Search results for: e-health care services

Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

Abstract:

Stroke is associated with a significant risk of morbidity and mortality. There is scarcity of research on the long-term survival after first-ever ischaemic stroke (IS) events in England with regards to effects of different medical therapies and comorbidities. The objective of this study was to model the all-cause mortality after an IS diagnosis in the adult population of England. Using a retrospective case-control design, we extracted the electronic medical records of patients born prior to or in year 1960 in England with a first-ever ischaemic stroke diagnosis from January 1986 to January 2017 within the Health and Improvement Network (THIN) database. Participants with a history of ischaemic stroke were matched to 3 controls by sex and age at diagnosis and general practice. The primary outcome was the all-cause mortality. The hazards of the all-cause mortality were estimated using a Weibull-Cox survival model which included both scale and shape effects and a shared random effect of general practice. The model included sex, birth cohort, socio-economic status, comorbidities and medical therapies. 20,250 patients with a history of IS (cases) and 55,519 controls were followed up to 30 years. From 2008 to 2015, the one-year all-cause mortality for the IS patients declined with an absolute change of -0.5%. Preventive treatments to cases increased considerably over time. These included prescriptions of statins and antihypertensives. However, prescriptions for antiplatelet drugs decreased in the routine general practice since 2010. The survival model revealed a survival benefit of antiplatelet treatment to stroke survivors with hazard ratio (HR) of 0.92 (0.90 – 0.94). IS diagnosis had significant interactions with gender and age at entry and hypertension diagnosis. IS diagnosis was associated with high risk of all-cause mortality with HR= 3.39 (3.05-3.72) for cases compared to controls. Hypertension was associated with poor survival with HR = 4.79 (4.49 - 5.09) for hypertensive cases relative to non-hypertensive controls, though the detrimental effect of hypertension has not reached significance for hypertensive controls, HR = 1.19(0.82-1.56). This study of English primary care data showed that between 2008 and 2015, the rates of prescriptions of stroke preventive treatments increased, and a short-term all-cause mortality after IS stroke declined. However, stroke resulted in poor long-term survival. Hypertension, a modifiable risk factor, was found to be associated with poor survival outcomes in IS patients. Antiplatelet drugs were found to be protective to survival. Better efforts are required to reduce the burden of stroke through health service development and primary prevention.

Keywords: general practice, hazard ratio, health improvement network (THIN), ischaemic stroke, multiple imputation, Weibull-Cox model.

Procedia PDF Downloads 174

Authors: Richard Sogah

Abstract:

The significance of transport infrastructure investments for economic growth and development has been central to the World Bank’s strategy for poverty reduction. Among the conventional surface transport infrastructures, road infrastructure is significant in facilitating the movement of human capital goods and services. When transport projects (i.e., roads, super-highways) are implemented, they come along with some negative social values (costs), such as increased noise and air pollution for local residents living near these facilities, displaced individuals, etc. However, these projects also facilitate better utilization of existing capital stock and generate other observable benefits that can be easily quantified. For example, the improvement or construction of roads creates employment, stimulates revenue generation (toll), reduces vehicle operating costs and accidents, increases accessibility, trade expansion, safety improvement, etc. Aside from these benefits, travel time savings (TTSs) which are the major economic benefits of urban and inter-urban transport projects and therefore integral in the economic assessment of transport projects, are often overlooked and omitted when estimating the benefits of transport projects, especially in developing countries. The absence of current and reliable domestic travel data and the inability of replicated models from the developed world to capture the actual value of travel time savings due to the large unemployment, underemployment, and other labor-induced distortions has contributed to the failure to assign value to travel time savings when estimating the benefits of transport schemes in developing countries. This omission of the value of travel time savings from the benefits of transport projects in developing countries poses problems for investors and stakeholders to either accept or dismiss projects based on schemes that favor reduced vehicular operating costs and other parameters rather than those that ease congestion, increase average speed, facilitate walking and handloading, and thus save travel time. Given the complex reality in the estimation of the value of travel time savings and the presence of widespread informal labour activities in Sub-Saharan Africa, we construct a “nationally ranked distribution of time values” and estimate the value of travel time savings based on the area beneath the distribution. Compared with other approaches, our method captures both formal sector workers and individuals/people who work outside the formal sector and hence changes in their time allocation occur in the informal economy and household production activities. The dataset for the estimations is sourced from the World Bank, the International Labour Organization, etc.

Keywords: road infrastructure, transport projects, travel time savings, congestion, Sub-Sahara Africa

Procedia PDF Downloads 99

Authors: Eva Degraeuwe, Margo Vandenheede, Nicholas Rennie, Jolien Braem, Miryam Serry, Frederik Berrevoet, Piet Pattyn, Wouter Willaert, InciSioN Belgium Consortium

Abstract:

Background: Worldwide, five billion people lack access to safe and affordable surgical care. An added 1.27 million surgeons, anesthesiologists, and obstetricians (SAO) are needed by 2030 to meet the target of 20 per 100,000 population and to reach the goal of the Lancet Commission on Global Surgery. A well-informed future generation exposed early on to the current challenges in global surgery (GS) is necessary to ensure a sustainable future. Methods: InciSioN, the International Student Surgical Network, is a non-profit organization by and for students, residents, and fellows in over 80 countries. InciSioN Belgium, one of the prominent national working groups, has made a vast progression and collaborated with other networks to fill the educational gap, stimulate advocacy efforts and increase interactions with the international network. This report describes a roadmap to achieve sustainable development and education within GS, with the example of InciSioN Belgium. Results: Since the establishment of the organization’s branch in 2019, it has hosted an educational workshop for first-year residents in surgery, engaging over 2500 participants, and established a recurring directing board of 15 members. In the year 2020-2021, InciSioN Ghent has organized three workshops combining educational and interactive sessions for future prime advocates and surgical candidates. InciSioN Belgium has set up a strong formal coalition with the Belgian Medical Students’ Association (BeMSA), with its own standing committee, reaching over 3000+ medical students annually. In 2021-2022, InciSioN Belgium broadened to a multidisciplinary approach, including dentistry and nursing students and graduates within workshops and research projects, leading to a member and exposure increase of 450%. This roadmap sets strategic goals and mechanisms for the GS community to achieve nationwide sustained improvements in the research and education of GS focused on future SAOs, in order to achieve the GS sustainable development goals. In the coming year, expansion is directed to a formal integration of GS into the medical curriculum and increased international advocacy whilst inspiring SAOs to integrate into GS in Belgium. Conclusion: The development and implementation of durable change for GS are necessary. The student organization InciSioN Belgium is growing and hopes to close the colossal gap in GS and inspire the growth of other branches while sharing the know-how of a student organization.

Keywords: advocacy, education, global surgery, InciSioN, student network

Procedia PDF Downloads 161

Authors: Julianne Mullen-Williams

Abstract:

This paper will provide an overview of a three year mixed methods research project that explores if methods from the supervision of dramatherapy can augment the occupational psychology of newly qualified secondary school teachers. It will consider how creativity and the use of metaphor, as applied in the supervision of dramatherapists, can be translated to an educational context in order to explore the explicit / implicit dynamics between the teacher trainee/ newly qualified teacher and the organisation in order to support the super objective in training for teaching; how to ‘be a teacher.’ There is growing evidence that attrition rates among teachers are rising after only five years of service owing to too many national initiatives, an unmanageable curriculum and deteriorating student discipline. The fieldwork conducted entailed facilitating a reflective space for Newly Qualified Teachers from all subject areas, using methods from the supervision of dramatherapy, to explore the social and emotional aspects of teaching and learning with the ultimate aim of improving the occupational psychology of teachers. Clinical supervision is a formal process of professional support and learning which permits individual practitioners in frontline service jobs; counsellors, psychologists, dramatherapists, social workers and nurses to expand their knowledge and proficiency, take responsibility for their own practice, and improve client protection and safety of care in complex clinical situations. It is deemed integral to continued professional practice to safeguard vulnerable people and to reduce practitioner burnout. Dramatherapy supervision incorporates all of the above but utilises creative methods as a tool to gain insight and a deeper understanding of the situation. Creativity and the use of metaphor enable the supervisee to gain an aerial view of the situation they are exploring. The word metaphor in Greek means to ‘carry across’ indicating a transfer of meaning form one frame of reference to another. The supervision support was incorporated into each group’s induction training programme. The first year group attended fortnightly one hour sessions, the second group received two one hour sessions every term. The existing literature on the supervision and mentoring of secondary school teacher trainees calls for changes in pre-service teacher education and in the induction period. There is a particular emphasis on the need to include reflective and experiential learning, within training programmes and within the induction period, in order to help teachers manage the interpersonal dynamics and emotional impact within a high pressurised environment

Keywords: dramatherapy supervision, newly qualified secondary school teachers, professional development, teacher education

