Search results for: background risk

Authors: Rofaida Ashour

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This study discusses the implementation of quality improvement initiatives aimed at reducing contamination rates in cultured karyotyping samples. The primary objective was to enhance patient outcomes through systematic audits and targeted staff engagement. Recognizing the critical impact of sample integrity on diagnostic accuracy, a thorough analysis was conducted to identify the root causes of contamination. The project involved two audit cycles, which facilitated a comprehensive assessment of adherence to local protocols. Key issues identified included lapses in the use of personal protective equipment (PPE) and inadequate awareness of proper sample handling procedures among staff. To address these challenges, a multi-faceted approach was adopted. Firstly, a presentation was delivered to the laboratory team emphasizing the significance of strict adherence to PPE guidelines during the collection and handling of samples. This session aimed to raise awareness and foster a culture of safety within the unit. Additionally, informative posters illustrating the correct procedures were strategically placed around the laboratory to serve as ongoing visual reminders for staff. Recognizing the heightened risk associated with patients exhibiting fever or signs of infection, special measures were introduced to manage their sample collection. These proactive strategies were designed to minimize the likelihood of introducing contaminated samples into the culture process. The results of the audits demonstrated a significant reduction in contamination rates, underscoring the effectiveness of the interventions. This experience reinforced the importance of continuous quality improvement in healthcare settings, particularly in ensuring the delivery of high-quality, safe, and efficient services. Conducting regular audits not only provided valuable insights into operational practices but also highlighted the critical role of active team engagement and a data-driven approach in decision-making. Effective communication and collaboration among team members emerged as essential components for the success of quality improvement initiatives.

Keywords: quality improvement, contamination rates, karyotyping samples, healthcare protocols, staff engagement

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Authors: Alireza Fallahfard, Ludwig Vinches, Stephane Halle

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In the workplace, the exposure level of airborne contaminants should be evaluated due to health and safety issues. It can be done by numerical models or experimental measurements, but the numerical approach can be useful when it is challenging to perform experiments. One of the simplest models is the well-mixed room (WMR) model, which has shown its usefulness to predict inhalation exposure in many situations. However, since the WMR is limited to gases and vapors, it cannot be used to predict exposure to aerosols. The main objective is to modify the WMR model to expand its application to exposure scenarios involving aerosols. To reach this objective, the standard WMR model has been modified to consider the deposition of particles by gravitational settling and Brownian and turbulent deposition. Three deposition models were implemented in the model. The time-dependent concentrations of airborne particles predicted by the model were compared to experimental results conducted in a 0.512 m3 chamber. Polystyrene particles of 1, 2, and 3 µm in aerodynamic diameter were generated with a nebulizer under two air changes per hour (ACH). The well-mixed condition and chamber ACH were determined by the tracer gas decay method. The mean friction velocity on the chamber surfaces as one of the input variables for the deposition models was determined by computational fluid dynamics (CFD) simulation. For the experimental procedure, the particles were generated until reaching the steady-state condition (emission period). Then generation stopped, and concentration measurements continued until reaching the background concentration (decay period). The results of the tracer gas decay tests revealed that the ACHs of the chamber were: 1.4 and 3.0, and the well-mixed condition was achieved. The CFD results showed the average mean friction velocity and their standard deviations for the lowest and highest ACH were (8.87 ± 0.36) ×10-2 m/s and (8.88 ± 0.38) ×10-2 m/s, respectively. The numerical results indicated the difference between the predicted deposition rates by the three deposition models was less than 2%. The experimental and numerical aerosol concentrations were compared in the emission period and decay period. In both periods, the prediction accuracy of the modified model improved in comparison with the classic WMR model. However, there is still a difference between the actual value and the predicted value. In the emission period, the modified WMR results closely follow the experimental data. However, the model significantly overestimates the experimental results during the decay period. This finding is mainly due to an underestimation of the deposition rate in the model and uncertainty related to measurement devices and particle size distribution. Comparing the experimental and numerical deposition rates revealed that the actual particle deposition rate is significant, but the deposition mechanisms considered in the model were ten times lower than the experimental value. Thus, particle deposition was significant and will affect the airborne concentration in occupational settings, and it should be considered in the airborne exposure prediction model. The role of other removal mechanisms should be investigated.

Keywords: aerosol, CFD, exposure assessment, occupational settings, well-mixed room model, zonal model

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Authors: Camila Lemos Pinto, Juliana Alves Carneiro, Patrícia Borges Botelho, João Felipe Mota

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Sarcopenia, a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, currently affects over 50 million people and increases the risk of adverse outcomes such as physical disability, poor quality of life and death. The aim of this study was to examine the efficacy of creatine supplementation associated with resistance training on muscle mass in the elderly. A 12-week, double blind, randomized, parallel group, placebo controlled trial was conducted. Participants were randomly allocated into one of the following groups: placebo with resistance training (PL+RT, n=14) and creatine supplementation with resistance training (CR + RT, n=13). The subjects from CR+RT group received 5 g/day of creatine monohydrate and the subjects from the PL+RT group were given the same dose of maltodextrin. Participants were instructed to ingest the supplement on non-training days immediately after lunch and on training days immediately after resistance training sessions dissolved in a beverage comprising 100 g of maltodextrin lemon flavored. Participants of both groups undertook a supervised exercise training program for 12 weeks (3 times per week). The subjects were assessed at baseline and after 12 weeks. The primary outcome was muscle mass, assessed by dual energy X-ray absorptiometry (DXA). The secondary outcome included diagnose participants with one of the three stages of sarcopenia (presarcopenia, sarcopenia and severe sarcopenia) by skeletal muscle mass index (SMI), handgrip strength and gait speed. CR+RT group had a significant increase in SMI and muscle (p<0.0001), a significant decrease in android and gynoid fat (p = 0.028 and p=0.035, respectively) and a tendency of decreasing in body fat (p=0.053) after the intervention. PL+RT only had a significant increase in SMI (p=0.007). The main finding of this clinical trial indicated that creatine supplementation combined with resistance training was capable of increasing muscle mass in our elderly cohort (p=0.02). In addition, the number of subjects diagnosed with one of the three stages of sarcopenia at baseline decreased in the creatine supplemented group in comparison with the placebo group (CR+RT, n=-3; PL+RT, n=0). In summary, 12 weeks of creatine supplementation associated with resistance training resulted in increases in muscle mass. This is the first research with elderly of both sexes that show the same increase in muscle mass with a minor quantity of creatine supplementation in a short period. Future long-term research should investigate the effects of these interventions in sarcopenic elderly.

Keywords: creatine, dietetic supplement, elderly, resistance training

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Authors: Lorand Ujhazi

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The vast majority of existing canonical studies about migration are focused on examining the general pastoral and legal regulations of the Catholic Church. The weakness of this approach is that it ignores a number of important factors; like the financial, legal and personal circumstances of a particular church or the canonical position of certain organizations which actually look after the immigrants. This paper is a case study, which analyses the current and historical migration related policies and activities of the Catholic Church in Hungary. To achieve this goal the study uses canon law, historical publications, various instructions and communications issued by church superiors, Hungarian and foreign media reports and the relevant Hungarian legislation. The paper first examines how the Hungarian Catholic Church assisted migrants like Armenians fleeing from the Ottoman Empire, Poles escaping during the Second World War, East German and Romanian citizens in the 1980s and refugees from the former Yugoslavia in the 1990s. These events underline the importance of past historical experience in the development of contemporary pastoral and humanitarian policy of the Catholic Church in Hungary. Then the paper turns to the events of the ongoing crisis by describing the unique challenges faced by churches in transit countries like Hungary. Then the research contrasts these findings with the typical responsibilities of churches in countries which are popular destinations for immigrants. The next part of the case study focuses on the changes to the pre-crisis legal and canonical framework which influenced the actions of hierarchical and charity organizations in Hungary. Afterwards, the paper illustrates the dangers of operating in an unclear legal environment, where some charitable activities of the church like a fundraising campaign may be interpreted as a national security risk by state authorities. Then the paper presents the reactions of Hungarian academics to the current migration crisis and finally it offers some proposals how to improve parts of Canon Law which govern immigration. The conclusion of the paper is that during the formulation of the central refugee policy of the Catholic Church decision makers must take into consideration the peculiar circumstances of its particular churches. This approach may prevent disharmony between the existing central regulations, the policy of the Vatican and the operations of the local church organizations.

