Search results for: cancer care services
Commenced in January 2007
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Edition: International
Paper Count: 8593

Search results for: cancer care services

763 Financial Innovations for Companies Offered by Banks: Polish Experience

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

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

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

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762 Changes in Cognition of Elderly People: A Longitudinal Study in Kanchanaburi Province, Thailand

Authors: Natchaphon Auampradit, Patama Vapattanawong, Sureeporn Punpuing, Malee Sunpuwan, Tawanchai Jirapramukpitak

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Longitudinal studies related to cognitive impairment in elderly are necessary for health promotion and development. The purposes of this study were (1) to examine changes in cognition of elderly over time and (2) to examine the impacts of changes in social determinants of health (SDH) toward changes in cognition of elderly by using the secondary data derived from the Kanchanaburi Demographic Surveillance System (KDSS) by the Institute for Population and Social Research (IPSR) which contained longitudinal data on individuals, households, and villages. Two selected projects included the Health and Social Support for Elderly in KDSS in 2007 and the Population, Economic, Social, Cultural, and Long-term Care Surveillance for Thai Elderly People’s Health Promotion in 2011. The samples were 586 elderly participated in both projects. SDH included living arrangement, social relationships with children, relatives, and friends, household asset-based wealth index, household monthly income, loans for livings, loans for investment, and working status. Cognitive impairment was measured by category fluency and delayed recall. This study employed Generalized Estimating Equation (GEE) model to investigate changes in cognition by taking SDH and other variables such as age, gender, marital status, education, and depression into the model. The unstructured correlation structure was selected to use for analysis. The results revealed that 24 percent of elderly had cognitive impairment at baseline. About 13 percent of elderly still had cognitive impairment during 2007 until 2011. About 21 percent and 11 percent of elderly had cognitive decline and cognitive improvement, respectively. The cross-sectional analysis showed that household asset-based wealth index, social relationship with friends, working status, age, marital status, education, and depression were significantly associated with cognitive impairment. The GEE model revealed longitudinal effects of household asset-based wealth index and working status against cognition during 2007 until 2011. There was no longitudinal effect of social conditions against cognition. Elderly living with richer household asset-based wealth index, still being employed, and being younger were less likely to have cognitive impairment. The results strongly suggested that poorer household asset-based wealth index and being unemployed were served as a risk factor for cognitive impairment over time. Increasing age was still the major risk for cognitive impairment as well.

Keywords: changes in cognition, cognitive impairment, elderly, KDSS, longitudinal study

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761 Exploring the Link between Hoarding Disorder and Trauma: A Scoping Review

Authors: Murray Anderson, Galina Freed, Karli Jahn

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Trauma is increasingly recognized as an important construct that has health implications for those who struggle with various mental health issues. For those individuals who meet the criteria for a diagnosis of hoarding disorder (HD), many have experienced some form of trauma. Further, some of the therapeutic interventions for those with HD can further perpetuate or magnify the experience of trauma. Therefore, the aim of this scoping review is to identify and document the nature and extent of research evidence related to trauma as it connects with HD. This review was guided by the questions, ‘How can our understanding of the trauma cycle help us to better appreciate the experiences of individuals who hoard, and how will a trauma informed lens inform the interventions for hoarding disorder? A comprehensive literature search was performed to identify original studies that contained the words “hoarding” and “trauma.” PsychINFO”,''EBSCO host,” “CINAHL” and “PubMed” were searched between January 2005 and April 2021. Articles were screened by three reviewers. Data extracted included publication date, demographics, study design, type of analysis, and noted connections between hoarding and trauma. Of the 329 articles, all duplicates, articles on hoardings of animals, articles not in English, and those without full-text availability were removed. Five categories were found in the remaining 45 articles, including (a) traumatic and stressful life events; (b) the link between posttraumatic stress disorder, trauma, and hoarding; (c) the relationships between different comorbidities, trauma, and hoarding; (d) the lack of early emotional expression and other forms of parental deprivation; and (e) the role of attachment. Lastly, the literature explains how the links between hoarding and trauma are difficult to study due to the highly stigmatized identities with this population. The review provided strong support for the connections between the experience of trauma and HD. What is missing from the literature is the use of a trauma-informed lens to better account for the ways in which hoarding disorder is understood. Other missing pieces in the literature are the potential uses of a trauma-informed lens to enhance the therapeutic process, to understand and reduce treatment attrition, and to improve treatment outcomes. The application of a trauma informed lens could improve our understanding of effective interactions among clients, families, and communities and improve the education around hoarding-related matters. Exploring the connections between trauma and HD can improve therapeutic delivery and destigmatize the experience of dealing with clutter and hoarding concerns. This awareness can also provide health care professionals with both the language and skills to liberate them from a reductionist view on HD.

Keywords: hoarding, attachment, parental deprivation, trauma

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760 Anatomical and Histochemical Investigation of the Leaf of Vitex agnus-castus L.

Authors: S. Mamoucha, J. Rahul, N. Christodoulakis

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Introduction: Nature has been the source of medicinal agents since the dawn of the human existence on Earth. Currently, millions of people, in the developing world, rely on medicinal plants for primary health care, income generation and lifespan improvement. In Greece, more than 5500 plant taxa are reported while about 250 of them are considered to be of great pharmaceutical importance. Among the plants used for medical purposes, Vitex agnus-castus L. (Verbenaceae) is known since ancient times. It is a small tree or shrub, widely distributed in the Mediterranean basin up to the Central Asia. It is also known as chaste tree or monks pepper. Theophrastus mentioned the shrub several times, as ‘agnos’ in his ‘Enquiry into Plants’. Dioscorides mentioned the use of V. agnus-castus for the stimulation of lactation in nursing mothers and the treatment of several female disorders. The plant has important medicinal properties and a long tradition in folk medicine as an antimicrobial, diuretic, digestive and insecticidal agent. Materials and methods: Leaves were cleaned, detached, fixed, sectioned and investigated with light and Scanning Electron Microscopy (SEM). Histochemical tests were executed as well. Specific histochemical reagents (osmium tetroxide, H2SO4, vanillin/HCl, antimony trichloride, Wagner’ s reagent, Dittmar’ s reagent, potassium bichromate, nitroso reaction, ferric chloride and di methoxy benzaldehyde) were used for the sub cellular localization of secondary metabolites. Results: Light microscopical investigations of the elongated leaves of V. agnus-castus revealed three layers of palisade parenchyma, just below the single layered adaxial epidermis. The spongy parenchyma is rather loose. Adaxial epidermal cells are larger in magnitude, compared to those of the abaxial epidermis. Four different types of capitate, secreting trichomes, were localized among the abaxial epidermal cells. Stomata were observed at the abaxial epidermis as well. SEM revealed the interesting arrangement of trichomes. Histochemical treatment on fresh and plastic embedded tissue sections revealed the nature and the sites of secondary metabolites accumulation (flavonoids, steroids, terpenes). Acknowledgment: This work was supported by IKY - State Scholarship Foundation, Athens, Greece.

