Search results for: age related macular degeneration
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9441

Search results for: age related macular degeneration

1101 Moving Forward to Stand Still: Social Experiences of Children with a Parent in Prison in Ireland

Authors: Aisling Parkes, Fiona Donson

Abstract:

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

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

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1100 A Mixed Integer Linear Programming Model for Container Collection

Authors: J. Van Engeland, C. Lavigne, S. De Jaeger

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In the light of the transition towards a more circular economy, recovery of products, parts or materials will gain in importance. Additionally, the EU proximity principle related to waste management and emissions generated by transporting large amounts of end-of-life products, shift attention to local recovery networks. The Flemish inter-communal cooperation for municipal solid waste management Meetjesland (IVM) is currently investigating the set-up of such a network. More specifically, the network encompasses the recycling of polyvinyl chloride (PVC), which is collected in separate containers. When these containers are full, a truck should transport them to the processor which can recycle the PVC into new products. This paper proposes a model to optimize the container collection. The containers are located at different Civic Amenity sites (CA sites) in a certain region. Since people can drop off their waste at these CA sites, the containers will gradually fill up during a planning horizon. If a certain container is full, it has to be collected and replaced by an empty container. The collected waste is then transported to a single processor. To perform this collection and transportation of containers, the responsible firm has a set of vehicles stationed at a single depot and different personnel crews. A vehicle can load exactly one container. If a trailer is attached to the vehicle, it can load an additional container. Each day of the planning horizon, the different crews and vehicles leave the depot to collect containers at the different sites. After loading one or two containers, the crew has to drive to the processor for unloading the waste and to pick up empty containers. Afterwards, the crew can again visit sites or it can return to the depot to end its collection work for that day. All along the collection process, the crew has to respect the opening hours of the sites. In order to allow for some flexibility, a crew is allowed to wait a certain amount of time at the gate of a site until it opens. The problem described can be modelled as a variant to the PVRP-TW (Periodic Vehicle Routing Problem with Time Windows). However, a vehicle can at maximum load two containers, hence only two subsequent site visits are possible. For that reason, we will refer to the model as a model for building tactical waste collection schemes. The goal is to a find a schedule describing which crew should visit which CA site on which day to minimize the number of trucks and the routing costs. The model was coded in IBM CPLEX Optimization studio and applied to a number of test instances. Good results were obtained, and specific suggestions concerning route and truck costs could be made. For a large range of input parameters, collection schemes using two trucks are obtained.

Keywords: container collection, crew scheduling, mixed integer linear programming, waste management

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1099 The Affordable Housing Problems Of Elderly Households In The Istanbul Metropolitan Area

Authors: Elifsu Sahin

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In the world and in Turkey, approximately 1 in 10 people is 65 years of age or older. The age group of 65 and over is the fastest-growing age group since 1990. This demographic aging trend and demographic transformation have spread over a long period in Western Europe and North America, while in Turkey, they have occurred over a relatively short period. The aging of the population poses many challenges in terms of housing supply, housing satisfaction, and economic access to housing, due to factors such as a decrease in the number of people in households, low incomes, and increased time spent in housing and housing neighborhoods. On the other hand, since 2000, neoliberal economic policies and government policies have led to serious growth in the construction and housing sectors in Turkey. During this process, the housing market in Turkey generally produced housing for high-income groups and foreigners. Housing has become an investment instrument, and rising housing prices and rents have seriously reduced both the affordability of housing and households' chances of living in healthy housing. Housing has become a growing problem for vulnerable groups such as low- and middle-income households, students, refugees, and the elderly. Moreover, in recent years, international migration, pandemics, economic crises, inflation, and the expected Istanbul earthquake have raised housing prices and rent in Turkey as a whole, especially in Istanbul. The aim of the study is to investigate how elderly households that don't own homes deal with the economic accessibility of housing and other affordability-related housing problems in the Istanbul Metropolitan Area today, when housing becomes an investment instrument, the issue of social housing is not on the agenda, and households can be added to the market according to their ability to pay. A complex method was adopted in the research, using a combination of various statistical data and interview findings. Based on household income, in-depth interviews were conducted with 100 elderly households who don't own their own homes and were randomly selected in identified neighborhoods, analyzing the micro-area within the districts in the Istanbul Metropolitan Area, where middle- and low-income households are concentrated. The study found that more than 50% of the net income of elderly households was spent on rent and other housing expenses. Some of the households said that they restrict spending on food, health, and entertainment because of their housing expenses. Among the findings of the study is that households receive financial support from their children or move into their children’s house for economic reasons. Due to the decrease in household income, especially after the loss of a spouse, the single individual moves into their children’s house. Moreover, some of the interviewed households had to change their house and move to a smaller, lower-rent house on the urban periphery for economic reasons after retirement, especially after 2020, despite their unwillingness.

Keywords: affordable housing, elderly households, housing policy, istanbul metropolitan area

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1098 Scenario of Some Minerals and Impact of Promoter Hypermethylation of DAP-K Gene in Gastric Carcinoma Patients of Kashmir Valley

Authors: Showkat Ahmad Bhat, Iqra Reyaz, Falaque ul Afshan, Ahmad Arif Reshi, Muneeb U. Rehman, Manzoor R. Mir, Sabhiya Majid, Sonallah, Sheikh Bilal, Ishraq Hussain

Abstract:

Background: Gastric cancer is the fourth most common cancer and the second leading cause of worldwide cancer-related deaths, with a wide variation in incidence rates across different geographical areas. The current view of cancer is that a malignancy arises from a transformation of the genetic material of a normal cell, followed by successive mutations and by chain of alterations in genes such as DNA repair genes, oncogenes, Tumor suppressor genes. Minerals are necessary for the functioning of several transcriptional factors, proteins that recognize certain DNA sequences and have been found to play a role in gastric cancer. Material Methods:The present work was a case control study and its aim was to ascertain the role of minerals and promoter hypermethylation of CpG islands of DAP-K gene in Gastric cancer patients among the Kashmiri population. Serum was extracted from all the samples and mineral estimation was done by AAS from serum, DNA was also extracted and was modified using bisulphite modification kit. Methylation-specific PCR was used for the analysis of the promoter hypermethylation status of DAP-K gene. The epigenetic analysis revealed that unlike other high risk regions, Kashmiri population has a different promoter hypermethylation profile of DAP-K gene and has different mineral profile. Results: In our study mean serum copper levels were significantly different for the two genders (p<0.05), while as no significant differences were observed for iron and zinc levels. In Methylation-specific PCR the methylation status of the promoter region of DAP-K gene was as 67.50% (27/40) of the gastric cancer tissues showed methylated DAP-K promoter and 32.50% (13/40) of the cases however showed unmethylated DAP-K promoter. Almost all 85% (17/20) of the histopathologically confirmed normal tissues showed unmethylated DAP-K promoter except only in 3 cases where DAP-K promoter was found to be methylated. The association of promoter hypermethylation with gastric cancer was evaluated by χ2 (Chi square) test and was found to be significant (P=0.0006). Occurrence of DAP-K methylation was found to be unequally distributed in males and females with more frequency in males than in females but the difference was not statistically significant (P =0.7635, Odds ratio=1.368 and 95% C.I=0.4197 to 4.456). When the frequency of DAP-K promoter methylation was compared with clinical staging of the disease, DAP-K promoter methylation was found to be certainly higher in Stage III/IV (85.71%) compared to Stage I/ II (57.69%) but the difference was not statistically significant (P =0.0673). These results suggest that DAP-K aberrant promoter hypermethylation in Kashmiri population contributes to the process of carcinogenesis in Gastric cancer and is reportedly one of the commonest epigenetic changes in the development of Gastric cancer.

