Search results for: patient knowledge

Authors: Alvine Sandrine Ndinchout, D. P. Chattopadhyay, Moundipa Fewou Paul, Nyegue Maximilienne Ascension, Varinder Kaur, Sukhraj Kaur, B. H. Patel

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Dacryodes macrophylla is a species of the Burseraceae family that is widespread in Cameroon, Equatorial Guinea, and Gabon. The only part of D. macrophylla known to use is the pulp contained in the fruit. This very juicy pulp is consumed directly and used in making juices. During consumption, these fruit leaves a dark blackish colour on fingers and garment. This observation means that D. macrophylla fruits must be a good source of natural dye with probably good fastness properties on textile materials. But D. macrophylla has not yet been investigated with reference as a potential source of natural dye to our best knowledge. Natural dye has been extracted using water as solvent by soxhlet extraction method. The extracted color was characterized by spectroscopic studies like UV/Visible and further tested for antimicrobial activity against gram-negative (Vibrio cholerae, Escherichia coli, Salmonella enterica serotype Typhi, Shigella flexneri) and gram-positive (Listeria monocytogenes, Staphylococcus aureus) bacteria. It was observed that the water extract of D. macrophylla showed antimicrobial activities against S. enterica. The results of fastness properties of the dyed fabrics were fair to good. Taken together, these results indicate that D. macrophylla can be used as natural dye not only in textile but also in other domains like food coloring.

Keywords: antimicrobial activity, natural dye, silk, wash fastness, wool

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Authors: S. Cheng, C. Catallo

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Introduction: Canada's healthcare and social services systems are failing high risk, vulnerable older adults. Care for vulnerable older Canadians (65 and older) is not optimal in Canada. It does not address the care needs of vulnerable, high risk adults using a holistic approach. Given the growing aging population, and the care needs for seniors with complex conditions is one of the highest in Canada's health care system, there is a sense of urgency to optimize care. Integration of health and social services is an emerging trend in Canada when compared to European countries. There is no common and universal understanding of healthcare and social services integration within the country. Consequently, a clear understanding and definition of integrated health and social services are absent in Canada. Objectives: A study was undertaken to develop a case definition for integrated health and social care initiatives that serve older adults, which was then tested against three Canadian integrated initiatives. Methodology: A limited literature review was undertaken to identify common characteristics of integrated health and social care initiatives that serve older adults, and comprised both scientific and grey literature, in order to develop a case definition. Three Canadian integrated initiatives that are located in the province of Ontario, were identified using an online search and a screening process. They were surveyed to determine if the literature-based integration definition applied to them. Results: The literature showed that there were 24 common healthcare and social services integration characteristics that could be categorized into ten themes: 1) patient-care approach; 2) program goals; 3) measurement; 4) service and care quality; 5) accountability and responsibility; 6) information sharing; 7) Decision-making and problem-solving; 8) culture; 9) leadership; and 10) staff and professional interaction. The three initiatives showed agreement on all the integration characteristics except for those characteristics associated with healthcare and social care professional interaction, collaborative leadership and shared culture. This disagreement may be due to several reasons, including the existing governance divide between the healthcare and social services sectors within the province of Ontario that has created a ripple effect in how professions in the two different sectors interact. In addition, the three initiatives may be at maturing levels of integration, which may explain disagreement on the characteristics associated with leadership and culture. Conclusions: The development of a case definition for healthcare and social services integration that incorporates common integration characteristics can act as a useful instrument in identifying integrated healthcare and social services, particularly given the emerging and evolutionary state of this phenomenon within Canada.

Keywords: Canada, case definition, healthcare and social services integration, integration, seniors health, services delivery

Procedia PDF Downloads 161

Authors: Marco Castagna

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Proposed paper is aimed to inquire about the relation between text and reader, focusing on the concept of ‘attestation’. Indeed, despite being widely accepted in semiotic research, even today the concept of text remains uncertainly defined. So, it seems to be undeniable that what is called ‘text’ offers an image of internal cohesion and coherence, that makes it possible to analyze it as an object. Nevertheless, this same object remains problematic when it is pragmatically activated by the act of reading. In fact, as for the T.A.R:D.I.S., that is the unique space-temporal vehicle used by the well-known BBC character Doctor Who in his adventures, every text appears to its own readers not only “bigger inside than outside”, but also offering spaces that change according to the different traveller standing in it. In a few words, as everyone knows, this singular condition raises the questions about the gnosiological relation between text and reader. How can a text be considered the ‘same’, even if it can be read in different ways by different subjects? How can readers can be previously provided with knowledge required for ‘understanding’ a text, but at the same time learning something more from it? In order to explain this singular condition it seems useful to start thinking about text as a device more than an object. In other words, this unique status is more clearly understandable when ‘text’ ceases to be considered as a box designed to move meaning from a sender to a recipient (marking the semiotic priority of the “code”) and it starts to be recognized as performative meaning hypothesis, that is discursively configured by one or more forms and empirically perceivable by means of one or more substances. Thus, a text appears as a “semantic hanger”, potentially offered to the “unending deferral of interpretant", and from time to time fixed as “instance of Discourse”. In this perspective, every reading can be considered as an answer to the continuous request for confirming or denying the meaning configuration (the meaning hypothesis) expressed by text. Finally, ‘attestation’ is exactly what regulates this dynamic of request and answer, through which the reader is able to confirm his previous hypothesis on reality or maybe acquire some new ones.Proposed paper is aimed to inquire about the relation between text and reader, focusing on the concept of ‘attestation’. Indeed, despite being widely accepted in semiotic research, even today the concept of text remains uncertainly defined. So, it seems to be undeniable that what is called ‘text’ offers an image of internal cohesion and coherence, that makes it possible to analyze it as an object. Nevertheless, this same object remains problematic when it is pragmatically activated by the act of reading. In fact, as for the T.A.R:D.I.S., that is the unique space-temporal vehicle used by the well-known BBC character Doctor Who in his adventures, every text appears to its own readers not only “bigger inside than outside”, but also offering spaces that change according to the different traveller standing in it. In a few words, as everyone knows, this singular condition raises the questions about the gnosiological relation between text and reader. How can a text be considered the ‘same’, even if it can be read in different ways by different subjects? How can readers can be previously provided with knowledge required for ‘understanding’ a text, but at the same time learning something more from it? In order to explain this singular condition it seems useful to start thinking about text as a device more than an object. In other words, this unique status is more clearly understandable when ‘text’ ceases to be considered as a box designed to move meaning from a sender to a recipient (marking the semiotic priority of the “code”) and it starts to be recognized as performative meaning hypothesis, that is discursively configured by one or more forms and empirically perceivable by means of one or more substances. Thus, a text appears as a “semantic hanger”, potentially offered to the “unending deferral of interpretant", and from time to time fixed as “instance of Discourse”. In this perspective, every reading can be considered as an answer to the continuous request for confirming or denying the meaning configuration (the meaning hypothesis) expressed by text. Finally, ‘attestation’ is exactly what regulates this dynamic of request and answer, through which the reader is able to confirm his previous hypothesis on reality or maybe acquire some new ones.

