Search results for: Yuzawa family health plan

Authors: Tarek Elnimr, Rabab El-kelany

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Heavy metals are environmental contaminants that may pose long-term health risks. Unfortunately, the consequent implementation of preventive measures was generally delayed, causing important negative effects to the exposed populations. The objective of this study was to determine whether co-consumption of nutritional supplements as selenium and vitamin E would treat the hazardous effects of exposure to mercury, lead and cadmium. 108 workers (60 males and 48 females) were the subject of this study, their ages ranged from 19-63 years, (M = 29.5±10.12). They were working in lamp factory for an average of 0.5-40 years (M= 5.3±8.8). Twenty control subjects matched for age and gender were used for comparison. All workers were subjected to neuropsychiatric evaluation. General Health Questionnaire (GHQ-28) revealed that 44.4% were complaining of anxiety, 52.7% of depression, 41.6% of social dysfunction and 22.2% of somatic symptoms. Cognitive tests revealed that long-term memory was not affected significantly when compared with controls, while short term memory and perceptual ability were affected significantly. Blood metal levels were measured by Inductively Coupled Plasma – optical emission spectrometry(ICP-OES), and revealed that the mean blood mercury, lead and cadmium concentrations before treatment were 1.6 mg/l, 0.39 mg/l and 1.7 µg/l, while they decreased significantly after treatment to 1.2 mg/l, 0.29 mg/l and 1.3 µg/l respectively. Anti-oxidative enzymes (paraoxonase and catalase) and lipid peroxidation product (malondialdehyde) were measured before and after treatment with selenium and vitamin E, and showed significant improvement. It could be concluded that co-consumption of selenium and vitamin E produces significant decrease in mercury, lead and cadmium levels in blood.

Keywords: mercury, lead, cadmium, neuropsychiatric impairment, selenium, vitamin E

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Authors: Tom Ryan

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This paper investigates the rural mobility and accessibility challenges of a specific target group - Seniors. The target group is those over 66 years of age who are entitled to use the Public Transport (PT) Free Travel Scheme in rural Ireland. The paper explores at a high level some of the projected rural PT challenges and requirements over the next 10-15 years, noting that statistical predictions show that there will be a significant population demographic shift within the Senior's age profile. Using the PESTEL framework, the literature review explored existing research concerning mobility, accessibility challenges, and the opportunities Seniors face. Twenty-seven qualitative in-depth interviews with stakeholders within the ecosystem were undertaken. The stakeholders included: rural PT customers, Local-Link managers, NTA senior management, a Minister of State, and a European parliament policymaker. Tier 1 interviewee feedback spotlights that the PT network system does not exist for rural patients to access hospital facilities. There was no evidence from the Tier 2 research findings to show that health policymakers and transport planners are working to deliver a national solution to support patients getting access to hospital appointments. Several research interviewees discussed the theme of isolation and the perceived stigma of senior males utilising PT. The findings indicated that MaaS is potentially revolutionary in the PT arena. Finally, this paper suggests several short-, medium- and long-term recommendations based on the research findings. These recommendations are a potential springboard to ensure that rural PT is suitable for future Irish generations.

Keywords: accessibility, active ageing, car dependence, isolation, seniors health issues, behavioural changes, environmental challenges, internet of things, demand responsive, mobility as a service

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Authors: Aisling Parkes, Fiona Donson

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There is no doubt that parental imprisonment directly alters the social experiences of childhood for many children worldwide today. Indeed, the extent to which meaningful contact with a parent in prison can positively impact on the life of a child is well documented as are the benefits for the prisoner, particularly in the long term and post-release. However, despite the growing acceptance of children’s rights in Ireland over the past decade in particular, it appears that children’s rights have not yet succeeded in breaking through the walls of Irish prisons when children are visiting an incarcerated parent. In a prison system that continues to prioritise security over all other considerations, little attention has been given to the importance of recognising and protecting the rights of children affected by parental imprisonment in Ireland for children, families and society in the long term. This paper will present the findings which have emerged from a national qualitative research project (the first of its kind to be conducted in Ireland) which examines the current visiting conditions for children and families, and the related culture of visitation within the Irish Prison system. This study investigated, through semi-structured interviews and focus groups, the unique and specialist perspectives of senior prison management, prison governors, prison officers, support organisations, prison child care workers, as well as those with a family member in prison who have direct experience of prison visits in Ireland which involve children and young people. The reality of the current system of visitation that operates in Irish prisons and its impact on children’s rights is presented from a variety of perspectives. The idea of what meaningful contact means from a children’s rights based perspective is interrogated as are the benefits long term for both the child and the offender. The current system is benchmarked against well-accepted international children’s rights norms as reflected under the UN Convention on the Rights of the Child 1989. The dissonance that continues to exist between the theory of children’s rights which includes the right to maintain meaningful contact with a parent in prison and current practice and procedure in Irish Prisons will be explored. In adopting a children’s rights based perspective combined with socio-legal research, this paper will explore the added value that this approach to prison visiting might offer in responding to this particularly marginalised group of children in terms of their social experience of childhood. Finally, the question will be raised as to whether or not there is a responsibility on prisons to view children as independent rights holders when they come to visit the prison or is the prison entitled to focus solely on the prisoner with their children being viewed as a circumstance of the offender? Do the interests of the child and the prisoner have to be exclusive or is there any way of marrying the two?

Keywords: children’s rights, prisoners, sociology, visitation

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Authors: Sanjay Shukla, A. Nayak, R. K. Sharma, A. P. Singh, S. P. Tiwari

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Excessive use of antibiotics is a major problem in the treatment of wounds and other chronic infections, and antibiotic treatment is frequently non-curative, thus alternative treatment is necessary. Phage therapy is considered one of the most promising approaches to treat multi-drug resistant bacterial pathogens. Infections caused by Staphylococcus aureus are very efficiently controlled with phage cocktails, containing a different individual phages lysate infecting a majority of known pathogenic S. aureus strains. The aim of the present study was to evaluate the efficacy of a purified phage cocktail for prophylactic as well as therapeutic application in mouse model and in large animals with chronic septic infection of wounds. A total of 150 sewage samples were collected from various livestock farms. These samples were subjected for the isolation of bacteriophage by the double agar layer method. A total of 27 sewage samples showed plaque formation by producing lytic activity against S. aureus in the double agar overlay method out of 150 sewage samples. In TEM, recovered isolates of bacteriophages showed hexagonal structure with tail fiber. In the bacteriophage (ØVS) had an icosahedral symmetry with the head size 52.20 nm in diameter and long tail of 109 nm. Head and tail were held together by connector and can be classified as a member of the Myoviridae family under the order of Caudovirale. Recovered bacteriophage had shown the antibacterial activity against the S. aureus in vitro. Cocktail (ØVS1, ØVS5, ØVS9, and ØVS 27) of phage lysate were tested to know in vivo antibacterial activity as well as the safety profile. Result of mice experiment indicated that the bacteriophage lysate were very safe, did not show any appearance of abscess formation, which indicates its safety in living system. The mice were also prophylactically protected against S. aureus when administered with cocktail of bacteriophage lysate just before the administration of S. aureuswhich indicates that they are good prophylactic agent. The S. aureusinoculated mice were completely recovered by bacteriophage administration with 100% recovery, which was very good as compere to conventional therapy. In the present study, ten chronic cases of the wound were treated with phage lysate, and follow up of these cases was done regularly up to ten days (at 0, 5, and 10 d). The result indicated that the six cases out of ten showed complete recovery of wounds within 10 d. The efficacy of bacteriophage therapy was found to be 60% which was very good as compared to the conventional antibiotic therapy in chronic septic wounds infections. Thus, the application of lytic phage in single dose proved to be innovative and effective therapy for the treatment of septic chronic wounds.

