Search results for: parents' role
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11215

Search results for: parents' role

2965 TNFRSF11B Gene Polymorphisms A163G and G11811C in Prediction of Osteoporosis Risk

Authors: I. Boroňová, J.Bernasovská, J. Kľoc, Z. Tomková, E. Petrejčíková, D. Gabriková, S. Mačeková

Abstract:

Osteoporosis is a complex health disease characterized by low bone mineral density, which is determined by an interaction of genetics with metabolic and environmental factors. Current research in genetics of osteoporosis is focused on identification of responsible genes and polymorphisms. TNFRSF11B gene plays a key role in bone remodeling. The aim of this study was to investigate the genotype and allele distribution of A163G (rs3102735) osteoprotegerin gene promoter and G1181C (rs2073618) osteoprotegerin first exon polymorphisms in the group of 180 unrelated postmenopausal women with diagnosed osteoporosis and 180 normal controls. Genomic DNA was isolated from peripheral blood leukocytes using standard methodology. Genotyping for presence of different polymorphisms was performed using the Custom Taqman®SNP Genotyping assays. Hardy-Weinberg equilibrium was tested for each SNP in the groups of participants using the chi-square (χ2) test. The distribution of investigated genotypes in the group of patients with osteoporosis were as follows: AA (66.7%), AG (32.2%), GG (1.1%) for A163G polymorphism; GG (19.4%), CG (44.4%), CC (36.1%) for G1181C polymorphism. The distribution of genotypes in normal controls were follows: AA (71.1%), AG (26.1%), GG (2.8%) for A163G polymorphism; GG (22.2%), CG (48.9%), CC (28.9%) for G1181C polymorphism. In A163G polymorphism the variant G allele was more common among patients with osteoporosis: 17.2% versus 15.8% in normal controls. Also, in G1181C polymorphism the phenomenon of more frequent occurrence of C allele in the group of patients with osteoporosis was observed (58.3% versus 53.3%). Genotype and allele distributions showed no significant differences (A163G: χ2=0.270, p=0.605; χ2=0.250, p=0.616; G1181C: χ2= 1.730, p=0.188; χ2=1.820, p=0.177). Our results represents an initial study, further studies of more numerous file and associations studies will be carried out. Knowing the distribution of genotypes is important for assessing the impact of these polymorphisms on various parameters associated with osteoporosis. Screening for identification of “at-risk” women likely to develop osteoporosis and initiating subsequent early intervention appears to be most effective strategy to substantially reduce the risks of osteoporosis.

Keywords: osteoporosis, real-time PCR method, SNP polymorphisms

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2964 The Effects of Semi-Public Spaces with Distinctive Functions on the Urban Space Quality

Authors: Melike Orhan

Abstract:

Along with impetuous physical change, configuration and increase in the density of cities, urban public spaces have started to become a transition area rather than spaces to inhabit. The insufficiency of public spaces, one of the most significant components of a city, where communal life is maintained and the decrease in the quality of urban spaces have led to an increase in the use of semi-public spaces as urban space. Semi-public spaces are those that ensure transition between private and public spaces and can be seen, observed, reached and used by urban-dwellers. Humans are in a constant relation to their surroundings and care for integration as part of their surroundings. Semi-public spaces providing balance for the individual between private spaces (structures) and urban-public spaces make this integration easier. Spaces with a semi-public characteristic serve for a particular neighboring unit and the user (i.e. common use areas in residential spaces and dwellings, common outdoor areas situated between office buildings, and etc.) These spaces, whose density of usage is increased with distinctive functions and activities, gain different attributions according to the characteristics of the urban space they are located in (commercial, residential, touristic, and etc.) and to the functions of the structures with which they are in relation. At the same time, they begin to serve other neighboring units along with an increase in public usage. As a result, the interaction between environment-space-structure-humans changes, which directly affects the urban space quality. The aim of this study is to determine how and depending on what characteristics the public usage density of semi-public spaces change and to put forth the effects of this change on the urban environment it is located in and to designate its role in terms of 'urban space quality'. In conclusion, within the scope of this study, semi-public spaces located in urban spaces with distinctive functions will be explored through examples, and the effects of these spaces with altered public usage and density on urban space and quality of life will be put forward. Accordingly, applicable criteria will be determined by means of semi-public spaces oriented at increasing and sustaining the quality of urban space.

Keywords: semi-public spaces, urban public spaces, urban space quality, public usage

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2963 Relative Importance of Contact Constructs to Acute Respiratory Illness in General Population in Hong Kong

Authors: Kin On Kwok, Vivian Wei, Benjamin Cowling, Steven Riley, Jonathan Read

Abstract:

Background: The role of social contact behavior measured in different contact constructs in the transmission of respiratory pathogens with acute respiratory illness (ARI) remains unclear. We, therefore, aim to depict the individual pattern of ARI in the community and investigate the association between different contact dimensions and ARI in Hong Kong. Methods: Between June 2013 and September 2013, 620 subjects participated in the last two waves of recruitment of the population based longitudinal phone social contact survey. Some of the subjects in this study are from the same household. They are also provided with the symptom diaries to self-report any acute respiratory illness related symptoms between the two days of phone recruitment. Data from 491 individuals who were not infected on the day of phone recruitment and returned the symptom diaries after the last phone recruitment were used for analysis. Results: After adjusting different follow-up periods among individuals, the overall incidence rate of ARI was 1.77 per 100 person-weeks. Over 75% ARI episodes involve running nose, cough, sore throat, which are followed by headache (55%), malagia (35%) and fever (18%). Using a generalized estimating equation framework accounting for the cluster effect of subjects living in the same household, we showed that both daily number of locations visited with contacts and the number of contacts, explained the ARI incidence rate better than only one single contact construct. Conclusion: Our result suggests that it is the intertwining property of contact quantity (number of contacts) and contact intensity (ratio of subject-to-contact) that governs the infection risk by a collective set of respiratory pathogens. Our results provide empirical evidence that multiple contact constructs should be incorporated in the mathematical transmission models to feature a more realistic dynamics of respiratory disease.