Keywords: attestation, meaning, reader, text

Procedia PDF Downloads 238

Authors: Yakubu Nkom Bityong, A. I. Kabido, K. Venkateswarlu

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The influence of branding and consultancy services on sports development and marketing mix has been a matter of interest among coaches athletes and sports managers in Nigeria. Marketers use sports as a promotional vehicle towards attracting customers to their products and services. The use of images, names, and photographs of sports personalities to advertise beverages, cars, and a whole range of other products and services as it is clearly noticed all over the television, radio and print media has generated a lot of argument among consumers who have vested interest and are more drawn to their favorite teams and sports personalities than they are to many company products This paper examines the influence of branding and consultancy services on sports Performance of coaches, athletes and sports managers in Nigeria. From a population of 7,441 made up of coaches, athletes and sports managers, 372 respondents were sampled for the study. A self developed and standardized questionnaire was the instrument used for data collection. One-tailed t-test was used to test the hypothesis. Results revealed that branding and consultancy services influence the performances of coaches, athletes and sports managers in Nigeria. It was concluded that the establishment of the National Institute of Sports (NIS) in Lagos with affiliated sports training programmes in Nigerian Universities is responsible for boosting the performance of sports personalities in Nigeria. It was recommended that National Policy on Sports should be reviewed in order to inculcate new methods and strategies towards enhancing sports development initiatives in the country while stakeholders should intensify regular training and retraining programmes for coaches, athletes and sports managers to update their knowledge and skills.

Keywords: branding, consultancy, sports performance, sports development

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Authors: Sarah E. Nelson, Casey Weiner, Alexander Sigmon, Jun Hua, Haris I. Sair, Jose I. Suarez, Robert D. Stevens

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Graph-theoretical information from structural connectomes indicated significant connectivity changes and improved acute prognostication in a Random Forest (RF) model in aneurysmal subarachnoid hemorrhage (aSAH), which can lead to significant morbidity and mortality and has traditionally been fraught by poor methods to predict outcome. This study’s hypothesis was that structural connectivity changes occur in canonical brain networks of acute aSAH patients, and that these changes are associated with functional outcome at six months. In a prospective cohort of patients admitted to a single institution for management of acute aSAH, patients underwent diffusion tensor imaging (DTI) as part of a multimodal MRI scan. A weighted undirected structural connectome was created of each patient’s images using Constant Solid Angle (CSA) tractography, with 176 regions of interest (ROIs) defined by the Johns Hopkins Eve atlas. ROIs were sorted into four networks: Default Mode Network, Executive Control Network, Salience Network, and Whole Brain. The resulting nodes and edges were characterized using graph-theoretic features, including Node Strength (NS), Betweenness Centrality (BC), Network Degree (ND), and Connectedness (C). Clinical (including demographics and World Federation of Neurologic Surgeons scale) and graph features were used separately and in combination to train RF and Logistic Regression classifiers to predict two outcomes: dichotomized modified Rankin Score (mRS) at discharge and at six months after discharge (favorable outcome mRS 0-2, unfavorable outcome mRS 3-6). A total of 56 aSAH patients underwent DTI a median (IQR) of 7 (IQR=8.5) days after admission. The best performing model (RF) combining clinical and DTI graph features had a mean Area Under the Receiver Operator Characteristic Curve (AUROC) of 0.88 ± 0.00 and Area Under the Precision Recall Curve (AUPRC) of 0.95 ± 0.00 over 500 trials. The combined model performed better than the clinical model alone (AUROC 0.81 ± 0.01, AUPRC 0.91 ± 0.00). The highest-ranked graph features for prediction were NS, BC, and ND. These results indicate reorganization of the connectome early after aSAH. The performance of clinical prognostic models was increased significantly by the inclusion of DTI-derived graph connectivity metrics. This methodology could significantly improve prognostication of aSAH.

Keywords: connectomics, diffusion tensor imaging, graph theory, machine learning, subarachnoid hemorrhage

Procedia PDF Downloads 193

Authors: Adama NS Bah

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Background: Loss of teeth has a negative influence on essential oral functions such as phonetics, mastication, and aesthetics. Dentists treat people with prosthodontic rehabilitation to recover essential oral functions. The oral health quality of life inventory reflects the success of prosthodontic rehabilitation. In many countries, the current conventional care delivered to replace missing teeth for adult patients involves the provision of removable partial dentures. Aim: The aim of this systematic review and meta-analysis is to gather the best available evidence to determine patients’ oral health-related quality of life improvement after treatment with partial dentures. Methods: We searched electronic databases from January 2010 to September 2019, including PubMed, ProQuest, Science Direct, Scopus and Google Scholar. In this paper, studies were included only if the average age was 30 years and above and also published in English. Two reviewers independently screened and selected all the references based on inclusion criteria using the PRISMA guideline, and assessed the quality of the included references using the Joanna Briggs Institute quality assessment tools. Data extracted were analyzed in RevMan 5.0 software, the heterogeneity between the studies was assessed using Forest plot, I2 statistics and chi-square test with a statistical P value less than 0.05 to indicate statistical significance. Random effect models were used in case of moderate or high heterogeneity. Four studies were included in the systematic review and three studies were pooled for meta-analysis. Results: Four studies included in the systematic review and three studies included in the meta-analysis with a total of 285 patients comparing the improvement in oral health-related quality of life before and after rehabilitation with partial denture, the pooled results showed a better improvement of oral health-related quality of life after treatment with partial dentures (mean difference 5.25; 95% CI [3.81, 6.68], p < 0.00001) favoring the wearing of partial dentures. In order to ascertain the reliability of the included studies for meta-analysis risk of bias was assessed and found to be low in all included studies for meta-analysis using the Cochrane collaboration tool for risk of bias assessment. Conclusion: There is high evidence that rehabilitation with partial dentures can improve the patient’s oral health-related quality of life measured with Oral Health Impact Profile 14. This review has clinical evidence value for dentists treating the expanding vulnerable adult population.