Keywords: gastric cancer, minerals, AAS, hypermethylation, CpG islands, DAP-K gene

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1097 Nuclear Near Misses and Their Learning for Healthcare

Authors: Nick Woodier, Iain Moppett

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Background: It is estimated that one in ten patients admitted to hospital will suffer an adverse event in their care. While the majority of these will result in low harm, patients are being significantly harmed by the processes meant to help them. Healthcare, therefore, seeks to make improvements in patient safety by taking learning from other industries that are perceived to be more mature in their management of safety events. Of particular interest to healthcare are ‘near misses,’ those events that almost happened but for an intervention. Healthcare does not have any guidance as to how best to manage and learn from near misses to reduce the chances of harm to patients. The authors, as part of a larger study of near-miss management in healthcare, sought to learn from the UK nuclear sector to develop principles for how healthcare can identify, report, and learn from near misses to improve patient safety. The nuclear sector was chosen as an exemplar due to its status as an ultra-safe industry. Methods: A Grounded Theory (GT) methodology, augmented by a scoping review, was used. Data collection included interviews, scenario discussion, field notes, and the literature. The review protocol is accessible online. The GT aimed to develop theories about how nuclear manages near misses with a focus on defining them and clarifying how best to support reporting and analysis to extract learning. Near misses related to radiation release or exposure were focused on. Results: Eightnuclear interviews contributed to the GT across nuclear power, decommissioning, weapons, and propulsion. The scoping review identified 83 articles across a range of safety-critical industries, with only six focused on nuclear. The GT identified that nuclear has a particular focus on precursors and low-level events, with regulation supporting their management. Exploration of definitions led to the recognition of the importance of several interventions in a sequence of events, but that do not solely rely on humans as these cannot be assumed to be robust barriers. Regarding reporting and analysis, no consistent methods were identified, but for learning, the role of operating experience learning groups was identified as an exemplar. The safety culture across nuclear, however, was heard to vary, which undermined reporting of near misses and other safety events. Some parts of the industry described that their focus on near misses is new and that despite potential risks existing, progress to mitigate hazards is slow. Conclusions: Healthcare often sees ‘nuclear,’ as well as other ultra-safe industries such as ‘aviation,’ as homogenous. However, the findings here suggest significant differences in safety culture and maturity across various parts of the nuclear sector. Healthcare can take learning from some aspects of management of near misses in nuclear, such as how they are defined and how learning is shared through operating experience networks. However, healthcare also needs to recognise that variability exists across industries, and comparably, it may be more mature in some areas of safety.

Keywords: culture, definitions, near miss, nuclear safety, patient safety

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1096 Self-Care and Emotional Wellbeing of Nurses Using Playback Theatre and Expressive Arts

Authors: Radhika Jain

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The nursing community in India face unique challenges ranging from lack of adequate career progression, low social status attached to the profession, poor nurse-to-patient ratio leading to heavy workload resulting in stress and burnout, lack of general recognition and the responsibility of often having to deal with the ire of the patients and their families. This study explores how a combination of Playback Theatre and Expressive Arts could be used as a very powerful tool to understand the concerns, and consequently as a self-care tool to bring about the sense of well-being and emotional awareness for the nurses. For the purpose of this study, Playback Theatre was used as an entry tool to understand the thoughts, feelings and concerns. Playback theatre is a unique improvisational form of theatre developed by Jonathan Fox and Jo Salas in 1975, in which audience share their own stories from their lives and the performers play them back through a range of improv techniques such as metaphor, poetry, music and movement. Playback Theatre helped in first warming them up to the idea of sharing and then gave them the confidence of a safe space to collectively go deeper into their emotional experiences. As the next step, structured sessions of Expressive Arts were conducted with the same set of nurses, for them to work on the issues and concerns they have (and which they shared during the Playback performance). These sessions were to enable longer engagements as many of the concerns expressed were related to perceptions and beliefs that have been ingrained over a period of time and hence it needs a longer engagement to be worked on in detail. The Expressive Art sessions helped in this regard. Expressive arts therapy combines psychology and the creative process to promote emotional growth and healing. The study was conducted at two places: one a geriatric centre and the other, a palliative care centre. The study revealed that concerns and challenges would not be identical across the nursing community or across similar types of health care organizations but would be specific to each organization or centre as the circumstances and set-up at each place would be different. At the geriatric centre, stress and burnout emerged as the main concerns while at the palliative care centre, the main concern that came up was around the difficulty the nurses faced in expressing emotions and in communicating their feelings. The objective analysis of the results of the study indicated how longer-term engagements using Expressive Arts as the modality helped the nurses have better awareness of their emotions and helped them develop tools of self-care tools while also tapping into their emotions to express and experience. The process of eliciting the main concerns from the nurses using a Playback Theatre performance and then following that with subsequent sessions of expressive arts helped the nurses in the way nurses approached their job and the reduced level of overwhelm that they felt.

Keywords: palliative care, nurses, self-care, expressive arts, playback theatre

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1095 The Use of Punctuation by Primary School Students Writing Texts Collaboratively: A Franco-Brazilian Comparative Study

Authors: Cristina Felipeto, Catherine Bore, Eduardo Calil

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This work aims to analyze and compare the punctuation marks (PM) in school texts of Brazilian and French students and the comments on these PM made spontaneously by the students during the ongoing text. Assuming textual genetics as an investigative field within a dialogical and enunciative approach, we defined a common methodological design in two 1st year classrooms (7 years old) of the primary school, one classroom in Brazil (Maceio) and the other one in France (Paris). Through a multimodal capture system of writing processes in real time and space (Ramos System), we recorded the collaborative writing proposal in dyads in each of the classrooms. This system preserves the classroom’s ecological characteristics and provides a video recording synchronized with dialogues, gestures and facial expressions of the students, the stroke of the pen’s ink on the sheet of paper and the movement of the teacher and students in the classroom. The multimodal register of the writing process allowed access to the text in progress and the comments made by the students on what was being written. In each proposed text production, teachers organized their students in dyads and requested that they should talk, combine and write a fictional narrative. We selected a Dyad of Brazilian students (BD) and another Dyad of French students (FD) and we have filmed 6 proposals for each of the dyads. The proposals were collected during the 2nd Term of 2013 (Brazil) and 2014 (France). In 6 texts written by the BD there were identified 39 PMs and 825 written words (on average, a PM every 23 words): Of these 39 PMs, 27 were highlighted orally and commented by either student. In the texts written by the FD there were identified 48 PMs and 258 written words (on average, 1 PM every 5 words): Of these 48 PM, 39 were commented by the French students. Unlike what the studies on punctuation acquisition point out, the PM that occurred the most were hyphens (BD) and commas (FD). Despite the significant difference between the types and quantities of PM in the written texts, the recognition of the need for writing PM in the text in progress and the comments have some common characteristics: i) the writing of the PM was not anticipated in relation to the text in progress, then they were added after the end of a sentence or after the finished text itself; ii) the need to add punctuation marks in the text came after one of the students had ‘remembered’ that a particular sign was needed; iii) most of the PM inscribed were not related to their linguistic functions, but the graphic-visual feature of the text; iv) the comments justify or explain the PM, indicating metalinguistic reflections made by the students. Our results indicate how the comments of the BD and FD express the dialogic and subjective nature of knowledge acquisition. Our study suggests that the initial learning of PM depends more on its graphic features and interactional conditions than on its linguistic functions.

Keywords: collaborative writing, erasure, graphic marks, learning, metalinguistic awareness, textual genesis

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1094 Debunking Sexual Myths in Bangladesh through an Intervention on the Internet

Authors: E. Rommes, Els Toonen, Rahil Roodsaz, Suborna Camellia, Farhana Alam, Saad Khan, Jhalok Ranjon Talukder, Tanveer Hassan, Syeda Farjana Ahmed, Sabina Faiz Rashid

Abstract:

In Bangladesh, a country in which adults (both parents and teachers) find it particularly hard to speak with youth about sexuality, adolescents seem to struggle with various insecurities about their sexual feelings, thoughts, behavior and physical characteristics. On the basis of a large number of interviews and focus groups with rural and urban Bangla adolescent girls and boys of lower and middle class as part of the large-scale three-year project ‘Breaking the Shame’, we have identified ten sexual themes or ‘myths’ that youth struggle with most. These encompass amongst others beliefs and insecurities on masturbation, discharge, same-sex behavior and feelings, the effects of watching porn and gender norms. We argue that the Internet is a particularly suitable medium to ‘debunk’ those myths, as youth can consult it anonymously and privately and so avoid social shame. Moreover, amongst the myths, we have identified two kinds which may need different debunking techniques. One kind of myth concerns scientifically uncontested, generally biological related information, such as the effects of having sex with a pregnant woman, questions on the effects of a penile or vaginal discharge or questions on the effects of masturbation. The second kind of myths concerns more diverse information sources and deals with e.g. religious or culturally specific norms, such as on the meaning and existence of homosexuality or gender appropriate norms of behavior in Bangladesh. For addressing both kinds of myths, expert information including a wealth of references to information resources needs to be provided, which the Internet is very suitable for. For the second kind of myths, adolescents also need to learn how to deal with sometimes conflicting norms and information sources, and they need to develop and reflect on their own opinions as part of their identity formation. On the basis of a literature review, we thus distinguish general information needs from identity formation needs, which includes the need to be able to relate information and opinions to one’s own opinions and situation. Hence, we argue that youth not only need abstract expert information to be able to debunk sexual myths, but also the option to discuss this information with other adolescents and compare their own situation and opinions with other peers, who in that way serve as ‘warm experts’ for each other. In this paper, we will describe the outcomes of our qualitative study above. In addition, we will present our findings of an intervention by presenting youth with general, uncontested information on the Internet with additional peer discussion options to compare the debunking effects on different kinds of myths.

