Search results for: women population

Authors: Mary Elizabeth Bernardin, Margie Batek, Joseph Moen, David Schnadower

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Background: Injuries due to interpersonal violence are a common reason for emergency department (ED) visits amongst the American pediatric population. Gun violence, in particular, is associated with high morbidity, mortality as well as financial costs. Patterns of pediatric ED usage may be an indicator of risk for future violence, but very little data on the topic exists. Objective: The aims of this study were to assess for frequencies of ED usage for previous interpersonal violence, mental/behavioral issues, sexual/reproductive issues and concerns for abuse in youths presenting to EDs due to physical assault injuries (PAIs) compared to firearm injuries (FIs). Methods: In this retrospective case-control study, ED charts of children ages 8-19 years who presented with injuries due to interpersonal violent encounters from 2014-2017 were reviewed. Data was collected regarding all previous ED visits for injuries due to interpersonal violence (including physical assaults and firearm injuries), mental/behavioral health visits (including depression, suicidal ideation, suicide attempt, homicidal ideation and violent behavior), sexual/reproductive health visits (including sexually transmitted infections and pregnancy related issues), and concerns for abuse (including physical abuse or domestic violence, neglect, sexual abuse, sexual assault, and intimate partner violence). Logistic regression was used to identify predictors of gun violence based on previous ED visits amongst physical assault injured versus firearm injured youths. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed, 251 (62%) of which were due to physical assault injuries (PAIs) and 156 (38%) due to firearm injuries (FIs). The majority of both PAI and FI patients had no previous history of ED visits for violence, mental/behavioral health, sexual/reproductive health or concern for abuse (60.8% PAI, 76.3% FI). 19.2% of PAI and 13.5% of FI youths had previous ED visits for physical assault injuries (OR 0.68, P=0.24, 95% CI 0.36 to 1.29). 1.6% of PAI and 3.2% of FI youths had a history of ED visits for previous firearm injuries (OR 3.6, P=0.34, 95% CI 0.04 to 2.95). 10% of PAI and 3.8% of FI youths had previous ED visits for mental/behavioral health issues (OR 0.91, P=0.80, 95% CI 0.43 to 1.93). 10% of PAI and 2.6% of FI youths had previous ED visits due to concerns for abuse (OR 0.76, P=0.55, 95% CI 0.31 to 1.86). Conclusions: There are no statistically significant differences between physical assault-injured and firearm-injured youths in terms of ED usage for previous violent injuries, mental/behavioral health visits, sexual/reproductive health visits or concerns for abuse. However, violently injured youths in this study have more than twice the number of previous ED usage for physical assaults and mental health visits than previous literature indicates. Data comparing ED usage of victims of interpersonal violence to nonviolent ED patients is needed, but this study supports the notion that EDs may be a useful place for identification of and enrollment in interventions for youths most at risk for future violence.

Keywords: child abuse, emergency department usage, pediatric gun violence, pediatric interpersonal violence, pediatric mental health, pediatric reproductive health

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Authors: Kiran Kumar Gellaboina, Padmaja Kaja

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Agricultural Education and Research in India needs a transformation to serve the needs of the farmers and that of the nation. The fact that Agriculture and allied activities act as main source of livelihood for more than 70% population of rural India reinforces its importance in administrative and policy arena. As per Census 2011 of India it provides employment to approximately 56.6 % of labour. India has achieved significant growth in agriculture, milk, fish, oilseeds and fruits and vegetables owing to green, white, blue and yellow revolutions which have brought prosperity to farmers. Many factors are responsible for these achievement viz conducive government policies, receptivity of the farmers and also establishment of higher agricultural education institutions. The new breed of skilled human resources were instrumental in generating new technologies, and in its assessment, refinement and finally its dissemination to the farming community through extension methods. In order to sustain, diversify and realize the potential of agriculture sectors, it is necessary to develop skilled human resources. Agricultural human resource development is a continuous process undertaken by agricultural universities. The Department of Agricultural Research and Education (DARE) coordinates and promotes agricultural research & education in India. In India, agricultural universities were established on ‘land grant’ pattern of USA which helped incorporation of a number of diverse subjects in the courses as also provision of hands-on practical exposure to the student. The State Agricultural Universities (SAUs) established through the legislative acts of the respective states and with major financial support from them leading to administrative and policy controls. It has been observed that pace and quality of technology generation and human resource development in many of the SAUs has gone down. The reason for this slackening are inadequate state funding, reduced faculty strength, inadequate faculty development programmes, lack of modern infrastructure for education and research etc. Establishment of new state agricultural universities and new faculties/colleges without providing necessary financial and faculty support has aggrieved the problem. The present work highlights some of the key issues affecting agricultural education and research in India and the impact it would have on farm productivity and sustainability. Secondary data pertaining to budgetary spend on agricultural education and research will be analyzed. This paper will study the trends in public spending on agricultural education and research and the per capita income of farmers in India. This paper tries to suggest that agricultural education and research has a key role in equipping the human resources for enhanced agricultural productivity and sustainable use of natural resources. Further, a total re-orientation of agricultural education with emphasis on other agricultural related social sciences is needed for effective agricultural policy research.

Keywords: agriculture, challenges, education, research

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Authors: Miguel Angel Calvo Salve

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This qualitative and quantitative study will identify the impact of tourism pressure on the intangible cultural heritage of the pilgrim route of El Camino de Santiago (Saint James Way) and propose an approach to a sustainable touristic model for these Cultural Routes. Since 1993, the Spanish Section of the Pilgrim Route of El Camino de Santiago has been on the World Heritage List. In 1994, the International Committee on Cultural Routes (CIIC-ICOMOS) initiated its work with the goal of studying, preserving, and promoting the cultural routes and their significance as a whole. Another ICOMOS group, the Charter on Cultural Routes, pointed out in 2008 the importance of both tangible and intangible heritage and the need for a holistic vision in preserving these important cultural assets. Tangible elements provide a physical confirmation of the existence of these cultural routes, while the intangible elements serve to give sense and meaning to it as a whole. Intangible assets of a Cultural Route are key to understanding the route's significance and its associated heritage values. Like many pilgrim routes, the Route to Santiago, as the result of a long evolutionary process, exhibits and is supported by intangible assets, including hospitality, cultural and religious expressions, music, literature, and artisanal trade, among others. A large increase in pilgrims walking the route, with very different aims and tourism pressure, has shown how the dynamic links between the intangible cultural heritage and the local inhabitants along El Camino are fragile and vulnerable. Economic benefits for the communities and population along the cultural routes are commonly fundamental for the micro-economies of the people living there, substituting traditional productive activities, which, in fact, modifies and has an impact on the surrounding environment and the route itself. Consumption of heritage is one of the major issues of sustainable preservation promoted with the intention of revitalizing those sites and places. The adaptation of local communities to new conditions aimed at preserving and protecting existing heritage has had a significant impact on immaterial inheritance. Based on questionnaires to pilgrims, tourists and local communities along El Camino during the peak season of the year, and using official statistics from the Galician Pilgrim’s Office, this study will identify the risk and threats to El Camino de Santiago as a Cultural Route. The threats visible nowadays due to the impact of mass tourism include transformations of tangible heritage, consumerism of the intangible, changes of local activities, loss in the authenticity of symbols and spiritual significance, and pilgrimage transformed into a tourism ‘product’, among others. The study will also approach some measures and solutions to mitigate those impacts and better preserve this type of cultural heritage. Therefore, this study will help the Route services providers and policymakers to better preserve the Cultural Route as a whole to ultimately improve the satisfying experience of pilgrims.

