLa. However, the underlying mechanisms remain unknown. The aim of this study is to decipher the mechanism of MIP induced HeLa cell death. Methods: The cytotoxicity of Mycobacterium indicus pranii against HeLa cells was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Apoptosis was detected by annexin V and Propidium iodide (PI) staining. The assessment of reactive oxygen species (ROS) generation and cell cycle analysis were measured by flow cytometry. The expression of apoptosis associated genes was analyzed by real time PCR. Result: MIP could inhibit the proliferation of HeLa cell in a time and dose dependent manner but caused minor damage to normal cells. The induction of apoptosis was confirmed by the cell surface presentation of phosphatidyl serine, DNA fragmentation, and mitochondrial damage. MIP caused very early (as early as 30 minutes) transcriptional activation of p53, followed by a higher activation (32 fold) at 24 hours suggesting prime importance of p53 in MIP-induced apoptosis in HeLa cell. The up regulation of p53 dependent pro-apoptotic genes Bax, Bak, PUMA, and Noxa followed a lag phase that was required for the transcriptional p53 program. MIP also caused the transcriptional up regulation of Toll like receptor 2 and 4 after 30 minutes of MIP treatment suggesting recognition of MIP by toll like receptors. Moreover, MIP caused the inhibition of expression of HPV anti apoptotic gene E6, which is known to interfere with p53/PUMA/Bax apoptotic cascade. This inhibition might have played a role in transcriptional up regulation of PUMA and subsequently apoptosis. ROS was generated transiently which was concomitant with the highest transcription activation of p53 suggesting a plausible feedback loop network of p53 and ROS in the apoptosis of HeLa cells. Scavenger of ROS, such as N-acetyl-L-cysteine, decreased apoptosis suggesting ROS is an important effector of MIP induced apoptosis. Conclusion: Taken together, MIP possesses full potential to be a novel therapeutic agent in the clinical treatment of cervical cancer.

Keywords: cancer, mycobacterium, immunity, immunotherapy.

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Authors: Hajar Al Rajaibi, Kawla Al Toubi, Saeed Al Jaadi, Deepali Jaju, Sanjay Jaju

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Background: The available evidence in Oman on lack of physical activity call for immediate intervention. Physical activity counseling by doctors to their patients is influenced by their attitudes and personal physical fitness. To our best knowledge, the physical activity status of Omani medical students has not been addressed before. These future doctors will have a critical role in improving physical activity in patients and thus their overall health. Objective: The aim of the study is to assess the physical activity level, physical fitness level, and attitudes towards physical activity among Sultan Qaboos University senior medical students. Methods: In this cross-sectional study (N=110; males 55), physical activity level was assessed using International Physical Activity Questionnaire (IPAQ ) short form and attitudes towards physical activity using a fifty-four-items Kenyon questionnaire. The physical fitness level was assessed by estimating maximal oxygen uptake (VO₂max) using Chester step test. Results: Female students reported more sitting time more than 7hr/day (85.5%) compared to male students (40%; p < 0.05). The IPAQ revealed moderate level of physical activity in 58% of students. Students showed a high positive attitude towards physical activity for health and fitness and low attitude for physical activity as tension and risk. Both female and male students had a similar level and attitude towards physical activity. Physical fitness level was excellent (VO₂max > 55ml O₂/kg/min) in 11% of students, good (VO₂max>44-54ml O₂/kg/min) in 49% and average to below-average in 40%. Objectively measured physical fitness level, subjectively reported physical activity level or attitudes towards physical activity were not correlated. Conclusion: Omani medical students have a positive attitude towards physical activity but moderate physical activity level. Longer sitting time in females need further evaluation. Efforts are required to understand reasons for present physical activity level and to promote good physical activity among medical students by creating more awareness and facilities.

Keywords: Chester step test, Kenyon scale, medical students, physical activity, physical fitness

Procedia PDF Downloads 155

Authors: P. Efstathiou, E. Kouskouni, Z. Manolidou, K. Karageorgou, M. Tseroni, A. Efstathiou, V. Karyoti, I. Agrafa

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Aim: The aim of this prospective comparative study is to evaluate the reduction of microbial flora on the surface of an axillary digital thermometer, made of antimicrobial copper, in relation with a common digital thermometer. Material – Methods: A brand new digital electronic thermometer implemented with antimicrobial copper (Cu 70% - Nic 30%, low lead) on the two edges of the device (top and bottom: World Patent Number WO2013064847 and Register Number by the Hellenic Copper Development Institute No 11/2012) was manufactured and a comparative study with common digital electronic thermometer was conducted on 18 ICU (Intensive Care Unit) patients of three different hospitals. The thermometry was performed in accordance with the projected International Nursing Protocols for body temperature measurement. A total of 216 microbiological samples were taken from the axillary area of the patients, using both of the investigated body temperature devises. Simultaneously the “Halo” phenomenon (phenomenon “Stefanis”) was studied at the non-antimicrobial copper-implemented parts of the antimicrobial digital electronic thermometer. Results: In all samples collected from the surface of the antimicrobial electronic digital thermometer, the reduction of microbial flora (Klebsiella spp, Staphylococcus aureus, Staphylococcus epidermitis, Candida spp, Pneudomonas spp) was progressively reduced to 99% in two hours after the thermometry. The above flora was found in the axillary cavity remained the same in common thermometer. The statistical analysis (SPSS 21) showed a statistically significant reduction of the microbial load (N = 216, < 0.05). Conclusions: The hospital-acquired infections are linked to the transfer of pathogens due to the multi-usage of medical devices from both health professionals and patients, such as axillary thermometers. The use of antimicrobial digital electronic thermometer minimizes microbes' transportation between patients and health professionals while having all the conditions of reliability, proper functioning, security, ease of use and reduced cost.

Keywords: antimicrobial copper, cross infections, digital thermometers, ICU

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Authors: Suin Seo, Sung-Il Cho

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Background: The use of mobile apps for smoking cessation has grown exponentially in recent years. Yet, there were limited researches which evaluated the quality of smoking cessation apps to our knowledge. In most cases, a clinical practice guideline which is focused on clinical physician was used as an evaluation tool. Objective: The objective of this study was to develop a user-centered measure for quality of mobile smoking cessation apps. Methods: A literature search was conducted to identify articles containing explicit smoking cessation guideline for smoker published until January 2018. WHO’s guide for tobacco users to quit was adopted for evaluation tool which assesses smoker-oriented contents of smoking cessation apps. Compared to the clinical practice guideline, WHO guideline was designed for smokers (non-specialist). On the basis of existing criteria which was developed based on 2008 clinical practice guideline for Treating Tobacco Use and Dependence, evaluation tool was modified and developed by an expert panel. Results: There were five broad categories of criteria that were identified including five objective quality scales: enhancing motivation, assistance with a planning and making quit attempts, preparation for relapse, self-efficacy, connection to smoking. Enhancing motivation and assistance with planning and making quit attempts were similar to contents of clinical practice guideline, but preparation for relapse, self-efficacy and connection to smoking (environment or habit which reminds of smoking) only existed on WHO guideline. WHO guideline had more user-centered elements than clinical guideline. Especially, self-efficacy is the most important determinant of behavior change in accordance with many health behavior change models. With the WHO guideline, it is now possible to analyze the content of the app in the light of a health participant, not a provider. Conclusion: The WHO guideline evaluation tool is a simple, reliable and smoker-centered tool for assessing the quality of mobile smoking cessation apps. It can also be used to provide a checklist for the development of new high-quality smoking cessation apps.

