Search results for: clinical advice services
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7540

Search results for: clinical advice services

880 Scaling out Sustainable Land Use Systems in Colombia: Some Insights and Implications from Two Regional Case Studies

Authors: Martha Lilia Del Rio Duque, Michelle Bonatti, Katharina Loehr, Marcos Lana, Tatiana Rodriguez, Stefan Sieber

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Nowadays, most agricultural practices can reduce the ability of ecosystems to provide goods and services. To enhance environmentally friendly food production and to maximize social and economic benefits, sustainable land use systems (SLUS) are one of the most critical strategies increasingly/strongly promoted by donors organizations, international agencies, and policymakers. This process involves the question of how SLUS can be scaled out also large-scale landscapes and not merely isolated experiments. As SLUS are context-specific strategies, diffusion and replication of successful SLUS in Colombia required the identification of main factors that facilitate this scaling out process. We applied a case study approach to investigate the scaling out process of SLUS in cocoa and livestock sector within peacebuilding territories in Colombia, specifically, in Cesar and Caqueta region. These two regions are contrasting, but both have a current trend of increasing land degradation. Presently in Colombia, Caqueta is one of the most deforested departments, and Cesar has some most degraded soils. Following a qualitative research approach, 19 semi-structured interviews and 2 focus groups were conducted with agroforestry experts in both regions to analyze (1) what does it mean a sustainable land use system in Cocoa/Livestock, specifically in Caqueta or Cesar and (2) to identify the key elements at the level of the following dimensions: biophysical, economic and profitability, market, social, policy and institutions that can explain how and why SLUS are replicated and spread among more producers. The Interviews were coded and analyzed using MAXQDA to identify, analyze and report patterns (themes) within data. As the results show, key themes, among which: premium market, solid regional markets and price stability, water availability and management, generational renewal, land use knowledge and diversification, producer organization and certifications are crucial to understand how the SLUS can have an impact across large-scale landscapes and how the scaling out process can be set up best in order to be successful across different contexts. The analysis further reveals which key factors might affect SLUS efficiency.

Keywords: agroforestry, cocoa sector, Colombia, livestock sector, sustainable land use system

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879 Platelet Volume Indices: Emerging Markers of Diabetic Thrombocytopathy

Authors: Mitakshara Sharma, S. K. Nema

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Diabetes mellitus (DM) is metabolic disorder prevalent in pandemic proportions, incurring significant morbidity and mortality due to associated vascular angiopathies. Platelet related thrombogenesis plays key role in pathogenesis of these complications. Most patients with type II DM suffer from preventable vascular complications and early diagnosis can help manage these successfully. These complications are attributed to platelet activation which can be recognised by the increase in Platelet Volume Indices(PVI) viz. Mean Platelet Volume(MPV) and Platelet Distribution Width(PDW). This study was undertaken with the aim of finding a relationship between PVI and vascular complications of Diabetes mellitus, their importance as a causal factor in these complications and use as markers for early detection of impending vascular complications in patients with poor glycaemic status. This is a cross-sectional study conducted for 2 years with total 930 subjects. The subjects were segregated in 03 groups on basis of glycosylated haemoglobin (HbA1C) as: - (a) Diabetic, (b) Non-Diabetic and (c) Subjects with Impaired fasting glucose(IFG) with 300 individuals in IFG and non-diabetic group & 330 individuals in diabetic group. The diabetic group was further divided into two groups: - (a) Diabetic subjects with diabetes related vascular complications (b) Diabetic subjects without diabetes related vascular complications. Samples for HbA1C and platelet indices were collected using Ethylene diamine tetracetic acid(EDTA) as anticoagulant and processed on SYSMEX-XS-800i autoanalyser. The study revealed stepwise increase in PVI from non-diabetics to IFG to diabetics. MPV and PDW of diabetics, IFG and non diabetics were 17.60 ± 2.04, 11.76 ± 0.73, 9.93 ± 0.64 and 19.17 ± 1.48, 15.49 ± 0.67, 10.59 ± 0.67 respectively with a significant p value 0.00 and a significant positive correlation (MPV-HbA1c r = 0.951; PDW-HbA1c r = 0.875). However, significant negative correlation was found between glycaemic levels and total platelet count (PC- HbA1c r =-0.164). MPV & PDW of subjects with and without diabetes related complications were (15.14 ± 1.04) fl & (17.51±0.39) fl and (18.96 ± 0.83) fl & (20.09 ± 0.98) fl respectively with a significant p value 0.00.The current study demonstrates raised platelet indices & reduced platelet counts in association with rising glycaemic levels and diabetes related vascular complications across various study groups & showed that platelet morphology is altered with increasing glycaemic levels. These changes can be known by measurements of PVI which are important, simple, cost effective, effortless tool & indicators of impending vascular complications in patients with deranged glycaemic control. PVI should be researched and explored further as surrogate markers to develop a clinical tool for early recognition of vascular changes related to diabetes and thereby help prevent them. They can prove to be more useful in developing countries with limited resources. This study is multi-parameter, comprehensive with adequately powered study design and represents pioneering effort in India on account of the fact that both Platelet indices (MPV & PDW) along with platelet count have been evaluated together for the first time in Diabetics, non diabetics, patients with IFG and also in the diabetic patients with and without diabetes related vascular complications.

Keywords: diabetes, HbA1C, IFG, MPV, PDW, PVI

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878 Effect of Lifestyle Modification for Two Years on Obesity and Metabolic Syndrome Components in Elementary Students: A Community-Based Trial

Authors: Bita Rabbani, Hossein Chiti, Faranak Sharifi, Saeedeh Mazloomzadeh

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Background: Lifestyle modifications, especially improving nutritional patterns and increasing physical activity, are the most important factors in preventing obesity and metabolic syndrome in children and adolescents. For this purpose, the following interventional study was designed to investigate the effects of educational programs for students, as well as changes in diet and physical activity, on obesity and components of the metabolic syndrome. Methods: This study is part of an interventional research project (elementary school) conducted on all students of Sama schools in Zanjan and Abhar in three levels of elementary, middle, and high school, including 1000 individuals in Zanjan (intervention group) and 1000 individuals (control group) in Abhar in 2011. Interventions were based on educating students, teachers, and parents, changes in food services, and physical activity. We primarily measured anthropometric indices, fasting blood sugar, lipid profiles, and blood pressure and completed standard nutrition and physical activity questionnaires. Also, blood insulin levels were randomly measured in a number of students. Data analysis was done by SPSS software version 16.0. Results: Overall, 589 individuals (252 male, 337 female) entered the case group, and 803 individuals (344 male, 459 female) entered the control group. After two years of intervention, mean waist circumference (63.8 ± 10.9) and diastolic BP (63.8 ± 10.4) were significantly lower; however, mean systolic BP (10.1.0 ± 12.5), food score (25.0 ± 5.0) and drinking score (12.1 ± 2.3) were higher in the intervention group (p<0.001). Comparing components of metabolic syndrome between the second year and at time of recruitment within the intervention group showed that although number of overweight/obese individuals, individuals with hypertriglyceridemia and high LDL increased, abdominal obesity, high BP, hyperglycemia, and insulin resistance decreased (p<0.001). On the other hand, in the control group, number of individuals with high BP increased significantly. Conclusion: The prevalence of abdominal obesity and hypertension, which are two major components of metabolic syndrome, are much higher in our study than in other regions of country. However, interventions for modification of diet and increase in physical activity are effective in lowering their prevalence.

Keywords: metabolic syndrome, obesity, life style, nutrition, hypertension

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877 Decision-Making in the Internationalization Process of Small and Medium Sized Companies: Experience from Managers in a Small Economy

Authors: Gunnar Oskarsson, Gudjon Helgi Egilsson

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Due to globalization, small and medium-sized enterprises (SME) increasingly offer their products and services in foreign markets. The main reasons are either to compensate for a decreased market share in their home market or to exploit opportunities in foreign markets, which are becoming less distant and better accessible than before. International markets are particularly important for companies located in a small economy and offering specialized products. Although more accessible, entering international markets is both expensive and difficult. In order to select the most appropriate markets, it is, therefore, important to gain an insight into the factors that have an impact on success, or potential failure. Although there has been a reasonable volume of research into the theory of internationalization, there is still a need to gain further understanding of the decision-making process of SMEs in small economies and the most important characteristics that distinguish between success and failure. The main objective of this research is to enhance knowledge on the internationalization of SMEs, including the drivers for the decision to internationalize, and the most important factors contributing to success in their internationalization activities. A qualitative approach was found to be most appropriate for this kind of research, with the objective of gaining a deeper understanding and discovering factors which impact a company’s decision-making and potential success. In-depth interviews were conducted with 14 companies in different industries located in Iceland, a country extensively dependent on export revenues. The interviews revealed several factors as drivers of internationalization and, not surprisingly, the most frequently mentioned source of motivation was that the local market is inadequate to maintain a sustainable operation. Good networking relationships were seen as a particular priority for potential success, searching for new markets was mainly carried out through the internet, although sales exhibitions and sales trips were also considered important. When it comes to the final decision as to whether a market should be considered for further analysis, economy, labor cost, legal environment, and cultural barriers were the most common factors to be weighted. The ultimate answer to successful internationalization, however, is largely dependent on a coordinated and experienced management team. The main contribution of this research is offering an insight into factors affecting decision-making in the internationalization process of SMEs, based on the opinion and experience of managers of SMEs in a small economy.