Keywords: Vitex agnus-castus, leaf anatomy, histochemical reagents, secondary metabolites

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759 A Patient-Centered Approach to Clinical Trial Development: Real-World Evidence from a Canadian Medical Cannabis Clinic

Authors: Lucile Rapin, Cynthia El Hage, Rihab Gamaoun, Maria-Fernanda Arboleda, Erin Prosk

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Introduction: Sante Cannabis (SC), a Canadian group of clinics dedicated to medical cannabis, based in Montreal and in the province of Quebec, has served more than 8000 patients seeking cannabis-based treatment over the past five years. As randomized clinical trials with natural medical cannabis are scarce, real-world evidence offers the opportunity to fill research gaps between scientific evidence and clinical practice. Data on the use of medical cannabis products from SC patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to report information on the profiles of both patients and prescribed medical cannabis products at SC clinics, and to assess the safety of medical cannabis among Canadian patients. Methods: This is an observational retrospective study of 1342 adult patients who were authorized with medical cannabis products between October 2017 and September 2019. Information regarding demographic characteristics, therapeutic indications for medical cannabis use, patterns in dosing and dosage form of medical cannabis and adverse effects over one-year follow-up (initial and 4 follow-up (FUP) visits) were collected. Results: 59% of SC patients were female, with a mean age of 56.7 (SD= 15.6, range= (19-97)). Cannabis products were authorized mainly for patients with a diagnosis of chronic pain (68.8% of patients), cancer (6.7%), neurological disorders (5.6%), and mood disorders (5.4 %). At initial visit, a large majority (70%) of patients were authorized exclusively medical cannabis products, 27% were authorized a combination of pharmaceutical cannabinoids and medical cannabis and 3% were prescribed only pharmaceutical cannabinoids. This pattern was recurrent over the one-year follow-up. Overall, oil was the preferred formulation (average over visits 72.5%) followed by a combination of oil and dry (average 19%), other routes of administration accounted for less than 4%. Patients were predominantly prescribed products with a balanced THC:CBD ratio (59%-75% across visits). 28% of patients reported at least one adverse effect (AE) at the 3-month follow-up visit and 12% at the six-month FUP visit. 84.8% of total AEs were mild and transient. No serious AE was reported. Overall, the most common side effects reported were dizziness (11.95% of total AEs), drowsiness (11.4%), dry mouth (5.5%), nausea (4.8%), headaches (4.6%), cough (4.4%), anxiety (4.1%) and euphoria (3.5%). Other adverse effects accounted for less than 3% of total AE. Conclusion: Our results confirm that the primary area of clinical use for medical cannabis is in pain management. Patients in this cohort are largely utilizing plant-based cannabis oil products with a balanced ratio of THC:CBD. Reported adverse effects were mild and included dizziness and drowsiness. This real-world data confirms the tolerable safety profile of medical cannabis and suggests medical indications not yet validated in controlled clinical trials. Such data offers an important opportunity for the investigation of the long-term effects of cannabinoid exposure in real-life conditions. Real-world evidence can be used to direct clinical trial research efforts on specific indications and dosing patterns for product development.

Keywords: medical cannabis, safety, real-world data, Canada

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758 Pesticide Use Practices among Female Headed Households in the Amhara Region, Ethiopia

Authors: Birtukan Atinkut Asmare, Bernhard Freyer, Jim Bingen

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

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

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757 Water Balance in the Forest Basins Essential for the Water Supply in Central America

Authors: Elena Listo Ubeda, Miguel Marchamalo Sacristan

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

Keywords: Costa Rica, infiltration, soil, water

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756 Evaluation of the Role of Simulation and Virtual Reality as High-Yield Adjuncts to Paediatric Education

Authors: Alexandra Shipley

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Background: Undergraduate paediatric teaching must overcome two major challenges: 1) balancing patient safety with active student engagement and 2) exposing students to a comprehensive range of pathologies within a relatively short clinical placement. Whilst lectures and shadowing on paediatric wards constitute the mainstay of learning, Simulation and Virtual Reality (VR) are emerging as effective teaching tools, which - immune to the unpredictability and seasonal variation of hospital presentations - could expose students to the entire syllabus more reliably, efficiently, and independently. We aim to evaluate the potential utility of Simulation and VR in addressing gaps within the traditional paediatric curriculum from the perspective of medical students. Summary of Work: Exposure to and perceived utility of various learning opportunities within the Paediatric and Emergency Medicine courses were assessed through a questionnaire completed by 5th year medical students (n=23). Summary of Results: Students reported limited exposure to several common acute paediatric presentations, such as bronchiolitis (41%), croup (32%) or pneumonia (14%), and to clinical emergencies, including cardiac/respiratory arrests or trauma calls (27%). Across all conditions, average self-reported confidence in assessment and management to the level expected of an FY1 is greater amongst those who observed at least one case (e.g. 7.6/10 compared with 3.6/10 for croup). Students rated exposure through Simulation or VR to be of similar utility to witnessing a clinical scenario on the ward. In free text responses, students unanimously favoured being ‘challenged’ through ‘hands-on’ patient interaction over passive shadowing, where it is ‘easy to zone out.’ In recognition of the fact that such independence is only appropriate in certain clinical situations, many students reported wanting more Simulation and VR teaching. Importantly, students raised the necessity of ‘proper debriefs’ after these sessions to maximise educational value. Discussion and Conclusion: Our questionnaire elicited several student-perceived challenges in paediatric education, including incomplete exposure to common pathologies and limited opportunities for active involvement in patient care. Indeed, these experiences seem to be important predictors of confidence. Quantitative and qualitative feedback suggests that VR and Simulation satisfy students’ self-reported appetite for independent engagement with authentic clinical scenarios. Take-aways: Our findings endorse further development of VR and Simulation as high-yield adjuncts to paediatric education.