Keywords: canon law, Catholic Church, civil law, Hungary, immigration, national security

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Authors: Nahal Najafi, Afsaneh Yegdaneh, Sedigheh Saberi

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Introduction: Leishmaniasis poses a substantial global risk, affecting millions and resulting in thousands of cases each year in endemic regions. Challenges in current leishmaniasis treatments include drug resistance, high toxicity, and pancreatitis. Marine compounds, particularly brown algae, serve as a valuable source of inspiration for discovering treatments against Leishmania. Material and method: Padina pavonica was collected from the Persian Gulf. The seaweeds were dried and extracted with methanol: ethylacetate (1:1). The extract was partitioned to hexane (Hex), dicholoromethane (DCM), butanol, and water by Kupchan partitioning method. Hex partition was fractionated by silica gel column chromatography to 10 fractions (Fr. 1-10). Fr. 6 was further separated by the normal phase HPLC method to yield compounds 1-3. The structures of isolated compounds were elucidated by NMR, Mass, and other spectroscopic methods. Hex and DCM partitions, Fr. 6 and compounds 1-3, were tested for anti-leishmanicidal activity. RAW cell lines were cultured in enriched RPMI (10% FBS, 1% pen-strep) in a 37°C CO2 5% incubator, while promastigote cells were initially cultured in NNN culture and subsequently transferred to the aforementioned medium. Cytotoxicity was assessed using MTT tests, anti-promastigote activity was evaluated through Hemocytometer chamber promastigote counting, and the impact of amastigote damage was determined by counting amastigotes within 100 macrophages. Results: NMR and Mass identified isolated compounds as fucosterol and two sulfoquinovosyldiacylglycerols (SQDG). Among the samples tested, Fr.6 exhibited the highest cytotoxicity (CC50=60.24), while compound 2 showed the lowest cytotoxicity (CC50=21984). Compound 1 and dichloromethane fraction demonstrated the highest and lowest anti-promastigote activity (IC50=115.7, IC50=16.42, respectively), and compound 1 and hexane fraction exhibited the highest and lowest anti-amastigote activity (IC50=7.874, IC50=40.18, respectively). Conclusion: All six samples, including Hex and DCM partitions, Fr.6, and compounds 1-3, demonstrate a noteworthy correlation between rising concentration and time, with a statistically significant P-value of ≤0.05. Considering the higher selectivity index of compound 2 compared to others, it can be inferred that the presence of sulfur groups and unsaturated chains potentially contributes to these effects by impeding the DNA polymerase, which, of course, needs more research.

Keywords: Padina, leishmania, sulfoquinovosyldiacylglycerol, cytotoxicity

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Authors: Tzipi Eshet

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The importance of environmental education as part of a national strategy to promote the environment is recognized around the world. Lecturers at colleges of teacher education have considerable responsibility, directly and indirectly, for the environmental literacy of students who will end up teaching in the school system. This study examined whether lecturers in colleges of teacher education and teacher training in Israel, are able and willing to develop among the students, environmental literacy. Capability and readiness is assessed by evaluating the level of environmental literacy dimensions that include knowledge on environmental issues, positions related to the environmental agenda and "green" patterns of behavior in everyday life. The survey included 230 lecturers from 22 state colleges coming from various sectors (secular, religious, and Arab), from different academic fields and different personal backgrounds. Firstly, the results show that the higher the commitment to environmental issues, the lower the satisfaction with the current situation. In general, the respondents show positive environmental attitudes in all categories examined, they feel that they can personally influence responsible environmental behavior of others and are able to internalize environmental education in schools and colleges; they also report positive environmental behavior. There are no significant differences between teachers of different background characteristics when it comes to behavior patterns that generate personal income funds (e.g. returning bottles for deposit). Women show a more responsible environmental behavior than men. Jewish lecturers, in most categories, show more responsible behavior than Druze and Arab lecturers; however, when referring to positions, Arabs and Druze have a better sense in their ability to influence the environmental agenda. The Knowledge test, which included 15 questions, was mostly based on basic environmental issues. The average score was adequate - 83.6. Science lecturers' environmental literacy is higher than the other lecturers significantly. The larger the environmental knowledge base is, they are more environmental in their attitudes, and they feel more responsible toward the environment. It can be concluded from the research findings, that knowledge is a fundamental basis for developing environmental literacy. Environmental knowledge has a positive effect on the development of environmental commitment that is reflected in attitudes and behavior. This conclusion is probably also true of the general public. Hence, there is a great importance to the expansion of knowledge among the general public and teacher educators in particular on environmental. From the open questions in the survey, it is evident that most of the lecturers are interested in the subject and understand the need to integrate environmental issues in the colleges, either directly by teaching courses on the environment or indirectly by integrating environmental issues in different professions as well as asking the students to set an example (such as, avoid unnecessary printing, keeping the environment clean). The curriculum at colleges should include a variety of options for the development and enhancement of environmental literacy of student teachers, but first there must be a focus on bringing their teachers to a high literacy level so they can meet the difficult and important task they face.

Keywords: colleges of teacher education, environmental literacy, environmental education, teacher's teachers

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Authors: Bouchekoua Myriam, Aloui Dorsaf, Trabelsi Sonia

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Introduction Food hygiene in hospitals is important, particularly among patients who could be more vulnerable than healthy subjects to microbiological and nutritional risks. The consumption of contaminated food may be responsible for foodborne diseases, which can be severe among hospitalized patients, especially those immunocompromised. The aim of our study was to assess the state of hygiene in the internal catering department of a Tunisian hospital. Methodology and major results: A prospective study was conducted for one year in the Parasitology-Mycology laboratory of Charles Nicolle Hospital. Samples were taken from the kitchen staff, worktops, and cooking utensils used in the internal catering department. Thirty one employees have benefited from stool exams and scotch tape in order to evaluate the degree of infestation of parasites. 35% of stool exams were positive. Protozoa were the only parasites detected. Blastocystis sp was the species mostly found in nine food handlers. Its role as a human pathogen is still controversial. Pathogenic protozoa were detected in two food handlers (Giardia intestinalis in one person and Dientamoeba fragilis in the other one. Non-pathogenic protozoa were found in two cases; among them, only one had digestive symptoms without a statistically significant association with the carriage of intestinal parasites. Moreover, samples were performed from the hands of the staff in order to search for a fungal carriage. Thus, 25 employees (81%) were colonized by fungi, including molds. Besides, mycological examination among food handlers with a suspected dermatomycosis for diagnostic confirmation concluded foot onychomycosis in 32% of cases and interdigital intertrigo in 26%. Only one person had hand onychomycosis. Among the 17 samples taken from worktops and kitchen utensils, fungal contamination was detected in 13 sites. Hot and cold equipment were the most contaminated. Molds were mainly identified as belonging to five different genera. Cladosporium sp was predominant. Conclusion: In the view of the importance of intestinal parasites among food handlers, the intensity of fungi hand carriage among these employees, and the high level of fungal contamination in worktops and kitchen utensils, a reinforcement of hygiene measures is more than essential in order to minimize the alimentary contamination-risk.

Keywords: hospital kitchen, environment, intestinal parasitosis, fungal carriage, fungal contamination

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Authors: Ana Ferraz, Martim Santos, M. Graça Pereira

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Distress among parents of children with acute lymphoblastic leukemia (ALL) is common during treatment and can persist several years post-diagnosis, impacting the adjustment of children and parents themselves. Current evidence is needed to examine the scope and nature of parental distress in childhood ALL. This review focused on associated variables, predictors, and outcomes of parental distress following their ALL diagnosis of their child. PubMed, Web of Science, and PsycINFO databases were searched for English and Spanish papers published from 1983 to 2021. PRISMA statement was followed, and papers were evaluated through a standardized methodological quality assessment tool (NHLBI). Of the 28 papers included, 16 were evaluated as fair, eight as good, and four as poor. Regarding results, 11 papers reported subgroup differences, and 15 found potential predictors of parental distress, including sociodemographic, psychosocial, psychological, family, health, and ALL-specific variables. Significant correlations were found between parental distress, social support, illness cognitions, and resilience, as well as contradictory results regarding the impact of sociodemographic variables on parental distress. Family cohesion and caregiver burden were associated with distress, and the use of healthy coping strategies was associated with less anxiety. Caregiver strain contributed to distress, and the overall impact of illness positively predicted anxiety in mothers and somatization in fathers. Differences in parental distress were found regarding group risk, time since diagnosis, and treatment phases. Thirteen papers explored the outcomes of parental distress on psychological, family, health, and social/education outcomes. Parental distress was the most important predictor of family strain. Significant correlations were found between parental distress at diagnosis and further psychological adjustment of parents themselves and their children. Most papers reported correlations between parental distress on children’s adjustment and quality of life, although few studies reported no association. Correlations between maternal depression and child participation in education and social life were also found. Longitudinal studies are needed to better understand parental distress and its consequences on health outcomes, in particular. Future interventions should focus mainly on parents on distress reduction and psychological adjustment, both in parents and children over time.