Keywords: internationalization, success factors, small and medium-sized enterprises (SMEs), drivers, decision making

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876 The Differential Impacts of Shame and Guilt on Father Involvement in Families with Special Needs Children

Authors: Lo Kai Chung

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Fathers in the family of disabled children play a crucial role in fostering child development. Previous studies addressing emotions of father involvement in rearing children with special needs have been rare. With reference to the cultural orientation and masculine idea of Chinese fathers, shame and guilt are probable causal emotions that affect fathers’ psycho-behavioral reactions and, thus, father involvement. Based on the findings of our earlier qualitative studies, the current study aims to develop and validate a multi-item scale of guilt or shame and explore their relations with and fatherhood in families with children with special needs. A model is proposed to understand the roles that shame and guilt play in affecting fathers’ involvement in their family system. The severity and type of the child’s special needs are regarded as independent variables affecting the father’s emotional responses – shame and guilt. It is hypothesized that shame and guilt, under the influence of masculinity, lead to avoidance and compensation, respectively, which subsequently decrease and increase father involvement with children with special needs. A cross-sectional online questionnaire survey of fathers with children with special needs recruited by convenience sampling was conducted. Potential participants were reached by bulk emails, related groups on the Internet and education/social services providers. Totally 537 valid sets of online questionnaires were collected from fathers of children with special needs. EFA on the items pool of shame and guilt was performed, resulting in an x-item single-factor solution and y-item single-factor solution, respectively. Further path model analysis revealed that shame and guilt, under the influence of masculinity, showed differential avoidance and compensation responses and resulted in a decrease and increase in father involvement with special needs children. Demographic and key confounding variables were controlled in the analysis. The shame and guilt scales developed show good psychometric properties. Furthermore, they showed significant differential impacts, under the influence of masculinity, on avoidance and compensation behaviours, consequently resulting in a decrease/increase in father involvement in the expected directions. The findings have important theoretical and practical implications. At the community and policy level, the findings inform the design of strategies for strengthening the role of men in families with special needs children.

Keywords: emotions, father involvement, guilt, shame, special needs

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875 A Service Evaluation Exploring the Effectiveness of a Tier 3 Weight Management Programme Offering Face-To-Face and Remote Dietetic Support

Authors: Rosemary E. Huntriss, Lucy Jones

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Obesity and excess weight continue to be significant health problems in England. Traditional weight management programmes offer face-to-face support or group education. Remote care is recognised as a viable means of support; however, its effectiveness has not previously been evaluated in a tier 3 weight management setting. This service evaluation explored the effectiveness of online coaching, telephone support, and face-to-face support as optional management strategies within a tier 3 weight management programme. Outcome data were collected for adults with a BMI ≥ 45 or ≥ 40 with complex comorbidity who were referred to a Tier 3 weight management programme from January 2018 and had been discharged before October 2018. Following an initial 45-minute consultation with a specialist weight management dietitian, patients were offered a choice of follow-up support in the form of online coaching supported by an app (8 x 15 minutes coaching), face-to-face or telephone appointments (4 x 30 minutes). All patients were invited to a final 30-minute face-to-face assessment. The planned intervention time was between 12 and 24 weeks. Patients were offered access to adjunct face-to-face or telephone psychological support. One hundred and thirty-nine patients were referred into the programme from January 2018 and discharged before October 2018. One hundred and twenty-four patients (89%) attended their initial assessment. Out of those who attended their initial assessment, 110 patients (88.0%) completed more than half of the programme and 77 patients (61.6%) completed all sessions. The average length of the completed programme (all sessions) was 17.2 (SD 4.2) weeks. Eighty-five (68.5%) patients were coached online, 28 (22.6%) patients were supported face-to-face support, and 11 (8.9%) chose telephone support. Two patients changed from online coaching to face-to-face support due to personal preference and were included in the face-to-face group for analysis. For those with data available (n=106), average weight loss across the programme was 4.85 (SD 3.49)%; average weight loss was 4.70 (SD 3.19)% for online coaching, 4.83 (SD 4.13)% for face-to-face support, and 6.28 (SD 4.15)% for telephone support. There was no significant difference between weight loss achieved with face-to-face vs. online coaching (4.83 (SD 4.13)% vs 4.70 (SD 3.19) (p=0.87) or face-to-face vs. remote support (online coaching and telephone support combined) (4.83 (SD 4.13)% vs 4.85 (SD 3.30)%) (p=0.98). Remote support has been shown to be as effective as face-to-face support provided by a dietitian in the short-term within a tier 3 weight management setting. The completion rates were high compared with another tier 3 weight management services suggesting that offering remote support as an option may improve completion rates within a weight management service.

Keywords: dietitian, digital health, obesity, weight management

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874 Contextual Meaning of Work and its Sociological Significance among the Yoruba People in Nigeria

Authors: Aroge Stephen Talabi

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Work is a term that appears to be very common in usage and occurrence the world over. The meanings attached to it and what it implies equally appears to be that common and somewhat similar in description by individuals and groups as derivatives of their contexts. Work is generally seen as the exertion of efforts and the application of knowledge and skills to achieve different purposes comprising of earning a living, making money, prestige, achievement, recognition, companionship and other satisfactions. The paper examined the general meanings of work from the perspectives of various religions. It situated these meanings by drawing on the sociological significance of work among the Yoruba. It established work as social control for a reorientation in peoples approach to work. The Yoruba people of the Western Nigeria share, to a great extent, in common conceptualization and application of work as they believe and understand that their individual and community existence and living are contingent on work participation. The contextual meaning and sociological significance of work as investigated in this paper show that the Yorubas concept of work is daily applied variously in both their material and non-material cultural undertakings to influence individual and group for effective participation in productive ventures for overall social well-being. The Yoruba use all forms of training method which could be adopted by adult educators as pathways to increase individual’s work participation and to improve productivity in work organizations.The paper found out that in the Yoruba socio cultural milieu, the meanings, conceptions and the importance attached to work are used as method of inculcating in members of society the spirit of commitment and hard-work and the advantages thereof. Yoruba contexts of work are geared towards enhancement of commitment, diligence and improved productivity on-the-job behaviour. The paper, therefore, submits that using the Yoruba’s conceptions of work could enhance commitment on the parts of all those engaged in production of goods and services. The paper also suggests that the Yoruba principle and perception and application of work could be used as one of the training techniques in industrial education, which is a major aspect of adult education programmes for inculcating ethics in the workplace. Thus, effort should be made to embrace the Yoruba conception and tenet of work by all stakeholders such as the workers, group (Union), managers and the society at large. Such principles and tenet of work should be included in industrial education curriculum.

Keywords: work, contextual meaning, sociological significance, Yoruba-people, social milieu, productivity

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873 National Branding through Education: South Korean Image in Romania through the Language Textbooks for Foreigners

Authors: Raluca-Ioana Antonescu

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The paper treats about the Korean public diplomacy and national branding strategies, and how the Korean language textbooks were used in order to construct the Korean national image. The field research of the paper stands at the intersection between Linguistics and Political Science, while the problem of the research is the role of language and culture in national branding process. The research goal is to contribute to the literature situated at the intersection between International Relations and Applied Linguistics, while the objective is to conceptualize the idea of national branding by emphasizing a dimension which is not much discussed, and that would be the education as an instrument of the national branding and public diplomacy strategies. In order to examine the importance of language upon the national branding strategies, the paper will answer one main question, How is the Korean language used in the construction of national branding?, and two secondary questions, How are explored in literature the relations between language and national branding construction? and What kind of image of South Korea the language textbooks for foreigners transmit? In order to answer the research questions, the paper starts from one main hypothesis, that the language is an essential component of the culture, which is used in the construction of the national branding influenced by traditional elements (like Confucianism) but also by modern elements (like Western influence), and from two secondary hypothesis, the first one is that in the International Relations literature there are little explored the connections between language and national branding, while the second hypothesis is that the South Korean image is constructed through the promotion of a traditional society, but also a modern one. In terms of methodology, the paper will analyze the textbooks used in Romania at the universities which provide Korean Language classes during the three years program B.A., following the dialogs, the descriptive texts and the additional text about the Korean culture. The analysis will focus on the rank status difference, the individual in relation to the collectivity, the respect for the harmony, and the image of the foreigner. The results of the research show that the South Korean image projected in the textbooks convey the Confucian values and it does not emphasize the changes suffered by the society due to the modernity and globalization. The Westernized aspect of the Korean society is conveyed more in an informative way about the Korean international companies, Korean internal development (like the transport or other services), but it does not show the cultural changed the society underwent. Even if the paper is using the textbooks which are used in Romania as a teaching material, it could be used and applied at least to other European countries, since the textbooks are the ones issued by the South Korean language schools, which other European countries are using also.