Keywords: peer discussion, intervention, sexual myths, shame

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1093 Psychopathic Manager Behavior and the Employee Workplace Deviance: The Mediating Role of Revenge Motive, the Moderating Roles of Core Self-Evaluations and Attitude Importance

Authors: Sinem Bulkan

Abstract:

This study introduces the construct of psychopathic manager behaviour and aims for the development of psychopathic manager behaviour (Psycho-Man B) measure. The study also aims for the understanding of the relationship between psychopathic manager behaviour and workplace deviance while investigating the mediating role of a revenge motive and the moderating roles of the core self-evaluations and the attitude importance. Data were collected from 519 employees from a wide variety of jobs and industries who currently work for or previously worked for a manager in a collectivist culture, Turkey. Psycho-Man B Measure was developed resulting in five dimensions as opposed to the proposed ten dimensions. Simple linear and hierarchical regression analyses were conducted to test the hypotheses. The results of simple linear regression analyses showed that psychopathic manager behaviour was positively significantly related to supervisor-directed and organisation-directed deviance. Revenge motive towards the manager partially mediated the relationship between psychopathic manager behaviour and supervisor-directed deviance. Similarly, revenge motive towards the organisation partially mediated the relationship between psychopathic manager behaviour and organisation-directed deviance. Furthermore, no support was found for the expected moderating role of core self-evaluations in the revenge motive towards the manager-supervisor-directed deviance and revenge motive towards the organisation-organisation-directed deviance relationships. Attitude importance moderated the relationship between revenge motive towards the manager and supervisor-directed deviance; revenge motive towards the organisation and organisation-directed deviance. Moderated-mediation hypotheses were not supported for core self-evaluations but were supported for the attitude importance. Additional analyses for sub-dimensions were conducted to further examine the hypotheses. Demographic variables were examined through independent samples t-tests, and one way ANOVA. Finally, findings are discussed; limitations, suggestions and implications are presented. The major contribution of this study is that ‘psychopathic manager behaviour’ construct was introduced to the literature and a scale for the reliable identification of psychopathic manager behaviour was developed in to evaluate managers’ level of sub-clinical psychopathy in the workforce. The study introduced that employees engage in different forms of supervisor-directed deviance and organisation-directed deviance depending on the level of the emotions and personal goals. Supervisor-directed deviant behaviours and organisation-directed deviant behaviours became distinct in a way as impulsive and premeditated, active or passive, direct and indirect actions. Accordingly, it is important for organisations to notice that employees’ level of affective state and attitude importance for psychopathic manager behaviours predetermine the certain type of employee deviant behaviours.

Keywords: attitude importance, core self evaluations, psychopathic manager behaviour, revenge motive, workplace deviance

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1092 Risk Assessment of Flood Defences by Utilising Condition Grade Based Probabilistic Approach

Authors: M. Bahari Mehrabani, Hua-Peng Chen

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Management and maintenance of coastal defence structures during the expected life cycle have become a real challenge for decision makers and engineers. Accurate evaluation of the current condition and future performance of flood defence structures is essential for effective practical maintenance strategies on the basis of available field inspection data. Moreover, as coastal defence structures age, it becomes more challenging to implement maintenance and management plans to avoid structural failure. Therefore, condition inspection data are essential for assessing damage and forecasting deterioration of ageing flood defence structures in order to keep the structures in an acceptable condition. The inspection data for flood defence structures are often collected using discrete visual condition rating schemes. In order to evaluate future condition of the structure, a probabilistic deterioration model needs to be utilised. However, existing deterioration models may not provide a reliable prediction of performance deterioration for a long period due to uncertainties. To tackle the limitation, a time-dependent condition-based model associated with a transition probability needs to be developed on the basis of condition grade scheme for flood defences. This paper presents a probabilistic method for predicting future performance deterioration of coastal flood defence structures based on condition grading inspection data and deterioration curves estimated by expert judgement. In condition-based deterioration modelling, the main task is to estimate transition probability matrices. The deterioration process of the structure related to the transition states is modelled according to Markov chain process, and a reliability-based approach is used to estimate the probability of structural failure. Visual inspection data according to the United Kingdom Condition Assessment Manual are used to obtain the initial condition grade curve of the coastal flood defences. The initial curves then modified in order to develop transition probabilities through non-linear regression based optimisation algorithms. The Monte Carlo simulations are then used to evaluate the future performance of the structure on the basis of the estimated transition probabilities. Finally, a case study is given to demonstrate the applicability of the proposed method under no-maintenance and medium-maintenance scenarios. Results show that the proposed method can provide an effective predictive model for various situations in terms of available condition grading data. The proposed model also provides useful information on time-dependent probability of failure in coastal flood defences.

Keywords: condition grading, flood defense, performance assessment, stochastic deterioration modelling

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1091 Elimination of Mother to Child Transmission of HIV/AIDS: A Study of the Knowledge, Attitudes and Perceptions of Healthcare Workers in Abuja Nigeria

Authors: Ezinne K. Okoro, Takahiko Katoh, Yoko Kawamura, Stanley C. Meribe

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HIV infection in children is largely as a result of vertical transmission (mother to child transmission [MTCT]). Thus, elimination of mother to child transmission of HIV/AIDS is critical in eliminating HIV infection in children. In Nigeria, drawbacks such as; limited pediatric screening, limited human capital, insufficient advocacy and poor understanding of ART guidelines, have impacted efforts at combating the disease, even as treatment services are free. Prevention of Mother to Child Transmission (PMTCT) program relies on health workers who not only counsel pregnant women on first contact but can competently provide HIV-positive pregnant women with accurate information about the PMTCT program such as feeding techniques and drug adherence. In developing regions like Nigeria where health care delivery faces a lot of drawbacks, it becomes paramount to address these issues of poor PMTCT coverage by conducting a baseline assessment of the knowledge, practices and perceptions related to HIV prevention amongst healthcare workers in Nigeria. A descriptive cross-sectional study was conducted amongst 250 health workers currently employed in health facilities in Abuja, Nigeria where PMTCT services were offered with the capacity to carry out early infant diagnosis testing (EID). Data was collected using a self-administered, pretested, structured questionnaire. This study showed that the knowledge of PMTCT of HIV was poor (30%) among healthcare workers who offer this service day-to-day to pregnant women. When PMTCT practices were analyzed in keeping with National PMTCT guidelines, over 61% of the respondents reported observing standard practices and the majority (58%) had good attitudes towards caring for patients with HIV/AIDS. Although 61% of the respondents reported being satisfied with the quality of service being rendered, 63% reported not being satisfied with their level of knowledge. Predictors of good knowledge were job designation and level of educational attainment. Health workers who were more satisfied with their working conditions and those who had worked for a longer time in the PMTCT service were more likely to observe standard PMTCT practices. With over 62% of the healthcare workers suggesting that more training would improve the quality of service being rendered, this is a strong pointer to stakeholders to consider a ‘healthcare worker-oriented approach’ when planning and conducting PMTCT training for healthcare workers. This in turn will increase pediatric ARV coverage, the knowledge and effectiveness of the healthcare workers in carrying out appropriate PMTCT interventions and culminating in the reduction/elimination of HIV transmission to newborns.