Keywords: paediatric emergency education, simulation, virtual reality, medical education

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755 Department of Social Development/Japan International Cooperation Agency's Journey from South African Community to Southern African Region

Authors: Daisuke Sagiya, Ren Kamioka

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

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

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754 Coaching for Lecturers at German Universities: An Inventory Based on a Qualitative Interview Study

Authors: Freya Willicks

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

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

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753 State Forest Management Practices by Indigenous Peoples in Dharmasraya District, West Sumatra Province, Indonesia

Authors: Abdul Mutolib, Yonariza Mahdi, Hanung Ismono

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

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

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752 A Retrospective Study: Correlation between Enterococcus Infections and Bone Carcinoma Incidence

Authors: Sonia A. Stoica, Lexi Frankel, Amalia Ardeljan, Selena Rashid, Ali Yasback, Omar Rashid

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Introduction Enterococcus is a vast genus of lactic acid bacteria, gram-positivecocci species. They are common commensal organisms in the intestines of humans: E. faecalis (90–95%) and E. faecium (5–10%). Rare groups of infections can occur with other species, including E. casseliflavus, E. gallinarum, and E. raffinosus. The most common infections caused by Enterococcus include urinary tract infections, biliary tract infections, subacute endocarditis, diverticulitis, meningitis, septicemia, and spontaneous bacterial peritonitis. The treatment for sensitive strains of these bacteria includes ampicillin, penicillin, cephalosporins, or vancomycin, while the treatment for resistant strains includes daptomycin, linezolid, tygecycline, or streptogramine. Enterococcus faecalis CECT7121 is an encouraging nominee for being considered as a probiotic strain. E. faecalis CECT7121 enhances and skews the profile of cytokines to the Th1 phenotype in situations such as vaccination, anti-tumoral immunity, and allergic reactions. It also enhances the secretion of high levels of IL-12, IL-6, TNF alpha, and IL-10. Cytokines have been previously associated with the development of cancer. The intention of this study was to therefore evaluate the correlation between Enterococcus infections and incidence of bone carcinoma. Methods A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th and 10th codes for bone carcinoma diagnosis in a previously Enterococcus infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). Access to the database was granted by Holy Cross Health for academic research. Chi-squared test was used to assess statistical significance. Results A total number of 17,056 patients was obtained in Enterococcus infected group as well as in the control population (matched by Age range and CCI score). Subsequent bone carcinoma development was seen at a rate of 1.07% (184) in the Enterococcal infectious group and 3.42% (584) in the control group, respectively. The difference was statistically significant by p= 2.2x10-¹⁶, Odds Ratio = 0.355 (95% CI 0.311 - 0.404) Treatment for enterococcus infection was analyzed and controlled for in both enterococcus infected and noninfected populations. 78 out of 6,624 (1.17%) patients with a prior enterococcus infection and treated with antibiotics were compared to 202 out of 6,624 (3.04%) patients with no history of enterococcus infection (control) and received antibiotic treatment. Both populations subsequently developed bone carcinoma. Results remained statistically significant (p<2.2x10-), Odds Ratio=0.456 (95% CI 0.396-0.525). Conclusion This study shows a statistically significant correlation between Enterococcus infection and a decreased incidence of bone carcinoma. The immunologic response of the organism to Enterococcus infection may exert a protecting mechanism from developing bone carcinoma. Further exploration is needed to identify the potential mechanism of Enterococcus in reducing bone carcinoma incidence.

Keywords: anti-tumoral immunity, bone carcinoma, enterococcus, immunologic response

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751 The Evolution of Moral Politics: Analysis on Moral Foundations of Korean Parties

Authors: Changdong Oh

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With the arrival of post-industrial society, social scientists have been giving attention to issues of which factors shape cleavage of political parties. Especially, there is a heated controversy over whether and how social and cultural values influence the identities of parties and voting behavior. Drawing from Moral Foundations Theory (MFT), which approached similar issues by considering the effect of five moral foundations on political decision-making of people, this study investigates the role of moral rhetoric in the evolution of Korean political parties. Researcher collected official announcements released by the major two parties (Democratic Party of Korea, Saenuri Party) from 2007 to 2016, and analyzed the data by using Word2Vec algorithm and Moral Foundations Dictionary. Five moral decision modules of MFT, composed of care, fairness (individualistic morality), loyalty, authority and sanctity (group-based, Durkheimian morality), can be represented in vector spaces consisted of party announcements data. By comparing the party vector and the five morality vectors, researcher can see how the political parties have actively used each of the five moral foundations to express themselves and the opposition. Results report that the conservative party tends to actively draw on collective morality such as loyalty, authority, purity to differentiate itself. Notably, such moral differentiation strategy is prevalent when they criticize an opposition party. In contrast, the liberal party tends to concern with individualistic morality such as fairness. This result indicates that moral cleavage does exist between parties in South Korea. Furthermore, individualistic moral gaps of the two political parties are eased over time, which seems to be due to the discussion of economic democratization of conservative party that emerged after 2012, but the community-related moral gaps widened. These results imply that past political cleavages related to economic interests are diminishing and replaced by cultural and social values associated with communitarian morality. However, since the conservative party’s differentiation strategy is largely related to negative campaigns, it is doubtful whether such moral differentiation among political parties can contribute to the long-term party identification of the voters, thus further research is needed to determine it is sustainable. Despite the limitations, this study makes it possible to track and identify the moral changes of party system through automated text analysis. More generally, this study could contribute to the analysis of various texts associated with the moral foundation and finding a distributed representation of moral, ethical values.

Keywords: moral foundations theory, moral politics, party system, Word2Vec

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750 Pleading the Belly: Sentencing of Convicted Pregnant Women under the Common Law

Authors: Nana Yaw Ofori Gyasi

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Under the Common Law, there was a procedure called pleading the belly which allowed a woman who had reached the advanced stage of pregnancy to receive a reprieve of her death sentence until after she had put to bed. The plea was replaced with a legislation, which provides that a pregnant woman would automatically have her death sentence commuted to life imprisonment with hard labour. This Common Law principle has been continued and enacted into law by the various countries where the Common Law is practiced. This paper takes a look at what it terms as Pregnancy Legislations in some selected Common Law countries such as United States of America, Canada, England and Wales, Ghana and India to examine the scope, procedure and effect of such legislations. The paper adopts a comparative study approach to ascertain the country with the widest scope, non-complicated procedure and far-reaching effects of the Pregnancy Legislations. It is observed that some legislations make provision for the conversion of death penalty to life imprisonment for capital offences and also prescribe non-custodial sentence for non-capital offences. There are other legislations that merely suspend the death penalty while the convict is found to be pregnant. In terms of the procedure, some of the legislations make the issue of pregnancy a question of fact to be determined by a jury and in other legislations, the trial judge makes that determination after the judge is satisfied on the question of the convict being pregnant. The effects of the Pregnancy Legislation are observed to be varying. Women who give birth in prison are highly at risk of having stillbirth. Most of the prisons do not have adequate facilities to support expectant and lactating mothers while in prison. It has also been observed that with the number of female prisoners increasing over the years, custodial sentence for convicted pregnant women has a wider societal effect. The paper identifies certain gaps left in some of the legislations which relate to the procedure to be followed after custodial sentence is suspended for a convicted pregnant woman. The time the accused person got pregnant- whether before her arrest or during trial- and the effect of the timing of the pregnancy are gaps left in some of the legislations. The paper argues that such gaps should be filled by the legislator to prevent accused persons taking undue advantage of the Pregnancy Legislations. It is further argued that if convicted pregnant women will have to spend time in prison at all for very heinous crimes, the prison facilities should be improved so that expectant and lactating mothers can comfortably care for their babies and themselves to prevent dire health consequences for such mothers and the society at a whole.