Keywords: confucianism, modernism, national branding, public diplomacy, traditionalism

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872 A Qualitative Study on Cyberbullying and Traditional Bullying among Taiwanese High School Students

Authors: Chia-Wen Wang, Patou Masika Musumari, Teeranee Techasrivichien, S. Pilar Suguimoto, Chang-Chuan Chan, Masako Ono-Kihara, Masahiro Kihara

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Background: In recent years, a particular form of bullying, referred to as 'cyberbullying' has emerged along with the rapid expansion of the Internet, social network services (SNSs) and smart phones. Many Asian countries, including Taiwan, are faced with both the cyberbullying and the traditional form of bullying. This study aims to explore Taiwanese adolescents’ experiences, perceptions and opinions regarding cyberbullying and traditional bullying through the perspective of victim, perpetrator, or witness. Method: This is a qualitative study using face-to-face in-depth interviews guided by a semi-structured questionnaire among high school students -aged 16 to 18 years- in Taipei, Taiwan. The participants were recruited through convenience sampling from five high schools between June and November 2016. Interviews were digitally recorded, transcribed, and analyzed using the thematic analysis approach. Results: Forty-eight participants were recruited, of which, 14 (29.2%) reported had ever experienced bullying. Specifically, 7 participants (14.6%) reported had ever been victims of cyberbullying, 1 (2%) had been victims of traditional bullying, and 6 (12.5%) had been victims of both cyber and traditional bullying. The majority (70.8%) reported had ever witnessed acts of bullying; however, none of the participants recognized had ever been a perpetrator of bullying. Cyberbullying mostly happens on social media (Facebook and Instagram) or LINE instant messaging application, and included upload and sharing of degrading pictures and videos of victims, as well as gossip and mean messages by the perpetrators. The anonymous and public nature of social media groups in schools made it easier to perpetrate bullying. The victim of traditional bullying reported being the target of verbal attack because of his physical appearance. Regardless of the type of bullying, victims reported feeling bad, angry, or depressed as a result of being bullied. Witnesses of both cyber- and traditional bullying cited physical appearance (e.g. having the big/flat bust or big butt, or overweight or obese) and disability as the most reasons of being a bullying victim. Conclusion: Both cyberbullying and traditional bullying had negative emotional and psychological impacts on victims. This study warrants further research to assess the extent of this phenomenon and understand the characteristics of perpetrators, victims, and witnesses to inform the design of tailored interventions using appropriate channels of dissemination.

Keywords: cyberbullying, traditional bullying, social media, adolescents

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871 Music in Religion Culture of the Georgian Pentecostals

Authors: Nino Naneishvili

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The study of religious minorities and their musical culture has attracted scant academic attention in Georgia. Within wider Georgian society, it would seem that the focus of discourse to date has been on the traditional orthodox religion and its musical expression, with other forms of religious expression regarded as intrinsically less valuable. The goal of this article is to study Georgia's different religious and musical picture which, this time, is presented on the example of the Pentecostals. The first signs of the Pentecostal movement originated at the end of the 19th Century in the USA, and first appeared in Georgia as early as 1914. An ethnomusicological perspective allows the use of anthropological and sociological approaches. The basic methodology is an ethnographic method. This involved attending religious services, observation, in-depth interviews and musical material analysis. This analysis, based on a combined use of various theoretical and methodological approaches, reveals that Georgian Pentecostals, apart from polyphonic singing, are characterised by “ bi-musicality.“ This phenomenon together with Georgian three part polyphony combines vocalisation within “social polyphony.“ The concept of back stage and front stage is highlighted. Chanters also try to express national identity. In some cases however it has been observed that they abandon or conceal certain musical forms of expression which are considered central to Georgian identity. The famous hymn “Thou art a Vineyard” is a case in point. The reason given for this omission within the Georgian Pentecostal church is that within Pentecostal doctrine, God alone is the object of worship. Therefore there is no veneration of Saints as representatives of the Divine. In some cases informants denied the existence of this hymn, and others explain that the meaning conveyed to the Vineyard is that of Jesus Christ and not the Virgin Mary. Others stated that they loved Virgin Mary and were therefore free to sing this song outside church circles. The results of this study illustrates that one of the religious minorities in Georgia, the Pentecostals, are characterised by a deviation in musical thinking from Homo Polyphonicus. They actively change their form of musical worship to secondary ethno hearing – bi-musicality. This outcome is determined by both new religious thinking and the process of globalization. A significant principle behind this form of worship is the use of forms during worship which are acceptable and accessible to all. This naturally leads to the development of modern forms. Obtained material does not demonstrate a connection between traditional religious music in general. Rather, it constitutes an independent domain.

Keywords: Georgia, globalization, music, pentecostal

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870 Reducing Unnecessary CT Aorta Scans in the Emergency Department

Authors: Ibrahim Abouelkhir

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Background: Prior to this project, the number of CT aorta requests from our Emergency Department (ED) was reported by the radiology department to be high with a low positive event rate: only 1- 2% of CT aortas performed were positive for acute aortic syndrome. This trend raised concerns about the time required to process and report these scans, potentially impacting the timely reporting of other high-priority imaging, such as trauma-related scans. Other harms identified were unnecessary radiation, patients spending longer in ED contributing to overcrowding, and, most importantly, the patient not getting the right care the first time. The radiology department also raised the problem of reporting bias because they expected our CT aortas to be normal. Aim: The main aim of this project was to reduce the number of unnecessary CT aortas requested, which would be shown by 1. Number of CT aortas requested and 2. Positive event rate. Methodology: This was a quality improvement project carried out in the ED at Frimley Park Hospital, UK. Starting from 1 st January 2024, we recorded the number of days required to reach 35 CT aorta requests. We looked at all patients presenting to the ED over the age of 16 for whom a CT aorta was requested by the ED team. We looked at how many of these scans were positive for acute aortic syndrome. The intervention was a change in practice: all CT aortas should be approved by an ED consultant or ST4+ registrar (5th April 2024). We then reviewed the number of days it took to reach a total of 35 CT aorta requests following the intervention and again reviewed how many were positive. Results: Prior to the intervention, 35 CT Aorta scans were performed over a 20-day period. Following the implementation of the ED senior doctor vetting process, the same number of CT Aorta scan requests was observed over 50 days - more than twice the pre-intervention period. This indicates a significant reduction in the rate of CT Aorta scans being requested. During the pre-intervention phase, there were two positive cases of acute aortic syndrome. In the post-intervention period, there were zero. Conclusion: The mandatory review of CT Aorta scan requested by the ED consultant effectively reduced the number of scans requested. However, this intervention did not lead to an increase in positive scan results. We noted that post-intervention, approximately 50% of scans had been approved by registrar-grade doctors and, only 50% had been approved by ED consultants, and the majority were not in-person reviews. We wonder if restricting the approval to consultant grade only might improve the results, and furthermore, in person reviews should be the gold standard.