Keywords: smoking cessation, evaluation, mobile application, WHO, guideline

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Authors: Esengül Elibol, Arzu Kader Harmancı Seren

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Individuals' reasons to choose a profession, profession image perceptions and future plans related to that profession affect their success in their future work lives. For nursing profession, this situation at the same time is important in terms of the health and safety of patients. The purpose of this study is to determine why medical vocational high school students in İstanbul choose nursing profession, their nursing image perceptions and future plans related to the profession. Descriptive and cross-sectional design are used. The study was carried out in four medical vocational high school in İstanbul. All third and fourth grade students who are attending to nursing programs and voluntary for participation were included in the study. In collecting data, two questionnaires that aim to learn about socio-demographic characteristics, profession choice reasons and future plans of nursing students and ‘Nursing Image Scale’ were used. Scale consisted of 28 items including individuals' opinions on nursing profession image and three sub-categories ‘General View,’ ‘Communication,’ and ‘Vocational-Educational Qualities.’ Analyzing profession choice reasons and future plans of participants, it is determined that majority chose nursing for easily finding a job (46.9%) and that majority had a dream profession other than nursing (65.8%). Analyzing nursing image perception of participants, it is determined that average of general view sub-category total scores was 9.75±2.27, average of communication sub-category total scores was8.68±2.86, and average of vocational-educational qualities sub-category total score was 21.18±3.96. In the perception score averages, meaningful differences were found according to independent variables. In conclusion, it was determined that majority of the participant students chose nursing for easily finding a job, perceived profession image negatively, and had a dream profession other than nursing.

Keywords: nursing image, medical vocational health school, perception, profession, student nurse

Procedia PDF Downloads 279

Authors: Suresh Lokiah

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The emerging trend of integrating robots into elderly care, particularly for assisting patients with dementia, holds the potential to greatly transform the sector. Assisted living facilities, which house a significant number of elderly individuals and dementia patients, constantly strive to engage their residents in stimulating activities. However, due to staffing shortages, they often rely on volunteers to introduce new activities. Despite the availability of social interaction, these residents, frequently overlooked in society, are in desperate need of additional support. Robots designed for elder care are categorized based on their design and functionality. These categories include companion robots, telepresence robots, health monitoring robots, and rehab robots. However, the integration of such robots raises significant ethical concerns, notably regarding privacy, autonomy, and the risk of dehumanization. Privacy issues arise as these robots may need to continually monitor patient activities. There is also a risk of patients becoming overly dependent on these robots, potentially undermining their autonomy. Furthermore, the replacement of human touch with robotic interaction may lead to the dehumanization of care. This paper delves into the ethical considerations of incorporating robotic assistance in eldercare. It proposes a series of guidelines and strategies to ensure the ethical deployment of these robots. These guidelines suggest involving patients in the design and development process of the robots and emphasize the critical need for human oversight to respect the dignity and rights of the elderly and dementia patients. The paper also recommends implementing robust privacy measures, including secure data transmission and data anonymization. In conclusion, this paper offers a thorough examination of the ethical implications of using robotic assistance in elder care. It provides a strategic roadmap to ensure this technology is utilized ethically, thereby maximizing its potential benefits and minimizing any potential harm.

Keywords: human-robot interaction, robots for eldercare, ethics, health, dementia

Procedia PDF Downloads 100

Authors: Lamia Bouzgarrou, Amira Omrane, Leila Mrabet, Taoufik Khalfallah

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Background and aims: School accidents are one of the leading causes of morbidity and mortality among pupils and students. Indeed, they may induce an elevated number of lost school days, heavy emotional and physical disabilities, and financial costs on the victims and their families. This study aims to evaluate the annual incidence of school accidents in the central Tunisian governorate of Mahdia and to identify the epidemiological profile of victims and risk factors of these accidents. Methods: A retrospective study was conducted over the period of 5 school years, focusing on school accidents that occurred in public educational institutions (primary, basic, secondary and university) in the governorate of Mahdia (area = 2 966 km² and number of inhabitants in 2014 = 410 812). All accidents declared near the only official insurance of this type of injuries (MASU: Mutual School and University Accidents), and initially taken in charge at the University Hospital of Mahdia were included. Data was collected from the MASU reporting forms and the medical records of emergency and other specialized hospital departments. Results: With 3248 identified victims, the annual incidence of school accidents was equal to 0.69 per 100 pupils and students per year. The average age of victims was 14.51 ± 0.059 years and the sex ratio was 1.58. Pupils aged between 12 and 15 years, were concerned by 46.7% of the identified accidents. The practice of sports was the most relevant circumstances of these accidents (76.2 %). In 56.58 % of cases, falls were the leading mechanism. Bruises and fractures were the most frequent lesions (32.43 % and 30.51 %). Serious school accidents were noted in 28% of cases with hospitalization in 2.27 % of them. The average lost school days, was 12.23±1.73 days. Accidents occurring during sports or leisure activities were significantly more serious (p= 0.021). Furthermore, the frequency of hospitalization was significantly higher among boys (2.81% vs. 1.43%; p= 0.035), students ≤11 years (p= 0.008), and following crush trauma (p= 0.000). In addition, the surgical interventions were statistically more frequent among male victims (p=0.00), accidents occurring during physical education sessions (p=0.000); those associated to falls (p=0.000) and to crushes mechanisms (p=0.002), and injuries affecting lower limbs (p=0.000). Following this Multi-varied analysis concluded that the severity of school accident is correlated to the activity practiced during the trauma and the geographical location of the school. Conclusion: Children and adolescents are one of the most vulnerable groups against incidents with the risk of permanent disability, mainly related to the perturbation of the growth process and physiological limitations. Our five-year study, objectified a real elevate incidence of school accident among children and adolescents, with a considerable rate of severe injuries. In any community, the promotion of adolescents and children’s health is an important indicator of the public health level. Thus, it’s important to develop a multidisciplinary prevention strategy of school accident, based on safety and security rules and adapted to the specificity of our context.