Procedia PDF Downloads 377

Authors: Purnima Anjali Mohanty, Mousumi Padhi

Abstract:

Background of the study: In the background of the passage of the Transgender Bill 2016, which is the first such step of formal recognition of the rights of transgender, the Hijras have been recognized under the wider definition of Transgender. Fascinatingly, in the Hindu social context, Hijras have a long social standing during marriages and childbirths. Other than this ironically, they live an ostracized life. The Bill rather than recognizing their unique characteristics and needs, reinforces the societal dualism through a parallelism of their legal rights with rights available to women. Purpose of the paper: The research objective was to probe why and to what extent did they identify themselves with the feminine gender roles. Originality of the paper: In the Indian context, the subject of eunuch has received relatively little attention. Among the studies that exist, there has been a preponderance of studies from the perspective of social exclusion, rights, and physical health. There has been an absence of research studying the self-identity of Hijras from the gender perspective. Methodology: The paper adopts the grounded theory method to investigate and discuss the underlying gender identity of transgenders. Participants in the study were 30 hijras from various parts of Odisha. 4 Focus group discussions were held for collecting data. The participants were approached in their natural habitat. Following the methodological recommendations of the grounded theory, care was taken to select respondents with varying experiences. The recorded discourses were transcribed verbatim. The transcripts were analysed sentence by sentence, and coded. Common themes were identified, and responses were categorized under the themes. Data collected in the latter group discussions were added till saturation of themes. Finally, the themes were put together to prove that despite the demand for recognition as third gender, the eunuchs of Odisha identify themselves with the feminine roles. Findings: The Hijra have their own social structure and norms which are unique and are in contrast with the mainstream culture. These eunuchs live and reside in KOTHIS (house), where the family is led by a matriarch addressed as Maa (mother) with her daughters (the daughters are eunuchs/effeminate men castrated and not castrated). They all dress up as woman, do womanly duties, expect to be considered and recognized as woman and wife and have the behavioral traits of a woman. Looking from the stance of Feminism one argues that when the Hijras identify themselves with the gender woman then on what grounds they are given the recognition as third gender. As self-identified woman; their claim for recognition as third gender falls flat. Significance of the study: Academically it extends the study of understanding of gender identity and psychology of the Hijras in the Indian context. Practically its significance is far reaching. The findings can be used to address legal and social issues with regards to the rights available to the Hijras.

Keywords: feminism, gender perspective, Hijras, rights, self-identity

Procedia PDF Downloads 420

Authors: Rishi Pal Singh

Abstract:

In Indian Scenario, Organic agriculture is growing by the conscious efforts of inspired people who are able to create the best promising relationship between the earth and men. Nowadays, the major challenge is its entry into the policy-making framework, its entry into the global market and weak sensitization among the farmers. But, during the last two decades, the contamination in environment and food which is linked with the bad agricultural potential/techniques has diverted the mind set of farmers towards the organic farming. In the view of above concept, a small-scale project has been installed to promote the 20 farmers from the Kunjura and surrounding villages for organic farming. This project is working since from the last 3 crops (starting from October, 2016) and found that it can meet both demands and complete development of rural areas. Farmers of this concept are working on the principles such that the nature never demands unreasonable quantities of water, mining and to destroy the microbes and other organisms. As per details of Organic Monitor estimates, global sales reached in billion in the present analysis. In this initiative, firstly, wheat and rice were considered for farming and observed that the production of crop has grown almost 10-15% per year from the last crop production. This is not linked only with the profit or loss but also emphasized on the concept of health, ecology, fairness and care of soil enrichment. Several techniques were used like use of biological fertilizers instead of chemicals, multiple cropping, temperature management, rain water harvesting, development of own seed, vermicompost and integration of animals. In the first year, to increase the fertility of the land, legumes (moong, cow pea and red gram) were grown in strips for the 60, 90 and 120 days. Simultaneously, the mixture of compost and vermicompost in the proportion of 2:1 was applied at the rate of 2.0 ton per acre which was enriched with 5 kg Azotobacter and 5 kg Rhizobium biofertilizer. To complete the amount of phosphorus, 250 kg rock phosphate was used. After the one month, jivamrut can be used with the irrigation water or during the rainy days. In next season, compost-vermicompost mixture @ 2.5 ton/ha was used for all type of crops. After the completion of this treatment, now the soil is ready for high value ordinary/horticultural crops. The amount of above stated biofertilizers, compost-vermicompost and rock phosphate may be increased for the high alternative fertilizers. The significance of the projects is that now the farmers believe in cultural alternative (use of disease-free their own seed, organic pest management), maintenance of biodiversity, crop rotation practices and health benefits of organic farming. This type of organic farming projects should be installed at the level of gram/block/district administration.

Keywords: organic farming, Kunjpura, compost, bio-fertilizers

Procedia PDF Downloads 187

Authors: Elizabeth Ankiambom Chiatii

Abstract:

The effective participation of graduates as leaders in entrepreneurial resilience is a key driver to achieving sustainable job creation and curbing unemployment issues in the urban and rural communities of Cameroon. The unemployment problem is a global challenge in the Labour market, especially for youths graduating from universities. Statistics from the Cameroon National Institute of statistics indicate that the unemployment rate in the country increased to 3.9% in 2021 from 3.8% in 2020. One of the main causes of unemployment challenges and job hooping among university graduates is the high expectation for “white-collar jobs syndrome” as opposed to involvement in ‘blue-collar jobs’. In the recent years, the Catholic University of Cameroon has engaged its resources in problem and project based learning (PBL) approaches in order to enable the students at the end of their course work to be competent and resourceful in impacting their communities and the world at large. It is so encouraging to notice that most of our current and female ex-students have engaged as leaders in fostering entrepreneurial resilience through small and medium size ‘blue-collar’ enterprises like seamstresses or tailors, designers, catering services, poultry owners, traditional regalia designers, phone booth operators, farming (gardening) activities, saloon owners, wedding designers, restaurant operators and many other creative jobs where they also act as petty employers. A good number of them sponsor their university studies through these self-income generating activities. Part one of this paper centres on the introduction and background of study. Part two embodies some literature review in which we concentrate on some related conceptual issues. For example, we have some analogy of employment difficulties faced by the university graduates. Secondly, we will examine the details on entrepreneurial resilience within the context of Bamenda- Cameroon. Thirdly, we expound on the leadership role played by these graduates in building resilience as entrepreneurs stemming from their university training. The primary method of data collection is implemented, where questionnaires are distributed to at least 100 of these graduates engaged in building entrepreneurial resilience. The IVProbit regression analysis is used to determine the effect of these graduate participation as leader on entrepreneurial resilience. The results can contribute to the development of entrepreneurial resilience, and recommendations will be made to CATUC Bamenda, some communities and government leaders to enhance their policies to empower these young graduates in fostering these resourceful activities.

Keywords: graduates entrepreneurial resilience, unemployment challenges, white-collar job syndrome, small and medium size blue-collar enterprises

Procedia PDF Downloads 59

Authors: André Pasti

Abstract:

Historically, the communication sector in Argentina is characterized by intense monopolization and geographical concentration in the city of Buenos Aires. In 2000, the four major media conglomerates in operation – Clarín, Telefónica, America and Hadad – controlled 84% of the national media market. By 2009, new policies were implemented as a result of civil society organizations demands. Legally, a new regulatory framework was approved: the law 26,522 of Audiovisual Communications Services. Supposedly, these policies intend to create new conditions for the development of the audiovisual economy in the territory of Argentina. The regionalization of audiovisual production and the democratization of channels and access to media were among the priorities. This paper analyses the main changes and continuities in the organization of the spatial circuit of the audiovisual industry in Argentina provoked by these new policies. These new policies aim at increasing the diversity of audiovisual producers and promoting regional audiovisual industries. For this purpose, a national program for the development of audiovisual centers within the country was created. This program fostered a federalized production network, based on nine audiovisual regions and 40 nodes. Each node has created technical, financial and organizational conditions to gather different actors in audiovisual production – such as SMEs, social movements and local associations. The expansion of access to technical networks was also a concern of other policies, such as ‘Argentina connected’, whose objective was to expand access to broadband Internet. The Open Digital Television network also received considerable investments. Furthermore, measures have been carried out in order to impose limits on the concentration of ownership as well as to eliminate the oligopolies and to ensure more competition in the sector. These actions intended to force a divide of the media conglomerates into smaller groups. Nevertheless, the corporations that compose these conglomerates resist strongly, making full use of their economic and judiciary power. Indeed, the absence of effective impact of such measures can be testified by the fact that the audiovisual industry remains strongly concentrated in Argentina. Overall, these new policies were designed properly to decentralize audiovisual production and expand the regional diversity of the audiovisual industry. However, the effective transformation of the organization of the audiovisual circuit in the territory faced several resistances. This can be explained firstly and foremost by the ideological and economic power of the media conglomerates. In the second place, there is an inherited inertia from the unequal distribution of the objects needed for the audiovisual production and consumption. Lastly, the resistance also relies on financial needs and in the excessive dependence of the state for the promotion of regional audiovisual production.