Keywords: quality improvement project, CT aorta scans, emergency department, radiology department, aortic dissection, scan request vetting, clinical outcomes, imaging efficiency

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869 A Description Analysis of Mortality Rate of Human Infection with Avian Influenza A(H7N9) Virus in China

Authors: Lei Zhou, Chao Li, Ruiqi Ren, Dan Li, Yali Wang, Daxin Ni, Zijian Feng, Qun Li

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Background: Since the first human infection with avian influenza A(H7N9) case was reported in China on 31 March 2013, five epidemics have been observed in China through February 2013 and September 2017. Though the overall mortality rate of H7N9 has remained as high as around 40% throughout the five epidemics, the specific mortality rate in Mainland China varied by provinces. We conducted a descriptive analysis of mortality rates of H7N9 cases to explore the various severity features of the disease and then to provide clues of further analyses of potential factors associated with the severity of the disease. Methods: The data for analysis originated from the National Notifiable Infectious Disease Report and Surveillance System (NNIDRSS). The surveillance system and identification procedure for H7N9 infection have not changed in China since 2013. The definition of a confirmed H7N9 case is as same as previous reports. Mortality rates of H7N9 cases are described and compared by time and location of reporting, age and sex, and genetic features of H7N9 virus strains. Results: The overall mortality rate, the male and female specific overall rates of H7N9 is 39.6% (608/1533), 40.3% (432/1072) and 38.2% (176/461), respectively. There was no significant difference between the mortality rates of male and female. The age-specific mortality rates are significantly varied by age groups (χ²=38.16, p < 0.001). The mortality of H7N9 cases in the age group between 20 and 60 (33.17%) and age group of over 60 (51.16%) is much higher than that in the age group of under 20 (5.00%). Considering the time of reporting, the mortality rates of cases which were reported in the first (40.57%) and fourth (42.51%) quarters of each year are significantly higher than the mortality of cases which were reported in the second (36.02%) and third (27.27%) quarters (χ²=75.18, p < 0.001). The geographic specific mortality rates vary too. The mortality rates of H7N9 cases reported from the Northeast China (66.67%) and Westeast China (56.52%) are significantly higher than that of H7N9 cases reported from the remained area of mainland China. The mortality rate of H7N9 cases reported from the Central China is the lowest (34.38%). The mortality rates of H7N9 cases reported from rural (37.76%) and urban (38.96%) areas are similar. The mortality rate of H7N9 cases infected with the highly pathogenic avian influenza A(H7N9) virus (48.15%) is higher than the rate of H7N9 cases infected with the low pathogenic avian influenza A(H7N9) virus (37.57%), but the difference is not statistically significant. Preliminary analyses showed that age and some clinical complications such as respiratory failure, heart failure, and septic shock could be potential risk factors associated with the death of H7N9 cases. Conclusions: The mortality rates of H7N9 cases varied by age, sex, time of reporting and geographical location in mainland China. Further in-depth analyses and field investigations of the factors associated with the severity of H7N9 cases need to be considered.

Keywords: H7N9 virus, Avian Influenza, mortality, China

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868 Financial Innovations for Companies Offered by Banks: Polish Experience

Authors: Joanna Błach, Anna Doś, Maria Gorczyńska, Monika Wieczorek-Kosmala

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Financial innovations can be regarded as the cause and the effect of the evolution of the financial system. Most of financial innovations are created by various financial institutions for their own purposes and needs. However, due to their diversity, financial innovations can be also applied by various business entities (other than financial institutions). This paper focuses on the potential application of financial innovations by non-financial companies. It is assumed that financial innovations may be effectively applied in all fields of corporate financial decisions integrating financial management with the risk management process. Appropriate application of financial innovations may enhance the development of the company and increase its value by improving its financial situation and reducing the level of risk. On the other hand, misused financial innovations may become the source of extra risk for the company threatening its further operation. The main objective of the paper is to identify the major types of financial innovations offered to non-financial companies by the banking system in Poland. It also aims at identifying the main factors determining the creation of financial innovations in the banking system in Poland and indicating future directions of their development. This paper consists of conceptual and empirical part. Conceptual part based on theoretical study is focused on the determinants of the process of financial innovations and their application by the non-financial companies. Theoretical study is followed by the empirical research based on the analysis of the actual offer of the 20 biggest banks operating in Poland with regard to financial innovations offered to SMEs and large corporations. These innovations are classified according to the main functions of the integrated financial management, such as: Financing, investment, working capital management and risk management. Empirical study has proved that the biggest banks operating in the Polish market offer to their business customers many types and classes of financial innovations. This offer appears vast and adequate to the needs and purposes of the Polish non-financial companies. It was observed that financial innovations pertained to financing decisions dominate in the banks’ offer. However, due to high diversification of the offered financial innovations, business customers may effectively apply them in all fields and areas of integrated financial management. It should be underlined, that the banks’ offer is highly dispersed, which may limit the implementation of financial innovations in the corporate finance. It would be also recommended for the banks operating in the Polish market to intensify the education campaign aiming at increasing knowledge about financial innovations among business customers.

Keywords: banking products and services, banking sector in Poland, corporate financial management, financial innovations, theory of innovation

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867 Evaluation of the Weight-Based and Fat-Based Indices in Relation to Basal Metabolic Rate-to-Weight Ratio

Authors: Orkide Donma, Mustafa M. Donma

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Basal metabolic rate is questioned as a risk factor for weight gain. The relations between basal metabolic rate and body composition have not been cleared yet. The impact of fat mass on basal metabolic rate is also uncertain. Within this context, indices based upon total body mass as well as total body fat mass are available. In this study, the aim is to investigate the potential clinical utility of these indices in the adult population. 287 individuals, aged from 18 to 79 years, were included into the scope of the study. Based upon body mass index values, 10 underweight, 88 normal, 88 overweight, 81 obese, and 20 morbid obese individuals participated. Anthropometric measurements including height (m), and weight (kg) were performed. Body mass index, diagnostic obesity notation model assessment index I, diagnostic obesity notation model assessment index II, basal metabolic rate-to-weight ratio were calculated. Total body fat mass (kg), fat percent (%), basal metabolic rate, metabolic age, visceral adiposity, fat mass of upper as well as lower extremities and trunk, obesity degree were measured by TANITA body composition monitor using bioelectrical impedance analysis technology. Statistical evaluations were performed by statistical package (SPSS) for Windows Version 16.0. Scatterplots of individual measurements for the parameters concerning correlations were drawn. Linear regression lines were displayed. The statistical significance degree was accepted as p < 0.05. The strong correlations between body mass index and diagnostic obesity notation model assessment index I as well as diagnostic obesity notation model assessment index II were obtained (p < 0.001). A much stronger correlation was detected between basal metabolic rate and diagnostic obesity notation model assessment index I in comparison with that calculated for basal metabolic rate and body mass index (p < 0.001). Upon consideration of the associations between basal metabolic rate-to-weight ratio and these three indices, the best association was observed between basal metabolic rate-to-weight and diagnostic obesity notation model assessment index II. In a similar manner, this index was highly correlated with fat percent (p < 0.001). Being independent of the indices, a strong correlation was found between fat percent and basal metabolic rate-to-weight ratio (p < 0.001). Visceral adiposity was much strongly correlated with metabolic age when compared to that with chronological age (p < 0.001). In conclusion, all three indices were associated with metabolic age, but not with chronological age. Diagnostic obesity notation model assessment index II values were highly correlated with body mass index values throughout all ranges starting with underweight going towards morbid obesity. This index is the best in terms of its association with basal metabolic rate-to-weight ratio, which can be interpreted as basal metabolic rate unit.

Keywords: basal metabolic rate, body mass index, children, diagnostic obesity notation model assessment index, obesity

Procedia PDF Downloads 150
866 Cognitive Control Moderates the Concurrent Effect of Autistic and Schizotypal Traits on Divergent Thinking

Authors: Julie Ramain, Christine Mohr, Ahmad Abu-Akel

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Divergent thinking—a cognitive component of creativity—and particularly the ability to generate unique and novel ideas, has been linked to both autistic and schizotypal traits. However, to our knowledge, the concurrent effect of these trait dimensions on divergent thinking has not been investigated. Moreover, it has been suggested that creativity is associated with different types of attention and cognitive control, and consequently how information is processed in a given context. Intriguingly, consistent with the diametric model, autistic and schizotypal traits have been associated with contrasting attentional and cognitive control styles. Positive schizotypal traits have been associated with reactive cognitive control and attentional flexibility, while autistic traits have been associated with proactive cognitive control and the increased focus of attention. The current study investigated the relationship between divergent thinking, autistic and schizotypal traits and cognitive control in a non-clinical sample of 83 individuals (Males = 42%; Mean age = 22.37, SD = 2.93), sufficient to detect a medium effect size. Divergent thinking was evaluated in an adapted version of-of the Figural Torrance Test of Creative Thinking. Crucially, since we were interested in testing divergent thinking productivity across contexts, participants were asked to generate items from basic shapes in four different contexts. The variance of the proportion of unique to total responses across contexts represented a measure of context adaptability, with lower variance indicating increased context adaptability. Cognitive control was estimated with the Behavioral Proactive Index of the AX-CPT task, with higher scores representing the ability to actively maintain goal-relevant information in a sustained/anticipatory manner. Autistic and schizotypal traits were assessed with the Autism Quotient (AQ) and the Community Assessment of Psychic Experiences (CAPE-42). Generalized linear models revealed a 3-way interaction of autistic and positive schizotypal traits, and proactive cognitive control, associated with increased context adaptability. Specifically, the concurrent effect of autistic and positive schizotypal traits on increased context adaptability was moderated by the level of proactive control and was only significant when proactive cognitive control was high. Our study reveals that autistic and positive schizotypal traits interactively facilitate the capacity to generate unique ideas across various contexts. However, this effect depends on cognitive control mechanisms indicative of the ability to proactively maintain attention when needed. The current results point to a unique profile of divergent thinkers who have the ability to respectively tap both systematic and flexible processing modes within and across contexts. This is particularly intriguing as such combination of phenotypes has been proposed to explain the genius of Beethoven, Nash, and Newton.