Keywords: phage therapy, S aureus, antimicrobial resistance, lytic phage, and bacteriophage

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Authors: Manjula Kola, K. Chandralekha

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Anaemia is one of the world’s most widespread health problems. Prevalence of anemia in south Asia is among the highest in the world. Iron deficiency anemia accounts for almost 85 percent of all types of anemia in India and affects more than half of the total population. Women of childbearing age particularly pregnant women, infants, preschool children and adolescents are at greatest risk of developing iron deficiency anemia. In India, 74 percent children between 6-35 months of age are anemic. Children between 1-6 years in major cities are found with a high prevalence rate of 64.8 percent. Iron deficiency anemia is not only a public health problem, but also a development problem. Its prevention and reduction must be viewed as investment in human capital that will enhance development and reduce poverty. Ending this hidden hunger in the form of iron deficiency is the most important achievable international health goal. Eliminating the underlying problem is essential to the sustained elimination of the iron deficiency anemia. The intervention programmes toward the sustained elimination need to be broadly based so that interventions become accepted community practices. Hence, intervention strategies need to go well beyond traditional health and nutrition systems and based upon empowering people and communities so that they will be capable of arranging for and sustaining an adequate intake of foods with respect to iron, independent of external support. Such strategies must necessarily be multisectoral and integrate interventions with social communications, evaluation and surveillance. The main objective of the study was to design a community based Nutrition intervention using theoretical framework of social marketing to sustain improvement of iron nutriture among preschool children. In order to carryout the study eight rural communities In Chittoor district of Andhra Pradesh, India were selected. A formative research was carryout for situational analysis and baseline data was generated with regard to demographic and socioeconomic status, dietary intakes, Knowledge, Attitude and Practices of the mothers of preschool children, clinical and hemoglobin status of the target group. Based on the formative research results, the research area was divides into four groups as experimental area I,II,III and control area. A community based, integrated and comprehensive social marketing intervention was designed based on various theories and models of nutrition education/ communication. In Experimental area I, Nutrition intervention using social marketing and a weekly iron folic acid supplementation was given to improve iron nutriture of preschool children. In experimental area II, Social marketing alone was implemented and in experimental area III Iron supplementation alone was given. No intervention was given in control area. The Impact evaluation revealed that among different interventions tested, the integrated social marketing intervention resulted best outcomes. The overall observations of the study state that social marketing, an integrated and functional strategy for nutrition communication to prevent and control iron deficiency. Various theoretical frame works / models for nutrition communication facilitate to design culturally appropriate interventions thus achieved improvements in the knowledge, attitude and practices there by resulting successful impact on nutritional status of the target groups.

Keywords: anemia, iron deficiency, social marketing, theoretical framework

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Authors: Zatil Athaillah, Anastasia Devi, Dian Muzdalifah, Wirasuwasti Nugrahani, Linar Udin

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During tempe fermentation, some chemical changes occurred and they contributed to sensory, appearance, and health benefits of soybeans. Many studies on health properties of tempe have specialized on their isoflavones. In this study, other components of tempe, particularly water soluble chemicals, was investigated for their biofunctionality. The study was focused on the ability to suppress MCF-7 breast cancer cell growth and antioxidant activity, as expressed by DPPH radical scavenging activity, total phenols and total flavonoids, of the water extracts. Fermentation time of tempe was extended up to 120 hr to increase the possibility to find the functional components. Extraction yield and soluble nitrogen content were also quantified as accompanying data. Our findings suggested that yield of water extraction of tempe increased as fermentation was extended up to 120 hr, except for a slight decrease at 72 hr. Water extracts of tempe showed inhibition of MCF-7 breast cancer cell growth, as shown by lower IC50 values when compared to control (unfermented soybeans). Among the varied fermentation timescales, 60-hr period showed the highest activity (IC50 of 8.7 ± 4.95 µg/ml). The anticancer activity of extracts obtained from different fermentation time was positively correlated with total soluble nitrogens, but less relevant with antioxidant data. During 48-72 hr fermentation, at which cancer suppression activity was significant, the antioxidant properties from the three assays were not higher than control. These findings indicated that water extracts of tempe from extended fermentation could inhibit breast cancer cell growth but further study to determine the mechanism and compounds that play important role in the activity should be conducted.

Keywords: tempe, anticancer, antioxidant, phenolic compounds

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Authors: Arfaoui Emna, Nouira Mariem

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Background and aims: Breastfeeding is the reference feeding for a child, especially during the first months of life. It is not widespread in many countries due to many factors. There has been a decline in exclusive breastfeeding (EB) practice, particularly in the middle- and low-income countries, i.e., Tunisia. The aim of our study was to describe the knowledge, attitudes, and practice of a sample of Tunisian mothers toward breastfeeding. Methods: It was a descriptive cross-sectional study conducted during the year 2022 over a period of two months in three health structures in the north of Tunisia among mothers of infants aged 2 to 18 months. Levels of mothers’ knowledge (low/moderate/high) were determined using a score ranging from 0 to 11 points. EB was defined as the proportion of infants who were exclusively breastfed during the first six months of life. Results: A total of 180 women with a mean age of 33±4.9 years were included. The average knowledge score was equal to 6.4 ±1.5 points, with extremes ranging from 3 to 11 points. Most of the respondents had a moderate knowledge level (44.4%). More than half of surveyed mothers (66.1%) thought that breastfeeding deforms breasts, and 16.7% thought that breastfeeding is specific to women who do not work. Breastfeeding experience during the first week of life was considered difficult in 70% of cases. The prevalence of EB up to 6 months of age was equal to 16.4% [10.8-23.2]. The main reported obstacles during breastfeeding practice were having an insufficient quantity of breast milk (18.3%) and child difficulties with sucking (12.8%), and having pain in the breast while breastfeeding (12.80%). Conclusion: Our results highlighted the insufficient level of knowledge and a low prevalence of EB in our study population. Improving mothers’ knowledge and promoting EB practice is needed. Implementing health education strategies involving healthcare workers, who represent a main actor in education and breastfeeding promotion, is very important to reach a satisfactory frequency for EB.

Keywords: breastfeeding, practices, knowledge, Tunisia

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Authors: R. R. Dewi Rahmawaty Aktyani Putri, Earmporn Thongkrajai, Dedy Purwito

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There were many instruments have been developed to assess social support which has the different dimension in breast cancer patients. The Issue of measurement is a challenge to determining the component of dimensional concept, defining the unit of measurement, and establishing the validity and reliability of the measurement. However, the instruments where need to know how much support which obtained and perceived among women with breast cancer who undergone chemotherapy which it can help nurses to prevent of non-adherence in chemotherapy. This study aimed to measure the reliability of BC-SSAS instrument among 30 Indonesian women with breast cancer aged 18 years and above who undergone chemotherapy for six cycles in the oncological unit of Outpatient Department (OPD), Margono Soekardjo Hospital, Central Java, Indonesia. Data were collected during October to December 2015 by using modified the Breast Cancer Social Support Assessment (BC-SSAS). The Cronbach’s alpha analysis was carried out to measure internal consistency for reliability test of BC-SSAS instrument. This study used five experts for content validity index. The results showed that for content validity, I-CVI was 0.98 and S-CVI was 0.98; Cronbach’s alpha value was 0.971 and the Cronbach’s alpha coefficients for the subscales were high, with 0.903 for emotional support, 0.865 for informational support, 0.901 for tangible support, 0.897 for appraisal support and 0.884 for positive interaction support. The results confirmed that the BC-SSAS instrument has high reliability. BC-SSAS instruments were reliable and can be used in health care services to measure the social support received and perceived among women with breast cancer who undergone chemotherapy so that preventive interventions can be developed and the quality of health services can be improved.

Keywords: BC-SSAS, women with breast cancer, chemotherapy, Indonesia

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Authors: S. Brain, P. J. Storer, H. Strydom, Z. M. Solaiman

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Increasing farmer awareness of soil health, the impact of agricultural management practices, and the requirement for high-quality agricultural produce are major factors driving the rapid adoption of biological seed treatments - currently valued globally at USD 1.5 billion. Biological seed coatings with multistrain plant beneficial microbial technology have the capability to affect plant establishment, growth, and development positively. These beneficial plant microbes can potentially increase soil health, plant yield, and nutrition – acting as bio fertilisers, rhizoremediators, phytostimulators, and stress modulators, and can ultimately reduce the overall use of agrichemicals. A field trial was conducted on MACE wheat in the central wheat belt of Western Australia to evaluate a proprietary seed coating technology (Langleys Bio-EnergeticTM Microbe blend (BMB)) on a conventional program (+/- BMB microbes) and a Regenerative Biomineral fertiliser program (+/- BMB microbes). The Conventional (+BMB) and Biomineral (+BMB) treated plants had no fungicide treatments and had no disease issues. Control (No fertiliser, No microbes), Conventional (No Microbes), and Biomineral (No Microbes) were treated with fungicides (seed dressing and foliar). From the research findings, compared to control and no microbe treatments, both the Conventional (+ BMB) and Biomineral (+ BMB) showed significant increases in Soil Carbon (SOC), Seed germination, nutrient use efficiency (NUE) of nitrogen, phosphate and mineral nutrients, grain mineral nutrient uptake, protein %, hectolitre weight, and fewer screenings, yield, and gross margins.