Keywords: Argentina, audiovisual industry, communication policies, geographic concentration, regionalization, spatial circuit

Procedia PDF Downloads 206

Authors: Jemely M. Punzalan, Christine B. Bernal, Beatrice B. Canonigo, Maria Rosario F. Cabansag, Dennis S. Flores, Paul Joseph T. Galutira, Remedios D. Chan

Abstract:

Background: Systemic lupus erythematosus (SLE) is one of the most common autoimmune disorders predominates in women of childbearing age. Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY) is the only health specific quality of life tool for pediatric SLE, which has been translated to different languages except in Filipino. Objective: The primary objective of this study was to develop a Filipino translation of the SMILEY and to examine the validity and reliability of this translation. Methodology: The SMILEY was translated into Filipino by a bilingual individual and back-translated by another bilingual individual blinded from the original English version. The translation was evaluated for content validity by a panel of experts and subjected to pilot testing. The pilot-tested translation was used in the validity and reliability testing proper. The SMILEY, together with the previously validated PEDSQL 4.0 Generic Core Scale was administered to lupus pediatric patients and their parent at two separate occasions: a baseline and a re-test seven to fourteen days apart. Tests for convergent validity, internal consistency, and test-retest reliability were performed. Results: A total of fifty children and their parent were recruited. The mean age was 15.38±2.62 years (range 8-18 years), mean education at high school level. The mean duration of SLE was 28 months (range 1-81 months). Subjects found the questionnaires to be relevant, easy to understand and answer. The validity of the SMILEY was demonstrated in terms of content validity, convergent validity, internal consistency, and test-retest reliability. Age, socioeconomic status and educational attainment did not show a significant effect on the scores. The difference between scores of child and parent report was showed to be significant with SMILEY total (p=0.0214), effect on social life (p=0.0000), and PEDSQL physical function (p=0.0460). Child reports showed higher scores for the following domains compared to their parent. Conclusion: SMILEY is a brief, easy to understand, valid and reliable tool for assessing pediatric SLE specific HRQOL. It will be useful in providing better care, understanding and may offer critical information regarding the effect of SLE in the quality of life of our pediatric lupus patients. It will help physician understands the needs of their patient not only on treatment of the specific disease but as well as the impact of the treatment on their daily lives.

Keywords: systemic lupus erythematosus, pediatrics, quality of life, Simple Measure of Impact of Lupus Erythematosus in Youngsters (SMILEY)

Procedia PDF Downloads 433

Authors: Fatemeh Noori

Abstract:

The fashion industry is a dynamic and ever-evolving realm that continuously shapes societal perceptions of beauty and style. Within this industry, fashion modeling plays a crucial role, acting as the visual representation of brands and designers. However, behind the glamorous façade lies a complex web of legal considerations that govern the rights, responsibilities, and ethical practices within the field. This paper aims to explore the legal landscape surrounding fashion modeling, shedding light on key issues such as contract law, intellectual property, labor rights, and the increasing importance of ethical considerations in the industry. Fashion modeling involves the collaboration of various stakeholders, including models, designers, agencies, and photographers. To ensure a fair and transparent working environment, it is imperative to establish a comprehensive legal framework that addresses the rights and obligations of each party involved. One of the primary legal considerations in fashion modeling is the contractual relationship between models and agencies. Contracts define the terms of engagement, including payment, working conditions, and the scope of services. This section will delve into the essential elements of modeling contracts, the negotiation process, and the importance of clarity to avoid disputes. Models are not just individuals showcasing clothing; they are integral to the creation and dissemination of artistic and commercial content. Intellectual property rights, including image rights and the use of a model's likeness, are critical aspects of the legal landscape. This section will explore the protection of models' image rights, the use of their likeness in advertising, and the potential for unauthorized use. Models, like any other professionals, are entitled to fair and ethical treatment. This section will address issues such as working conditions, hours, and the responsibility of agencies and designers to prioritize the well-being of models. Additionally, it will explore the global movement toward inclusivity, diversity, and the promotion of positive body image within the industry. The fashion industry has faced scrutiny for perpetuating harmful standards of beauty and fostering a culture of exploitation. This section will discuss the ethical responsibilities of all stakeholders, including the promotion of diversity, the prevention of exploitation, and the role of models as influencers for positive change. In conclusion, the legal considerations in fashion modeling are multifaceted, requiring a comprehensive approach to protect the rights of models and ensure ethical practices within the industry. By understanding and addressing these legal aspects, the fashion industry can create a more transparent, fair, and inclusive environment for all stakeholders involved in the art of modeling.

Keywords: fashion modeling contracts, image rights in modeling, labor rights for models, ethical practices in fashion, diversity and inclusivity in modeling

Procedia PDF Downloads 56

Authors: Raudone Lina, Raudonis Raimondas, Liaudanskas Mindaugas, Pukalskas Audrius, Viskelis Pranas, Janulis Valdimaras

Abstract:

Human health fortification, its protection and disease prophylaxis are the main problems of the health care systems. Plant origin materials and their preparations are applied for the prevention of the common diseases. Oxidative stress takes part in the pathogenesis of many autoimmune, neurodegenerative, tumor and ageing processes. The antioxidants are able to protect the human body from the free radicals and to stop the progression of numerous chronic diseases. The research of plant origin materials is relevant for the search of natural antioxidants. A group of compounds that gained scientific attention due to antioxidant properties and effects on human health are phenolic compounds. Phenolic compounds are widely abundant in various parts of plants, i.e. leaves, stems, roots, flowers and fruits. Most commonly consumed fruits all over the world are apples. It is very important to analyze the antioxidant activity of apples as they are extensively used in the prevention of various diseases. The aim of this study was to determine the antioxidant profiles of Malus domestica Borkh fruit cultivars (Aldas, Auksis, Connel Red, Ligol, Lodel, Rajka) and to identify the phenolic compounds with potent contribution to antioxidant activity. Nineteen constituents were identified in apple cultivars using ultra high performance liquid chromatography coupled to quadruple and time-of-flight mass spectrometers (UPLC–QTOF–MS). Phytochemical profile was constituted of phenolic acids, procyanidins, quercetin derivatives and dihydrochalcones. Reducing and radical scavenging activities of individual constituents were determined using high performance liquid chromatography (HPLC) coupled to post-column FRAP and ABTS assay, respectively. Significant differences of total radical scavenging and reducing activity (expressed as trolox equivalents, TE µmol/g) were determined between the investigated cultivars. Chlorogenic acid and complex of procyanidins were the main contributors to antioxidant activity determining up to 35 % and 55 % of total TE values, respectively. Determined phenolic composition and antioxidant activity significantly depend on apple cultivars. It is important to determine the individual compounds that are significant for antioxidant activity and that could be investigated in vivo systems. The identification of the antioxidants provides information for the further research of standardized extracts that could be used for pharmaceutical preparations with specific phenolic traits.

Keywords: FRAP, ABTS, antioxidant, phenolic, apples, chlorogenic acid

Procedia PDF Downloads 394

Authors: Celestine Odigwe, Epoke Lincoln, Rhoda-Dara Ephraim

Abstract:

Background; Immunization against the childhood killer diseases is the cardinal strategy for the prevention of these diseases all over the world in under five children, these diseases include; Tuberculosis, Measles, Polio, Tetanus, Diphthria, Pertusis, Yellow Fever, Hepatitis B, Haemophilus Influenza type B. 6.9 million children die before their fifth birthday , 80% of the worlds death in children under 5 years occur in 25 countries most in Africa and Asia and 2 million children can be saved each year with routine immunization Therefore failure to achieve total immunization coverage puts several children at risk. Aim; The aim of the study was to ascertain the prevalence, Investigate the various reasons and causes why several under five children in a suburb of calabar municipal county fail to get the required immunizations as at and when due and possibly the consequences, so that efforts can be re-directed towards the solution of the problems so identified. Methods; the study was a community based cross sectional study. The respondents were the mothers/guardians of the sampled children who were all aged 0-59 months. To be eligible for recruitment into the study, the parent or guardian was required to give an informed consent, reside within the Calabar South County with his/her children aged 0-59 months. We calculated our sample size using the Leslie-Kish formula and we used a two-staged sampling method, first to ballot for the wards to be involved and then to select four of the most populated ones in the wards chosen. Data collection was by interviewer administered structured questionnaire (Appendix I), Data collected was entered and analyzed using Statistical Package for the Social Sciences (SPSS) Version 20. Percentages were calculated and represented using charts and tables Results; The number of children sampled was 159. We found that 150 were fully immunized and 9 were not, the prevalence of missed opportunity was 32% from the study. The reasons for missed opportunities were varied, ranging from false contraindications, logistical problems resulting in very poor access roads to health facilities and poor organization of health centers together with negative health worker attitudes. Some of the consequences of these missed opportunities were increased susceptibility to vaccine preventable diseases, resurgence of the above diseases and increased morbidity and mortality of children aged less than 5 years. Conclusion; We found that ignorance on the part of both parents/guardians and health care staff together with infrastructural inadequacies in the county such as- roads, poor electric power supply for storage of vaccines were hugely responsible for most missed opportunities for immunization. The details of these and suggestions for improvement and the way forward are discussed.