Keywords: autism, schizotypy, creativity, cognitive control

Procedia PDF Downloads 137
865 Hierarchical Zeolites as Potential Carriers of Curcumin

Authors: Ewelina Musielak, Agnieszka Feliczak-Guzik, Izabela Nowak

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Based on the latest data, it is expected that the substances of therapeutic interest used will be as natural as possible. Therefore, active substances with the highest possible efficacy and low toxicity are sought. Among natural substances with therapeutic effects, those of plant origin stand out. Curcumin isolated from the Curcuma longa plant has proven to be particularly important from a medical point of view. Due to its ability to regulate many important transcription factors, cytokines, and protein kinases, curcumin has found use as an anti-inflammatory, antioxidant, antiproliferative, antiangiogenic, and anticancer agent. The unfavorable properties of curcumin, such as low solubility, poor bioavailability, and rapid degradation under neutral or alkaline pH conditions, limit its clinical application. These problems can be solved by combining curcumin with suitable carriers such as hierarchical zeolites. This is a new class of materials that exhibit several advantages. Hierarchical zeolites used as drug carriers enable delayed release of the active ingredient and promote drug transport to the desired tissues and organs. In addition, hierarchical zeolites play an important role in regulating micronutrient levels in the body and have been used successfully in cancer diagnosis and therapy. To apply curcumin to hierarchical zeolites synthesized from commercial FAU zeolite, solutions containing curcumin, carrier and acetone were prepared. The prepared mixtures were then stirred on a magnetic stirrer for 24 h at room temperature. The curcumin-filled hierarchical zeolites were drained into a glass funnel, where they were washed three times with acetone and distilled water, after which the obtained material was air-dried until completely dry. In addition, the effect of piperine addition to zeolite carrier containing a sufficient amount of curcumin was studied. The resulting products were weighed and the percentage of pure curcumin in the hierarchical zeolite was calculated. All the synthesized materials were characterized by several techniques: elemental analysis, transmission electron microscopy (TEM), Fourier transform infrared spectroscopy, Fourier transform infrared (FT-IR), N2 adsorption, and X-ray diffraction (XRD) and thermogravimetric analysis (TGA). The aim of the presented study was to improve the biological activity of curcumin by applying it to hierarchical zeolites based on FAU zeolite. The results showed that the loading efficiency of curcumin into hierarchical zeolites based on commercial FAU-type zeolite is enhanced by modifying the zeolite carrier itself. The hierarchical zeolites proved to be very good and efficient carriers of plant-derived active ingredients such as curcumin.

Keywords: carriers of active substances, curcumin, hierarchical zeolites, incorporation

Procedia PDF Downloads 98
864 Pesticide Use Practices among Female Headed Households in the Amhara Region, Ethiopia

Authors: Birtukan Atinkut Asmare, Bernhard Freyer, Jim Bingen

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Though it is possible to transform the farming system towards a healthy, sustainable, and toxic-free food system by reducing pesticide use both in the field and postharvest, pesticides, including those that have been banned or severely restricted from use in developed countries, are indiscriminately used in African agriculture. Drawing on social practice theory, this study is about pesticide use practices in smallholder farms and its adverse impacts on women’s health and the environment, with reference to Africa, with an empirical focus on Ethiopia. Data have been collected via integrating diverse quantitative and qualitative approaches such as household surveys (n= 318), focus group discussions (n=6), field observations (n=30), and key informant interviews (n=18), with people along the pesticide value chain, including sellers and extension workers up to women farmers. A binary logistic regression model was used to investigate the factors that influence the adoption of personal protective equipment among female headed households. The findings show that Female-headed households carried out risky and unsafe practices from pesticide purchasing up to disposal, largely motivated by material elements (such as labor, income, time, and the provisioning system) but were notably shaped by competences (skills and knowledge), and meanings (norms, values, rules, and shared ideas). The main meaning or material aspect for pesticide purchasing were the perceptions of efficacy on pests, diseases, and weeds (65%), cost and availability in smaller quantities (60.7%), and a woman’s available time and mobility (58.9%). Pesticide hazards to human health or the environment seem not to be relevant for most female headed households. Unsafe practices of pesticide use among women led to the loss of biodiversity and ecosystem degradation, let alone their and family’s health. As the regression results show, the significant factors that influenced PPE adoption among female headed households were age and retailer information (p < 0.05). In line with the empirical finding, in addition to changing individual competences through advisory services and training, a foundational shift is needed in the sociocultural environment (e.g., policy, advisory), or a change in the meanings (social norms), where women are living and working.

Keywords: biodiversity, competences, ecosystems, ethiopia, female headed households, materials, meanings, pesticide purchasing, pesticide using, social practice theory

Procedia PDF Downloads 77
863 Data Mining in Healthcare for Predictive Analytics

Authors: Ruzanna Muradyan

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Medical data mining is a crucial field in contemporary healthcare that offers cutting-edge tactics with enormous potential to transform patient care. This abstract examines how sophisticated data mining techniques could transform the healthcare industry, with a special focus on how they might improve patient outcomes. Healthcare data repositories have dynamically evolved, producing a rich tapestry of different, multi-dimensional information that includes genetic profiles, lifestyle markers, electronic health records, and more. By utilizing data mining techniques inside this vast library, a variety of prospects for precision medicine, predictive analytics, and insight production become visible. Predictive modeling for illness prediction, risk stratification, and therapy efficacy evaluations are important points of focus. Healthcare providers may use this abundance of data to tailor treatment plans, identify high-risk patient populations, and forecast disease trajectories by applying machine learning algorithms and predictive analytics. Better patient outcomes, more efficient use of resources, and early treatments are made possible by this proactive strategy. Furthermore, data mining techniques act as catalysts to reveal complex relationships between apparently unrelated data pieces, providing enhanced insights into the cause of disease, genetic susceptibilities, and environmental factors. Healthcare practitioners can get practical insights that guide disease prevention, customized patient counseling, and focused therapies by analyzing these associations. The abstract explores the problems and ethical issues that come with using data mining techniques in the healthcare industry. In order to properly use these approaches, it is essential to find a balance between data privacy, security issues, and the interpretability of complex models. Finally, this abstract demonstrates the revolutionary power of modern data mining methodologies in transforming the healthcare sector. Healthcare practitioners and researchers can uncover unique insights, enhance clinical decision-making, and ultimately elevate patient care to unprecedented levels of precision and efficacy by employing cutting-edge methodologies.

Keywords: data mining, healthcare, patient care, predictive analytics, precision medicine, electronic health records, machine learning, predictive modeling, disease prognosis, risk stratification, treatment efficacy, genetic profiles, precision health

Procedia PDF Downloads 63
862 Water Balance in the Forest Basins Essential for the Water Supply in Central America

Authors: Elena Listo Ubeda, Miguel Marchamalo Sacristan

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The demand for water doubles every twenty years, at a rate which is twice as fast as the world´s population growth. Despite it´s great importance, water is one of the most degraded natural resources in the world, mainly because of the reduction of natural vegetation coverage, population growth, contamination and changes in the soil use which reduces its capacity to collect water. This situation is especially serious in Central America, as reflected in the Human Development reports. The objective of this project is to assist in the improvement of water production and quality in Central America. In order to do these two watersheds in Costa Rica were selected as experiments: that of the Virilla-Durazno River, located in the extreme north east of the central valley which has an Atlantic influence; and that of the Jabillo River, which flows directly into the Pacific. The Virilla river watershed is located over andisols, and that of the Jabillo River is over alfisols, and both are of great importance for water supply to the Greater Metropolitan Area and the future tourist resorts respectively, as well as for the production of agriculture, livestock and hydroelectricity. The hydrological reaction in different soil-cover complexes, varying from the secondary forest to natural vegetation and degraded pasture, was analyzed according to the evaluation of the properties of the soil, infiltration, soil compaction, as well as the effects of the soil cover complex on erosion, calculated by the C factor of the Revised Universal Soil Loss Equation (RUSLE). A water balance was defined for each watershed, in which the volume of water that enters and leaves were estimated, as well as the evapotranspiration, runoff, and infiltration. Two future scenarios, representing the implementation of reforestation and deforestation plans, were proposed, and were analyzed for the effects of the soil cover complex on the water balance in each case. The results obtained show an increase of the ground water recharge in the humid forest areas, and an extension of the study of the dry areas is proposed since the ground water recharge here is diminishing. These results are of great significance for the planning, design of Payment Schemes for Environmental Services and the improvement of the existing water supply systems. In Central America spatial planning is a priority, as are the watersheds, in order to assess the water resource socially and economically, and securing its availability for the future.

