Search results for: Greek public hospital sector
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10040

Search results for: Greek public hospital sector

1610 Study of Natural Radioactive and Radiation Hazard Index of Soil from Sembrong Catchment Area, Johor, Malaysia

Authors: M. I. A. Adziz, J. Sharib Sarip, M. T. Ishak, D. N. A. Tugi

Abstract:

Radiation exposure to humans and the environment is caused by natural radioactive material sources. Given that exposure to people and communities can occur through several pathways, it is necessary to pay attention to the increase in naturally radioactive material, particularly in the soil. Continuous research and monitoring on the distribution and determination of these natural radionuclides' activity as a guide and reference are beneficial, especially in an accidental exposure. Surface soil/sediment samples from several locations identified around the Sembrong catchment area were taken for the study. After 30 days of secular equilibrium with their daughters, the activity concentrations of the naturally occurring radioactive material (NORM) members, i.e. ²²⁶Ra, ²²⁸Ra, ²³⁸U, ²³²Th, and ⁴⁰K, were measured using high purity germanium (HPGe) gamma spectrometer. The results obtained showed that the radioactivity concentration of ²³⁸U ranged between 17.13 - 30.13 Bq/kg, ²³²Th ranged between 22.90 - 40.05 Bq/kg, ²²⁶Ra ranged between 19.19 - 32.10 Bq/kg, ²²⁸Ra ranged between 21.08 - 39.11 Bq/kg and ⁴⁰K ranged between 9.22 - 51.07 Bq/kg with average values of 20.98 Bq/kg, 27.39 Bq/kg, 23.55 Bq/kg, 26.93 Bq/kg and 23.55 Bq/kg respectively. The values obtained from this study were low or equivalent to previously reported in previous studies. It was also found that the mean/mean values obtained for the four parameters of the Radiation Hazard Index, namely radium equivalent activity (Raeq), external dose rate (D), annual effective dose and external hazard index (Hₑₓ), were 65.40 Bq/kg, 29.33 nGy/h, 19.18 ¹⁰⁻⁶Sv and 0.19 respectively. These obtained values are low compared to the world average values and the values of globally applied standards. Comparison with previous studies (dry season) also found that the values for all four parameters were low and equivalent. This indicates the level of radiation hazard in the area around the study is safe for the public.

Keywords: catchment area, gamma spectrometry, naturally occurring radioactive material (NORM), soil

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1609 Socio-Economic Setting and Implications to Climate Change Impacts in Eastern Cape Province, South Africa

Authors: Kenneth Nhundu, Leocadia Zhou, Farhad Aghdasi, Voster Muchenje

Abstract:

Climate change poses increased risks to rural communities that rely on natural resources, such as forests, cropland and rangeland, waterways, and open spaces Because of their connection to the land and the potential for climate change to impact natural resources and disrupt ecosystems and seasons, rural livelihoods and well-being are disproportionately vulnerable to climate change. Climate change has the potential to affect the environment in a number of ways that place increased stress on everyone, but disproportionately on the most vulnerable populations, including the young, the old, those with chronic illness, and the poor. The communities in the study area are predominantly rural, resource-based and are generally surrounded by public or private lands that are dominated by natural resources, including forests, rangelands, and agriculture. The livelihoods of these communities are tied to natural resources. Therefore, targeted strategies to cope will be required. This paper assessed the household socio-economic characteristics and their implications to household vulnerability to climate change impacts in the rural Eastern Cape Province, South Africa. The results indicate that the rural communities are climate-vulnerable populations as they have a large proportion of people who are less economically or physically capable of adapting to climate change. The study therefore recommends that at each level, the needs, knowledge, and voices of vulnerable populations, including indigenous peoples and resource-based communities, deserve consideration and incorporation so that climate change policy (1) ensures that all people are supported and able to act, (2) provides as robust a strategy as possible to address a rapidly changing environment, and (3) enhances equity and justice.

Keywords: climate change, vulnerable, socio-economic, livelihoods

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1608 Biases in Macroprudential Supervision and Their Legal Implications

Authors: Anat Keller

Abstract:

Given that macro-prudential supervision is a relatively new policy area and its empirical and analytical research are still in their infancy, its theoretical foundations are also lagging behind. This paper contributes to the developing discussion on effective legal and institutional macroprudential supervision frameworks. In the first part of the paper, it is argued that effectiveness as a key benchmark poses some challenges in the context of macroprudential supervision such as the difficulty in proving causality between supervisory actions and the achievement of the supervisor’s mission. The paper suggests that effectiveness in the macroprudential context should, therefore, be assessed at the supervisory decision-making process (to be differentiated from the supervisory outcomes). The second part of the essay examines whether insights from behavioural economics can point to biases in the macroprudential decision-making process. These biases include, inter alia, preference bias, groupthink bias and inaction bias. It is argued that these biases are exacerbated in the multilateral setting of the macroprudential supervision framework in the EU. The paper then examines how legal and institutional frameworks should be designed to acknowledge and perhaps contain these identified biases. The paper suggests that the effectiveness of macroprudential policy will largely depend on the existence of clear and robust transparency and accountability arrangements. Accountability arrangements can be used as a vehicle for identifying and addressing potential biases in the macro-prudential framework, in particular, inaction bias. Inclusiveness of the public in the supervisory process in the form of transparency and awareness of the logic behind policy decisions may assist in minimising their potential unpopularity thus promoting their effectiveness. Furthermore, a governance structure which facilitates coordination of the macroprudential supervisor with other policymakers and incorporates outside perspectives and opinions could ‘break-down’ groupthink bias as well as inaction bias.

Keywords: behavioural economics and biases, effectiveness of macroprudential supervision, legal and institutional macroprudential frameworks, macroprudential decision-making process

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1607 A Regional Analysis on Co-movement of Sovereign Credit Risk and Interbank Risks

Authors: Mehdi Janbaz

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The global financial crisis and the credit crunch that followed magnified the importance of credit risk management and its crucial role in the stability of all financial sectors and the whole of the system. Many believe that risks faced by the sovereign sector are highly interconnected with banking risks and most likely to trigger and reinforce each other. This study aims to examine (1) the impact of banking and interbank risk factors on the sovereign credit risk of Eurozone, and (2) how the EU Credit Default Swaps spreads dynamics are affected by the Crude Oil price fluctuations. The hypothesizes are tested by employing fitting risk measures and through a four-staged linear modeling approach. The sovereign senior 5-year Credit Default Swap spreads are used as a core measure of the credit risk. The monthly time-series data of the variables used in the study are gathered from the DataStream database for a period of 2008-2019. First, a linear model test the impact of regional macroeconomic and market-based factors (STOXX, VSTOXX, Oil, Sovereign Debt, and Slope) on the CDS spreads dynamics. Second, the bank-specific factors, including LIBOR-OIS spread (the difference between the Euro 3-month LIBOR rate and Euro 3-month overnight index swap rates) and Euribor, are added to the most significant factors of the previous model. Third, the global financial factors including EURO to USD Foreign Exchange Volatility, TED spread (the difference between 3-month T-bill and the 3-month LIBOR rate based in US dollars), and Chicago Board Options Exchange (CBOE) Crude Oil Volatility Index are added to the major significant factors of the first two models. Finally, a model is generated by a combination of the major factor of each variable set in addition to the crisis dummy. The findings show that (1) the explanatory power of LIBOR-OIS on the sovereign CDS spread of Eurozone is very significant, and (2) there is a meaningful adverse co-movement between the Crude Oil price and CDS price of Eurozone. Surprisingly, adding TED spread (the difference between the three-month Treasury bill and the three-month LIBOR based in US dollars.) to the analysis and beside the LIBOR-OIS spread (the difference between the Euro 3M LIBOR and Euro 3M OIS) in third and fourth models has been increased the predicting power of LIBOR-OIS. Based on the results, LIBOR-OIS, Stoxx, TED spread, Slope, Oil price, OVX, FX volatility, and Euribor are the determinants of CDS spreads dynamics in Eurozone. Moreover, the positive impact of the crisis period on the creditworthiness of the Eurozone is meaningful.