Keywords: missed opportunity, immunization, under five, Calabar south

Procedia PDF Downloads 315

Authors: Sigal Gat-Lazer, Ronny Geva, Dan Ramon, Eitan Gur, Daniel Stein

Abstract:

Introduction: Eating disorders (ED) are common psychopathologies which involve distorted body image and eating disturbances. Binge-purge eating disorders (B/P ED) are characterized by repetitive events of binge eating followed by purges. Patients with B/P ED behavior may be seen as impulsive especially when relate to food stimulation and affective conditions. The current study included innovative modification of the day-night task targeted to assess inhibitory control among patients with B/P ED. Methods: This prospective study included 50 patients with B/P ED during acute phase of illness (T1) upon their admission to specialized ED department in tertiary center. 34 patients repeated the study towards discharge to ambulatory care (T2). Treatment effect was evaluated by BMI and emotional questionnaires regarding depression and anxiety by the Beck Depression Inventory and State Trait Anxiety Inventory questionnaires. Control group included 36 healthy controls with matched demographic parameters who performed both T1 and T2 assessments. The current modification is based on the emotional day-night task (EDNT) which involves five emotional stimulation added to the sun and moon pictures presented to participants. In the current study, we designed the food-emotional modification day night task (F-EDNT) food stimulations of egg and banana which resemble the sun and moon, respectively, in five emotional states (angry, sad, happy, scrambled and neutral). During this computerized task, participants were instructed to push on “day” bottom in response to moon and banana stimulations and on “night” bottom when sun and egg were presented. Accuracy (A) and reaction time (RT) were evaluated and compared between EDNT and F-EDNT as a reflection of participants’ inhibitory control. Results: Patients with B/P ED had significantly improved BMI, depression and anxiety scores on T2 compared to T1 (all p<0.001). Task performance was similar among patients and controls in the EDNT without significant A or RT differences in both T1 and T2. On F-EDNT during T1, B/P ED patients had significantly reduced accuracy in 4/5 emotional stimulation compared to controls: angry (73±25% vs. 84±15%, respectively), sad (69±25% vs. 80±18%, respectively), happy (73±24% vs. 82±18%, respectively) and scrambled (74±24% vs. 84±13%, respectively, all p<0.05). Additionally, patients’ RT to food stimuli was significantly faster compared to neutral ones, in both cry and neutral emotional stimulations (356±146 vs. 400±141 and 378±124 vs. 412±116 msec, respectively, p<0.05). These significant differences between groups as a function of stimulus type were diminished on T2. Conclusion: Having to process food related content, in particular in emotional context seems to be impaired in patients with B/P ED during the acute phase of their illness and elicits greater impulsivity. Innovative modification using such procedures seem to be sensitive to patients’ illness phase and thus may be implemented during screening and follow up through the clinical management of these patients.

Keywords: binge purge eating disorders, day night task modification, eating disorders, food related stimulations

Procedia PDF Downloads 377

Authors: Mas Pertiwi I. G. AG Istri, Sri Kristinayanti Wayan, Oka Aryawan I. Gede Made

Abstract:

Ability of government to meet the needs of infrastructure investment constrained by the size of the budget commitments for other sectors. Another barrier is the complexity of the process of land acquisition. Public Private Partnership can help bridge the investment gap by including the amount of funding from the private sector, shifted the responsibility of financing, construction of the asset, and the operation and post-project design and care to them. In principle, a construction project implementation always requires the investor as a party to provide resources in the form of funding which it must be contained in a successor agreement in the form of a contract. In general, construction contracts consist of contracts which passed in Indonesia and contract International. One source of funding used in the implementation of construction projects comes from funding that comes from the collaboration between the government and the private sector, for example with the system: BLT (Build Lease Transfer), BOT (Build Operate Transfer), BTO (Build Transfer Operate) and BOO (Build Operate Own). And form of payment under a construction contract can be distinguished several ways: monthly payment, payments based on progress and payment after completed projects (Turn Key). One of the tools used to analyze the feasibility of the investment is to use financial models. The financial model describes the relationship between different variables and assumptions used. From a financial model will be known how the cash flow structure of the project, which includes revenues, expenses, liabilities to creditors and the payment of taxes to the government. Net cash flow generated from the project will be used as a basis for analyzing the feasibility of investment source of project financing Public Private Partnership could come from equity or debt. The proportion of funding according to its source is a comparison of a number of investment funds originating from each source of financing for a total investment cost during the construction period by selected the contract system and several alternative financing percentage ratio determined according to sources will generate cash flow structure that is different. Of the various possibilities for the structure of the cash flow generated will be analyzed by software is to test T Paired to compared the contract system used by various alternatives comparison of financing to determine the effect of the contract system and the comparison of such financing for the feasibility of investment toll road construction project for the economic life of 20 (twenty) years. In this use case studies of toll road contruction project Bali Mandara. And in this analysis only covered two systems contracts, namely Build Operate Transfer and Turn Key. Based on the results obtained by analysis of the variable investment feasibility of the NPV, BCR and IRR between the contract system Build Operate Transfer and contract system Turn Key on the interest rate of 9%, 12% and 15%.

Keywords: contract system, financing, internal rate of return, net present value

Procedia PDF Downloads 220

Authors: Abhimanyu Kumar

Abstract:

The relationship between religion and medicine is much evident in the context of Buddhism. This paper is an attempt to look at the processes of social and cultural evolution of scientific creativity in the field of medicine and institutionalization of medical practices. The objective of the paper is to understand the Buddhist responses towards health as understood from the Vinaya Piṭaka and the Jātaka. This work is a result of the analysis of two important Buddhist texts: the Vinaya Piṭaka and the Jātaka. Broadly the Vinaya Piṭaka is concerned with the growth of Buddhist monasticism. The Vinaya Piṭaka is considered one of the most important sacred texts of the Buddhists, and contains rules for monastic life. These rules deal with such aspects as formal meetings of the saṃgha (monastery), expiation, confession, training, and legal questions. The Jātaka stories, on the other hand, are in the form of folk narratives, and provide a major source of medical consultation for all classes. These texts help us to ascertain the ‘proficiency and perceptions’ of the prevailing medical traditions. The Jātakas are a collection of 547 stories about the past lives of the Buddha, who is represented in anthropomorphic and animal form. The Jātaka connects itself between existing cognitive environments related to ethics and Buddhist didacticism. These stories are a reflection of the connection between the past and contemporary times (in the sense of time of creation of the story) as well. This is visible through the narrative strategy of the text, where every story is sub-divided into the story of the past and story of the present, and there is a significant identification element or connection that established at the end of each story. The minimal presence of philosophical content and the adoption of a narrative strategy make it possible for more of everyday life. This study gives me an opportunity to raise questions about how far were the body and mind closely interrelated in the Buddhist perceptions, and also did the society act like a laboratory for the Buddhists to practice healing activities? How far did religious responses to afflictions, be they leprosy or plague or anger, influence medical care; what impact did medical practitioners, religious authorities and the regulation of medical activity and practice have on healing the body and the mind; and, how has the healing environment been viewed. This paper is working with the idea that medical science in early India was not only for the curative purpose of diseases, but it fulfilled a greater cause of promoting, maintaining and restoring human health. In this regard, studying these texts gives an insight regarding religious responses to epidemics, from leprosy to plague, as well as to behavioral disorder such as anger. In other words, it deals with the idea about healing the body and healing the soul from a religious perspective.

