Search results for: financial risk
902 Longitudinal impact on Empowerment for Ugandan Women with Post-Primary Education
Authors: Shelley Jones
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Assumptions abound that education for girls will, as a matter of course, lead to their economic empowerment as women; yet. little is known about the ways in which schooling for girls, who traditionally/historically would not have had opportunities for post-primary, or perhaps even primary education – such as the participants in this study based in rural Uganda - in reality, impacts their economic situations. There is a need forlongitudinal studies in which women share experiences, understandings, and reflections of their lives that can inform our knowledge of this. In response, this paper reports on stage four of a longitudinal case study (2004-2018) focused on education and empowerment for girls and women in rural Uganda, in which 13 of the 15 participants from the original study participated. This paper understands empowerment as not simply increased opportunities (e.g., employment) but also real gains in power, freedoms that enable agentive action, and authentic and viable choices/alternatives that offer ‘exit options’ from unsatisfactory situations. As with the other stages, this study used a critical, postmodernist, global feminist ethnographic methodology, multimodal and qualitative data collection. Participants participated in interviews, focus group discussions, and a two-day workshop, which explored their understandings of how/if they understood post-primary education to have contributed to their economic empowerment. A constructivist grounded theory approach was used for data analysis to capture major themes. Findings indicate that although all participants believe that post-primary education provided them with economic opportunities they would not have had otherwise, the parameters of their economic empowerment were severely constrained by historic and extant sociocultural, economic, political, and institutional structures that continue to disempower girls and women, as well as additional financial responsibilities that they assumed to support others. Even though the participants had post-primary education, and they were able to obtain employment or operate their own businesses that they would not likely have been able to do without post-primary education, the majority of the participants’ incomes were not sufficient to elevate them financially above the extreme poverty level, especially as many were single mothers and the sole income earners in their households. Furthermore, most deemed their working conditions unsatisfactory and their positions precarious; they also experienced sexual harassment and abuse in the labour force. Additionally, employment for the participants resulted in a double work burden: long days at work, surrounded by many hours of domestic work at home (which, even if they had spousal partners, still fell almost exclusively to women). In conclusion, although the participants seem to have experienced some increase in economic empowerment, largely due to skills, knowledge, and qualifications gained at the post-primary level, numerous barriers prevented them from maximizing their capabilities and making significant gains in empowerment. There is need, in addition to providing education (primary, secondary, and tertiary) to girls, to address systemic gender inequalities that mitigate against women’s empowerment, as well as opportunities and freedom for women to come together and demand fair pay, reasonable working conditions, and benefits, freedom from gender-based harassment and assault in the workplace, as well as advocate for equal distribution of domestic work as a cultural change.Keywords: girls' post-primary education, women's empowerment, uganda, employment
Procedia PDF Downloads 141901 Co-management Organizations: A Way to Facilitate Sustainable Management of the Sundarbans Mangrove Forests of Bangladesh
Authors: Md. Wasiul Islam, Md. Jamius Shams Sowrov
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The Sundarbans is the largest single tract of mangrove forest in the world. This is located in the southwest corner of Bangladesh. This is a unique ecosystem which is a great breeding and nursing ground for a great biodiversity. It supports the livelihood of about 3.5 million coastal dwellers and also protects the coastal belt and inland areas from various natural calamities. Historically, the management of the Sundarbans was controlled by the Bangladesh Forest Department following top-down approach without the involvement of local communities. Such fence and fining-based blue-print approach was not effective to protect the forest which caused Sundarbans to degrade severely in the recent past. Fifty percent of the total tree cover has been lost in the last 30 years. Therefore, local multi-stakeholder based bottom-up co-management approach was introduced at some of the parts of the Sundarbans in 2006 to improve the biodiversity status by enhancing the protection level of the forest. Various co-management organizations were introduced under co-management approach where the local community people could actively involve in various activities related to the management and welfare of the Sundarbans including the decision-making process to achieve the goal. From this backdrop, the objective of the study was to assess the performance of co-management organizations to facilitate sustainable management of the Sundarbans mangrove forests. The qualitative study followed face-to-face interview to collect data using two sets of semi-structured questionnaires. A total of 40 respondents participated in the research that was from eight villagers under two forest ranges. 32 representatives from the local communities as well as 8 official representatives involved in co-management approach were interviewed using snowball sampling technique. The study shows that the co-management approach improved governance system of the Sundarbans through active participation of the local community people and their interactions with the officials via the platform of co-management organizations. It facilitated accountability and transparency system to some extent through following some formal and informal rules and regulations. It also improved the power structure of the management process by fostering local empowerment process particularly the women. Moreover, people were able to learn from their interactions with and within the co-management organizations as well as interventions improved environmental awareness and promoted social learning. The respondents considered good governance as the most important factor for achieving the goal of sustainable management and biodiversity conservation of the Sundarbans. The success of co-management planning process also depends on the active and functional participation of different stakeholders including the local communities where co-management organizations were considered as the most functional platform. However, the governance system was also facing various challenges which resulted in barriers to the sustainable management of the Sundarbans mangrove forest. But still there were some members involved in illegal forest operations and created obstacles against sustainable management of the Sundarbans. Respondents recommended greater patronization from the government, financial and logistic incentives for alternative income generation opportunities with effective participatory monitoring and evaluation system to improve sustainable management of the Sundarbans.Keywords: Bangladesh, co-management approach, co-management organizations, governance, Sundarbans, sustainable management
Procedia PDF Downloads 166900 Assessment of the State of Hygiene in a Tunisian Hospital Kitchen: Interest of Mycological and Parasitological Samples from Food Handlers and Environment
Authors: Bouchekoua Myriam, Aloui Dorsaf, Trabelsi Sonia
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Introduction Food hygiene in hospitals is important, particularly among patients who could be more vulnerable than healthy subjects to microbiological and nutritional risks. The consumption of contaminated food may be responsible for foodborne diseases, which can be severe among hospitalized patients, especially those immunocompromised. The aim of our study was to assess the state of hygiene in the internal catering department of a Tunisian hospital. Methodology and major results: A prospective study was conducted for one year in the Parasitology-Mycology laboratory of Charles Nicolle Hospital. Samples were taken from the kitchen staff, worktops, and cooking utensils used in the internal catering department. Thirty one employees have benefited from stool exams and scotch tape in order to evaluate the degree of infestation of parasites. 35% of stool exams were positive. Protozoa were the only parasites detected. Blastocystis sp was the species mostly found in nine food handlers. Its role as a human pathogen is still controversial. Pathogenic protozoa were detected in two food handlers (Giardia intestinalis in one person and Dientamoeba fragilis in the other one. Non-pathogenic protozoa were found in two cases; among them, only one had digestive symptoms without a statistically significant association with the carriage of intestinal parasites. Moreover, samples were performed from the hands of the staff in order to search for a fungal carriage. Thus, 25 employees (81%) were colonized by fungi, including molds. Besides, mycological examination among food handlers with a suspected dermatomycosis for diagnostic confirmation concluded foot onychomycosis in 32% of cases and interdigital intertrigo in 26%. Only one person had hand onychomycosis. Among the 17 samples taken from worktops and kitchen utensils, fungal contamination was detected in 13 sites. Hot and cold equipment were the most contaminated. Molds were mainly identified as belonging to five different genera. Cladosporium sp was predominant. Conclusion: In the view of the importance of intestinal parasites among food handlers, the intensity of fungi hand carriage among these employees, and the high level of fungal contamination in worktops and kitchen utensils, a reinforcement of hygiene measures is more than essential in order to minimize the alimentary contamination-risk.Keywords: hospital kitchen, environment, intestinal parasitosis, fungal carriage, fungal contamination
Procedia PDF Downloads 103899 A Systematic Review on Factors/Predictors and Outcomes of Parental Distress in Childhood Acute Lymphoblastic Leukemia
Authors: Ana Ferraz, Martim Santos, M. Graça Pereira