Keywords: biological seed coating, biomineral fertiliser, plant nutrition, regenerative and conventional agriculture

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Authors: Tereza Hruskova

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200 million people globally experience serious mental health problems, and only one third seek professional help, and help-seeking is described as a last resort. Adolescents and young adults have a high prevalence of mental illness. Mental stigma is a key element in the decision to seek help and is divided into (i) self-stigma (self-stigmatization), including internal beliefs, low self-esteem, and lower quality of life, and (ii) public stigma (social stigma) containing stereotypes, beliefs and society's disapproval of help-seeking having a negative effect on help-seeking and our attitudes. Previous research has mainly focused on examining the construct of help seeking, avoidance, and delaying separately and trying to find out why people do not seek help in time and what obstacles stand in the way. Barriers are not static and may change over time and the stage of help-seeking. Attitudes are closely related to self-stigma and social stigma and predict whether a person will seek help. Barriers (stigmatization, a sense of humiliation, insufficient recognition of the problem, preferences, solving it alone, and distrust of a professional) and facilitators (previous experience with mental problems, social support, and help from others) are factors influencing help-seeking. The current research on the Czech population of young adults responds to the gap between a person with mental health problems and actually seeking professional help. The aim of the study is to describe in detail the individual constructs and factors, to understand the person seeking help, and to define possible obstacles on this path of seeking help. A sample of approximately 250 participants (age 18-35) would take part in the online questionnaire, conducted in May-June 2023, and would be administered a demographic questionnaire and four scales measuring attitudes (Attitudes Toward Seeking Professional Psychological Help – Short form), barriers (Barrier to Help Seeking Scale), self-stigma (Self Stigma of Seeking Help) and stigmatization (Perceptions of Stigmatization by Others for seeking help). Firstly, all four scales would be translated into the Czech language. The aim is (I) to determine the validity and reliability of the Czech translation of the scales, (II) to examine the factors of the scales on the Czech population and compare them retrospectively with the results of reliability and validity from the original language of the scales and (III) to examine the connections between attitudes towards seeking, avoidance or delaying the search for professional psychological help due to the demographic and individual differences of the participants, barriers, self-stigmatization and social stigmatization. We expect to carry out the first study on the given topic in the Czech Republic, to identify and better understand the factors leading to the avoidance of seeking professional help and to reveal the relationships between stigmatization, attitudes and barriers leading to the avoidance or postponement of seeking professional help. The belief is to find out whether the Czech population of young adults differs from the data found on the foreign population in individual constructs, as cultural differences in individual countries were found.

Keywords: mental health, stigma, problems, seeking psychological help

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Authors: Sharmistha Chanda, Anindita Choudhuri

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This exploratory study highlights the psychological aspects of women's empowerment to find the importance of the psychological dimension of empowerment, such as; meaning, competence, self-determination, impact, and assumption, especially in the weaker marginalized section of women. A large proportion of rural, suburban, and urban poor survive by working in unorganized sectors of metropolitan cities. Relative Poverty and lack of employment in rural areas and small towns drive many people to the metropolitan city for work and livelihood. Women working in that field remain unrecognized as people of low socio-economic status. They are usually willing to do domestic work as daily wage workers, single wage earners, street vendors, family businesses like agricultural activities, domestic workers, and self-employed. Usually, these women accept such jobs because they do not have such an opportunity as they lack the basic level of education that is required for better-paid jobs. The unorganized sector, on the other hand, has no such clear-cut employer-employee relationships and lacks most forms of social protection. Having no fixed employer, these workers are casual, contractual, migrant, home-based, own-account workers who attempt to earn a living from whatever meager assets and skills they possess. Women have become more empowered both financially and individually through small-scale business ownership or entrepreneurship development and in household-based work. In-depth interviews have been done with 10 participants in order to understand their living styles, habits, self-identity, and empowerment in their society in order to evaluate the key challenges that they may face following by qualitative research approach. Transcription has been done from the collected data. The three-layer coding technique guides the data analysis process, encompassing – open coding, axial coding, and selective coding. Women’s Entrepreneurship is one of the foremost concerns as the Government, and non-government institutions are readily serving this domain with the primary objectives of promoting self-employment opportunities in general and empowering women in specific. Thus, despite hardship and unrecognition unorganized sector provides a huge array of opportunities for rural and sub-urban poor to earn. Also, the upper section of society tends to depend on this working force. This study gave an idea about the well-being, and meaning in life, life satisfaction on the basis of their lived experience.

Keywords: marginalized women, psychological empowerment, relative poverty, unorganized sector

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Authors: Natnicha Wareesamarn, Waruntorn Jongrungrotsakul, Anon Wisutthananon

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Occupational illnesses and injuries are the partial results of unsafe work behaviors. Safety training, an occupational health and safety standard, could either reduce or prevent such illnesses and injuries. This quasi-experimental research aimed to examine the effect of integrated safety training on safety work behaviors among 54 waste collectors working in the Su-ngai Kolok and Muang districts in Narathiwat Province. The workers were equally divided into an experimental or a control group (27 in each). The study was implemented from September to November 2021. The research instruments consisted of 1) an integrated safety promotion program on safety work behaviors which was developed based on the literature review, and 2) a questionnaire on safe working behaviors among waste collectors modified from a safety work behaviors questionnaire by Sitthichai Jaikhan et al. (2019). The content validity of the questionnaire was confirmed by experts with a content validity index of 0.97, while reliability was at an acceptable level (0.86 - 0.90). Data were analyzed using descriptive statistics and a t-test. The findings showed that after receiving the integrated safety promotion program on safety work behaviors, the mean scores for safety work behaviors among the experimental group (x ̅ = 73.89, S.D.=1.12) were significantly higher than those of the control group (x ̅ = 47.93, S.D.= 2.45) (p<.001). Furthermore, it was found that the mean score for safety work behaviors among the experimental group after receiving the integrated safety promotion program (x ̅=73.89, S.D.= 2.45) was significantly higher than that before receiving the program (x ̅=47.85, S.D.= 2.16) (p<.001). These findings indicate that occupational health nurses and related staff should place great concern on the application of integrated safety promotion programs into their own work. This is anticipated to enhance safe work behaviors, thereby reducing occupational illnesses and injuries, as well as enhancing the quality of working life among waste collectors.