Keywords: food for health, folk narratives, human body, materia medica, social sickness

Procedia PDF Downloads 272

Authors: Supria Sarkar, Vasit Sagan, Sourav Bhadra, Meghnath Pokharel, Felix B.Fritschi

Abstract:

Soybean and their derivatives are very important agricultural commodities around the world because of their wide applicability in human food, animal feed, biofuel, and industries. However, the significance of soybean production depends on the quality of the soybean seeds rather than the yield alone. Seed composition is widely dependent on plant physiological properties, aerobic and anaerobic environmental conditions, nutrient content, and plant phenological characteristics, which can be captured by high temporal resolution remote sensing datasets. Planet scope (PS) satellite images have high potential in sequential information of crop growth due to their frequent revisit throughout the world. In this study, we estimate soybean seed composition while the plants are in the field by utilizing PlanetScope (PS) satellite images and different machine learning algorithms. Several experimental fields were established with varying genotypes and different seed compositions were measured from the samples as ground truth data. The PS images were processed to extract 462 hand-crafted vegetative and textural features. Four machine learning algorithms, i.e., partial least squares (PLSR), random forest (RFR), gradient boosting machine (GBM), support vector machine (SVM), and two recurrent neural network architectures, i.e., long short-term memory (LSTM) and gated recurrent unit (GRU) were used in this study to predict oil, protein, sucrose, ash, starch, and fiber of soybean seed samples. The GRU and LSTM architectures had two separate branches, one for vegetative features and the other for textures features, which were later concatenated together to predict seed composition. The results show that sucrose, ash, protein, and oil yielded comparable prediction results. Machine learning algorithms that best predicted the six seed composition traits differed. GRU worked well for oil (R-Squared: of 0.53) and protein (R-Squared: 0.36), whereas SVR and PLSR showed the best result for sucrose (R-Squared: 0.74) and ash (R-Squared: 0.60), respectively. Although, the RFR and GBM provided comparable performance, the models tended to extremely overfit. Among the features, vegetative features were found as the most important variables compared to texture features. It is suggested to utilize many vegetation indices for machine learning training and select the best ones by using feature selection methods. Overall, the study reveals the feasibility and efficiency of PS images and machine learning for plot-level seed composition estimation. However, special care should be given while designing the plot size in the experiments to avoid mixed pixel issues.

Keywords: agriculture, computer vision, data science, geospatial technology

Procedia PDF Downloads 126

Authors: Pamela Aimee Rigor

Abstract:

This study aims to examine the representation of Syrian refugees resettled in Vancouver and the Lower Mainland in local community and major newspapers. While there is strong support for immigration in Canada, public opinion towards refugees and asylum seekers is a bit more varied. Concerns about the legitimacy of refugee claims are among the common concerns of Canadians, and hateful or negative narratives are still present in Canadian media discourse which affects how people view refugees. To counter the narratives, these Syrian refugees must publicly declare how grateful they are because they are resettled in Canada. The dominant media discourse is that these refugees should be grateful as they have been graciously accepted by Canada and Canadians, once again upholding the image of Canada being a generous and humanitarian nation. The study examined the representation of Syrian refugees and the Syrian refugee resettlement in Canadian newspapers from September 2015 to October 2017 – around the time Prime Minister Trudeau came into power up until the present. Using a combination of content and discourse analysis, it aimed to uncover how local community and major newspapers in Vancouver covered the Syrian refugee ‘crisis’ – more particularly, the arrival and resettlement of the refugees in the country. Using the qualitative data analysis software Nvivo 12, the newspapers were analyzed and sorted into themes. Based on the initial findings, the discourse of Canada being a humanitarian country and Canadians being generous, as well as the idea of Syrian refugees having to publicly announce how grateful they are, is still present in the local community newspapers. This seems to be done to counter the hateful narratives of citizens who might view them as people who are abusing help provided by the community or the services provided by the government. However, compared to the major and national newspapers in Canada, many these local community newspapers are very inclusive of Syrian refugee voices. Most of the News and Community articles interview Syrian refugees and ask them their personal stories of plight, survival, resettlement and starting a ‘new life’ in Canada. They are not seen as potential threats nor are they dismissed – the refugees were named and were allowed to share their personal experiences in these news articles. These community newspapers, even though their representations are far from perfect, actually address some aspects of the refugee resettlement issue and respond to their community’s needs. There are quite a number of news articles that announce community meetings and orientations about the Syrian refugee crisis, ways to help in the resettlement process, as well as community fundraising activities to help sponsor refugees or resettle newly arrived refugees. This study aims to promote awareness of how these individuals are socially constructed so we can, in turn, be aware of the certain biases and stereotypes present, and its implications on refugee laws and public response to the issue.

Keywords: forced migration and conflict, media representations, race and multiculturalism, refugee studies

Procedia PDF Downloads 234

Authors: Cathy Basterfield

Abstract:

Issue: To engage in one’s own health care, health professionals need to be aware of an individual’s specific skills and abilities for best communication. One of the most discussed is health literacy. One of the assumed skills and abilities for adults is an individuals’ health literacy. Background: A review of publicly available health content appears to assume all adult readers will have a broad and full capacity to read at a high level of literacy, often at a post-school education level. Health information writers and clinicians need to recognise one critical area for why there may be little or no change in a person’s behaviour, or no-shows to appointments. Perhaps unintentionally, they are miscommunicating with the majority of the adult population. Health information contains many literacy domains. It usually includes technical medical terms or jargon. Many fact sheets and other information require scientific literacy with or without specific numerical literacy. It may include graphs, percentages, timing, distance, or weights. Each additional word or concept in these domains decreases the readers' ability to meaningfully read, understand and know what to do with the information. An attempt to begin to read the heading where long or unfamiliar words are used will reduce the readers' motivation to attempt to read. Critically people who have low literacy are overwhelmed when pages are covered with lots of words. People attending a health environment may be unwell or anxious about a diagnosis. These make it harder to read, understand and know what to do with the information. But access to health information must consider an even wider range of adults, including those with poor school attainment, migrants, and refugees. It is also homeless people, people with mental health illnesses, or people who are ageing. People with low literacy also may include people with lifelong disabilities, people with acquired disabilities, people who read English as a second (or third) language, people who are Deaf, or people who are vision impaired. Outcome: This paper will discuss Easy English, which is developed for adults. It uses the audiences’ everyday words, short sentences, short words, and no jargon. It uses concrete language and concrete, specific images to support the text. It has been developed in Australia since the mid-2000s. This paper will showcase various projects in the health domain which use Easy English to improve the understanding and functional use of written information for the large numbers of adults in our communities who do not have the health literacy to manage a range of day to day reading tasks. See examples from consent forms, fact sheets and choice options, instructions, and other functional documents, where Easy English has been developed. This paper will ask individuals to reflect on their own work practice and consider what written information must be available in Easy English. It does not matter how cutting-edge a new treatment is; when adults can not read or understand what it is about and the positive and negative outcomes, they are less likely to be engaged in their own health journey.

Keywords: health literacy, inclusion, Easy English, communication

Procedia PDF Downloads 113

Authors: Alexis Naranjo

Abstract:

In the current global stage, a new sense and mix feelings against the globalization has started to take shape thanks to events such as Brexit and the 2016 US election. The perceptions towards the globalization have started to focus in a resistance movement called the 'anti-globalization movement'. This paper examines the current global stage vs. leadership decisions in a time when market integrations are not longer seeing as an opportunity for an economic growth buster. The biggest economy in the world the United States of America has started to face a new beginning of something called 'anti-globalization', in the current global stage starting with the United Kingdom to the United States a new strategy to help local economies has started to emerge. A new nationalist movement has started to focus on their local economies which now represents a direct threat to the globalization, trade agreements, wages and free markets. Business leaders of multinationals now in our days face a new dilemma, how to address the feeling that globalization and outsourcing destroy and take away jobs from local economies. The initial perception of the literature and data rebels that companies in Western countries like the US sees many risks associate with outsourcing, however, saving cost associated with outsourcing is greater than the firm’s local reputation. Starting with India as a good example of a supplier of IT developers, analysts and call centers we can start saying that India is an industrialized nation which has not yet secured its spot and title. India has emerged as a powerhouse in the outsource industry, which makes India hold the number one spot in the world to outsource IT services. Thanks to the globalization of economies and markets around the globe that new ideas to increase productivity at a lower cost has been existing for years and has started to offer new ideas and options to businesses in different industries. The economic growth of the information technology (IT) industry in India is an example of the power of the globalization which in the case of India has been tremendous and significant especially in the economic arena. This research paper concentrates in understand the behavior of business leaders: First, how multinational’s leaders will face the new challenges and what actions help them to lead in turbulent times. Second, if outsourcing or withdraw from a market is an option what are the consequences and how you communicate and negotiate from the business leader perspective. Finally, is the perception of leaders focusing on financial results or they have a different goal? To answer these questions, this study focuses on the most recent data available to outline and present the findings of the reason why outsourcing is and option and second, how and why those decisions are made. This research also explores the perception of the phenomenon of outsourcing in many ways and explores how the globalization has contributed to its own questioning.