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Distress among parents of children with acute lymphoblastic leukemia (ALL) is common during treatment and can persist several years post-diagnosis, impacting the adjustment of children and parents themselves. Current evidence is needed to examine the scope and nature of parental distress in childhood ALL. This review focused on associated variables, predictors, and outcomes of parental distress following their ALL diagnosis of their child. PubMed, Web of Science, and PsycINFO databases were searched for English and Spanish papers published from 1983 to 2021. PRISMA statement was followed, and papers were evaluated through a standardized methodological quality assessment tool (NHLBI). Of the 28 papers included, 16 were evaluated as fair, eight as good, and four as poor. Regarding results, 11 papers reported subgroup differences, and 15 found potential predictors of parental distress, including sociodemographic, psychosocial, psychological, family, health, and ALL-specific variables. Significant correlations were found between parental distress, social support, illness cognitions, and resilience, as well as contradictory results regarding the impact of sociodemographic variables on parental distress. Family cohesion and caregiver burden were associated with distress, and the use of healthy coping strategies was associated with less anxiety. Caregiver strain contributed to distress, and the overall impact of illness positively predicted anxiety in mothers and somatization in fathers. Differences in parental distress were found regarding group risk, time since diagnosis, and treatment phases. Thirteen papers explored the outcomes of parental distress on psychological, family, health, and social/education outcomes. Parental distress was the most important predictor of family strain. Significant correlations were found between parental distress at diagnosis and further psychological adjustment of parents themselves and their children. Most papers reported correlations between parental distress on children’s adjustment and quality of life, although few studies reported no association. Correlations between maternal depression and child participation in education and social life were also found. Longitudinal studies are needed to better understand parental distress and its consequences on health outcomes, in particular. Future interventions should focus mainly on parents on distress reduction and psychological adjustment, both in parents and children over time.Keywords: childhood acute lymphoblastic leukemia, family, parental distress, psychological adjustment, quality of life
Procedia PDF Downloads 102898 Adequacy of Antenatal Care and Its Relationship with Low Birth Weight in Botucatu, São Paulo, Brazil: A Case-Control Study
Authors: Cátia Regina Branco da Fonseca, Maria Wany Louzada Strufaldi, Lídia Raquel de Carvalho, Rosana Fiorini Puccini
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Background: Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. The purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil. Methods: A case-control study was conducted in Botucatu, São Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the official medical records of pregnant women). The study population consisted of two groups, each with 860 newborns. The case group comprised newborns weighing less than 2,500 grams, while the control group comprised live newborns weighing greater than or equal to 2,500 grams. Adequacy of ANC was evaluated according to three measurements: 1. Adequacy of the number of ANC visits adjusted to gestational age; 2. Modified Kessner Index; and 3. Adequacy of ANC laboratory studies and exams summary measure according to parameters defined by the Ministry of Health in the Program for Prenatal and Birth Care Humanization. Results: Analyses revealed that LBW was associated with the number of ANC visits adjusted to gestational age (OR = 1.78, 95% CI 1.32-2.34) and the ANC laboratory studies and exams summary measure (OR = 4.13, 95% CI 1.36-12.51). According to the modified Kessner Index, 64.4% of antenatal visits in the LBW group were adequate, with no differences between groups. Conclusions: Our data corroborate the association between inadequate number of ANC visits, laboratory studies and exams, and increased risk of LBW newborns. No association was found between the modified Kessner Index as a measure of adequacy of ANC and LBW. This finding reveals the low indices of coverage for basic actions already well regulated in the Health System in Brazil. Despite the association found in the study, we cannot conclude that LBW would be prevented only by an adequate ANC, as LBW is associated with factors of complex and multifactorial etiology. The results could be used to plan monitoring measures and evaluate programs of health care assistance during pregnancy, at delivery and to newborns, focusing on reduced LBW rates.Keywords: low birth weight, antenatal care, prenatal care, adequacy of health care, health evaluation, public health system
Procedia PDF Downloads 423897 Navigating through Uncertainty: An Explorative Study of Managers’ Experiences in China-foreign Cooperative Higher Education
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To drive practical interpretations and applications of various policies in building the transnational education joint-ventures, middle managers learn to navigate through uncertainties and ambiguities. However, the current literature views very little about those middle managers’ experiences, perceptions, and practices. This paper takes the empirical approach and aims to uncover the middle managers’ experiences by conducting interviews, campus visits, and document analysis. Following the qualitative research method approach, the researchers gathered information from a mixture of fourteen foreign and Chinese managers. Their perceptions of the China-foreign cooperation in higher education and their perceived roles have offered important, valuable insights to this group of people’s attitudes and management performances. The diverse cultural and demographic backgrounds contributed to the significance of the study. There are four key findings. One, middle managers’ immediate micro-contexts and individual attitudes are the top two influential factors in managers’ performances. Two, the foreign middle managers showed a stronger sense of self-identity in risk-taking. Three, the Chinese middle managers preferred to see difficulties as part of their assigned responsibilities. Four, middle managers in independent universities demonstrated a stronger sense of belonging and fewer frustrations than middle managers in secondary institutes. The researchers propose that training for managers in a transnational educational setting should consider these discoveries when select fitting topics and content. In particular, middle managers should be better prepared to anticipate their everyday jobs in the micro-environment; hence, information concerning sponsor organizations’ working culture is as essential as knowing the national and local regulations, and socio-culture. Different case studies can help the managers to recognize and celebrate the diversity in transnational education. Situational stories can help them to become aware of the diverse and wide range of work contexts so that they will not feel to be left alone when facing challenges without relevant previous experience or training. Though this research is a case study based in the Chinese transnational higher education setting, the implications could be relevant and comparable to other transnational higher education situations and help to continue expanding the potential applications in this field.Keywords: educational management, middle manager performance, transnational higher education
Procedia PDF Downloads 154896 Evaluation of Human Amnion Hemocompatibility as a Substitute for Vessels
Authors: Ghasem Yazdanpanah, Mona Kakavand, Hassan Niknejad
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Objectives: An important issue in tissue engineering (TE) is hemocompatibility. The current engineered vessels are seriously at risk of thrombus formation and stenosis. Amnion (AM) is the innermost layer of fetal membranes that consists of epithelial and mesenchymal sides. It has the advantages of low immunogenicity, anti-inflammatory and anti-bacterial properties as well as good mechanical properties. We recently introduced the amnion as a natural biomaterial for tissue engineering. In this study, we have evaluated hemocompatibility of amnion as potential biomaterial for tissue engineering. Materials and Methods: Amnions were derived from placentas of elective caesarean deliveries which were in the gestational ages 36 to 38 weeks. Extracted amnions were washed by cold PBS to remove blood remnants. Blood samples were obtained from healthy adult volunteers who had not previously taken anti-coagulants. The blood samples were maintained in sterile tubes containing sodium citrate. Plasma or platelet rich plasma (PRP) were collected by blood sample centrifuging at 600 g for 10 min. Hemocompatibility of the AM samples (n=7) were evaluated by measuring of activated partial thromboplastin time (aPTT), prothrombin time (PT), hemolysis, and platelet aggregation tests. P-selectin was also assessed by ELISA. Both epithelial and mesenchymal sides of amnion were evaluated. Glass slide and expanded polytetrafluoroethylene (ePTFE) samples were defined as control. Results: In comparison with glass as control (13.3 ± 0.7 s), prothrombin time was increased significantly while each side of amnion was in contact with plasma (p<0.05). There was no significant difference in PT between epithelial and mesenchymal surfaces (17.4 ± 0.7 s vs. 15.8 ± 0.7 s, respectively). However, aPPT was not significantly changed after incubation of plasma with amnion epithelial and mesenchymal surfaces or glass (28.61 ± 1.39 s, 31.4 ± 2.66 s, glass, 30.76 ± 2.53 s, respectively, p>0.05). Amnion surfaces, ePTFE and glass samples have less hemolysis induction than water considerably (p<0.001), in which no differences were detected. Platelet aggregation measurements showed that platelets were less stimulated by the amnion epithelial and mesenchymal sides, in comparison with ePTFE and glass. In addition, reduction in amount of p-selectin, as platelet activation factor, after incubation of samples with PRP indicated that amnion has less stimulatory effects on platelets than ePTFE and glass. Conclusion: Amnion as a natural biomaterial has the potential to be used in tissue engineering. Our results suggest that amnion has appropriate hemocompatibility to be employed as a vascular substitute.Keywords: amnion, hemocompatibility, tissue engineering, biomaterial
Procedia PDF Downloads 386895 Effect of Automatic Self Transcending Meditation on Perceived Stress and Sleep Quality in Adults
Authors: Divya Kanchibhotla, Shashank Kulkarni, Shweta Singh