Keywords: attitudes, HIV/AIDS, healthcare workers, knowledge, mother to child transmission, Nigeria, perceptions

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1090 Preliminary Efficacy of a Pilot Paediatric Day Hospital Program Project to Address Severe Mental Illness, Obesity, and Binge Eating

Authors: Alene Toulany, Elizabeth Dettmer, Seena Grewal, Kaley Roosen, Andrea Regina, Cathleen Steinegger, Kate Stadelman, Melissa Chambers, Lindsay Lochhead, Kelsey Gallagher, Alissa Steinberg, Andrea Leyser, Allison Lougheed, Jill Hamilton

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Obesity and psychiatric disorders occur together so frequently that the combination has been coined an epidemic within an epidemic. Youth living with obesity are at increased risk for trauma, depression, anxiety and disordered eating. Although symptoms of binge eating disorder are common in paediatric obesity management programs, they are often not identified or addressed within treatment. At The Hospital for Sick Children (SickKids), a tertiary care paediatric hospital in Toronto, Canada, adolescents with obesity are treated in an interdisciplinary outpatient clinic (1-2 hours/week). This intensity of care is simply not enough to help these extremely complex patients. Existing day treatment programs for eating, and psychiatric disorders are not well suited for patients with obesity. In order to address this identified care gap, a unique collaboration was formed between the obesity, psychiatry, and eating disorder programs at SickKids in 2015. The aim of this collaboration was to provide an enhanced treatment arm to our general psychiatry day hospital program that addresses both the mental health issues and the lifestyle challenges common to youth with obesity and binge eating. The program is currently in year-one of a two-year pilot project and is designed for a length of stay of approximately 6 months. All youth participate in daily group therapy, academics, and structured mealtimes. The groups are primarily skills-based and are informed by cognitive/dialectical behavioural therapies. Weekly family therapy and individual therapy, as well as weekly medical appointments with a psychiatrist and a nurse, are provided. Youth in the enhanced treatment arm also receive regular sessions with a dietitian to establish normalized eating behaviours and monthly multifamily meal sessions to address challenges related to behaviour change and mealtimes in the home. Outcomes that will be evaluated include measures of mental health, anthropometrics, metabolic status, and healthcare satisfaction. At the end of the two years, it is expected that we will have had about 16 youth participants. This model of care delivery will be the first of its kind in Canada and is expected to inform future paediatric treatment practices.

Keywords: adolescent, binge eating, mental illness, obesity

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1089 Endemic Asteraceae from Mauritius Islands as Potential Phytomedicines

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

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

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

Procedia PDF Downloads 509
1088 Exploring Tweeters’ Concerns and Opinions about FIFA Arab Cup 2021: An Investigation Study

Authors: Md. Rafiul Biswas, Uzair Shah, Mohammad Alkayal, Zubair Shah, Othman Althawadi, Kamila Swart

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Background: Social media platforms play a significant role in the mediated consumption of sport, especially so for sport mega-event. The characteristics of Twitter data (e.g., user mentions, retweets, likes, #hashtag) accumulate the users in one ground and spread information widely and quickly. Analysis of Twitter data can reflect the public attitudes, behavior, and sentiment toward a specific event on a larger scale than traditional surveys. Qatar is going to be the first Arab country to host the mega sports event FIFA World Cup 2022 (Q22). Qatar has hosted the FIFA Arab Cup 2021 (FAC21) to serve as a preparation for the mega-event. Objectives: This study investigates public sentiments and experiences about FAC21 and provides an insight to enhance the public experiences for the upcoming Q22. Method: FCA21-related tweets were downloaded using Twitter Academic research API between 01 October 2021 to 18 February 2022. Tweets were divided into three different periods: before T1 (01 Oct 2021 to 29 Nov 2021), during T2 (30 Nov 2021 -18 Dec 2021), and after the FAC21 T3 (19 Dec 2021-18 Feb 2022). The collected tweets were preprocessed in several steps to prepare for analysis; (1) removed duplicate and retweets, (2) removed emojis, punctuation, and stop words (3) normalized tweets using word lemmatization. Then, rule-based classification was applied to remove irrelevant tweets. Next, the twitter-XLM-roBERTa-base model from Huggingface was applied to identify the sentiment in the tweets. Further, state-of-the-art BertTopic modeling will be applied to identify trending topics over different periods. Results: We downloaded 8,669,875 Tweets posted by 2728220 unique users in different languages. Of those, 819,813 unique English tweets were selected in this study. After splitting into three periods, 541630, 138876, and 139307 were from T1, T2, and T3, respectively. Most of the sentiments were neutral, around 60% in different periods. However, the rate of negative sentiment (23%) was high compared to positive sentiment (18%). The analysis indicates negative concerns about FAC21. Therefore, we will apply BerTopic to identify public concerns. This study will permit the investigation of people’s expectations before FAC21 (e.g., stadium, transportation, accommodation, visa, tickets, travel, and other facilities) and ascertain whether these were met. Moreover, it will highlight public expectations and concerns. The findings of this study can assist the event organizers in enhancing implementation plans for Q22. Furthermore, this study can support policymakers with aligning strategies and plans to leverage outstanding outcomes.

Keywords: FIFA Arab Cup, FIFA, Twitter, machine learning

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1087 Facies Sedimentology and Astronomic Calibration of the Reinech Member (Lutetian)

Authors: Jihede Haj Messaoud, Hamdi Omar, Hela Fakhfakh Ben Jemia, Chokri Yaich

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The Upper Lutetian alternating marl–limestone succession of Reineche Member was deposited over a warm shallow carbonate platform that permits Nummulites proliferation. High-resolution studies of 30 meters thick Nummulites-bearing Reineche Member, cropping out in Central Tunisia (Jebel Siouf), have been undertaken, regarding pronounced cyclical sedimentary sequences, in order to investigate the periodicity of cycles and their related orbital-scale oceanic and climatic changes. The palaeoenvironmental and palaeoclimatic data are preserved in several proxies obtainable through high-resolution sampling and laboratories measurement and analysis as magnetic susceptibility (MS) and carbonates contents in conjunction with a wireline logging tools. The time series analysis of proxies permits to establish cyclicity orders present in the studied intervals which could be linked to the orbital cycles. MS records provide high-resolution proxies for relative sea level change in Late Lutetian strata. The spectral analysis of MS fluctuations confirmed the orbital forcing by the presence of the complete suite of orbital frequencies in the precession of 23 ka, the obliquity of 41 ka, and notably the two modes of eccentricity of 100 and 405 ka. Regarding the two periodic sedimentary cycles detected by wavelet analysis of proxy fluctuations which coincide with the long-term 405 ka eccentricity cycle, the Reineche Member spanned 0,8 Myr. Wireline logging tools as gamma ray and sonic were used as a proxies to decipher cyclicity and trends in sedimentation and contribute to identifying and correlate units. There are used to constraint the highest frequency cyclicity modulated by a long term wavelength cycling apparently controlled by clay content. Interpreted as a result of variations in carbonate productivity, it has been suggested that the marl-limestone couplets, represent the sedimentary response to the orbital forcing. The calculation of cycle durations through Reineche Member, is used as a geochronometer and permit the astronomical calibration of the geologic time scale. Furthermore, MS coupled with carbonate contents, and fossil occurrences provide strong evidence for combined detrital inputs and marine surface carbonate productivity cycles. These two synchronous processes were driven by the precession index and ‘fingerprinted’ in the basic marl–limestone couplets, modulated by orbital eccentricity.