Keywords: meta-analysis, oral health impact profile, partial dentures, systematic review

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Authors: Naouel Zoghlami

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Spoken-word recognition involves the simultaneous activation of potential word candidates which compete with each other for final correct recognition. In continuous speech, the activation-competition process gets more complicated due to speech reductions existing at word boundaries. Lexical processing is more difficult in L2 than in L1 because L2 listeners often lack phonetic, lexico-semantic, syntactic, and prosodic knowledge in the target language. In this study, we investigate the on-line lexical segmentation hypotheses that French listeners of L2 English form and then revise as subsequent perceptual evidence is revealed. Our purpose is to shed further light on the processes of L2 spoken-word recognition in context and better understand L2 listening difficulties through a comparison of skilled and unskilled reactions at the point where their working hypothesis is rejected. We use a variant of the gating experiment in which subjects transcribe an English sentence presented in increments of progressively greater duration. The spoken sentence was “And this amazing athlete has just broken another world record”, chosen mainly because it included common reductions and phonetic features in English, such as elision and assimilation. Our preliminary results show that there is an important difference in the manner in which proficient and less-proficient L2 listeners handle connected speech. Less-proficient listeners delay recognition of words as they wait for lexical and syntactic evidence to appear in the gates. Further statistical results are currently being undertaken.

Keywords: gating paradigm, spoken word recognition, online lexical segmentation, L2 listening

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Authors: Cassey Younghans

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Background: Current health care trends demonstrate that there is an increasing number of patients being hospitalized with complex comorbidities. These complex needs require advanced therapies, and treatment goals often focus on doing everything possible to prolong life rather than focusing on the individual patient’s quality of life which is the goal of palliative care efforts. Patients benefit from palliative care in the early stages of the illness rather than after the disease progressed or the state of acuity has advanced. The clinical problem identified was that palliative care was not being implemented early enough in the disease process with patients who had complex medical conditions and who would benefit from the philosophy and skills of palliative care professionals. Purpose: The purpose of this quality improvement study was to increase the number of palliative care screenings and consults completed on adults after being admitted to one Non-ICU and Non-COVID hospital unit. Methods: A retrospective chart review assessing for possible missed opportunities to introduce palliation was performed for patients with six primary diagnoses, including heart failure, liver failure, end stage renal disease, chronic obstructive pulmonary disease, cerebrovascular accident, and cancer in a population of adults over the ago of 19 on one medical-surgical unit over a three-month period prior to the intervention. An educational session with the nurses on the benefits of palliative care was conducted by the researcher, and a screening tool was implemented. The expected outcome was to have an increase in early palliative care consultation with patients with complex comorbid conditions and a decrease in missed opportunities for the implementation of palliative care. Another retrospective chart review was completed following completion of the three month piloting of the tool. Results: During the retrospective chart review, 46 patients were admitted to the medical-surgical floor with the primary diagnoses identified in the inclusion criteria. Six patients had palliative care consults completed during that time. Twenty-two palliative care screening tools were completed during the intervention period. Of those, 15 of the patients scored a 7 or higher, suggesting that a palliative care consultation was warranted. The final retrospective chart review identified that 4 palliative consults were implemented during that time of the 31 patients who were admitted over the three month time frame. Conclusion: Educating nurses and implementing a palliative care screening upon admission can be of great value in providing early identification of patients who might benefit from palliative care. Recommendations – It is recommended that this screening tool should be used to help identify the patents of whom would benefit from a palliative care consult, and nurses would be able to initiated a palliative care consultation themselves.

Keywords: palliative care, screening, early, palliative care consult

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Authors: Terefe Fuge, George Tsourtos , Emma Miller

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Objectives: Maintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of adherence and viral suppression, as well as its associated factors in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors to this amongst prisoners in South Ethiopia. Methods: A prospective cohort study was conducted between June 1, 2019 and July 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration-related characteristics was collected using a structured questionnaire. Adherence was determined based on participants’ self-report and pharmacy refill records, and plasma viral load measurements which were undertaken within the study period were prospectively extracted to determine viral suppression. Various univariate and multivariate regression models were used to analyse data. Results: Self-reported dose adherence was approximately similar between ILWHA and non-incarcerated PLWHA (81% and 83% respectively), but ILWHA had a significantly higher medication possession ratio (MPR) (89% vs 75%). The prevalence of viral failure (VF) was slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31-35 years and in those who experienced social stigma, regardless of their incarceration status. Conclusions: This study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to doses and so to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors was found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

Keywords: Adherence , Antiretroviral therapy, Incarceration, South Ethiopia, Viral suppression

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Authors: Caner Yilmaz, Zuhal Didem Takinaci

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Introduction: Today, our knowledge about the effects of physical activity performed at the different intensity of the cardiovascular system are still not clear. Therefore, to contribute to the literature, in our study, sedentary individuals and amateur athletes were assessed in a single session with the aim of evaluating the cardiovascular effects of the moderate and severe exercise. Methods: 80 participants (40 amateur athletes and 40 sedentary, young adults) participated in our study. Participants were divided into two groups: amateur athletes (mean age: 25.0 ± 3.6 yrs) and sedentary in group II (mean age: 23.8 ± 3.7 yrs). Participants in both groups were assessed twice, namely, firstly, at moderate intensity (5km/h 30 min. walking) and secondly at the vigorous intensity (8km/h 20 min. jogging). Participants’ SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure), HR (Heart Rate), SpO₂ (Oxygen Saturation), BT (Body Temperature) and RR (Respiratory Rate) were measured. Results: In our study, the findings showed that after moderate-intensity aerobic exercise, change in SBP, DBP, and SpO₂ were significantly higher in Group II (p < 0.05). After the severe intensity aerobic exercises, change in SBP, SpO₂, HR, and RR was significantly higher in Group II (p < 0.05). The BORG score of Group II was significantly higher after both moderate and severe intensity aerobic exercise (p < 0.05). Conclusion: The cardiovascular responses of amateur athletes were closer to initial values, and the differences between the two groups were increased in direct proportion to the intensity of the exercise. Both exercise intensities could be adequate.