Keywords: children and adolescents, children health, injuries and disability, school accident

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Authors: Ghufran Ahmed, Muhammad Osama Siddiqui, Shahbaz Siddiqui, Rauf Ahmad Shams Malick, Faisal Khan, Mubashir Khan

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In this paper, a machine learning-based approach for early prediction of diseases in cows is proposed. Different ML algos are applied to extract useful patterns from the available dataset. Technology has changed today’s world in every aspect of life. Similarly, advanced technologies have been developed in livestock and dairy farming to monitor dairy cows in various aspects. Dairy cattle monitoring is crucial as it plays a significant role in milk production around the globe. Moreover, it has become necessary for farmers to adopt the latest early prediction technologies as the food demand is increasing with population growth. This highlight the importance of state-ofthe-art technologies in analyzing how important technology is in analyzing dairy cows’ activities. It is not easy to predict the activities of a large number of cows on the farm, so, the system has made it very convenient for the farmers., as it provides all the solutions under one roof. The cattle industry’s productivity is boosted as the early diagnosis of any disease on a cattle farm is detected and hence it is treated early. It is done on behalf of the machine learning output received. The learning models are already set which interpret the data collected in a centralized system. Basically, we will run different algorithms on behalf of the data set received to analyze milk quality, and track cows’ health, location, and safety. This deep learning algorithm draws patterns from the data, which makes it easier for farmers to study any animal’s behavioral changes. With the emergence of machine learning algorithms and the Internet of Things, accurate tracking of animals is possible as the rate of error is minimized. As a result, milk productivity is increased. IoT with ML capability has given a new phase to the cattle farming industry by increasing the yield in the most cost-effective and time-saving manner.

Keywords: IoT, machine learning, health care, dairy cows

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Authors: R. Bužgová, R. Kozáková, M. Škutová, M. Bar, P. Ressner, P. Bártová

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Introduction: Currently, there has been an increasing concern about the provision of palliative care in non-oncological patients in both professional literature and clinical practice. However, there is not much scientific information on how to provide neurological and palliative care together. The main objective of the project is to create and to verify a concept of neuro-palliative and rehabilitative care for patients with selected neurological diseases in an advanced stage of the disease and also to evaluate bio-psychosocial and spiritual needs of these patients and their caregivers related to the quality of life using created standardized tools. Methodology: Triangulation of research methods (qualitative and quantitative) will be used. A concept of care and assessment tools will be developed by analyzing interviews and focus groups. Qualitative data will be analyzed using grounded theory. The concept of care will be tested in the context of the intervention study. Using quantitative analysis, we will assess the effect of an intervention provided on the saturation of needs, quality of life, and quality of care. A research sample will be made up of the patients with selected neurological diseases (Parkinson´s syndrome, motor neuron disease, multiple sclerosis, Huntington’s disease), together with patients´ family members. Based on the results, educational materials and a certified course for health care professionals will be created. Findings: Based on qualitative data analysis, we will propose the concept of integrated care model combining neurological, rehabilitative and specialist palliative care for patients with selected neurological diseases in different settings of care and services. Patients´ needs related to quality of life will be described by newly created and validated measuring tools before the start of intervention (application of neuro-palliative and palliative approach) and then in the time interval. Conclusion: Based on the results, educational materials and a certified course for doctors and health care professionals will be created.

Keywords: multidisciplinary approach, neuropalliative care, research, quality of life

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Authors: Pauline Blanchet

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In a world where images are a prominent part of our daily lives and a way of absorbing information, the analysis of the representation of migration narratives is vital. This thesis raises questions concerning the power of illustrations, drawings and visual culture in order to represent the migration narratives in the age of Instagram. The rise of graphic novels and comics has come about in the last fifteen years, specifically regarding contemporary authors engaging with complex social issues such as migration and refugeehood. Due to this, refugee subjects are often in these narratives, whether they are autobiographical stories or whether the subject is included in the creative process. Growth in discourse around migration has been present in other art forms; in 2018, there has been dedicated exhibitions around migration such as Tania Bruguera at the TATE (2018-2019), ‘Journeys Drawn’ at the House of Illustration (2018-2019) and dedicated film festivals (2018; the Migration Film Festival), which have shown the recent considerations of using the arts as a medium of expression regarding themes of refugeehood and migration. Graphic visuals are fast becoming a key instrument when representing migration, and the central thesis of this paper is to show the strength and limitations of this form as well the methodology used by the actors in the production process. Recent works which have been released in the last ten years have not being analysed in the same context as previous graphic novels such as Palestine and Persepolis. While a lot of research has been done on the mass media portrayals of refugees in photography and journalism, there is a lack of literature on the representation with illustrations. There is little research about the accessibility of graphic novels such as where they can be found and what the intentions are when writing the novels. It is interesting to see why these authors, NGOs, and curators have decided to highlight these migrant narratives in a time when the mainstream media has done extensive coverage on the ‘refugee crisis’. Using primary data by doing one on one interviews with artists, curators, and NGOs, this paper investigates the efficiency of graphic novels for depicting refugee stories as a viable alternative to other mass medium forms. The paper has been divided into two distinct sections. The first part is concerned with the form of the comic itself and how it either limits or strengthens the representation of migrant narratives. This will involve analysing the layered and complex forms that comics allow such as multimedia pieces, use of photography and forms of symbolism. It will also show how the illustration allows for anonymity of refugees, the empathetic aspect of the form and how the history of the graphic novel form has allowed space for positive representations of women in the last decade. The second section will analyse the creative and methodological process which takes place by the actors and their involvement with the production of the works.