Keywords: CDS, crude oil, interbank risk, LIBOR-OIS, OVX, sovereign credit risk, TED

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1606 Geographic Information System Based Development Potentiality Assessment for Rural Villages: Case Study in Fuliang County, Jingdezhen

Authors: Sishen Wang

Abstract:

Chinese rural industry development is the major task currently during rapid urbanization. Development of potentiality assessment, evaluate the overall suitability of each village for further industrial development, could offer reference for policy makers, especially considering the limited data available in Chinese rural regions. The study focuses on 157 official villages in Fuliang County and evaluates their development potentiality by their topography, transportation condition, population, income of villagers, infrastructure and environmental conditions. Land cover changes for Fuliang county and surrounding areas of each village is also investigated for reference. The final development potentiality of each village was calculated by adding different weighted scores of different categories. Besides, inverse distance weighting (IDW) images for both final score of development potentiality and each factor were made and compared to help to understand the final result. The study found that village in the southern and northern regions have higher development potentiality than villages in the eastern and western regions, mainly because of higher income of villagers, good accessibilities and a large amount of population size. In addition, the Fuliang county was divided into five regions based on final result and policy reference for the development of each region were put forward individually. In addition, three suggestions were made for better local development potentiality: Firstly, the transportation accessibility needs to be improved in the northern regions by building more public transit system there. Secondly, the environmental conditions and infrastructure conditions in the eastern region of the county need some improvement. Thirdly, some encouragement and job opportunities should beset up in the western regions to attract labor force to move in and settle down.

Keywords: development potentiality, Fuliang GIS-Based, GIS, official village

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1605 Sustainable Use of Agricultural Waste to Enhance Food Security and Conserve the Environment

Authors: M. M. Tawfik, Ezzat M. Abd El Lateef, B. B. Mekki, Amany A. Bahr, Magda H. Mohamed, Gehan S. Bakhoom

Abstract:

The rapid increase in the world’s population coupled by decrease the arable land per capita has resulted into an increased demand for food which has in turn led to the production of large amounts of agricultural wastes, both at the farmer, municipality and city levels. Agricultural wastes can be a valuable resource for improving food security. Unfortunately, agricultural wastes are likely to cause pollution to the environment or even harm to human health. This calls for increased public awareness on the benefits and potential hazards of agricultural wastes, especially in developing countries. Agricultural wastes (residual stalks, straw, leaves, roots, husks, shells etcetera) and animal waste (manures) are widely available, renewable and virtually free, hence they can be an important resource. They can be converted into heat, steam, charcoal, methanol, ethanol, bio diesel as well as raw materials (animal feed, composting, energy and biogas construction etcetera). agricultural wastes are likely to cause pollution to the environment or even harm to human health, if it is not used in a sustainable manner. Organic wastes could be considered an important source of biofertilizer for enhancing food security in the small holder farming communities that would not afford use of expensive inorganic fertilizers. Moreover, these organic wastes contain high levels of nitrogen, phosphorus, potassium, and organic matter important for improving nutrient status of soils in urban agriculture. Organic compost leading to improved crop yields and its nutritional values as compared with inorganic fertilization. This paper briefly reviews how agricultural wastes can be used to enhance food security and conserve the environment.

Keywords: agricultural waste, organic compost, environment, valuable resources

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1604 How Children Synchronize with Their Teacher: Evidence from a Real-World Elementary School Classroom

Authors: Reiko Yamamoto

Abstract:

This paper reports on how synchrony occurs between children and their teacher, and what prevents or facilitates synchrony. The aim of the experiment conducted in this study was to precisely analyze their movements and synchrony and reveal the process of synchrony in a real-world classroom. Specifically, the experiment was conducted for around 20 minutes during an English as a foreign language (EFL) lesson. The participants were 11 fourth-grade school children and their classroom teacher in a public elementary school in Japan. Previous researchers assert that synchrony causes the state of flow in a class. For checking the level of flow, Short Flow State Scale (SFSS) was adopted. The experimental procedure had four steps: 1) The teacher read aloud the first half of an English storybook to the children. Both the teacher and the children were at their own desks. 2) The children were subjected to an SFSS check. 3) The teacher read aloud the remaining half of the storybook to the children. She made the children remove their desks before reading. 4) The children were again subjected to an SFSS check. The movements of all participants were recorded with a video camera. From the movement analysis, it was found that the children synchronized better with the teacher in Step 3 than in Step 1, and that the teacher’s movement became free and outstanding without a desk. This implies that the desk acted as a barrier between the children and the teacher. Removal of this barrier resulted in the children’s reactions becoming synchronized with those of the teacher. The SFSS results proved that the children experienced more flow without a barrier than with a barrier. Apparently, synchrony is what caused flow or social emotions in the classroom. The main conclusion is that synchrony leads to cognitive outcomes such as children’s academic performance in EFL learning.

Keywords: engagement in a class, English as a foreign language (EFL) learning, interactional synchrony, social emotions

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1603 Acute Respiratory Infections in a Rural Area of the Southwestern Region of Bangladesh: Perceptions, Practices and the Role of First-Time Mothers

Authors: Sonia Mannan

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A qualitative study was conducted in a rural area of the southwestern region of Bangladesh to identify perceptions, practices, and the role of first-time mothers surrounding acute respiratory infections (ARI) in infants and children aged under four years. The study reveals that all mothers had knowledge of ARI and were able to identify a number of signs and symptoms. They also recognized pneumonia and thought it to be caused by exposure to cold or weather change, supernatural causes, evil influences, mothers’ negligence, and failure to observe ‘purdah’. They were able to identify chest retractions, difficult breathing, and inability to feed as signs of severe disease needing treatment outside the home. In these cases, spiritual healers were sought, and allopathic treatment was delayed or avoided. Home care practices involved massaging the child with oil and avoiding 'cooling' foods, including water. With the presence of fever and breathing difficulty, mothers tended to increase the number and diversity of medicines, although more concern was expressed about fever than about breathing difficulty. Effective medical care was more likely to be delayed for infants than for older children (they often waited 2-5 days after signs of illness appeared); infants were also more likely to be taken to a spiritual healer as the first-choice provider. The reasons for these perceptions and practices and their implications on the ARI of infants and young children are discussed. Community intervention is identified as viable, effective, and practical to address the body of local socio-cultural knowledge about family practices and the role of the mother regarding the mitigation of ARI in infants and young children.