Keywords: integrated safety promotion program, safety work behaviors, waste collectors, safety training

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Authors: S.Kauroo, J. Govinden Soulange, D. Marie

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Psiadia species from the Asteraceae are traditionally used in the folk medicine of Mauritius to treat cutaneous and bronchial infections. The present study aimed at validating the phytomedicinal properties of the selected species from the Asteraceae family, namely Psiadia arguta, Psiadia viscosa, Psiadia lithospermifolia, and Distephanus populifolius. Dried hexane, ethyl acetate, and methanol leaf extracts were studied for their antioxidant properties using the DPPH (1, 1-diphenyl-2-picryl-hydrazyl), FRAP (Ferric Reducing Ability of Plasma), and Deoxyribose assays. Antibacterial activity against human pathogenic bacteria namely Escherichia coli (ATCC 27853), Staphylococcus aureus (ATCC 29213), Enterococcus faecalis (ATCC 29212), Klebsiella pneumonia (ATCC27853), Pseudomonas aeruginosa (ATCC 27853), and Bacillus cereus (ATCC 11778) was measured using the broth microdilution assay. Qualitative phytochemical screening using standard methods revealed the presence of coumarins, tannins, leucoanthocyanins, and steroids in all the tested extracts. The measured phenolics level of the selected plant extracts varied from 24.0 to 231.6 mg GAE/g with the maximum level in methanol extracts in all four species. The highest flavonoids and proanthocyanidins content was noted in Psiadia arguta methanolic extracts with 65.7±1.8 mg QE/g and 5.1±0.0 mg CAT/g dry weight (DW) extract, respectively. The maximum free radical scavenging activity was measured in Psiadia arguta methanol and ethyl acetate extracts with IC50 11.3±0.2 and 11.6± 0.2 µg/mL, respectively and followed by Distephanus populifolius methanol extracts with an IC50 of 11.3± 0.8 µg/mL. The maximum ferric reducing antioxidant potential was noted in Psiadia lithospermifolia methanol extracts with a FRAP value of 18.8 ± 0.4 µmol Fe2+/L/g DW. The antioxidant capacity based on DPPH and Deoxyribose values were negatively related to total phenolics, flavonoid and proanthocyanidins content while the ferric reducing antioxidant potential were strongly correlated to total phenolics, flavonoid and proanthocyanidins content. All four species exhibited antimicrobial activity against the tested bacteria (both Gram-negative and Gram-positive). Interestingly, the hexane and ethyl acetate extracts of Psiadia viscosa and Psiadia lithospermifolia were more active than the control antibiotic Chloramphenicol. The Minimum inhibitory concentration (MIC) values for hexane and ethyl acetate extracts of Psiadia viscosa and Psiadia lithospermifolia against the tested bacteria ranged from (62.5 to 500 µg/ml). These findings validate the use of these tested Asteraceae in the traditional medicine of Mauritius and also highlight their pharmaceutical potential as prospective phytomedicines.

Keywords: antibacterial, antioxidant, DPPH, flavonoids, FRAP, Psiadia spp

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Authors: Mei-Hsia Dai

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Venerable Master Di-Chiao has been devoted all her life practicing the Earth Store Bodhisattva’s spirit and is one of the greatest masters in modern Buddhism. All Buddha and Bodhisattvas pay great respect to the Earth Store Bodhisattva because He vowed that He would not become Buddha until the hell is empty, and He would only achieve Bodhi until all sentient beings have been saved. The aim of this study is to investigate Venerable Master Di-Chiao, who actualizes the Buddha’s teaching and practices the Earth Store Bodhisattva’s compassion and apply them to help people. In fact, she has integrated her learning to teach people how to eliminate their karmic suffering with her close attention and full effort, even though she would be hurt all over or she had to sacrifice her own life. This qualitative research gathers data in terms of a field study, including an interview with Venerable Master Di-Chiao, a book about the Master and three books about true stories of people saved by the Master, and about 300 online feedbacks from her disciples and followers explaining how they were helped by the Master through their difficulties, together with a year-long observation at the Dharma services held in Taipei Di-Zang Temple. This article is divided into four parts: The first part depicts Master Di-Chiao’s original intent of being a nun and her three-step-one-bow pilgrimage experience around Taiwan. Part two illustrates the invitation of the Master’s being the Abbess of Tsiang-Te Temple, which was designated by Bodhisattva Avalokitesvara in a manager’s dream of the temple, and many unexpected difficulties ahead of the cultivation in the Master’s Buddha Path. In addition to maintenance of Tsiang-Te Temple, the third part will discuss the purpose of founding Taipei Di-Zang Temple, in which the Master always tries her best with various methods to cultivate good seeds for her disciples and followers and watches out for their karma and does her utmost effort to help them overcome it. The final part will briefly explain the Three Buddhalization: Buddhist wedding, Buddhist prenatal education and Buddhist family, which the Master has been advocating and considers them the essence of constructing a harmonious society and having a meaningful and enlightening life. Extraordinary results of practicing the Three Buddhalization will be given. Findings show that Master’s Di-Chiao’s actualization of Buddha’s teaching and Bodhisattva’s compassion is incredibly amazing and powerful, and she has helped countless people to conquer their difficulties and purify their evil habits. With the Master’s assistance and their hardworking and faith to the Master’s teaching, some of her disciples and followers have gone to the Maitreya Inside Realm, where the future Buddha has resided, and continue their cultivation. True stories will be presented to illuminate the incredibility of the Master’s compassion, her brevity and perseverance in the course of the Buddhahood. Venerable Master Di-Chiao is the embodiment of the Earth Store Bodhisattva for her disciples and followers.

Keywords: compassion, the Earth Store Bodhisattva, three Buddhalization, venerable Master Di-Chiao

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Authors: Farideh Gheitasi, Amir Hossain Jaberansari, Payam Abedini

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The World Health Organization (WHO) Manifesto for Safe Communities states that "All human beings have an equal right to health and safety". The purpose of a safe Community is to minimize the damages threatening people. It seems that not sufficient attention has been given to relate environment and objectives of the safe Community. The reason for that can be assigned to the lack of enough information about environmental parameters and their relation with indices of the safe community like type and effect time of damages resulting from air pollution. Air pollution can be characterized as one of main environmental problems of Tehran. This problem is mostly due to the special geographic and climate situation, high population density and irregular growth in the number of vehicles. This paper is aimed at investigating the necessity of considering environmental factors to obtain a safe community through determining the effects of environmental pollution, particularly air pollution, on 490000 elders (+65) of Tehran. The methodology used in this study was on the basis of Random sampling and social surveying. The number of questionnaires was determined to be 321 through using Cochran method and the questionnaires were filled out by elders during personal interviews. The analysis of obtained results indicated that elders believe the major effects of air pollution include heart and respiratory diseases, obligation to stay at home on polluted days and its associated mental problems. Moreover, it was found that there is direct link between the number of polluted days and mortality frequency of elders. Having an environmental view may have an appreciable influence on the qualitative and quantitative development of activities and also facilitate obtaining the goals of the Safe Communities. In addition to reduce damages caused by pollutions, this view will encourage friends of the environment to cooperate with authorities of the safe community.

Keywords: air pollution, elderly people, environment, waste management

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Authors: Roya Yumul, Chse, Ofelia Loani Elvir Lazo, David Chernobylsky, Omar Durra

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Background: Preoperative anxiety has been shown to be caused by the fear associated with surgical and anesthetic complications; however, the current gold standard for assessing patient anxiety, the STAI, is problematic to use in the preoperative setting given the duration and concentration required to complete the 40-item extensive questionnaire. Our primary aim in the study is to investigate the correlation of the Visual Facial Anxiety Scale (VFAS) and Numerical Verbal Rating Scale (NVRS) to State-Trait Anxiety Inventory (STAI) to determine the optimal anxiety scale to use in the perioperative setting. Methods: A clinical study of patients undergoing various surgeries was conducted utilizing each of the preoperative anxiety scales. Inclusion criteria included patients undergoing elective surgeries, while exclusion criteria included patients with anesthesia contraindications, inability to comprehend instructions, impaired judgement, substance abuse history, and those pregnant or lactating. 293 patients were analyzed in terms of demographics, anxiety scale survey results, and anesthesia data via Spearman Coefficients, Chi-Squared Analysis, and Fischer’s exact test utilized for comparison analysis. Results: Statistical analysis showed that VFAS had a higher correlation to STAI than NVRS (rs=0.66, p<0.0001 vs. rs=0.64, p<0.0001). The combined VFAS-Categorization Scores showed the highest correlation with the gold standard (rs=0.72, p<0.0001). Subgroup analysis showed similar results. STAI evaluation time (247.7 ± 54.81 sec) far exceeds VFAS (7.29 ± 1.61 sec), NVRS (7.23 ± 1.60 sec), and Categorization scales (7.29 ± 1.99 sec). Patients preferred VFAS (54.4%), Categorization (11.6%), and NVRS (8.8%). Anesthesiologists preferred VFAS (63.9%), NVRS (22.1%), and Categorization Scales (14.0%). Of note, the top five causes of preoperative anxiety were determined to be waiting (56.5%), pain (42.5%), family concerns (40.5%), no information about surgery (40.1%), or anesthesia (31.6%). Conclusions: Combined VFAS-Categorization Score (VCS) demonstrates the highest correlation to the gold standard, STAI. Both VFAS and Categorization tests also take significantly less time than STAI, which is critical in the preoperative setting. Among both patients and anesthesiologists, VFAS was the most preferred scale. This forms the basis of the Yumul FACES Anxiety Scale, designed for quick quantization and assessment in the preoperative setting while maintaining a high correlation to the golden standard. Additional studies using the formulated Yumul FACES Anxiety Scale are merited.