Keywords: graphic novel, refugee, communication, media, migration

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Authors: Elyria Kemp, Kelly Cowart, My Bui

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According to the National Institute of Mental Health, an estimated 31.9% of adolescents have had an anxiety disorder. Several environmental factors may help to contribute to high levels of anxiety and depression in young people (i.e., Generation Z, Millennials). However, as young people negotiate life on social media, they may begin to evaluate themselves using excessively high standards and adopt self-perfectionism tendencies. Broadly defined, self-perfectionism involves very critical evaluations of the self. Perfectionism may also come from others and may manifest as socially prescribed perfectionism, and young adults are reporting higher levels of socially prescribed perfectionism than previous generations. This rising perfectionism is also associated with anxiety, greater physiological reactivity, and a sense of social disconnection. However, theories from psychology suggest that improvement in emotion regulation can contribute to enhanced psychological and emotional well-being. Emotion regulation refers to the ways people manage how and when they experience and express their emotions. Cognitive reappraisal and expressive suppression are common emotion regulation strategies. Cognitive reappraisal involves changing the meaning of a stimulus that involves construing a potentially emotion-eliciting situation in a way that changes its emotional impact. By contrast, expressive suppression involves inhibiting the behavioral expression of emotion. The purpose of this research is to examine the efficacy of social marketing initiatives which promote emotion regulation strategies to help young adults regulate their emotions. In Study 1 a single factor (emotional regulation strategy: a cognitive reappraisal, expressive, control) between-subjects design was conducted using an online, non-student consumer panel (n=96). Sixty-eight percent of participants were male, and 32% were female. Study participants belonged to the Millennial and Gen Z cohort, ranging in age from 22 to 35 (M=27). Participants were first told to spend at least three minutes writing about a public speaking appearance which made them anxious. The purpose of this exercise was to induce anxiety. Next, participants viewed one of three advertisements (randomly assigned) which promoted an emotion regulation strategy—cognitive reappraisal, expressive suppression, or an advertisement non-emotional in nature. After being exposed to one of the ads, participants responded to a measure composed of two items to access their emotional state and the efficacy of the messages in fostering emotion management. Findings indicated that individuals in the cognitive reappraisal condition (M=3.91) exhibited the most positive feelings and more effective emotion regulation than the expressive suppression (M=3.39) and control conditions (M=3.72, F(1,92) = 3.3, p<.05). Results from this research can be used by institutions (e.g., schools) in taking a leadership role in attacking anxiety and other mental health issues. Social stigmas regarding mental health can be removed and a more proactive stance can be taken in promoting healthy coping behaviors and strategies to manage negative emotions.

Keywords: emotion regulation, anxiety, social marketing, generation z

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Authors: Go Iwashita

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The paper describes how the frequencies of heatstroke occurring in indoor built environment are related to the outdoor thermal environment with big statistical data. As the statistical accident data of heatstroke, the nationwide accident data were obtained from the National Agency for the Advancement of Sports and Health (NAASH) . The meteorological database of the Japanese Meteorological Agency supplied data about 1-hour average temperature, humidity, wind speed, solar radiation, and so forth. Each heatstroke data point from the NAASH database was linked to the meteorological data point acquired from the nearest meteorological station where the accident of heatstroke occurred. This analysis was performed for a 10-year period (2005–2014). During the 10-year period, 3,819 cases of heatstroke were reported in the NAASH database for the investigated secondary/high schools of the nine Japanese representative cities. Heatstroke most commonly occurred in the outdoor schoolyard at a wet-bulb globe temperature (WBGT) of 31°C and in the indoor gymnasium during athletic club activities at a WBGT > 31°C. The determined accident ratio (number of accidents during each club activity divided by the club’s population) in the gymnasium during the female badminton club activities was the highest. Although badminton is played in a gymnasium, these WBGT results show that the risk level during badminton under hot and humid conditions is equal to that of baseball or rugby played in the schoolyard. Except sports, the high risk of heatstroke was observed in schools houses during cultural activities. The risk level for indoor environment under hot and humid condition would be equal to that for outdoor environment based on the above results of WBGT. Therefore control measures against hot and humid indoor condition were needed as installing air conditions not only schools but also residences.

Keywords: accidents in schools, club activity, gymnasium, heatstroke

Procedia PDF Downloads 218

Authors: M. Keršič, M. Lužnik, J. Lužnik

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Cervical dilatation and membrane herniation before 26th week of gestation poses very high risk for extremely and very premature childbirth. Cerclage with mesh cap (mesh cerclage, MC) can greatly diminish this risk and provide additional positive effects. Between 2005 and 2014, MC has been performed in 9 patients with singleton pregnancies who had prolapsed membranes beyond external cervical/uterine os before 25th week of pregnancy (one in 29th). With patients in general anaesthesia, lithotomy and Trendelenburg position (about 25°) prolapsed membranes were repositioned in the uterine cavity, using tampon soaked in antiseptic solution (Skinsept mucosa). A circular, a type of purse-string suture (main band) with double string Ethilon 1 was applied at about 1 to 1.5 cm from the border of the external uterine os - 6 to 8 stitches were placed, so the whole external uterine os was encircled (modified McDonald). In the next step additional Ethilon 0 sutures were placed around all exposed parts of the main double circular suture and loosely tightened. On those sutures, round tailored (diameter around 6 cm) mesh (Prolene® or Gynemesh* PS) was attached. In all 9 cases, gestation was prolonged on average for 9 weeks and 4 days (67 days). In four cases maturity was achieved. Mesh was removed in 37th–38th week of pregnancy or if spontaneous labour began. In two cases, a caesarean section was performed because of breech presentation. In the first week after birth in 22nd week one new born died because of immaturity (premature birth was threatening in 18th week and then MC was placed). Ten years after first MC, 8 of 9 women with singleton pregnancy and MC performed have 8 healthy children from these pregnancies. Mesh cerclage successfully closed the opened cervical canal or uterine orifice and prevented further membrane herniation and membrane rupture. MC also provides a similar effect as with occluding the external os with suturing but without interrupting the way for excretion of abundant cervical mucus. The mesh also pulls the main circular band outwards and thus lowers the chance of suture cutting through the remaining cervix. MC prolonged gestation very successfully (mean for 9 weeks and 4 days) and thus increased possibility for survival and diminished the risk for complications in very early preterm delivered survivors in cases with cervical dilatation and membrane herniation before 26th week of gestation. Without action possibility to achieve at least 28th or 32nd week of gestation would be poor.

Keywords: cervical insufficiency, mesh cerclage, membrane protrusion, premature birth prevention, physical exam-indicated cerclage, rescue cerclage

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Authors: Emilia R. Serrano, Pedro M. David Gara, Gustavo T. Ruiz