Keywords: acute respiratory illness, longitudinal study, social contact, symptom diaries

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2962 Biodiversity Conservation Practices and Extent of Environmental Stewardship Among Indigenous Peoples in Caraga Region, Mindanao, Philippines

Authors: Milagros S. Salibad, Levita B. Grana

Abstract:

The presence and role of Indigenous Peoples (IPs) residing in key biodiversity, protected, and watershed areas within the ancestral domain in the Caraga region, Mindanao, Philippines, hold immense significance. Recognizing their importance and rights, this study aimed to determine the level of biodiversity conservation practices and extent of environmental stewardship among the Mamanwas, Manobos, and Higaonons, assess potential differences in these practices, and identify factors that facilitate or hinder them. Employing an explanatory sequential mixed-method research design, 421 respondents participated through a researcher-made questionnaire. Additional data were collected through focus group discussions, key informant interviews, researcher field notes, community immersions, and secondary sources. The results revealed a high level of biodiversity conservation practices across the three IP groups, with variations influenced by their cultural and traditional practices, awareness, and access to resources and information. Each group exhibited unique environmental practices shaped by their distinct cultures, traditions, and customary knowledge. They have a strong sense of ownership and responsibility towards their ancestral lands and territories and adopt traditional knowledge and practices that promote sustainable resource management and biodiversity conservation. These practices align with the Indigenous Peoples Rights Act (IPRA), also known as Republic Act No. 8371. Various facilitating and hindering factors influenced their conservation efforts. To uphold the region's biodiversity resources, it is recommended that government agencies continue to evaluate and monitor the sustainability of IPs' local biodiversity conservation practices. Additionally, efforts should be made to involve IP communities as essential contributors and stakeholders in these conservation endeavors.

Keywords: biodiversity, conservation, indigenous peoples, traditional knowledge, environmental stewardship

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2961 Advancement in Scour Protection with Flexible Solutions: Interpretation of Hydraulic Tests Data for Reno Mattresses in Open Channel Flow

Authors: Paolo Di Pietro, Matteo Lelli, Kinjal Parmar

Abstract:

Water hazards are consistently identified as among the highest global risks in terms of impact. Riverbank protection plays a key role in flood risk management. For erosion control and scour protection, flexible solutions like gabions & mattresses are being used since quite some time now. The efficacy of erosion control systems depends both on the ability to prevent soil loss underneath, as well as to maintain their integrity under the effects of the water flow. The paper presents the results of a research carried out at the Colorado State University on the performance of double twisted wire mesh products, known as Reno Mattresses, used as soil erosion control system. Mattresses were subjected to various flow conditions on a 10m long flume where they were placed on a 0.30 m thick soil layer. The performance against erosion was evaluated by assessing the effect of the stone motion inside the mattress combined with the condition of incipient soil erosion underneath, in relationship to the mattress thickness, the filling stone properties and under variable hydraulic flow regimes. While confirming the stability obtained using a conventional design approach (commonly referred to tractive force theories), the results of the research allowed to introduce a new performance limit based on incipient soil erosion underneath the revetment. Based on the research results, the authors propose to express the shear resistance of mattresses used as soil erosion control system as a function of the size of the filling stones, their uniformity, their unit weight, the thickness of the mattress, and the presence of vertical connecting elements between the mattress lid and bottom.

Keywords: Reno Mattress, riverbank protection, hydraulics, full scale tests

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2960 Influence of Microstructure on Deformation Mechanisms and Mechanical Properties of Additively Manufactured Steel

Authors: Etienne Bonnaud, David Lindell

Abstract:

Correlations between microstructure, deformation mechanisms, and mechanical properties in additively manufactured 316L steel components have been investigated. Mechanical properties in the vertical direction (building direction) and in the horizontal direction (in plane directions) are markedly different. Vertically built specimens show lower yield stress but higher elongation than their horizontally built counterparts. Microscopic observations by electron back scattered diffraction (EBSD) for both build orientations reveal a strong [110] fiber texture in the build direction but different grain morphologies. These microstructures are used as input in subsequent crystal plasticity numerical simulations to understand their influence on the deformation mechanisms and the mechanical properties. Mean field simulations using a visco plastic self consistent (VPSC) model were carried out first but did not give results consistent with the tensile test experiments. A more detailed full-field model had to be used based on the Visco Plastic Fast Fourier Transform (VPFTT) method. A more accurate microstructure description was then input to the simulation model, where thin vertical regions of smaller grains were also taken into account. It turned out that these small grain clusters were responsible for the discrepancies in yield stress and hardening. Texture and morphology have a strong effect on mechanical properties. The different mechanical behaviors between vertically and horizontally printed specimens could be explained by means of numerical full-field crystal plasticity simulations, and the presence of thin clusters of smaller grains was shown to play a central role in the deformation mechanisms.

Keywords: additive manufacturing, crystal plasticity, full-field simulations, mean-field simulations, texture

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2959 Theoretical Study of Substitutional Phosphorus and Nitrogen Pairs in Diamond

Authors: Tahani Amutairi, Paul May, Neil Allan

Abstract:

Many properties of semiconductor materials (mechanical, electronic, magnetic, and optical) can be significantly modified by introducing a point defect. Diamond offers extraordinary properties as a semiconductor, and doping seems to be a viable method of solving the problem associated with the fabrication of diamond-based electronic devices in order to exploit those properties. The dopants are believed to play a significant role in reducing the energy barrier to conduction and controlling the mobility of the carriers and the resistivity of the film. Although it has been proven that the n-type diamond semiconductor can be obtained with phosphorus doping, the resulting ionisation energy and mobility are still inadequate for practical application. Theoretical studies have revealed that this is partly because the effects of the many phosphorus atoms incorporated in the diamond lattice are compensated by acceptor states. Using spin-polarised hybrid density functional theory and a supercell approach, we explored the effects of bonding one N atom to a P in adjacent substitutional sites in diamond. A range of hybrid functional, including HSE06, B3LYP, PBE0, PBEsol0, and PBE0-13, were used to calculate the formation, binding, and ionisation energies, in order to explore the solubility and stability of the point defect. The equilibrium geometry and the magnetic and electronic structures were analysed and presented in detail. The defect introduces a unique reconstruction in a diamond where one of the C atoms coordinated with the N atom involved in the elongated C-N bond and creates a new bond with the P atom. The simulated infrared spectra of phosphorus-nitrogen defects were investigated with different supercell sizes and found to contain two sharp peaks at the edges of the spectrum, one at a high frequency 1,379 cm⁻¹ and the second appearing at the end range, 234 cm⁻¹, as obtained with the largest supercell (216).