Keywords: sentence of pregnant women, custodial sentence, , pregnant women, , common law

Procedia PDF Downloads 34
749 Developing an Intervention Program to Promote Healthy Eating in a Catering System Based on Qualitative Research Results

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

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

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

Procedia PDF Downloads 184
748 Family-School-Community Engagement: Building a Growth Mindset

Authors: Michelann Parr

Abstract:

Family-school-community engagement enhances family-school-community well-being, collective confidence, and school climate. While it is often referred to as a positive thing in the literature for families, schools, and communities, it does not come without its struggles. While there are numerous things families, schools, and communities do each and every day to enhance engagement, it is often difficult to find our way to true belonging and engagement. Working our way surface level barriers is easy; we can provide childcare, transportation, resources, and refreshments. We can even change the environment so that families will feel welcome, valued, and respected. But there are often mindsets and perpsectives buried deep below the surface, most often grounded in societal, familial, and political norms, expectations, pressures, and narratives. This work requires ongoing energy, commitment, and engagement of all stakeholders, including families, schools, and communities. Each and every day, we need to take a reflective and introspective stance at what is said and done and how it supports the overall goal of family-school-community engagement. And whatever we must occur within a paradigm of care in additional to one of critical thinking and social justice. Families, and those working with families, must not simply accept all that is given, but should instead ask these types of questions: a) How, and by whom, are the current philosophies and practices of family-school engagement interrogated? b) How might digging below surface level meanings support understanding of what is being said and done? c) How can we move toward meaningful and authentic engagement that balances knowledge and power between family, school, district, community (local and global), and government? This type of work requires conscious attention and intentional decision-making at all levels bringing us one step closer to authentic and meaningful partnerships. Strategies useful to building a growth mindset include: a) interrogating and exploring consistencies and inconsistencies by looking at what is done and what is not done through multiple perspectives; b) recognizing that enhancing family-engagement and changing mindsets take place at the micro-level (e.g., family and school), but also require active engagement and awareness at the macro-level (e.g., community agencies, district school boards, government); c) taking action as an advocate or activist. Negative narratives about families, schools, and communities should not be maintained, but instead critical and courageous conversations in and out of school should be initiated and sustained; and d) maintaining consistency, simplicity, and steady progress. All involved in engagement need to be aware of the struggles, but keep them in check with the many successes. Change may not be observed on a day-to-day basis or even immediately, but stepping back and looking from the outside in, might change the view. Working toward a growth mindset will produce better results than a fixed mindset, and this takes time.

Keywords: family engagment, family-school-community engagement, parent engagement, parent involvment

Procedia PDF Downloads 174
747 The Monitor for Neutron Dose in Hadrontherapy Project: Secondary Neutron Measurement in Particle Therapy

Authors: V. Giacometti, R. Mirabelli, V. Patera, D. Pinci, A. Sarti, A. Sciubba, G. Traini, M. Marafini

Abstract:

The particle therapy (PT) is a very modern technique of non invasive radiotherapy mainly devoted to the treatment of tumours untreatable with surgery or conventional radiotherapy, because localised closely to organ at risk (OaR). Nowadays, PT is available in about 55 centres in the word and only the 20\% of them are able to treat with carbon ion beam. However, the efficiency of the ion-beam treatments is so impressive that many new centres are in construction. The interest in this powerful technology lies to the main characteristic of PT: the high irradiation precision and conformity of the dose released to the tumour with the simultaneous preservation of the adjacent healthy tissue. However, the beam interactions with the patient produce a large component of secondary particles whose additional dose has to be taken into account during the definition of the treatment planning. Despite, the largest fraction of the dose is released to the tumour volume, a non-negligible amount is deposed in other body regions, mainly due to the scattering and nuclear interactions of the neutrons within the patient body. One of the main concerns in PT treatments is the possible occurrence of secondary malignant neoplasm (SMN). While SMNs can be developed up to decades after the treatments, their incidence impacts directly life quality of the cancer survivors, in particular in pediatric patients. Dedicated Treatment Planning Systems (TPS) are used to predict the normal tissue toxicity including the risk of late complications induced by the additional dose released by secondary neutrons. However, no precise measurement of secondary neutrons flux is available, as well as their energy and angular distributions: an accurate characterization is needed in order to improve TPS and reduce safety margins. The project MONDO (MOnitor for Neutron Dose in hadrOntherapy) is devoted to the construction of a secondary neutron tracker tailored to the characterization of that secondary neutron component. The detector, based on the tracking of the recoil protons produced in double-elastic scattering interactions, is a matrix of thin scintillating fibres, arranged in layer x-y oriented. The final size of the object is 10 x 10 x 20 cm3 (squared 250µm scint. fibres, double cladding). The readout of the fibres is carried out with a dedicated SPAD Array Sensor (SBAM) realised in CMOS technology by FBK (Fondazione Bruno Kessler). The detector is under development as well as the SBAM sensor and it is expected to be fully constructed for the end of the year. MONDO will make data tacking campaigns at the TIFPA Proton Therapy Center of Trento, at the CNAO (Pavia) and at HIT (Heidelberg) with carbon ion in order to characterize the neutron component and predict the additional dose delivered on the patients with much more precision and to drastically reduce the actual safety margins. Preliminary measurements with charged particles beams and MonteCarlo FLUKA simulation will be presented.

Keywords: secondary neutrons, particle therapy, tracking detector, elastic scattering