Keywords: aerobic, exercise, sedantary, cardi̇ovascular

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Authors: Sebahat Seker

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Since there is a parallel connection between drinking water quality and public health, studies on drinking and domestic water are of vital importance. Ardahan Province is one of the provinces located in the Northeast Anatolian Region, where animal husbandry and agriculture are carried out economically. City mains water uses underground spring water as a source and is chlorinated and given to the city center by gravity. However, mains water cannot be used outside the central district of the city, and the majority of the people meet their drinking and utility water needs from the wells they have opened individually. The water element, which is vital for all living things, is the most important substance that sustains life for humans. Under normal conditions, a healthy person consumes approximately 1.8-2 liters of water. The quality and use of potable water is one of the most important issues in terms of health. The quality parameters of drinking and utility water have been revealed by the scientific world. Scientific studies on drinking water quality in the world and its impact on public health are among the most popular topics. Although our country is surrounded by water on three sides, potable water resources are very few. In the Eastern Anatolia Region, it is difficult for the public to access drinking and utility water due to the difficult conditions both climatically and geographically. In this study, samples taken from drinking and utility water at certain intervals from the stations determined, and water quality parameters will be determined. The fact that such a study has not been carried out in the region before and the knowledge of the local people about water quality is very important in terms of its original and widespread effect.

Keywords: water quality, modelling, evaluation, northeastern anatolia

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Authors: Cecilia Jatu, Adventino

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Gedangsari is located in Gunungkidul, Yogyakarta Province, which has several criteria to be used as a new geosite object. The research area is located in the southern mountain zone of Java, composed of 5 rock formations with Oligocene up to Middle Miocene age. The purpose of this study is to reveal the potential of geotourism and the geoheritage to be proposed as a new geosite and to make a geosite map of Gedangsari. The research method used is descriptive data collection and which includes quantitative geological data collection, geotourism, and heritage sites, then supported by petrographic analysis, geological structure, geological mapping, and SWOT analysis. The geological data proved that Gedangsari consists of igneous rock (intrusion), pyroclastic rock, and sediment rock. This condition caused many varieties and particular geomorphological platform. Geotourism that include in Gedangsari are Luweng Sampang Canyon, Gedangsari Bouma Sequence, Watugajah Columnar Joint, Gedangsari Marine Fan Sediment, and Tegalrejo Waterfall. There is also Tegalrejo Village, which can be considered as geoheritage site because of its culture and batik traditional cloth. The results of the SWOT analysis, Gedangsari geosite must be developed and appropriately promoted in order to improve the existence. The development of geosite area will have a significant impact that improve the economic growth of the surrounding community and can be used by the government as base information for sustainable development. In addition, the making of an educational map about the geological conditions and geotourism location of the Gedangsari geosite can increase the people's knowledge about Gedangsari.

Keywords: Gedangsari, geoheritage, geotourism, geosite

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Authors: Rana Mohamed

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Despite youth in Egypt were away from political life for a long time; they are able to make a tangible difference in political status. Purpose: This exploratory study aims to determine whether and how much the prevailing political culture influence participatory behavior with a special focus on political awareness factors among university students in Egypt. Methodology: The study employed several data collection methods to ensure the validity of the results, quantitative and qualitative, verifying the positive relationships between the levels of political awareness and political participation and between political values in society and the level of political participation among university students. For achieving the objectives of the paper in the light of the pool of available literature and data, the study adopts system analysis method to apply input-output and conversions associated with the phenomena of political participation to analyze the different factors that have an effect upon the prevailing political culture and the patterns of values in Egyptian society. Findings: The result reveals that the level of political awareness and political participation for students were low, with a statistically significant relationship. In addition, the patterns of values in Egyptian culture significantly influence the levels of student participation. Therefore, the study recommends formulating policies that aim to increase awareness levels and integrate youth into the political process. Originality/Value: The importance of the academic study stems from addressing one of the central issues in political science; this study measures the change in the Egyptian patterns of culture and values among university students.

Keywords: political awareness, political participation, civic culture, citizenship, Egyptian universities, political knowledge

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Authors: E. Gopi, E. Devaindran

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Objective: Non-operative management of blunt splenic trauma have started to overtake the traditional splenectomy in recent years across the grade of splenic injury. The two main non-operative methods are observation and angioembolisation. However, the post management convalescence in these groups are still being investigated. The study attempts to quantify the clinical indicators among the two in particular complications, mortalities, conversions to operative management and duration of inpatient stay. Methodology: A systematic search was done via PUBMED, MEDLINE, and EMBASE. A total of 639 articles identified and subsequently 68 articles were identified post duplicates, full text, and inclusion and exclusion criteria. Main exclusions were non-English articles without English translation, pure observational or angioembolisation articles of which no comparison data could be identified and articles looking into pure hemodynamically unstable patients. Results: 24 non randomized controlled trial, 5 clinical control trial and 39 retrospective studies analyzing a total of 23700 patients with blunt splenic trauma. Discrepancies in data were noted in the group who had observational management versus angioembolisation in particular as data was compared among the classes of splenic rupture, the protocol of management in different centers, availability of angiogram suite, and the study design. Further variability was also noted in the angioembolisation arm as the preference for treatment differs between distal versus proximal splenic artery involvement. Overall the cumulative mortality in both observational and angioembolisation group were similar, 2.78% and 5.97% respectively. The cause of death however is not directly attributed to the management itself but rather patient comorbidities, other associated injuries and conversions to splenectomy leading to post splenectomy complications. The cumulative morbidity among each group appears to be same approximately 12% in observational versus 15% in angioembolisation. However, the type of complications varies with the observational group having higher rates of inpatient stay and intrabdominal hematoma infection and angioembolisation group developing more splenic infarcts and bleeds. There were significant disparity in reporting the actual data on duration of inpatient stay and complications to allow a statistically significant quantitative analysis to be done, 15 articles however are currently being considered. Conclusions: Observational management appears to be much effective in managing lower grade splenic trauma (grade 1 and 2) where else angioembolisation appears to play a bigger role in intermediate grades (grade 3-4) in ensuring splenic function preservation. Care has to be taken however in the angioembolisation group in view of distal splenic infarct group compromising splenic function. The cumulated data of 15 articles are now being considered for a meta-analysis.