Keywords: DFT, HSE06, B3LYP, PBE0, PBEsol0, PBE0-13

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2958 Gender Discrimination and Wellbeing in Family Sphere Due to Male Migration and Remittances: A Study of Doaba Region of Punjab

Authors: Atinder Pal Kaur

Abstract:

A central characteristic of people is their apparent movement from one station to other for their sustenance. Human migration has become one of the most challenging issues faced by the world today. Migration represents an important dimension in world-wide setting; and remittances received by families constitute a major agent in integrating societies in the all over the world, both economically and socially. This paper is an attempt to explore the impact of male migration and remittances upon the family system. This paper brings out how the women play the role of head of the household and take all the economic decisions, but still faces discrimination in the family, that bring loneliness and emotional breakdown on their personal front. For the purpose of this study, data was collected using 30 interviews and 10 case studies in the Doaba region of Punjab. The respondents were classified into two age groups 20-35 years and above 40 years aged women whose husbands migrated abroad. The findings of this study revealed that even though the women were taking some of the economic decisions, but in majority of the cases the patriarchal structure still existed and power remained in the hands of their husbands or in-laws. It was found that women of different age groups reported differently in terms of authority that they have regarding remittances and its consequences in their emotional well-being. The distinction related to their participation in public and private spheres still exists and public spheres are mostly dominated by male members of the family. It can be concluded that freedom of women to take decision on their own is still restricted and they are subjugated to follow their husband or in-law’s opinion in matters related to both public and private spheres. However, old age group women enjoyed more independence and freedom to take decision in comparison to young age women. Loneliness and depression were more common in the young age respondent’s group than in old age women.

Keywords: gender discrimination, migration, patriarchal structure, remittances

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2957 Formulation and Evaluation of Piroxicam Hydrotropic Starch Gel

Authors: Mohammed Ghazwani, Shyma Ali Alshahrani, Zahra Abdu Yousef, Taif Torki Asiri, Ghofran Abdur Rahman, Asma Ali Alshahrani, Umme Hani

Abstract:

Background and introduction: Piroxicam is a nonsteroidal anti-inflammatory drug characterized by low solubility-high permeability used to reduce pain, swelling, and joint stiffness from arthritis. Hydrotropes are a class of compounds that normally increase the aqueous solubility of insoluble solutes. Aim: The objective of the present research study was to formulate and optimize Piroxicam hydrotropic starch gel using sodium salicylate, sodium benzoate as hydrotropic salts, and potato starch for topical application. Materials and methods: The prepared Piroxicam hydrotropic starch gel was characterized for various physicochemical parameters like drug content estimation, pH, tube extrudability, and spreadability; all the prepared formulations were subjected to in-vitro diffusion studies for six hours in 100 ml phosphate buffer (pH 7.4) and determined gel strength. Results: All formulations were found to be white opaque in appearance and have good homogeneity. The pH of formulations was found to be between 6.9-7.9. Drug content ranged from 96.8%-99.4.5%. Spreadability plays an important role in patient compliance and helps in the uniform application of gel to the skin as gels should spread easily; F4 showed a spreadability of 2.4cm highest among all other formulations. In in vitro diffusion studies, extrudability and gel strength were good with F4 in comparison with other formulations; hence F4 was selected as the optimized formulation. Conclusion: Isolated potato starch was successfully employed to prepare the gel. Hydrotropic salt sodium salicylate increased the solubility of Piroxicam and resulted in a stable gel, whereas the gel prepared using sodium benzoate changed its color after one week of preparation from white to light yellowish. Hydrotropic potato starch gel proposed a suitable vehicle for the topical delivery of Piroxicam.

Keywords: Piroxicam, potato starch, hydrotropic salts, hydrotropic starch gel

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2956 Linking Temporal Changes of Climate Factors with Staple Cereal Yields in Southern Burkina Faso

Authors: Pius Borona, Cheikh Mbow, Issa Ouedraogo

Abstract:

In the Sahel, climate variability has been associated with a complex web of direct and indirect impacts. This natural phenomenon has been an impediment to agro-pastoral communities who experience uncertainty while involving in farming activities which is also their key source of livelihood. In this scenario, the role of climate variability in influencing the performance, quantity and quality of staple cereals yields, vital for food and nutrition security has been a topic of importance. This response of crops and subsequent yield variability is also a subject of immense debate due to the complexity of crop development at different stages. This complexity is further compounded by influence of slowly changing non-climatic factors. With these challenges in mind, the present paper initially explores the occurrence of climate variability at an inter annual and inter decadal level in South Burkina Faso. This is evidenced by variation of the total annual rainfall and the number of rainy days among other climatic descriptors. Further, it is shown how district-scale cereal yields in the study area including maize, sorghum and millet casually associate variably to the inter-annual variation of selected climate variables. Statistical models show that the three cereals widely depict sensitivity to the length of the growing period and total dry days in the growing season. Maize yields on the other hand relate strongly to the rainfall amount variation (R2=51.8%) showing high moisture dependence during critical growth stages. Our conclusions emphasize on adoption of efficient water utilization platforms especially those that have evidently increased yields and strengthening of forecasts dissemination.

Keywords: climate variability, cereal yields, seasonality, rain fed farming, Burkina Faso, rainfall

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2955 Diversity of Dermatophytes and Keratinophilic Fungi from Inernational Tourist Spots, City of Taj Mahal

Authors: Harison Masih, Jyotsna Kiran Peter, Sundara Singh, Geetha Singh

Abstract:

The present investigation deals with diversity of dermatophytes and keratinophilic fungi from different tourist spots such as Agra Fort, Akbar tomb, It-Mat-Ud-Daulah, Mariam tomb, Radha Swami Bagh, and Taj Mahal of Agra City. These fungi are medically important which causes various infections and diseases in humans and animals. The main reservoir of these pathogens are the keratinous substances that increases due to birds and animal activities in the vicinity of monuments, where thousands (5413266) annual visitors from all over the world are visiting. The soil samples were subjected to isolate the pathogenic fungi through bait technique (buffalo skin, chicken feathers, human hair and goat tail hair). Baits were spread over the soil samples and incubated at room temperature for 30-35 days and pure culture isolates were maintained in SDA medium, stored at 4°C. Highest number of visitors were (3906453) from Taj Mahal, minimum 10785 at Mariam tomb annually, the total 271 isolates were encountered from soil samples out of these 18 genera and 38 species were found in different season. Highest incidence was 4.79% frequency shown by Chrysosporium keratinophilum while least 738% frequency occurrence by Trichophyton simii in soil samples. From the present study it was concluded that the incidence of pathogenic fungal isolates were the common in tourists soil that are etiological agents of superficial mycosis. Thus, both human and animal activity seemed to play an important role in occurrence and distribution of keratinophilic and related dermatophytes at various tourist places of Agra city.