Keywords: magnetic susceptibility, cyclostratigraphy, orbital forcing, spectral analysis, Lutetian

Procedia PDF Downloads 282
1086 Reflections of Narrative Architecture in Transformational Representations on the Architectural Design Studio

Authors: M. Mortas, H. Asar, P. Dursun Cebi

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The visionary works of architectural representation in the 21st century's present situation, are practiced through the methodologies which try to expose the intellectual and theoretical essences of futurologist positions that are revealed with this era's interactions. Expansions of conceptual and contextual inputs related to one architectural design representation, depend on its deepness of critical attitudes, its interactions with the concepts such as experience, meaning, affection, psychology, perception and aura, as well as its communication with spatial, cultural and environmental factors. The purpose of this research study is to be able to offer methodological application areas for the design dimensions of experiential practices into architectural design studios, by focusing on the architectural representative narrations of 'transformation,' 'metamorphosis,' 'morphogenesis,' 'in-betweenness', 'superposition' and 'intertwine’ in which they affect and are affected by the today’s spatiotemporal hybridizations of architecture. The narrative representations and the visual theory paradigms of the designers are chosen under the main title of 'transformation' for the investigation of these visionary and critical representations' dismantlings and decodings. Case studies of this research area are chosen from Neil Spiller, Bryan Cantley, Perry Kulper and Dan Slavinsky’s transformative, morphogenetic representations. The theoretical dismantlings and decodings which are obtained from these artists’ contemporary architectural representations are tried to utilize and practice in the structural design studios as alternative methodologies when to approach architectural design processes, for enriching, differentiating, diversifying and 'transforming' the applications of so far used design process precedents. The research aims to indicate architectural students about how they can reproduce, rethink and reimagine their own representative lexicons and so languages of their architectural imaginations, regarding the newly perceived tectonics of prosthetic, biotechnology, synchronicity, nanotechnology or machinery into various experiential design workshops. The methodology of this work can be thought as revealing the technical and theoretical tools, lexicons and meanings of contemporary-visionary architectural representations of our decade, with the essential contents and components of hermeneutics, etymology, existentialism, post-humanism, phenomenology and avant-gardism disciplines to re-give meanings the architectural visual theorists’ transformative representations of our decade. The value of this study may be to emerge the superposed and overlapped atmospheres of futurologist architectural representations for the students who need to rethink on the transcultural, deterritorialized and post-humanist critical theories to create and use the representative visual lexicons of themselves for their architectural soft machines and beings by criticizing the now, to be imaginative for the future of architecture.

Keywords: architectural design studio, visionary lexicon, narrative architecture, transformative representation

Procedia PDF Downloads 126
1085 Yoga for Holistic Health Wellbeing

Authors: Pothula Madhusudhan Reddy

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Introduction: Yoga is a way of life. of uniting the mind, body and soul. It is also an art of living the right way. The techniques of Yoga are very practical, so they can always be applied. This is the reason why Yoga has been practiced for thousands of years and is still valid today. Importance of Yoga: Yoga that helps to inculcate healthy habits and adopt a healthy lifestyle to achieve good health Research Aim: The aim of this study is to explore the potential benefits of yoga for holistic health and wellbeing, both at an individual and societal level The ultimate goal of human being is to attain the state of perfect freedom from the shackles of ignorance, which is the generator of all the pangs and miseries of life. Methodology: This research follows a thematic and practical experience approach. Yoga includes body postures and movements (stretching), breathing practices, imagery, meditation, and progressive relaxation techniques. Data Collection: The data for this research is collected through a combination of literature review, expert interviews, and practical yoga sessions. The literature review provides a comprehensive understanding of the principles and practices of yoga, while expert interviews offer insights from experienced practitioners. Practical yoga sessions allow for first hand experiences and observations, facilitating a deeper understanding of the subject matter. Analysis Procedures: The collected data is analyzed thematically, where key themes and patterns related to the benefits and effects of yoga on holistic health and wellbeing are identified. The findings are then interpreted and synthesized to draw meaningful conclusions. Questions Addressed: This research addresses the following questions: What are the potential benefits of yoga for holistic health and wellbeing? How does yoga promote rejuvenate the body, mind, and senses? What are the implications of a society embracing yoga for overall societal wellbeing and happiness? Findings: The research highlights that practicing yoga can lead to increased awareness of the body, mind, and senses. It promotes overall physical and mental health, helping individuals achieve a state of happiness and contentment. Moreover, the study emphasizes that a society embracing yoga can contribute to the development of a healthy and happy community. Theoretical Importance: The study of yoga for holistic health and wellbeing holds theoretical importance as it provides insights into the science of yoga and its impact on individuals and society. It contributes to the existing body of knowledge on the subject and further establishes yoga as a potential tool for enhancing overall wellness. Conclusion: The study concludes that yoga is a powerful practice for achieving holistic health and wellbeing. This research provides valuable insights into the science of yoga and its potential as a tool for promoting overall wellness.

Keywords: yoga, asana, pranayama, meditation

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1084 Severe Infestation of Laspeyresia Koenigana Fab. and Alternaria Leaf Spot on Azadirachta Indica (Neem)

Authors: Shiwani Bhatnagar, K. K. Srivastava, Sangeeta Singh, Ameen Ullah Khan, Bundesh Kumar, Lokendra Singh Rathore

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From the instigation of the world medicinal plants are treated as part and parcel of human society to fight against diseases. Azadirachta indica (Neem) a herbal plant has been used as an Indian traditional medicine since ages and its products are acknowledged to solve agricultural, forestry and public health related problems, owing to its beneficial medicinal properties. Each part of the neem tree is known for its medicinal property. Bark & leaf extracts of neem have been used to control leprosy, respiratory disorders, constipation and also as blood purifier and a general health tonic. Neem is still regarded as ' rural community dispensary' in India or a tree for solving medical problems. Use of Neem as pesticides for the management of insect pest of agriculture crops and forestry has been seen as a shift in the use of synthetic pesticides to ecofriendly botanicals. Neem oil and seed extracts possess germicidal and anti-bacterial properties which when sprayed on the plant helps in protecting them from foliage pests. Azadirachtin, the main active ingredient found in neem tree, acts as an insect repellent and antifeedant. However the young plants are susceptible to many insect pest and foliar diseases. Recently, in the avenue plantation, planted by Arid Forest Research Institute, Jodhpur, around the premises of IIT Jodhpur, two years old neem plants were found to be severely infested with tip borer Laspeyresia koenigana (Family: Eucosmidae). The adult moth of L. koenigana lays eggs on the tender shoots and the young larvae tunnel into the shoot and feed inside. A small pinhole can be seen at the entrance point, from where the larva enters in to the stem. The severely attached apical shoots exhibit profuse gum exudation resulting in development of a callus structure. The internal feeding causes the stem to wilt and the leaves to dry up from the tips resulting in growth retardation. Alternaria Leaf spot and blight symptoms were also recorded on these neem plants. For the management of tip borer and Alternaria Leaf spot, foliar spray of monocrotophos @0.05% and Dithane M-45 @ 0.15% and powermin @ 2ml/lit were found efficient in managing the insect pest and foliar disease problem. No Further incidence of pest/diseases was noticed.

Keywords: azadirachta indica, alternaria leaf spot, laspeyresia koenigana, management

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1083 Open Joint Surgery for Temporomandibular Joint Internal Derangement: Wilkes Stages III-V

Authors: T. N. Goh, M. Hashmi, O. Hussain

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Temporomandibular joint (TMJ) dysfunction (TMD) is a condition that may affect patients via restricted mouth opening, significant pain during normal functioning, and/or reproducible joint noise. TMD includes myofascial pain, TMJ functional derangements (internal derangement, dislocation), and TMJ degenerative/inflammatory joint disease. Internal derangement (ID) is the most common cause of TMD-related clicking and locking. These patients are managed in a stepwise approach, from patient education (homecare advice and analgesia), splint therapy, physiotherapy, botulinum toxin treatment, to arthrocentesis. Arthrotomy is offered when the aforementioned treatment options fail to alleviate symptoms and improve quality of life. The aim of this prospective study was to review the outcomes of jaw joint open surgery in TMD patients. Patients who presented from 2015-2022 at the Oral and Maxillofacial Surgery Department in the Doncaster NHS Foundation Trust, UK, with a Wilkes classification of III -V were included. These patients underwent either i) discopexy with bone-anchoring suture (9); ii) intrapositional temporalis flap (ITF) with bone-anchoring suture (3); iii) eminoplasty and discopexy with suturing to the capsule (3); iii) discectomy + ITF with bone-anchoring suture (1); iv) discoplasty + bone-anchoring suture (1); v) ITF (1). Maximum incisal opening (MIO) was assessed pre-operatively and at each follow-up. Pain score, determined via the visual analogue scale (VAS, with 0 being no pain and 10 being the worst pain), was also recorded. A total of 18 eligible patients were identified with a mean age of 45 (range 22 - 79), of which 16 were female. The patients were scored by Wilkes Classification as III (14), IV (1), or V (4). Twelve patients had anterior disc displacement without reduction (66%) and six had degenerative/arthritic changes (33%) to the TMJ. The open joint procedure resulted in an increase in MIO and reduction in pain VAS and for the majority of patients, across all Wilkes Classifications. Pre-procedural MIO was 22.9 ± 7.4 mm and VAS was 7.8 ± 1.5. At three months post-procedure there was an increase in MIO to 34.4 ± 10.4 mm (p < 0.01) and a decrease in the VAS to 1.5 ± 2.9 (p < 0.01). Three patients were lost to follow-up prior to six months. Six were discharged at six month review and five patients were discharged at 12 months review as they were asymptomatic with good mouth opening. Four patients are still attending for annual botulinum toxin treatment. Two patients (Wilkes III and V) subsequently underwent TMJ replacement (11%). One of these patients (Wilkes III) had improvement initially to MIO of 40 mm, but subsequently relapsed to less than 20 mm due to lack of compliance with jaw rehabilitation device post-operatively. Clinical improvements in 89% of patients within the study group were found, with a return to near normal MIO range and reduced pain score. Intraoperatively, the operator found bone-anchoring suture used for discopexy/discoplasty more secure than the soft tissue anchoring suturing technique.