Keywords: anti-globalization, globalization, leadership, outsourcing

Procedia PDF Downloads 181

Authors: Dina C. Castro, Rossana Boyd, Eugenia Papadaki

Abstract:

Immigration within and across continents is currently a global reality. The number of people leaving their communities in search for a better life for them and their families has increased dramatically during the last twenty years. Therefore, young children of the 21st century around the World are growing up in diverse communities, exposed to many languages and cultures. One consequence of these migration movements is the increased linguistic diversity in school settings. Depending on the linguistic history and the status of languages in the communities (i.e., minority-majority; majority-majority) the instructional approaches will differ. This session will discuss how bilingualism is addressed in early education programs in both minority-majority and majority-majority language communities, analyzing experiences in three countries with very distinct societal and demographic characteristics: Peru (South America), the United States (North America), and Italy (European Union). The ultimate goal is to identify commonalities and differences across the three experiences that could lead to a discussion of bilingualism in early education from a global perspective. From Peru, we will discuss current national language and educational policies that have lead to the design and implementation of bilingual and intercultural education for children in indigenous communities. We will also discuss how those practices are being implemented in preschool programs, the progress made and challenges encountered. From the United States, we will discuss the early education of Spanish-English bilingual preschoolers, including the national policy environment, as well as variations in language of instruction approaches currently being used with these children. From Italy, we will describe early education practices in the Bilingual School of Monza, in northern Italy, a school that has 20 years promoting bilingualism and multilingualism in education. While the presentations from Peru and the United States will discuss bilingualism in a majority-minority language environment, this presentation will lead to a discussion on the opportunities and challenges of promoting bilingualism in a majority-majority language environment. It is evident that innovative models and policies are necessary to prevent inequality of opportunities for bilingual children beginning in their earliest years. The cross-cultural examination of bilingual education experiences for young children in three part of the World will allow us to learn from our success and challenges. The session will end with a discussion of the following question: To what extent are early care and education programs being effective in promoting positive development and learning among all children, including those from diverse language, ethnic and cultural backgrounds? We expect to identify, with participants to our session, a set of recommendations for policy and program development that could ensure access to high quality early education for all bilingual children.

Keywords: early education for bilingual children, global perspectives in early education, cross-cultural, language policies

Procedia PDF Downloads 292

Authors: Kever Gomes, Rosana Martins

Abstract:

The use of environmental indicators is today an important strategy for analyzing the sustainability of agricultural systems. Despite of the considerable importance of family agriculture for Brazilian economy, sustainable agricultural practices are still weakly known, and the known ones, underused. Currently, economic aspects of the relationship between man and nature lead to the destruction of natural ecosystems, which justifies the urgent need for dissemination and usage of new sustainable production techniques. The study shows the agro-social and social-cultural trajectory of the farmers and hypothesis are advanced on what would imply the adoption of agroforestry systems in family agriculture. This study aimed to investigate aspects related to the perception of sustainable agriculture, especially on agroforestry systems in farms of farmers from Distrito Federal-Brazil. Agro-social characteristics of farmers were systematized considering their perceptions about agroforestry systems for the preparation of proposal for a program of Environmental Services Payment, intended for families who are involved in the various activities of home gardens. This study used qualitative methodological approaches of quantitative research, using descriptive exploratory research. To get the necessary elements for the intended analysis, interviews were conducted at 40 heads of households of which 15 were men and 25 women. The results were analyzed using descriptive statistics, having been considered in the analysis the frequency, consistency, coherence and originality of responses. It was found that the lack of financial resources and lack of technical assistance are limiting factors for the dissemination and use of sustainable agricultural practices. Considering the great number of species found for the main categories of use, it can be inferred that the home gardens play important functions for the interviewed families, contributing for the food and medicine production destined for the consumption by the families themselves, and also playing an important esthetic function thanks to the variety of their ornamental plants. The wealth of these home gardens may be related to the rural origin and to the culture of the owners, who still keep a cultivation tradition. It was found that the products obtained from the home gardens contributed for the diet’s variety of the informants, representing a promising potential for the improvement of the population alimentation. The study reached the conclusion over the need to motivate the interest of these farmers to seek information and resources to enable the implementation of Agroforestry projects, including the recovery of areas in their properties, even those distinct from their backyards. The study shows the agro-social and social-cultural trajectory of the farmers and hypothesis are advanced on what would imply the adoption of agroforestry systems in family agriculture.

Keywords: agro-biodiversity, natural conservation, silviculture, urban agriculture

Procedia PDF Downloads 190

Authors: Vesa Salminen, Esa Santakallio, Heikki Ruohomaa

Abstract:

Introduction: The city of Riihimäki has decided robotics on well-being, service and industry as the main focus area on their ecosystem strategy. Robotics is going to be an important part of the everyday life of citizens and present in the working day of the average citizen and employee in the future. For that reason, also education system and education programs on all levels of education from diaper age to doctorate have been directed to fulfill this ecosystem strategy. Goal: The objective of this activity has been to develop education continuity from diaper age to doctorate. The main target of the development activity is to create a unique robotics study entity that enables ongoing robotics studies from preprimary education to university. The aim is also to attract students internationally and supply a skilled workforce to the private sector, capable of the challenges of the future. Methodology: Education instances (high school, second grade, Universities on all levels) in a large area of Tavastia Province have gradually directed their education programs to support this goal. On the other hand, applied research projects have been created to make proof of concept- phases on areal real environment field labs to test technology opportunities and digitalization to change business processes by applying robotic solutions. Customer-oriented applied research projects offer for students in robotics education learning environments to learn new knowledge and content. That is also a learning environment for education programs to adapt and co-evolution. New content and problem-based learning are used in future education modules. Major findings: Joint robotics education entity is being developed in cooperation with the city of Riihimäki (primary education), Syria Education (secondary education) and HAMK (bachelor and master education). The education modules have been developed to enable smooth transitioning from one institute to another. This article is introduced a case study of the change of education of wellbeing education because of digitalization and robotics. Riihimäki's Elderly citizen's service house, Riihikoti, has been working as a field lab for proof-of-concept phases on testing technology opportunities. According to successful case studies also education programs on various levels of education have been changing. Riihikoti has been developed as a physical learning environment for home care and robotics, investigating and developing a variety of digital devices and service opportunities and experimenting and learn the use of equipment. The environment enables the co-development of digital service capabilities in the authentic environment for all interested groups in transdisciplinary cooperation.

Keywords: ecosystem strategy, digitalization and robotics, education continuity, learning environment, transdisciplinary co-operation

Procedia PDF Downloads 167

Authors: Rahy Farooq, Maria Ahmad Khan, Ayesha Isani Majeed

Abstract:

Objective: The main aim of this research is to assess the knowledge, attitude and practices of female nursing staff and nursing students regarding breast cancer, to provide a baseline for monitoring trends of breast cancer awareness in them. Background: Healthcare professionals are a direct source of information for the patients and the general public as a whole. It is, therefore, essential that the information they convey be accurate and helps in building additional awareness. However, clinical experience does not influence the knowledge, attitude and practices regarding breast cancer. Nurses, being the prime part of the healthcare professionals, play a significant role and hence, their awareness regarding this pressing issue is pertinent. Lack of awareness regarding common presenting symptoms or breast cancer risk factors translates to poor breast cancer screening practices and late diagnosis. Methodology: A cross-sectional study of 280 female nurses was conducted at a tertiary care hospital in Islamabad, Pakistan. A pre-tested structured questionnaire with additional variables like cultural barriers to seeking medical help was used. The scores for outcome variables including knowledge, attitude and practices were pre-defined. Data was analyzed using SPSSv23. Results: Of the 280 participants with a mean age of 28.99±9.98 years, 142 (50.7%) were married, and 138 (49.3%) were unmarried. Mean scores were computed to be 6.14±2.93 (out of 12), 0.30±0.7 (out of 3) and 9.53±1.92 (out of 16) for knowledge, attitude and practice respectively. Using independent sample T-test, a statistically significant correlation was found when means for the score of Attitude was compared with age. With a p-value of 0.018, 117 nurses of age more than 30 years, faced more practical, financial, emotional and service barriers as compared to 163 women younger than 30 years of age. Knowledge of age-related lifetime risks was also significantly poor more in single women; with a p-value of 0.006 for identification of correct age as a risk factor and a p-value of 0.005 for correct identification of risk for development of breast cancer in the lifetime of women. By application of Chi-square test, there was a significant correlation between marital status and cultural barriers to seeking medical help, showing that single women (58.7%) shy away from talking about breast cancer considering it a taboo (p-value 0.028) whereas, more married nurses (59.2%) were apprehensive that they might be considered at fault by the society, as compared to 40.8% of single nurses. (p-value 0.038). Conclusion: Owing to the scarcity of awareness among nurses, this study recognizes the need for delivering effective information to the female nurses regarding breast cancer. Educating patients is likely to be effective if the female nurses play their part and have correct attitudes towards breast cancer practices. A better understanding of the knowledge and practices regarding breast cancer among the nursing population will enable high-risk patients to be recognized early. Therefore, we recommend arrangement of special courses and seminars for all healthcare professionals including the nursing staff.