Keywords: numerical verbal anxiety scale, preoperative anxiety, state-trait anxiety inventory, visual facial anxiety scale

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Authors: A. E. Mukhametov, M. T. Yerbulekova, D. R. Dautkanova, G. A. Tuyakova, G. Aitkhozhayeva

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The accumulation of heavy metals in food is a constant problem in many parts of the world. Vegetable oils are widely used, both for cooking and for processing in the food industry, meeting the main dietary requirements. One of the main chemical pollutants, heavy metals, is usually found in vegetable oils. These chemical pollutants are carcinogenic, teratogenic and immunotoxic, harmful to consumption and have a negative effect on human health even in trace amounts. Residues of these substances can easily accumulate in vegetable oil during cultivation, processing and storage. In this article, the content of the concentration of heavy metal ions in vegetable oils of Kazakhstan production is studied: sunflower, rapeseed, safflower and linseed oil. Heavy metals: arsenic, cadmium, lead and nickel, were determined in three repetitions by the method of flame atomic absorption. Analysis of vegetable oil samples revealed that the largest lead contamination (Pb) was determined to be 0.065 mg/kg in linseed oil. The content of cadmium (Cd) in the largest amount of 0.009 mg/kg was found in safflower oil. Arsenic (As) content was determined in rapeseed and safflower oils at 0.003 mg/kg, and arsenic (As) was not detected in linseed and sunflower oil. The nickel (Ni) content in the largest amount of 0.433 mg/kg was in linseed oil. The heavy metal contents in the test samples complied with the requirements of regulatory documents for vegetable oils. An assessment of the health risk of vegetable oils with a daily consumption of 36 g per day shows that all samples of vegetable oils produced in Kazakhstan are safe for consumption. But further monitoring is needed, since all these metals are toxic and their harmful effects become apparent only after several years of exposure.

Keywords: vegetable oil, sunflower oil, linseed oil, safflower oil, toxic metals, food safety, rape oil

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Authors: Syed Qasim Gilani, Muhammad Umair, Muhammad Noman, Syed Bilawal Shah, Aqib Abbasi, Muhammad Waheed

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Cardiovascular Diseases(CVD's) are the major cause of death in the world. The main reason for these deaths is the unavailability of first aid for heart failure. In many cases, patients die before reaching the hospital. We in this paper are presenting innovative online health service for Cardiac Patients. The proposed online health system has two ends. Users through device developed by us can communicate with their doctor through a mobile application. This interface provides them with first aid.Also by using this service, they have an easy interface with their doctors for attaining medical advice. According to the proposed system, we developed a device called Cardiac Care. Cardiac Care is a portable device which a patient can use at their home for monitoring heart condition. When a patient checks his/her heart condition, Electrocardiogram (ECG), Blood Pressure(BP), Temperature are sent to the central database. The severity of patients condition is checked using Artificial Intelligence Algorithm at the database. If the patient is suffering from the minor problem, our algorithm will suggest a prescription for patients. But if patient's condition is severe, patients record is sent to doctor through the mobile Android application. Doctor after reviewing patients condition suggests next step. If a doctor identifies the patient condition as critical, then the message is sent to the central database for sending an ambulance for the patient. Ambulance starts moving towards patient for bringing him/her to hospital. We have implemented this model at prototype level. This model will be life-saving for millions of people around the globe. According to this proposed model patients will be in contact with their doctors all the time.

Keywords: cardiovascular disease, classification, electrocardiogram, blood pressure

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Authors: Taarika Singh

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Military wives – women married to army officers have largely been recognized as mere supporters or as auxiliaries to military men rather than propagators of thought and ideologies. The military wife (and her participation) is often dismissed as 'private', 'domestic', or 'trivial' and is acknowledged, if at all, only as an (inevitable/normative) entity, seen as a natural product/outcome of militarization. It is because the military wife has come to be constructed and accepted as normative by states and militaries that women of the military are easily ‘trivialised’ and are made to appear to be socially, politically, or theoretically irrelevantand/or insignificant. This paper, using ethnography-- structured and semi-structured interviews -- makes a gendered analysis of militarization, by bringing the military wife to the forefront and placing her at the nexus of the military and state apparatus. Moving away from gendered analyses that focus on the impact of militarization on women or draw attention to the ways in which militarization has been challenged/resisted by women, the paper pays attention to the centrality of women in shaping, validating, and perpetuating militarization, patriarchal control, and gendered hierarchies. The paper will demonstrate how military wives accept and comply with patriarchy as an institutional form of social organization that extends beyond the family and kinship relations into the military as an organization of the state. The paper will draw attention to the ways in which military norms, patriarchal values, and belief systems shape the social personhood, identity, and worldview of military wives; as a consequence of which, women play a central role in upholding and reproducing social inequalities and hierarchies; in shaping social status, and power relationships amongst men and women within and outside the military. The paper will allude to the processes and ideologies via which womena) accept and reproducemen as exclusive holders of power, status, and privilege; and b) recognize international relations, politics, andmatters related to security to be male dominated arenas inviting overwhelming masculine participation. In doing so, the paper will argue that women of the military play a critical role in perpetuating and upholding gendered meanings associated with the notion of and discourse around security. The paper will illustratehow military wives accept and assume security to be inherently a gendered idea -- a masculine notion, a male dominated arena, as something granted by men. In other words, the paper will demonstrate how the militarization of the military wives and the perpetuation of militarization by military wives plays a crucial role in propagating and perpetuating security to be a masculine notion or a male dominated arena. The paper will then question the degree to which such gendered analyses can shape the broader meanings, definitions, and discourses around security, matters related to security, and security threats.

Keywords: gender, militarisation, security, women

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Authors: Shabnam Najafi, Metin Turkay

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Network design problem (NDP) is used to determine the set of optimal values for certain pre-specified decision variables such as capacity expansion of nodes and links by optimizing various system performance measures including safety, congestion, and accessibility. The designed transportation network should improve objective functions defined for the system by considering the route choice behaviors of network users at the same time. The NDP studies mostly investigated the random demand and route selection constraints separately due to computational challenges. In this work, we consider both random demand and route selection constraints simultaneously. This work presents a nonlinear stochastic model for land use and road network design problem to address the development of different functional zones in urban areas by considering both cost function and air pollution. This model minimizes cost function and air pollution simultaneously with random demand and stochastic route selection constraint that aims to optimize network performance via road capacity expansion. The Bureau of Public Roads (BPR) link impedance function is used to determine the travel time function in each link. We consider a city with origin and destination nodes which can be residential or employment or both. There are set of existing paths between origin-destination (O-D) pairs. Case of increasing employed population is analyzed to determine amount of roads and origin zones simultaneously. Minimizing travel and expansion cost of routes and origin zones in one side and minimizing CO emission in the other side is considered in this analysis at the same time. In this work demand between O-D pairs is random and also the network flow pattern is subject to stochastic user equilibrium, specifically logit route choice model. Considering both demand and route choice, random is more applicable to design urban network programs. Epsilon-constraint is one of the methods to solve both linear and nonlinear multi-objective problems. In this work epsilon-constraint method is used to solve the problem. The problem was solved by keeping first objective (cost function) as the objective function of the problem and second objective as a constraint that should be less than an epsilon, where epsilon is an upper bound of the emission function. The value of epsilon should change from the worst to the best value of the emission function to generate the family of solutions representing Pareto set. A numerical example with 2 origin zones and 2 destination zones and 7 links is solved by GAMS and the set of Pareto points is obtained. There are 15 efficient solutions. According to these solutions as cost function value increases, emission function value decreases and vice versa.