Keywords: bone anchoring suture, open temporomandibular joint surgery, temporomandibular joint, temporomandibular joint dysfunction

Procedia PDF Downloads 94
1082 Complementing Assessment Processes with Standardized Tests: A Work in Progress

Authors: Amparo Camacho

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ABET accredited programs must assess the development of student learning outcomes (SOs) in engineering programs. Different institutions implement different strategies for this assessment, and they are usually designed “in house.” This paper presents a proposal for including standardized tests to complement the ABET assessment model in an engineering college made up of six distinct engineering programs. The engineering college formulated a model of quality assurance in education to be implemented throughout the six engineering programs to regularly assess and evaluate the achievement of SOs in each program offered. The model uses diverse techniques and sources of data to assess student performance and to implement actions of improvement based on the results of this assessment. The model is called “Assessment Process Model” and it includes SOs A through K, as defined by ABET. SOs can be divided into two categories: “hard skills” and “professional skills” (soft skills). The first includes abilities, such as: applying knowledge of mathematics, science, and engineering and designing and conducting experiments, as well as analyzing and interpreting data. The second category, “professional skills”, includes communicating effectively, and understanding professional and ethnical responsibility. Within the Assessment Process Model, various tools were used to assess SOs, related to both “hard” as well as “soft” skills. The assessment tools designed included: rubrics, surveys, questionnaires, and portfolios. In addition to these instruments, the Engineering College decided to use tools that systematically gather consistent quantitative data. For this reason, an in-house exam was designed and implemented, based on the curriculum of each program. Even though this exam was administered during various academic periods, it is not currently considered standardized. In 2017, the Engineering College included three standardized tests: one to assess mathematical and scientific reasoning and two more to assess reading and writing abilities. With these exams, the college hopes to obtain complementary information that can help better measure the development of both hard and soft skills of students in the different engineering programs. In the first semester of 2017, the three exams were given to three sample groups of students from the six different engineering programs. Students in the sample groups were either from the first, fifth, and tenth semester cohorts. At the time of submission of this paper, the engineering college has descriptive statistical data and is working with various statisticians to have a more in-depth and detailed analysis of the sample group of students’ achievement on the three exams. The overall objective of including standardized exams in the assessment model is to identify more precisely the least developed SOs in order to define and implement educational strategies necessary for students to achieve them in each engineering program.

Keywords: assessment, hard skills, soft skills, standardized tests

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1081 Perception of Health Care Providers: A Need to Introduce Screening of Maternal Mental Health at Primary Health Care in Nepal

Authors: Manisha Singh, Padam Simkhada

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Background: Although mental health policy has been adapted in Nepal since 1997, the implementation of the policy framework is yet to happen. The fact that mental health services are largely concentrated in urban areas more specific to treatment only provides a clear picture of the scarcity of mental health services in the country. The shreds of evidence from around the world, along with WHO’s (World Health Organization) Mental Health Gap Action Program (mhGAP) suggest that effective mental health services can be provided from Primary Health Care (PHC) centers through community-based programs without having to place a specialized health worker. However, the country is still facing the same challenges to date with very few psychiatrists and psychologists, but they are largely based in cities. Objectives: The main objectives of this study are; (a) to understand the perception of health workers at PHC on maternal mental health, and (b) to assess the availability of the mental health services at PHC to address maternal mental health. Methods: This study used a qualitative approach where an in-depth interview was conducted with the health workers at the primary level. “Mayadevi” rural municipality in Rupendehi District that comprised of 13 small villages, was chosen as the study site. A total 8 health institutions which covered all 13 sites were included where either the health post in- charge or health worker working in maternal and child health care was interviewed for the study. All the health posts in the study area were included in the study. The interviews were conducted in Nepali; later, they were translated in English, transcribed, and triangulated. NViVO was used for the analysis. Results: The findings show that most of the health workers understood what maternal mental health was and deemed it as a public health issue. They could explain the symptoms and knew what medication to prescribe if need be. However, the majority of them failed to name the screening tools in place for maternal mental health. Moreover, they hadn’t even seen one. None of the health care centers had any provision for screening mental health status. However, one of the centers prescribed medication when the patients displayed symptoms of depression. But they believed there were a significant number of hidden cases in the community due to the stigma around mental health and being a woman with mental health problem makes the situation even difficult. Nonetheless, the health workers understood the importance of having screening tools and acknowledged the need of training and support in order to provide the services from PHC. Conclusion: Community health workers can identify cases with mental health problems and prevent them from deteriorating further. But there is a need for robust training and support to build the capacity of the health workers. The screening tools on mental health needs to be encouraged to be used in the PHC levels. Furthermore, community-based culture-sensitive programs need to be initiated and implemented to mitigate the stigma related issues around mental health.

Keywords: maternal mental health, health care providers, screening, Nepal

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1080 Trade in Value Added: The Case of the Central and Eastern European Countries

Authors: Łukasz Ambroziak

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Although the impact of the production fragmentation on trade flows has been examined many times since the 1990s, the research was not comprehensive because of the limitations in traditional trade statistics. Early 2010s the complex databases containing world input-output tables (or indicators calculated on their basis) has made available. It increased the possibilities of examining the production sharing in the world. The trade statistic in value-added terms enables us better to estimate trade changes resulted from the internationalisation and globalisation as well as benefits of the countries from international trade. In the literature, there are many research studies on this topic. Unfortunately, trade in value added of the Central and Eastern European Countries (CEECs) has been so far insufficiently studied. Thus, the aim of the paper is to present changes in value added trade of the CEECs (Bulgaria, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia and Slovenia) in the period of 1995-2011. The concept 'trade in value added' or 'value added trade' is defined as the value added of a country which is directly and indirectly embodied in final consumption of another country. The typical question would be: 'How much value added is created in a country due to final consumption in the other countries?' The data will be downloaded from the World Input-Output Database (WIOD). The structure of this paper is as follows. First, theoretical and methodological aspects related to the application of the input-output tables in the trade analysis will be studied. Second, a brief survey of the empirical literature on this topic will be presented. Third, changes in exports and imports in value added of the CEECs will be analysed. A special attention will be paid to the differences in bilateral trade balances using traditional trade statistics (in gross terms) on one side, and value added statistics on the other. Next, in order to identify factors influencing value added exports and value added imports of the CEECs the generalised gravity model, based on panel data, will be used. The dependent variables will be value added exports and imports. The independent variables will be, among others, the level of GDP of trading partners, the level of GDP per capita of trading partners, the differences in GDP per capita, the level of the FDI inward stock, the geographical distance, the existence (or non-existence) of common border, the membership (or not) in preferential trade agreements or in the EU. For comparison, an estimation will also be made based on exports and imports in gross terms. The initial research results show that the gravity model better explained determinants of trade in value added than gross trade (R2 in the former is higher). The independent variables had the same direction of impact both on value added exports/imports and gross exports/imports. Only value of coefficients differs. The most difference concerned geographical distance. It had smaller impact on trade in value added than gross trade.