Keywords: childhood acute lymphoblastic leukemia, family, parental distress, psychological adjustment, quality of life

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Authors: Anne-Margré C. Vink

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Background: Food-related allergies and intolerances are frequently occurring in dogs. Diagnosis and monitoring according to ‘Golden Standard’ of elimination efficiency are time-consuming, expensive, and requires expert clinical setting. In order to facilitate rapid and robust, quantitative testing of intolerance, and determining the individual offending foods, a serological test is implicated. Method: As we developed Medisynx IgG Human Screening Test ELISA before and the dog’s immune system is most similar to humans, we were able to develop Medisynx IgG Dog Screening Test ELISA as well. In this study, 47 dogs suffering from Canine Atopic Dermatitis (CAD) and several secondary induced reactions were included to participate in serological Medisynx IgG Dog Screening Test ELISA (within < 0,02 % SD). Results were expressed as titers relative to the standard OD readings to diagnose alimentary induced diseases and monitoring the efficacy of an individual eliminating diet in dogs. Split sample analysis was performed by independently sending 2 times 3 ml serum under two unique codes. Results: The veterinarian monitored these dogs to check dog’ results at least at 3, 7, 21, 49, 70 days and after period of 6 and 12 months on an individual negative diet and a positive challenge (retrospectively) at 6 months. Data of each dog were recorded in a screening form and reported that a complete recovery of all clinical manifestations was observed at or less than 70 days (between 50 and 70 days) in the majority of dogs(44 out of 47 dogs =93.6%). Conclusion: Challenge results showed a significant result of 100% in specificity as well as 100% positive predicted value. On the other hand, sensitivity was 95,7% and negative predictive value was 95,7%. In conclusion, an individual diet based on IgG ELISA in dogs provides a significant improvement of atopic dermatitis and pruritus including all other non-specific defined allergic skin reactions as erythema, itching, biting and gnawing at toes, as well as to several secondary manifestations like chronic diarrhoea, chronic constipation, otitis media, obesity, laziness or inactive behaviour, pain and muscular stiffness causing a movement disorders, excessive lacrimation, hyper behaviour, nervous behaviour and not possible to stay alone at home, anxiety, biting and aggressive behaviour and disobedience behaviour. Furthermore, we conclude that a relatively more severe systemic candidiasis, as shown by relatively higher titer (class 3 and 4 IgG reactions to Candida albicans), influence the duration of recovery from clinical manifestations in affected dogs. These findings are consistent with our preliminary human clinical studies.

Keywords: allergy, canine atopic dermatitis, CAD, food allergens, IgG-ELISA, food-incompatibility

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Authors: Mareike Dornhoefer, Madjid Fathi

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Water supply and water quality are key problems of mankind at the moment and - due to increasing population - in the future. Management disciplines like water, environment and quality management therefore need to closely interact, to establish a high level of water quality and to guarantee water supply in all parts of the world. Groundwater remediation is one aspect in this process. From a knowledge management perspective it is only possible to solve complex ecological or environmental problems if different factors, expert knowledge of various stakeholders and formal regulations regarding water, waste or chemical management are interconnected in form of a knowledge base. In general knowledge management focuses the processes of gathering and representing existing and new knowledge in a way, which allows for inference or deduction of knowledge for e.g. a situation where a problem solution or decision support are required. A knowledge base is no sole data repository, but a key element in a knowledge based system, thus providing or allowing for inference mechanisms to deduct further knowledge from existing facts. In consequence this knowledge provides decision support. The given paper introduces an environmental knowledge system in water management. The proposed environmental knowledge system is part of a research concept called Green Knowledge Management. It applies semantic technologies or concepts such as ontology or linked open data to interconnect different data and information sources about environmental aspects, in this case, water quality, as well as background material enriching an established knowledge base. Examples for the aforementioned ecological or environmental factors threatening water quality are among others industrial pollution (e.g. leakage of chemicals), environmental changes (e.g. rise in temperature) or floods, where all kinds of waste are merged and transferred into natural water environments. Water quality is usually determined with the help of measuring different indicators (e.g. chemical or biological), which are gathered with the help of laboratory testing, continuous monitoring equipment or other measuring processes. During all of these processes data are gathered and stored in different databases. Meanwhile the knowledge base needs to be established through interconnecting data of these different data sources and enriching its semantics. Experts may add their knowledge or experiences of previous incidents or influencing factors. In consequence querying or inference mechanisms are applied for the deduction of coherence between indicators, predictive developments or environmental threats. Relevant processes or steps of action may be modeled in form of a rule based approach. Overall the environmental knowledge system supports the interconnection of information and adding semantics to create environmental knowledge about water environment, supply chain as well as quality. The proposed concept itself is a holistic approach, which links to associated disciplines like environmental and quality management. Quality indicators and quality management steps need to be considered e.g. for the process and inference layers of the environmental knowledge system, thus integrating the aforementioned management disciplines in one water management application.

Keywords: water quality, environmental knowledge system, green knowledge management, semantic technologies, quality management

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Authors: Qian Wang, Haibo Gu

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To drive practical interpretations and applications of various policies in building the transnational education joint-ventures, middle managers learn to navigate through uncertainties and ambiguities. However, the current literature views very little about those middle managers’ experiences, perceptions, and practices. This paper takes the empirical approach and aims to uncover the middle managers’ experiences by conducting interviews, campus visits, and document analysis. Following the qualitative research method approach, the researchers gathered information from a mixture of fourteen foreign and Chinese managers. Their perceptions of the China-foreign cooperation in higher education and their perceived roles have offered important, valuable insights to this group of people’s attitudes and management performances. The diverse cultural and demographic backgrounds contributed to the significance of the study. There are four key findings. One, middle managers’ immediate micro-contexts and individual attitudes are the top two influential factors in managers’ performances. Two, the foreign middle managers showed a stronger sense of self-identity in risk-taking. Three, the Chinese middle managers preferred to see difficulties as part of their assigned responsibilities. Four, middle managers in independent universities demonstrated a stronger sense of belonging and fewer frustrations than middle managers in secondary institutes. The researchers propose that training for managers in a transnational educational setting should consider these discoveries when select fitting topics and content. In particular, middle managers should be better prepared to anticipate their everyday jobs in the micro-environment; hence, information concerning sponsor organizations’ working culture is as essential as knowing the national and local regulations, and socio-culture. Different case studies can help the managers to recognize and celebrate the diversity in transnational education. Situational stories can help them to become aware of the diverse and wide range of work contexts so that they will not feel to be left alone when facing challenges without relevant previous experience or training. Though this research is a case study based in the Chinese transnational higher education setting, the implications could be relevant and comparable to other transnational higher education situations and help to continue expanding the potential applications in this field.