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Water pollution is an urgent global issue, impacting not only the availability and quality of water for consumption but also the health and lifestyle of populations worldwide. One growing concern is the presence of pharmaceuticals in natural waters, which pose significant risks to both the environment and public health. These substances, even in trace amounts, can cause physiological effects that are often undetected due to insufficient monitoring. Among the many compounds of concern are caffeine, paracetamol, ibuprofen, and enrofloxacin, all of which have been detected in rivers across Argentina. These substances are part of a broader class of emerging pollutants (EPs), which also include chemicals from household and personal care products. The environmental dangers posed by EPs are substantial, particularly their effects on the biotic components of aquatic ecosystems. Bioaccumulation of these pollutants has been observed in various aquatic organisms, raising concerns about long-term ecological impacts. Additionally, continuous exposure to EPs has been linked to a range of harmful effects, including cytotoxicity, genotoxicity, apoptosis, and functional impairments in living organisms. More alarmingly, the prevalence of antibiotics in the environment contributes to the growing issue of antibiotic resistance, creating a significant global health crisis. Unfortunately, these pollutants often go unnoticed during routine water quality assessments, which underscores the need for innovative approaches to mitigate their impact. One promising solution lies in the use of transition metal coordination compounds as photosensitizers, which can help degrade EPs through photocatalytic processes. Transition metals like rhenium (Re) form stable complexes with organic ligands, and these Re(I) complexes (ReC) exhibit tunable photophysical and photochemical properties based on metal-ligand combinations. By focusing on bi-azinic ligands, we aim to optimize the behavior of Re(I) complexes, enhancing their efficiency as photosensitizers in the degradation of harmful pollutants. ReC molecules are of particular interest due to their excellent thermal and photochemical stability, as well as their ability to facilitate electron transfer and redox reactions. When activated by light, these complexes generate reactive species capable of breaking down toxic pollutants into less harmful byproducts. This photo-driven degradation process offers a sustainable and environmentally friendly approach to removing EPs from natural waters, reducing their impact on aquatic life and human health. The unique properties of ReC, such as their excited-state behavior and efficient energy transfer, make them highly suitable for photocatalytic applications aimed at mitigating water pollution. The methodology employed in this research integrates several techniques to explore the effectiveness of ReC in pollutant degradation. These include optoacoustic measurements, absorption and fluorescence spectroscopy, laser flash photolysis, and the use of a phoreactor to simulate real-world conditions. Our recent results showed that a ferrocene-rhenium complex with phenanthroline enhanced the photodegradation of ibuprofen under oxidizing conditions. While promising, further studies, such as HPLC, are needed to determine the exact nature of the degradation products and assess the efficiency of the process. Through this approach, this research aims to contribute to the development of efficient, green technologies for degrading emerging pollutants in natural waters.

Keywords: Rhenium complexes, photosensitizers, emerging pollutants, Ibuprofen

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Authors: B. M. Pardeshi

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Introduction: Minerals and trace elements are chemical elements required by our bodies for numerous biological and physiological processes that are necessary for the maintenance of health. Medicinal plants are highly beneficial for the maintenance of good health and prevention of diseases. They are known as potential sources of minerals and vitamins. 30 to 40% of today’s conventional drugs used in the medicinal and curative properties of various plants are employed in herbal supplement botanicals, nutraceuticals and drug. Aim: The authors explored the mineral element content of some herbs, because mineral elements may have significant role in the development and treatment of gastrointestinal diseases, and a close connection between the presence or absence of mineral elements and inflammatory mediators was noted. Methods: Present study deals with the elemental analysis of medicinal plants by Instrumental Neutron activation Analysis and Atomic Absorption Spectroscopy. Medicinal herbals prescribed for skin diseases were purchased from markets and were analyzed by Instrumental Neutron Activation Analysis (INAA) using 252Cf Californium spontaneous fission neutron source (flux * 109 n s-1) and the induced activities were counted by γ-ray spectrometry and Atomic Absorption Spectroscopy (AAS) techniques (Perkin Elmer 3100 Model) available at Department of Chemistry University of Pune, INDIA, was used for the measurement of major, minor and trace elements. Results: 15 elements viz. Al, K, Cl, Na, Mn by INAA and Cu, Co, Pb, Ni, Cr, Ca, Fe, Zn, Hg and Cd by AAS were analyzed from different medicinal plants from India. A critical examination of the data shows that the elements Ca , K, Cl, Al, and Fe are found to be present at major levels in most of the samples while the other elements Na, Mn, Cu, Co, Pb, Ni, Cr, Ca, Zn, Hg and Cd are present in minor or trace levels. Conclusion: The beneficial therapeutic effect of the studied herbs may be related to their mineral element content. The elemental concentration in different medicinal plants is discussed.

Keywords: instrumental neutron activation analysis, atomic absorption spectroscopy, medicinal plants, trace elemental analysis, mineral contents

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Authors: Nayab Kanwal, Noor Us Saher

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The management and utilization of food resources is becoming a big issue due to rapid urbanization, wastage and non-sustainable use of food, especially in developing countries. Therefore, the use of seafood as alternative sources is strongly promoted worldwide. Marine pollution strongly affects marine organisms, which ultimately decreases their export quality. The monitoring of contamination in marine organisms is a good indicator of the environmental quality as well as seafood quality. Monitoring the accumulation of chemical elements within various tissues of organisms has become a useful tool to survey current or chronic levels of heavy metal exposure within an environment. In this perspective, this study was carried out to compare the previous and current levels (Year 2012 and 2014) of heavy metals (Cd, Pb, Cr, Cu and Zn) in crabs marketed in Karachi and to estimate the toxicological risk associated with their intake. The accumulation of metals in marine organisms, both essential (Cu and Zn) and toxic (Pb, Cd and Cr), natural and anthropogenic, is an actual food safety issue. Significant (p>0.05) variations in metal concentrations were found in all crab species between the two years, with most of the metals showing high accumulation in 2012. For toxicological risk assessment, EWI (Estimated weekly intake), Target Hazard quotient (THQ) and cancer risk (CR) were also assessed and high EWI, Non- cancer risk (THQ < 1) showed that there is no serious threat associated with the consumption of shellfish species on Karachi coast. The Cancer risk showed the highest risk from Cd and Pb pollution if consumed in excess. We summarize key environmental health research on health effects associated with exposure to contaminated seafood. It could be concluded that considering the Pakistan coast, these edible species may be sensitive and vulnerable to the adverse effects of environmental contaminants; more attention should be paid to the Pb and Cd metal bioaccumulation and to toxicological risks to seafood and consumers.