Keywords: Costa Rica, infiltration, soil, water

Procedia PDF Downloads 384
861 Consideration of Whether Participation in the International '16 Days of Activism against Gender Based Violence' Campaign Is an Effective Teaching Tool for Raising Awareness and Understanding of Gender Based Violence

Authors: Kayliegh Richardson, Ana Speed

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The international campaign, '16 Days of Activism against Gender Based Violence', seeks to raise awareness and understanding of gender based violence in a variety of settings. The campaign requires its participants to join in for advancing the right to education and challenging violence, discrimination, and inequality and take into account intersections such as gender, race, ethnicity, religion, sexual orientation, socio-economic status and other social identifiers. The authors of this paper are both clinic supervisors at Northumbria University in Newcastle Upon Tyne, England. As part of their research project, the authors are going to ask final year students on the MLaw degree at Northumbria University to become involved in the campaign by participating in a variety of awareness-raising activities during the course of the 16 days, which runs from 27 November 2017 until 10 December 2017. As part of the campaign, the authors will be running the following activities for students to participate in 1. Documentary showing of Banaz, a love story followed by discussion group. 2. 16 blogs for 16 days. Students will contribute to our family law blog over the 16 days, with articles about gender based violence. 3. Guest lecture on domestic violence (potentially run by a domestic violence organisation) 4. Workshop by Professor Ruth Lewis who will be presenting her innovative research in gender based violence and online abuse. 5. Poster competition - the students are asked to submit a poster about the different forms of gender based violence or proposals for ending violence against women and girls. The research aims are to identify whether participation in the project: 1. increases the students' engagement with issues of gender justice 2. is an effective educational tool for raising the students' awareness and understanding of gender based violence in its many forms. 3. increases the students' understanding of the domestic and international framework for protecting victims (in particular women and children) of gender based violence. After the activities, an impartial, experienced researcher will be holding a focus group with volunteering students to discuss their experiences of participating in the activities and whether they felt that participation in the project achieved the aims set out above. This paper will discuss the activities undertaken by the students and will address the data gathered during the focus group. Finally, the authors will discuss their thoughts on whether awareness of gender-based violence and other international family law issues can be appropriately raised in an educational setting.

Keywords: gender based violence, clinical legal education, international family law, domestic abuse

Procedia PDF Downloads 339
860 Endocrine Therapy Resistance and Epithelial to Mesenchymal Transition Inhibits by INT3 & Quercetin in MCF7 Cell Lines

Authors: D. Pradhan, G. Tripathy, S. Pradhan

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Objectives: Imperviousness gainst estrogen treatments is a noteworthy reason for infection backslide and mortality in estrogen receptor alpha (ERα)- positive breast diseases. Tamoxifen or estrogen withdrawal builds the reliance of breast malignancy cells on INT3 flagging. Here, we researched the commitment of Quercetin and INT3 motioning in endocrine-safe breast tumor cells. Methods: We utilized two models of endocrine treatments safe (ETR) breast tumor: Tamoxifen-safe (TamR) and long haul estrogen-denied (LTED) MCF7 cells. We assessed the transitory and intrusive limit of these cells by Transwell cells. Articulation of epithelial to mesenchymal move (EMT) controllers and in addition INT3 receptors and targets were assessed by constant PCR and western smudge investigation. Besides, we tried in-vitro hostile to Quercetin monoclonal Antibodies (mAbs) and Gamma Secretase Inhibitors (GSIs) as potential EMT inversion remedial specialists. At last, we created stable Quercetin overexpressing MCF7 cells and assessed their EMT components and reaction to Tamoxifen. Results: We found that ETR cells procured an Epithelial to Mesenchymal move (EMT) phenotype and showed expanded levels of Quercetin and INT3 targets. Interestingly, we distinguished more elevated amount of INT3 however lower levels of INT1 and INT3 proposing a change to motioning through distinctive INT3 receptors after obtaining of resistance. Against Quercetin monoclonal antibodies and the GSI PF03084014 were powerful in obstructing the Quercetin/INT3 pivot and in part repressing the EMT process. As a consequence of this, cell relocation and attack were weakened and the immature microorganism like populace was essentially decreased. Hereditary hushing of Quercetin and INT3 prompted proportionate impacts. At long last, stable overexpression of Quercetin was adequate to make MCF7 lethargic to Tamoxifen by INT3 initiation. Conclusions: ETR cells express abnormal amounts of Quercetin and INT3, whose actuation eventually drives intrusive conduct. Hostile to Quercetin mAbs and GSI PF03084014 lessen articulation of EMT particles decreasing cell obtrusiveness. Quercetin overexpression instigates Tamoxifen resistance connected to obtaining of EMT phenotype. Our discovering propose that focusing on Quercetin and INT3 warrants further clinical Correlation as substantial restorative methodologies in endocrine-safe breast.

Keywords: endocrine, epithelial, mesenchymal, INT3, quercetin, MCF7

Procedia PDF Downloads 305
859 Estimation of Morbidity Level of Industrial Labour Conditions at Zestafoni Ferroalloy Plant

Authors: M. Turmanauli, T. Todua, O. Gvaberidze, R. Javakhadze, N. Chkhaidze, N. Khatiashvili

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Background: Mining process has the significant influence on human health and quality of life. In recent years the events in Georgia were reflected on the industry working process, especially minimal requirements of labor safety, hygiene standards of workplace and the regime of work and rest are not observed. This situation is often caused by the lack of responsibility, awareness, and knowledge both of workers and employers. The control of working conditions and its protection has been worsened in many of industries. Materials and Methods: For evaluation of the current situation the prospective epidemiological study by face to face interview method was conducted at Georgian “Manganese Zestafoni Ferroalloy Plant” in 2011-2013. 65.7% of employees (1428 bulletin) were surveyed and the incidence rates of temporary disability days were studied. Results: The average length of a temporary disability single accident was studied taking into consideration as sex groups as well as the whole cohort. According to the classes of harmfulness the following results were received: Class 2.0-10.3%; 3.1-12.4%; 3.2-35.1%; 3.3-12.1%; 3.4-17.6%; 4.0-12.5%. Among the employees 47.5% and 83.1% were tobacco and alcohol consumers respectively. According to the age groups and years of work on the base of previous experience ≥50 ages and ≥21 years of work data prevalence respectively. The obtained data revealed increased morbidity rate according to age and years of work. It was found that the bone and articulate system and connective tissue diseases, aggravation of chronic respiratory diseases, ischemic heart diseases, hypertension and cerebral blood discirculation were the leading among the other diseases. High prevalence of morbidity observed in the workplace with not satisfactory labor conditions from the hygienic point of view. Conclusion: According to received data the causes of morbidity are the followings: unsafety labor conditions; incomplete of preventive medical examinations (preliminary and periodic); lack of access to appropriate health care services; derangement of gathering, recording, and analysis of morbidity data. This epidemiological study was conducted at the JSC “Manganese Ferro Alloy Plant” according to State program “ Prevention of Occupational Diseases” (Program code is 35 03 02 05).