Keywords: acute respiratory infections , public health, pneumonia, Bangladesh

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1602 Experiences and Coping of Adults with Death of Siblings during Childhood in Chinese Context: Implications for Therapeutic Interventions

Authors: Sze Yee Lee

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The death of a sibling in childhood leads to significant impacts on both the personal and family development of the surviving siblings. Yet, the effects of sibling loss in Chinese societies such as Hong Kong have been inadequately documented in the literature. In particular, there is a gap in the literature about the long term impacts on surviving siblings. This paper explores the experience of adult siblings encountering siblings’ death during childhood with the use of in-depth interviews. Through thematic analysis and in-depth interviews, the author explores the impacts on surviving siblings’ emotions, coping styles, struggles and challenges, and personal development. Furthermore, the influences on family dynamics are explored thoroughly, including the changes in a family atmosphere, family roles, family relationships, family communication, and parenting styles. More importantly, the author identifies (i) existing continuing bonds, (ii) crying, (iii) adequate social support, (iv) hiding own emotions as a gesture of protecting parents as the crucial elements pertinent to surviving siblings’ successful adaptation in the face of sibling loss. In addition, 'child-centered' and 'family-centered' interventions for families with siblings' death in a Chinese context are discussed. With the use of age-appropriate language and children’s participation in the preparation of death and after-death arrangements, surviving siblings could be assisted in transforming bereavement into opportunities for growth. In addition, the bereaved family could better cope with grief with open communication platforms, adequate social support, and family education resources. Meanwhile, life-and-death education at both school and community levels could enhance the public’s awareness and understanding of the bereaved individuals to prevent creating further harm to them.

Keywords: children and adolescent bereavement, children-centered, family-centered, sibling’s death

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1601 How Consumers Perceive Health and Nutritional Information and How It Affects Their Purchasing Behavior: Comparative Study between Colombia and the Dominican Republic

Authors: Daniel Herrera Gonzalez, Maria Luisa Montas

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There are some factors affecting consumer decision-making regarding the use of the front of package labels in order to find benefits to the well-being of the human being. Currently, there are several labels that help influence or change the purchase decision for food products. These labels communicate the impact that food has on human health; therefore, consumers are more critical and intelligent when buying and consuming food products. The research explores the association between front-of-pack labeling and food choice; the association between label content and purchasing decisions is complex and influenced by different factors, including the packaging itself. The main objective of this study was to examine the perception of health labels and nutritional declarations and their influence on buying decisions in the non-alcoholic beverages sector. This comparative study of two developing countries will show how consumers take nutritional labels into account when deciding to buy certain foods. This research applied a quantitative methodology with correlational scope. This study has a correlational approach in order to analyze the degree of association between variables. Likewise, the confirmatory factor analysis (CFA) method and structural equation modeling (SEM) as a powerful multivariate technique was used as statistical technique to find the relationships between observable and unobservable variables. The main findings of this research were the obtaining of three large groups and their perception and effects on nutritional and wellness labels. The first group is characterized by taking an attitude of high interest on the issue of the imposition of the nutritional information label on products and would agree that all products should be packaged given its importance to preventing illnesses in the consumer. Likewise, they almost always care about the brand, the size, the list of ingredients, and nutritional information of the food, and also the effect of these on health. The second group stands out for presenting some interest in the importance of the label on products as a purchase decision, in addition to almost always taking into account the characteristics of size, money, components, etc. of the products to decide on their consumption and almost always They are never interested in the effect of these products on their health or nutrition, and in group 3, it differs from the others by being more neutral regarding the issue of nutritional information labels, and being less interested in the purchase decision and characteristics of the product and also on the influence of these on health and nutrition. This new knowledge is essential for different companies that manufacture and market food products because they will have information to adapt or anticipate the new laws of developing countries as well as the new needs of health-conscious consumers when they buy food products.

Keywords: healthy labels, consumer behavior, nutritional information, healthy products

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1600 Storm-water Management for Greenfield Area Using Low Impact Development Concept for Town Planning Scheme Mechanism

Authors: Sahil Patel

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Increasing urbanization leads to a concrete forest. The effects of new development practices occur in the natural hydrologic cycle. Here the concerns have been raised about the groundwater recharge in sufficient quantity. With further development, porous surfaces reduce rapidly. A city like Ahmedabad, with a non-perennial river, is 100% dependent on groundwater. The Ahmedabad city receives its domestic use water from the Narmada river, located about 200 km away. The expenses to bring water is much higher. Ahmedabad city receives annually 800 mm rainfall, and mostly this water increases the local level waterlogging problems; after that, water goes to the Sabarmati river and merges into the sea. The existing developed area of Ahmedabad city is very dense, and does not offer many chances to change the built form and increase porous surfaces to absorb storm-water. Therefore, there is a need to plan upcoming areas with more effective solutions to manage storm-water. This paper is focusing on the management of stormwater for new development by retaining natural hydrology. The Low Impact Development (LID) concept is used to manage storm-water efficiently. Ahmedabad city has a tool called the “Town Planning Scheme,” which helps the local body drive new development by land pooling mechanism. This paper gives a detailed analysis of the selected area (proposed Town Planning Scheme area by the local authority) in Ahmedabad. Here the development control regulations for individual developers and some physical elements for public places are presented to manage storm-water. There is a different solution for the Town Planning scheme than that of the conventional way. A local authority can use it for any area, but it can be site-specific. In the end, there are benefits to locals with some financial analysis and comparisons.

Keywords: water management, green field development, low impact development, town planning scheme

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1599 Industrial Kaolinite Resource Deposits Study in Grahamstown Area, Eastern Cape, South Africa

Authors: Adeola Ibukunoluwa Samuel, Afsoon Kazerouni

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Industrial mineral kaolin has many favourable properties such as colour, shape, softness, non-abrasiveness, natural whiteness, as well as chemical stability. It occurs extensively in North of Bedford road Grahamstown, South Africa. The relationship between both the physical and chemical properties as lead to its application in the production of certain industrial products which are used by the public; this includes the prospect of production of paper, ceramics, rubber, paint, and plastics. Despite its interesting economic potentials, kaolinite clay mineral remains undermined, and this is threatening its sustainability in the mineral industry. This research study focuses on a detailed evaluation of the kaolinite mineral and possible ways to increase its lifespan in the industry. The methods employed for this study includes petrographic microscopy analysis, X-ray powder diffraction analysis (XRD), and proper field reconnaissance survey. Results emanating from this research include updated geological information on Grahamstown. Also, mineral transformation phases such as quartz, kaolinite, calcite and muscovite were identified in the clay samples. Petrographic analysis of the samples showed that the study area has been subjected to intense tectonic deformation and cement replacement. Also, different dissolution patterns were identified on the Grahamstown kaolinitic clay deposits. Hence incorporating analytical studies and data interpretations, possible ways such as the establishment of processing refinery near mining plants, which will, in turn, provide employment for the locals and land reclamation is suggested. In addition, possible future sustainable industrial applications of the clay minerals seem to be possible if additives, cellulosic wastes are used to alter the clay mineral.