Keywords: cancer risk, edible crabs, heavy metals pollution, risk assessment

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Authors: Anh Nguyen, Jane Fisher, Thach Tran, Anh T. T. Tran

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Trait Emotional Intelligence is the knowledge, beliefs, and attitudes an individual has about their own and other people’s emotions. It is believed that trait emotional intelligence is a component of personality. Petrides’ Trait Emotional Intelligence Questionnaire (TEIQue) is well regarded and well-established, with validation data about its functioning among adults from many countries. However, there is little data yet about its use among Asian populations, including adolescents. The aims were to translate and culturally verify the Trait Emotional Intelligence Adolescent Short Form (TEIQue-ASF) and investigate content validity, construct validity, and reliability among adolescents attending high schools in Vietnam. Content of the TEIQue-ASF was translated (English to Vietnamese) and back-translated (Vietnamese to English) in consultation with bilingual and bicultural health researchers and pilot tested among 51 potential respondents. Phraseology and wording were then adjusted and the final version is named the VN-TEIQue-ASF. The VN-TEIQue-ASF’s properties were investigated in a cross-sectional elf-report survey among high school students in Central Vietnam. In total 1,546 / 1,573 (98.3%) eligible students from nine high schools in rural, urban, and coastline areas completed the survey. Explanatory Factor Analysis yielded a four-factor solution, including some with facets that loaded differently compared to the original version: Well-being, Emotion in Relationships, Emotion Self-management, and Emotion Sensitivity. The Cronbach’s alpha of the global score for the VN-TEIQue-ASF was .77. The VN-TEIQue-ASF is comprehensible and has good content and construct validity and reliability among adolescents in Vietnam. The factor structure is only partly replicated the original version. The VN-TEIQue-ASF is recommended for use in school or community surveys and professional study in education, psychology, and public health to investigate the trait emotional intelligence of adolescents in Vietnam.

Keywords: adolescents, construct validity, content validity, factor analysis, questionnaire validity, trait emotional intelligence, Vietnam

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Authors: Kamelia Hamza

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Background: Proton pump inhibitors (PPIs) are the most prescribed drug classes for pediatric gastroesophageal reflux disease (GERD).Many patients are treated with these drugs for atypical manifestations attributed to gastroesophageal reflux (GER), even in the absence of proved causal relationship. There is an impression of increase use of PPI's treatment for reflux in "clalit health services," the largest health organization in Israel. In the recent years, the medicine is given without restriction, it's not limited to pediatric gastroenterologists only, but pediatricians and family doctors. The objective of this study is to evaluate the hypothesis that exposure to PPIs during the first year of life is associated with an increased risk of developing late adverse diseases: pneumonia, asthma, AGE, IBD, celiac disease, allergic disorders, obesity, attention deficit hyperactivity disorders (ADHD), autism spectrum disorders (ASD). Methods: The study is a retrospective case-control cohort study based on a computerized database of Clalit Health Services (CHS). It includes 9844 children born between 2002-2018 and reported to complain of at least one of the symptoms (reflux/ spitting up, irritability, feeding difficulties, colics). The study population included the study group (n=4922) of children exposed to PPIs at any time prior to the first year of life and a control group (n=4922) child not exposed to PPIs who were matched to each case of the study group on age, race, socioeconomic status, and year of birth. The prevalence of late complications/diseases in the study group was compared with the prevalence of late complications/diseases diagnosis between 2002-2020 in the control group. Odds ratios and 95% confidence intervals were calculated by using logistic regression models. Results: We found that compared to the control group, children exposed to PPIs in the first year of life had an increased risk of developing several late complications/ disorders: pneumonia, asthma, various allergies (urticaria, allergic rhinitis, or allergic conjunctivitis) OR, inhalant allergies, and food allergies. In addition, they showed an increased risk of being diagnosed with ADHD or ASD, but children exposed to PPIs in the first year of life had decrease the risk of obesity by 17% (OR 0.825, 95%CI 0.697-0.976). Conclusions: We found significant associations between the use of PPIs during the first year of life and subsequent development of late complications/diseases such as respiratory diseases, allergy diseases, ADHD, and ASD. More studies are needed to prove causality and determine the mechanism behind the effect of PPIs and the development of late complications.

Keywords: acid suppressing medications, proton pump inhibitors, histamine 2 blocker, late complications, gastroesophageal reflux, gastroesophageal reflux disease, acute gastroenteritis, community acquired pneumonia, asthma, allergic diseases, obesity, inflammatory bowel diseases, ulcerative colitis, crohn disease, attention deficit hyperactivity disorders, autism spectrum disorders

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Authors: Anupoju Rajeev, Joanne Mathew, Amit Shelke

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In the current study, a new type of Composite Structural Insulated Panels (CSIPs) is developed and investigated its performance against shock loading which can replace the conventional wooden structural materials. The CSIPs is made of Fibre Cement Board (FCB)/aluminum as the facesheet and the expanded polystyrene foam as the core material. As tornadoes are very often in the western countries, it is suggestable to monitor the health of the CSIPs during its lifetime. So, the composite structure is installed with three smart sensors located randomly at definite locations. Each smart sensor is fabricated with an embedded half stainless phononic crystal sensor attached to both ends of the nylon shaft that can resist the shock and impact on facesheet as well as polystyrene foam core and safeguards the system. In addition to the granular crystal sensors, the accelerometers are used in the horizontal spanning and vertical spanning with a definite offset distance. To estimate the health and damage of the CSIP panel using granular crystal sensor, shock wave loading experiments are conducted. During the experiments, the time of flight response from the granular sensors is measured. The main objective of conducting shock wave loading experiments on the CSIP panels is to study the effect and the sustaining capacity of the CSIP panels in the extreme hazardous situations like tornados and hurricanes which are very common in western countries. The effects have been replicated using a shock tube, an instrument that can be used to create the same wind and pressure intensity of tornado for the experimental study. Numerous experiments have been conducted to investigate the flexural strength of the CSIP. Furthermore, the study includes the damage detection using three smart sensors embedded in the CSIPs during the shock wave loading.

Keywords: composite structural insulated panels, damage detection, flexural strength, sandwich structures, shock wave loading

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Authors: Thaveesha Dheerasekera, Dileeka Sandamali Alwis