Keywords: educational management, middle manager performance, transnational higher education

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Authors: Kenny Chi Man Chui

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Background: In Chinese culture, the traditional equivalent term for English dementia is chi dai zheng, which, whether translated as ‘insanity’ or ‘idiocy’ carries a sharply negative connotation. In fact, even though the traditional name for dementia has evolved, from chi dai zheng to shi zhi zheng, nao tui hua zheng or ren zhi zhang ai zheng, educating the population about more respectful terms for the condition and promoting a positive understanding about people with dementia in society have proven to be time-intensive endeavors. By extension, the use of such terms promotes the perception that people with dementia undergo a ‘total loss of self’ or experience a ‘living death’ or ‘social death’. Both in Asia and elsewhere, the appropriate nomenclature for dementia remains controversial, and different medical and healthcare professionals in Hong Kong have taken various stances on how to refer to the condition there. Indeed, how this negative perception affects the interaction between people with dementia and the surrounding others? Methodology: Qualitative research with the concept of postmodernism, interpretivism, and Foucauldian theory was adopted as frameworks in applying participatory observations, in-depth interviews, and other qualitative methods. First, ten people with dementia—one man and nine women—living in two residential care homes in Hong Kong were interviewed, as were ten members of the care staff, all of whom were women. Next, to coach the staff in understanding the feelings and self-perceptions of people with dementia, two reflective training sessions were provided. Afterward, to assess the impact of the training sessions on the staff, two focus groups were held. Findings: The findings revealed that residents with dementia did not perceive themselves as being ‘demented’ and were confused by not getting responses from the others. From the understanding of care staff, they perceived the residents as being ‘demented’, desolate troublemakers. They described people with dementia as ‘naughty children’ who should be controlled and be punished while treated them as ‘psychiatric patients’ who could be ignored and be mute. “Psychosocial restraint” happened regarding the discrepancy of perception between people with dementia and the care staff. People with dementia did not think that their confusion of memory was related to dementia or, frankly speaking, they did not know what dementia was. When others treated them as ‘demented patients, the residents with mild to moderate dementia fiercely rejected that designation and reported a host of negative feelings, hence the fluctuations of mood and emotion noted by the care staff. Conclusion: As the findings revealed, the people with dementia were also discontent with the care arrangements in the care homes, felt abandoned by others and worried about bothering others. Their shifting emotional states and moods were treated as the Behavioral and Psychological symptoms of Dementia (BPSD), which nothing can do reported by the care staff in the residential care homes. People with dementia become social withdrawal or isolated in daily living, which should be alert and be changed by the social work professionals about the occurrence of “psychosocial restraint” in dementia care.

Keywords: psychosocial restraint, qualitative research, social work with dementitude, voice of people with dementia

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Authors: Abraham Ampong

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BACKGROUND AND SIGNIFICANCE OF THE STUDY: The development of information technology and its influence today is inevitable in the world of education. The development of information technology and communication (ICT) has an impact on the use of teaching aids such as computers and the Internet, for example, E-learning. E-learning is a learning process attained through electronic means. But learning is not merely technology because learning is essentially more about the process of interaction between teacher, student, and source study. The main purpose of the study is to investigate learners’ online learning experiences in a blended learning approach, evaluate how learners’ experience of an online learning environment affects the blended learning approach and examine the future of online learning in a blended learning environment. Blended learning pedagogies have been recognized as a path to improve teacher’s instructional strategies for teaching using technology. Blended learning is perceived to have many advantages for teachers and students, including any-time learning, anywhere access, self-paced learning, inquiry-led learning and collaborative learning; this helps institutions to create desired instructional skills such as critical thinking in the process of learning. Blended learning as an approach to learning has gained momentum because of its widespread integration into educational organizations. METHODOLOGY: Based on the research objectives and questions of the study, the study will make use of the qualitative research approach. The rationale behind the selection of this research approach is that participants are able to make sense of their situations and appreciate their construction of knowledge and understanding because the methods focus on how people understand and interpret their experiences. A case study research design is adopted to explore the situation under investigation. The target population for the study will consist of selected students from selected universities. A simple random sampling technique will be used to select the targeted population. The data collection instrument that will be adopted for this study will be questions that will serve as an interview guide. An interview guide is a set of questions that an interviewer asks when interviewing respondents. Responses from the in-depth interview will be transcribed into word and analyzed under themes. Ethical issues to be catered for in this study include the right to privacy, voluntary participation, and no harm to participants, and confidentiality. INDICATORS OF THE MAJOR FINDINGS: It is suitable for the study to find out that online learning encourages timely feedback from teachers or that online learning tools are okay to use without issues. Most of the communication with the teacher can be done through emails and text messages. It is again suitable for sampled respondents to prefer online learning because there are few or no distractions. Learners can have access to technology to do other activities to support their learning”. There are, again, enough and enhanced learning materials available online. CONCLUSION: Unlike the previous research works focusing on the strengths and weaknesses of blended learning, the present study aims at the respective roles of its two modalities, as well as their interdependencies.

Keywords: online learning, blended learning, technologies, teaching methods

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Authors: A. F. Huseynov, N. T. Mardanov, J. Y. Nakhchivanski

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This practical research is aimed to improve the management quality and efficiency of public administration agencies providing e-services. The monitoring system developed will provide continuous review of the websites compliance with the selected indicators, their evaluation based on the selected indicators and ranking of services according to the quality criteria. The responsible departments in the government agencies were surveyed; the questionnaire includes issues of management and feedback, e-services provided, and the application of information systems. By analyzing the main affecting factors and barriers, the recommendations will be given that lead to the relevant decisions to strengthen the state agencies competencies for the management and the provision of their services. Component 1. E-services monitoring system. Three separate monitoring activities are proposed to be executed in parallel: Continuous tracing of e-government sites using built-in web-monitoring program; this program generates several quantitative values which are basically related to the technical characteristics and the performance of websites. The expert assessment of e-government sites in accordance with the two general criteria. Criterion 1. Technical quality of the site. Criterion 2. Usability/accessibility (load, see, use). Each high-level criterion is in turn subdivided into several sub-criteria, such as: the fonts and the color of the background (Is it readable?), W3C coding standards, availability of the Robots.txt and the site map, the search engine, the feedback/contact and the security mechanisms. The on-line survey of the users/citizens – a small group of questions embedded in the e-service websites. The questionnaires comprise of the information concerning navigation, users’ experience with the website (whether it was positive or negative), etc. Automated monitoring of web-sites by its own could not capture the whole evaluation process, and should therefore be seen as a complement to expert’s manual web evaluations. All of the separate results were integrated to provide the complete evaluation picture. Component 2. Assessment of the agencies/departments efficiency in providing e-government services. - the relevant indicators to evaluate the efficiency and the effectiveness of e-services were identified; - the survey was conducted in all the governmental organizations (ministries, committees and agencies) that provide electronic services for the citizens or the businesses; - the quantitative and qualitative measures are covering the following sections of activities: e-governance, e-services, the feedback from the users, the information systems at the agencies’ disposal. Main results: 1. The software program and the set of indicators for internet sites evaluation has been developed and the results of pilot monitoring have been presented. 2. The evaluation of the (internal) efficiency of the e-government agencies based on the survey results with the practical recommendations related to the human potential, the information systems used and e-services provided.

Keywords: e-government, web-sites monitoring, survey, internal efficiency

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Authors: Minjuan Sun

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Ever since the late 1990s, China has experienced explosive growth in consumer lending, especially in short-term consumer loans, among which, the growth rate of non-bank lending has surpassed bank lending due to the development in financial technology. On the other hand, China does not have a universal credit scoring and registration system that can guide lenders during the processes of credit evaluation and risk control, for example, an individual’s bank credit records are not available for online lenders to see and vice versa. Given this context, the purpose of this paper is three-fold. First, we explore if and how alternative digital footprint data can be utilized to assess borrower’s creditworthiness. Then, we perform a comparative analysis of machine learning methods for the canonical problem of credit default prediction. Finally, we analyze, from an institutional point of view, the necessity of establishing a viable and nationally universal credit registration and scoring system utilizing online digital footprints, so that more people in China can have better access to the consumption loan market. Two different types of digital footprint data are utilized to match with bank’s loan default records. Each separately captures distinct dimensions of a person’s characteristics, such as his shopping patterns and certain aspects of his personality or inferred demographics revealed by social media features like profile image and nickname. We find both datasets can generate either acceptable or excellent prediction results, and different types of data tend to complement each other to get better performances. Typically, the traditional types of data banks normally use like income, occupation, and credit history, update over longer cycles, hence they can’t reflect more immediate changes, like the financial status changes caused by the business crisis; whereas digital footprints can update daily, weekly, or monthly, thus capable of providing a more comprehensive profile of the borrower’s credit capabilities and risks. From the empirical and quantitative examination, we believe digital footprints can become an alternative information source for creditworthiness assessment, because of their near-universal data coverage, and because they can by and large resolve the "thin-file" issue, due to the fact that digital footprints come in much larger volume and higher frequency.