Keywords: kaolinite, industrial use, sustainability, Grahamstown, clay minerals

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1598 Objective-Based System Dynamics Modeling to Forecast the Number of Health Professionals in Pudong New Area of Shanghai

Authors: Jie Ji, Jing Xu, Yuehong Zhuang, Xiangqing Kang, Ying Qian, Ping Zhou, Di Xue

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Background: In 2014, there were 28,341 health professionals in Pudong new area of Shanghai and the number per 1000 population was 5.199, 55.55% higher than that in 2006. But it was always less than the average number of health professionals per 1000 population in Shanghai from 2006 to 2014. Therefore, allocation planning for the health professionals in Pudong new area has become a high priority task in order to meet the future demands of health care. In this study, we constructed an objective-based system dynamics model to forecast the number of health professionals in Pudong new area of Shanghai in 2020. Methods: We collected the data from health statistics reports and previous survey of human resources in Pudong new area of Shanghai. Nine experts, who were from health administrative departments, public hospitals and community health service centers, were consulted to estimate the current and future status of nine variables used in the system dynamics model. Based on the objective of the number of health professionals per 1000 population (8.0) in Shanghai for 2020, the system dynamics model for health professionals in Pudong new area of Shanghai was constructed to forecast the number of health professionals needed in Pudong new area in 2020. Results: The system dynamics model for health professionals in Pudong new area of Shanghai was constructed. The model forecasted that there will be 37,330 health professionals (6.433 per 1000 population) in 2020. If the success rate of health professional recruitment changed from 20% to 70%, the number of health professionals per 1000 population would be changed from 5.269 to 6.919. If this rate changed from 20% to 70% and the success rate of building new beds changed from 5% to 30% at the same time, the number of health professionals per 1000 population would be changed from 5.269 to 6.923. Conclusions: The system dynamics model could be used to simulate and forecast the health professionals. But, if there were no significant changes in health policies and management system, the number of health professionals per 1000 population would not reach the objectives in Pudong new area in 2020.

Keywords: allocation planning, forecast, health professional, system dynamics

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1597 Telepsychiatry for Asian Americans

Authors: Jami Wang, Brian Kao, Davin Agustines

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COVID-19 highlighted the active discrimination against the Asian American population easily seen through media, social tension, and increased crimes against the specific population. It is well known that long-term racism can also have a large impact on both emotional and psychological well-being. However, the healthcare disparity during this time also revealed how the Asian American community lacked the research data, political support, and medical infrastructure for this particular population. During a time when Asian American fear for safety with decreasing mental health, telepsychiatry is particularly promising. COVID-19 demonstrated how well psychiatry could integrate with telemedicine, with psychiatry being the second most utilized telemedicine visits. However, the Asian American community did not utilize the telepsychiatry resources as much as other groups. Because of this, we wanted to understand why the patient population who was affected the most by COVID-19 mentally did not seek out care. To do this, we decided to study the top top telepsychiatry platforms. The current top telepsychiatry companies in the United States include Teladoc and BetterHelp. In the Teladoc mental health sector, they only had 4 available languages (English, Spanish, French, and Danis,) with none of them being an Asian language. In a similar manner, Teladoc’s top competitor in the telepsychiatry space, BetterHelp, only listed a total of 3 Asian languages, including Mandarin, Japanese, and Malaysian. However, this is still a short list considering they have over 20 languages available. The shortage of available physicians that speak multiple languages is concerning, as it could be difficult for the Asian American community to relate with. There are limited mental health resources that cater to their likely cultural needs, further exacerbating the structural racism and institutional barriers to appropriate care. It is important to note that these companies do provide interpreters to comply with the nondiscrimination and language assistance federal law. However, interactions with an interpreter are not only more time-consuming but also less personal than talking directly with a physician. Psychiatry is the field that emphasizes interpersonal relationships. The trust between a physician and the patient is critical in developing patient rapport to guide in better understanding the clinical picture and treating the patient appropriately. The language barrier creates an additional barrier between the physician and patient. Because Asian Americans are one of the largest growing patient population bases, these telehealth companies have much to gain by catering to the Asian American market. Without providing adequate access to bilingual and bicultural physicians, the current system will only further exacerbate the growing disparity. The healthcare community and telehealth companies need to recognize that the Asian American population is a severely underserved population in mental health and has much to gain from telepsychiatry. The lack of language is one of many reasons why there is a disparity for Asian Americans in the mental health space.

Keywords: telemedicine, psychiatry, Asian American, disparity

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1596 Employee Wellbeing: The Key to Organizational Success

Authors: Crystal Hoole

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Employee well-being has become an area of concern for top executives and organizations worldwide. In developing countries such as South Africa, and especially in the educational sector, employees have to deal with anxiety, stress, fear, student protests, political and economic turmoil and excessive work demands on a daily basis. Research has shown that workplaces with higher resilience and better well-being strategies also report higher productivity, increased innovation, better employee retention and better employee engagement. Many organisations offer standard employee assistance programs and once-off short interventions. However, most of these well-being initiatives are perceived as ineffective. Some of the criticism centers around a lack of holistic well-being approaches, no proof of the success of well-being initiatives, not being part of the organization’s strategies and a lack of genuine leadership support. This study attempts to illustrate how a holistic well-being intervention, over a period of 100 days, is far more effective in impacting organizational outcomes. A quasi-experimental design, with a pre-test and pro-test design with a randomization strategy, will be used. Measurements of organizational outcomes are taken at three-time points throughout the study, before, middle and after. The constructs that will be measured are employee engagement, psychological well-being, organizational culture and trust, and perceived stress. The well-being is imitative follows a salutogenesis approach and is aimed at building resilience through focusing on six focal areas, namely sleep, mindful eating, exercise, love, gratitude and appreciation, breath work and mindfulness, and finally, purpose. Certain organizational constructs, including employee engagement, psychological well-being, organizational culture and trust and perceived stress, will be measured at three-time points during the study, namely before, middle and after. A quasi-experimental, pre-test and post-test design will be applied, also using a randomization strategy to limit potential bias. Repeated measure ANCOVA will be used to determine whether any change occurred over the period of 100 days. The study will take place in a Higher Education institution in South Africa. The sample will consist of academic and administrative staff. Participants will be assigned to a test and control group. All participants will complete a survey measuring employee engagement, psychological well-being, organizational culture and trust, and perceived stress. Only the test group will undergo the well-being intervention. The study envisages contributing on several levels: Firstly, the study hopes to find a positive increase in the various well-being indicators of the participants who participated in the study and secondly to illustrate that a longer more holistic approach is successful in improving organisational success (as measured in the various organizational outcomes).