Keywords: cultural routes, El Camino de Santiago, impact of tourism, intangible heritage

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Authors: Ponshano Kaselekela, Simooya O. Oscar, Lunshano Boyd

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The Copperbelt University Health Services (CBUHS) was designated by the Zambia Medicines Regulatory Authority (ZAMRA), formally the Pharmaceutical Regulatory Authority (PRA) as a regional pharmacovigilance centre to carryout activities of drug safety monitoring in four provinces in Zambia. CBUHS’s mandate included stimulating the reporting of adverse drug reactions (ADRs), as well as collecting and collating ADR reports from health institutions in the four provinces. This report covers the researchers’ experiences from May 2008 to September, 2016. The main objectives are 1) to monitor ADRs in the Zambian population, 2) to disseminate information to all health professionals in the region advising that the CBU health was a centre for reporting ADRs in the region, 3) to monitor polypharmacy as well as the benefit-risk profile of medicines, 4) to generate independent, evidence based recommendations on the safety of medicines, 5) to support ZAMRA in formulating safety related regulatory decisions for medicines, and 6) to communicate findings with all key stakeholders. The methodology involved monthly visits, beginning in early May 2008 to September, 2016, by the CBUHS to health institutions in the programme areas. Activities included holding discussions with health workers, distribution of ADR forms and collection of ADRs reports. These reports, once collected, were documented and assessed at the CBUHS. A report was then prepared for ZAMRA on quarterly basis. At ZAMRA, serious ADRs were noted and recommendations made to the Ministry of Health of the Republic of Zambia. The results show that 2,600 ADRs reports were received at the pharmacovigilance regional centre. Most of the ADRs reports that received were due to antiretroviral drugs, as well as a few from anti-malarial drugs like Artemether/Lumefantrine – Coartem®. Three hundred and twelve ADRs were entered in the Uppsala Monitoring Centre WHO Vigiflow for further analysis. It was concluded that in general, 2008-16 were exciting years for the pharmacovigilance group at CBUHS. From a very tentative beginning, a lot of strides were made and contacts established with healthcare facilities in the region. The researchers were encouraged by the support received from the Copperbelt University management, the motivation provided by ZAMRA and most importantly the enthusiasm of health workers in all the health care facilities visited. As a centre for drug safety in Zambia, the results show it achieves its objectives for monitoring ADRs, Pharmacovigilance (drug safety monitoring), and activities of monitoring ADRs as well as preventing them. However, the centre faces critical challenges caused by erratic funding that prevents the smooth running of the programme.

Keywords: adverse drug reactions, drug safety, monitoring, pharmacovigilance

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Authors: E. O. Egieyeh, N. Butler, R. Coetzee, M. Van Huyssteen, A. Bheekie

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Background: High rate of maternal and child mortality is a global concern. Nationally, it constitutes one of South Africa’s quadruple burdens of diseases. Pharmacists have a crucial role in maternal and child health care delivery and as such should be equipped with adequate knowledge and skill required to contribute to maternal and child well-being. The International Pharmaceutical Federation statement of policy (2013) outlines pharmacist-led interventions in accordance with the World Health Organisation’s interventions in maternal, new-born and child health care. The South African Pharmacy Council’s guideline on Good Pharmacy Practice (2010) also stipulates the minimum standards required to participate in reproductive, maternal and child care. Pharmacy schools are obliged to train pharmacy students to meet priority health needs of the population so that graduates are ‘fit for purpose’. The purpose of the study is to evaluate the knowledge and skill of final year pharmacy students at a university in South Africa to determine their preparedness to contribute effectively to maternal and child health care. Method: A quantitative, descriptive, non-randomized baseline study was conducted among the final year students at the School of Pharmacy. Data was collected using a questionnaire designed in sections to assess knowledge of contraception, maternal and child health directed at the primary care level and framed within the scope of practice required of an entry-level generalist pharmacist. Participants’ skill in infant growth assessment was assessed in a section of the questionnaire in a written format. Participants ticked the topics they had been exposed to on a curriculum content assessment tool which was not graded. A pilot study examined the clarity and suitability of question items, and duration to complete the questionnaire. A score of 50% in each section of the questionnaire indicated a pass. The questionnaire was delivered in campus lecture venue. Results: Of the 102 students in final year, 53 (52%) students consented to participate in the study. Only 13.2% of participants scored above 50% in each section. Forty five (85%) participants scored above 50% in the contraception section while 40 (75%) scored less than 50% in the skills assessment. Less than half (45.3%) of the participants had a total score above 50%. Being a parent or working part-time as pharmacist assistance did not have any influence on the performance of the participants. Evaluation of participants’ curriculum content exposure showed differences in exposure to the various topics. Exposure to contraception teaching received the most recognition. Conclusion: Maternal and child health curriculum content should be reviewed at the university to enhance the knowledge and skill of pharmacy graduates.

Keywords: final year pharmacy students, knowledge and skill, maternal and child health, South Africa

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Authors: Henry Acurio, Alvaro Corral, Juan Fonseca

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In Ecuador, subventions on fossil fuels for the road transportation sector have always been part of its economy throughout time, mainly because of demagogy and populism from political leaders. It is clearly seen that the government cannot maintain the subsidies anymore due to its commercial balance and its general state budget; subsidies are a key barrier to implementing the use of cleaner technologies. However, during the last few months, the elimination of subsidies has been done gradually with the purpose of reaching international prices. It is expected that with this measure, the population will opt for other means of transportation, and in a certain way, it will promote the use of private electric vehicles and public, e.g., taxis and buses (urban transport). Considering the three main elements of sustainable development, an analysis of the social, economic, and environmental impacts of eliminating subsidies will be generated at the country level. To achieve this, four scenarios will be developed in order to determine how the subsidies will contribute to the promotion of electro-mobility: 1) A Business as Usual (BAU) scenario; 2) the introduction of 10 000 electric vehicles by 2025; 3) the introduction of 100 000 electric vehicles by 2030; 4) the introduction of 750 000 electric vehicles by 2040 (for all the scenarios, buses, taxis, lightweight duty vehicles, and private vehicles will be introduced, as it is established in the National Electro Mobility Strategy for Ecuador). The Low Emissions Analysis Platform (LEAP) will be used, and it will be suitable to determine the cost for the government in terms of importing derivatives for fossil fuels and the cost of electricity to power the electric fleet that can be changed. The elimination of subventions generates fiscal resources for the state that can be used to develop other kinds of projects that will benefit Ecuadorian society. It will definitely change the energy matrix, and it will provide energy security for the country; it will be an opportunity for the government to incentivize a greater introduction of renewable energies, e.g., solar, wind, and geothermal. At the same time, it will also reduce greenhouse gas emissions (GHG) from the transportation sector, considering its mitigation potential, which as a result, will ameliorate the inhabitant quality of life by improving the quality of air, therefore reducing respiratory diseases associated with exhaust emissions, consequently, achieving sustainability, the Sustainable Development Goals (SDGs), and complying with the agreements established in the Paris Agreement COP 21 in 2015. Electro-mobility in Latin America and the Caribbean can only be achieved by the implementation of the right policies by the central government, which need to be accompanied by a National Urban Mobility Policy (NUMP), and can encompass a greater vision to develop holistic, sustainable transport systems at local governments.

Keywords: electro mobility, energy, policy, sustainable transportation

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Authors: Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem

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Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well.

Keywords: perioperative cardiac arrest, trauma patients, emergency surgery, anesthesia, factors risk, incidence

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Authors: J. Manuel Bello-López, Julieta Rojo-Medina

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Introduction: The transplant of Umbilical Cord Blood Units (UCBU) are a therapeutic possibility for patients with oncohaematological disorders, especially in children. In Mexico, 48.5% of oncological diseases in children 1-4 years old are leukemias; whereas in patients 5-14 and 15-24 years old, lymphomas and leukemias represent the second and third cause of death in these groups respectively. Therefore it is necessary to have more registries of UCBU in order to ensure genetic diversity in the country; the above because the search for appropriate a UCBU is increasingly difficult for patients of mixed ethnicity. Objective: To estimate the genetic diversity (polymorphisms) of Human Leucocyte Antigen (HLA) Class I (A, B) and Class II (DRB1) in UCBU cryopreserved for transplant at Cord Blood Bank of the NCBT. Material and Methods: HLA typing of 533 UCBU for transplant was performed from 2003-2012 at the Histocompatibility Laboratory from the Research Department (evaluated by Los Angeles Ca. Immunogenetics Center) of the NCBT. Class I HLA-A, HLA-B and Class II HLA-DRB1 typing was performed using medium resolution Sequence-Specific Primer (SSP). In cases of an ambiguity detected by SSP; Sequence-Specific Oligonucleotide (SSO) method was carried out. A strict analysis of populations genetic parameters were done in 5 representative UCBU populations. Results: 46.5% of UCBU were collected from Mexico City, State of Mexico (30.95%), Puebla (8.06%), Morelos (6.37%) and Veracruz (3.37%). The remaining UCBU (4.75%) are represented by other states. The identified genotypes correspond to Amerindian origins (HLA-A*02, 31; HLA-B*39, 15, 48), Caucasian (HLA-A*02, 68, 01, 30, 31; HLA-B*35, 15, 40, 44, 07 y HLA-DRB1*04, 08, 07, 15, 03, 14), Oriental (HLA-A*02, 30, 01, 31; HLA-B* 35, 39, 15, 40, 44, 07,48 y HLA-DRB1*04, 07,15, 03) and African (HLA-A*30 y HLA-DRB1*03). The genetic distances obtained by Cavalli-Sforza analysis of the five states showed significant genetic differences by comparing genetic frequencies. The shortest genetic distance exists between Mexico City and the state of Puebla (0.0039) and the largest between Veracruz and Morelos (0.0084). In order to identify significant differences between this states, the ANOVA test was performed. This demonstrates that UCBU is significantly different according to their origin (P <0.05). This is shown by the divergence between arms at the Dendogram of Neighbor-Joining. Conclusions: The NCBT provides UCBU in patients with oncohaematological disorders in all the country. There is a group of patients for which not compatible UCBU can be find due to the mixed ethnic origin. For example, the population of northern Mexico is mostly Caucasian. Most of the NCBT donors are of various ethnic origins, predominantly Amerindians and Caucasians; although some ethnic minorities like Oriental, African and pure Indian ethnics are not represented. The NCBT is, therefore, establishing agreements with different states of Mexico to promote the altruistic donation of Umbilical Cord Blood in order to enrich the genetic diversity in its files.