Keywords: credit score, digital footprint, Fintech, machine learning

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Authors: A. Venkatakrishnan, M. Juneja, S. Kapoor

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Background: Gastrointestinal dysfunction is an emerging co morbidity seen in autism and may further strengthen the association between autism and celiac disease. This is supported by increased rates (22-70%) of gastrointestinal symptoms like diarrhea, constipation, abdominal discomfort/pain, and gastrointestinal inflammation in children with the etiology of autism is still elusive. In addition to genetic factors, environmental factors such as toxin exposure, intrauterine exposure to certain teratogenic drugs, are being proposed as possible contributing factors in the etiology of Autism Spectrum Disorders (ASD) in cognizance with reports of increased gut permeability and high rates of gastrointestinal symptoms noted in children with ASD, celiac disease has also been proposed as a possible etiological factor. Despite insufficient evidence regarding the benefit of restricted diets in Autism, GFD has been promoted as an alternative treatment for ASD. This study attempts to discern any correlation between ASD and celiac disease. Objective: This cross sectional study aims to determine the proportion of celiac disease in children with ASD. Methods: Study included 155 participants aged 2-12 yrs, diagnosed as ASD as per DSM-5 attending the child development center at a tertiary care hospital in Northern India. Those on gluten free diet or having other autoimmune conditions were excluded. A detailed Performa was filled which included sociodemographic details, history of gastrointestinal symptoms, anthropometry, systemic examination, and pertinent psychological testing was done using was assessed using Developmental Profile-3(DP-3) for Developmental Quotient, Childhood Autism Rating Scale-2 (CARS-2) for severity of ASD, Vineland Adaptive Behavior Scales (VABS) for adaptive behavior, Child Behavior Checklist (CBCL) for behavioral problems and BAMBI (Brief Autism Mealtime Behavior Scales) for feeding problems. Screening for celiac was done by TTG-IgA levels, and total serum IgA levels were measured to exclude IgA deficiency. Those with positive screen were further planned for HLA typing and endoscopic biopsy. Results: A total of 155 cases were included, out of which 5 had low IgA levels and were hence excluded from the study. The rest 150 children had TTG levels below the ULN and normal total serum IgA level. History of Gastrointestinal symptoms was present in 51 (34%) cases abdominal pain was the most frequent complaint (16.6%), followed by constipation (12.6%). Diarrhea was seen in 8 %. Gastrointestinal symptoms were significantly more common in children with ASD above 5 yrs (p-value 0.006) and those who were verbal (p = 0.000). There was no significant association between socio-demographic factors, anthropometric data, or severity of autism with gastrointestinal symptoms. Conclusion: None of the150 patients with ASD had raised TTG levels; hence no association was found between ASD and celiac disease. There is no justification for routine screening for celiac disease in children with ASD. Further studies are warranted to evaluate association of Non Celiac Gluten Sensitivity with ASD and any role of gluten-free diet in such patients.

Keywords: autism, celiac, gastrointestinal, gluten

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Authors: Ghasem Yazdanpanah, Mona Kakavand, Hassan Niknejad

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Objectives: An important issue in tissue engineering (TE) is hemocompatibility. The current engineered vessels are seriously at risk of thrombus formation and stenosis. Amnion (AM) is the innermost layer of fetal membranes that consists of epithelial and mesenchymal sides. It has the advantages of low immunogenicity, anti-inflammatory and anti-bacterial properties as well as good mechanical properties. We recently introduced the amnion as a natural biomaterial for tissue engineering. In this study, we have evaluated hemocompatibility of amnion as potential biomaterial for tissue engineering. Materials and Methods: Amnions were derived from placentas of elective caesarean deliveries which were in the gestational ages 36 to 38 weeks. Extracted amnions were washed by cold PBS to remove blood remnants. Blood samples were obtained from healthy adult volunteers who had not previously taken anti-coagulants. The blood samples were maintained in sterile tubes containing sodium citrate. Plasma or platelet rich plasma (PRP) were collected by blood sample centrifuging at 600 g for 10 min. Hemocompatibility of the AM samples (n=7) were evaluated by measuring of activated partial thromboplastin time (aPTT), prothrombin time (PT), hemolysis, and platelet aggregation tests. P-selectin was also assessed by ELISA. Both epithelial and mesenchymal sides of amnion were evaluated. Glass slide and expanded polytetrafluoroethylene (ePTFE) samples were defined as control. Results: In comparison with glass as control (13.3 ± 0.7 s), prothrombin time was increased significantly while each side of amnion was in contact with plasma (p<0.05). There was no significant difference in PT between epithelial and mesenchymal surfaces (17.4 ± 0.7 s vs. 15.8 ± 0.7 s, respectively). However, aPPT was not significantly changed after incubation of plasma with amnion epithelial and mesenchymal surfaces or glass (28.61 ± 1.39 s, 31.4 ± 2.66 s, glass, 30.76 ± 2.53 s, respectively, p>0.05). Amnion surfaces, ePTFE and glass samples have less hemolysis induction than water considerably (p<0.001), in which no differences were detected. Platelet aggregation measurements showed that platelets were less stimulated by the amnion epithelial and mesenchymal sides, in comparison with ePTFE and glass. In addition, reduction in amount of p-selectin, as platelet activation factor, after incubation of samples with PRP indicated that amnion has less stimulatory effects on platelets than ePTFE and glass. Conclusion: Amnion as a natural biomaterial has the potential to be used in tissue engineering. Our results suggest that amnion has appropriate hemocompatibility to be employed as a vascular substitute.

Keywords: amnion, hemocompatibility, tissue engineering, biomaterial

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Authors: Divya Kanchibhotla, Shashank Kulkarni, Shweta Singh

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Chronic stress and sleep quality reduces mental health and increases the risk of developing depression and anxiety as well. There is increasing evidence for the utility of meditation as an adjunct clinical intervention for conditions like depression and anxiety. The present study is an attempt to explore the impact of Sahaj Samadhi Meditation (SSM), a category of Automatic Self Transcending Meditation (ASTM), on perceived stress and sleep quality in adults. The study design was a single group pre-post assessment. Perceived Stress Scale (PSS) and the Pittsburgh Sleep Quality Index (PSQI) were used in this study. Fifty-two participants filled PSS, and 60 participants filled PSQI at the beginning of the program (day 0), after two weeks (day 16) and at two months (day 60). Significant pre-post differences for the perceived stress level on Day 0 - Day 16 (p < 0.01; Cohen's d = 0.46) and Day 0 - Day 60 (p < 0.01; Cohen's d = 0.76) clearly demonstrated that by practicing SSM, participants experienced reduction in the perceived stress. The effect size of the intervention observed on the 16th day of assessment was small to medium, but on the 60th day, a medium to large effect size of the intervention was observed. In addition to this, significant pre-post differences for the sleep quality on Day 0 - Day 16 and Day 0 - Day 60 (p < 0.05) clearly demonstrated that by practicing SSM, participants experienced improvement in the sleep quality. Compared with Day 0 assessment, participants demonstrated significant improvement in the quality of sleep on Day 16 and Day 60. The effect size of the intervention observed on the 16th day of assessment was small, but on the 60th day, a small to medium effect size of the intervention was observed. In the current study we found out that after practicing SSM for two months, participants reported a reduction in the perceived stress, they felt that they are more confident about their ability to handle personal problems, were able to cope with all the things that they had to do, felt that they were on top of the things, and felt less angered. Participants also reported that their overall sleep quality improved; they took less time to fall asleep; they had less disturbances in sleep and less daytime dysfunction due to sleep deprivation. The present study provides clear evidence of the efficacy and safety of non-pharmacological interventions such as SSM in reducing stress and improving sleep quality. Thus, ASTM may be considered a useful intervention to reduce psychological distress in healthy, non-clinical populations, and it can be an alternative remedy for treating poor sleep among individuals and decreasing the use of harmful sedatives.