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Chronic stress and sleep quality reduces mental health and increases the risk of developing depression and anxiety as well. There is increasing evidence for the utility of meditation as an adjunct clinical intervention for conditions like depression and anxiety. The present study is an attempt to explore the impact of Sahaj Samadhi Meditation (SSM), a category of Automatic Self Transcending Meditation (ASTM), on perceived stress and sleep quality in adults. The study design was a single group pre-post assessment. Perceived Stress Scale (PSS) and the Pittsburgh Sleep Quality Index (PSQI) were used in this study. Fifty-two participants filled PSS, and 60 participants filled PSQI at the beginning of the program (day 0), after two weeks (day 16) and at two months (day 60). Significant pre-post differences for the perceived stress level on Day 0 - Day 16 (p < 0.01; Cohen's d = 0.46) and Day 0 - Day 60 (p < 0.01; Cohen's d = 0.76) clearly demonstrated that by practicing SSM, participants experienced reduction in the perceived stress. The effect size of the intervention observed on the 16th day of assessment was small to medium, but on the 60th day, a medium to large effect size of the intervention was observed. In addition to this, significant pre-post differences for the sleep quality on Day 0 - Day 16 and Day 0 - Day 60 (p < 0.05) clearly demonstrated that by practicing SSM, participants experienced improvement in the sleep quality. Compared with Day 0 assessment, participants demonstrated significant improvement in the quality of sleep on Day 16 and Day 60. The effect size of the intervention observed on the 16th day of assessment was small, but on the 60th day, a small to medium effect size of the intervention was observed. In the current study we found out that after practicing SSM for two months, participants reported a reduction in the perceived stress, they felt that they are more confident about their ability to handle personal problems, were able to cope with all the things that they had to do, felt that they were on top of the things, and felt less angered. Participants also reported that their overall sleep quality improved; they took less time to fall asleep; they had less disturbances in sleep and less daytime dysfunction due to sleep deprivation. The present study provides clear evidence of the efficacy and safety of non-pharmacological interventions such as SSM in reducing stress and improving sleep quality. Thus, ASTM may be considered a useful intervention to reduce psychological distress in healthy, non-clinical populations, and it can be an alternative remedy for treating poor sleep among individuals and decreasing the use of harmful sedatives.Keywords: automatic self transcending meditation, Sahaj Samadhi meditation, sleep, stress
Procedia PDF Downloads 128894 Investigation of the Role of Lipoprotein a rs10455872 Gene Polymorphism in Childhood Obesity
Authors: Mustafa M. Donma, Ayşen Haksayar, Bahadır Batar, Buse Tepe, Birol Topçu, Orkide Donma
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Childhood obesity is an ever-increasing health problem. The Association of obesity with severe chronic diseases such as diabetes and cardiovascular diseases makes the problem life-threatening. Aside from psychological, societal and metabolic factors, genetic polymorphisms have gained importance concerning etiology in recent years. The aim of this study was to evaluate the relationship between rs10455872 gene polymorphism in the Lipoprotein (a) locus and the development of childhood obesity. This was a prospective study carried out according to the Helsinki Declarations. The study protocol was approved by the Institutional Ethics Committee. This study was supported by Tekirdag Namik Kemal University Rectorate, Scientific Research Projects Coordination Unit. Project No: NKUBAP.02.TU.20.278. A total of 180 children (103 obese (OB) and 77 healthy), aged 6-18 years, without any acute or chronic disease, participated in the study. Two different groups were created: OB and healthy control. Each group was divided into two further groups depending on the nature of the polymorphism. Anthropometric measurements were taken during the detailed physical examination. Laboratory tests and TANITA measurements were performed. For the statistical evaluations, SPSS version 28.0 was used. A P-value smaller than 0.05 was the statistical significance degree. The distribution of lipoprotein (a) rs10455872 gene polymorphism did not differ between OB and healthy children. Children with AG genotype in both OB and control groups had lower body mass index (BMI), diagnostic obesity notation model assessment index (DONMA II), body fat ratio (BFR), C-reactive protein (CRP), and metabolic syndrome index (MetS index) values compared to children with normal AA genotype. In the OB group, serum iron, vitamin B12, hemoglobin, MCV, and MCH values were found to be higher in the AG genotype group than those of children with the normal AA genotype. A significant correlation was found between the MetS index and BFR among OB children with normal homozygous genotype. MetS index increased as BFR increased in this group. However, such a correlation was not observed in the OB group with heterozygous AG genotype. To the best of our knowledge, the association of lipoprotein (a) rs10455872 gene polymorphism with the etiology of childhood obesity has not been studied yet. Therefore, this study was the first report suggesting polymorphism with AG genotype as a good risk factor for obesity.Keywords: child, gene polymorphism, lipoprotein (a), obesity, rs10455872
Procedia PDF Downloads 64893 Effects of Concomitant Use of Metformin and Powdered Moringa Oleifera Leaves on Glucose Tolerance in Sprague-Dawley Rats
Authors: Emielex M. Aguilar, Kristen Angela G. Cruz, Czarina Joie L. Rivera, Francis Dave C. Tan, Gavino Ivan N. Tanodra, Dianne Katrina G. Usana, Mary Grace T. Valentin, Nico Albert S. Vasquez, Edwin Monico C. Wee
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The risk of diabetes mellitus is increasing in the Philippines, with Metformin and Insulin as drugs commonly used for its management. The use of herbal medicines has grown increasingly, especially among the elderly population. Moringa oleifera or malunggay is one of the most common plants in the country, and several studies have shown the plant to exhibit a hypoglycemic property with its flavonoid content. This study aims to investigate the possible effects of concomitant use of Metformin and powdered M. oleifera leaves (PMOL) on blood glucose levels. Twenty male Sprague-Dawley rats were equally distributed into four groups. Fasting blood glucose levels of the rats were measured prior to experimentation. The following treatments were administered to the four groups, respectively: glucose only 2 g/kg; glucose 2 g/kg + Metformin 100 mg/kg; glucose 2 g/kg + PMOL 200 mg/kg; and glucose 2 g/kg + PMOL 200 mg/kg and Metformin 100 mg/kg. Blood glucose levels were determined on the 1st, 2nd, 3rd, and 4th hour post-treatment and compared between groups. Statistical analysis showed that the type of intervention did not show significance in the reduction of blood glucose levels when compared with the other groups (p=0.378), while the effect of time exhibited significance (p=0.000). The interaction between the type of intervention and time of blood glucose measurement was shown to be significant (p=0.024). Within each group, the control and PMOL-treated groups showed significant reduction in blood glucose levels over time with p-values of 0.000 and 0.000, respectively, while the Metformin-treated and the combination groups had p-values of 0.062 and 0.093, respectively, which are not significant. The descriptive data also showed that the mean total reduction of blood glucose levels of the Metformin and PMOL combination treatment group was lower than the PMOL-treated group alone, while the mean total reduction of blood glucose levels of the combination group was higher than the Metformin-treated group alone. Based on the results obtained, the combination of Metformin and PMOL did not significantly lower the blood glucose levels of the rats as compared to the other groups. However, the concomitant use of Metformin and PMOL may affect each other’s blood glucose lowering activity. Additionally, prolonged time of exposure and delay in the first blood glucose measurement after treatment could exhibit a significant effect in the blood glucose levels. Further studies are recommended regarding the effects of the concomitant use of the two agents on blood glucose levels.Keywords: blood glucose levels, concomitant use, metformin, Moringa oleifera
Procedia PDF Downloads 400892 Attributable Mortality of Nosocomial Infection: A Nested Case Control Study in Tunisia
Authors: S. Ben Fredj, H. Ghali, M. Ben Rejeb, S. Layouni, S. Khefacha, L. Dhidah, H. Said
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Background: The Intensive Care Unit (ICU) provides continuous care and uses a high level of treatment technologies. Although developed country hospitals allocate only 5–10% of beds in critical care areas, approximately 20% of nosocomial infections (NI) occur among patients treated in ICUs. Whereas in the developing countries the situation is still less accurate. The aim of our study is to assess mortality rates in ICUs and to determine its predictive factors. Methods: We carried out a nested case-control study in a 630-beds public tertiary care hospital in Eastern Tunisia. We included in the study all patients hospitalized for more than two days in the surgical or medical ICU during the entire period of the surveillance. Cases were patients who died before ICU discharge, whereas controls were patients who survived to discharge. NIs were diagnosed according to the definitions of ‘Comité Technique des Infections Nosocomiales et les Infections Liées aux Soins’ (CTINLIS, France). Data collection was based on the protocol of Rea-RAISIN 2009 of the National Institute for Health Watch (InVS, France). Results: Overall, 301 patients were enrolled from medical and surgical ICUs. The mean age was 44.8 ± 21.3 years. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR= 2.9, 95% CI, 1.6 to 5.3). The population-attributable fraction due to ICU-NI in patients who died before ICU discharge was 23.46% (95% CI, 13.43%–29.04%). Overall, 62 case-patients were compared to 239 control patients for the final analysis. Case patients and control patients differed by age (p=0,003), simplified acute physiology score II (p < 10-3), NI (p < 10-3), nosocomial pneumonia (p=0.008), infection upon admission (p=0.002), immunosuppression (p=0.006), days of intubation (p < 10-3), tracheostomy (p=0.004), days with urinary catheterization (p < 10-3), days with CVC ( p=0.03), and length of stay in ICU (p=0.003). Multivariate analysis demonstrated 3 factors: age older than 65 years (OR, 5.78 [95% CI, 2.03-16.05] p=0.001), duration of intubation 1-10 days (OR, 6.82 [95% CI, [1.90-24.45] p=0.003), duration of intubation > 10 days (OR, 11.11 [95% CI, [2.85-43.28] p=0.001), duration of CVC 1-7 days (OR, 6.85[95% CI, [1.71-27.45] p=0.007) and duration of CVC > 7 days (OR, 5.55[95% CI, [1.70-18.04] p=0.004). Conclusion: While surveillance provides important baseline data, successful trials with more active intervention protocols, adopting multimodal approach for the prevention of nosocomial infection incited us to think about the feasibility of similar trial in our context. Therefore, the implementation of an efficient infection control strategy is a crucial step to improve the quality of care.Keywords: intensive care unit, mortality, nosocomial infection, risk factors