Keywords: breast cancer, cultural barriers, kap, nurses

Procedia PDF Downloads 229

Authors: Preetinder Kaur Randhawa

Abstract:

The rural areas can be differentiated from urban areas in terms of their economic activities as rural areas are primarily involved in agricultural sector and provide natural resources whereas, urban areas are primarily involved in infrastructure sector and provide manufacturing services. Census of India defines a Census Town as an area which satisfies the following three criteria i.e. population exceeds 5000, at least 75 percent of male population engaged in non-agricultural sector and minimum population density of 400 persons per square kilometers. Urban areas can be attributed to the improvement of transport facilities, the massive decline in agricultural, especially male workers and workers shift to non-agricultural activities. This study examines the pattern, process of rural areas transformed into urban areas/ census town. The study has analyzed the various factors which are responsible for land transformation as well as the socio-economic transformation of the village population. Nilpur (CT) which belongs to Rajpura Tehsil in Patiala district, Punjab has been selected for the present study. The methodology adopted includes qualitative and quantitative research design, methods based on secondary data. Secondary data has been collected from unpublished revenue record office of Rajpura Tehsil and Primary Census Abstract of Patiala district, Census of India 2011. The results have showed that rate of transformation of a village to census town in Rajpura Tehsil has been one of highest among other villages. The census town has evolved through the evolutionary process of human settlement which grows in size, population and physical development. There must be a complete economic transformation and attainment of high level of technological development. Urban design and construction of buildings and infrastructure can be carried out better and faster and can be used to aid human habitation with the enhancement of quality of life. The study has concluded that in the selected area i.e Nilpur (CT) literacy rate has increased to 72.1 percent in year 2011 from 67.6 percent in year 2001. Similarly non-agricultural work force has increased to 95.2 percent in year 2011 from 81.1 percent in year 2001. It is very much clear that the increased literacy rate has put a positive impact on the involvement of non-agricultural workers have enhanced. The study has concluded that rural-urban linkages are important tools for understanding complexities of people livelihood and their strategies which involve mobility migration and the diversification of income sources and occupations.

Keywords: Census Town, India, Nilpur, Punjab

Procedia PDF Downloads 243

Authors: Kumaran Letchmanan, Shou-Cang Shen, Wai Kiong Ng

Abstract:

Postoperative implant-associated infections in soft tissues and bones remain a serious complication in orthopaedic surgery, which leads to impaired healing, re-implantation, prolong hospital stay and increase cost. Drug-loaded implants with sustained release of antibiotics at the local site are current research interest to reduce the risk of post-operative infections and osteomyelitis, thus, minimize the need for follow-up care and increase patient comfort. However, the improved drug release of the drug-loaded bone cements is usually accompanied by a loss in mechanical strength, which is critical for weight-bearing bone cement. Recently, more attempts have been undertaken to develop techniques to enhance the antibiotic elution as well as preserve the mechanical properties of the bone cements. The present study investigates the potential influence of addition of mesoporous silica nanoparticles (MSN) on the in vitro drug release kinetics of gentamicin (GTMC), along with the mechanical properties of bone cements. Simplex P was formulated with MSN and loaded with GTMC by direct impregnation. Meanwhile, Simplex P with water soluble poragen (xylitol) and high loading of GTMC as well as commercial bone cement CMW Smartset GHV were used as controls. MSN-formulated bone cements are able to increase the drug release of GTMC by 3-fold with a cumulative release of more than 46% as compared with other control groups. Furthermore, a sustained release could be achieved for two months. The loaded nano-sized MSN with uniform pore channels significantly build up an effective nano-network path in the bone cement facilitates the diffusion and extended release of GTMC. Compared with formulations using xylitol and high GTMC loading, incorporation of MSN shows no detrimental effect on biomechanical properties of the bone cements as no significant changes in the mechanical properties as compared with original bone cement. After drug release for two months, the bending modulus of MSN-formulated bone cements is 4.49 ± 0.75 GPa and the compression strength is 92.7 ± 2.1 MPa (similar to the compression strength of Simplex-P: 93.0 ± 1.2 MPa). The unaffected mechanical properties of MSN-formulated bone cements was due to the unchanged microstructures of bone cement, whereby more than 98% of MSN remains in the matrix and supports the bone cement structures. In contrast, the large portions of extra voids can be observed for the formulations using xylitol and high drug loading after the drug release study, thus caused compressive strength below the ASTM F541 and ISO 5833 minimum of 70 MPa. These results demonstrate the potential applicability of MSN-functionalized poly(methyl methacrylate)-based bone cement as a highly efficient, sustained and local drug delivery system with good mechanical properties.

Keywords: antibiotics, biomechanical properties, bone cement, sustained release

Procedia PDF Downloads 250

Authors: A. Venkatakrishnan, M. Juneja, S. Kapoor

Abstract:

Background: Gastrointestinal dysfunction is an emerging co morbidity seen in autism and may further strengthen the association between autism and celiac disease. This is supported by increased rates (22-70%) of gastrointestinal symptoms like diarrhea, constipation, abdominal discomfort/pain, and gastrointestinal inflammation in children with the etiology of autism is still elusive. In addition to genetic factors, environmental factors such as toxin exposure, intrauterine exposure to certain teratogenic drugs, are being proposed as possible contributing factors in the etiology of Autism Spectrum Disorders (ASD) in cognizance with reports of increased gut permeability and high rates of gastrointestinal symptoms noted in children with ASD, celiac disease has also been proposed as a possible etiological factor. Despite insufficient evidence regarding the benefit of restricted diets in Autism, GFD has been promoted as an alternative treatment for ASD. This study attempts to discern any correlation between ASD and celiac disease. Objective: This cross sectional study aims to determine the proportion of celiac disease in children with ASD. Methods: Study included 155 participants aged 2-12 yrs, diagnosed as ASD as per DSM-5 attending the child development center at a tertiary care hospital in Northern India. Those on gluten free diet or having other autoimmune conditions were excluded. A detailed Performa was filled which included sociodemographic details, history of gastrointestinal symptoms, anthropometry, systemic examination, and pertinent psychological testing was done using was assessed using Developmental Profile-3(DP-3) for Developmental Quotient, Childhood Autism Rating Scale-2 (CARS-2) for severity of ASD, Vineland Adaptive Behavior Scales (VABS) for adaptive behavior, Child Behavior Checklist (CBCL) for behavioral problems and BAMBI (Brief Autism Mealtime Behavior Scales) for feeding problems. Screening for celiac was done by TTG-IgA levels, and total serum IgA levels were measured to exclude IgA deficiency. Those with positive screen were further planned for HLA typing and endoscopic biopsy. Results: A total of 155 cases were included, out of which 5 had low IgA levels and were hence excluded from the study. The rest 150 children had TTG levels below the ULN and normal total serum IgA level. History of Gastrointestinal symptoms was present in 51 (34%) cases abdominal pain was the most frequent complaint (16.6%), followed by constipation (12.6%). Diarrhea was seen in 8 %. Gastrointestinal symptoms were significantly more common in children with ASD above 5 yrs (p-value 0.006) and those who were verbal (p = 0.000). There was no significant association between socio-demographic factors, anthropometric data, or severity of autism with gastrointestinal symptoms. Conclusion: None of the150 patients with ASD had raised TTG levels; hence no association was found between ASD and celiac disease. There is no justification for routine screening for celiac disease in children with ASD. Further studies are warranted to evaluate association of Non Celiac Gluten Sensitivity with ASD and any role of gluten-free diet in such patients.

Keywords: autism, celiac, gastrointestinal, gluten

Procedia PDF Downloads 113

Authors: S. Hatamikia, A. Biguri, H. Furtado, G. Kronreif, J. Kettenbach, W. Birkfellner

Abstract:

Nowadays, three dimensional Cone Beam CT (CBCT) has turned into a widespread clinical routine imaging modality for interventional radiology. In conventional CBCT, a circular sourcedetector trajectory is used to acquire a high number of 2D projections in order to reconstruct a 3D volume. However, the accumulated radiation dose due to the repetitive use of CBCT needed for the intraoperative procedure as well as daily pretreatment patient alignment for radiotherapy has become a concern. It is of great importance for both health care providers and patients to decrease the amount of radiation dose required for these interventional images. Thus, it is desirable to find some optimized source-detector trajectories with the reduced number of projections which could therefore lead to dose reduction. In this study we investigate some source-detector trajectories with the optimal arbitrary orientation in the way to maximize performance of the reconstructed image at particular regions of interest. To achieve this approach, we developed a box phantom consisting several small target polytetrafluoroethylene spheres at regular distances through the entire phantom. Each of these spheres serves as a target inside a particular region of interest. We use the 3D Point Spread Function (PSF) as a measure to evaluate the performance of the reconstructed image. We measured the spatial variance in terms of Full-Width-Half-Maximum (FWHM) of the local PSFs each related to a particular target. The lower value of FWHM shows the better spatial resolution of reconstruction results at the target area. One important feature of interventional radiology is that we have very well-known imaging targets as a prior knowledge of patient anatomy (e.g. preoperative CT) is usually available for interventional imaging. Therefore, we use a CT scan from the box phantom as the prior knowledge and consider that as the digital phantom in our simulations to find the optimal trajectory for a specific target. Based on the simulation phase we have the optimal trajectory which can be then applied on the device in real situation. We consider a Philips Allura FD20 Xper C-arm geometry to perform the simulations and real data acquisition. Our experimental results based on both simulation and real data show our proposed optimization scheme has the capacity to find optimized trajectories with minimal number of projections in order to localize the targets. Our results show the proposed optimized trajectories are able to localize the targets as good as a standard circular trajectory while using just 1/3 number of projections. Conclusion: We demonstrate that applying a minimal dedicated set of projections with optimized orientations is sufficient to localize targets, may minimize radiation.