Keywords: blunt splenic trauma, conservative, non-operative, angioembolisation

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Authors: G. Chipili, J. Msuya

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The Central Province of Zambia contains the majority of the nation’s malnourished children, despite being the most productive province in terms of Agriculture. Most studies in the province have not paid attention to the linkages between agriculture performance and nutrition outcomes of the population. In light of this knowledge gap, this study focused on the linkage between nutrition and agriculture. In 2010 the Ministry of Agriculture in the Central Province while working with Non-Governmental Organizations (NGOs), the Ministry of Health and the Ministry of Education started a pilot project in Kapiri-Mponshi on Orange-fleshed Sweet Potatoes and Orange Maize and educating farmers on the importance of crop diversity. The study assessed the extent to which the small scale farmers are implementing the best practices of nutrition-sensitive agriculture in the Central Province. This study sought to determine the association of crop diversity and nutritional status of children aged 6-59 months in Kapiri-Mposhi district in the Central Province of Zambia. A cross-sectional descriptive study was conducted using a structured questionnaire. A total of 365 households were randomly sampled and the nutritional status of one child from each household assessed using anthropometric measurements. A total of 100 children were included in the study. Up to 21% of the children were stunted; 2% were wasted; and 9% underweight. There was a significant relationship between crops grown in households (ground nuts, maize and mangoes) and Z-scores for stunting (HAZ) and underweight (WAZ) (p< 0.05). This study has established that farmers may not diversify if they have high market demands on the staple.

Keywords: agriculture, crop diversity, children, nutrition

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Authors: Jessica A. Hellings, Piyushkumar Jani

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Background: Systemic autoimmune disorders are increasingly implicated in neuropsychiatric illness, especially in the setting of treatment resistance in individuals of all ages. Gluten allergy in fullest extent results in celiac disease, affecting multiple organs including central nervous system (CNS). Clinicians often lack awareness of the association between neuropsychiatric illness and gluten allergy, partly since many such research studies are published in immunology and gastroenterology journals. Methods: Following a Pubmed literature search and online searches on celiac disease websites, 40 articles are critically reviewed in detail. This work reviews celiac disease, gluten intolerance and current evidence of their relationship to neuropsychiatric and systemic illnesses. The review also covers current work-up and diagnosis, as well as dietary interventions, gluten restriction outcomes, and future research directions. Results: Gluten allergy in susceptible individuals damages the small intestine, producing a leaky gut and malabsorption state, as well as allowing antibodies into the bloodstream, which attack major organs. Lack of amino acid precursors for neurotransmitter synthesis together with antibody-associated brain changes and hypoperfusion may result in neuropsychiatric illness. This is well documented; however, studies in neuropsychiatry are often small. In the large CATIE trial, subjects with schizophrenia had significantly increased antibodies to tissue transglutaminase (TTG), and antigliadin antibodies, both significantly greater gluten antibodies than in control subjects. On later follow up, TTG-6 antibodies were identified in these subjects’ brains but not in their intestines. Significant evidence mostly from small studies also exists for gluten allergy and celiac-related depression, anxiety disorders, attention-deficit/hyperactivity disorder, autism spectrum disorders, ataxia, and epilepsy. Dietary restriction of gluten resulted in remission in several published cases, including for treatment-resistant schizophrenia. Conclusions: Ongoing and larger studies are needed of the diagnosis and treatment efficacy of the gluten-free diet in neuropsychiatric illness. Clinicians should ask about the patient history of anemia, hypothyroidism, irritable bowel syndrome and family history of benefit from the gluten-free diet, not limited to but especially in cases of treatment resistance. Obtaining gluten antibodies by a simple blood test, and referral for gastrointestinal work-up in positive cases should be considered.

Keywords: celiac, gluten, neuropsychiatric, translational

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Authors: Jonathan Marks, Lauren Katz

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Family firms are a vital component of a country’s stability, prosperity and development. Their sustainability, longevity and continuity are critical. Given the premise that family firms wish to continue the business for the benefit of the family, the family founder / owner is faced with an emotionally charged transition option; either to transfer the family business to a family member or to transfer the firm to a non-family member. The rationale employed by family founders to select non-family members as successors/ executives of choice and the concomitant rationale employed by non-family members to select family firms as employers of choice, has been under-researched in the literature of family business succession planning. This qualitative study used semi-structured interviews to gain access to family firm founders/ owners, non-family successors/ executives and industry experts on family business. The findings indicated that the rationale for family members to select non-family successors/ executives was underpinned by the objective to grow the family firm for the benefit of the family. If non-family members were the most suitable candidates to ensure this outcome, family members were comfortable to employ non-family members. Non- family members, despite the knowledge that benefit lay primarily with family members, chose to work for family firms for personal benefits in terms of wealth, security and close connections. A commonly shared value system was a pre-requisite for all respondents. The research study provides insights from family founders/ owners, non-family successors/ executives, and industry experts on the subject of succession planning outside the family structure.

Keywords: agency theory, family business, institutional logics, non-family successors, Stewardship Theory

Procedia PDF Downloads 373

Authors: M. Saiful Islam, M. Mohandes, S. Rehman, S. Badran

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Increasing necessity of wind power is directing us to have precise knowledge on wind resources. Methodical investigation of potential locations is required for wind power deployment. High penetration of wind energy to the grid is leading multi megawatt installations with huge investment cost. This fact appeals to determine appropriate places for wind farm operation. For accurate assessment, detailed examination of wind speed profile, relative humidity, temperature and other geological or atmospheric parameters are required. Among all of these uncertainty factors influencing wind power estimation, vertical extrapolation of wind speed is perhaps the most difficult and critical one. Different approaches have been used for the extrapolation of wind speed to hub height which are mainly based on Log law, Power law and various modifications of the two. This paper proposes a Artificial Neural Network (ANN) and Genetic Algorithm (GA) based hybrid model, namely GA-NN for vertical extrapolation of wind speed. This model is very simple in a sense that it does not require any parametric estimations like wind shear coefficient, roughness length or atmospheric stability and also reliable compared to other methods. This model uses available measured wind speeds at 10m, 20m and 30m heights to estimate wind speeds up to 100m. A good comparison is found between measured and estimated wind speeds at 30m and 40m with approximately 3% mean absolute percentage error. Comparisons with ANN and power law, further prove the feasibility of the proposed method.