Procedia PDF Downloads 399891 South African Multiple Deprivation-Concentration Index Quantiles Differentiated by Components of Success and Impediment to Tuberculosis Control Programme Using Mathematical Modelling in Rural O. R. Tambo District Health Facilities
Authors: Ntandazo Dlatu, Benjamin Longo-Mbenza, Andre Renzaho, Ruffin Appalata, Yolande Yvonne Valeria Matoumona Mavoungou, Mbenza Ben Longo, Kenneth Ekoru, Blaise Makoso, Gedeon Longo Longo
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Background: The gap between complexities related to the integration of Tuberculosis /HIV control and evidence-based knowledge motivated the initiation of the study. Therefore, the objective of this study was to explore correlations between national TB management guidelines, multiple deprivation indexes, quantiles, components and levels of Tuberculosis control programme using mathematical modeling in rural O.R. Tambo District Health Facilities, South Africa. Methods: The study design used mixed secondary data analysis and cross-sectional analysis between 2009 and 2013 across O.R Tambo District, Eastern Cape, South Africa using univariate/ bivariate analysis, linear multiple regression models, and multivariate discriminant analysis. Health inequalities indicators and component of an impediment to the tuberculosis control programme were evaluated. Results: In total, 62 400 records for TB notification were analyzed for the period 2009-2013. There was a significant but negative between Financial Year Expenditure (r= -0.894; P= 0.041) Seropositive HIV status(r= -0.979; P= 0.004), Population Density (r = -0.881; P= 0.048) and the number of TB defaulter in all TB cases. It was shown unsuccessful control of TB management program through correlations between numbers of new PTB smear positive, TB defaulter new smear-positive, TB failure all TB, Pulmonary Tuberculosis case finding index and deprivation-concentration-dispersion index. It was shown successful TB program control through significant and negative associations between declining numbers of death in co-infection of HIV and TB, TB deaths all TB and SMIAD gradient/ deprivation-concentration-dispersion index. The multivariate linear model was summarized by unadjusted r of 96%, adjusted R2 of 95 %, Standard Error of estimate of 0.110, R2 changed of 0.959 and significance for variance change for P=0.004 to explain the prediction of TB defaulter in all TB with equation y= 8.558-0.979 x number of HIV seropositive. After adjusting for confounding factors (PTB case finding the index, TB defaulter new smear-positive, TB death in all TB, TB defaulter all TB, and TB failure in all TB). The HIV and TB death, as well as new PTB smear positive, were identified as the most important, significant, and independent indicator to discriminate most deprived deprivation index far from other deprivation quintiles 2-5 using discriminant analysis. Conclusion: Elimination of poverty such as overcrowding, lack of sanitation and environment of highest burden of HIV might end the TB threat in O.R Tambo District, Eastern Cape, South Africa. Furthermore, ongoing adequate budget comprehensive, holistic and collaborative initiative towards Sustainable Developmental Goals (SDGs) is necessary for complete elimination of TB in poor O.R Tambo District.Keywords: tuberculosis, HIV/AIDS, success, failure, control program, health inequalities, South Africa
Procedia PDF Downloads 154890 Standardizing and Achieving Protocol Objectives for ChestWall Radiotherapy Treatment Planning Process using an O-ring Linac in High-, Low- and Middle-income Countries
Authors: Milton Ixquiac, Erick Montenegro, Francisco Reynoso, Matthew Schmidt, Thomas Mazur, Tianyu Zhao, Hiram Gay, Geoffrey Hugo, Lauren Henke, Jeff Michael Michalski, Angel Velarde, Vicky de Falla, Franky Reyes, Osmar Hernandez, Edgar Aparicio Ruiz, Baozhou Sun
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Purpose: Radiotherapy departments in low- and middle-income countries (LMICs) like Guatemala have recently introduced intensity-modulated radiotherapy (IMRT). IMRT has become the standard of care in high-income countries (HIC) due to reduced toxicity and improved outcomes in some cancers. The purpose of this work is to show the agreement between the dosimetric results shown in the Dose Volume Histograms (DVH) to the objectives proposed in the adopted protocol. This is the initial experience with an O-ring Linac. Methods and Materials: An O-Linac Linac was installed at our clinic in Guatemala in 2019 and has been used to treat approximately 90 patients daily with IMRT. This Linac is a completely Image Guided Device since to deliver each radiotherapy session must take a Mega Voltage Cone Beam Computerized Tomography (MVCBCT). In each MVCBCT, the Linac deliver 9 UM, and they are taken into account while performing the planning. To start the standardization, the TG263 was employed in the nomenclature and adopted a hypofractionated protocol to treat ChestWall, including supraclavicular nodes achieving 40.05Gy in 15 fractions. The planning was developed using 4 semiarcs from 179-305 degrees. The planner must create optimization volumes for targets and Organs at Risk (OARs); the difficulty for the planner was the dose base due to the MVCBCT. To evaluate the planning modality, we used 30 chestwall cases. Results: The plans created manually achieve the protocol objectives. The protocol objectives are the same as the RTOG1005, and the DHV curves look clinically acceptable. Conclusions: Despite the O-ring Linac doesn´t have the capacity to obtain kv images, the cone beam CT was created using MV energy, the dose delivered by the daily image setup process still without affect the dosimetric quality of the plans, and the dose distribution is acceptable achieving the protocol objectives.Keywords: hypofrationation, VMAT, chestwall, radiotherapy planning
Procedia PDF Downloads 104889 An AHP Study on The Migrant and Refugee Employees Occupational Health and Safety Issues in Turkey
Authors: Cengiz Akyildiz, Ismail Ekmekci
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In the past 15 years, many people have sought refuge and emigrated to developed countries due to the civil war in Syria, terrorism and turmoil in Iraq, Iran and Afghanistan, hunger problems in Africa and the purpose of work. Many of these people came to Turkey. By the end of the 2019, in Turkey, regular and irregular migrants, asylum seekers and foreigners under international protection are about 6 million people. The majority of these people are Syrians. Approximately 2 800 000 immigrants and refugees are in the workforce. Migrant workers in our country constitute the largest proportion among all countries in the world according to the local labor force. 2.5 million of these employees, with a high rate of about 90%, work informally and do not have legal records and valid employment contracts as a workforce; They cannot benefit from Occupational Health and Safety (OHS) services. Migrant workers generally receive less wages than local workers, working longer hours and worse conditions; they are often subjected to human rights violations, harassment, human trafficking and violence. Migrant workers face problems such as OHS practices, environmental and occupational exposures, language / cultural barriers, access to health services, and lack of documentation. Therefore, the OHS problems of these employees are becoming an increasingly problematic area. However, there is not enough research, analysis and academic studies in this field. The order of importance should be known for the radical solution of the problems, because of the problems with high severity are also at high risk. In this study, for the first time, a Search Conference was held with the participation of 45 stakeholders to reveal the OHS problems of regular and irregular migrant workers in our country. The problems arising from this workshop were compared with the problems in the literature and the problems in this field were determined and weighted for our country. Later, to determine the significance levels of these problems, AHP study, which is a Multi Criteria Decision Making Method in which 15 experts participated, was conducted and the significance levels of these problems were determined. When the data obtained are evaluated, it has been seen that the OSH risks of migrant workers arise from 58% laws and government policies, 29% from employers, 13% from personal faults of employees. An academic study has been carried out for the first time in this field regarding the OHS problems of migrant workers, and an academic study has been created to guide which of the problems should be prioritized.Keywords: environmental conditions, migrant workers, OHS issues, workplace conditions
Procedia PDF Downloads 142888 Understanding Awareness, Agency and Autonomy of Mothers and Potential of Digital Technology in Expanding Maternal Health Information Access: A Survey of Mothers in Urban India
Authors: Sumiti Saharan, Pallav Patankar, Lily W. Lee
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Understanding the health-seeking behaviors and attitudes of women towards maternal health in the context of gender roles and family dynamics is tremendously crucial for designing effective and impactful interventions aimed at improving maternal and child health outcomes. Further, as the digital world becomes more accessible and affordable, it is imperative to scope the potential of digital technology in enabling access to maternal health information in different socio-economic groups (SEGs). In the summer of 2017, we conducted a study with 500 women across different SEGs in urban India who were pregnant or had had a delivery in the last year. The study was undertaken to assess their maternal health information seeking behavior with a particular focus on probing their use of digital technology for health-related information. The study also measured women's decision-making autonomy in the context of maternal health, awareness of their rights to quality and respectful maternal healthcare, and agency to voice their rights. We probed the impact of key variables including education, age, and socioeconomic status on all outcome variables. In terms of health-seeking behaviors, we found that women heavily relied on medical professionals and/or their mothers and mothers-in-law for all maternal health advice. Digital adoption was found to be high across all SEGs, with around 70% of women from all populations using the internet several times a week. On the other hand, use of the internet for both accessing maternal health information and choosing maternity hospitals were both significantly dependent on SEG. The key reasons reported for not using the internet for health purposes were lack of awareness and lack of trust on content accuracy. Decisions around health practices and type of delivery were found to be jointly made by women and other family members. Almost all women reported their husbands to play a key role in all maternal health decisions and for decisions with a clear financial implication like choice of hospital for delivery, husbands were reported to be the sole decision maker by a majority of women. The agency of women was also found to be low in interactions with maternal healthcare providers with a third of respondents not comfortable with voicing their opinions and preferences to their doctors. Interestingly, we find that this relatively low agency was prominent in both lower middle class and middle-class SEGs. Recognition of the sociocultural determinants of behavior is the first step in developing actionable strategies for improving maternal health outcomes. Our study quantifies the agency and autonomy of women in urban India and the variables that impact them. Our findings emphasize the value of gender normative approaches that factor in the key role husbands play in guiding maternal health decisions. They also highlight the power of digital approaches for catalyzing access to maternal health information. These insights into the attitude and behaviors of mothers in context of their sociocultural environments—and their relationship with digital technology—can help pave the way towards designing effective, scalable maternal and child health programs in developing nations like India.Keywords: access to healthcare information, behavior, digital health, maternal health