Keywords: epsilon-constraint, multi-objective, network design, stochastic

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Authors: Archil Undilashvili, Ketevan Stvilia, Dustin Gilbreath, Giorgi Dzneladze, Gordon Charchward

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Introduction: In recent years, diverse types of wheelchairs, both local production and imported, have been made available on the Georgian market for wheelchair users. Some types of wheelchairs are sold together with a service package, while the others, including the State Program, Supported locally-produced ones, don’t provide adjustment and maintenance service packages to users. Within the USAID Physical Rehabilitation Project in Georgia, a study was conducted to assess the impact of the wheelchair service provision in line with the WHO guidelines on the health and overall satisfaction of wheelchair users in Georgia. Methodology: A cross-sectional survey was conducted in May 2021. A structured questionnaire was used for telephone interviews that, along with socio-demographic characteristics, included questions for assessment of accessibility, availability, timeliness, cost and quality of wheelchair services received. Out of 1060 individuals listed in the census of wheelchair users, 752 were available for interview, with an actual response rate of 73.4%. 552 wheelchair users (31%) or their caregivers (69%) agreed to participate in the survey. In addition to using descriptive statistics, the study used multivariate matching of wheelchair users who received wheelchair services and who did not (control group). In addition, to evaluate satisfaction with service provision, respondents were asked to assess services. Findings: The majority (67%) of wheelchair users included in the survey were male. The average age of participants was 43. The three most frequently named reasons for using a wheelchair were cerebral palsy (29%), followed by stroke (18%), and amputation (12%). Users have had their current chair for four years on average. Overall, 60% of respondents reported that they were assessed before providing a wheelchair, but only half of them reported that their preferences and needs were considered. Only 13% of respondents had services in line with WHO guidelines and only 22% of wheelchair users had training when they received their current chair. 16% of participants said they had follow-up services, and 41% received adjustment services after receiving the chair. A slight majority (56%) of participants were satisfied with the quality of service provision and the service provision overall. Similarly, 55% were satisfied with the accessibility of service provision. A slightly larger majority (61%) were satisfied with the timeliness of service provision. The matching analysis suggests that users that received services in line with WHO guidelines were more satisfied with their chairs (the difference 17 point/0-100 scale) and they were four percentage points less likely to have health problems attributed to the chair. The regression analysis provides a similar finding of a 21 point increase in satisfaction attributable to services. Conclusion: The provision of wheelchair services in line with WHO guidelines and with follow-up services is likely to have a positive impact on the daily lives of wheelchair users in Georgia. Wheelchair services should be institutionalized as a standard component of wheelchair provision in Georgia.

Keywords: physical rehabilitation, wheelchair users, persons with disabilities, wheelchair production

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Authors: A. M. S. S. Amarasiri, A. P. Attanayake, K. A. P. W. Jayatilaka, L. K. B. Mudduwa

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Adriamycin (ADR) is an effective anthracyclin antitumor drug, but its clinical use is limited due to renal toxicity. The leaves of Asparagus falcatus (Family: Liliaceae) have been used in the management of renal diseases since antiquity. In the present investigation, the aqueous leaf extract of A. falcatus was evaluated for acute nephroprotective activity in ADR induced nephrotoxic rats. Nephrotoxicity was induced in healthy male Wistar rats by intraperitoneal administration of ADR 20 mg/kg. The lyophilized powder of the aqueous refluxed (4h) leaf extract of A. falcatus was administered orally at three selected doses; 200, 400 and 600 mg/kg for three consecutive days. Fosinopril sodium (0.09 mg/kg) was used as the standard drug. Administration of the plant extract and the standard drug was commenced 24 hours after the induction of nephrotoxicity to rats. The nephroprotective effect was determined by selected biochemical parameters and by the assessment of histopathology on H and E stained kidney sections. The results were compared to a group of control rats with ADR induced nephrotoxicity. A group of rats administered with the equivalent volume of normal saline served as the healthy control. Administration of ADR 20 mg/kg produced a significant increase in the concentrations of serum creatinine (61%) and urine protein (73%) followed by a significant decrease in serum total protein (21%) and albumin (44%) of the plant extract treated animals compared to the healthy control group (p < 0.05). The aqueous extract of Asparagus falcatus at the three doses; 200, 400 and 600 mg/kg and the standard drug were found to decrease the elevation of concentrations of serum creatinine (33%, 51%, 54% and 42%) and urine protein (8%, 63%, 80% and 86%) respectively. The serum concentrations of total protein (12%, 17%, 29% and 12%) and albumin (3%, 17%, 17% and 16%) were significantly increased compared to the nephrotoxic control group respectively. Assessment of histopathology on H and E stained kidney sections demonstrated that ADR induced renal injury, as evidenced by loss of brush border, cytoplasmic vacuolization, pyknosis in renal tubular epithelial cells, haemorrhages, glomerular congestion and presence of hyaline casts. Treatment with the plant extract and the standard drug resulted in attenuation of the morphological destruction in rats. The results of the present study revealed that the aqueous leaf extract of A. falcatus possesses significant nephroprotective activity against adriamycin induced acute nephrotoxicity. The improved kidney functions were supported with the results of selected biochemical parameters and histological changes observed on H and E stained sections of the kidney tissues in Wistar rats.

Keywords: adriamycin induced nephrotoxicity, asparagus falcatus, biochemical assessment, histopathological assessment, nephroprotective activity

Procedia PDF Downloads 155

Authors: Emily Warren

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Despite the growing body of research on Japanese food history, little has been written about the attitudes and perspectives premodern Japanese people held about their food, even on special celebratory days. In fact, the overall image that arises from the literature is one of ambivalence: that the medieval nobility of the Heian and Kamakura periods (795-1333) did not much care about what they ate and for that reason, food seems relatively scarce in certain historical records. This study challenges this perspective by analyzing the manuals written to guide palace management and feast preparation for royals, introducing two of the sources into English for the first time. This research is primarily based on three manuals that address different aspects of royal food culture and preparation. The Chujiruiki, or Record of the Palace Kitchens (1295), is a fragmentary manual written by a bureaucrat in charge of the main palace kitchen office. This document collection details the utensils, furnishing, and courses that officials organized for the royals’ two daily meals in the morning (asagarei gozen) and in the afternoon (hiru gozen) when they enjoyed seven courses, each one carefully cooked and plated. The orchestration of daily meals and frequent banquets would have been complicated affairs for those preparing the tableware and food, thus requiring texts like the Chûjiruiki, as well as another manual, the Nicchûgyôji (11th c.), or The Daily Functions. Because of the complex coordination between various kitchen-related bureaucratic offices, kitchen officials endeavored to standardize the menus and place settings depending on the time of year, religious abstinence days, and available ingredients flowing into the capital as taxes. For the most important annual banquets and rites celebrating deities and the royal family, kitchen officials would likely refer to the Engi Shiki (927), or Protocols of the Engi Era, for details on offerings, servant payments, and menus. This study proposes that many of the great feast events, and indeed even daily meals at the palace, were so standardized and carefully planned for repetition that there would have been little need for the contents of such feasts to be detailed in diaries or novels—places where historians have noted a lack of the mention of food descriptions. These descriptions were not included for lack of interest on the part of the nobility, but rather because knowledge of what would be served at banquets and feasts would be considered a matter-of-course in the same way that a modern American would likely not need to state the menu of a traditional Thanksgiving meal to an American audience. Where food was concerned, novelty more so than tradition prompted a response in personal records, like diaries.