Keywords: wind profile, vertical extrapolation of wind, genetic algorithm, artificial neural network, hybrid machine learning

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Authors: Genevieve Zingg

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Modern technology and social media platforms have fundamentally altered the nature of war crimes investigations by providing new forms of data, evidence, and documentation, and pose a unique opportunity to expand the efficacy of international law. However, much of the open source information available is deemed inadmissible in subsequent legal proceedings and fails to function as evidence largely due to issues of reliability and verifiability. Focusing on current judicial investigations related to ongoing conflicts in Syria and Iraq, this paper will examine key challenges and opportunities for the effective use of open source information in securing justice. This paper will consider strategies and approaches that can be used to ensure that information collected by affected populations meets basic admissibility standards. This paper argues that the critical failure to equip civilian populations in conflict zones with knowledge and information regarding established admissibility standards and guidelines both jeopardizes the potential of open source information and compromises the ability of victims to participate effectively in justice and accountability processes. The ultimate purpose of this paper is, therefore, to examine how to maximize the value of open source information based on the rules of evidence in international, regional, and national courts, and how to maximize the participation of affected populations in holding their abusers to account.

Keywords: human rights, international criminal law, international justice, international law, Iraq, open source information, social media, Syria, transitional justice, war crimes

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Authors: ZeinolAbedin Rahmani, Marzieh Evazi Borazjani, Nooshin Salehi

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Organizations are increasingly facing changes and developments scientific, technological, social, cultural changes among these organizations those ones are reckoned successful and effective that in addition to coordinating the development of modern society can forecast future changes and be able to accommodate these changes in order to create favorable developments to build a better future. But we can change that with the changes that occur in the organization of the program it will distinguish. Today's organizations need leaders that change and grow them have to survive. In fact, without transformational managers and leaders, it is certainly difficult to create changes in organizations. Both private and public organizations need to increase knowledge and awareness of the cause widespread changes in the structure, culture and practice for the viability and sustainability of life and growth and development. By now, different signs have determined different causes for a suitable function of employees. However, the important thing is that the commitment of the employees to their organization has always been very important. Since the decrease of organization commitment causes the high rate of absenteeism, turnover intentions, and even to reduce the impact of health staff. and these factors prevent organizations from achieving its goals. If organizations want to retain staff, the organization must find a way to be happy and continue their work with commitment, motivation, and willingness. So here is the need for strong leaders, analysts, creative and transformational upper ranks more than ever is felt. The aim of this study is to revise history, the leadership style of managers shipbuilding company by using the MLQ model.

Keywords: leadership style, managers, organizational, manufacturing company, sustainability of life

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Authors: Ardiansyah I. Ryan, Ashsholih K. R., Fathurrohman G. R., Kurniadi M. R., Huda P. A

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The burden of brain-related disease is very high. There are a lot of brain-related diseases with limited treatment result and thus raise the burden more. The Parkinson Disease (PD), Mental Health Problem, or Paralysis of extremities treatments had risen concern, as the patients for those diseases usually had a low quality of life and low chance to recover fully. There are also many other brain or related neural diseases with the similar condition, mainly the treatments for those conditions are still limited as our understanding of the brain function is insufficient. Brain Implant Technology had given hope to help in treating this condition. In this paper, we examine the current update of the brain implant technology. Neurotechnology is growing very rapidly worldwide. The United States Food and Drug Administration (FDA) has approved the use of Deep Brain Stimulation (DBS) as a brain implant in humans. As for neural implant both the cochlear implant and retinal implant are approved by FDA too. All of them had shown a promising result. DBS worked by stimulating a specific region in the brain with electricity. This device is planted surgically into a very specific region of the brain. This device consists of 3 main parts: Lead (thin wire inserted into the brain), neurostimulator (pacemaker-like device, planted surgically in the chest) and an external controller (to turn on/off the device by patient/programmer). FDA had approved DBS for the treatment of PD, Pain Management, Epilepsy and Obsessive Compulsive Disorder (OCD). The target treatment of DBS in PD is to reduce the tremor and dystonia symptoms. DBS has been showing the promising result in animal and limited human trial for other conditions such as Alzheimer, Mental Health Problem (Major Depression, Tourette Syndrome), etc. Every surgery has risks of complications, although in DBS the chance is very low. DBS itself had a very satisfying result as long as the subject criteria to be implanted this device based on indication and strictly selection. Other than DBS, there are several brain implant devices that still under development. It was included (not limited to) implant to treat paralysis (In Spinal Cord Injury/Amyotrophic Lateral Sclerosis), enhance brain memory, reduce obesity, treat mental health problem and treat epilepsy. The potential of neurotechnology is unlimited. When brain function and brain implant were fully developed, it may be one of the major breakthroughs in human history like when human find ‘fire’ for the first time. Support from every sector for further research is very needed to develop and unveil the true potential of this technology.