Procedia PDF Downloads 129887 The Use of Telecare in the Re-design of Overnight Supports for People with Learning Disabilities: Implementing a Cluster-based Approach in North Ayrshire
Authors: Carly Nesvat, Dominic Jarrett, Colin Thomson, Wilma Coltart, Thelma Bowers, Jan Thomson
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Introduction: Within Scotland, the Same As You strategy committed to moving people with learning disabilities out of long-stay hospital accommodation into homes in the community. Much of the focus of this movement was on the placement of people within individual homes. In order to achieve this, potentially excessive supports were put in place which created dependence, and carried significant ongoing cost primarily for local authorities. The greater focus on empowerment and community participation which has been evident in more recent learning disability strategy, along with the financial pressures being experienced across the public sector, created an imperative to re-examine that provision, particularly in relation to the use of expensive sleepover supports to individuals, and the potential for this to be appropriately scaled back through the use of telecare. Method: As part of a broader programme of redesigning overnight supports within North Ayrshire, a cluster of individuals living in close proximity were identified, who were in receipt of overnight supports, but who were identified as having the capacity to potentially benefit from their removal. In their place, a responder service was established (an individual staying overnight in a nearby service user’s home), and a variety of telecare solutions were placed within individual’s homes. Active and passive technology was connected to an Alarm Receiving Centre, which would alert the local responder service when necessary. Individuals and their families were prepared for the change, and continued to be informed about progress with the pilot. Results: 4 individuals, 2 of whom shared a tenancy, had their sleepover supports removed as part of the pilot. Extensive data collection in relation to alarm activation was combined with feedback from the 4 individuals, their families, and staff involved in their support. Varying perspectives emerged within the feedback. 3 of the individuals were clearly described as benefitting from the change, and the greater sense of independence it brought, while more concerns were evident in relation to the fourth. Some family members expressed a need for greater preparation in relation to the change and ongoing information provision. Some support staff also expressed a need for more information, to help them understand the new support arrangements for an individual, as well as noting concerns in relation to the outcomes for one participant. Conclusion: Developing a telecare response in relation to a cluster of individuals was facilitated by them all being supported by the same care provider. The number of similar clusters of individuals being identified within North Ayrshire is limited. Developing other solutions such as a response service for redesign will potentially require greater collaboration between different providers of home support, as well as continuing to explore the full range of telecare, including digital options. The pilot has highlighted the need for effective preparatory and ongoing engagement with staff and families, as well as the challenges which can accompany making changes to long-standing packages of support.Keywords: challenges, change, engagement, telecare
Procedia PDF Downloads 164886 Cercarial Diversity in Freshwater Snails from Selected Freshwater Bodies and Its Implication for Veterinary and Public Health in Kaduna State, Nigeria
Authors: Fatima Muhammad Abdulkadir, D. B. Maikaje, Y. A. Umar
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A study conducted to determine cercariae diversity and prevalence of trematode infection in freshwater snails from six freshwater bodies selected by systematic random sampling in Kaduna State was carried from January 2013 to December 2013. Freshwater snails and cercariae harvested from the study sites were morphologically identified. A total of 23,823 freshwater snails were collected from the six freshwater bodies: Bagoma dam, Gimbawa dam, Kangimi dam, Kubacha dam, Manchok water intake and Saminaka water intake. The observed freshwater snail species were: Melanoides tuberculata, Biomphalaria pfeifferi, Bulinus globosus, Lymnaea natalensis, Physa sp., Cleopatra bulimoides, Bellamya unicolor and Lanistes varicus. The freshwater snails were exposed to artificial bright light from a 100 Watt electric bulb in the laboratory to induce cercarial shedding. Of the total freshwater snails collected, 10.55% released one or more types of cercariae. Seven morphological types of cercariae were shed by six freshwater snail species namely: Brevifurcate-apharyngeate distome, Amphistome, Gymnocephalus, Longifurcate-pharyngeate monostome, Longifurcate-pharyngeate distome, Echinostome and Xiphidio cercariae. Infection was monotype in most of the freshwater snails collected; however, Physa species presented a mixed infection with Gymnocephalus and Longifurcate-pharyngeate distome cercariae. B. globosus and B. pfeifferi were the most preferred intermediate hosts with the prevalence of 13.48% and 13.46%, respectively. The diversity and prevalence of cercariae varied among the six freshwater bodies with Manchok water intake having the highest infestation (14.3%) and the least recorded in Kangimi dam (3.9%). There was a correlation trend between the number of freshwater snails and trematode infection with Manchok exhibiting the highest and Bagoma none. The highest cercarial diversity was observed in B. pfeifferi and B. globosus with four morphotypes each, and the lowest was in M. tuberculata with one morphotype. The general distribution of freshwater snails and the trematode cercariae they shed suggests the risk of human and animals to trematodiasis in Manchok community. Public health education to raise awareness on individual and communal action that may control snail breeding sites, prevent transmission and provide access to treatment should be intensified.Keywords: Cercariae, diversity, freshwater snails, prevalence, trematodiasis
Procedia PDF Downloads 219885 Identifying Physical and Psycho-Social Issues Facing Breast Cancer Survivors after Definitive Treatment for Early Breast Cancer: A Nurse-Led Clinic Model
Authors: A. Dean, M. Pitcher, L. Storer, K. Shanahan, I. Rio, B. Mann
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Purpose: Breast cancer survivors are at risk of specific physical and psycho-social issues, such as arm swelling, fatigue, and depression. Firstly, we investigate symptoms reported by Australia breast cancer survivors upon completion of definitive treatment. Secondly, we evaluate the appropriateness and effectiveness of a multi-centre pilot program nurse-led clinic to identify these issues and make timely referrals to available services. Methods: Patients post-definitive treatment (excluding ongoing hormonal therapy) for early breast cancer or ductal carcinoma in situ were invited to participate. An hour long appointment with a breast care nurse (BCN) was scheduled. In preparation, patients completed validated quality-of-life surveys (FACT-B, Menopause Rating Scale, Distress Thermometer). During the appointment, issues identified in the surveys were addressed and referrals to appropriate services arranged. Results: 183 of 274 (67%) eligible patients attended a nurse-led clinic. Mean age 56.8 years (range 29-87 years), 181/183 women, 105/183 post-menopausal. 96 (55%) participants reported significant level of distress; 31 (18%) participants reported extreme distress or depression. Distress stemmed from a lack of energy (56/175); poor quality of sleep (50/176); inability to work or participate in household activities (35/172) and problems with sex life (28/89). 166 referrals were offered; 94% of patients accepted the referrals. 65% responded to a follow-up survey: the majority of women either strongly agreed or agreed that the BCN was overwhelmingly supportive, helpful in making referrals, and compassionate towards them. 39% reported making lifestyle changes as a result of the BCN. Conclusion: Breast cancer survivors experience a unique set of challenges, including low mood, difficulty sleeping, problems with sex life and fear of disease recurrence. The nurse-led clinic model is an appropriate and effective method to ensure physical and psycho-social issues are identified and managed in a timely manner. This model empowers breast cancer survivors with information about their diagnosis and available services.Keywords: early breast cancer, survivorship, breast care nursing, oncology nursing and cancer care
Procedia PDF Downloads 390884 Athlete Coping: Personality Dimensions of Recovery from Injury
Authors: Randall E. Osborne, Seth A. Doty