Keywords: wellbeing, resilience, organizational success, intervention

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1595 H. P. Grice’s Cooperative Principle in a Reproductive Health Clinic in Kenya

Authors: Melvin Ouma

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Language is one of the most crucial tools in medical interaction. Its importance is as great today as it was many decades ago. Difficulty in openly discussing certain diseases and body parts is one of the challenges in language use in medical contexts. Guided by H. P. Grice’s Cooperative Principle, this paper explores the flouting of the cooperative principles in Swahili speaking medical setting. The paper examines how men flout the maxims using the Swahili language when reporting reproductive health problems to the doctor. The data used was gathered from a qualitative study carried out in a reproductive health clinic in a public facility in Nakuru County, Kenya. All the research protocols were observed by acquiring all the research permits. Respondents' ethical considerations of consent, privacy, and confidentiality were observed. The respondents recruited were men who visited the reproductive health clinic and voluntarily agreed to participate in the study without coercion or compensation. Participant observation was the key data collection tool, with the doctor and patient conversation digitally recorded. The researcher was allowed into the clinic in a socially acceptable role. Male patients flouted the maxims of quantity, quality, relation, and manner in order to describe their reproductive health problems without embarrassment using the Swahili language. The flouting was done through the discursive strategies of narration and circumlocution. Flouting of the maxims was acceptable to the doctor and patient due to the fact that sexual intercourse and private body parts are taboo topics and uncomfortable to talk about. The quality of health care received by the patient depended on the doctor’s patience when all the maxims were flouted. In the reproductive health clinic, flouting of maxims hindered communication and, at the same time, enhanced communication between the doctor and patient.

Keywords: cooperative principle, doctor, men, reproductive health

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1594 The Growth Role of Natural Gas Consumption for Developing Countries

Authors: Tae Young Jin, Jin Soo Kim

Abstract:

Carbon emissions have emerged as global concerns. Intergovernmental Panel of Climate Change (IPCC) have published reports about Green House Gases (GHGs) emissions regularly. United Nations Framework Convention on Climate Change (UNFCCC) have held a conference yearly since 1995. Especially, COP21 held at December 2015 made the Paris agreement which have strong binding force differently from former COP. The Paris agreement was ratified as of 4 November 2016, they finally have legal binding. Participating countries set up their own Intended Nationally Determined Contributions (INDC), and will try to achieve this. Thus, carbon emissions must be reduced. The energy sector is one of most responsible for carbon emissions and fossil fuels particularly are. Thus, this paper attempted to examine the relationship between natural gas consumption and economic growth. To achieve this, we adopted the Cobb-Douglas production function that consists of natural gas consumption, economic growth, capital, and labor using dependent panel analysis. Data were preprocessed with Principal Component Analysis (PCA) to remove cross-sectional dependency which can disturb the panel results. After confirming the existence of time-trended component of each variable, we moved to cointegration test considering cross-sectional dependency and structural breaks to describe more realistic behavior of volatile international indicators. The cointegration test result indicates that there is long-run equilibrium relationship between selected variables. Long-run cointegrating vector and Granger causality test results show that while natural gas consumption can contribute economic growth in the short-run, adversely affect in the long-run. From these results, we made following policy implications. Since natural gas has positive economic effect in only short-run, the policy makers in developing countries must consider the gradual switching of major energy source, from natural gas to sustainable energy source. Second, the technology transfer and financing business suggested by COP must be accelerated. Acknowledgement—This work was supported by the Energy Efficiency & Resources Core Technology Program of the Korea Institute of Energy Technology Evaluation and Planning (KETEP) granted financial resource from the Ministry of Trade, Industry & Energy, Republic of Korea (No. 20152510101880) and by the National Research Foundation of Korea Grant funded by the Korean Government (NRF-205S1A3A2046684).

Keywords: developing countries, economic growth, natural gas consumption, panel data analysis

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1593 Providing Resilience: An Overview of the Actions in an Elderly Suburban Area in Rio de Janeiro

Authors: Alan Silva, Carla Cipolla

Abstract:

The increase of life expectancy in the world is a current challenge for governments, demanding solutions towards elderly people. In this context, service design and age-friendly design appear as an approach to create solutions which favor active aging by social inclusion and better life quality. In essence, the age-friendly design aims to include elderly people in the democratic process of creation in order to strengthen the participation and empowerment of them through intellectual, social, civic, recreational, cultural and spiritual activities. All of these activities aim to provide resilience to this segment by granting access to the reserves needed for adaptation and growth in the face of life's challenges. On that approach, the following research brings an overview of the actions related to the integration and social qualification of the elderly people, considering a suburban area of Rio de Janeiro. Based on Design Thinking presented by Brown (2009), this research has a qualitative-exploratory approach demanding certain necessities and actions, which are collected through observation and interviews about the daily life of the elderly community individuals searching for information about personal capacitation and social integration of the studied population. Subsequently, a critical analysis is done on this overview, pointing out the potentialities and limitations of these actions. At the end of the research, a well-being map of solutions classified as physical, mental and social is created, also indicating which current services are relevant and which activities can be transformed into services to that community. In conclusion, the contribution of this research is the construction of a map of solutions that provides resilience to the studied public and favors the concept of active aging in society. From this map of solutions, it is possible to discriminate what are the resources necessary for the solutions to be operationalized and their journeys with the users of the elderly segment.

Keywords: resilience, age-friendly design, service design, active aging

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1592 Before Decision: Career Motivation of Teacher Candidates

Authors: Pál Iván Szontagh

Abstract:

We suppose that today, the motivation for the career of a pedagogue (including its existential, organizational and infrastructural conditions) is different from the level of commitment to the profession of an educator (which can be experienced informally, or outside of the public education system). In our research, we made efforts to address the widest possible range of student elementary teachers, and to interpret their responses using different filters. In the first phase of our study, we analyzed first-year kindergarten teacher students’ career motivation and commitment to the profession, and in the second phase, that of final-year kindergarten teacher candidates. In the third phase, we conducted surveys to explore students’ motivation for the profession and the career path of a pedagogue in four countries of the Carpathian Basin (Hungary, Slovakia, Romania and Serbia). The surveys were conducted in 17 campuses of 11 Hungarian teacher’s training colleges and universities. Finally, we extended the survey to practicing graduates preparing for their on-the-job rating examination. Based on our results, in all breakdowns, regardless of age group, training institute or - in part - geographical location and nationality, it is proven that lack of social- and financial esteem of the profession poses serious risks for recruitment and retention of teachers. As a summary, we searched for significant differences between the professional- and career motivations of the three respondent groups (kindergarten teacher students, elementary teacher students and practicing teachers), i.e. the motivation factors that change the most with education and/or with the time spent on the job. Based on our results, in all breakdowns, regardless of age group, training institute or - in part - geographical location and nationality, it is proven that lack of social- and financial esteem of the profession poses serious risks for recruitment and retention of teachers.