Keywords: dermatophytic fungal diversity, bait technique, visitors at tourist spots, human and animal activities, soil samples

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2954 Dietary Intake and the Risk of Hypertriglyceridemia in Adults: Tehran Lipid and Glucose Study

Authors: Parvin Mirmiran, Zahra Bahadoran, Sahar Mirzae, Fereidoun Azizi

Abstract:

Background and aim: Lifestyle factors, especially dietary intakes play an important role in metabolism of lipids and lipoproteins. In this study, we assessed the association between dietary factors and 3-year changes of serum triglycerides (TG), HDL-C and the atherogenic index of plasma among Iranian adults. This longitudinal study was conducted on 1938 subjects, aged 19-70 years, who participated in the Tehran Lipid and Glucose Study. Demographics, anthropometrics and biochemical measurements including serum TG were assessed at baseline (2006-2008) and after a 3-year follow-up (2009-2011). Dietary data were collected by using a 168-food item, validated semi-quantitative food frequency questionnaire at baseline. The risk of hypertriglyceridemia in the quartiles of dietary factors was evaluated using logistic regression models with adjustment for age, gender, body mass index, smoking, physical activity and energy intakes. Results: Mean age of the participants at baseline was 41.0±13.0 y. Mean TG and HDL-C at baseline was 143±86 and 42.2±10.0 mg/dl, respectively. Three-year change of serum TG were inversely related energy intake from phytochemical rich foods, whole grains, and legumes (P<0.05). Higher intakes compared to lower ones of dietary fiber and phytochemical-rich foods had similar impact on decreased risk of hyper-triglyceridemia (OR=0.58, 95% CI=0.34-1.00). Higher- compared to lower-dietary sodium to potassium ratios (Na/K ratio) increased the risk of hypertriglyceridemia by 63% (OR=0.1.63, 95% CI= 0.34-1.00). Conclusion: Findings showed that higher intakes of fiber and phytochemical rich foods especially whole grain and legumes could have protective effects against lipid disorders; in contrast higher sodium to potassium ratio had undesirable effect on triglycerides.

Keywords: lipid disorders, hypertriglyceridemia, diet, food science

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2953 Ba'albakī's Influence on 1950s and 1960s Lebanese Women Writers

Authors: Khaled Igbaria

Abstract:

While Ba'albakī ceased writing or publishing since 1964, it is considerable and significant to investigate Ba'albakī's influence on others. This paper examines her influence on three Lebanese women writers: Emily Nasrallah, Muná Jabbūr, and Hanan al-Shaykh. However, the aim is not simply to examine the influence of the writer on these three authors, but rather to note similarities and differences in the challenges they faced and the agendas they followed in their fiction writing. For each of these writers, this article will describe elements of their literature, and then sketch out the influence which Ba'albakī has had on them. This paper relies on material from Sidawi because it includes interviews with the female writers discussed that are relevant to the current discussion. Sidawi asked them about Ba'albakī and her influence on them, the challenges they faced, and how they coped with them. This paper points out their comments using their own words. To be clear, examining these writers' notes and works is beyond the scope of this paper. To sum up, there are significant parallels between the life and work of Ba'albakī, and other Lebanese women writers such as Nasrallah, Jabbūr and al-Shaykh. Like Ba'albakī, Nasrallah and al-Shaykh also suffered in their struggle against their families. Nasrallah and al-Shaykh, like Ba'albakī, suffered because their society did not trust in their abilities and creativity. Ba'albakī opted for isolation because of her conflict with patriarchal society including the Lebanese women’s groups, while Nasrallah's isolation was because she preferred individualism and autonomy, and Jabbūr, as could be speculated, was not able to cope with the suffering caused by her role as a woman writer within Lebanese society. Whereas Ba'albakī isolated herself from the Lebanese women’s groups, focusing instead on her feminist writing and joining the Shi'r group, Al-Shaykh and the Lebanese women’s groups are able to cooperate in harmony. Furthermore, while Nasrallah and Al-Shaykh continued to publish fiction, Ba'albakī stopped publishing fiction in 1964. All of the above confirms not only that it is worthy to investigate deeply and academically both the biography and the works of Ba'albakī, but also that she deserves to include her throughout the top great Arab female writers, at the time, like Al-Shaykh and Nawal El Saadawi.

Keywords: feminist writing, Hanan Al-Shaykh, Laylá Ba'albakī, Lebanese women writers, Muná Jabbūr

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2952 Monitoring and Management of Aquatic Macroinvertebrates for Determining the Level of Water Pollution Catchment Basin of Debed River, Armenia

Authors: Inga Badasyan

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Every year we do monitoring of water pollution of catchment basin of Debed River. Next, the Ministry of Nature Protection does modeling programme. Finely, we are managing the impact of water pollution in Debed river. Ecosystem technologies efficiency performance were estimated based on the physical, chemical, and macrobiological analyses of water on regular base between 2012 to 2015. Algae community composition was determined to assess the ecological status of Debed river, while vegetation was determined to assess biodiversity. Last time, experts werespeaking about global warming, which is having bad impact on the surface water, freshwater, etc. As, we know that global warming is caused by the current high levels of carbon dioxide in the water. Geochemical modelling is increasingly playing an important role in various areas of hydro sciences and earth sciences. Geochemical modelling of highly concentrated aqueous solutions represents an important topic in the study of many environments such as evaporation ponds, groundwater and soils in arid and semi-arid zones, costal aquifers, etc. The sampling time is important for benthic macroinvertebrates, for that reason we have chosen in the spring (abundant flow of the river, the beginning of the vegetation season) and autumn (the flow of river is scarce). The macroinvertebrates are good indicator for a chromic pollution and aquatic ecosystems. Results of our earlier investigations in the Debed river reservoirs clearly show that management problem of ecosystem reservoirs is topical. Research results can be applied to studies of monitoring water quality in the rivers and allow for rate changes and to predict possible future changes in the nature of the lake.