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As participation in organized sports increases, so does the risk of sustaining an athletic injury. These unfortunate injuries result in missed time from practice and, inevitably, the field of competition. Recovery time plays a pivotal role in the overall rehabilitation of the athlete. With time and rehabilitation, an athlete’s physical injury can be properly treated. However, there seem to be few measures assessing psychological recovery from injury. Although an athlete has been cleared to return to play, there may still be lingering doubt about their injury. Overall, there is a vast difference between being physically cleared to play and being psychologically ready to return to play. Certain personality traits might serve as predictors of an individual’s rate of psychological recovery from an injury. The purpose of this research study is to explore the correlations between athletes’ personality and their recovery from an athletic injury, specifically, examining how locus of control has been utilized through other studies and can be beneficial to the current study. Additionally, this section will examine the link between hardiness and coping strategies. In the current study, mental toughness is being tested, but it is important to determine the link between these two concepts. Hardiness and coping strategies are closely related and can play a major role in an athlete’s mental toughness. It is important to examine competitive trait anxiety to illustrate perceived anxiety during athletic competition. The Big 5 and Social Support will also be examined in conjunction with recovery from athletic injury. Athletic injury is a devastating and common occurrence that can happen in any sport. Injured athletes often require resources and treatment to be able to return to the field of play. Athletes become more involved with physical and mental treatment as the length of recovery time increases. It is very reasonable to assume that personality traits would be predictive of athlete recovery from injury. The current study investigated the potential relationship between personality traits and recovery time; more specifically, the personality traits of locus of control, hardiness, social support, competitive trait anxiety, and the “Big 5” personality traits. Results indicated that athletes with a higher internal locus of control tend to report being physically ready to return to play and “ready” to return to play faster than those with an external locus of control. Additionally, Openness to Experience (among the Big 5 personality dimensions) was also related to the speed of return to play.Keywords: athlete, injury, personality, readiness to play, recovery
Procedia PDF Downloads 128883 Influence of Plant Cover and Redistributing Rainfall on Green Roof Retention and Plant Drought Stress
Authors: Lubaina Soni, Claire Farrell, Christopher Szota, Tim D. Fletcher
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Green roofs are a promising engineered ecosystem for reducing stormwater runoff and restoring vegetation cover in cities. Plants can contribute to rainfall retention by rapidly depleting water in the substrate; however, this increases the risk of plant drought stress. Green roof configurations, therefore, need to provide plants the opportunity to efficiently deplete the substrate but also avoid severe drought stress. This study used green roof modules placed in a rainout shelter during a six-month rainfall regime simulated in Melbourne, Australia. Rainfall was applied equally with an overhead irrigation system on each module. Aside from rainfall, modules were under natural climatic conditions, including temperature, wind, and radiation. A single species, Ficinia nodosa, was planted with five different treatments and three replicates of each treatment. In this experiment, we tested the impact of three plant cover treatments (0%, 50% and 100%) on rainfall retention and plant drought stress. We also installed two runoff zone treatments covering 50% of the substrate surface for additional modules with 0% and 50% plant cover to determine whether directing rainfall resources towards plant roots would reduce drought stress without impacting rainfall retention. The retention performance for the simulated rainfall events was measured, quantifying all components for hydrological performance and survival on green roofs. We found that evapotranspiration and rainfall retention were similar for modules with 50% and 100% plant cover. However, modules with 100% plant cover showed significantly higher plant drought stress. Therefore, planting at a lower cover/density reduced plant drought stress without jeopardizing rainfall retention performance. Installing runoff zones marginally reduced evapotranspiration and rainfall retention, but by approximately the same amount for modules with 0% and 50% plant cover. This indicates that reduced evaporation due to the installation of the runoff zones likely contributed to reduced evapotranspiration and rainfall retention. Further, runoff occurred from modules with runoff zones faster than those without, indicating that we created a faster pathway for water to enter and leave the substrate, which also likely contributed to lower overall evapotranspiration and retention. However, despite some loss in retention performance, modules with 50% plant cover installed with runoff zones showed significantly lower drought stress in plants compared to those without runoff zones. Overall, we suggest that reducing plant cover represents a simple means of optimizing green roof performance but creating runoff zones may reduce plant drought stress at the cost of reduced rainfall retention.Keywords: green roof, plant cover, plant drought stress, rainfall retention
Procedia PDF Downloads 108882 Employment Mobility and the Effects of Wage Level and Tenure
Authors: Idit Kalisher, Israel Luski
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One result of the growing dynamicity of labor markets in recent decades is a wider scope of employment mobility – i.e., transitions between employers, either within or between careers. Employment mobility decisions are primarily affected by the current employment status of the worker, which is reflected in wage and tenure. Using 34,328 observations from the National Longitudinal Survey of Youth 1979 (NLS79), which were derived from the USA population between 1990 and 2012, this paper aims to investigate the effects of wage and tenure over employment mobility choices, and additionally to examine the effects of other personal characteristics, individual labor market characteristics and macroeconomic factors. The estimation strategy was designed to address two challenges that arise from the combination of the model and the data: (a) endogeneity of the wage and the tenure in the choice equation; and (b) unobserved heterogeneity, as the data of this research is longitudinal. To address (a), estimation was performed using two-stage limited dependent variable procedure (2SLDV); and to address (b), the second stage was estimated using femlogit – an implementation of the multinomial logit model with fixed effects. Among workers who have experienced at least one turnover, the wage was found to have a main effect on career turnover likelihood of all workers, whereas the wage effect on job turnover likelihood was found to be dependent on individual characteristics. The wage was found to negatively affect the turnover likelihood and the effect was found to vary across wage level: high-wage workers were more affected compared to low-wage workers. Tenure was found to have a main positive effect on both turnover types’ likelihoods, though the effect was moderated by the wage. The findings also reveal that as their wage increases, women are more likely to turnover than men, and academically educated workers are more likely to turnover within careers. Minorities were found to be as likely as Caucasians to turnover post wage-increase, but less likely to turnover with each additional tenure year. The wage and the tenure effects were found to vary also between careers. The difference in attitude towards money, labor market opportunities and risk aversion could explain these findings. Additionally, the likelihood of a turnover was found to be affected by previous unemployment spells, age, and other labor market and personal characteristics. The results of this research could assist policymakers as well as business owners and employers. The former may be able to encourage women and older workers’ employment by considering the effects of gender and age on the probability of a turnover, and the latter may be able to assess their employees’ likelihood of a turnover by considering the effects of their personal characteristics.Keywords: employment mobility, endogeneity, femlogit, turnover
Procedia PDF Downloads 139881 Sources and Content of Sexual Information among School Going Adolescents in Uganda
Authors: Jonathan Magala
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Context: Adolescents in Uganda face significant challenges related to sexual health due to inadequate sexual information. This lack of information puts young people at risk of early pregnancies, sexually transmitted infections, and poverty. Therefore, it is essential to understand the sources, content, and challenges of acquiring sexual information among secondary school-going adolescents in Uganda. Research Aim: The aim of this study was to establish the sources, content, and challenges of acquiring sexual information among secondary school-going adolescents in Luwero Town Council, Uganda. Methodology: This study used a cross-sectional approach with both qualitative and quantitative methods. Questionnaires and in-depth interviews were conducted with 384 school-going adolescents aged between 13-19 years in Luwero Town Council, Uganda. Findings: The results of the study revealed that adolescents receive sexual information from various sources, with schools being the most common source, followed by parents and religious institutions being the least utilized. Adolescents received information on various topics related to sexuality, including puberty and sexual changes, pregnancy and reproduction, STD information, abstinence, and family planning. However, the content of sexual information was inadequate in addressing the challenges facing adolescents, and there were generation gaps, lack of role models, peer influence, and government policies. The male character from all the sources was the least in offering sexual information to adolescents. Theoretical Importance: The study's findings highlight the need for policy implementation to strengthen sexual education in school curriculum, as the sources of sexual information and the content are inadequate. The various topics should be addressed in schools to provide comprehensive education on sexual health for adolescents. Data Collection and Analysis Procedures: Data collection involved questionnaires and in-depth interviews with school-going adolescents. The data gathered were analyzed using descriptive statistics and thematic analysis. Questions Addressed: The study aimed to answer questions about the sources of sexual information among school-going adolescents, the content of sexual information provided, the challenges faced in accessing the information, and the importance of sex education policy implementation. Conclusion: The study concludes that schools are a popular source of sexual information among school-going adolescents in Uganda. However, the content of the information provided is inadequate in addressing the challenges that adolescents face regarding their sexual health. Therefore, policy implementation is essential in strengthening sexual education in the school curriculum and addressing various topics related to sexual health.Keywords: adolescents, sexual information, schools, reproductive health