Keywords: career motivation, career socialization, professional motivation, teacher training

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1591 Our Shared Humanity: Bridging the Great Divide of Different Religions

Authors: Aida Raissi, Holly Wong, Elma Raissi

Abstract:

Background: Connection is a primal need established during infancy and reiterated in many forms of social interaction. When we make connections with others we experience growth, continuity, and gain an understanding of the other’s sense of the world. Feeling socially connected to another individual or community has been shown to increase self-esteem, happiness, and meaning. However, feeling connected to another individual or a specific community may also decrease the motivation to seek connection with more distant individuals or communities. Furthermore, we allow ourselves to interact with those in other communities as apart from us, and in some cases, to dehumanize their existence. Objective: The aim of this project is to bridge the gap between different communities, specifically religious communities and foster feelings of connection as one with all members through the medium of art, specifically photography. Method: Members of all major faiths including Agnosticism, Atheism, Buddhism, Catholicism, Christianity, Ismaili, Jewish, Ja’far Shia, Sunni will be interviewed. Participants will be asked to partake in a brief interview of two parts: A. Answering two questions: 1. What are you most looking forward to in the future, and why? 2. What does religion mean to you? B. Having their picture taken. Our questions aim to elicit individual stories that together, show that we have more in common, than differences, despite our faiths. With the completion of the interviews, the responses will be compiled together and major themes will be identified. Impact: The resulting stories and corresponding individual pictures provide an excellent opportunity to encourage and inspire people to get to know those of other beliefs and values, participate in each other’s communities and develop a sense of oneness within our shared humanity. Knowledge translation: The personal stories, and the common themes they illustrate, will be shared with various audiences, including the general public, academia and targeted groups such as students. This will be done through displaying the photographs and responses at art galleries, conferences, in print and online.

Keywords: social justice, religion, connection, understanding, community

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1590 Management of Hypoglycemia in Von Gierke’s Disease

Authors: Makda Aamir, Sood Aayushi, Syed Omar, Nihan Khuld, Iskander Peter, Ijaz Naeem, Sharma Nishant

Abstract:

Introduction:Glycogen Storage Disease Type-1 (GSD-1) is a rare phenomenon primarily affecting the liver and kidney. Excessive accumulation of glycogen and fat in liver, kidney, and intestinal mucosa is noted in patients with deficiency of Glucose-6-phosphatase deficiency. Patients with GSD-1 have a wide spectrum of symptoms, including hepatomegaly, hypoglycemia, lactic acidemia, hyperlipidemia, hyperuricemia, and growth retardation. Age of onset, rate of disease progression and its severity is variable in this disease.Case:An 18-year-old male with GSD-1a, Von Gierke’s disease, hyperuricemia, and hypertension presented to the hospital with nausea and vomiting. The patient followed an hourly cornstarch regimen during the day and overnight through infusion via a PEG tube. The complaints started at work, where he was unable to tolerate oral cornstarch. He washemodynamically stable on arrival. ABG showed pH 7.372, PaCO2 30.3, and PaO2 92.2. WBC 16.80, K+ 5.8, HCO3 13, BUN 28, Cr 2.2, Glucose 60, AST 115, ALT 128, Cholesterol 352, Triglycerides >1000, Uric Acid 10.6, Lactic Acid 11.8 which trended down to 8.0. CT abdomen showed hepatomegaly and fatty infiltration with the PEG tube in place.He was admitted to the ICU and started on D5NS for hypoglycemia and lactic acidosis. Per request by the patient’s pediatrician, he was transitioned to IV D10/0.45NS at 110mL/Hr to maintain blood glucose above 75 mg/L. Frequent accuchecks were done till he could tolerate his dietary regimen with cornstarch. Lactic acid downtrend to 2.9, and accuchecks ranged between 100-110. Cr improved to 1.3, and his home medications (Allopurinol and Lisinopril) were resumed. He was discharged in stable condition with plans for further genetic therapy work up.Discussion:Mainstay therapy for Von Gierke’s Disease is the prevention of metabolic derangements for which dietary and lifestyle changes are recommended. A low fructose and sucrose diet is recommended by limiting the intake of galactose and lactose to one serving per day. Hypoglycemia treatment in such patients is two-fold, utilizing both quick and stable release sources. Cornstarch has been one such therapy since the 1980s; its slow digestion provides a steady release of glucose over a longer period of time as compared with other sources of carbohydrates. Dosing guidelines vary from age to age and person to person, but it is highly recommended to check BG levels frequently to maintain a BG > 70 mg/dL. Associated high levels of triglycerides and cholesterol can be treated with statins, fibrates, etc. Conclusion:The management of hypoglycemia in GSD 1 disease presents various obstacles which could prove to be fatal. Due to the deficiency of G6P, treatment with a specialized hypoglycemic regimen is warranted. A D10 ½ NS infusion can be used to maintain blood sugar levels as well as correct metabolic or lactate imbalances. Infusion should be gradually weaned off after the patient can tolerate oral feeds as this can help prevent the risk of hypoglycemia and other derangements. Further research is needed in regards to these patients for more sustainable regimens.

Keywords: von gierke, glycogen storage disease, hypoglycemia, genetic disease

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1589 Systematic Review of Digital Interventions to Reduce the Carbon Footprint of Primary Care

Authors: Anastasia Constantinou, Panayiotis Laouris, Stephen Morris

Abstract:

Background: Climate change has been reported as one of the worst threats to healthcare. The healthcare sector is a significant contributor to greenhouse gas emissions with primary care being responsible for 23% of the NHS’ total carbon footprint. Digital interventions, primarily focusing on telemedicine, offer a route to change. This systematic review aims to quantify and characterize the carbon footprint savings associated with the implementation of digital interventions in the setting of primary care. Methods: A systematic review of published literature was conducted according to PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. MEDLINE, PubMed, and Scopus databases as well as Google scholar were searched using key terms relating to “carbon footprint,” “environmental impact,” “sustainability”, “green care”, “primary care,”, and “general practice,” using citation tracking to identify additional articles. Data was extracted and analyzed in Microsoft Excel. Results: Eight studies were identified conducted in four different countries between 2010 and 2023. Four studies used interventions to address primary care services, three studies focused on the interface between primary and specialist care, and one study addressed both. Digital interventions included the use of mobile applications, online portals, access to electronic medical records, electronic referrals, electronic prescribing, video-consultations and use of autonomous artificial intelligence. Only one study carried out a complete life cycle assessment to determine the carbon footprint of the intervention. It estimate that digital interventions reduced the carbon footprint at primary care level by 5.1 kgCO2/visit, and at the interface with specialist care by 13.4 kg CO₂/visit. When assessing the relationship between travel-distance saved and savings in emissions, we identified a strong correlation, suggesting that most of the carbon footprint reduction is attributed to reduced travel. However, two studies also commented on environmental savings associated with reduced use of paper. Patient savings in the form of reduced fuel cost and reduced travel time were also identified. Conclusion: All studies identified significant reductions in carbon footprint following implementation of digital interventions. In the future, controlled, prospective studies incorporating complete life cycle assessments and accounting for double-consulting effects, use of additional resources, technical failures, quality of care and cost-effectiveness are needed to fully appreciate the sustainable benefit of these interventions

Keywords: carbon footprint, environmental impact, primary care, sustainable healthcare

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1588 Phytomining for Rare Earth Elements: A Comparative Life Cycle Assessment