Procedia PDF Downloads 218
746 Pulmonary Complications of Dengue Infection

Authors: Shilpa Avarebeel

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Background: India is one of the seven identified countries in South-East Asia region, regularly reporting dengue infection and may soon transform into a major niche for dengue epidemics. Objective: To study the clinical profile of dengue in our setting with special reference to respiratory complication. Study design: Descriptive and exploratory study, for one year in 2014. All patients confirmed as dengue infection were followed and their clinical profile, along with outcome was determined. Study proforma was designed based on the objective of the study and it was pretested and used after modification. Data was analyzed using statistical software SPSS-Version 16. Data were expressed as mean ±S .D for parametric variables and actual frequencies or percentage for non-parametric data. Comparison between groups was done using students’ t-test for independent groups, Chie square test, one-way ANOVA test, Karl Pearson’s correlation test. Statistical significance is taken at P < 0.05. Results: Study included 134 dengue positive cases. 81% had dengue fever, 18% had dengue hemorrhagic fever, and one had dengue shock syndrome. Most of the cases reported were during the month of June. Maximum number of cases was in the age group of 26-35 years. Average duration of hospital stay was less than seven days. Fever and myalgia was present in all the 134 patients, 16 had bleeding manifestation. 38 had respiratory symptoms, 24 had breathlessness, and 14 had breathlessness and dry cough. On clinical examination of patients with respiratory symptoms, all twenty-eight had hypoxia features, twenty-four had signs of pleural effusion, and four had ARDS features. Chest x-ray confirmed the same. Among the patients with respiratory symptoms, the mean platelet count was 26,537 c/cmm. There was no statistical significant difference in the platelet count in those with ARDS and other dengue complications. Average four units of platelets were transfused to all those who had ARDS in view of bleeding tendency. Mechanical ventilator support was provided for ARDS patients. Those with pleural effusion and pulmonary oedema were given NIV (non-invasive ventilation) support along with supportive care. However, steroids were given to patients with ARDS and 10 patients with signs of respiratory distress. 100%. Mortality was seen in patients with ARDS. Conclusion: Dengue has to be checked for those presenting with fever and breathlessness. Supportive treatments remain the cornerstone of treatment. Platelet transfusion has to be given only by clinical judgment. Steroids have no role except in early ARDS, which is controversial. Early NIV support helps in speedy recovery of dengue patients with respiratory distress.

Keywords: adult respiratory distress syndrome, dengue fever, non-invasive ventilation, pulmonary complication

Procedia PDF Downloads 424
745 Basotho Cultural Shift: The Role of Dress in the Shift

Authors: Papali Elizabeth Maqalika

Abstract:

Introduction: Dress is used daily and can be used to define culture, and through it, individuals form a sense of self and identity. One of the characteristics of culture is that it evolves; Basotho culture is no exception to this. It has evolved through rites of entry, significant ceremonies, daily living, and an approach to others. Most of these affect and have been affected by the local/traditional dress. The study focused on the evolution of culture, and the role played by dress as it is one of the major contributors to non-verbal communication. Methodology: Secondary data were used since most of the original cultural practices are no longer held dear in the value system and so no longer practiced. Interviews were conducted to get some insights from the senior citizens and their responses compared to those of the present adults. Content analysis was used for the interview data. Results: The nature of governance in Lesotho has clearly contributed to the current cultural state of confusion. The Basotho culture has indeed shifted, and the difference in dress code explains it. Acculturation, the alteration in environments, and the type of occasions Basotho attended lately contributed to the shift. Technology brought about a difference in the mode of transport, sports, household activities, and gender roles. Conclusion and Recommendations: It was concluded that since culture is imparted through socialisation, a change in availability of most Basotho women leaves little time left for socialisation with children and resorts to other upbringing patterns, most of which are not cultural; this has brought a cultural shift. In addition, acculturation has contributed massively to the value system of Basotho. The type of dress worn by Basotho presently shifts the culture, and the shifting culture also shifts the dress required to suit the present culture. Because of the type of mindset Basotho has now, it is recommended that cultural days be observed in schools, including the multi-racial ones, and media should assist in this information transmission. The campaigns regarding the value of traditional dress and what it represents are recommended. The local dressmakers manufacturing the Seshoeshoe and any other traditional dress need to be educated about the fabric history, fiber content, and consequent care to be in a position to guide ultimate consumers of the products. Awareness campaigns that the culture shifts and may not necessarily result in negative should be ventured. Cultural exhibitions should also be held ideally at places that hold some cultural heritage. The ministry of sports and culture, together with that of tourism, should run with cultural awareness and enriching vision with a focus on education as opposed to revenue collection.

Keywords: Basotho, culture, dress, acculturation, influence, cultural heritage, socialization, non-verbal communication, Seshoeshoe

Procedia PDF Downloads 64
744 Parental Education on Early Childhood Development Using Mobile App and Website in China

Authors: Margo O'Sullivan, Xuefeng Chen, Qi Zhao, J. Jiang, Ning Fu

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Early childhood development, or ECD, is about the 'whole child' – the physical, social and emotional, cognitive thinking and language progression of each young individual. Overwhelming evidence is now available to support investment in Early Childhood Development internationally, attendance at ECD leads to: improved learning outcomes; improved completion and reduced less dropout rates; and most notably, Professor Heckman, Nobel Laureate’s, findings that for every dollar invested, there is an economic return of up to 17%. Notably, ECD has been included in the 2015-2030 Sustainable Development Goals. The Government of China (GOC) has embraced this research and in 2010, State Council, announced focus on ECD setting a target to provide access to ECD for 85% of 3-6 year olds by 2020; to date, the target has surpassed expectations and reached 70.4%. GoC is also increasingly focusing on the even more critical 0-3 age group, when the plasticity of the brain is at its peak and neurons form connections as fast as 1,000 per second. Key to ECD are parents and caregivers of young children, with parental education critical to fully exploiting the significant potential of the early years of children. In China, with such vast numbers, one in seven pre-school age children in the world live in China, the Ministry of Education (MoE) and the National Centre for Education Technology, explored how to best provide parental education and provide key child developmental related knowledge to parents and caregivers. In response, MoE and UNICEF created a resource for parenting information that began with a computer website in 2012, followed by piloting a kiosk service in 2013 for parents in remote areas without access to the internet, and then a mobile phone application in 2014. The resource includes 269 ECD messages and 200 micro-videos covering critical issues of early childhood development from birth to age 6 years: daily care, nutrition and feeding, disease prevention, immunization, development and education, and safety and protection. To date, there have been 397,599 unique views on the website, and data for the mobile app currently being analysed (Links: http://yuer.cbern.gov.cn/; App: https://appsto.re/cn/OiKPZ.i). This paper will explore the development of this resource, its use by parents and the public, efforts to assess the effectiveness in improving parenting and child development, and future plans to roll an updated version in 2016 to all parents.