Procedia PDF Downloads 66880 The Risk of Occupational Health in the Shipbuilding Industry in Bangladesh
Authors: Md. Rashel Sheikh
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The shipbuilding industry in Bangladesh had become a fast-growing industry in recent years when it began to export newly built ships. The various activities of shipbuilding industries in their limited, confined spaces added occupational worker exposures to chemicals, dusts, and metal fumes. The aim of this literature search is to identify the potential sources of occupational health hazards in shipyards and to promote the regulation of appropriate personal protective equipment (PPE) for the workers. In shipyards, occupational workers are involved in various activities, such as the manufacture, repair, maintenance, dismantling of boats and ships, building small ocean-going vessels and ferries. The occupational workers in the shipbuilding industry suffer from a number of hazardous issues, such as asthma, dermatitis, hearing deficits, and musculoskeletal disorders. The use of modern technologies, such as underwater plasma welding, electron beam welding, and friction stir welding and laser cutting and welding, and appropriate PPE (i.e., long-sleeved shirt and long pants, shoes plus socks, safety masks, chemical resistant gloves, eyewear, face shield, and respirators) can help reduce the occupational exposure to environmental hazards created by different activities in the shipyards. However, most shipyards in Bangladesh use traditional methods, e.g., flame cutting and arc, that add hazardous waste and pollutants to the environment in and around the shipyard. The safety and security of occupational workers in the shipyard workplace are very important. It is the primary responsibility of employers to ensure the safety and security of occupational workers in the shipyards. Employers must use advanced technologies and supply adequate and appropriate PPE for the workers. There are a number of accidents and illnesses that happen daily in the shipyard industries in Bangladesh due to the negligence and lack of adequate technologies and appropriate PPE. In addition, there are no specific regulations and implementations available to use the PPE. It is essential to have PPE regulations and strict enforcement for the adoption of PPE in the shipbuilding industries in Bangladesh. Along with the adoption of PPE with regular health examinations, health education to the workers regarding occupational hazards and lifestyle diseases are also important and require reinforcement. Monitoring health and safety hazards in shipyards are essential to enhance worker protection, and ensure worker safety, and mitigate workplace injuries and illnesses.Keywords: shipbuilding Industries, health education, occupational health hazards, personal protective equipment, shipyard workers, occupational workers, shipyards
Procedia PDF Downloads 157879 Extracorporeal Co2 Removal (Ecco2r): An Option for Treatment for Refractory Hypercapnic Respiratory Failure
Authors: Shweh Fern Loo, Jun Yin Ong, Than Zaw Oo
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Acute respiratory distress syndrome (ARDS) is a common serious condition of bilateral lung infiltrates that develops secondary to various underlying conditions such as diseases or injuries. ARDS with severe hypercapnia is associated with higher ICU mortality and morbidity. Venovenous Extracorporeal membrane oxygenation (VV-ECMO) support has been established to avert life-threatening hypoxemia and hypercapnic respiratory failure despite optimal conventional mechanical ventilation. However, VV-ECMO is relatively not advisable in particular groups of patients, especially in multi-organ failure, advanced age, hemorrhagic complications and irreversible central nervous system pathology. We presented a case of a 79-year-old Chinese lady without any pre-existing lung disease admitted to our hospital intensive care unit (ICU) after acute presentation of breathlessness and chest pain. After extensive workup, she was diagnosed with rapidly progressing acute interstitial pneumonia with ARDS and hypercapnia respiratory failure. The patient received lung protective strategies of mechanical ventilation and neuromuscular blockage therapy as per clinical guidelines. However, hypercapnia respiratory failure was refractory, and she was deemed not a good candidate for VV-ECMO support given her advanced age and high vasopressor requirements from shock. Alternative therapy with extracorporeal CO2 removal (ECCO2R) was considered and implemented. The patient received 12 days of ECCO2R paired with muscle paralysis, optimization of lung-protective mechanical ventilation and dialysis. Unfortunately, the patient still had refractory hypercapnic respiratory failure with dual vasopressor support despite prolonged therapy. Given failed and futile medical treatment, the family opted for withdrawal of care, a conservative approach, and comfort care, which led to her demise. The effectivity of extracorporeal CO2 removal may depend on disease burden, involvement and severity of the disease. There is insufficient data to make strong recommendations about its benefit-risk ratio for ECCO2R devices, and further studies and data would be required. Nonetheless, ECCO2R can be considered an alternative treatment for refractory hypercapnic respiratory failure patients who are unsuitable for initiating venovenous ECMO.Keywords: extracorporeal CO2 removal (ECCO2R), acute respiratory distress syndrome (ARDS), acute interstitial pneumonia (AIP), hypercapnic respiratory failure
Procedia PDF Downloads 57878 Determination of Burnout Levels and Associated Factors of Teachers Working During the COVID-19 Pandemic Period
Authors: Kemal Kehan, Emine Aktas Bajalan
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This study was carried out to determine the burnout levels and related factors of teachers working in primary schools affiliated to the Turkish Republic of Northern Cyprus (TRNC) Ministry of National Education during the COVID-19 pandemic period. The research was conducted in descriptive cross-sectional design. The population of the research consists of 1071 teachers working in 93 primary schools in 6 central districts affiliated to the TRNC Ministry of National Education in the 2021-2022 academic year. When the sample size of the study was calculated by power analysis, it was determined that 202 teachers should be reached with 95% confidence (1-α), 95% test power (1-β) and d=0.5 effect size. Within the scope of the inclusion criteria of the research, the main sample of the study consisted of 300 teachers and the baist random sampling method was used. The data were collected using the Sociodemographic Data Form consisting of 34 questions, including the sociodemographic characteristics of the teachers and the 22-item Maslach Burnout Scale (MBS). The analysis of the data was carried out using descriptive and correlational analyzes in the SPSS 22 package program. In the study, it was determined that 65% of the teachers were women, 68% were married, 84% had a bachelor's degree, 70.33% had children, and 67.67% were dependents. Regarding how teachers evaluate the COVID-19 pandemic period; 90% of them said, “I am worried about my family's health and the risk of infection”, 80% of them, “I feel that my profession does not get the value it deserves”, 75.67% of them mentioned “My hopes for the future have started to wane”, 75.33% of them say “I am worried about my own health”. It was determined that they gave the answer of, “I am worried about the issue”. It was found that the teachers' MBS total score average was 48.63±8.01, the burnout level was moderate, and the average score they got from the sub-dimensions of the scale was also moderate. It has been found that there are negative correlations between the professional satisfaction scores of the teachers during and before the COVID-19 pandemic and the scores they received from the general and sub-dimensions of MBS. It was determined that there was a statistically significant difference (p<0.05) between the scores of teachers diagnosed with COVID-19 from the scale and its sub-dimensions. As a result, it is suggested that social activities should be increased and professional development and promotion opportunities should be offered in order to ensure that teachers are satisfied with their work areas, to reduce their burnout levels or to prevent them completely.Keywords: teachers, burnout, maslach burnout scale, pandemic, online education
Procedia PDF Downloads 59877 Tension-Free Vaginal Tape Secur (TVT Secur) versus Tension-Free Vaginal Tape-Obturator (TVT-O) from inside to outside in Surgical Management of Genuine Stress Urinary Incontinence
Authors: Ibrahim Mohamed Ibrahim Hassanin, Hany Hassan Mostafa, Mona Mohamed Shaban, Ahlam El Said Kamel
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Background: New so-called minimally invasive devices have been developed to limit groin pain after sling placement for treatment of stress urinary incontinence (SUI) to minimize the risk of postoperative pain and organ perforation. A new generation of suburethral slings was described that avoided skin incision to pull out and tension the sling. Evaluation of this device through prospective short-term series has shown controversial results compared with other tension-free techniques. The aim of this study is to compare success rates and complications for tension-free vaginal tape secur (TVT secur) and trans-obturator sub urethral tape inside-out technique (TVT-O) for treatment of stress urinary incontinence (SUI). Materials and Methods: Fifty patients with genuine SUI were divided into two groups: group S (n=25) were operated upon using (TVT secur) and group O (n=25) were operated upon using trans-obturator suburethral tape inside-out technique (TVT-O). Success rate, quality of life and postoperative complications such as groin pain, urgency, urine retention and vaginal tape erosion were reported in both groups at one, three, and six months after surgery. Results: As regards objective cure rate at one, three, six months intervals; there was a significant difference between group S (56%, 64%, and 60%), and group O (80%, 88%, and 88%) respectively (P <0.05). As regards subjective cure rate at one, three, six months intervals; there was a significant difference between group S (44%, 44%, and 48%), and group O (76%, 80%, and 80%) respectively (P <0.05). Quality of life (QoL) parameters improved significantly in cured patients with no difference between both groups. As regards complications, group O had a higher frequency of complications than group S; groin pain (12% vs 12% p= 0.05), urgency (4% (1 case) vs 0%), urine retention (8% (2 cases) vs 0%), vaginal tape erosion (4% (1 case) vs 0%). No cases were complicated with wound infection. Conclusion: Compared to TVT secur, TVT-O showed higher subjective and objective cure rates after six months but higher rate of complications. Both techniques were comparable as regards improvement of quality of life after surgery.Keywords: stress urinary incontinence, trans-vaginal tape-obturator, TVT Secur, TVT-O