Keywords: cord blood, genetic diversity, human leucocyte antigen, transplant

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Authors: Magdalena Biela, Marta Weber-Siwirska, Edyta Sierka

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The current noticed trend in Central European countries, as in other regions of the world, is for people to migrate to cities. As a result, the urban population is to have reached 70% of the total by 2050. Due to this tendency, as well as taking high real estate prices and limited reserves of city green areas into consideration, the greenery and agricultural soil adjacent to cities is are to be devoted to housing projects, while city centres are expected to undergo partial depopulation. Urban heat islands and phenomena such as torrential rains may cause serious damage. They may even endanger the very life and health of the inhabitants. Due to these tangible effects of climate change, residents expect that local government takes action to develop green infrastructure (GI). The main purpose of our research has been to assess the degree of readiness on the part of the local government in Poland to develop BGI. A questionnaire using the CAWI method was prepared, and a survey was carried out. The target group were town hall employees in all 380 powiat cities and towns (380 county centres) in Poland. The form contained 14 questions covering, among others, actions taken to support the development of GI and ways of motivating residents to take such actions. 224 respondents replied to the questions. The results of the research show that 52% of the cities/towns have taken or intend to take measures to favour the development of green spaces. Currently, the installation of green roofs and living walls is are only carried out by 6 Polish cities, and a few more are at the stage of preparing appropriate regulations. The problem of rainwater retention is much more widespread. Among the municipalities declaring any activities for the benefit of GI, approximately 42% have decided to work on this problem. Over 19% of the respondents are planning an increase in the surface occupied by green areas, 14% - the installation of green roofs, and 12% - redevelopment of city greenery. It is optimistic that 67% of the respondents are willing to acquire knowledge about BGI by means of taking part in educational activities both at the national and international levels. There are many ways to help GI development. The most common type of support in the cities and towns surveyed is co-financing (35%), followed by full financing of projects (11%). About 15% of the cities declare only advisory support. Thus, the problem of GI in Central European cities is at the stage of initial development and requires advanced measures and implementation of both proven solutions applied in other European and world countries using the concept of Nature-based Solutions.

Keywords: city/town, blue-green infrastructure, green roofs, climate change adaptation

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Authors: Diana F. Lopes, Jorge Simoes, José Martins, Eduardo Castro

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Health professionals are the keystone of any health system, by delivering health services to the population. Given the time and cost involved in training new health professionals, the planning process of the health workforce is particularly important as it ensures a proper balance between the supply and demand of these professionals and it plays a central role on the Health 2020 policy. In the past 40 years, the planning of the health workforce in Portugal has been conducted in a reactive way lacking a prospective vision based on an integrated, comprehensive and valid analysis. This situation may compromise not only the productivity and the overall socio-economic development but the quality of the healthcare services delivered to patients. This is even more critical given the expected shortage of the health workforce in the future. Furthermore, Portugal is facing an aging context of some professional classes (physicians and nurses). In 2015, 54% of physicians in Portugal were over 50 years old, and 30% of all members were over 60 years old. This phenomenon associated to an increasing emigration of young health professionals and a change in the citizens’ illness profiles and expectations must be considered when planning resources in healthcare. The perspective of sudden retirement of large groups of professionals in a short time is also a major problem to address. Another challenge to embrace is the health workforce imbalances, in which Portugal has one of the lowest nurse to physician ratio, 1.5, below the European Region and the OECD averages (2.2 and 2.8, respectively). Within the scope of the HEALTH 2040 project – which aims to estimate the ‘Future needs of human health resources in Portugal till 2040’ – the present study intends to get a comprehensive dynamic approach of the problem, by (i) estimating the needs of physicians and nurses in Portugal, by specialties and by quinquenium till 2040; (ii) identifying the training needs of physicians and nurses, in medium and long term, till 2040, and (iii) estimating the number of students that must be admitted into medicine and nursing training systems, each year, considering the different categories of specialties. The development of such approach is significantly more critical in the context of limited budget resources and changing health care needs. In this context, this study presents the drivers of the healthcare needs’ evolution (such as the demographic and technological evolution, the future expectations of the users of the health systems) and it proposes a Bayesian methodology, combining the best available data with experts opinion, to model such evolution. Preliminary results considering different plausible scenarios are presented. The proposed methodology will be integrated in a user-friendly decision support system so it can be used by politicians, with the potential to measure the impact of health policies, both at the regional and the national level.

Keywords: bayesian estimation, health economics, health workforce planning, human health resources planning

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Authors: Hossam N. Alhawatmeh, Areen I. Albustanji

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Hemodialysis negatively affects physical and psychological health. Pain, poor sleep quality, and low self-esteem are highly prevalent among patients with end-stage renal disease (ESRD) who receive hemodialysis, significantly increasing mortality and morbidity of those patients. Mind-body interventions (MBI), such as mindfulness meditation, have been recently gaining popularity that improved pain, sleep quality, and self-esteem in different populations. However, to our best knowledge, its effects on these health problems in patients receiving hemodialysis have not been studied in Jordan. Thus, the purpose of the study was to examine the effect of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESR receiving hemodialysis in Jordan. An experimental repeated-measures, randomized, parallel control design was conducted on (n =60) end-stage renal disease patients undergoing hemodialysis between March and June 2023 in the dialysis center at a public hospital in Jordan. Participants were randomly assigned to the experimental (n =30) and control groups (n =30) using a simple random assignment method. The experimental group practiced mindfulness meditation for 30 minutes three times per week for five weeks during their hemodialysis treatments. The control group's patients continued to receive hemodialysis treatment as usual for five weeks during hemodialysis sessions. The study variables for both groups were measured at baseline (Time 0), two weeks after intervention (Time 1), and at the end of intervention (Time 3). The numerical rating scale (NRS), the Rosenberg Self-Esteem Scale (RSES-M), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure pain, self-esteem, and sleep quality, respectively. SPSS version 25 was used to analyze the study data. The sample was described by frequency, mean, and standard deviation as an appropriate. The repeated measures analysis of variance (ANOVA) tests were run to test the study hypotheses. The results of repeated measures ANOVA (within-subject) revealed that mindfulness meditation significantly decrease pain by the end of the intervention in the experimental group. Additionally, mindfulness meditation improved sleep quality and self-esteem in the experimental group, and these improvements occurred significantly after two weeks of the intervention and at the end of the intervention. The results of repeated measures ANOVA (within and between-subject) revealed that the experimental group, compared to the control group, experienced lower levels of pain and higher levels of sleep quality and self-esteem over time. In conclusion, the results provided substantial evidence supporting the positive impacts of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESRD undergoing hemodialysis. These results highlight the potential of mindfulness meditation as an adjunctive therapy in the comprehensive care of this patient population. Incorporating mindfulness meditation into the treatment plan for patients receiving hemodialysis may contribute to improved well-being and overall quality of life.