Keywords: automatic self transcending meditation, Sahaj Samadhi meditation, sleep, stress

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Authors: Mustafa M. Donma, Ayşen Haksayar, Bahadır Batar, Buse Tepe, Birol Topçu, Orkide Donma

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Childhood obesity is an ever-increasing health problem. The Association of obesity with severe chronic diseases such as diabetes and cardiovascular diseases makes the problem life-threatening. Aside from psychological, societal and metabolic factors, genetic polymorphisms have gained importance concerning etiology in recent years. The aim of this study was to evaluate the relationship between rs10455872 gene polymorphism in the Lipoprotein (a) locus and the development of childhood obesity. This was a prospective study carried out according to the Helsinki Declarations. The study protocol was approved by the Institutional Ethics Committee. This study was supported by Tekirdag Namik Kemal University Rectorate, Scientific Research Projects Coordination Unit. Project No: NKUBAP.02.TU.20.278. A total of 180 children (103 obese (OB) and 77 healthy), aged 6-18 years, without any acute or chronic disease, participated in the study. Two different groups were created: OB and healthy control. Each group was divided into two further groups depending on the nature of the polymorphism. Anthropometric measurements were taken during the detailed physical examination. Laboratory tests and TANITA measurements were performed. For the statistical evaluations, SPSS version 28.0 was used. A P-value smaller than 0.05 was the statistical significance degree. The distribution of lipoprotein (a) rs10455872 gene polymorphism did not differ between OB and healthy children. Children with AG genotype in both OB and control groups had lower body mass index (BMI), diagnostic obesity notation model assessment index (DONMA II), body fat ratio (BFR), C-reactive protein (CRP), and metabolic syndrome index (MetS index) values compared to children with normal AA genotype. In the OB group, serum iron, vitamin B12, hemoglobin, MCV, and MCH values were found to be higher in the AG genotype group than those of children with the normal AA genotype. A significant correlation was found between the MetS index and BFR among OB children with normal homozygous genotype. MetS index increased as BFR increased in this group. However, such a correlation was not observed in the OB group with heterozygous AG genotype. To the best of our knowledge, the association of lipoprotein (a) rs10455872 gene polymorphism with the etiology of childhood obesity has not been studied yet. Therefore, this study was the first report suggesting polymorphism with AG genotype as a good risk factor for obesity.

Keywords: child, gene polymorphism, lipoprotein (a), obesity, rs10455872

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Authors: Tamas Dani

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The author’s research explores the geo-economical role and importance of some small and medium sized states, reviews their adaption strategies in foreign trade and also in foreign affairs in the course of changing into a multipolar world, uses international background. With these, the paper analyses the recent years and the future of ‘Opening towards Eastern foreign economic policies’ from East-Central Europe and parallel with that the ‘Western foreign economy policies’ from Asia, as the Chinese One Belt One Road new silk route plans (so far its huge part is an infrastructural development plan to reach international trade and investment aims). It can be today’s question whether these ideas will reshape the global trade or not. How does the new silk road initiatives and the Eurasian Union reflect the effect of globalization? It is worth to analyse that how did Central and Eastern European countries open to Asia; why does China have the focus of the opening policies in many countries and why could China be seen as the ‘winner’ of the world economic crisis after 2008. The research is based on the following methodologies: national and international literature, policy documents and related design documents, complemented by processing of international databases, statistics and live interviews with leaders from East-Central European countries’ companies and public administration, diplomats and international traders. The results also illustrated by mapping and graphs. The research will find out as major findings whether the state decision-makers have enough margin for manoeuvres to strengthen foreign economic relations. This work has a hypothesis that countries in East-Central Europe have real chance to diversify their relations in foreign trade, focus beyond their traditional partners. This essay focuses on the opportunities of East-Central-European countries in diversification of foreign trade relations towards China and Russia in terms of ‘Eastern Openings’. The effects of the new silk road initiatives and the Eurasian Union to Hungary’s economy with a comparing outlook on East-Central European countries and exploring common regional cooperation opportunities in this area. The essay concentrate on the changing trade relations between East-Central-Europe and China as well as Russia, try to analyse the effects of the new silk road initiatives and the Eurasian Union also. In the conclusion part, it shows how the cooperation is necessary for the East-Central European countries if they want to have a non-asymmetric trade with Russia, China or some Chinese regions (Pearl River Delta, Hainan, …). The form of the cooperation for the East-Central European nations can be Visegrad 4 Cooperation (V4), Central and Eastern European Countries (CEEC16), 3 SEAS Cooperation (or BABS – Baltic, Adriatic, Black Seas Initiative).

Keywords: China, East-Central Europe, foreign trade relations, geoeconomics, geopolitics, Russia

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Authors: Joao Barbosa

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After an intense dispute between the big bang cosmology and its big rival, the steady-state cosmology, some important experimental observations, such as the determination of helium abundance in the universe and the discovery of the cosmic background radiation in the 1960s were decisive for the progressive and wide acceptance of big bang cosmology and the inevitable abandonment of steady-state cosmology. But, despite solid theoretical support and those solid experimental observations favorable to big bang cosmology, Fred Hoyle, one of the proponents of the steady-state and the main opponent of the idea of the big bang (which, paradoxically, himself he baptized), never gave up and continued to fight for the idea of a stationary (or quasi-stationary) universe until the end of his life, even after decades of widespread consensus around the big bang cosmology. We can try to understand this persistent attitude of Hoyle by applying Holton’s thematic analysis to cosmology. Holton recognizes in the scientific activity a dimension that, even unconscious or not assumed, is nevertheless very important in the work of scientists, in implicit articulation with the experimental and the theoretical dimensions of science. This is the thematic dimension, constituted by themata – concepts, methodologies, and hypotheses with a metaphysical, aesthetic, logical, or epistemological nature, associated both with the cultural context and the individual psychology of scientists. In practice, themata can be expressed through personal preferences and choices that guide the individual and collective work of scientists. Thematic analysis shows that big bang cosmology is mainly based on a set of themata consisting of evolution, finitude, life cycle, and change; the cosmology of the steady-state is based on opposite themata: steady-state, infinity, continuous existence, and constancy. The passionate controversy that these cosmological views carried out is part of an old cosmological opposition: the thematic opposition between an evolutionary view of the world (associated with Heraclitus) and a stationary view (associated with Parmenides). Personal preferences seem to have been important in this (thematic) controversy, and the thematic analysis that was developed shows that Hoyle is a very illustrative example of a life-long personal commitment to some themata, in this case to the opposite themata of the big bang cosmology. His struggle against the big bang idea was strongly based on philosophical and even religious reasons – which, in a certain sense and in a Holtonian perspective, is related to thematic preferences. In this personal and persistent struggle, Hoyle always refused the way how some experimental observations were considered decisive in favor of the big bang idea, arguing that the success of this idea is based on sociological and cultural prejudices. This Hoyle’s attitude is a personal thematic attitude, in which the acceptance or rejection of what is presented as proof or scientific fact is conditioned by themata: what is a proof or a scientific fact for one scientist is something yet to be established for another scientist who defends different or even opposites themata.

Keywords: cosmology, experimental observations, fred hoyle, interpretation, life-long personal commitment, Themata

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Authors: Hamdan Hamood Aldumaini, Amjad Hussein Meqdam, Shamsaldeen kassim Ali, Hamed Mohammed Al-Yousefi, Haron Ahmed Al-Badawi

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Background: Autism Spectrum Disorder (ASD) is a complex developmental challenge characterized by significant impairments in social interaction, communication, and behavioral patterns. Diagnosing ASD is challenging due to the lack of definitive medical tests, making early identification crucial. Therefore, increasing people's awareness about autism leads to early diagnosis and better prognosis. Objective: Our study aims to identify the initial symptoms prompting families to seek medical advice, determine the timeline between symptom onset and formal diagnosis, and explore methods for assessing the severity of ASD. Subjects and Methods: The study design employed was a descriptive cross-sectional design, which was suitable for the nature of the research. The data collection took place from March 5, 2022, to April 5, 2022, in Autism Rehabilitation Centers in Sana'a, Yemen. The study population consisted of all children who were diagnosed with autism and visited Autism rehabilitation centers in Sana'a city. The sample size was determined using Epi info version 7, and a total population of 587 autistic children attending the treatment was calculated, but only 250 children were included in this study (176 were male vs. 74 female). Result: In terms of sociability problems, it was found that a significant proportion of Yemeni children with autism experienced difficulties in this area. Specifically, 39.6% were classified as having severe sociability problems, while 28.4% were classified as having moderate issues. Sensory-cognitive awareness problems were also prevalent among the respondents, with 29.6% exhibiting severe difficulties in this domain. Health and physical problems were identified as significant concerns for Yemeni children with autism. The results indicated that 38.4% of the participants experienced severe health and physical issues. Identifying the first symptoms of autism is crucial for early detection and intervention. According to the study, speech delay was the most commonly observed first abnormality, reported by 71.3% of parents. Communication difficulties with others were the second most noticed abnormality, reported by 54.9% of parents. Repetitive movements were the third most commonly observed abnormality, reported by 18% of parents. Regarding the awareness among parents of ASD, our study showed that a significant portion (62%) of parents lack awareness about Autism Spectrum Disorder (ASD) and its causes. Surprisingly, a majority of these parents (over 80%) believe that autism is a curable condition. Additionally, more than half (51.2%) of the parents surveyed reported insufficient knowledge about medication options available to support therapy and rehabilitation for their autistic children.