Authors: Mohsen Rabbani, Trista McLaughlin, Ehsan Vahidi

Abstract:

the remediation of polluted sites with heavy metals, such as rare earth elements (REEs), has been a primary concern of researchers to decontaminate the soil. Among all developed methods to address this concern, phytoremediation has been established as efficient, cost-effective, easy-to-use, and environmentally friendly way, providing a long-term solution for addressing this global concern. Furthermore, this technology has another great potential application in the metals production sector through returning metals buried in soil via metals cropping. Considering the significant metal concentration in hyper-accumulators, the utilization of bioaccumulated metals to extract metals from plant matter has been proposed as a sub-economic area called phytomining. As a recent, more advanced technology to eliminate such pollutants from the soil and produce critical metals, bioharvesting (phytomining/agromining) has been considered another compromising way to produce metals and meet the global demand for critical/target metals. The bio-ore obtained from phytomining can be safely disposed of or introduced to metal production pathways to obtain the most demanded metals, such as REEs. It is well-known that some hyperaccumulators, e.g., fern Dicranopteris linearis, can be used to absorb REE metals from the polluted soils and accumulate them in plant organs, such as leaves and stems. After soil remediation, the plant species can be harvested and introduced to the downstream steps, namely crushing/grinding, leaching, and purification processes, to extract REEs from plant matter. This novel interdisciplinary field can fill the gap between agriculture, mining, metallurgy, and the environment. Despite the advantages of agromining for the REEs production industry, key issues related to the environmental sustainability of the entire life cycle of this new concept have not been assessed yet. Hence, a comparative life cycle assessment (LCA) study was conducted to quantify the environmental footprints of REEs phytomining. The current LCA study aims to estimate and calculate environmental effects associated with phytomining by considering critical factors, such as climate change, land use, and ozone depletion. The results revealed that phytomining is an easy-to-use and environmentally sustainable approach to either eliminate REEs from polluted sites or produce REEs, offering a new source of such metals production. This LCA research provides guidelines for researchers active in developing a reliable relationship between agriculture, mining, metallurgy, and the environment to encounter soil pollution and keep the earth green and clean.

Keywords: phytoremediation, phytomining, life cycle assessment, environmental impacts, rare earth elements, hyperaccumulator

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1587 Ecological Concerns in Food Systems: An Ethnographical Approach on Vegan Impact in Governmentality

Authors: Jessica Gonzalez

Abstract:

Veganism, along with different types of vegetarianism, consists in the abstinence of animal products. Far from being only an alimentary regulation, it stands as a political posture against the food industry generating itself a set of beliefs, prohibitions, and attitudes that compel the individual to a reevaluation of his obligations towards the environment. Veganism defends animal rights and at the same time reinforces a different conception of natural resources embodying it in alimentary restrictions. These practices emerge in the context of alimentary modernity, which is characterized by bringing new concerns to the consumer. An increased skepticism towards the government ability to protect food supply; a notable distrust toward the market guaranties on providing safe food with sustainable techniques and the desire to react to the neoliberal forms of exploitation are some of its consequences of this phenomenon. This study aims to approach the concept of governmentality as a coproduced system of legitimized practices and knowledge, formed by the interaction of the different actors that are involved. In a scenario where the State seems to retreat from centralized regulation of food production giving up importance to citizens, dietary consultants, farmers, and stockbreeders, veganism plays its role on the conformation of distinctive forms of environmentalism, nature rights and responses to ecological crisis. The ethnographic method allows observing the mechanisms of interaction of consumers and discourses with the mainstream food system, providing evidence about the means of generation of new conceptions about nature and the environment. The paper focuses on how the dietary restrictions, consumption patterns and public discourses of vegans in Barcelona impact local consumption, demonstrating its relevance as a mechanism that associates particular concerns about food with political economy.

Keywords: animal rights, environmentalism, food system, governmentality, veganism

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1586 Transcriptomine: The Nuclear Receptor Signaling Transcriptome Database

Authors: Scott A. Ochsner, Christopher M. Watkins, Apollo McOwiti, David L. Steffen Lauren B. Becnel, Neil J. McKenna

Abstract:

Understanding signaling by nuclear receptors (NRs) requires an appreciation of their cognate ligand- and tissue-specific transcriptomes. While target gene regulation data are abundant in this field, they reside in hundreds of discrete publications in formats refractory to routine query and analysis and, accordingly, their full value to the NR signaling community has not been realized. One of the mandates of the Nuclear Receptor Signaling Atlas (NURSA) is to facilitate access of the community to existing public datasets. Pursuant to this mandate we are developing a freely-accessible community web resource, Transcriptomine, to bring together the sum total of available expression array and RNA-Seq data points generated by the field in a single location. Transcriptomine currently contains over 25,000,000 gene fold change datapoints from over 1200 contrasts relevant to over 100 NRs, ligands and coregulators in over 200 tissues and cell lines. Transcriptomine is designed to accommodate a spectrum of end users ranging from the bench researcher to those with advanced bioinformatic training. Visualization tools allow users to build custom charts to compare and contrast patterns of gene regulation across different tissues and in response to different ligands. Our resource affords an entirely new paradigm for leveraging gene expression data in the NR signaling field, empowering users to query gene fold changes across diverse regulatory molecules, tissues and cell lines, target genes, biological functions and disease associations, and that would otherwise be prohibitive in terms of time and effort. Transcriptomine will be regularly updated with gene lists from future genome-wide expression array and expression-sequencing datasets in the NR signaling field.

Keywords: target gene database, informatics, gene expression, transcriptomics

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1585 Multiplying Vulnerability of Child Health Outcome and Food Diversity in India

Authors: Mukesh Ravi Raushan

Abstract:

Despite consideration of obesity as a deadly public health issue contributing 2.6 million deaths worldwide every year developing country like India is facing malnutrition and it is more common than in Sub-Saharan Africa. About one in every three malnourished children in the world lives in India. The paper assess the nutritional health among children using data from total number of 43737 infant and young children aged 0-59 months (µ = 29.54; SD = 17.21) of the selected households by National Family Health Survey, 2005-06. The wasting was measured by a Z-score of standardized weight-for-height according to the WHO child growth standards. The impact of education with place of residence was found to be significantly associated with the complementary food diversity score (CFDS) in India. The education of mother was positively associated with the CFDS but the degree of performance was lower in rural India than their counterpart from urban. The result of binary logistic regression on wasting with WHO seven types of recommended food for children in India suggest that child who consumed the milk product food (OR: 0.87, p<0.0001) were less likely to be malnourished than their counterparts who did not consume, whereas, in case of other food items as the child who consumed food product of seed (OR: 0.75, p<0.0001) were less likely to be malnourished than those who did not. The nutritional status among children were negatively associated with the protein containing complementary food given the child as those child who received pulse in last 24 hour were less likely to be wasted (OR: 0.87, p<0.00001) as compared to the reference categories. The frequency to feed the indexed child increases by 10 per cent the expected change in child health outcome in terms of wasting decreases by 2 per cent in India when place of residence, education, religion, and birth order were controlled. The index gets improved as the risk for malnutrition among children in India decreases.

Keywords: CFDS, food diversity index, India, logistic regression

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1584 Psychical Impacts of Episiotomy: First Results

Authors: Clesse C., Lighezzolo-Alnot J., De Lavergne S.