Keywords: hemodialysis, pain, sleep quality, self-esteem, mindfulness

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Authors: J. Bastos, P. Marques, S. Batterman, F. Freire

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Due to demands of a growing urban population, it is crucial to manage urban development and its associated environmental impacts. While most of the environmental analyses have addressed buildings and transportation separately, both the design and location of a building affect environmental performance and focusing on one or the other can shift impacts and overlook improvement opportunities for more sustainable urban development. Recently, several life-cycle (LC) studies of residential buildings have integrated user transportation, focusing exclusively on primary energy demand and/or greenhouse gas emissions. Additionally, most papers considered only private transportation (mainly car). Although it is likely to have the largest share both in terms of use and associated impacts, exploring the variability associated with mode choice is relevant for comprehensive assessments and, eventually, for supporting decision-makers. This paper presents a life-cycle assessment (LCA) of a residential building in Lisbon (Portugal), addressing building construction, use and user transportation (commuting with private and public transportation). Five environmental indicators or categories are considered: (i) non-renewable primary energy (NRE), (ii) greenhouse gas intensity (GHG), (iii) eutrophication (EUT), (iv) acidification (ACID), and (v) ozone layer depletion (OLD). In a first stage, the analysis addresses the overall life-cycle considering the statistical model mix for commuting in the residence location. Then, a comparative analysis compares different available transportation modes to address the influence mode choice variability has on the results. The results highlight the large contribution of transportation to the overall LC results in all categories. NRE and GHG show strong correlation, as the three LC phases contribute with similar shares to both of them: building construction accounts for 6-9%, building use for 44-45%, and user transportation for 48% of the overall results. However, for other impact categories there is a large variation in the relative contribution of each phase. Transport is the most significant phase in OLD (60%); however, in EUT and ACID building use has the largest contribution to the overall LC (55% and 64%, respectively). In these categories, transportation accounts for 31-38%. A comparative analysis was also performed for four alternative transport modes for the household commuting: car, bus, motorcycle, and company/school collective transport. The car has the largest results in all impact categories. When compared to the overall LC with commuting by car, mode choice accounts for a variability of about 35% in NRE, GHG and OLD (the categories where transportation accounted for the largest share of the LC), 24% in EUT and 16% in ACID. NRE and GHG show a strong correlation because all modes have internal combustion engines. The second largest results for NRE, GHG and OLD are associated with commuting by motorcycle; however, for ACID and EUT this mode has better performance than bus and company/school transport. No single transportation mode performed best in all impact categories. Integrated assessments of buildings are needed to avoid shifts of impacts between life-cycle phases and environmental categories, and ultimately to support decision-makers.

Keywords: environmental impacts, LCA, Lisbon, transport

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Authors: Claudia Popescu, Adriana Mihaela Soaita

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Within the EU accession process, Romania, as well as other CEE countries, have embarked on the post-1990 urbanization wave aiming to reduce the gaps between ‘older’ and ‘new’ EU member states. While post-socialist urban transitions have been extensively scrutinized, little is known about the developing trajectories of these new towns across the CEE region. To start addressing this knowledge gap, we wish to bring to the fore one of the most humble expressions of urbanism, that of the small, new towns of Romania. Despite rural-to-urban reclassification, urbanization levels have remained persistently low over the last three decades. In this context, it is timely and legitimate to ask about the prospects of new towns for a ‘successful’ socioeconomic performance within the urban network and avoidance of precarity and marginalization and adequate measure of place performance within the urban/settlement network and understanding the drivers that trigger towns’ socioeconomic performances. To answer these, we create a socioeconomic index of the place in order to compare the profile of the 60 new towns with large cities, old small towns and rural. We conceive ‘successful’ and ‘precarious’ performance in terms of a locality’s index value being above or below all small towns’ index average. Second, we performed logistic regression to interrogate the relevance of some key structural factors to the new towns’ socioeconomic performance (i.e. population size, urban history, regional location, connectivity and political determination of their local governments). Related to the first research question, our findings highlight the precarity of place as a long-standing condition of living and working in the new towns of Romania, particularly evident through our cross-comparative analysis across key category along the rural-urban continuum. We have substantiated the socioeconomic condition of precarity in rural places, with the new towns still maintaining features of ‘rurality’ rather than ‘urbanity’ - except a few successful satellites of economically striving large cities, particularly the country capital of Bucharest, which benefited from spillover effects. Related to our second research question, we found that the new towns of Romania have significantly higher odds of being characterized by precarity as a socioeconomic condition than all other small towns and urban places, but less so compared to the even more marginalized rural areas. Many new towns contain resource-dependent rural communities with a poor response to the context of change. Therefore, issues pertaining to local capacity building to adapt to the new urban environment should be addressed by the spatial planning policy. Our approach allowed us to bring to the fore the idea of precarity as a condition of whole localities. Thinking of precarity of place is important as it brings the whole institutional and political apparatus of spatial planning, urban and regional, into conversation with other causative or substantive axes of precarity developed in the literature. We recommend future research on the new towns in Romania and elsewhere.

Keywords: politics of fantasy, precarity of place, urbanization, Romania

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Authors: H. E. Elzain, S. Y. Chung, V. Senapathi, Kye-Hun Park

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Groundwater is considered a significant source for drinking and irrigation purposes in Miryang city, and it is attributed to a limited number of a surface water reservoirs and high seasonal variations in precipitation. Population growth in addition to the expansion of agricultural land uses and industrial development may affect the quality and management of groundwater. This research utilized multidisciplinary approaches of geostatistics such as multivariate statistics, factor analysis, cluster analysis and kriging technique in order to identify the hydrogeochemical process and characterizing the control factors of the groundwater geochemistry distribution for developing risk maps, exploiting data obtained from chemical investigation of groundwater samples under the area of study. A total of 79 samples have been collected and analyzed using atomic absorption spectrometer (AAS) for major and trace elements. Chemical maps using 2-D spatial Geographic Information System (GIS) of groundwater provided a powerful tool for detecting the possible potential sites of groundwater that involve the threat of contamination. GIS computer based map exhibited that the higher rate of contamination observed in the central and southern area with relatively less extent in the northern and southwestern parts. It could be attributed to the effect of irrigation, residual saline water, municipal sewage and livestock wastes. At wells elevation over than 85m, the scatter diagram represents that the groundwater of the research area was mainly influenced by saline water and NO3. Level of pH measurement revealed low acidic condition due to dissolved atmospheric CO2 in the soil, while the saline water had a major impact on the higher values of TDS and EC. Based on the cluster analysis results, the groundwater has been categorized into three group includes the CaHCO3 type of the fresh water, NaHCO3 type slightly influenced by sea water and Ca-Cl, Na-Cl types which are heavily affected by saline water. The most predominant water type was CaHCO3 in the study area. Contamination sources and chemical characteristics were identified from factor analysis interrelationship and cluster analysis. The chemical elements that belong to factor 1 analysis were related to the effect of sea water while the elements of factor 2 associated with agricultural fertilizers. The degree level, distribution, and location of groundwater contamination have been generated by using Kriging methods. Thus, geostatistics model provided more accurate results for identifying the source of contamination and evaluating the groundwater quality. GIS was also a creative tool to visualize and analyze the issues affecting water quality in the Miryang city.

Keywords: groundwater characteristics, GIS chemical maps, factor analysis, cluster analysis, Kriging techniques

Procedia PDF Downloads 168

Authors: Abdoulie K. Ceesay

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Within the sequence of the whole genome, it is known that 99.9% of the human genome is similar, whilst our difference lies in just 0.1%. Among these minor dissimilarities, the most common type of genetic variations that occurs in a population is SNP, which arises due to nucleotide substitution in a protein sequence that leads to protein destabilization, alteration in dynamics, and other physio-chemical properties’ distortions. While causing variations, they are equally responsible for our difference in the way we respond to a treatment or a disease, including various cancer types. There are two types of SNPs; synonymous single nucleotide polymorphism (sSNP) and non-synonymous single nucleotide polymorphism (nsSNP). sSNP occur in the gene coding region without causing a change in the encoded amino acid, while nsSNP is deleterious due to its replacement of a nucleotide residue in the gene sequence that results in a change in the encoded amino acid. Predicting the effects of cancer related nsSNPs on protein stability, function, and dynamics is important due to the significance of phenotype-genotype association of cancer. In this thesis, Data of 5 oncogenes (ONGs) (AKT1, ALK, ERBB2, KRAS, BRAF) and 5 tumor suppressor genes (TSGs) (ESR1, CASP8, TET2, PALB2, PTEN) were retrieved from ClinVar. Five common in silico tools; Polyphen, Provean, Mutation Assessor, Suspect, and FATHMM, were used to predict and categorize nsSNPs as deleterious, benign, or neutral. To understand the impact of each variation on the phenotype, Maestro, PremPS, Cupsat, and mCSM-NA in silico structural prediction tools were used. This study comprises of in-depth analysis of 10 cancer gene variants downloaded from Clinvar. Various analysis of the genes was conducted to derive a meaningful conclusion from the data. Research done indicated that pathogenic variants are more common among ONGs. Our research also shows that pathogenic and destabilizing variants are more common among ONGs than TSGs. Moreover, our data indicated that ALK(409) and BRAF(86) has higher benign count among ONGs; whilst among TSGs, PALB2(1308) and PTEN(318) genes have higher benign counts. Looking at the individual cancer genes predisposition or frequencies of causing cancer according to our research data, KRAS(76%), BRAF(55%), and ERBB2(36%) among ONGs; and PTEN(29%) and ESR1(17%) among TSGs have higher tendencies of causing cancer. Obtained results can shed light to the future research in order to pave new frontiers in cancer therapies.