Keywords: autism characteristics, rehabilitation centres, yemen, children

Procedia PDF Downloads 47

Authors: Emielex M. Aguilar, Kristen Angela G. Cruz, Czarina Joie L. Rivera, Francis Dave C. Tan, Gavino Ivan N. Tanodra, Dianne Katrina G. Usana, Mary Grace T. Valentin, Nico Albert S. Vasquez, Edwin Monico C. Wee

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The risk of diabetes mellitus is increasing in the Philippines, with Metformin and Insulin as drugs commonly used for its management. The use of herbal medicines has grown increasingly, especially among the elderly population. Moringa oleifera or malunggay is one of the most common plants in the country, and several studies have shown the plant to exhibit a hypoglycemic property with its flavonoid content. This study aims to investigate the possible effects of concomitant use of Metformin and powdered M. oleifera leaves (PMOL) on blood glucose levels. Twenty male Sprague-Dawley rats were equally distributed into four groups. Fasting blood glucose levels of the rats were measured prior to experimentation. The following treatments were administered to the four groups, respectively: glucose only 2 g/kg; glucose 2 g/kg + Metformin 100 mg/kg; glucose 2 g/kg + PMOL 200 mg/kg; and glucose 2 g/kg + PMOL 200 mg/kg and Metformin 100 mg/kg. Blood glucose levels were determined on the 1st, 2nd, 3rd, and 4th hour post-treatment and compared between groups. Statistical analysis showed that the type of intervention did not show significance in the reduction of blood glucose levels when compared with the other groups (p=0.378), while the effect of time exhibited significance (p=0.000). The interaction between the type of intervention and time of blood glucose measurement was shown to be significant (p=0.024). Within each group, the control and PMOL-treated groups showed significant reduction in blood glucose levels over time with p-values of 0.000 and 0.000, respectively, while the Metformin-treated and the combination groups had p-values of 0.062 and 0.093, respectively, which are not significant. The descriptive data also showed that the mean total reduction of blood glucose levels of the Metformin and PMOL combination treatment group was lower than the PMOL-treated group alone, while the mean total reduction of blood glucose levels of the combination group was higher than the Metformin-treated group alone. Based on the results obtained, the combination of Metformin and PMOL did not significantly lower the blood glucose levels of the rats as compared to the other groups. However, the concomitant use of Metformin and PMOL may affect each other’s blood glucose lowering activity. Additionally, prolonged time of exposure and delay in the first blood glucose measurement after treatment could exhibit a significant effect in the blood glucose levels. Further studies are recommended regarding the effects of the concomitant use of the two agents on blood glucose levels.

Keywords: blood glucose levels, concomitant use, metformin, Moringa oleifera

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Authors: Milton Ixquiac, Erick Montenegro, Francisco Reynoso, Matthew Schmidt, Thomas Mazur, Tianyu Zhao, Hiram Gay, Geoffrey Hugo, Lauren Henke, Jeff Michael Michalski, Angel Velarde, Vicky de Falla, Franky Reyes, Osmar Hernandez, Edgar Aparicio Ruiz, Baozhou Sun

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Purpose: Radiotherapy departments in low- and middle-income countries (LMICs) like Guatemala have recently introduced intensity-modulated radiotherapy (IMRT). IMRT has become the standard of care in high-income countries (HIC) due to reduced toxicity and improved outcomes in some cancers. The purpose of this work is to show the agreement between the dosimetric results shown in the Dose Volume Histograms (DVH) to the objectives proposed in the adopted protocol. This is the initial experience with an O-ring Linac. Methods and Materials: An O-Linac Linac was installed at our clinic in Guatemala in 2019 and has been used to treat approximately 90 patients daily with IMRT. This Linac is a completely Image Guided Device since to deliver each radiotherapy session must take a Mega Voltage Cone Beam Computerized Tomography (MVCBCT). In each MVCBCT, the Linac deliver 9 UM, and they are taken into account while performing the planning. To start the standardization, the TG263 was employed in the nomenclature and adopted a hypofractionated protocol to treat ChestWall, including supraclavicular nodes achieving 40.05Gy in 15 fractions. The planning was developed using 4 semiarcs from 179-305 degrees. The planner must create optimization volumes for targets and Organs at Risk (OARs); the difficulty for the planner was the dose base due to the MVCBCT. To evaluate the planning modality, we used 30 chestwall cases. Results: The plans created manually achieve the protocol objectives. The protocol objectives are the same as the RTOG1005, and the DHV curves look clinically acceptable. Conclusions: Despite the O-ring Linac doesn´t have the capacity to obtain kv images, the cone beam CT was created using MV energy, the dose delivered by the daily image setup process still without affect the dosimetric quality of the plans, and the dose distribution is acceptable achieving the protocol objectives.

Keywords: hypofrationation, VMAT, chestwall, radiotherapy planning

Procedia PDF Downloads 119

Authors: Cengiz Akyildiz, Ismail Ekmekci

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In the past 15 years, many people have sought refuge and emigrated to developed countries due to the civil war in Syria, terrorism and turmoil in Iraq, Iran and Afghanistan, hunger problems in Africa and the purpose of work. Many of these people came to Turkey. By the end of the 2019, in Turkey, regular and irregular migrants, asylum seekers and foreigners under international protection are about 6 million people. The majority of these people are Syrians. Approximately 2 800 000 immigrants and refugees are in the workforce. Migrant workers in our country constitute the largest proportion among all countries in the world according to the local labor force. 2.5 million of these employees, with a high rate of about 90%, work informally and do not have legal records and valid employment contracts as a workforce; They cannot benefit from Occupational Health and Safety (OHS) services. Migrant workers generally receive less wages than local workers, working longer hours and worse conditions; they are often subjected to human rights violations, harassment, human trafficking and violence. Migrant workers face problems such as OHS practices, environmental and occupational exposures, language / cultural barriers, access to health services, and lack of documentation. Therefore, the OHS problems of these employees are becoming an increasingly problematic area. However, there is not enough research, analysis and academic studies in this field. The order of importance should be known for the radical solution of the problems, because of the problems with high severity are also at high risk. In this study, for the first time, a Search Conference was held with the participation of 45 stakeholders to reveal the OHS problems of regular and irregular migrant workers in our country. The problems arising from this workshop were compared with the problems in the literature and the problems in this field were determined and weighted for our country. Later, to determine the significance levels of these problems, AHP study, which is a Multi Criteria Decision Making Method in which 15 experts participated, was conducted and the significance levels of these problems were determined. When the data obtained are evaluated, it has been seen that the OSH risks of migrant workers arise from 58% laws and government policies, 29% from employers, 13% from personal faults of employees. An academic study has been carried out for the first time in this field regarding the OHS problems of migrant workers, and an academic study has been created to guide which of the problems should be prioritized.

Keywords: environmental conditions, migrant workers, OHS issues, workplace conditions

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Authors: Angela Evans, Gabriel Gijon-Nogueron, Alfonso Martinez-Nova

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Background The health sector, whose mission is protecting health, also contributes to the climate crisis, the greatest health threat of the 21st century. The carbon footprint from healthcare exceeds 5% of emissions globally, surpassing 7% in the USA and Australia. Global recognition has led to the Paris Agreement, the United Nations Sustainable Development Goals, and the World Health Organization's Climate Change Action Plan. It is agreed that the majority of health impacts stem from energy and resource consumption, as well as the production of greenhouse gases in the environment and deforestation. Many professional medical associations and healthcare providers advocate for their members to take the lead in environmental sustainability. Objectives To avail and expand ‘Green Podiatry’ via the three pillars of: Exercise ; Evidence ; Everyday changes; to highlight the benefits of physical activity and exercise for both human health and planet health. Walking and running are beneficial for health, provide low carbon transport, and have evidence-based health benefits. Podiatrists are key healthcare professionals in the physical activity space and can influence and guide their patients to increase physical activity and avert the many non-communicable diseases that are decimating public health, eg diabetes, arthritis, depression, cancer, obesity. Methods Publications, conference presentations, and pilot projects pertinent to ‘Green Podiatry’ have been activated since 2021, and a survey of podiatrist’s knowledge and awareness has been undertaken.The survey assessed attitudes towards environmental sustainability in work environment. The questions addressed commuting habits, hours of physical exercise per week, and attitudes in the clinic, such as prescribing unnecessary treatments or emphasizing sports as primary treatment. Results Teaching and Learning modules have been developed for podiatric medicine students and graduates globally. These will be availed. A pilot foot orthoses recycling project has been undertaken and will be reported, in addition to established footwear recycling. The preliminary survey found almost 90% of respondents had no knowledge of green podiatry or footwear recycling. Only 30% prescribe sports/exercise as the primary treatment for patients, and 45% do not to prescribe unnecessary treatments. Conclusions Podiatrists are in a good position to lead in the crucial area of healthcare and climate change implications. Sufficient education of podiatrists is essential for the profession to beneficially promote health and physical activity, which is beneficial for the health of all peoples and all communities.