Keywords: early childhood development, mobile apps for education, parental education, China

Procedia PDF Downloads 215
743 Mapping Actors in Sao Paulo's Urban Development Policies: Interests at Stake in the Challenge to Sustainability

Authors: A. G. Back

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In the context of global climate change, extreme weather events are increasingly intense and frequent, challenging the adaptability of urban space. In this sense, urban planning is a relevant instrument for addressing, in a systemic manner, various sectoral policies capable of linking the urban agenda to the reduction of social and environmental risks. The Master Plan of the Municipality of Sao Paulo, 2014, presents innovations capable of promoting the transition to sustainability in the urban space. Among such innovations, the following stand out: i) promotion of density in the axes of mass transport involving mixture of commercial, residential, services, and leisure uses (principles related to the compact city); ii) vulnerabilities reduction based on housing policies, including regular sources of funds for social housing and land reservation in urbanized areas; iii) reserve of green areas in the city to create parks and environmental regulations for new buildings focused on reducing the effects of heat island and improving urban drainage. However, long-term implementation involves distributive conflicts and may change in different political, economic, and social contexts over time. Thus, the central objective of this paper is to identify which factors limit or support the implementation of these policies. That is, to map the challenges and interests of converging and/or divergent urban actors in the sustainable urban development agenda and what resources they mobilize to support or limit these actions in the city of Sao Paulo. Recent proposals to amend the urban zoning law undermine the implementation of the Master Plan guidelines. In this context, three interest groups with different views of the city come into dispute: the real estate market, upper middle class neighborhood associations ('not in my backyard' movements), and social housing rights movements. This paper surveys the different interests and visions of these groups taking into account their convergences, or not, with the principles of sustainable urban development. This approach seeks to fill a gap in the international literature on the causes that underpin or hinder the continued implementation of policies aimed at the transition to urban sustainability in the medium and long term.

Keywords: adaptation, ecosystem-based adaptation, interest groups, urban planning, urban transition to sustainability

Procedia PDF Downloads 112
742 Reading Strategies of Generation X and Y: A Survey on Learners' Skills and Preferences

Authors: Kateriina Rannula, Elle Sõrmus, Siret Piirsalu

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Mixed generation classroom is a phenomenon that current higher education establishments are faced with daily trying to meet the needs of modern labor market with its emphasis on lifelong learning and retraining. Representatives of mainly X and Y generations in one classroom acquiring higher education is a challenge to lecturers considering all the characteristics that differ one generation from another. The importance of outlining different strategies and considering the needs of the students lies in the necessity for everyone to acquire the maximum of the provided knowledge as well as to understand each other to study together in one classroom and successfully cooperate in future workplaces. In addition to different generations, there are also learners with different native languages which have an impact on reading and understanding texts in third languages, including possible translation. Current research aims to investigate, describe and compare reading strategies among the representatives of generation X and Y. Hypotheses were formulated - representatives of generation X and Y use different reading strategies which is also different among first and third year students of the before mentioned generations. Current study is an empirical, qualitative study. To achieve the aim of the research, relevant literature was analyzed and a semi-structured questionnaire conducted among the first and third year students of Tallinn Health Care College. Questionnaire consisted of 25 statements on the text reading strategies, 3 multiple choice questions on preferences considering the design and medium of the text, and three open questions on the translation process when working with a text in student’s third language. The results of the questionnaire were categorized, analyzed and compared. Both, generation X and Y described their reading strategies to be 'scanning' and 'surfing'. Compared to generation X, first year generation Y learners valued interactivity and nonlinear texts. Students frequently used strategies of skimming, scanning, translating and highlighting together with relevant-thinking and assistance-seeking. Meanwhile, the third-year generation Y students no longer frequently used translating, resourcing and highlighting while Generation X learners still incorporated these strategies. Knowing about different needs of the generations currently inside the classrooms and on the labor market enables us with tools to provide sustainable education and grants the society a work force that is more flexible and able to move between professions. Future research should be conducted in order to investigate the amount of learning and strategy- adoption between generations. As for reading, main suggestions arising from the research are as follows: make a variety of materials available to students; allow them to select what they want to read and try to make those materials visually attractive, relevant, and appropriately challenging for learners considering the differences of generations.

Keywords: generation X, generation Y, learning strategies, reading strategies

Procedia PDF Downloads 173
741 Efficacy of Ergonomics Ankle Support on Squatting Pushing Skills during the Second Stage of Labor

Authors: Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee

Abstract:

Objective: To compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor. The three positions were: semi-recumbent, squatting, and squatting with the aid of ergonomically designed ankle supports. Methods: A randomized controlled trial was conducted at a regional teaching hospital in northern Taiwan. Data were collected from 168 primiparous women in their 38th to 42nd gestational week. None of the participants received epidural analgesia during labor and all were free of pregnancy and labor-related complications. Intervention: During labor, after full cervical dilation and when the fetal head had descended to at least the +1 station and had turned to the occiput anterior position, the experimental group was asked to push in the squatting position while wearing the ergonomically designed ankle supports; comparison group A was asked to push in the squatting position without the use of these supports; and comparison group B was asked to push in a standard semi-recumbent position. Measures: The participants completed a demographic and obstetrics datasheet, the Short Form McGill Pain Questionnaire (MPQ-SF), and the Labor Pushing Experience scale within 4-hours postpartum. Conclusion: In terms of delivery time, the duration between the start of pushing to crowning for the experimental group (squatting with ankle supports) averaged 25.52 minutes less (F =6.02, p< .05) than the time for comparison group B (semi-recumbent). Furthermore, the duration between the start of pushing to infant birth averaged 25.21 minutes less for the experimental group than for comparison group B (F =6.14, p< .05). Moreover, the experimental group had a lower average VAS pain score (5.05±3.22) than comparison group B and the average McGill pain score for the experimental group was lower than both comparison groups (F=18.12, p< .001). In summary, the participants in the group that delivered from a squatting position with ankle supports had better labor pushing experiences than their peers in the comparison groups. Results: In comparison to both unsupported squatting and semi-recumbent pushing, squatting with the aid of ergonomically designed ankle supports reduced pushing times, ameliorated labor pain, and improved the pushing experience. Clinical application and suggestion: The squatting with ankle-support intervention introduced in the present study may significantly reduce tiredness and difficulties in maintaining balance as well as increase pushing efficiency. Thus, this intervention may reduce the caring needs of women during the second stage of labor. This intervention may be introduced in midwifery education programs and in clinical practice as a method to improve the care of women during the second stage of labor.

Keywords: second stage of labor, pushing, squatting with ankle supports, squatting

Procedia PDF Downloads 265
740 Scalable UI Test Automation for Large-scale Web Applications

Authors: Kuniaki Kudo, Raviraj Solanki, Kaushal Patel, Yash Virani

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This research mainly concerns optimizing UI test automation for large-scale web applications. The test target application is the HHAexchange homecare management WEB application that seamlessly connects providers, state Medicaid programs, managed care organizations (MCOs), and caregivers through one platform with large-scale functionalities. This study focuses on user interface automation testing for the WEB application. The quality assurance team must execute many manual users interface test cases in the development process to confirm no regression bugs. The team automated 346 test cases; the UI automation test execution time was over 17 hours. The business requirement was reducing the execution time to release high-quality products quickly, and the quality assurance automation team modernized the test automation framework to optimize the execution time. The base of the WEB UI automation test environment is Selenium, and the test code is written in Python. Adopting a compilation language to write test code leads to an inefficient flow when introducing scalability into a traditional test automation environment. In order to efficiently introduce scalability into Test Automation, a scripting language was adopted. The scalability implementation is mainly implemented with AWS's serverless technology, an elastic container service. The definition of scalability here is the ability to automatically set up computers to test automation and increase or decrease the number of computers running those tests. This means the scalable mechanism can help test cases run parallelly. Then test execution time is dramatically decreased. Also, introducing scalable test automation is for more than just reducing test execution time. There is a possibility that some challenging bugs are detected by introducing scalable test automation, such as race conditions, Etc. since test cases can be executed at same timing. If API and Unit tests are implemented, the test strategies can be adopted more efficiently for this scalability testing. However, in WEB applications, as a practical matter, API and Unit testing cannot cover 100% functional testing since they do not reach front-end codes. This study applied a scalable UI automation testing strategy to the large-scale homecare management system. It confirmed the optimization of the test case execution time and the detection of a challenging bug. This study first describes the detailed architecture of the scalable test automation environment, then describes the actual performance reduction time and an example of challenging issue detection.