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The escalating prevalence of mental health issues, such as depression and suicidal ideation, is a matter of significant global concern. It is plausible that a variety of factors, such as life events, social isolation, and preexisting physiological or psychological health conditions, could instigate or exacerbate these conditions. Traditional approaches to diagnosing depression entail a considerable amount of time and necessitate the involvement of adept practitioners. This underscores the necessity for automated systems capable of promptly detecting and diagnosing symptoms of depression. The PsyVBot system employs sophisticated natural language processing and machine learning methodologies, including the use of the NLTK toolkit for dataset preprocessing and the utilization of a Long Short-Term Memory (LSTM) model. The PsyVBot exhibits a remarkable ability to diagnose depression with a 94% accuracy rate through the analysis of user input. Consequently, this resource proves to be efficacious for individuals, particularly those enrolled in academic institutions, who may encounter challenges pertaining to their psychological well-being. The PsyVBot employs a Long Short-Term Memory (LSTM) model that comprises a total of three layers, namely an embedding layer, an LSTM layer, and a dense layer. The stratification of these layers facilitates a precise examination of linguistic patterns that are associated with the condition of depression. The PsyVBot has the capability to accurately assess an individual's level of depression through the identification of linguistic and contextual cues. The task is achieved via a rigorous training regimen, which is executed by utilizing a dataset comprising information sourced from the subreddit r/SuicideWatch. The diverse data present in the dataset ensures precise and delicate identification of symptoms linked with depression, thereby guaranteeing accuracy. PsyVBot not only possesses diagnostic capabilities but also enhances the user experience through the utilization of audio outputs. This feature enables users to engage in more captivating and interactive interactions. The PsyVBot platform offers individuals the opportunity to conveniently diagnose mental health challenges through a confidential and user-friendly interface. Regarding the advancement of PsyVBot, maintaining user confidentiality and upholding ethical principles are of paramount significance. It is imperative to note that diligent efforts are undertaken to adhere to ethical standards, thereby safeguarding the confidentiality of user information and ensuring its security. Moreover, the chatbot fosters a conducive atmosphere that is supportive and compassionate, thereby promoting psychological welfare. In brief, PsyVBot is an automated conversational agent that utilizes an LSTM model to assess the level of depression in accordance with the input provided by the user. The demonstrated accuracy rate of 94% serves as a promising indication of the potential efficacy of employing natural language processing and machine learning techniques in tackling challenges associated with mental health. The reliability of PsyVBot is further improved by the fact that it makes use of the Reddit dataset and incorporates Natural Language Toolkit (NLTK) for preprocessing. PsyVBot represents a pioneering and user-centric solution that furnishes an easily accessible and confidential medium for seeking assistance. The present platform is offered as a modality to tackle the pervasive issue of depression and the contemplation of suicide.

Keywords: chatbot, depression diagnosis, LSTM model, natural language process

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Authors: Akhil Teja Kambhampati, Mark A. Hoffman

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In the realm of infectious disease research, airborne viral transmission stands as a paramount concern due to its pivotal role in propagating pathogens within densely populated regions. However, amidst this landscape, the phenomenon of hygroscopic growth within respiratory bioaerosols remains relatively underexplored. Unlike pure water aerosols, the unique composition of respiratory bioaerosols leads to varied evaporation rates and hygroscopic growth patterns, influenced by factors such as ambient humidity, temperature, and airflow. This study addresses this gap by focusing on the behaviors of single respiratory bioaerosol utilizing salinity to induce saliva-like hygroscopic behavior. By employing mass, momentum, and energy equations, the study unveils the intricate interplay between evaporation and hygroscopic growth over time. The numerical model enables temporal analysis of bioaerosol characteristics, including size, temperature, and trajectory. The analysis reveals that due to evaporation, there is a reduction in initial size, which shortens the lifetime and distance traveled. However, when hygroscopic growth begins to influence the bioaerosol size, the rate of size reduction slows significantly. The interplay between evaporation and hygroscopic growth results in bioaerosol size within the inhalation range of humans and prolongs the traveling distance. Findings procured from the analysis are crucial for understanding the spread of infectious diseases, especially in high-risk environments such as healthcare facilities and public transportation systems. By elucidating the nuanced behaviors of respiratory bioaerosols, this study seeks to inform the development of more effective preventative strategies against pathogens propagation in the air, thereby contributing to public health efforts on a global scale.

Keywords: airborne viral transmission, high-risk environments, hygroscopic growth, evaporation, numerical modeling, pathogen propagation, preventative strategies, public health, respiratory bioaerosols

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Authors: Sidra Jawed

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The accessibility constructs and the body privilege discourse has been a major problem while dealing with health inequities and inaccessibility. The inherent problem in this arbitrary view of disability is that disability would never be the productive way of living. For past thirty years, disability activists have been working to differentiate ‘impairment’ from ‘disability’ and probing for more understanding of limitation imposed by society, this notion is ultimately known as the Social Model of Disability. The vulnerable population as disability community remains marginalized and seen relentlessly fighting to highlight the importance of social factors. It does not only constitute physical architectural barriers and famous blue symbol of access to the healthcare but also invisible, intangible barriers as attitudes and behaviours. Conventionally the idea of ‘disability’ has been laden with prejudiced perception amalgamating with biased attitude. Equity in contemporary setup necessitates the restructuring of organizational structure. Apparently simple, the complex interplay of disability and contemporary healthcare set up often ends up at negotiating vital components of basic healthcare needs. The role of society is indispensable when it comes to people with disability (PWD), everything from the access to healthcare to timely interventions are strongly related to the set up in place and the attitude of healthcare providers. It is vital to understand the association between assumptions and the quality of healthcare PWD receives in our global healthcare setup. Most of time the crucial physician-patient relationship with PWD is governed by the negative assumptions of the physicians. The multifaceted, troubled patient-physicians’ relationship has been neglected in past. To compound it, insufficient work has been done to explore physicians’ perspective about the disability and access to healthcare PWD have currently. This research project is directed towards physicians’ perspective on the intersection of health and access of healthcare for PWD. The principal aim of the study is to explore the perception of disability in family medicine physicians, highlighting the underpinning of medical perspective in healthcare institution. In the quest of removing barriers, the first step must be to identify the barriers and formulate a plan for future policies, involving all the stakeholders. There would be semi-structured interviews to explore themes as accessibility, medical training, construct of social model and medical model of disability, time limitations, financial constraints. The main research interest is to identify the obstacles to inclusion and marginalization continuing from the basic living necessities to wide health inequity in present society. Physicians point of view is largely missing from the research landscape and the current forum of knowledge with regards to physicians’ standpoint. This research will provide policy makers with a starting point and comprehensive background knowledge that can be a stepping stone for future researches and furthering the knowledge translation process to strengthen healthcare. Additionally, it would facilitate the process of knowledge translation between the much needed medical and disability community.

Keywords: disability, physicians, social model, accessibility

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Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth

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Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.

Keywords: aesthetic, Asian, breast, reconstruction

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Authors: Dina Jalalvand, Joshua A. Cleland

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This double-blind, randomized control trial with parallel groups aimed to examine the effectiveness of office-based occupational therapy for office workers with low back pain on the intensity of pain and range of motion. Seventy-two male office workers (age: 20-50 years) with chronic low back pain (more than three months with at least two symptoms of chronic low back pain) satisfied eligibility criteria and agreed to participate in this study. The absence of joint burst following magnetic resonance imagining (MRI) was considered as an important inclusion criterion as well. Subjects were randomly assigned to a control or experimental group. The experimental group received the modified package of exercise-based occupational therapy, which included 11 simple exercise movements (derived from Williams and McKenzie), and the control group just received the conventional therapy, which included their routine physiotherapy sessions. The subjects completed the exercises three times a week for a duration of six weeks. Each exercise session was 10-15 minutes. Pain intensity and range of motion were the primary outcomes and were measured at baseline, 6 weeks, and 12 weeks after the end of the intervention using the numerical rating scale (NRS) and goniometer accordingly. Repeated measure ANOVA was used for analyzing data. The results of this study showed that significant decreases in pain intensity (p ≤ 0.05) and an increase in range of motion (p ≤ 0.001) in the experimental group in comparison with the control group after 6 and 12 weeks of intervention (between-group comparisons). In addition, there was a significant decrease in intensity of the pain (p ≤ 0.05) and an increase (p ≤ 0.001) in range of motion in the intervention group in comparison with baseline after 6 and 12 weeks (within-group comparison). This showed a positive effect of exercise-based occupational therapy that could potentially be used with low cost among office workers who suffer from low back pain. In addition, it should be noted that the introduced package of exercise training is easy to do, and there is not a need for a specific introduction.