Keywords: tumor suppressor genes (TSGs), oncogenes (ONGs), non synonymous single nucleotide polymorphism (nsSNP), single nucleotide polymorphism (SNP)

Procedia PDF Downloads 86

Authors: Rosilyn Sanders

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This qualitative study examined the impact of hiring people with intellectual disabilities (ID). The research questions were: What defines a disability? What accommodations are needed to ensure the success of a person with a disability? As a leader, what benefits do people with intellectual disabilities bring to the organization? What are the benefits of hiring people with intellectual disabilities in retail organizations? Moreover, how might people with intellectual disabilities contribute to the organizational culture of retail organizations? A narrative strength approach was used as a theoretical framework to guide the discussion and uncover the benefits of hiring individuals with intellectual disabilities in various retail organizations. Using qualitative interviews, the following themes emerged: diversity and inclusion, accommodations, organizational culture, motivation, and customer service. These findings put to rest some negative stereotypes and perceptions of persons with ID as being unemployable or unable to perform tasks when employed, showing instead that persons with ID can work efficiently when given necessary work accommodations and support in an enabling organizational culture. All participants were recruited and selected through various forms of electronic communication via social media, email invitations, and phone; this was conducted through the methodology of snowball sampling with the following demographics: age, ethnicity, gender, number of years in retail, number of years in management, and number of direct reports. The sample population was employed in several retail organizations throughout Arkansas and Texas. The small sample size for qualitative research in this study helped the researcher develop, build, and maintain close relationships that encouraged participants to be forthcoming and honest with information (Clow & James, 2014 ). Participants were screened to ensure they met the researcher's study; and screened to ensure that they were over 18 years of age. Participants were asked if they recruit, interview, hire, and supervise individuals with intellectual disabilities. Individuals were given consent forms via email to indicate their interest in participating in this study. Due to COVID-19, all interviews were conducted via teleconferencing (Zoom or Microsoft Teams) that lasted approximately 1 hour, which were transcribed, coded for themes, and grouped based on similar responses. Further, the participants were not privy to the interview questions beforehand, and demographic questions were asked at the end, including questions concerning age, education level, and job status. Each participant was assigned random numbers using an app called ‘The Random Number Generator ‘to ensure that all personal or identifying information of participants were removed. Regarding data storage, all documentation was stored on a password-protected external drive, inclusive of consent forms, recordings, transcripts, and researcher notes.

Keywords: diversity, positive psychology, organizational development, leadership

Procedia PDF Downloads 67

Authors: M. Benjamin Stacey

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Energy efficiency has been increasingly recognized as a high value resource through state policies that require utility companies to implement efficiency programs. While policymakers have recognized the statewide economic, environmental, and health related value to residents who rely on this grid supplied resource, varying interests in energy efficiency between socioeconomic groups stands undifferentiated in most state legislation. Instead, the benefits are oftentimes assumed to be distributed equitably across these groups. Despite this fact, these policies are frequently sited by advocacy groups, regulatory bodies and utility companies for their ability to address the negative financial, health and other social impacts of energy poverty in low income communities. Yet, while most states like Michigan require programs that target low income consumers, oftentimes no requirements exist for the equitable investment and energy savings for low income consumers, nor does it stipulate minimal spending levels on low income programs. To further understand the impact of the absence of these factors in legislation, this study examines the distribution of program funds and energy efficiency savings to answer a fundamental energy justice concern; Are there disparities in the investment and benefits of energy efficiency programs between socioeconomic groups? This study compiles data covering the history of Michigan’s Energy Efficiency policy implementation from 2010-2016, analyzing the energy efficiency portfolios of Michigan’s two main energy providers. To make accurate comparisons between these two energy providers' investments and energy savings in low and non-low income programs, the socioeconomic variation for each utility coverage area was captured and accounted for using GIS and US Census data. Interestingly, this study found that both providers invested more equitably in natural gas efficiency programs, however, together these providers invested roughly three times less per household in low income electricity efficiency programs, which resulted in ten times less electricity savings per household. This study also compares variation in commission approved utility plans and actual spending and savings results, with varying patterns pointing to differing portfolio management strategies between companies. This study reveals that for the history of the implementation of Michigan’s Energy Efficiency Policy, that the 35% of Michigan’s population who qualify as low income have received substantially disproportionate funding and energy savings because of the policy. This study provides an overview of results from a social perspective, raises concerns about the impact on energy poverty and equity between consumer groups and is an applicable tool for law makers, regulatory agencies, utility portfolio managers, and advocacy groups concerned with addressing issues related to energy poverty.

Keywords: energy efficiency, energy justice, low income, state policy

Procedia PDF Downloads 187

Authors: A. Anastasiou, K. S. Tingay

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Background: Discovering suitable datasets is an important part of health research, particularly for projects working with clinical data from patients organized in cohorts (cohort data), but with the proliferation of so many national and international initiatives, it is becoming increasingly difficult for research teams to locate real world datasets that are most relevant to their project objectives. We present a method for identifying healthcare institutes in the European Union (EU) which may hold haemato-oncology (HO) data. A key enabler of this research was the bibInsight platform, a scientometric data management and analysis system developed by the authors at Swansea University. Method: A PubMed search was conducted using HO clinical terms taken from previous work. The resulting XML file was processed using the bibInsight platform, linking affiliations to the Global Research Identifier Database (GRID). GRID is an international, standardized list of institutions, including the city and country in which the institution exists, as well as a category of the main business type, e.g., Academic, Healthcare, Government, Company. Countries were limited to the 28 current EU members, and institute type to 'Healthcare'. An article was considered valid if at least one author was affiliated with an EU-based healthcare institute. Results: The PubMed search produced 21,310 articles, consisting of 9,885 distinct affiliations with correspondence in GRID. Of these articles, 760 were from EU countries, and 390 of these were healthcare institutes. One affiliation was excluded as being a veterinary hospital. Two EU countries did not have any publications in our analysis dataset. The results were analysed by country and by individual healthcare institute. Networks both within the EU and internationally show institutional collaborations, which may suggest a willingness to share data for research purposes. Geographical mapping can ensure that data has broad population coverage. Collaborations with industry or government may exclude healthcare institutes that may have embargos or additional costs associated with data access. Conclusions: Data reuse is becoming increasingly important both for ensuring the validity of results, and economy of available resources. The ability to identify potential, specific data sources from over twenty thousand articles in less than an hour could assist in improving knowledge of, and access to, data sources. As our method has not yet specified if these healthcare institutes are holding data, or merely publishing on that topic, future work will involve text mining of data-specific concordant terms to identify numbers of participants, demographics, study methodologies, and sub-topics of interest.