Keywords: central and eastern European countries, gravity model, input-output tables, trade in value added

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1079 Social Ties and the Prevalence of Single Chronic Morbidity and Multimorbidity among the Elderly Population in Selected States of India

Authors: Sree Sanyal

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Research in ageing often highlights the age-related health dimension more than the psycho-social characteristics of the elderly, which also influences and challenges the health outcomes. Multimorbidity is defined as the person having more than one chronic non-communicable diseases and their prevalence increases with ageing. The study aims to evaluate the influence of social ties on self-reported prevalence of multimorbidity (selected chronic non-communicable diseases) among the selected states of elderly population in India. The data is accessed from Building Knowledge Base on Population Ageing in India (BKPAI), collected in 2011 covering the self-reported chronic non-communicable diseases like arthritis, heart disease, diabetes, lung disease with asthma, hypertension, cataract, depression, dementia, Alzheimer’s disease, and cancer. The data of the above diseases were taken together and categorized as: ‘no disease’, ‘one disease’ and ‘multimorbidity’. The predicted variables were demographic, socio-economic, residential types, and the variable of social ties includes social support, social engagement, perceived support, connectedness, and importance of the elderly. Predicted probability for multiple logistic regression was used to determine the background characteristics of the old in association with chronic morbidities showing multimorbidity. The finding suggests that 24.35% of the elderly are suffering from multimorbidity. Research shows that with reference to ‘no disease’, according to the socio-economic characteristics of the old, the female oldest old (80+) from others in caste and religion, widowed, never had any formal education, ever worked in their life, coming from the second wealth quintile standard, from rural Maharashtra are more prone with ‘one disease’. From the social ties background, the elderly who perceives they are important to the family, after getting older their decision-making status has been changed, prefer to stay with son and spouse only, satisfied with the communication from their children are more likely to have less single morbidity and the results are significant. Again, with respect to ‘no disease’, the female oldest old (80+), who are others in caste, Christian in religion, widowed, having less than 5 years of education completed, ever worked, from highest wealth quintile, residing in urban Kerala are more associated with multimorbidity. The elderly population who are more socially connected through family visits, public gatherings, gets support in decision making, who prefers to spend their later years with son and spouse only but stays alone shows lesser prevalence of multimorbidity. In conclusion, received and perceived social integration and support from associated neighborhood in the older days, knowing about their own needs in life facilitates better health and wellbeing of the elderly population in selected states of India.

Keywords: morbidity, multi-morbidity, prevalence, social ties

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1078 Civic E-Participation in Central and Eastern Europe: A Comparative Analysis

Authors: Izabela Kapsa

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Civic participation is an important aspect of democracy. The contemporary model of democracy is based on citizens' participation in political decision-making (deliberative democracy, participatory democracy). This participation takes many forms of activities like display of slogans and symbols, voting, social consultations, political demonstrations, membership in political parties or organizing civil disobedience. The countries of Central and Eastern Europe after 1989 are characterized by great social, economic and political diversity. Civil society is also part of the process of democratization. Civil society, funded by the rule of law, civil rights, such as freedom of speech and association and private ownership, was to play a central role in the development of liberal democracy. Among the many interpretations of concepts, defining the concept of contemporary democracy, one can assume that the terms civil society and democracy, although different in meaning, nowadays overlap. In the post-communist countries, the process of shaping and maturing societies took place in the context of a struggle with a state governed by undemocratic power. State fraud or repudiation of the institution is a representative state, which in the past was the only way to manifest and defend its identity, but after the breakthrough became one of the main obstacles to the development of civil society. In Central and Eastern Europe, there are many obstacles to the development of civil society, for example, the elimination of economic poverty, the implementation of educational campaigns, consciousness-related obstacles, the formation of social capital and the deficit of social activity. Obviously, civil society does not only entail an electoral turnout but a broader participation in the decision-making process, which is impossible without direct and participative democratic institutions. This article considers such broad forms of civic participation and their characteristics in Central and Eastern Europe. The paper is attempts to analyze the functioning of electronic forms of civic participation in Central and Eastern European states. This is not accompanied by a referendum or a referendum initiative, and other forms of political participation, such as public consultations, participative budgets, or e-Government. However, this paper will broadly present electronic administration tools, the application of which results from both legal regulations and increasingly common practice in state and city management. In the comparative analysis, the experiences of post-communist bloc countries will be summed up to indicate the challenges and possible goals for further development of this form of citizen participation in the political process. The author argues that for to function efficiently and effectively, states need to involve their citizens in the political decision-making process, especially with the use of electronic tools.

Keywords: Central and Eastern Europe, e-participation, e-government, post-communism

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1077 Evaluation of Role of Surgery in Management of Pediatric Germ Cell Tumors According to Risk Adapted Therapy Protocols

Authors: Ahmed Abdallatif

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Background: Patients with malignant germ cell tumors have age distribution in two peaks, with the first one during infancy and the second after the onset of puberty. Gonadal germ cell tumors are the most common malignant ovarian tumor in females aged below twenty years. Sacrococcygeal and retroperitoneal abdominal tumors usually presents in a large size before the onset of symptoms. Methods: Patients with pediatric germ cell tumors presenting to Children’s Cancer Hospital Egypt and National Cancer Institute Egypt from January 2008 to June 2011 Patients underwent stratification according to risk into low, intermediate and high risk groups according to children oncology group classification. Objectives: Assessment of the clinicopathologic features of all cases of pediatric germ cell tumors and classification of malignant cases according to their stage, and the primary site to low, intermediate and high risk patients. Evaluation of surgical management in each group of patients focusing on surgical approach, the extent of surgical resection according to each site, ability to achieve complete surgical resection and perioperative complications. Finally, determination of the three years overall and disease-free survival in different groups and the relation to different prognostic factors including the extent of surgical resection. Results: Out of 131 cases surgically explored only 26 cases had re exploration with 8 cases explored for residual disease 9 cases for remote recurrence or metastatic disease and the other 9 cases for other complications. Patients with low risk kept under follow up after surgery, out of those of low risk group (48 patients) only 8 patients (16.5%) shifted to intermediate risk. There were 20 patients (14.6%) diagnosed as intermediate risk received 3 cycles of compressed (Cisplatin, Etoposide and Bleomycin) and all high risk group patients 69patients (50.4%) received chemotherapy. Stage of disease was strongly and significantly related to overall survival with a poorer survival in late stages (stage IV) as compared to earlier stages. Conclusion: Overall survival rate at 3 three years was (76.7% ± 5.4, 3) years EFS was (77.8 % ±4.0), however 3 years DFS was much better (89.8 ± 3.4) in whole study group with ovarian tumors had significantly higher Overall survival (90% ± 5.1). Event Free Survival analysis showed that Male gender was 3 times likely to have bad events than females. Patients who underwent incomplete resection were 4 times more than patients with complete resection to have bad events. Disease free survival analysis showed that Patients who underwent incomplete surgery were 18.8 times liable for recurrence compared to those who underwent complete surgery, and patients who were exposed to re-excision were 21 times more prone to recurrence compared to other patients.

Keywords: extragonadal, germ cell tumors, gonadal, pediatric

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1076 Interface Designer as Cultural Producer: A Dialectic Materialist Approach to the Role of Visual Designer in the Present Digital Era

Authors: Cagri Baris Kasap

Abstract:

In this study, how interface designers can be viewed as producers of culture in the current era will be interrogated from a critical theory perspective. Walter Benjamin was a German Jewish literary critical theorist who, during 1930s, was engaged in opposing and criticizing the Nazi use of art and media. ‘The Author as Producer’ is an essay that Benjamin has read at the Communist Institute for the Study of Fascism in Paris. In this article, Benjamin relates directly to the dialectics between base and superstructure and argues that authors, normally placed within the superstructure should consider how writing and publishing is production and directly related to the base. Through it, he discusses what it could mean to see author as producer of his own text, as a producer of writing, understood as an ideological construct that rests on the apparatus of production and distribution. So Benjamin concludes that the author must write in ways that relate to the conditions of production, he must do so in order to prepare his readers to become writers and even make this possible for them by engineering an ‘improved apparatus’ and must work toward turning consumers to producers and collaborators. In today’s world, it has become a leading business model within Web 2.0 services of multinational Internet technologies and culture industries like Amazon, Apple and Google, to transform readers, spectators, consumers or users into collaborators and co-producers through platforms such as Facebook, YouTube and Amazon’s CreateSpace Kindle Direct Publishing print-on-demand, e-book and publishing platforms. However, the way this transformation happens is tightly controlled and monitored by combinations of software and hardware. In these global-market monopolies, it has become increasingly difficult to get insight into how one’s writing and collaboration is used, captured, and capitalized as a user of Facebook or Google. In the lens of this study, it could be argued that this criticism could very well be considered by digital producers or even by the mass of collaborators in contemporary social networking software. How do software and design incorporate users and their collaboration? Are they truly empowered, are they put in a position where they are able to understand the apparatus and how their collaboration is part of it? Or has the apparatus become a means against the producers? Thus, when using corporate systems like Google and Facebook, iPhone and Kindle without any control over the means of production, which is closed off by opaque interfaces and licenses that limit our rights of use and ownership, we are already the collaborators that Benjamin calls for. For example, the iPhone and the Kindle combine a specific use of technology to distribute the relations between the ‘authors’ and the ‘prodUsers’ in ways that secure their monopolistic business models by limiting the potential of the technology.