Keywords: public health, office workers, low back pain, occupational therapy

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Authors: Abhay Vir Singh Kanwar

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The pharmaceutical industry today is a multi-billion dollar business and yet disadvantages people in many corners of the globe who are still dying in large numbers from curable illnesses for lack of access to drugs. The astronomical prices of essential and life-saving drugs is not just an economic problem that can be settled through clever market strategies but is an ethical issue, given the accumulated wealth of today’s humanity and the sense of global justice that it increasingly comes to share. In this paper, I make a very practical argument for what I shall call ‘the ethical healthcare paradigm’, which, I propose, can replace the economistic paradigm that can still drive the healthcare sector without creating spillover effects on the market. Taking off from the ethical-philosophical argument for recognizing every individual’s right to capability to be healthy, I shall come to the focused practical proposal of the cost-rationalization and universal availability of essential, life-saving drugs through the undertaking of research and development funding for drug innovation by the business establishment as such in terms of the concept of CSR. The paper will first expose the concepts of basic and fundamental capabilities in relation to education and health, after which it will focus on the right to capability to be healthy of every person. In the third section, it will discuss the ‘ethical healthcare paradigm’ as opposed to the economistic health paradigm and will argue that the patient will have to be considered the primary stakeholder of this paradigm or the very ‘subject’ of healthcare. The next section will be on an ethical-historical critique of the pharmaceutical industry’s profit driven economism. The section after that will look at the business operation and the stages in the life cycle of a drug that comes to the market in order to understand the risks, strengths and problems of the pharmaceutical industry. Finally, the paper will discuss the concept of CSR in relation to the ethical healthcare paradigm in order to propose CSR funding in research and development for innovation on drugs so that life-saving drugs can be made available to every sick person cost-effectively.

Keywords: capability approach, healthcare, CSR, patient

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Authors: Elena Arquer Cuenca

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The gypsy community has been a mistreated and rejected group since its arrival in the Iberian Peninsula in the 15th century. At present, despite being the largest ethnic minority group in Spain as well as in Europe, the different legal and social initiatives in favour of equality continue to suffer discrimination by the general society. This has fostered a strengthening of the endogroup accompanied by cultural conservatism as a form of self-protection. Despite the current trend of normalization of sexual diversity in modern societies, LGB people continue to suffer discrimination, especially in more traditional environments or communities. This rejection for reasons of sexual orientation within the family or community can hinder the free development of the person and compromise peaceful coexistence. The present work is intended as an approach to the attitudes of the gypsy population towards non-heterosexual sexual orientation. The objective is none other than ‘to know the appreciation that the gypsy population has about homosexual sex-affective relationships, in order to assess whether this has any impact on family and community coexistence’. The following specific objectives are derived from this general objective: ‘To find out whether there is a relationship between the dichotomous Roma gender system and the acceptance/rejection of homosexuality’; ‘to analyse whether sexual orientation has an impact on the coexistence of the Roman family and community’; ‘to analyse whether the historical discrimination suffered by the Roman population favours the maintenance of the patriarchal heterosexual reproductive family’; and lastly ‘to explore whether ICTs have promoted the process of normalisation and/or acceptance of homosexuality within the Roma community’. In order to achieve these objectives, a bibliographical and documentary review has been used, as well as the semi-structured interview technique, in which 4 gypsy people participated (2 women and 2 men of different ages). One of the main findings was the inappropriateness of the use of the homogenising category "Gypsy People" at present, given the great diversity among the Roma communities. Moreover, the difficulty in accepting homosexuality seems to be related to the fact that the heterosexual reproductive family has been the main survival mechanism of Roma communities over centuries. However, it will be concluded that attitudes towards homosexuality will vary depending on the socio-economic and cultural context and factors such as age or professed religion. Three main contributions of this research are: firstly, the inclusion of sexual orientation as a variable to be considered when analysing peaceful coexistence; secondly socio-historical dynamics and structures of inequality have been taken into account when analysing Roma attitudes towards homosexuality; and finally, the processual nature of socio-cultural changes has also been considered.

Keywords: gender, homosexuality, ICTs, peaceful coexistence, Roma community, sexual orientation

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Authors: Tamunotonye Mayowa Braide, Isaac Oluwatayo

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This study investigates multidimensional poverty, and its correlates among rural households in Sekhukhune and Capricorn District municipalities (SDM & CDM) in Limpopo Province, South Africa. Primary data were collected from 407 rural households selected through purposive and simple random sampling techniques. Analytical techniques employed include descriptive statistics, principal component analysis (PCA), and the Alkire Foster (A-F) methodology. The results of the descriptive statistics showed there are more females (66%) than males (34%) in rural areas of Limpopo Province, with about 45% of them having secondary school education as the highest educational level attained and only about 3% do not have formal education. In the analysis of deprivation, eight dimensions of deprivation, constructed from 21 variables, were identified using the PCA. These dimensions include type and condition of dwelling water and sanitation, educational attainment and income, type of fuel for cooking and heating, access to clothing and cell phone, assets and fuel for light, health condition, crowding, and child health. In identifying the poor with poverty cut-off (0.13) of all indicators, about 75.9% of the rural households are deprived in 25% of the total dimensions, with the adjusted headcount ratio (M0) being 0.19. Multidimensional poverty estimates showed higher estimates of poor rural households with 71%, compared to 29%, which fall below the income poverty line. The study conducted poverty decomposition, using sub-groups within the area by examining regions and household characteristics. In SDM, there are more multidimensionally poor households than in CDM. The water and sanitation dimension is the largest contributor to the multidimensional poverty index (MPI) in rural areas of Limpopo Province. The findings can, therefore, assist in better design of welfare policy and target poverty alleviation programs and as well help in efficient resource allocation at the provincial and local municipality levels.

Keywords: Alkire-Foster methodology, Limpopo province, multidimensional poverty, principal component analysis, South Africa

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