Keywords: aws, elastic container service, scalability, serverless, ui automation test

Procedia PDF Downloads 88
739 Assessment of Hydrologic Response of a Naturalized Tropical Coastal Mangrove Ecosystem Due to Land Cover Change in an Urban Watershed

Authors: Bryan Clark B. Hernandez, Eugene C. Herrera, Kazuo Nadaoka

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Mangrove forests thriving in intertidal zones in tropical and subtropical regions of the world offer a range of ecosystem services including carbon storage and sequestration. They can regulate the detrimental effects of climate change due to carbon releases two to four times greater than that of mature tropical rainforests. Moreover, they are effective natural defenses against storm surges and tsunamis. However, their proliferation depends significantly on the prevailing hydroperiod at the coast. In the Philippines, these coastal ecosystems have been severely threatened with a 50% decline in areal extent observed from 1918 to 2010. The highest decline occurred in 1950 - 1972 when national policies encouraged the development of fisheries and aquaculture. With the intensive land use conversion upstream, changes in the freshwater-saltwater envelope at the coast may considerably impact mangrove growth conditions. This study investigates a developing urban watershed in Kalibo, Aklan province with a 220-hectare mangrove forest replanted for over 30 years from coastal mudflats. Since then, the mangrove forest was sustainably conserved and declared as protected areas. Hybrid land cover classification technique was used to classify Landsat images for years, 1990, 2010, and 2017. Digital elevation model utilized was Interferometric Synthetic Aperture Radar (IFSAR) with a 5-meter resolution to delineate the watersheds. Using numerical modelling techniques, the hydrologic and hydraulic analysis of the influence of land cover change to flow and sediment dynamics was simulated. While significant land cover change occurred upland, thereby increasing runoff and sediment loads, the mangrove forests abundance adjacent to the coasts for the urban watershed, was somehow sustained. However, significant alteration of the coastline was observed in Kalibo through the years, probably due to the massive land-use conversion upstream and significant replanting of mangroves downstream. Understanding the hydrologic-hydraulic response of these watersheds to change land cover is essential to helping local government and stakeholders facilitate better management of these mangrove ecosystems.

Keywords: coastal mangroves, hydrologic model, land cover change, Philippines

Procedia PDF Downloads 113
738 Co-Culture with Murine Stromal Cells Enhances the In-vitro Expansion of Hematopoietic Stem Cells in Response to Low Concentrations of Trans-Resveratrol

Authors: Mariyah Poonawala, Selvan Ravindran, Anuradha Vaidya

Abstract:

Despite much progress in understanding the regulatory factors and cytokines that support the maturation of the various cell lineages of the hematopoietic system, factors that govern the self-renewal and proliferation of hematopoietic stem cells (HSCs) is still a grey area of research. Hematopoietic stem cell transplantation (HSCT) has evolved over the years and gained tremendous importance in the treatment of both malignant and non-malignant diseases. However, factors such as graft rejection and multiple organ failure have challenged HSCT from time to time, underscoring the urgent need for development of milder processes for successful hematopoietic transplantation. An emerging concept in the field of stem cell biology states that the interactions between the bone-marrow micro-environment and the hematopoietic stem and progenitor cells is essential for regulation, maintenance, commitment and proliferation of stem cells. Understanding the role of mesenchymal stromal cells in modulating the functionality of HSCs is, therefore, an important area of research. Trans-resveratrol has been extensively studied for its various properties to combat and prevent cancer, diabetes and cardiovascular diseases etc. The aim of the present study was to understand the effect of trans-resveratrol on HSCs using single and co-culture systems. We have used KG1a cells since it is a well accepted hematopoietic stem cell model system. Our preliminary experiments showed that low concentrations of trans-resveratrol stimulated the HSCs to undergo proliferation whereas high concentrations of trans-resveratrol did not stimulate the cells to proliferate. We used a murine fibroblast cell line, M210B4, as a stromal feeder layer. On culturing the KG1a cells with M210B4 cells, we observed that the stimulatory as well as inhibitory effects of trans-resveratrol at low and high concentrations respectively, were enhanced. Our further experiments showed that low concentration of trans-resveratrol reduced the generation of reactive oxygen species (ROS) and nitric oxide (NO) whereas high concentrations increased the oxidative stress in KG1a cells. We speculated that perhaps the oxidative stress was imposing inhibitory effects at high concentration and the same was confirmed by performing an apoptotic assay. Furthermore, cell cycle analysis and growth kinetic experiments provided evidence that low concentration of trans-resveratrol reduced the doubling time of the cells. Our hypothesis is that perhaps at low concentration of trans-resveratrol the cells get pushed into the G0/G1 phase and re-enter the cell cycle resulting in their proliferation, whereas at high concentration the cells are perhaps arrested at G2/M phase or at cytokinesis and therefore undergo apoptosis. Liquid Chromatography-Quantitative-Time of Flight–Mass Spectroscopy (LC-Q-TOF MS) analyses indicated the presence of trans-resveratrol and its metabolite(s) in the supernatant of the co-cultured cells incubated with high concentration of trans-resveratrol. We conjecture that perhaps the metabolites of trans-resveratrol are responsible for the apoptosis observed at the high concentration. Our findings may shed light on the unsolved problems in the in vitro expansion of stem cells and may have implications in the ex vivo manipulation of HSCs for therapeutic purposes.

Keywords: co-culture system, hematopoietic micro-environment, KG1a cell line, M210B4 cell line, trans-resveratrol

Procedia PDF Downloads 247
737 NHS Tayside Plastic Surgery Induction Cheat Sheet and Video

Authors: Paul Holmes, Mike N. G.