Keywords: banquets, bureaucracy, Engi shiki, Japanese food

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Authors: Velvizhi Dharmalingam, Rajalaksmi Ramalingam, Rekha Prabhu, Ilavarasan Raju

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Background: The use of herbal products for various therapeutic regimens has increased tremendously in the developing countries. Elaeocarpus ganitrus(Rudraksha) is a broad-leaved tree, belonging to the family Elaeocarpaceae found in tropical and subtropical areas. It is popular in an indigenous system of medicine like Ayurveda, Siddha, and Unani. According to Ayurvedic medicine, Rudraksha is used in the managing of blood pressure, asthma, mental disorders, diabetes, gynaecological disorders, neurological disorders such as epilepsy and liver diseases. Objectives: The present study aimed to study the physicochemical parameters of Elaeocarpus ganitrus(fruits) and identify the phenolic compounds (gallic acid, ellagic acid, and chebulinic acid). To estimate the microbial load and the antibacterial activity of extract of Elaeocarpus ganitrus for selective pathogens. Methodology: The dried powdered fruit of Elaeocarpus ganitrus was performed the physicochemical parameters (such as Loss on drying, Alcohol soluble extractive, Water soluble extractive, Total ash and Acid insoluble ash) and pH was measured. The dried coarse powdered fruit of Elaeocarpus ganitrus was extracted successively with hexane, chloroform, ethylacetate and aqueous alcohol by cold percolation method. Identification of phenolic compounds (gallic acid, ellagic acid, chebulinic acid) was done by HPTLC method and confirmed by co-TLC using different solvent system.The successive extracts of Elaeocarpus ganitrus and standards (like gallic acid, ellagic acid, and chebulinic acid) was approximately weighed and made up with alcohol. HPTLC (CAMAG) analysis was performed on a TLC over silica gel 60F254 precoated aluminium plate, layer thickness 0.2 mm (E.Merck, Germany) by using ATS4, Visualizer and Scanner with wavelength at 254 nm, 366 nm and derivatized with different reagents. The microbial load such as total bacterial count, total fungal count, Enterobacteria, Escherichia coli, Salmonella species, Staphylococcus aureus and Pseudomonas aeruginosa by serial dilution method and antibacterial activity of was measured by Kirby bauer method for selective pathogens. Results: The physicochemical parameter of Elaeocarpus ganitrus was studied for standardization of crude drug. Among all the successive extracts were identified with phenolic compounds and Elaeocarpus ganitrus extract having potent antibacterial activity against gram-positive and gram-negative bacteria.

Keywords: antimicrobial activity, Elaeocarpus ganitrus, HPTLC, phenolic compounds

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Authors: Shyamani Hettiarachchi, Gopi Kitnasamy

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Background: The potentially high level of physical need and dependency experienced by children with cerebral palsy could affect the quality of life (QOL) of the child, the caregiver and his/her family. Poor QOL in children with cerebral palsy is associated with the parent-child relationship, limited opportunities for social participation, limited access to healthcare services, psychological well-being and the child's physical functioning. Given that children experiencing disabilities have little access to remedial support with an inequitable service across districts in Sri Lanka, and given the impact of culture and societal stigma, there may be differing viewpoints across respondents. Objectives: The aim of this study was to evaluate the psychometric properties of the Tamil version of the Cerebral Palsy Quality of Life for Children (CPQOL-Child) Questionnaire. Design: An instrument development and validation study. Methods: Forward and backward translations of the CPQOL-Child were undertaken by a team comprised of a physiotherapist, speech and language therapist and two linguists for the primary caregiver form and the child self-report form. As part of a pilot phase, the Tamil version of the CPQOL was completed by 45 primary caregivers with children with cerebral palsy and 15 children with cerebral palsy (GMFCS level 3-4). In addition, the primary caregivers commented on the process of filling in the questionnaire. The psychometric properties of test-retest reliability, internal consistency and construct validity were undertaken. Results: The test-retest reliability and internal consistency were high. A significant association (p < 0.001) was found between limited motor skills and poor QOL. The Cronbach's alpha for the whole questionnaire was at 0.95.Similarities and divergences were found between the two groups of respondents. The child respondents identified limited motor skills as associated with physical well-being and autonomy. Akin to this, the primary caregivers associated the severity of motor function with limitations of physical well-being and autonomy. The trend observed was that QOL was not related to the level of impairment but connected to environmental factors by the child respondents. In addition to this, the main concern among primary caregivers about the child's future and on the child's lack of independence was not fully captured by the QOL questionnaire employed. Conclusions: Although the initial results of the CPQOL questionnaire show high test-retest reliability and internal consistency of the instrument, it does not fully reflect the socio-cultural realities and primary concerns of the caregivers. The current findings highlight the need to take child and caregiver perceptions of QOL into account in clinical practice and research. It strongly indicates the need for culture-specific measures of QOL.

Keywords: cerebral palsy, CPQOL, culture, quality of life

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Authors: Alexandra Steed

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Alexandra Steed URBAN was commissioned to undertake the South Essex Green and Blue Infrastructure Study (SEGBI) on behalf of the Association of South Essex Local Authorities (ASELA): a partnership of seven neighboring councils within the Thames Estuary. Located on London’s doorstep, the 70,000-hectare region is under extraordinary pressure for regeneration, further development, and economic expansion, yet faces extreme challenges: sea-level rise and inadequate flood defenses, stormwater flooding and threatened infrastructure, loss of internationally important habitats, significant existing community deprivation, and lack of connectivity and access to green space. The brief was to embrace these challenges in the creation of a document that would form a key part of ASELA’s Joint Strategic Framework and feed into local plans and master plans. Thus, helping to tackle climate change, ecological collapse, and social inequity at a regional scale whilst creating a relationship and awareness between urban communities and the surrounding landscapes and nature. The SEGBI project applied a ‘land-based’ methodology, combined with a co-design approach involving numerous stakeholders, to explore how living infrastructure can address these significant issues, reshape future planning and development, and create thriving places for the whole community of life. It comprised three key stages, including Baseline Review; Green and Blue Infrastructure Assessment; and the final Green and Blue Infrastructure Report. The resulting proposals frame an ambitious vision for the delivery of a new regional South Essex Estuary (SEE) Park – 24,000 hectares of protected and connected landscapes. This unified parkland system will drive effective place-shaping and “leveling up” for the most deprived communities while providing large-scale nature recovery and biodiversity net gain. Comprehensive analysis and policy recommendations ensure best practices will be embedded within planning documents and decisions guiding future development. Furthermore, a Natural Capital Account was undertaken as part of the strategy showing the tremendous economic value of the natural assets. This strategy sets a pioneering precedent that demonstrates how the prioritisation of living infrastructure has the capacity to address climate change and ecological collapse, while also supporting sustainable housing, healthier communities, and resilient infrastructures. It was only achievable through a collaborative and cross-boundary approach to strategic planning and growth, with a shared vision of place, and a strong commitment to delivery. With joined-up thinking and a joined-up region, a more impactful plan for South Essex was developed that will lead to numerous environmental, social, and economic benefits across the region, and enhancing the landscape and natural environs on the periphery of one of the largest cities in the world.

Keywords: climate change, green and blue infrastructure, landscape architecture, master planning, regional planning, social equity

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Authors: Louise Reyntjens

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The last quarter of the twentieth century was characterized by the emergence of a new kind of terrorism: religiously-inspired terrorism. Islam finds itself at the heart of this new wave, considering the number of international attacks committed by Islamic-inspired perpetrators. With religiously inspired terrorism as an operating framework, governments increasingly rely on immigration law to counter such terrorism. Immigration law seems particularly useful because its core task consists of keeping ‘unwanted’ people out. Islamic terrorists more often than not have an immigrant background and will be subject to immigration law. As a result, immigration law becomes more and more ‘securitized’. The European migration crisis has reinforced this trend. The research explores the human rights consequences of immigration law’s securitization in Europe. For this, the author selected four European countries for a comparative study: Belgium, France, the United Kingdom and Sweden. All these countries face similar social and security issues but respond very differently to them. The United Kingdom positions itself on the repressive side of the spectrum. Sweden on the other hand also introduced restrictions to its immigration policy but remains on the tolerant side of the spectrum. Belgium and France are situated in between. This contribution evaluates the situation in Belgium. Through a series of legislative changes, the Belgian parliament (i) greatly expanded the possibilities of expelling foreign nationals for (vaguely defined) reasons of ‘national security’; (ii) abolished almost all procedural protection associated with this decision (iii) broadened, as an extra security measure, the possibility of depriving individuals condemned of terrorism of their Belgian nationality. Measures such as these are obviously problematic from a human rights perspective; they jeopardize the principle of legality, the presumption of innocence, the right to protection of private and family life and the prohibition on torture. Moreover, this contribution also raises questions about the efficacy of immigration law’s suitability as a counterterrorism instrument. Is it a legitimate step, considering the type of terrorism we face today? Or, is it merely a strategic move, considering the broader maneuvering space immigration law offers and the lack of political resistance governments receive when infringing the rights of foreigners? Even more so, figures demonstrate that today’s terrorist threat does not necessarily stem from outside our borders. Does immigration law then still absorb - if it has ever done so (completely) - the threat? The study’s goal is to critically assess, from a human rights perspective, the counterterrorism strategies European governments have adopted. As most governments adopt a variation of the same core concepts, the study’s findings will hold true even beyond the four countries addressed.