Keywords: CBCT, C-arm, reconstruction, trajectory optimization

Procedia PDF Downloads 126

Authors: Watin Alkhelaiwi, Iseult Wilson, Marian Traynor, Katherine Rogers

Abstract:

Clinical nursing education allows nursing students to gain essential knowledge from practice experience and develop nursing skills in a variety of clinical environments. Integrating theoretical knowledge and practical skills is made easier for nursing students by providing opportunities for practice in a clinical environment. Nursing competency is an essential capability required to fulfill nursing responsibilities. Effective mentoring in clinical settings helps nursing students develop the necessary competence and promotes the integration of theory and practice. Preceptors play a considerable role in clinical nursing education, including the supervision of nursing students undergoing a rigorous clinical practicum. Preceptors are also involved in the clinical assessment of nursing students’ competency. The assessment of nursing students’ competence by professional practitioners is essential to investigate whether nurses have developed an adequate level of competence to deliver safe nursing care. Competency assessment remains challenging among nursing educators and preceptors, particularly owing to the complexity of the process. Consistency in terms of assessment methods and tools and valid and reliable assessment tools for measuring competence in clinical practice are lacking. Nurse preceptors must assess students’ competencies to prepare them for future professional responsibilities. Preceptors encounter difficulties in the assessment of competency owing to the nature of the assessment process, lack of standardised assessment tools, and a demanding clinical environment. The purpose of the study is to examine nursing preceptors’ experiences of assessing nursing interns’ competency in Saudi Arabia. There are three objectives in this study; the first objective is to examine the preceptors’ view of the Saudi assessment tool in relation to preceptorship, assessment, the assessment tool, the nursing curriculum, and the grading system. The second and third objectives are to examine preceptors’ view of "competency'' in nursing and their interpretations of the concept of competency and to assess the implications of the research in relation to the Saudi 2030 vision. The study uses an exploratory sequential mixed-methods design that involves a two-phase project: a qualitative focus group study is conducted in phase 1, and a quantitative study- a descriptive cross-sectional design (online survey) is conducted in phase 2. The results will inform the preceptors’ view of the Saudi assessment tool in relation to specific areas, including preceptorship and how the preceptors are prepared to be assessors, and assessment and assessment tools through identifying the appropriateness of the instrument for clinical practice. The results will also inform the challenges and difficulties that face the preceptors. These results will be analysed thematically for the focus group interview data, and SPSS software will be used for the analysis of the online survey data.

Keywords: clinical assessment tools, clinical competence, competency assessment, mentor, nursing, nurses, preceptor

Procedia PDF Downloads 53

Authors: Hamdan Hamood Aldumaini, Amjad Hussein Meqdam, Shamsaldeen kassim Ali, Hamed Mohammed Al-Yousefi, Haron Ahmed Al-Badawi

Abstract:

Background: Autism Spectrum Disorder (ASD) is a complex developmental challenge characterized by significant impairments in social interaction, communication, and behavioral patterns. Diagnosing ASD is challenging due to the lack of definitive medical tests, making early identification crucial. Therefore, increasing people's awareness about autism leads to early diagnosis and better prognosis. Objective: Our study aims to identify the initial symptoms prompting families to seek medical advice, determine the timeline between symptom onset and formal diagnosis, and explore methods for assessing the severity of ASD. Subjects and Methods: The study design employed was a descriptive cross-sectional design, which was suitable for the nature of the research. The data collection took place from March 5, 2022, to April 5, 2022, in Autism Rehabilitation Centers in Sana'a, Yemen. The study population consisted of all children who were diagnosed with autism and visited Autism rehabilitation centers in Sana'a city. The sample size was determined using Epi info version 7, and a total population of 587 autistic children attending the treatment was calculated, but only 250 children were included in this study (176 were male vs. 74 female). Result: In terms of sociability problems, it was found that a significant proportion of Yemeni children with autism experienced difficulties in this area. Specifically, 39.6% were classified as having severe sociability problems, while 28.4% were classified as having moderate issues. Sensory-cognitive awareness problems were also prevalent among the respondents, with 29.6% exhibiting severe difficulties in this domain. Health and physical problems were identified as significant concerns for Yemeni children with autism. The results indicated that 38.4% of the participants experienced severe health and physical issues. Identifying the first symptoms of autism is crucial for early detection and intervention. According to the study, speech delay was the most commonly observed first abnormality, reported by 71.3% of parents. Communication difficulties with others were the second most noticed abnormality, reported by 54.9% of parents. Repetitive movements were the third most commonly observed abnormality, reported by 18% of parents. Regarding the awareness among parents of ASD, our study showed that a significant portion (62%) of parents lack awareness about Autism Spectrum Disorder (ASD) and its causes. Surprisingly, a majority of these parents (over 80%) believe that autism is a curable condition. Additionally, more than half (51.2%) of the parents surveyed reported insufficient knowledge about medication options available to support therapy and rehabilitation for their autistic children.

Keywords: autism characteristics, rehabilitation centres, yemen, children

Procedia PDF Downloads 33

Authors: Nursyafiq Ali Shibramulisi, Nor Farah Fauzi, Nur Azniza Zawin Anuar, Nurul Atikah Azmi, Janice Hew Pei Fang

Abstract:

Background: Work related musculoskeletal disorders (WRMD) among dental personnel have been underestimated and under-reported worldwide and specifically in Malaysia. The problem will arise and progress slowly over time, as it results from accumulated injury throughout the period of work. Several risk factors, such as repetitive movement, static posture, vibration, and adapting poor working postures, have been identified to be contributing to WRMSD in dental practices. Dental personnel is at higher risk of getting this problem as it is their working nature and core business. This would cause pain and dysfunction syndrome among them and result in absence from work and substandard services to their patients. Methodology: A cross-sectional study involving 19 government dental clinics in Perak was done over the period of 3 months. Those who met the criteria were selected to participate in this study. Malay version of the Self-Reported Nordic Musculoskeletal Discomfort Form was used to identify the prevalence of WRMSD, while the intensity of pain in the respective regions was evaluated using a 10-point scale according to ‘Pain as The 5ᵗʰ Vital Sign’ by MOH Malaysia and later on were analyzed using SPSS version 25. Descriptive statistics, including mean and SD and median and IQR, were used for numerical data. Categorical data were described by percentage. Pearson’s Chi-Square Test and Spearman’s Correlation were used to find the association between the prevalence of WRMSD and other socio-demographic data. Results: 159 dentists, 73 dental therapists, 26 dental lab technicians, 81 dental surgery assistants, and 23 dental attendants participated in this study. The mean age for the participants was 34.9±7.4 and their mean years of service was 9.97±7.5. Most of them were female (78.5%), Malay (71.3%), married (69.6%) and right-handed (90.1%). The highest prevalence of WRMSD was neck (58.0%), followed by shoulder (48.1%), upper back (42.0%), lower back (40.6%), hand/wrist (31.5%), feet (21.3%), knee (12.2%), thigh 7.7%) and lastly elbow (6.9%). Most of those who reported having neck pain scaled their pain experiences at 2 out of 10 (19.5%), while for those who suffered upper back discomfort, most of them scaled their pain experience at 6 out of 10 (17.8%). It was found that there was a significant relationship between age and pain at neck (p=0.007), elbow (p=0.027), lower back (p=0.032), thigh (p=0.039), knee (p=0.001) and feet (p=0.000) regions. Job position also had been found to be having a significant relationship with pain experienced at the lower back (p=0.018), thigh (p=0.011), knee, and feet (p=0.000). Conclusion: The prevalence of WRMSD among dental personnel in Perak was found to be high. Age and job position were found to be having a significant relationship with pain experienced in several regions. Intervention programs should be planned and conducted to prevent and reduce the occurrence of WRMSD, as all harmful or unergonomic practices should be avoided at all costs.

Keywords: WRMSD, ergonomic, dentistry, dental

Procedia PDF Downloads 79