Keywords: data reuse, data discovery, data linkage, journal articles, text mining

Procedia PDF Downloads 115

Authors: Adamu Usman, Grace Stanley Balami

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Pearl millet (Pennisetum glaucum L. R. Br.) is a cereal cultivated in arid and semi-arid areas of the world. It supports more than 100 million people around the world. Parasitic weed (Striga hermonthica Del. Benth) is a major constraint to its production. Estimated yield losses are put at 10 - 95% depending on variety, ecology and cultural practices. Potentials in selection of traits in pearl millets for grain yield have been reported and it depends on genotypic variability and heritability among landraces. Variability and heritability among cultivars could offer opportunities for improvement. The study was conducted to determine the genetic variability among cultivars and estimate broad sense heritability among grain yield and related traits. F1 breeding populations were generated with 9 parental cultivars, viz; Ex-Gubio, Ex-Monguno, Ex-Baga as males and PEO 5984, Super-SOSAT, SOSAT-C88, Ex-Borno and LCIC9702 as females through Line × Tester mating during 2017 dry season at Lushi Irrigation Station, Bauchi Metropolitan in Bauchi State, Nigeria. The F1 population and the parents were evaluated during cropping season of 2018 at Bauchi and Maiduguri. Data collected were subjected to analysis of variance. Results showed significant difference among cultivars and among traits indicating variability. Number of plants at emergence, days to 50% flowering, days to 100% flowering, plant height, panicle length, number of plants at harvest, Striga count at 90 days after sowing, panicle weight and grain yield were significantly different. Significant variability offer opportunity for improvement as superior individuals can be isolated. Genotypic variance estimates of traits were largely greater than environmental variances except in plant height and 1000 seed weight. Environmental variances were low and in some cases negligible. The phenotypic variances of all traits were higher than genotypic variances. Similarly phenotypic coefficient of variation (PCV) was higher than genotypic coefficient of variation (GCV). High heritability was found in days to 50% flowering (90.27%), Striga count at 90 days after sowing (90.07%), number of plants at harvest (87.97%), days to 100% flowering (83.89%), number of plants at emergence (82.19%) and plant height (73.18%). Greater heritability estimates could be due to presence of additive gene. The result revealed wider variability among genotypes and traits. Traits having high heritability could easily respond to selection. High value of GCV, PCV and heritability estimates indicate that selection for these traits are possible and could be effective.

Keywords: variability, heritability, phenotypic, genotypic, striga

Procedia PDF Downloads 56

Authors: M. Shukry

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According to the United Nations Declaration of Human Rights in 1948, every human being is entitled to rights in life that should be respected by others and protected by the state and community. Such rights are inherent regardless of colour, ethnicity, gender, religion or otherwise, and it is expected that all humans alike have the right to live without discrimination of any sort. However, that has not been the case with Aborigines in Australia. Over a long period of time, the governments of the State and the Territories and the Australian Commonwealth denied the Aboriginal and Indigenous inhabitants of the Torres Strait Islands such rights. Past Australian governments set policies and laws that enabled them to forcefully remove Indigenous children from their parents, which resulted in creating lost generations living the trauma of the loss of cultural identity, alienation and even their own selfhood. Intending to reduce that population of natives and their Aboriginal culture while, on the other hand, assimilate them into mainstream society, they gave themselves the right to remove them from their families with no hope of return. That practice has led to tragic consequences due to the trauma that has affected those children, an experience that is depicted by Jane Harrison in her play Stolen. The drama is the outcome of a six-year project on lost children and which was first performed in 1997 in Melbourne. Five actors only appear on the stage, playing the role of all the different characters, whether the main protagonists or the remaining cast, present or non-present ones as voices. The play outlines the life of five children who have been taken from their parents at an early age, entailing a disastrous negative impact that differs from one to the other. Unknown to each other, what connects between them is being put in a children’s home. The purpose of this paper is to analyse the play’s text in light of the 1948 Declaration of Human Rights, using it as a lens that reflects the atrocities practiced against the Aborigines. It highlights how such practices formed an outrageous violation of those natives’ rights as human beings. Harrison’s dramatic technique in conveying the children’s experiences is through a non-linear structure, fluctuating between past and present that are linked together within each of the five characters, reflecting their suffering and pain to create an emotional link between them and the audience. Her dramatic handling of the issue by fusing tragedy with humour as well as symbolism is a successful technique in revealing the traumatic memory of those children and their present life. The play has made a difference in commencing to address the problem of the right of all children to be with their families, which renders the real meaning of having a home and an identity as people.

Keywords: aboriginal, audience, Australia, children, culture, drama, home, human rights, identity, Indigenous, Jane Harrison, memory, scenic effects, setting, stage, stage directions, Stolen, trauma

Procedia PDF Downloads 300

Authors: Sharmeen Rahman, Daniel Schmidt, Jane Hughes

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Paratya australiensis Kemp (Decapoda: Atyidae) is a widely distributed indigenous freshwater shrimp, highly abundant in eastern Australia. This species has been considered as a model stream organism to study genetics, dispersal, biology, behaviour and evolution in Atyids. Paratya has a filter feeding and scavenging habit which plays a significant role in the formation of lotic community structure. It has been shown to reduce periphyton and sediment from hard substrates of coastal streams and hence acts as a strongly-interacting ecosystem macroconsumer. Besides, Paratya is one of the major food sources for stream dwelling fishes. Paratya australiensis is a cryptic species complex consisting of 9 highly divergent mitochondrial DNA lineages. Among them, one lineage has been observed to favour upstream sites at higher altitudes, with cooler water temperatures. This study aims to identify local adaptation in upstream and downstream populations of this lineage in three streams in the Conondale Range, North-eastern Brisbane, Queensland, Australia. Two populations (up and down stream) from each stream have been chosen to test for local adaptation, and a parallel pattern of adaptation is expected across all streams. Six populations each consisting of 24 individuals were sequenced using the Restriction Site Associated DNA-seq (RAD-seq) technique. Genetic markers (SNPs) were developed using double digest RAD sequencing (ddRAD-seq). These were used for de novo assembly of Paratya genome. De novo assembly was done using the STACKs program and produced 56, 344 loci for 47 individuals from one stream. Among these individuals, 39 individuals shared 5819 loci, and these markers are being used to test for local adaptation using Fst outlier tests (Arlequin) and Bayesian analysis (BayeScan) between up and downstream populations. Fst outlier test detected 27 loci likely to be under selection and the Bayesian analysis also detected 27 loci as under selection. Among these 27 loci, 3 loci showed evidence of selection at a significance level using BayeScan program. On the other hand, up and downstream populations are strongly diverged at neutral loci with a Fst =0.37. Similar analysis will be done with all six populations to determine if there is a parallel pattern of adaptation across all streams. Furthermore, multi-locus among population covariance analysis will be done to identify potential markers under selection as well as to compare single locus versus multi-locus approaches for detecting local adaptation. Adaptive genes identified in this study can be used for future studies to design primers and test for adaptation in related crustacean species.

Keywords: Paratya australiensis, rainforest streams, selection, single nucleotide polymorphism (SNPs)

Procedia PDF Downloads 255

Authors: Rajkumar Ghosh

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The industrialization of coal mining and related activities has a significant impact on groundwater in the surrounding areas of the Damodar River. The Damodar River basin, located in eastern India, is known as the "Ruhr of India" due to its abundant coal reserves and extensive coal mining and industrial operations. One of the major consequences of collieries on groundwater is the contamination of water sources. Coal mining activities often involve the excavation and extraction of coal through underground or open-pit mining methods. These processes can release various pollutants and chemicals into the groundwater, including heavy metals, acid mine drainage, and other toxic substances. As a result, the quality of groundwater in the Damodar River region has deteriorated, making it unsuitable for drinking, irrigation, and other purposes. The high concentration of heavy metals, such as arsenic, lead, and mercury, in the groundwater has posed severe health risks to the local population. Prolonged exposure to contaminated water can lead to various health problems, including skin diseases, respiratory issues, and even long-term ailments like cancer. The contamination has also affected the aquatic ecosystem, harming fish populations and other organisms dependent on the river's water. Moreover, the excessive extraction of groundwater for industrial processes, including coal washing and cooling systems, has resulted in a decline in the water table and depletion of aquifers. This has led to water scarcity and reduced availability of water for agricultural activities, impacting the livelihoods of farmers in the region. Efforts have been made to mitigate these issues through the implementation of regulations and improved industrial practices. However, the historical legacy of coal industrialization continues to impact the groundwater in the Damodar River area. Remediation measures, such as the installation of water treatment plants and the promotion of sustainable mining practices, are essential to restore the quality of groundwater and ensure the well-being of the affected communities. In conclusion, the coal industrialization in the Damodar River surrounding has had a detrimental impact on groundwater. This research focuses on soil subsidence induced by the over-exploitation of ground water for dewatering open pit coal mines. Soil degradation happens in arid and semi-arid regions as a result of land subsidence in coal mining region, which reduces soil fertility. Depletion of aquifers, contamination, and water scarcity are some of the key challenges resulting from these activities. It is crucial to prioritize sustainable mining practices, environmental conservation, and the provision of clean drinking water to mitigate the long-lasting effects of collieries on the groundwater resources in the region.