Keywords: brain implant, deep brain stimulation (DBS), deep brain stimulation, Parkinson

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Authors: Maher El-Masri, Jamie Crawley, Judy Bornais, Abeer Omar

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Background: Misuse of Emergency Department (ED) for non-urgent healthcare results in unnecessary crowdedness that can result in long ED waits and delays in treatment, diversion of ambulances to other hospitals, poor health outcomes for patients, and increased risk of death Objectives: The main purpose of this study was to explore the independent predictors of non-urgent ED visits in Erie St. Clair LHIN. Secondary purposes of the study include comparison of the rates of non-urgent ED visits between urban and rural hospitals Design: A secondary analysis of archived population-based data on 597,373 ED visits in southwestern Ontario Results The results suggest that older (OR = .992; 95% CI .992 – .993) and female patients (OR = .940; 95% CI .929 - .950) were less likely to visit ED for non-urgent causes. Non-urgent ED visits during the winter, spring, and fall were 13%, 5.8%, and 7.5%, respectively, lesser than they were during the summer time. The data further suggest that non-urgent visits were 19.6% and 21.3% less likely to occur in evening and overnight shifts compared to the day shift. Non-urgent visits were 2.76 times more likely to present to small community hospitals than large community hospitals. Health care providers were 1.92 times more likely to refer patients with non-urgent health problem to the ED than the decision taken by patients, family member or caretakers. Conclusion: In conclusion, our study highlights a number of important factors that are associated with inappropriate use of ED visits for non-urgent health problems. Knowledge of these factors could be used to address the issue of unnecessary ED crowdedness.

Keywords: emergency department, non-urgent visits, predictors, logistic regression

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Authors: Bishwa Nath Oli

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Nepal is highly impacted by climate change and adaptation has been a major focus. This paper investigates the gaps and coherence in national policies across water, forestry, local development and agriculture sectors, identifies their links to climate change adaptation and national development plans and analyzes the effectiveness of climate change policy on adaptation. The study was based on a content analysis of relevant policy documents on the level of attention given to adaptation and key informant interviews. Findings show that sectoral policies have differing degrees of cross thematic coherence, often with mismatched priorities and differing the paths towards achieving climate change goal. They are somewhat coherent in addressing immediate disaster management issues rather than in climate adaptation. In some cases, they are too broad and complicated and the implementation suffers from barriers and limits due to lack of capacity, investment, research and knowledge needed for evidence-based policy process. They do not adequately provide operational guidance in supporting communities in adapting to climate change. The study recommends to a) embrace longer-term cross-sectoral planning within government structures to foster greater policy coherence and integrated adaptation planning, b) increase awareness and flow of information on the potential role of communities in climate change, c) review the existing development sectors from the climate change perspectives, and d) formulate a comprehensive climate change legislation based on the need to implement the new Constitution.

Keywords: agriculture, climate change adaptation, forestry, policies

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Authors: Hakam Alkhateeb

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Oleuropein, the main constituent of leaves and fruits of the olive tree, has been demonstrated to exert beneficial effects on parameters relevant to the normal homeostatic mechanisms of glucose regulation in rat skeletal muscle. However, the antidiabetic effect of oleuropein, to our knowledge, has not been examined. Therefore, in this study, we examined whether oleuropein ameliorated palmitate-induced insulin resistance in skeletal muscle. To examine this question, insulin resistance was rapidly induced by incubating (12h) soleus muscle with a high concentration of palmitate(2mM). Subsequently, we attempted to restore insulin sensitivity by incubating (12h) muscles with oleuropien (1.5mM), while maintaining high concentrations of palmitate. Palmitate treatment for 12 h reduced insulin-stimulated glucose transport, GLUT4 translocationandAS160 phosphorylation. Oleuropein treatment (12 h) fully restoredinsulin-stimulated glucose transport, GLUT4translocationandAS160 phosphorylation. Inhibition of PI3K phosphorylation with wortmannin (1µM)did not affect the oleuropein-induced improvements in insulin-stimulated glucose transport, GLUT4 translocation, and AS160 phosphorylation. These results suggested that the improvements in these parameters cannot account for activating PI3K pathway. Taken altogether, it appears that oleuropein, through activation of another pathway like activated protein kinase (AMPK), may provide a possible strategy by which they ameliorate palmitate-induced insulin resistance in skeletal muscles.

Keywords: AS160, diabetes, GLUT4, oleuropein

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Authors: Olatokunbo Shoyemi, Mario Brito, Ian Dawson

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In recent times, the Nigerian motor insurers have experienced high volume of motor insurance claim pay-outs and insignificant contribution to the net premium income of the Nigerian insurance market, which has been a major concern for the shareholders/stakeholders. It has been argued that there are many factors that have brought about these concerns. However, anecdotal evidence (ongoing debates among industry practitioners) suggests prevalence of fraud due to poor practices in motor insurance business in Nigeria. This study is therefore aimed to carry out an assessment of fraud in motor insurance claims as perceived by experts in the Nigerian insurance market. This study adopted a descriptive research design, and the analysis was built on a survey among insurance experts in Nigeria using a designed questionnaire. A purposive and snowball sampling were used to select our sample (N = 120) - representing a selection of all professionally qualified insurance experts in Nigeria insurance industry. The study found that Nigerian insurance experts (i) largely agree that there is a problematic level of fraud in the Nigerian motor insurance industry; (ii) perceive soft fraud to be about 3 times more common than hard fraud in the Nigerian motor insurance industry, and (iii) strongly agree there are problematic impacts from fraud on the solvency of the Nigerian motor insurers. This paper has provided an empirical understanding of the existence, extent, and impact of fraud risks within the Nigerian insurance market based on expert knowledge and insights rather than, as has often been the case, a reliance on individual anecdotes.

Keywords: claims, net premium income, motor insurance, soft fraud, hard fraud

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Authors: Iwuchukwu J. C., Mbah C.

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There seems to be dearth on information on how oil bean is being exploited, processed and conserved locally. This gap stifles initiatives on the evaluation of the suitability of the methods used and the invention of new and better methods. The study; therefore, assesses activities of processors in domestication/conservation and processing of oil bean (Pentaclethra macrophylla) Enugu State, South East Nigeria. Three agricultural zones, three blocks, nine circles and seventy-two respondents that were purposively selected made up the sample for the study. Data were presented in percentage, chart and mean score. The result shows that processors of oil bean in the area were middle-aged, married with relatively large household size and long years of experience in processing. They sourced oil bean they processed from people’s farmland and sourced information on processing of oil bean from friends and relatives. Activities involved in processing of oil bean were boiling, dehulling, washing, sieving, slicing, wrapping. However, the sequence of these activities varies among these processors. Little or nothing was done by the processors towards the conservation of the crop while poor storage and processing facilities and lack of knowledge on modern preservation technique were major constraints to processing of oil bean in the area. The study concluded that efforts should be made by governments and processors through cooperative group in provision of processing and storage facility for oil bean while research institute should conserve and generate improved specie of the crop to arouse interest of the farmers and processors on the crop which will invariably increase productivity.