Keywords: interface designer, cultural producer, Walter Benjamin, materialist aesthetics, dialectical thinking

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1075 Music as Source Domain: A Cross-Linguistic Exploration of Conceptual Metaphors

Authors: Eleanor Sweeney, Chunyuan Di

Abstract:

The metaphors people use in everyday discourse do not arise randomly; rather, they develop from our physical experiences in our social and cultural environments. Conceptual Metaphor Theory (CMT) explains that through metaphor, we apply our embodied understanding of the physical world to non-material concepts to understand and express abstract concepts. Our most productive source domains derive from our embodied understanding and allow us to develop primary metaphors, and from primary metaphors, an elaborate, creative world of culturally constructed complex metaphors. Cognitive Linguistics researchers draw upon individual embodied experience for primary metaphors. Socioculturally embodied experience through music has long furnished linguistic expressions in diverse languages, as conceptual metaphors or everyday expressions.  Can a socially embodied experience function in the same way as an individually embodied experience in the creation of conceptual metaphors? The authors argue that since music is inherently social and embodied, musical experiences function as a richly motivated source domain. The focus of this study is socially embodied musical experience which is then reflected and expressed through metaphors. This cross-linguistic study explores music as a source domain for metaphors of social alignment in English, French, and Chinese. The authors explored two public discourse sites, Facebook and Linguée, in order to collect linguistic metaphors from three different languages. By conducting this cross-linguistic study, cross-cultural similarities and differences in metaphors for which music is the source domain can be examined. Different musical elements, such as melody, speed, rhythm and harmony, are analyzed for their possible metaphoric meanings of social alignment. Our findings suggest that the general metaphor cooperation is music is a productive metaphor with some subcases, and that correlated social behaviors can be metaphorically expressed with certain elements in music. For example, since performance is a subset of the category behavior, there is a natural mapping from performance in music to behavior in social settings: social alignment is musical performance. Musical performance entails a collective social expectation that exerts control over individual behavior.  When individual behavior does not align with the collective social expectation, music-related expressions are often used to express how the individual is violating social norms. Moreover, when individuals do align their behavior with social norms, similar musical expressions are used. Cooperation is a crucial social value in all cultures, indeed it is a key element of survival, and music provides a coherent, consistent, and rich source domain—one based upon a universal and definitive cultural practice.

Keywords: Chinese, Conceptual Metaphor Theory, cross-linguistic, culturally embodied experience, English, French, metaphor, music

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1074 Evaluation of Cooperative Hand Movement Capacity in Stroke Patients Using the Cooperative Activity Stroke Assessment

Authors: F. A. Thomas, M. Schrafl-Altermatt, R. Treier, S. Kaufmann

Abstract:

Stroke is the main cause of adult disability. Especially upper limb function is affected in most patients. Recently, cooperative hand movements have been shown to be a promising type of upper limb training in stroke rehabilitation. In these movements, which are frequently found in activities of daily living (e.g. opening a bottle, winding up a blind), the force of one upper limb has to be equally counteracted by the other limb to successfully accomplish a task. The use of standardized and reliable clinical assessments is essential to evaluate the efficacy of therapy and the functional outcome of a patient. Many assessments for upper limb function or impairment are available. However, the evaluation of cooperative hand movement tasks are rarely included in those. Thus, the aim of this study was (i) to develop a novel clinical assessment (CASA - Cooperative Activity Stroke Assessment) for the evaluation of patients’ capacity to perform cooperative hand movements and (ii) to test its inter- and interrater reliability. Furthermore, CASA scores were compared to current gold standard assessments for upper extremity in stroke patients (i.e. Fugl-Meyer Assessment, Box & Blocks Test). The CASA consists of five cooperative activities of daily living including (1) opening a jar, (2) opening a bottle, (3) open and closing of a zip, (4) unscrew a nut and (5) opening a clipbox. Here, the goal is to accomplish the tasks as fast as possible. In addition to the quantitative rating (i.e. time) which is converted to a 7-point scale, also the quality of the movement is rated in a 4-point scale. To test the reliability of CASA, fifteen stroke subjects were tested within a week twice by the same two raters. Intra-and interrater reliability was calculated using the intraclass correlation coefficient (ICC) for total CASA score and single items. Furthermore, Pearson-correlation was used to compare the CASA scores to the scores of Fugl-Meyer upper limb assessment and the box and blocks test, which were assessed in every patient additionally to the CASA. ICC scores of the total CASA score indicated an excellent- and single items established a good to excellent inter- and interrater reliability. Furthermore, the CASA score was significantly correlated to the Fugl-Meyer and Box & Blocks score. The CASA provides a reliable assessment for cooperative hand movements which are crucial for many activities of daily living. Due to its non-costly setup, easy and fast implementation, we suggest it to be well suitable for clinical application. In conclusion, the CASA is a useful tool in assessing the functional status and therapy related recovery in cooperative hand movement capacity in stroke patients.

Keywords: activitites of daily living, clinical assessment, cooperative hand movements, reliability, stroke

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1073 Kitchen Bureaucracy: The Preparation of Banquets for Medieval Japanese Royalty

Authors: Emily Warren

Abstract:

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

Keywords: banquets, bureaucracy, Engi shiki, Japanese food

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1072 Family Cohesion, Social Networks, and Cultural Differences in Latino and Asian American Help Seeking Behaviors

Authors: Eileen Y. Wong, Katherine Jin, Anat Talmon

Abstract:

Background: Help seeking behaviors are highly contingent on socio-cultural factors such as ethnicity. Both Latino and Asian Americans underutilize mental health services compared to their White American counterparts. This difference may be related to the composite of one’s social support system, which includes family cohesion and social networks. Previous studies have found that Latino families are characterized by higher levels of family cohesion and social support, and Asian American families with greater family cohesion exhibit lower levels of help seeking behaviors. While both are broadly considered collectivist communities, within-culture variability is also significant. Therefore, this study aims to investigate the relationship between help seeking behaviors in the two cultures with levels of family cohesion and strength of social network. We also consider such relationships in light of previous traumatic events and diagnoses, particularly post-traumatic stress disorder (PTSD), to understand whether clinically diagnosed individuals differ in their strength of network and help seeking behaviors. Method: An adult sample (N = 2,990) from the National Latino and Asian American Study (NLAAS) provided data on participants’ social network, family cohesion, likelihood of seeking professional help, and DSM-IV diagnoses. T-tests compared Latino American (n = 1,576) and Asian American respondents (n = 1,414) in strength of social network, level of family cohesion, and likelihood of seeking professional help. Linear regression models were used to identify the probability of help-seeking behavior based on ethnicity, PTSD diagnosis, and strength of social network. Results: Help-seeking behavior was significantly associated with family cohesion and strength of social network. It was found that higher frequency of expressing one’s feelings with family significantly predicted lower levels of help-seeking behaviors (β = [-.072], p = .017), while higher frequency of spending free time with family significantly predicted higher levels of help-seeking behaviors (β = [.129], p = .002) in the Asian American sample. Subjective importance of family relations compared to that of one’s peers also significantly predict higher levels of help-seeking behaviors (β = [.095], p = .011) in the Asian American sample. Frequency of sharing one’s problems with relatives significantly predicted higher levels of help-seeking behaviors (β = [.113], p < .01) in the Latino American sample. A PTSD diagnosis did not have any significant moderating effect. Conclusion: Considering the underutilization of mental health services in Latino and Asian American minority groups, it is crucial to understand ways in which help seeking behavior can be encouraged. Our findings suggest that different dimensions within family cohesion and social networks have differential impacts on help-seeking behavior. Given the multifaceted nature of family cohesion and cultural relevance, the implications of our findings for theory and practice will be discussed.

Keywords: family cohesion, social networks, Asian American, Latino American, help-seeking behavior

Procedia PDF Downloads 47