Keywords: coal mining, groundwater, soil subsidence, water table, damodar river

Procedia PDF Downloads 80

Authors: Mustafa M. Donma, Orkide Donma

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The examination of both serum lipid fractions and body’s lipid composition are quite informative during the evaluation of obesity stages. Within this context, alterations in lipid parameters are commonly observed. The variations in the fat distribution of the body are also noteworthy. Total cholesterol (TC), triglycerides (TRG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C) are considered as the basic lipid fractions. Fat deposited in trunk and extremities may give considerable amount of information and different messages during discrete health states. Ratios are also derived from distinct fat distribution in these areas. Trunk-to-leg fat ratio (TLFR) and trunk-to-appendicular fat ratio (TAFR) are the most recently introduced ratios. In this study, lipid fractions and TLFR, as well as TAFR, were evaluated, and the distinctions among healthy, obese (OB), and morbid obese (MO) groups were investigated. Three groups [normal body mass index (N-BMI), OB, MO] were constituted from a population aged 6 to 18 years. Ages and sexes of the groups were matched. The study protocol was approved by the Non-interventional Ethics Committee of Tekirdag Namik Kemal University. Written informed consent forms were obtained from the parents of the participants. Anthropometric measurements (height, weight, waist circumference, hip circumference, head circumference, neck circumference) were obtained and recorded during the physical examination. Body mass index values were calculated. Total, trunk, leg, and arm fat mass values were obtained by TANITA Bioelectrical Impedance Analysis. These values were used to calculate TLFR and TAFR. Systolic (SBP) and diastolic blood pressures (DBP) were measured. Routine biochemical tests including TC, TRG, LDL-C, HDL-C, and insulin were performed. Data were evaluated using SPSS software. p value smaller than 0.05 was accepted as statistically significant. There was no difference among the age values and gender ratios of the groups. Any statistically significant difference was not observed in terms of DBP, TLFR as well as serum lipid fractions. Higher SBP values were measured both in OB and MO children than those with N-BMI. TAFR showed a significant difference between N-BMI and OB groups. Statistically significant increases were detected between insulin values of N-BMI group and OB as well as MO groups. There were bivariate correlations between LDL and TLFR (r=0.396; p=0.037) as well as TAFR values (r=0.413; p=0.029) in MO group. When adjusted for SBP and DBP, partial correlations were calculated as (r=0.421; p=0.032) and (r=0.438; p=0.025) for LDL-TLFR as well as LDL-TAFR, respectively. Much stronger partial correlations were obtained for the same couples (r=0.475; p=0.019 and r=0.473; p=0.020, respectively) upon controlling for TRG and HDL-C. Much stronger partial correlations observed in MO children emphasize the potential transition from morbid obesity to metabolic syndrome. These findings have concluded that LDL-C may be suggested as a discriminating parameter between OB and MO children.

Keywords: children, lipid parameters, obesity, trunk-to-leg fat ratio, trunk-to-appendicular fat ratio

Procedia PDF Downloads 111

Authors: Oto J. Okwu, Ornan Henry, Victor A. Otene

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The agricultural sector contributes a great deal to the sustenance of Nigeria’s food security and economy, with an attendant impact on rural development. In spite of the relatively high number of farmers in the country, self-sufficiency in food production is still a challenge. Farmers are faced with myriad problems which hinder their production efficiency, one of which is their access to agricultural inputs required for optimum production. To meet the challenges faced by farmers, the government at the federal level has come up with many agricultural policies, one of which is the Agricultural Transformation Agenda (ATA). The Growth Enhancement Support Scheme (GESS) is one of the critical components of ATA, which is aimed at ensuring the effective distribution of agricultural inputs delivered directly to farmers, and at a regulated cost. After about 8 years of launching this policy, it will be necessary to carry out an assessment of GESS and determine the impact it has made on rural farmers with respect to their access to farm inputs. This study was carried out to assess the Growth Enhancement Support Scheme (GESS) in Adamawa State, Nigeria. Crop farmers who registered under the GESS in Adamawa State, Nigeria, formed the population for the study. Primary data for the study were obtained through a survey, and the use of a structured questionnaire. A sample size of 167 respondents was selected using multi-stage, purposive, and random sampling techniques. The validity and reliability of the research instrument (questionnaire) were obtained through pilot testing and test-retest method, respectively. The objectives of the study were to determine the difference in the level of access to agricultural inputs before and after GESS, determine the difference in cost of agricultural inputs before and after GESS, and to determine the challenges faced by rural farmers in accessing agricultural inputs through GESS. Both descriptive and inferential statistics were used in analyzing the collected data. Specifically, Mann-Whitney, student t-test, and factor analysis were used to test the stated hypotheses. Research findings revealed there was a significant difference in the level of access to farm inputs after the introduction of GESS (Z=14.216). Also, there was a significant difference in the cost of agro-inputs after the introduction of GESS (Pr |T| > |t|= 0.0000). The challenges faced by respondents in accessing agro-inputs through GESS were administrative and technical in nature. Based on the findings of the research, it was recommended that efforts be made by the government to sustain the GESS, as it has significantly improved the level of farmers’ access to agricultural inputs and has reduced the cost of agro-inputs, while administrative challenges faced by the respondents in accessing inputs be addressed by the government, and extension agents assist the farmers to overcome the technical challenges they face in accessing inputs.

Keywords: agricultural policy, agro-inputs, assessment, growth enhancement support scheme, rural farmers

Procedia PDF Downloads 109

Authors: Flavia Kroetz

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From 1964 to 1985, Brazil was ruled by a dictatorial regime that, under the discourse of fight against terrorism and subversion, implemented cruel and atrocious practices against anyone who opposed the State ideology. At the same time, several Latin American countries faced dictatorial periods and experienced State repression through apparatuses of violence institutionalized in the very governmental structure. Despite the correspondence between repressive methods adopted by authoritarian regimes in States such as Argentina, Chile, El Salvador, Peru and Uruguay, the mechanisms of democratic transition adopted with the end of each dictatorship were significantly different. While some States have found ways to deal with past atrocities through serious and transparent investigations of the crimes perpetrated in the name of repression, in others, as in Brazil, a culture of impunity remains rooted in society, manifesting itself in the widespread disbelief of the population in governmental and democratic institutions. While Argentina, Chile, Peru and Uruguay are convincing examples of the possibility and importance of the prosecution of crimes such as torture, forced disappearance and murder committed by the State, El Salvador demonstrates the complete failure to punish or at least remove from power the perpetrators of serious crimes against civilians and political opponents. In a scenario of widespread violations of human rights, State violence becomes entrenched within society as a daily and even necessary practice. In Brazil, a lack of political and judicial will withstands the impunity of those who, during the military regime, committed serious crimes against human rights under the authority of the State. If the reproduction of violence is a direct consequence of the culture of denial and the rejection of everyone considered to be different, ‘the other’, then the adoption of transitional mechanisms that underpin the historical and political contexts of the time seems essential. Such mechanisms must strengthen democracy through the effective implementation of the rights to memory and to truth, the right to justice and reparations for victims and their families, as well as institutional changes in order to remove from power those who, when in power, could not distinguish between legality and authoritarianism. Against this background, this research analyses the importance of transitional justice for the restoration of democracy, considering the adoption of amnesty laws as a strategy to preclude criminal prosecution of offenses committed during dictatorial regimes. The study investigates the scope of Law No 6.683/79, the Brazilian amnesty law, which, according to a 2010 decision of the Brazilian Constitutional Supreme Court, granted amnesty to those responsible for political crimes and related crimes, committed between September 2, 1961 and August 15, 1979. Was the purpose of this Law to grant amnesty to violent crimes committed by the State? If so, is it possible to recognize the legitimacy of a Congress composed of indirectly elected politicians controlled by the dictatorship?

Keywords: amnesty law, criminal justice, dictatorship, state violence

Procedia PDF Downloads 438

Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan

Abstract:

Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.