Keywords: conservation, domestication, oil bean, processing

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Authors: Kshama Sharma

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Education is one of the most powerful tools to transform the world into a just, sustainable, and more peaceful place for existing lives across the globe. However, its recent objective approach focused on materialistic, factual, and existing knowledge, has a constraint of human experiences that is limited to certain dimensions only. And leads to a materialistic world which is deprived of spiritual approaches and makes it less compassionate, and more grades oriented. To make it more comprehensive, education should explore the subjective approaches towards spiritualism to connect lives with the greater self and consciousness of cosmic intelligence. This approach will bring a major shift in the orientation of pedagogical processes, assessment strategies, and administrative management of the present education system. Spirituality often related to the religious aspect of human civilization and development, however, when universal consciousness /cosmic intelligence (which is often claimed as dark energy) and the human mind competencies works in coherence and coordination then the efficiency of human mind reaches to a different dimension and achieve extraordinary level of human understanding. Quantitative analysis of the existing secondary data from the different agencies working in the field of meditation had been analyzed to conclude its implications on human mind and further how it can effectively use in education to bring the desired and expected results. Any kind of meditation practice affects the cognitive, mental, physical, emotional, and conscious state of mind. If aligned with the teaching and learning methodology will lead to conscious learner and peaceful world.

Keywords: spirituality, cosmic intelligence, consciousness, mind competencies

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Authors: S. Abera, T. Gidey, W. Terefe

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Introduction: Testing for HIV is the key entry point to HIV prevention, treatment, and care and support services. Hence, predictive data mining techniques can greatly benefit to analyze and discover new patterns from huge datasets like that of EDHS 2011 data. Objectives: The objective of this study is to build a predictive modeling for HIV testing and identify determinants of HIV testing for adults with age above fourteen years using data mining techniques. Methods: Cross-Industry Standard Process for Data Mining (CRISP-DM) was used to predict the model for HIV testing and explore association rules between HIV testing and the selected attributes among adult Ethiopians. Decision tree, Naïve-Bayes, logistic regression and artificial neural networks of data mining techniques were used to build the predictive models. Results: The target dataset contained 30,625 study participants; of which 16, 515 (53.9%) were women. Nearly two-fifth; 17,719 (58%), have never been tested for HIV while the rest 12,906 (42%) had been tested. Ethiopians with higher wealth index, higher educational level, belonging 20 to 29 years old, having no stigmatizing attitude towards HIV positive person, urban residents, having HIV related knowledge, information about family planning on mass media and knowing a place where to get testing for HIV showed an increased patterns with respect to HIV testing. Conclusion and Recommendation: Public health interventions should consider the identified determinants to promote people to get testing for HIV.

Keywords: data mining, HIV, testing, ethiopia

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Authors: L. Cruz-Lopes, M. Sell, P. Escudeiro, B. Esteves

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It might be difficult for deaf people to communicate since spoken and written languages are different from sign language. When it comes to getting information, going to places of cultural heritage, or using services and infrastructure, there is a clear lack of inclusiveness. By creating assistive technology that enables deaf individuals to get around communication hurdles and encourage inclusive tourism, the ICHT- Inclusive Cultural Heritage Tourism initiative hopes to increase knowledge of sign language. The purpose of the Inclusive Cultural Heritage Tourism (ICHT) project is to develop online and on-site sign language tools and material for usage at popular tourist destinations in the northern region of Portugal, including Torre dos Clérigos, the Lello bookstore, Maia Zoo, Porto wine cellars, and São Pedro do Sul (Viseu) thermae. The ICHT system consists of an application using holography, a mobile game, an online platform for collaboration with deaf and hearing users, and a collection of International Sign training courses. The project also offers a prospect for a more inclusive society by introducing a method of teaching sign languages to tourism industry professionals. As a result, the teaching and learning of sign language along with the assistive technology tools created by the project sets up an inclusive environment for the deaf community, producing results in the area of automatic sign language translation and aiding in the global recognition of the Portuguese tourism industry.

Keywords: inclusive tourism, games, international sign training, deaf community

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Authors: Danna Jia, Bin Li

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Background: Atopic dermatitis (AD) is a chronic and refractory inflammatory skin disease characterized by relapsing eczematous and pruritic skin lesions. The global prevalence of AD ranges from 1~ 20%, and its incidence rates are increasing. It affects individuals from infancy to adulthood, significantly impacting their daily lives and social activities. Despite its major health burden, the precise mechanisms underlying AD remain unknown. Understanding the genetic differences associated with AD is crucial for advancing diagnosis and targeted treatment development. This study aims to identify candidate genes of AD by using bioinformatics analysis. Methods: We conducted a comprehensive analysis of four pooled transcriptomic datasets (GSE16161, GSE32924, GSE130588, and GSE120721) obtained from the Gene Expression Omnibus (GEO) database. Differential gene expression analysis was performed using the R statistical language. The differentially expressed genes (DEGs) between AD patients and normal individuals were functionally analyzed using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. Furthermore, a protein-protein interaction (PPI) network was constructed to identify candidate genes. Results: Among the patient-level gene expression datasets, we identified 114 shared DEGs, consisting of 53 upregulated genes and 61 downregulated genes. Functional analysis using GO and KEGG revealed that the DEGs were mainly associated with the negative regulation of transcription from RNA polymerase II promoter, membrane-related functions, protein binding, and the Human papillomavirus infection pathway. Through the PPI network analysis, we identified eight core genes: CD44, STAT1, HMMR, AURKA, MKI67, and SMARCA4. Conclusion: This study elucidates key genes associated with AD, providing potential targets for diagnosis and treatment. The identified genes have the potential to contribute to the understanding and management of AD. The bioinformatics analysis conducted in this study offers new insights and directions for further research on AD. Future studies can focus on validating the functional roles of these genes and exploring their therapeutic potential in AD. While these findings will require further verification as achieved with experiments involving in vivo and in vitro models, these results provided some initial insights into dysfunctional inflammatory and immune responses associated with AD. Such information offers the potential to develop novel therapeutic targets for use in preventing and treating AD.

Keywords: atopic dermatitis, bioinformatics, biomarkers, genes

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