Keywords: ecohydrological monitoring, flood risk management, global warming, aquatic macroinvertebrates

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2951 Systematic Analysis of Immune Response to Biomaterial Surface Characteristics

Authors: Florian Billing, Soren Segan, Meike Jakobi, Elsa Arefaine, Aliki Jerch, Xin Xiong, Matthias Becker, Thomas Joos, Burkhard Schlosshauer, Ulrich Rothbauer, Nicole Schneiderhan-Marra, Hanna Hartmann, Christopher Shipp

Abstract:

The immune response plays a major role in implant biocompatibility, but an understanding of how to design biomaterials for specific immune responses is yet to be achieved. We aimed to better understand how changing certain material properties can drive immune responses. To this end, we tested immune response to experimental implant coatings that vary in specific characteristics. A layer-by-layer approach was employed to vary surface charge and wettability. Human-based in vitro models (THP-1 macrophages and primary peripheral blood mononuclear cells (PBMCS)) were used to assess immune responses using multiplex cytokine analysis, flow cytometry (CD molecule expression) and microscopy (cell morphology). We observed dramatic differences in immune response due to specific alterations in coating properties. For example altering the surface charge of coating A from anionic to cationic resulted in the substantial elevation of the pro-inflammatory molecules IL-1beta, IL-6, TNF-alpha and MIP-1beta, while the pro-wound healing factor VEGF was significantly down-regulated. We also observed changes in cell surface marker expression in relation to altered coating properties, such as CD16 on NK Cells and HLA-DR on monocytes. We furthermore observed changes in the morphology of THP-1 macrophages following cultivation on different coatings. A correlation between these morphological changes and the cytokine expression profile is ongoing. Targeted changes in biomaterial properties can produce vast differences in immune response. The properties of the coatings examined here may, therefore, be a method to direct specific biological responses in order to improve implant biocompatibility.

Keywords: biomaterials, coatings, immune system, implants

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2950 Phylogenetic Relationships between the Whole Sets of Individual Flow Sorted U, M, S and C Chromosomes of Aegilops and Wheat as Revealed by COS Markers

Authors: András Farkas, István Molnár, Jan Vrána, Veronika Burešová, Petr Cápal, András Cseh, Márta Molnár-Láng, Jaroslav Doležel

Abstract:

Species of Aegilops played a central role in the evolution of wheat and are sources of traits related to yield quality and tolerance against biotic and abiotic stresses. These wild genes and alleles are desirable to use in crop improvement programs via introgressive hybridization. However, the success of chromosome mediated gene transfer to wheat are hampered by the pour knowledge on the genome structure of Aegilops relative to wheat and by the low number of cost-effective molecular markers specific for Aegilops chromosomes. The COS markers specific for genes conserved throughout evolution in both sequence and copy number between Triticeae/Aegilops taxa and define orthologous regions, thus enabling the comparison of regions on the chromosomes of related species. The present study compared individual chromosomes of Aegilops umbellulata (UU), Ae. comosa (MM), Ae. speltoides (SS) and Ae. caudata (CC) purified by flourescent labelling with oligonucleotid SSR repeats and biparametric flow cytometry with wheat by identifying orthologous chromosomal regions by COS markers. The linear order of bin-mapped COS markers along the wheat D chromosomes was identified by the use of chromosome-specific sequence data and virtual gene order. Syntenic regions of wheat identifying genome rearrangements differentiating the U, M, S or C genomes from the D genome of wheat were detected. The conserved orthologous set markers assigned to Aegilops chromosomes promise to accelerate gene introgression by facilitating the identification of alien chromatin. The syntenic relationships between the Aegilops species and wheat will facilitate the targeted development of new markers specific for U, M, S and C genomic regions and will contribute to the understanding of molecular processes related to the evolution of Aegilops.

Keywords: Aegilops, cos-markers, flow-sorting, wheat

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2949 Semi-Automatic Segmentation of Mitochondria on Transmission Electron Microscopy Images Using Live-Wire and Surface Dragging Methods

Authors: Mahdieh Farzin Asanjan, Erkan Unal Mumcuoglu

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Mitochondria are cytoplasmic organelles of the cell, which have a significant role in the variety of cellular metabolic functions. Mitochondria act as the power plants of the cell and are surrounded by two membranes. Significant morphological alterations are often due to changes in mitochondrial functions. A powerful technique in order to study the three-dimensional (3D) structure of mitochondria and its alterations in disease states is Electron microscope tomography. Detection of mitochondria in electron microscopy images due to the presence of various subcellular structures and imaging artifacts is a challenging problem. Another challenge is that each image typically contains more than one mitochondrion. Hand segmentation of mitochondria is tedious and time-consuming and also special knowledge about the mitochondria is needed. Fully automatic segmentation methods lead to over-segmentation and mitochondria are not segmented properly. Therefore, semi-automatic segmentation methods with minimum manual effort are required to edit the results of fully automatic segmentation methods. Here two editing tools were implemented by applying spline surface dragging and interactive live-wire segmentation tools. These editing tools were applied separately to the results of fully automatic segmentation. 3D extension of these tools was also studied and tested. Dice coefficients of 2D and 3D for surface dragging using splines were 0.93 and 0.92. This metric for 2D and 3D for live-wire method were 0.94 and 0.91 respectively. The root mean square symmetric surface distance values of 2D and 3D for surface dragging was measured as 0.69, 0.93. The same metrics for live-wire tool were 0.60 and 2.11. Comparing the results of these editing tools with the results of automatic segmentation method, it shows that these editing tools, led to better results and these results were more similar to ground truth image but the required time was higher than hand-segmentation time

Keywords: medical image segmentation, semi-automatic methods, transmission electron microscopy, surface dragging using splines, live-wire

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2948 Factors That Influence Choice of Walking Mode in Work Trips: Case Study of Rasht, Iran

Authors: Nima Safaei, Arezoo Masoud, Babak Safaei

Abstract:

In recent years, there has been a growing emphasis on the role of urban planning in walking capability and the effects of individual and socioeconomic factors on the physical activity levels of city dwellers. Although considerable number of studies are conducted about walkability and for identifying the effective factors in walking mode choice in developed countries, to our best knowledge, literature lacks in the study of factors affecting choice of walking mode in developing countries. Due to the high importance of health aspects of human societies and in order to make insights and incentives for reducing traffic during rush hours, many researchers and policy makers in the field of transportation planning have devoted much attention to walkability studies; they have tried to improve the effective factors in the choice of walking mode in city neighborhoods. In this study, effective factors in walkability that have proven to have significant impact on the choice of walking mode, are studied at the same time in work trips. The data for the study is collected from the employees in their workplaces by well-instructed people using questionnaires; the statistical population of the study consists of 117 employed people who commute daily from work to home in Rasht city of Iran during the beginning of spring 2015. Results of the study which are found through the linear regression modeling, show that people who do not have freedom of choice for choosing their living locations and need to be present at their workplaces in certain hours have lower levels of walking. Additionally, unlike some of the previous studies which were conducted in developed countries, coincidental effects of Body Mass Index (BMI) and the income level of employees, do not have a significant effect on the walking level in work travels.

Keywords: BMI, linear regression, transportation, walking, work trips

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2947 Analyzing Middle Actors' Influence on Land Use Policy: A Case Study in Central Kalimantan, Indonesia

Authors: Kevin Soubly, Kaysara Khatun

Abstract:

This study applies the existing Middle-Out Perspective (MOP) as a complementing analytical alternative to the customary dichotomous options of top-down vs. bottom-up strategies of international development and commons governance. It expands the framework by applying it to a new context of land management and environmental change, enabling fresh understandings of decision making around land use. Using a case study approach in Central Kalimantan, Indonesia among a village of indigenous Dayak, this study explores influences from both internal and external middle actors, utilizing qualitative empirical evidence and incorporating responses across 25 village households and 11 key stakeholders. Applying the factors of 'agency' and 'capacity' specific to the MOP, this study demonstrates middle actors’ unique capabilities and criticality to change due to their influence across various levels of decision-making. Study results indicate that middle actors play a large role, both passively and actively, both directly and indirectly, across various levels of decision-making, perception-shaping, and commons governance. In addition, the prominence of novel 'passive' middle actors, such as the internet, can provide communities themselves with a level of agency beyond that provided by other middle actors such as NGOs and palm oil industry entities – which often operate at the behest of the 'top' or out of self-interest. Further, the study posits that existing development and decision-making frameworks may misidentify the 'bottom' as the 'middle,' raising questions about traditional development and livelihood discourse, strategies, and support, from agricultural production to forest management. In conclusion, this study provides recommendations including that current policy preconceptions be reevaluated to engage middle actors in locally-adapted, integrative manners in order to improve governance and rural development efforts more broadly.

Keywords: environmental management, governance, Indonesia, land use, middle actors, middle-out perspective

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2946 Occurence And Management Of Coliform Bacteria On Tomatoes

Authors: Cho Achidi

Abstract:

Tomato is a crucial food crop significantly contributes to global food and nutrition security. However, postharvest losses severely limit its role. Therefore, it is necessary to develop sustainable strategies to minimize these losses and improve the shelf-life of tomato fruits. One of the major concerns is bacterial infections, particularly by faecal coliform bacteria, which can cause food poisoning and illnesses like diarrhoea and dysentery. This study seeks to identify the presence of coliform bacteria on tomato fruits in fields and markets in Muea, Buea Municipality. The study also evaluated different management strategies to reduce the bacterial incidence and load on tomato fruits. A total of 200 fruits were sampled for both the coliform survey and shelf-life analysis. Ten farmers and traders provided samples, including asymptomatic and symptomatic tomato fruits. The samples designated for shelf-life analysis were treated with Aquatab, warm water, lemon, and onion. The results indicated that out of the 80 symptomatic samples collected, 12.5% contained faecal and total coliform species. Among the ten farms sampled, 14% were infected with coliform bacteria, with the highest infestation rate of 60% recorded in field 4. Furthermore, 15% of the asymptomatic tomato fruits were found to be infected by coliform bacteria. Regarding the management strategies, Aquatabs exhibited the highest efficacy in reducing the incidence of coliform bacteria on tomato fruits, followed by onion and lemon extracts. Although hot water treatment effectively removed bacteria from the fruits, damaging the cell wall negatively affected their shelf-life. Overall, this study emphasizes the severity of coliform bacterial pathogens in the Muea area, particularly their occurrence on asymptomatic tomatoes, which poses a significant concern for plant quarantine services. It also demonstrates potential options for mitigating this bacterial challenge.

Keywords: tomato, shelf-life analysis, food and nutrition security, coliform bbacteria

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2945 Female Sex Workers and Their Association with Self-Help Groups in Thane, Maharashtra, India: A Comparative Analysis in the Context of HIV Program Outcome

Authors: Awdhesh Yadav, P. S. Saravanamurthy, Shaikh Tayyaba, Uma Shah, Ashok Agarwal

Abstract:

Objectives: HIV interventions in India has leveraged Self-Help Group (SHG) as one of the key strategies under structural intervention to empower female sex workers (FSW) to reduce their risk exposure and vulnerability to STI/HIV. Understanding the role of SHGs in light of the evolving dynamics of sex work needs to be delved into to strategize HIV interventions among FSWs in India. This paper aims to study the HIV program outcome among the FSWs associated with SHGs and FSWs not associated with SHGs in Thane, Maharashtra. Study Design: This cross-sectional study, was undertaken from the Behavioral Tracking Survey (BTS) conducted among 503 FSWs in Thane in 2015. Two-stage probability based conventional sampling was done for selection of brothel and bar based FSWs, while Time Location Cluster (TLC) sampling was done for home, lodge and street-based sex workers. Methods: Bivariate and multivariate logistic regression were performed to compare and contrast between FSWs associated with SHG and those not associated with SHG with respect to the utilization of HIV related services by them. ‘Condom use’, ‘consistent condom use’, ‘contact with peer-educators’, ‘counseling sessions’ and ‘HIV testing’ were chosen as indicators on HIV service utilization. Results: 8% (38) of FSWs are registered with SHG; 92% aged ≥ 25 years, 47% illiterate, and 71% are currently married. The likelihood of utilizing HIV services including, knowledge on HIV/AIDS and its mode of transmission (OR:5.54; CI: 1.87-16.60; p < 0.05),accessed drop-in Centre (OR: 6.53; CI: 2.15-19.88; p < 0.10), heard about joint health camps (OR: 4.71; CI:2.12-10.46); p < 0.05), negotiated or stood up against police/broker/local goonda/clients (OR: 2.26; CI: 1.08-4.73; p < 0.05), turned away clients when they refused to use condom during sex (OR: 3.76; CI: 1.27-11.15; p < 0.05) and heard of ART (OR; 4.55; CI: 2.18-9.48; p < 0.01) were higher among FSWs associated with SHG in comparison to FSWs not associated with SHG. Conclusions: Considering the improved HIV program outcomes among FSWs associated with SHG; HIV interventions among FSWs could consider facilitating the formation of SHGs with FSWs as one of the key strategies to empower the community for ensuring better program outcomes.