Abstract:

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

Keywords: induction, junior doctor, handover, plastic surgery

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736 Accelerating Entrepreneurship among Young Women in Sabah Malaysia

Authors: Imelda Albert Gisip, Tarisah T. Z. Taman

Abstract:

In Asia, particularly in Malaysia, women entrepreneurs contribute substantially to economic growth. This paper presents a review of women entrepreneurs’ program, focusing on Creating Millionaires among Young Women Entrepreneurs (CREAM@YWE) program in Sabah Malaysia, which aims to accelerate entrepreneurship among young women in Sabah Malaysia. Entrepreneurs are seen as essential for growth, job creation, and social progress, and the virtues of small business for Sabah Maju Jaya (SMJ), the Sabah state government Sabah State development plan for the year 2021-2025. SMJ guides the direction of the government's policies and programs, further guiding the implementation in a planned and strategic manner to achieve targets and goals that coincide with the development needs of the state. One of the government’s agendas is to put more effort into ensuring that women entrepreneurs are well supported and enhanced. Thus, The CreaM@YWE Program was developed in 2018 with the main objective is to produce competitive young women entrepreneurs in Sabah and achieve "millionaire" status. CreaM@YWE Program is an innovation process specifically developed to accelerate the entrepreneurship sector, particularly for women entrepreneurs in Sabah, by incorporating strategic partnerships and collaborations with government agencies and industry players. Being the first of its kind in Sabah, the novelty of this project is providing a supportive ecosystem, including six months of intensive courses guided through "hands-holding”, collaborations with strategic partners, and easy access to government assistance. Since its inception, the program has significantly impacted society’s wellbeing, particularly in empowering young women entrepreneurs in Sabah for the past six years, and has produced many successful women entrepreneurs with “millionaire” status. Generally, improving the women’s enterprise sector in Malaysia needs an overall environment that provides development opportunities for women entrepreneurs, including access to resources and support services. Since achieving the goal of women's entrepreneurship policy requires effective partnerships and inclusiveness, Cream @YWE Program has managed to practice these in assisting small entrepreneurs among young women in Sabah in accessing public goods and business opportunities. This proves that achieving women’s economic empowerment requires sound policies, a holistic approach, and long-term commitment. Thus, this paper presents how the Cream@YWE Program has been supporting Sabah young women entrepreneurs by reforming the business environment to help create opportunities for women while addressing the few existing gender-specific hurdles.

Keywords: young, women, entrepreneurs, Sabah, Malaysia

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735 Unveiling Adorno’s Concern for Revolutionary Praxis and Its Enduring Significance: A Philosophical Analysis of His Writings on Sociology and Philosophy

Authors: Marie-Josee Lavallee

Abstract:

Adorno’s reputation as an abstract and pessimistic thinker who indulged in a critic of capitalist society and culture without bothering himself with opening prospects for change, and who has no interest in political activism, recently begun to be questioned. This paper, which has a twofold objective, will push revisionist readings a step further by putting forward the thesis that revolutionary praxis has been an enduring concern for Adorno, surfacing throughout his entire work. On the other hand, it will hold that his understanding of the relationships between theory and praxis, which will be explained by referring to Ernst Bloch’s distinction between the warm and cold currents of Marxism, can help to interpret the paralysis of revolutionary practice in our own time under a new light. Philosophy and its tasks have been an enduring topic of Adorno’s work from the 1930s to Negativ Dialektik. The writings in which he develops these ideas stand among his most obscure and abstract so that their strong ties to the political have remained mainly overlooked. Adorno’s undertaking of criticizing and ‘redeeming’ philosophy and metaphysics is inseparable from a care for retrieving the capacity to act in the world and to change it. Philosophical problems are immanent to sociological problems, and vice versa, he underlines in his Metaphysik. Begriff and Problem. The issue of truth cannot be severed from the contingent context of a given idea. As a critical undertaking extracting its contents from reality, which is what philosophy should be from Adorno's perspective, the latter has the potential to fully reveal the reification of the individual and consciousness resulting from capitalist economic and cultural domination, thus opening the way to resistance and revolutionary change. While this project, according to his usual method, is sketched mainly in negative terms, it also exhibits positive contours which depict a socialist society. Only in the latter could human suffering end, and mutilated individuals experiment with reconciliation in an authentic way. That Adorno’s continuous plea for philosophy’s self-critic and renewal hides an enduring concern for revolutionary praxis emerges clearly from a careful philosophical analysis of his writings on philosophy and a selection of his sociological work, coupled with references to his correspondences. This study points to the necessity of a serious re-evaluation of Adorno’s relationship to the political, which will impact on the interpretation of his whole oeuvre, is much needed. In the second place, Adorno's dialectical conception of theory and praxis is enlightening for our own time, since it suggests that we are experiencing a phase of creative latency rather an insurmountable impasse.

Keywords: Frankfurt school, philosophy and revolution, revolutionary praxis, Theodor W. Adorno

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734 Promoting 'One Health' Surveillance and Response Approach Implementation Capabilities against Emerging Threats and Epidemics Crisis Impact in African Countries

Authors: Ernest Tambo, Ghislaine Madjou, Jeanne Y. Ngogang, Shenglan Tang, Zhou XiaoNong

Abstract:

Implementing national to community-based 'One Health' surveillance approach for human, animal and environmental consequences mitigation offers great opportunities and value-added in sustainable development and wellbeing. 'One Health' surveillance approach global partnerships, policy commitment and financial investment are much needed in addressing the evolving threats and epidemics crises mitigation in African countries. The paper provides insights onto how China-Africa health development cooperation in promoting “One Health” surveillance approach in response advocacy and mitigation. China-Africa health development initiatives provide new prospects in guiding and moving forward appropriate and evidence-based advocacy and mitigation management approaches and strategies in attaining Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs). Early and continuous quality and timely surveillance data collection and coordinated information sharing practices in malaria and other diseases are demonstrated in Comoros, Zanzibar, Ghana and Cameroon. Improvements of variety of access to contextual sources and network of data sharing platforms are needed in guiding evidence-based and tailored detection and response to unusual hazardous events. Moreover, understanding threats and diseases trends, frontline or point of care response delivery is crucial to promote integrated and sustainable targeted local, national “One Health” surveillance and response approach needs implementation. Importantly, operational guidelines are vital in increasing coherent financing and national workforce capacity development mechanisms. Strengthening participatory partnerships, collaboration and monitoring strategies in achieving global health agenda effectiveness in Africa. At the same enhancing surveillance data information streams reporting and dissemination usefulness in informing policies decisions, health systems programming and financial mobilization and prioritized allocation pre, during and post threats and epidemics crises programs strengths and weaknesses. Thus, capitalizing on “One Health” surveillance and response approach advocacy and mitigation implementation is timely in consolidating Africa Union 2063 agenda and Africa renaissance capabilities and expectations.

Keywords: Africa, one health approach, surveillance, response

Procedia PDF Downloads 412