Keywords: Belgium, counterterrorism strategies, human rights, immigration law

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Authors: Eric Awich Ochen

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The end of the conflict in Northern Uganda in 2006 brought about an opportunity for the youth to return to their original home and contribute to the peace building and development process of their communities. Post-conflict is used here to refer to the post-armed conflict situation and activities of rebels of Joseph Kony in northern Uganda. While the rebels remain very much active in the Sudan and Central African Republic, in Uganda the last confrontations occurred around 2006 or earlier, and communities have returned to their homes and began the process of rebuilding their lives. It is argued that socio-economic reconstruction is at the heart of peacebuilding and sustenance of positive peace in the aftermath of conflict, as it has a bearing on post-conflict stability and good governance. We recognize that several post-conflict interventions within Northern Uganda have targeted women and children with a strong emphasis on family socio-economic empowerment and capacity building, including access to micro finance. The aim of this study was to examine the participation of the youth in post-conflict peace building and development in Northern Uganda by assessing the breadth and width of their engagement and the stages of programming cycle that they are involved in, interrogating the space for participation and how they are facilitating or constraining participation. It was further aimed at examining the various dimensions of participation at play in Northern Uganda and where this fits within the conceptual debates on peace building and development in the region. Supporting young people emerging out of protracted conflict to re-establish meaningful socio-economic engagements and livelihoods is fundamental to their participation in the affairs of the community. The study suggests that in the post-conflict development context of Northern Uganda, participation has rarely been disaggregated or differentiated by sectors or groups. Where some disaggregation occurs, then the main emphasis has always been on either women or children. It appears therefore that little meaningful space has thus been created for young people to engage and participate in peace building initiatives within the region. In other cases where some space is created for youth participation, this has been in pre-conceived programs or interventions conceived by the development organizations with the youth or young people only invited to participate at particular stages of the project implementation cycle. Still within the implementation of the intervention, the extent to which young people participate is bounded, with little power to influence the course of the interventions or make major decisions. It is thus visible that even here young people mainly validate and legitimize what are predetermined processes only act as pawns in the major chess games played by development actors (dominant peace building partners). This paper, therefore, concludes that the engagement of the youth in post-conflict peace building has been quite problematic and tokenistic and has not given the adequate youth space within which they could ably participate and express themselves in the ensuing interventions.

Keywords: youth, conflict, peace building, participation

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Authors: Loyd R. Hook, Maryam Moharek

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With the envisioned future growth of low altitude urban aircraft operations for airborne delivery service and advanced air mobility, strategies to coordinate and deconflict aircraft flight paths must be prioritized. Autonomous coordination and planning of flight trajectories is the preferred approach to the future vision in order to increase safety, density, and efficiency over manual methods employed today. Difficulties arise because any conflict resolution must be constrained by all other aircraft, all airspace restrictions, and all ground-based obstacles in the vicinity. These considerations make pair-wise tactical deconfliction difficult at best and unlikely to find a suitable solution for the entire system of vehicles. In addition, more traditional methods which rely on long time scales and large protected zones will artificially limit vehicle density and drastically decrease efficiency. Instead, strategic planning, which is able to respond to highly dynamic conditions and still account for high density operations, will be required to coordinate multiple vehicles in the highly constrained low altitude urban environment. This paper develops and evaluates such a planning algorithm which can be implemented autonomously across multiple aircraft and situations. Data from this evaluation provide promising results with simulations showing up to 10 aircraft deconflicted through a relatively narrow low-altitude urban canyon without any vehicle to vehicle or obstacle conflict. The algorithm achieves this level of coordination beginning with the assumption that each vehicle is controlled to follow an independently constructed flight path, which is itself free of obstacle conflict and restricted airspace. Then, by preferencing speed change deconfliction maneuvers constrained by the vehicles flight envelope, vehicles can remain as close to the original planned path and prevent cascading vehicle to vehicle conflicts. Performing the search for a set of commands which can simultaneously ensure separation for each pair-wise aircraft interaction and optimize the total velocities of all the aircraft is further complicated by the fact that each aircraft's flight plan could contain multiple segments. This means that relative velocities will change when any aircraft achieves a waypoint and changes course. Additionally, the timing of when that aircraft will achieve a waypoint (or, more directly, the order upon which all of the aircraft will achieve their respective waypoints) will change with the commanded speed. Put all together, the continuous relative velocity of each vehicle pair and the discretized change in relative velocity at waypoints resembles a hybrid reachability problem - a form of control reachability. This paper proposes two methods for finding solutions to these multi-body problems. First, an analytical formulation of the continuous problem is developed with an exhaustive search of the combined state space. However, because of computational complexity, this technique is only computable for pairwise interactions. For more complicated scenarios, including the proposed 10 vehicle example, a discretized search space is used, and a depth-first search with early stopping is employed to find the first solution that solves the constraints.

Keywords: strategic planning, autonomous, aircraft, deconfliction

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Authors: Tan Hui Ying Renee, Stella Rizalina Sasha, Farah Safdar Husain

Abstract:

Introduction: Menopause Hormone Therapy (MHT) is an effective drug indicated for the treatment of menopausal symptoms and as replacement therapy in women who undergo premature menopause. In 2020, less than 8.8% of perimenopausal Singaporean women are on hormonal therapy, as compared to the Western population, where up to 50% may be on MHT. Factors associated with MHT utilization have been studied from patient characteristics, but the impact of locally prescribing physicians resulting in low MHT utilization has yet to be evaluated. The aim of the study is to determine the level of knowledge physicians in the Obstetrics and Gynaecology specialty have and their attitudes toward MHT. We believe that knowledge of MHT is lacking and that negative attitudes towards MHT may influence its use and undermine the benefits MHT may have for women. This paper is a part of a larger study on Singaporean physicians’ knowledge and attitudes towards MHT. Methods: This is a cross-sectional study intended to assess the knowledge and attitudes of physicians toward Menopausal Hormone Therapy. An anonymous questionnaire was disseminated via institutional internal circulations to optimize reach to physicians who may prescribe MHT, particularly in the fields of Gynaecology, Family Medicine and Endocrinology. Responses were completed voluntarily. Physicians had the option for each question to declare that they were ‘unsure’ or that the question was ‘beyond their expertise’. 21 knowledge questions tested factual recall on indications, contraindications, and risks of MHT. The remaining 6 questions were clinical scenarios crafted with the intention of testing specific principles related to the use of MHT. These questions received face validation from experts in the field. 198 responses were collected, 79 of which were from physicians in the Obstetrics and Gynaecology specialty. The data will be statistically analyzed to investigate areas that can be improved to increase the overall benefits of MHT for the Singaporean population. Results: Preliminary results show that the prevailing factors that limit Singaporean gynecologists and obstetricians from prescribing MHT are a lack of knowledge of MHT and a lack of confidence in prescribing MHT. Risks and indications of MHT were not well known by many physicians, with the majority of the questions having more than 25% incorrect and ‘unsure’ as their reply. The clinical scenario questions revealed significant shortcomings in knowledge on how to navigate real-life challenges in MHT use, with 2 of 6 questions with more than 50% incorrect or ‘beyond their expertise’ as their reply. The portion of the questionnaire that investigated the attitudes of physicians showed that though a large majority believed MHT to be an effective drug, only 40.5% were confident in prescribing it. Conclusion: Physicians in the Obstetrics and Gynaecology specialty lack knowledge and confidence in MHT. Therefore, it is imperative to formulate solutions on both the individual and institutional levels to fill these gaps and ensure that MHT is used appropriately and prescribed to the patients who need it.

Keywords: menopause, menopause hormone therapy, physician factors, obstetrics and gynecology, menopausal symptoms, Singapore

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