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Considered as the most common surgical procedure worldwide, episiotomy can be defined as an incision around the vulva performed to enlarge it, in the aim of preventing the traumatic rupture of the perineum during childbirth. Rather mediatized, this practice raises many questions in the field of mental health, relayed by different users and health professionals. Today, is topicality is moderately hectic since many queries about the prophylactic exercise of episiotomy are subject to a relative consensus, particularly since WHO advocated in 1996 that only 10% of childbirths should involve an episiotomy. This indicator appeared after the publication of numerous results from randomized clinical trials. Unfortunately, these papers seem mostly centered about somatic impacts of episiotomy. From the side of psychological studies, they mostly integrate a major clinical methodological bias, especially considering that every primiparous woman is identical to the others face to the experience of parturition. In the aim to fill this lack of knowledge, we developed a longitudinal research starting in the 7th month of pregnancy and ending one year after delivery. We are studying in a comparative way different possible psychological consequences inherent to the use of episiotomy. To do this, we use a standardized methodology which combines semi-structured clinical interviews (IRMAG, IRMAN ...), free clinical interviews, a projective test (Rorschach) and five questionnaires (QIC, EPDS, CPQ WOMBLSQ4, SF36). Therefore, we can comprehend with shrewdness the question of psychic impacts of episiotomy in a qualitative and quantitative way by comparing it to other obstetric interventions. In this paper, we will present the first results obtained about a population of twenty-two primiparous women by focusing on body image, sexuality, quality of life, depressive affects, post-traumatic stress disorder and investment of the maternal role. Finally, we will consider the different implications and perspectives of this research which could improve the public health policies in the field of perinatal care.

Keywords: assessment, episiotomy, mental health, psychical impacts

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1583 The Effect of Extracts of 12 Local Medicinal Plants Against Uropathogenic Escherichia Coli

Authors: Hafida Merzouk

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Urinary tract infections are among the most serious public health issues in all age groups. Thus, the empirical therapy should based on local levels of resistance, as indicated in several studies from different countries, to effectively avoid the emergence of multidrug-resistant bacterial strains and recurrent infections. Numerous effective antibiotic treatments are available, but wouldbe ineffective for treating recurrent cystitis caused by a urinary tract infection, as well as the emergence of drug resistance. That iswhy the aim of this study was to highlight the antibacterial and the antioxidant activity of 11 medicinal plants used traditionally in Algeria against E. coli, the most responsible urinary tract infections. First, the extraction of total polyphenols with aqueous acetone showed variable yields. The highest yield was obtained by Asplenium trichomanes with 27%, followed by Petroselinum crispum and Ciannamomum cassia with an equal yield of 21%. Artemisia herba-alba gave the lowest yield (9%). The extracts of different plants showed variable contents of phenolic compounds. Reducing power and DPPH (2,2-diphenyl-1-picrylhydrazyl) scavenging activity revealed that most of the extracts studied had significant activity. The anti-free radical activity was very high in the extract of A splenium adiantum-nigrum compared with the other extracts studied, but Petroselinum crispum and Parietaria officinalis had the lowest reducing activity; Antibacterial activity was determined on E. coli strainsusing the diffusion, MICs (Minimum Inhibitory Concentrations) and MBCs (Minimum Bactericidal concentrations) methods. The strains tested were sensitive to most extracts studied, except Asplenium adiantum-nigrum extract, for which both strains showed resistance.

Keywords: E. coli, medicinal plants, phenolic compounds, urinary infections

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1582 Principles and Guidance for the Last Days of Life: Te Ara Whakapiri

Authors: Tania Chalton

Abstract:

In June 2013, an independent review of the Liverpool Care Pathway (LCP) identified a number of problems with the implementation of the LCP in the UK and recommended that it be replaced by individual care plans for each patient. As a result of the UK findings, in November 2013 the Ministry of Health (MOH) commissioned the Palliative Care Council to initiate a programme of work to investigate an appropriate approach for the care of people in their last days of life in New Zealand (NZ). The Last Days of Life Working Group commenced a process to develop national consensus on the care of people in their last days of life in April 2014. In order to develop its advice for the future provision of care to people in their last days of life, the Working Group (WG) established a comprehensive work programme and as a result has developed a series of working papers. Specific areas of focus included: An analysis of the UK Independent Review findings and an assessment of these findings to the NZ context. A stocktake of services providing care to people in their last days of life, including aged residential care (ARC); hospices; hospitals; and primary care. International and NZ literature reviews of evidence and best practice. Survey of family to understand the consumer perspective on the care of people in their last days of life. Key aspects of care that required further considerations for NZ were: Terminology: clarify terminology used in the last days of life and in relation to death and dying. Evidenced based: including specific review of evidence regarding, spiritual, culturally appropriate care as well as dementia care. Diagnosis of dying: need for both guidance around the diagnosis of dying and communication with family. Workforce issues: access to an appropriate workforce after hours. Nutrition and hydration: guidance around appropriate approaches to nutrition and hydration. Symptom and pain management: guidance around symptom management. Documentation: documentation of the person’s care which is robust enough for data collection and auditing requirements, not ‘tick box’ approach to care. Education and training: improved consistency and access to appropriate education and training. Leadership: A dedicated team or person to support and coordinate the introduction and implementation of any last days of life model of care. Quality indicators and data collection: model of care to enable auditing and regular reviews to ensure on-going quality improvement. Cultural and spiritual: address and incorporate any cultural and spiritual aspects. A final document was developed incorporating all the evidence which provides guidance to the health sector on best practice for people at end of life: “Principles and guidance for the last days of life: Te Ara Whakapiri”.

Keywords: end of life, guidelines, New Zealand, palliative care

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1581 The Right to Family Reunification of Immigrants in Spain

Authors: María José Benitez Jimenez

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This study seeks to make clear the importance of family reunification in order to establish consolidated habits of coexistence of immigrants, directly favoring the relationship of the family nucleus and indirectly the social integration of foreigners. In addition to the theoretical analysis of the subject, information has been reviewed by the National Institute of Statistics and Reports of Spanish organizations that compile data on immigrants and specifically on family reunification. The Spanish regulations on foreigners include the right of foreigners legally residing in Spain to regroup their families. The general conditions required to exercise this right are having legally resided in Spain for one year and having obtained authorization to reside for one more year. There are exceptions to the requirement of having resided for one year in our country. Article 39 of the Spanish Constitution, although it does not express what is to be understood as a family, does refer to the fact that ‘the public authorities ensure the social, economic and legal protection of the family’. Therefore for the Spanish State, the family institution, in a broad sense, enjoys a privileged treatment that is revealed in the Supreme Norm and that reflects the interest of our society to address the relationships that subjects have in their immediate environment. Although we are aware of the reluctant position of the Spanish Constitutional Court to consider as a fundamental right the right to family life despite being enshrined in Article 8 of the European Convention on Human Rights, it is questionable whether access to authorization for family reunification should be more uniform in terms of requirements related to nationality, employment or training of applicants in order to have an egalitarian character. The requirement of having resided one year in Spain to be able to request successful family reunification seems dispensable because if foreigners can obviate this requirement by having a certain status, its abolition would be feasible by equating all situations and benefiting foreigners in general. The achievement of this proposal would help to strengthen the family life of immigrants from the beginning of their life in Spain.

Keywords: family, immigrants, social integration, reunification

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