Keywords: occupational health, mining process, morbidity level, cerebral blood discirculation

Procedia PDF Downloads 428
858 Department of Social Development/Japan International Cooperation Agency's Journey from South African Community to Southern African Region

Authors: Daisuke Sagiya, Ren Kamioka

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South Africa has ratified the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) on 30th November 2007. In line with this, the Department of Social Development (DSD) revised the White Paper on the Rights of Persons with Disabilities (WPRPD), and the Cabinet approved it on 9th December 2015. The South African government is striving towards the elimination of poverty and inequality in line with UNCRPD and WPRPD. However, there are minimal programmes and services that have been provided to persons with disabilities in the rural community. In order to address current discriminative practices, disunity and limited self-representation in rural community, DSD in cooperation with the Japan International Cooperation Agency (JICA) is implementing the 'Project for the Promotion of Empowerment of Persons with Disabilities and Disability Mainstreaming' from May 2016 to May 2020. The project is targeting rural community as the project sites, namely 1) Collins Chabane municipality, Vhembe district, Limpopo and 2) Maluti-a-Phofung municipality, Thabo Mofutsanyana district, Free State. The project aims at developing good practices on Community-Based Inclusive Development (CBID) at the project sites which will be documented as a guideline and applied in other provinces in South Africa and neighbouring countries (Lesotho, Swaziland, Botswana, Namibia, Zimbabwe, and Mozambique). In cooperation with provincial and district DSD and local government, the project is currently implementing various community activities, for example: Establishment of Self-Help Group (SHG) of persons with disabilities and Peer Counselling in the villages, and will conduct Disability Equality Training (DET) and accessibility workshop in order to enhance the CBID in the project sites. In order to universalise good practices on CBID, the authors will explain lessons learned from the project by utilising the theories of disability and development studies and community psychology such as social model of disability, twin-track approach, empowerment theory, sense of community, helper therapy principle, etc. And the authors conclude that in order to realise social participation of persons with disabilities in rural community, CBID is a strong tool and persons with disabilities must play central roles in all spheres of CBID activities.

Keywords: community-based inclusive development, disability mainstreaming, empowerment of persons with disabilities, self-help group

Procedia PDF Downloads 239
857 Coaching for Lecturers at German Universities: An Inventory Based on a Qualitative Interview Study

Authors: Freya Willicks

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The society of the 21st century is characterized by dynamic and complexity, developments that also shape universities and university life. The Bologna reform, for example, has led to restructuring at many European universities. Today's university teachers, therefore, have to meet many expectations: Their tasks include not only teaching but also the general improvement of the quality of teaching, good research, the management of various projects or the development of their own personal skills. This requires a high degree of flexibility and openness to change. The resulting pressure can often lead to exhaustion. Coaching can be a way for university teachers to cope with these pressures because it gives them the opportunity to discuss stressful situations with a coach and self-reflect on them. As a result, more and more universities in Europe offer to coach to their teachers. An analysis of the services provided at universities in Germany, however, quickly reveals an immense disagreement with regard to the understanding of ‘coaching’. A variety of terms is used, such as coaching, counselling or supervision. In addition, each university defines its offer individually, from process-oriented consulting to expert consulting, from group training to individual coaching. The biographic backgrounds of those who coach are also very divergent, both external and internal coaches can be suitable. These findings lead to the following questions: Which structural characteristics for coaching at universities have been proven successful? What competencies should a good coach for university lecturers have? In order to answer these questions, a qualitative study was carried out. In a first step, qualitative semi-structured interviews (N = 14) were conducted, on the one hand with coaches for university teachers and on the other hand with university teachers who have been coached. In a second step, the interviews were transcribed and analyzed using Mayring's qualitative content analysis. The study shows how great the potential of coaching can be for university teachers, who otherwise have little opportunity to talk about their teaching in a private setting. According to the study, the coach should neither be a colleague nor a superior of the coachee but should take an independent perspective, as this is the only way for the coachee to openly reflect on himself/herself. In addition, the coach should be familiar with the university system, i.e., be an academic himself/herself. Otherwise, he/she cannot fully understand the complexity of the teaching situation and the role expectations. However, internal coaches do not necessarily have much coaching experience or explicit coaching competencies. They often come from the university's own didactics department, are experts in didactics, but do not necessarily have a certified coaching education. Therefore, it is important to develop structures and guidelines for internal coaches to support their coaching. In further analysis, such guidelines will be developed on the basis of these interviews.

Keywords: coaching, university coaching, university didactics, qualitative interviews

Procedia PDF Downloads 112
856 State Forest Management Practices by Indigenous Peoples in Dharmasraya District, West Sumatra Province, Indonesia

Authors: Abdul Mutolib, Yonariza Mahdi, Hanung Ismono

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The existence of forests is essential to human lives on earth, but its existence is threatened by forest deforestations and degradations. Forest deforestations and degradations in Indonesia is not only caused by the illegal activity by the company or the like, even today many cases in Indonesia forest damage caused by human activities, one of which cut down forests for agriculture and plantations. In West Sumatra, community forest management are the result supported the enactment of customary land tenure, including ownership of land within the forest. Indigenous forest management have a positive benefit, which gives the community an opportunity to get livelihood and income, but if forest management practices by indigenous peoples is not done wisely, then there is the destruction of forests and cause adverse effects on the environment. Based on intensive field works in Dhamasraya District employing some data collection techniques such as key informant interviews, household surveys, secondary data analysis, and satellite image interpretation. This paper answers the following questions; how the impact of forest management by local communities on forest conditions (foccus in Forest Production and Limited Production Forest) and knowledge of the local community on the benefits of forests. The site is a Nagari Bonjol, Dharmasraya District, because most of the forest in Dharmasraya located and owned by Nagari Bonjol community. The result shows that there is damage to forests in Dharmasraya because of forest management activities by local communities. Damage to the forest area of 33,500 ha in Dharmasraya because forests are converted into oil palm and rubber plantations with monocultures. As a result of the destruction of forests, water resources are also diminishing, and the community has experienced a drought in the dry season due to forest cut down and replaced by oil palm plantations. Knowledge of the local community on the benefits of low forest, the people considered that the forest does not have better benefits and cut down and converted into oil palm or rubber plantations. Local people do not understand the benefits of ecological and environmental services that forests. From the phenomena in Dharmasraya on land ownership, need to educate the local community about the importance of protecting the forest, and need a strategy to integrate forests management to keep the ecological functions that resemble the woods and counts the economic benefits for the welfare of local communities. One alternative that can be taken is to use forest management models agroforestry smallholders in accordance with the characteristics of the local community who still consider the economic, social and environmental.

Keywords: community, customary land, farmer plantations, and forests

Procedia PDF Downloads 335
855 Combining the Production of Radiopharmaceuticals with the Department of Radionuclide Diagnostics

Authors: Umedov Mekhroz, Griaznova Svetlana

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In connection with the growth of oncological diseases, the design of centers for diagnostics and the production of radiopharmaceuticals is the most relevant area of healthcare facilities. The design of new nuclear medicine centers should be carried out from the standpoint of solving the following tasks: the availability of medical care, functionality, environmental friendliness, sustainable development, improving the safety of drugs, the use of which requires special care, reducing the rate of environmental pollution, ensuring comfortable conditions for the internal microclimate, adaptability. The purpose of this article is to substantiate architectural and planning solutions, formulate recommendations and principles for the design of nuclear medicine centers and determine the connections between the production and medical functions of a building. The advantages of combining the production of radiopharmaceuticals and the department of medical care: less radiation activity is accumulated, the cost of the final product is lower, and there is no need to hire a transport company with a special license for transportation. A medical imaging department is a structural unit of a medical institution in which diagnostic procedures are carried out in order to gain an idea of the internal structure of various organs of the body for clinical analysis. Depending on the needs of a particular institution, the department may include various rooms that provide medical imaging using radiography, ultrasound diagnostics, and the phenomenon of nuclear magnetic resonance. The production of radiopharmaceuticals is an object intended for the production of a pharmaceutical substance containing a radionuclide and intended for introduction into the human body or laboratory animal for the purpose of diagnosis, evaluation of the effectiveness of treatment, or for biomedical research. The research methodology includes the following subjects: study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research; An integrated approach to the study of existing international experience of PET / CT scan centers and the production of radiopharmaceuticals; Elaboration of graphical analysis and diagrams based on the system analysis of the processed information; Identification of methods and principles of functional zoning of nuclear medicine centers. The result of the research is the identification of the design principles of nuclear medicine centers with the functions of the production of radiopharmaceuticals and the department of medical imaging. This research will be applied to the design and construction of healthcare facilities in the field of nuclear medicine.

Keywords: architectural planning solutions, functional zoning, nuclear medicine, PET/CT scan, production of radiopharmaceuticals, radiotherapy

Procedia PDF Downloads 89
854 NHS Tayside Plastic Surgery Induction Cheat Sheet and Video

Authors: Paul Holmes, Mike N. G.