Keywords: empowerment, female sex workers, HIV, Thane, self-help group

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2944 Survey on Resilience of Chinese Nursing Interns: A Cross-Sectional Study

Authors: Yutong Xu, Wanting Zhang, Jia Wang, Zihan Guo, Weiguang Ma

Abstract:

Background: The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience. Aims: To evaluate the resilience level of Chinese nursing interns and identify the factors affecting resilience early in their careers. Methods: The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment scale for Nurse, and the Career Adapt-Abilities Scale. Structural equation modeling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped Confidence Intervals. Results: The nursing interns showed a moderately high level of resilience[M(SD)=70.15(19.90)]. Gender, scholastic attainment, had a scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns’ resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.58, 0.12, respectively, p<0.01). career adaptability also positively affected career adaptability (β = 0.26, p < 0.01), and played a fully mediating role in the relationship between clinical learning environment and resilience. Conclusion: Career adaptability can enhance the influence of clinical learning environment on resilience. The promotion of career adaptability and the clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for those female nursing interns with low academic performance. Implications for Nursing Educators Nursing educators should pay attention to the cultivation of nursing students' resilience; for example, by helping them integrate to the clinical learning environment and improving their career adaptability. Reporting Method: The STROBE criteria were used to report the results of the observations critically. Patient or Public Contribution No patient or public contribution.

Keywords: resilience, clinical learning environment, career adaptability, nursing interns

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2943 Comparative Assessment of Geocell and Geogrid Reinforcement for Flexible Pavement: Numerical Parametric Study

Authors: Anjana R. Menon, Anjana Bhasi

Abstract:

Development of highways and railways play crucial role in a nation’s economic growth. While rigid concrete pavements are durable with high load bearing characteristics, growing economies mostly rely on flexible pavements which are easier in construction and more economical. The strength of flexible pavement is based on the strength of subgrade and load distribution characteristics of intermediate granular layers. In this scenario, to simultaneously meet economy and strength criteria, it is imperative to strengthen and stabilize the load transferring layers, namely subbase and base. Geosynthetic reinforcement in planar and cellular forms have been proven effective in improving soil stiffness and providing a stable load transfer platform. Studies have proven the relative superiority of cellular form-geocells over planar geosynthetic forms like geogrid, owing to the additional confinement of infill material and pocket effect arising from vertical deformation. Hence, the present study investigates the efficiency of geocells over single/multiple layer geogrid reinforcements by a series of three-dimensional model analyses of a flexible pavement section under a standard repetitive wheel load. The stress transfer mechanism and deformation profiles under various reinforcement configurations are also studied. Geocell reinforcement is observed to take up a higher proportion of stress caused by the traffic loads compared to single and double-layer geogrid reinforcements. The efficiency of single geogrid reinforcement reduces with an increase in embedment depth. The contribution of lower geogrid is insignificant in the case of the double-geogrid reinforced system.

Keywords: Geocell, Geogrid, Flexible Pavement, Repetitive Wheel Load, Numerical Analysis

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2942 Role of Spatial Variability in the Service Life Prediction of Reinforced Concrete Bridges Affected by Corrosion

Authors: Omran M. Kenshel, Alan J. O'Connor

Abstract:

Estimating the service life of Reinforced Concrete (RC) bridge structures located in corrosive marine environments of a great importance to their owners/engineers. Traditionally, bridge owners/engineers relied more on subjective engineering judgment, e.g. visual inspection, in their estimation approach. However, because financial resources are often limited, rational calculation methods of estimation are needed to aid in making reliable and more accurate predictions for the service life of RC structures. This is in order to direct funds to bridges found to be the most critical. Criticality of the structure can be considered either form the Structural Capacity (i.e. Ultimate Limit State) or from Serviceability viewpoint whichever is adopted. This paper considers the service life of the structure only from the Structural Capacity viewpoint. Considering the great variability associated with the parameters involved in the estimation process, the probabilistic approach is most suited. The probabilistic modelling adopted here used Monte Carlo simulation technique to estimate the Reliability (i.e. Probability of Failure) of the structure under consideration. In this paper the authors used their own experimental data for the Correlation Length (CL) for the most important deterioration parameters. The CL is a parameter of the Correlation Function (CF) by which the spatial fluctuation of a certain deterioration parameter is described. The CL data used here were produced by analyzing 45 chloride profiles obtained from a 30 years old RC bridge located in a marine environment. The service life of the structure were predicted in terms of the load carrying capacity of an RC bridge beam girder. The analysis showed that the influence of SV is only evident if the reliability of the structure is governed by the Flexure failure rather than by the Shear failure.

Keywords: Chloride-induced corrosion, Monte-Carlo simulation, reinforced concrete, spatial variability

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2941 Analyzing Doctors’ Knowledge of the United Kingdom Chief Medical Officer's Guidelines for Physical Activity: Survey of Secondary Care Doctors in a District General Hospital

Authors: Alexandra Von Guionneau, William Sloper, Charlotte Burford

Abstract:

The benefits of exercise for the prevention and management of chronic disease are well established and the importance of primary care practitioners in promoting exercise is becoming increasingly recognized. However, those with severe manifestations of the chronic disease are managed in a secondary care setting. Secondary care practitioners, therefore, have a role to play in promoting physical activity. Methods: In order to assess secondary care doctors’ knowledge of the Chief Medical Officer’s guidelines for physical activity, a 12-question survey was administered to staff working in a district general hospital in South England during team and unit meetings. Questions related to knowledge of the current guidelines for both 19 - 64 year olds and older adults (65 years and above), barriers to exercise discussion or prescription and doctors’ own exercise habits. Responses were collected anonymously and analyzed using SPSS Version 24.0. Results: 96 responses were collected. Doctors taking part in the survey ranged from foundation years (26%) to consultants (40%). 17.7% of participants knew the guidelines for moderate intensity activity for 19 - 64 year olds. Only one participant knew all of the guidance for both 19 - 64 year olds and older adults. While 71.6% of doctors felt they were adequately informed about how to exercise, only 45.6% met the minimum recommended guidance for moderate intensity activity. Conclusion: More work is needed to promote the physical activity guidelines and exercise prescription to doctors working within a secondary care setting. In addition, doctors require more support to personally meet the recommended minimum level of physical activity.