Keywords: frailty elderly, emergency, laparotomy

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Authors: Roberto Feltrero, Sara Osuna-Acedo

Abstract:

Responsible Research and Innovation have to accomplish one fundamental aim: everybody has to participate in the benefits of innovation, but also innovation has to be democratic; that is to say, everybody may have the possibility to participate in the decisions in the innovation process. Particularly, a democratic and inclusive model of social participation and innovation includes persons with disabilities and people at risk of discrimination. Innovations on Artificial Intelligence for social development have to accomplish the same dual goal: improving equality for accessing fields of public interest like education, training and public services, as well as improving civic and democratic participation in the process of developing such innovations for all. This research aims to develop innovations, policies and policy recommendations to apply and disseminate such artificial intelligence and social model for making educational and administrative processes more accessible. First, designing a citizen participation process to engage citizens in the designing and use of artificial intelligence tools for public services. This will result in improving trust in democratic institutions contributing to enhancing the transparency, effectiveness, accountability and legitimacy of public policy-making and allowing people to participate in the development of ethical standards for the use of such technologies. Second, improving educational tools for lifelong learning with AI models to improve accountability and educational data management. Dissemination, education and social participation will be integrated, measured and evaluated in innovative educational processes to make accessible all the educational technologies and content developed on AI about responsible and social innovation. A particular case will be presented regarding access for all to educational tools and public services. This accessibility requires cognitive adaptability because, many times, legal or administrative language is very complex. Not only for people with cognitive disabilities but also for old people or citizens at risk of educational or social discrimination. Artificial Intelligence natural language processing technologies can provide tools to translate legal, administrative, or educational texts to a more simple language that can be accessible to everybody. Despite technological advances in language processing and machine learning, this becomes a huge project if we really want to respect ethical and legal consequences because that kinds of consequences can only be achieved with civil and democratic engagement in two realms: 1) to democratically select texts that need and can be translated and 2) to involved citizens, experts and nonexperts, to produce and validate real examples of legal texts with cognitive adaptations to feed artificial intelligence algorithms for learning how to translate those texts to a more simple and accessible language, adapted to any kind of population.

Keywords: responsible research and innovation, AI social innovations, cognitive accessibility, public participation

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Authors: Elkington S. Mnguni

Abstract:

Water and sanitation services in South Africa are characterized by both achievements and challenges. After the end of apartheid in 1994 the newly elected government faced the challenge of eradicating backlogs with respect to access to basic services, including water and sanitation. Capital investment made in the development of new water and sanitation infrastructure to provide basic services to previously disadvantaged communities has grown, to a certain extent, at the expense of investment in the operation and maintenance of new and existing infrastructure. Challenges resulting from aging infrastructure and poor plant performance highlight the need for investing in the maintenance, rehabilitation, and replacement of existing infrastructure to optimize the return on investment. Advanced water infrastructure asset management (IAM) is key to achieving adequate levels of service, particularly with regard to reliable and high quality drinking water supply, prevention of urban flooding, efficient use of natural resources and prevention of pollution and associated risks. Against this backdrop, this paper presents an appraisal of water and sanitation IAM systems in South Africa’s three utilities, being metropolitan cities in the Gauteng Province. About a quarter of the national population lives in the three rapidly urbanizing cities of Johannesburg, Ekurhuleni and Tshwane, located in a semi-arid region. A literature review has been done and field visits to some of the utility facilities are being conducted. Semi-structured interviews will be conducted with the three utilities. The following critical factors are being analysed in terms of compliance with the national Water Services IAM Strategy (2011) and other applicable legislation: asset registers; capacity of assets; current and predicted demand; funding availability / budget allocations; plans: operation & maintenance, renewal & replacement, and risk management; no-drop status (non-revenue water levels); blue drop status (water quality); green drop status (effluent quality); and skills availability. Some of the key challenges identified in the literature review include: funding constraints, Skills shortage, and wastewater treatment plants operating beyond their design capacities. These challenges will be verified during field visits and research interviews. Gaps between literature and practice will be identified and relevant recommendations made if necessary. The objective of this study is to contribute to the resolution of the challenges brought about by the backlogs in the operation and maintenance of water and sanitation assets in the country in general, and in the three cities in particular, thus improving the sustainability thereof.

Keywords: asset management, backlogs, levels of service, sustainability, water and sanitation infrastructure

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Authors: Eva Degraeuwe, Margo Vandenheede, Nicholas Rennie, Jolien Braem, Miryam Serry, Frederik Berrevoet, Piet Pattyn, Wouter Willaert, InciSioN Belgium Consortium

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Background: Worldwide, five billion people lack access to safe and affordable surgical care. An added 1.27 million surgeons, anesthesiologists, and obstetricians (SAO) are needed by 2030 to meet the target of 20 per 100,000 population and to reach the goal of the Lancet Commission on Global Surgery. A well-informed future generation exposed early on to the current challenges in global surgery (GS) is necessary to ensure a sustainable future. Methods: InciSioN, the International Student Surgical Network, is a non-profit organization by and for students, residents, and fellows in over 80 countries. InciSioN Belgium, one of the prominent national working groups, has made a vast progression and collaborated with other networks to fill the educational gap, stimulate advocacy efforts and increase interactions with the international network. This report describes a roadmap to achieve sustainable development and education within GS, with the example of InciSioN Belgium. Results: Since the establishment of the organization’s branch in 2019, it has hosted an educational workshop for first-year residents in surgery, engaging over 2500 participants, and established a recurring directing board of 15 members. In the year 2020-2021, InciSioN Ghent has organized three workshops combining educational and interactive sessions for future prime advocates and surgical candidates. InciSioN Belgium has set up a strong formal coalition with the Belgian Medical Students’ Association (BeMSA), with its own standing committee, reaching over 3000+ medical students annually. In 2021-2022, InciSioN Belgium broadened to a multidisciplinary approach, including dentistry and nursing students and graduates within workshops and research projects, leading to a member and exposure increase of 450%. This roadmap sets strategic goals and mechanisms for the GS community to achieve nationwide sustained improvements in the research and education of GS focused on future SAOs, in order to achieve the GS sustainable development goals. In the coming year, expansion is directed to a formal integration of GS into the medical curriculum and increased international advocacy whilst inspiring SAOs to integrate into GS in Belgium. Conclusion: The development and implementation of durable change for GS are necessary. The student organization InciSioN Belgium is growing and hopes to close the colossal gap in GS and inspire the growth of other branches while sharing the know-how of a student organization.

Keywords: advocacy, education, global surgery, InciSioN, student network

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Authors: Sunidhi Sood, Drashti Narendrakumar Shah, Aakarsh Sharma, Nirali Harsh Panchal, Maria Karizhenskaia

Abstract:

Cancer is a global health concern, causing a significant number of deaths, with chemotherapy being a standard treatment method. However, chemotherapy often induces side effects that profoundly impact the physical and emotional well-being of patients, lowering their overall quality of life (QoL). This research aims to investigate the potential of music and art therapy as holistic adjunctive therapy for cancer patients undergoing chemotherapy, offering non-pharmacological support. This is achieved through a comprehensive review of existing literature with a focus on the following themes, including stress and anxiety alleviation, emotional expression and coping skill development, transformative changes, and pain management with mood upliftment. A systematic search was conducted using Medline, Google Scholar, and St. Lawrence College Library, considering original, peer-reviewed research papers published from 2014 to 2023. The review solely incorporated studies focusing on the impact of music and art therapy on the health and overall well-being of cancer patients undergoing chemotherapy in North America. The findings from 16 studies involving pediatric oncology patients, females affected by breast cancer, and general oncology patients show that music and art therapies significantly reduce anxiety (standardized mean difference: -1.10) and improve perceived stress (median change: -4.0) and overall quality of life in cancer patients undergoing chemotherapy. Furthermore, music therapy has demonstrated the potential to decrease anxiety, depression, and pain during infusion treatments (average changes in resilience scale: 3.4 and 4.83 for instrumental and vocal music therapy, respectively). This data calls for consideration of the integration of music and art therapy into supportive care programs for cancer patients undergoing chemotherapy. Moreover, it provides guidance to healthcare professionals and policymakers, facilitating the development of patient-centered strategies for cancer care in Canada. Further research is needed in collaboration with qualified therapists to examine its applicability and explore and evaluate patients' perceptions and expectations in order to optimize the therapeutic benefits and overall patient experience. In conclusion, integrating music and art therapy in cancer care promises to substantially enhance the well-being and psychosocial state of patients undergoing chemotherapy. However, due to the small population size considered in existing studies, further research is needed to bridge the knowledge gap and ensure a comprehensive, patient-centered approach, ultimately enhancing the quality of life (QoL) for individuals facing the challenges of cancer treatment.

Keywords: anxiety, cancer, chemotherapy, depression, music and art therapy, pain management, quality of life

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