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Foundation-year doctors face increased stress, pressure and uncertainty when starting new rotations throughout their first years of work. This research questionnaire resulted in an induction cheat sheet and induction video that enhanced the Junior doctor's understanding of how to work effectively within the plastic surgery department at NHS Tayside. The objectives and goals were to improve the transition between cohorts of junior doctors in ward 26 at Ninewells Hospital. Before this quality improvement project, the induction pack was 74 pages long and over eight years old. With the support of consultant Mike Ng a new up-to-date induction was created. This involved a questionnaire and cheat sheet being developed. The questionnaire covered clerking, venipuncture, ward pharmacy, theatres, admissions, specialties on the ward, the cardiac arrest trolley, clinical emergencies, discharges and escalation. This audit has three completed cycles between August 2022 and August 2023. The cheat sheet developed a concise two-page A4 document designed for doctors to be able to reference easily and understand the essentials. The document format is a table containing ward layout; specialty; location; physician associate, shift patterns; ward rounds; handover location and time; hours coverage; senior escalation; nights; daytime duties, meetings/MDTs/board meetings, important bleeps and codes; department guidelines; boarders; referrals and patient stream; pharmacy; absences; rota coordinator; annual leave; top tips. The induction video is a 10-minute in-depth explanation of all aspects of the ward. The video explores in more depth the contents of the cheat sheet. This alternative visual format familiarizes the junior doctor with all aspects of the ward. These were provided to all foundation year 1 and 2 doctors on ward 26 at Ninewells Hospital at NHS Tayside Scotland. This work has since been adopted by the General Surgery Department, which extends to six further wards and has improved the effective handing over of the junior doctor’s role between cohorts. There is potential to further expand the cheat sheet to other departments as the concise document takes around 30 minutes to complete by a doctor who is currently on that ward. The time spent filling out the form provides vital information to the incoming junior doctors, which has a significant possibility to improve patient care.

Keywords: induction, junior doctor, handover, plastic surgery

Procedia PDF Downloads 85
853 Developing an Intervention Program to Promote Healthy Eating in a Catering System Based on Qualitative Research Results

Authors: O. Katz-Shufan, T. Simon-Tuval, L. Sabag, L. Granek, D. R. Shahar

Abstract:

Meals provided at catering systems are a common source of workers' nutrition and were found as contributing high amounts calories and fat. Thus, eating daily catering food can lead to overweight and chronic diseases. On the other hand, the institutional dining room may be an ideal environment for implementation of intervention programs that promote healthy eating. This may improve diners' lifestyle and reduce their prevalence of overweight, obesity and chronic diseases. The significance of this study is in developing an intervention program based on the diners’ dietary habits, preferences and their attitudes towards various intervention programs. In addition, a successful catering-based intervention program may have a significant effect simultaneously on a large group of diners, leading to improved nutrition, healthier lifestyle, and disease-prevention on a large scale. In order to develop the intervention program, we conducted a qualitative study. We interviewed 13 diners who eat regularly at catering systems, using a semi-structured interview. The interviews were recorded, transcribed and then analyzed by the thematic method, which identifies, analyzes and reports themes within the data. The interviews revealed several major themes, including expectation of diners to be provided with healthy food choices; their request for nutrition-expert involvement in planning the meals; the diners' feel that there is a conflict between sensory attractiveness of the food and its' nutritional quality. In the context of the catering-based intervention programs, the diners prefer scientific and clear messages focusing on labeling healthy dishes only, as opposed to the labeling of unhealthy dishes; they were interested in a nutritional education program to accompany the intervention program. Based on these findings, we have developed an intervention program that includes: changes in food served such as replacing several menu items and nutritional improvement of some of the recipes; as well as, environmental changes such as changing the location of some food items presented on the buffet, placing positive nutritional labels on healthy dishes and an ongoing healthy nutrition campaign, all accompanied by a nutrition education program. The intervention program is currently being tested for its impact on health outcomes and its cost-effectiveness.

Keywords: catering system, food services, intervention, nutrition policy, public health, qualitative research

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852 Delay in Induction of Labour at Two Hospitals in Southeast Scotland: Outcomes

Authors: Bernard Ewuoso

Abstract:

Introduction: Induction of labor (IOL) usually involves the patient moving between antenatal, labor, and postnatal wards. Delay in IOL has been defined as delay in the time it takes a woman to wait for induction after her cervix is assessed to be favorable. Opinions vary on the acceptable time the patient is allowed to wait for once the cervix is adjudged ripe for induction. What has been considered a benchmark is a delay of up to 12 hours. There is evidence that delay in IOL is associated with adverse outcomes. Aim: To determine the number of women experiencing delay in induction of labor and their outcomes. Method: This audit was retrospective and observational. It included women who had induction of labor in the month of October 2023 in two hospitals. Clinical data was collected from electronic medical records into an Excel sheet for analysis. Women had cervical ripening as inpatient or outpatient. The primary objective was to determine the number of women experiencing delay in induction of labor, while the secondary objective was to outcome these women. Result: 136 women had IOL. The least percentage of data retrieved for any parameter was 80%. The mean gestational age at IOL was 278.26 days. The mean waiting time was 905.34mins. Seventy-five women had their IOL at the Royal Infirmary of Edinburgh (RIE), fifty-seven at St. John’s Hospital (SJH), and three women were transferred from RIE to SJH. The preferred method of cervical ripening was balloon closely followed by prostaglandin. Twenty-seven women did not require cervical ripening and had their process started with amniotomy. Prostaglandin was the method of choice of cervical ripening at RIE, while balloon was preferred in SJH. Of the thirty-five women found to be suitable for outpatient cervical ripening, thirteen had outpatient ripening. There was a significant increase in the number of women undergoing outpatient cervical ripening at RIE from 10.5% in April 2022 to 42.9%. The preferred method for outpatient cervical ripening at the RIE was balloon, while it was prostaglandin for SJH. These were contradictory to the preferred method of inpatient cervical ripening at both centers. The average waiting time for IOL at RIE, 1166.92mins, is more than double that of SJH, 442.93mins, and far exceed 12hours, which is the proposed benchmark. The waiting time tends to be shorter with prostaglandin. Out of the women that had outpatient cervical ripening 63.6% had to wait for more than 12hrs before being induced while it was 36.1% for women that had inpatient cervical ripening. Overall, 38.5% women waited for more than 12 hours before having their induction. A lesser proportion of the women who waited for more than 12 hours had caesarean section, assisted vaginal delivery, and postpartum hemorrhage, whereas a greater proportion had spontaneous vaginal delivery and intrapartum or postpartum infection. Conclusion: A significant number of the women included in the study experienced delay in their induction process, and this was associated with an increased occurrence of intrapartum or postpartum infection. Outpatient cervical ripening contributed to delay.

Keywords: delay in induction of labor, inpatient, outpatient, intrapartum, postpartum, infection

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851 Integrating Sexual Reproductive Health and Rights in Promoting Gender Equality, Equity, and Empowerment of Women

Authors: Danielle G. Saique

Abstract:

Introduction: Promoting Gender Equality, Equity and Empowerment of Women (GEE&EW) can be attained by practicing thereby exercising Sexual and Reproductive Health and Rights (SRHR). Gender Inequality is manifested thru Violence Against Women (VAW). Objectives: This study presents causes, prevalence, effects of Gender Inequality for not practicing and violating SRHR. This proposes Action Plan by promoting, integrating SRHR in the “holistic approach” of Social Work education, practice and service-delivery in any work-set-ups. Limitations: VAW cases showed victim and violator are known, related and living together. Cases transpired at home, reported, investigated in the police and filed in the legal court of law for the year 2013. Methods: Data from blotters, reports, filed cases, case studies gathered by the Social Worker (SWr). Qualitative analysis identified cause, prevalence of VAW related in violating SRHR. SWr serves innovative interventions in any work settings by applying SRHR background, skills in educating, counseling client-victims. Results: 65 VAW cases on non-negotiation or refusal of practicing SRHR. Non-acceptance of Family Planning yielded unwanted, unplanned pregnancies, abandoned children, battered women. Neglected pre-post natal maternal care caused complications or death. Rape, incest led trauma or death. Unsafe, unprotected sex transmitted STDs. Conclusions: Non-availing SRHR from health facilities, from Medical Health SWr concluded to non-practicing or violating rights to life, health care, protection, rights to information, education, rights to plan family, rights from torture, ill-treatment. VAW brings undesirable effects to the well-being, wellness and humaneness of the victim. Recommendations: The innovative intervention services on SRHR of a SWr and the findings, results in violating SRHR are recommendations in Action Planning by adding “The SRHR Concepts” in Social Work thereby preventing VAW; empowering women’s rights to development, gender equality, equity liberty, security, freedom; resilience and involvement in promoting, practicing, exercising SRHR at home. Recommended therefore to duplicate this innovative practice and experience on SRHR as implemented by the SWr in any work setting.

Keywords: women development, promoting gender equality, equity, empowerment of women

Procedia PDF Downloads 476