Keywords: exercise is medicine, exercise prescription, physical activity guidelines, exercise habits

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2940 Using Multi-Specialist Team to Care for a Breast Cancer Patient Who Received Total Mastectomy during Pregnancy

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

Abstract:

This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

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2939 A Crystallization Kinetic Model for Long Fiber-Based Composite with Thermoplastic Semicrystalline Polymer Matrix

Authors: Nicolas Bigot, M'hamed Boutaous, Nahiene Hamila, Shihe Xin

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Composite materials with polymer matrices are widely used in most industrial areas, particularly in aeronautical and automotive ones. Thanks to the development of a high-performance thermoplastic semicrystalline polymer matrix, those materials exhibit more and more efficient properties. The polymer matrix in composite materials can manifest a specific crystalline structure characteristic of crystallization in a fibrous medium. In order to guarantee a good mechanical behavior of structures and to optimize their performances, it is necessary to define realistic mechanical constitutive laws of such materials considering their physical structure. The interaction between fibers and matrix is a key factor in the mechanical behavior of composite materials. Transcrystallization phenomena which develops in the matrix around the fibers constitute the interphase which greatly affects and governs the nature of the fiber-matrix interaction. Hence, it becomes fundamental to quantify its impact on the thermo-mechanical behavior of composites material in relationship with processing conditions. In this work, we propose a numerical model coupling the thermal and crystallization kinetics in long fiber-based composite materials, considering both the spherulitic and transcrystalline types of the induced structures. After validation of the model with comparison to results from the literature and noticing a good correlation, a parametric study has been led on the effects of the thermal kinetics, the fibers volume fractions, the deformation, and the pressure on the crystallization rate in the material, under processing conditions. The ratio of the transcrystallinity is highlighted and analyzed with regard to the thermal kinetics and gradients in the material. Experimental results on the process are foreseen and pave the way to establish a mechanical constitutive law describing, with the introduction of the role on the crystallization rates and types on the thermo-mechanical behavior of composites materials.

Keywords: composite materials, crystallization, heat transfer, modeling, transcrystallization

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2938 Re-thinking Trust in Refugee Resettlement: A Contextual Perspective and Proposal for Reciprocal Integration

Authors: Mahfoudha Sid'Elemine

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The refugee resettlement process profoundly shapes the trajectories of individuals in their new host countries, exerting lasting effects on their long-term integration. Prevailing literature underscores the pivotal role of trust in facilitating successful refugee resettlement. However, this research challenges the notion of trust as universally paramount, contending that its significance is contingent upon variables such as the nature of resettlement programs and the diverse backgrounds and perspectives of refugees. Rather than advocating for a blanket approach to trust-building, this research contends that for certain resettlement programs, trust may prove counterproductive amidst resource constraints and tight service timelines. Moreover, trust may not uniformly emerge as a primary requisite for all refugees, presenting formidable challenges in its establishment. Focusing specifically on resettlement in the United States, this study illustrates how the temporal constraints of resettlement services, coupled with refugees' varied cultural experiences, can impede the cultivation of trust between aid workers and refugees. As an alternative paradigm, this research proposes an approach centered on fostering opportunities for reciprocal engagement, positioning refugees as active contributors within their newfound communities. Embracing reciprocity as the cornerstone of burgeoning relationships promises to fortify refugees' ties with the broader community, bolster their autonomy, and facilitate sustained integration over time. The research draws upon qualitative analyses of in-depth interviews conducted with a subset of resettled refugees, as well as aid workers and volunteers involved in refugee resettlement endeavors within Hampton Roads, Virginia, over the past decade. Through this nuanced examination, the study offers insights into the complexities of trust dynamics in refugee resettlement contexts and advocates for a paradigm shift towards reciprocal integration strategies.

Keywords: Resettlement programs, Trust dynamics, Reciprocity, Long-term integration

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2937 Leveraging on Application of Customer Relationship Management Strategy as Business Driving Force: A Case Study of Major Industries

Authors: Odunayo S. Faluse, Roger Telfer

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Customer relationship management is a business strategy that is centred on the idea that ‘Customer is the driving force of any business’ i.e. Customer is placed in a central position in any business. However, this belief coupled with the advancement in information technology in the past twenty years has experienced a change. In any form of business today it can be concluded that customers are the modern dictators to whom the industry always adjusts its business operations due to the increase in availability of information, intense market competition and ever growing negotiating ideas of customers in the process of buying and selling. The most vital role of any organization is to satisfy or meet customer’s needs and demands, which eventually determines customer’s long-term value to the industry. Therefore, this paper analyses and describes the application of customer relationship management operational strategies in some of the major industries in business. Both developed and up-coming companies nowadays value the quality of customer services and client’s loyalty, they also recognize the customers that are not very sensitive when it comes to changes in price and thereby realize that attracting new customers is more tasking and expensive than retaining the existing customers. However, research shows that several factors have recently amounts to the sudden rise in the execution of CRM strategies in the marketplace, such as a diverted attention of some organization towards integrating ideas in retaining existing customers rather than attracting new one, gathering data about customers through the use of internal database system and acquiring of external syndicate data, also exponential increase in technological intelligence. Apparently, with this development in business operations, CRM research in Academia remain nascent; hence this paper gives detailed critical analysis of the recent advancement in the use of CRM and key research opportunities for future development in using the implementation of CRM as a determinant factor for successful business optimization.

Keywords: agriculture, banking, business strategies, CRM, education, healthcare

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2936 Implementation of an Induction Programme to Help the International Medical Graduates in the NHS

Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw

Abstract:

Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.

Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.

Procedia PDF Downloads 135