Procedia PDF Downloads 348876 Heat Transfer and Trajectory Models for a Cloud of Spray over a Marine Vessel
Authors: S. R. Dehghani, G. F. Naterer, Y. S. Muzychka
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Wave-impact sea spray creates many droplets which form a spray cloud traveling over marine objects same as marine vessels and offshore structures. In cold climates such as Arctic reigns, sea spray icing, which is ice accretion on cold substrates, is strongly dependent on the wave-impact sea spray. The rate of cooling of droplets affects the process of icing that can yield to dry or wet ice accretion. Trajectories of droplets determine the potential places for ice accretion. Combining two models of trajectories and heat transfer for droplets can predict the risk of ice accretion reasonably. The majority of the cooling of droplets is because of droplet evaporations. In this study, a combined model using trajectory and heat transfer evaluate the situation of a cloud of spray from the generation to impingement. The model uses some known geometry and initial information from the previous case studies. The 3D model is solved numerically using a standard numerical scheme. Droplets are generated in various size ranges from 7 mm to 0.07 mm which is a suggested range for sea spray icing. The initial temperature of droplets is considered to be the sea water temperature. Wind velocities are assumed same as that of the field observations. Evaluations are conducted using some important heading angles and wind velocities. The characteristic of size-velocity dependence is used to establish a relation between initial sizes and velocities of droplets. Time intervals are chosen properly to maintain a stable and fast numerical solution. A statistical process is conducted to evaluate the probability of expected occurrences. The medium size droplets can reach the highest heights. Very small and very large droplets are limited to lower heights. Results show that higher initial velocities create the most expanded cloud of spray. Wind velocities affect the extent of the spray cloud. The rate of droplet cooling at the start of spray formation is higher than the rest of the process. This is because of higher relative velocities and also higher temperature differences. The amount of water delivery and overall temperature for some sample surfaces over a marine vessel are calculated. Comparing results and some field observations show that the model works accurately. This model is suggested as a primary model for ice accretion on marine vessels.Keywords: evaporation, sea spray, marine icing, numerical solution, trajectory
Procedia PDF Downloads 214875 Impact of Non-Parental Early Childhood Education on Digital Friendship Tendency
Authors: Sheel Chakraborty
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Modern society in developed countries has distanced itself from the earlier norm of joint family living, and with the increase of economic pressure, parents' availability for their children during their infant years has been consistently decreasing over the past three decades. During the same time, the pre-primary education system - built mainly on the developmental psychology theory framework of Jean Piaget and Lev Vygotsky, has been promoted in the US through the legislature and funding. Early care and education may have a positive impact on young minds, but a growing number of kids facing social challenges in making friendships in their teenage years raises serious concerns about its effectiveness. The survey-based primary research presented here shows a statistically significant number of millennials between the ages of 10 and 25 prefer to build friendships virtually than face-to-face interactions. Moreover, many teenagers depend more on their virtual friends whom they never met. Contrary to the belief that early social interactions in a non-home setup make the kids confident and more prepared for the real world, many shy-natured kids seem to develop a sense of shakiness in forming social relationships, resulting in loneliness by the time they are young adults. Reflecting on George Mead’s theory of self that is made up of “I” and “Me”, most functioning homes provide the required freedom and forgivable, congenial environment for building the "I" of a toddler; however, daycare or preschools can barely match that. It seems social images created from the expectations perceived by preschoolers “Me" in a non-home setting may interfere and greatly overpower the formation of a confident "I" thus creating a crisis around the inability to form friendships face to face when they grow older. Though the pervasive nature of social media can’t be ignored, the non-parental early care and education practices adopted largely by the urban population have created a favorable platform of teen psychology on which social media popularity thrived, especially providing refuge to shy Gen-Z teenagers. This can explain why young adults today perceive social media as their preferred outlet of expression and a place to form dependable friendships, despite the risk of being cyberbullied.Keywords: digital socialization, shyness, developmental psychology, friendship, early education
Procedia PDF Downloads 119874 Neuroblastoma in Children and the Potential Involvement of Viruses in Its Pathogenesis
Authors: Ugo Rovigatti
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Neuroblastoma (NBL) has epitomized for at least 40 years our understanding of cancer cellular and molecular biology and its potential applications to novel therapeutic strategies. This includes the discovery of the very first oncogene aberrations and tumorigenesis suppression by differentiation in the 80s; the potential role of suppressor genes in the 90s; the relevance of immunotherapy in the millennium first, and the discovery of additional mutations by NGS technology in the millennium second decade. Similar discoveries were achieved in the majority of human cancers, and similar therapeutic interventions were obtained subsequently to NBL discoveries. Unfortunately, targeted therapies suggested by specific mutations (such as MYCN amplification –MNA- present in ¼ or 1/5 of cases) have not elicited therapeutic successes in aggressive NBL, where the prognosis is still dismal. The reasons appear to be linked to Tumor Heterogeneity, which is particularly evident in NBL but also a clear hallmark of aggressive human cancers generally. The new avenue of cancer immunotherapy (CIT) provided new hopes for cancer patients, but we still ignore the cellular or molecular targets. CIT is emblematic of high-risk disease (HR-NBL) since the mentioned GD2 passive immunotherapy is still providing better survival. We recently critically reviewed and evaluated the literature depicting the genomic landscapes of HR-NBL, coming to the qualified conclusion that among hundreds of affected genes, potential targets, or chromosomal sites, none correlated with anti-GD2 sensitivity. A better explanation is provided by the Micro-Foci inducing Virus (MFV) model, which predicts that neuroblasts infection with the MFV, an RNA virus isolated from a cancer-cluster (space-time association) of HR-NBL cases, elicits the appearance of MNA and additional genomic aberrations with mechanisms resembling chromothripsis. Neuroblasts infected with low titers of MFV amplified MYCN up to 100 folds and became highly transformed and malignant, thus causing neuroblastoma in young rat pups of strains SD and Fisher-344 and larger tumor masses in nu/nu mice. An association was discovered with GD2 since this glycosphingolipid is also the receptor for the family of MFV virus (dsRNA viruses). It is concluded that a dsRNA virus, MFV, appears to provide better explicatory mechanisms for the genesis of i) specific genomic aberrations such as MNA; ii) extensive tumor heterogeneity and chromothripsis; iii) the effects of passive immunotherapy with anti-GD2 monoclonals and that this and similar models should be further investigated in both pediatric and adult cancers.Keywords: neuroblastoma, MYCN, amplification, viruses, GD2
Procedia PDF Downloads 94873 Design and Evaluation of a Prototype for Non-Invasive Screening of Diabetes – Skin Impedance Technique
Authors: Pavana Basavakumar, Devadas Bhat
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Diabetes is a disease which often goes undiagnosed until its secondary effects are noticed. Early detection of the disease is necessary to avoid serious consequences which could lead to the death of the patient. Conventional invasive tests for screening of diabetes are mostly painful, time consuming and expensive. There’s also a risk of infection involved, therefore it is very essential to develop non-invasive methods to screen and estimate the level of blood glucose. Extensive research is going on with this perspective, involving various techniques that explore optical, electrical, chemical and thermal properties of the human body that directly or indirectly depend on the blood glucose concentration. Thus, non-invasive blood glucose monitoring has grown into a vast field of research. In this project, an attempt was made to device a prototype for screening of diabetes by measuring electrical impedance of the skin and building a model to predict a patient’s condition based on the measured impedance. The prototype developed, passes a negligible amount of constant current (0.5mA) across a subject’s index finger through tetra polar silver electrodes and measures output voltage across a wide range of frequencies (10 KHz – 4 MHz). The measured voltage is proportional to the impedance of the skin. The impedance was acquired in real-time for further analysis. Study was conducted on over 75 subjects with permission from the institutional ethics committee, along with impedance, subject’s blood glucose values were also noted, using conventional method. Nonlinear regression analysis was performed on the features extracted from the impedance data to obtain a model that predicts blood glucose values for a given set of features. When the predicted data was depicted on Clarke’s Error Grid, only 58% of the values predicted were clinically acceptable. Since the objective of the project was to screen diabetes and not actual estimation of blood glucose, the data was classified into three classes ‘NORMAL FASTING’,’NORMAL POSTPRANDIAL’ and ‘HIGH’ using linear Support Vector Machine (SVM). Classification accuracy obtained was 91.4%. The developed prototype was economical, fast and pain free. Thus, it can be used for mass screening of diabetes.Keywords: Clarke’s error grid, electrical impedance of skin, linear SVM, nonlinear regression, non-invasive blood glucose monitoring, screening device for diabetes
Procedia PDF Downloads 318