Keywords: climate change, gait, green, healthcare, sustainability

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Authors: Sinem Tas

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This research paper attempts to study the perspective of personal experience in relation to spatial dynamics and artistic outcomes within the realm of cultural identity. This article serves as a partial analysis within a broader PhD investigation that focuses on the cultural dynamics and political structures behind cultural identity through an autoethnography of narrative while presenting its correlation with artistic creation in the context of space and people. Focusing on the artistic/creative practice project AUTRUI, the primary goal is to analyse and understand the influence of personal experiences and culturally constructed identity as an artist in resulting in the compositional modality of the last image considering self-reflective experience. Referencing the works of Joyce Davidson and Christine Milligan - the scholars who emphasise the importance of emotion and spatial experience in geographical studies contribute to this work as they highlight the significance of emotion across various spatial scales in their work Embodying Emotion Sensing Space: Introducing Emotional Geographies (2004). Their perspective suggests that understanding emotions within different spatial contexts is crucial for comprehending human experiences and interactions with space. Incorporating the insights of scholars like Yi-Fu Tuan, particularly his seminal work Space and Place: The Perspective of Experience (1979), is important for creating an in-depth frame of geographical experience. Tuan's humanistic perspective on space and place provides a valuable theoretical framework for understanding the interplay between personal experiences and spatial contexts. A substantial contextualisation of the geopolitics of Turkey - the implications for national identity and cohesion - will be addressed by drawing an outline of the political and geographical frame as a methodological strategy to understand the dynamics behind this research. Besides the bibliographical reading, the methods used to study this relation are participatory observation, memory work along with memoir analysis, personal interviews, and discussion of photographs and news. The utilisation of the self as data requires the analysis of the written sources with personal engagement. By delving into written sources such as written communications or diaries as well as memoirs, the research gains a firsthand perspective, enriching the analytical depth of the study. Furthermore, the examination of photography and news articles serves as a valuable means of contextualising experiences from a journalist's background within specific geographical settings. The inclusion of interviews with close family members access provides firsthand perspectives and intimate insights rooted in shared experiences within similar geographical contexts, offering complementary insights and diversified viewpoints, enhancing the comprehensiveness of the investigation.

Keywords: art, autoethnography, place and space, Turkey

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Authors: Mohamed Abo El Nasr, Mohamed Shoeib, Abdelhamid Abdelkhalik, Amro Serag

Abstract:

Background: Early assessment of severity of chest trauma, either blunt or penetrating is of critical importance in prediction of patient outcome. Different trauma scoring systems are widely available and are based on anatomical or physiological parameters to expect patient morbidity or mortality. Up till now, there is no ideal, universally accepted trauma score that could be applied in all trauma centers and is suitable for assessment of severity of chest trauma patients. Aim: Our aim was to compare various trauma scoring systems regarding their predictability of morbidity and mortality in chest trauma patients. Patients and Methods: This study was a prospective study including 400 patients with chest trauma who were managed at Tanta University Emergency Hospital, Egypt during a period of 2 years (March 2014 until March 2016). The patients were divided into 2 groups according to the mode of trauma: blunt or penetrating. The collected data included age, sex, hemodynamic status on admission, intrathoracic injuries, and associated extra-thoracic injuries. The patients outcome including mortality, need of thoracotomy, need for ICU admission, need for mechanical ventilation, length of hospital stay and the development of acute respiratory distress syndrome were also recorded. The relevant data were used to calculate the following trauma scores: 1. Anatomical scores including abbreviated injury scale (AIS), Injury severity score (ISS), New injury severity score (NISS) and Chest wall injury scale (CWIS). 2. Physiological scores including revised trauma score (RTS), Acute physiology and chronic health evaluation II (APACHE II) score. 3. Combined score including Trauma and injury severity score (TRISS ) and 4. Chest-Specific score Thoracic trauma severity score (TTSS). All these scores were analyzed statistically to detect their sensitivity, specificity and compared regarding their predictive power of mortality and morbidity in blunt and penetrating chest trauma patients. Results: The incidence of mortality was 3.75% (15/400). Eleven patients (11/230) died in blunt chest trauma group, while (4/170) patients died in penetrating trauma group. The mortality rate increased more than three folds to reach 13% (13/100) in patients with severe chest trauma (ISS of >16). The physiological scores APACHE II and RTS had the highest predictive value for mortality in both blunt and penetrating chest injuries. The physiological score APACHE II followed by the combined score TRISS were more predictive for intensive care admission in penetrating injuries while RTS was more predictive in blunt trauma. Also, RTS had a higher predictive value for expectation of need for mechanical ventilation followed by the combined score TRISS. APACHE II score was more predictive for the need of thoracotomy in penetrating injuries and the Chest-Specific score TTSS was higher in blunt injuries. The anatomical score ISS and TTSS score were more predictive for prolonged hospital stay in penetrating and blunt injuries respectively. Conclusion: Trauma scores including physiological parameters have a higher predictive power for mortality in both blunt and penetrating chest trauma. They are more suitable for assessment of injury severity and prediction of patients outcome.

Keywords: chest trauma, trauma scores, blunt injuries, penetrating injuries

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Authors: Fatima Muhammad Abdulkadir, D. B. Maikaje, Y. A. Umar

Abstract:

A study conducted to determine cercariae diversity and prevalence of trematode infection in freshwater snails from six freshwater bodies selected by systematic random sampling in Kaduna State was carried from January 2013 to December 2013. Freshwater snails and cercariae harvested from the study sites were morphologically identified. A total of 23,823 freshwater snails were collected from the six freshwater bodies: Bagoma dam, Gimbawa dam, Kangimi dam, Kubacha dam, Manchok water intake and Saminaka water intake. The observed freshwater snail species were: Melanoides tuberculata, Biomphalaria pfeifferi, Bulinus globosus, Lymnaea natalensis, Physa sp., Cleopatra bulimoides, Bellamya unicolor and Lanistes varicus. The freshwater snails were exposed to artificial bright light from a 100 Watt electric bulb in the laboratory to induce cercarial shedding. Of the total freshwater snails collected, 10.55% released one or more types of cercariae. Seven morphological types of cercariae were shed by six freshwater snail species namely: Brevifurcate-apharyngeate distome, Amphistome, Gymnocephalus, Longifurcate-pharyngeate monostome, Longifurcate-pharyngeate distome, Echinostome and Xiphidio cercariae. Infection was monotype in most of the freshwater snails collected; however, Physa species presented a mixed infection with Gymnocephalus and Longifurcate-pharyngeate distome cercariae. B. globosus and B. pfeifferi were the most preferred intermediate hosts with the prevalence of 13.48% and 13.46%, respectively. The diversity and prevalence of cercariae varied among the six freshwater bodies with Manchok water intake having the highest infestation (14.3%) and the least recorded in Kangimi dam (3.9%). There was a correlation trend between the number of freshwater snails and trematode infection with Manchok exhibiting the highest and Bagoma none. The highest cercarial diversity was observed in B. pfeifferi and B. globosus with four morphotypes each, and the lowest was in M. tuberculata with one morphotype. The general distribution of freshwater snails and the trematode cercariae they shed suggests the risk of human and animals to trematodiasis in Manchok community. Public health education to raise awareness on individual and communal action that may control snail breeding sites, prevent transmission and provide access to treatment should be intensified.

Keywords: Cercariae, diversity, freshwater snails, prevalence, trematodiasis

Procedia PDF Downloads 237

Authors: Urvi Panwar, Kanchan Mishra, Kanjaksha Ghosh, ShankerLal Kothari

Abstract:

Background: Day-by-day the increasing prevalence of neurodegenerative diseases have become a global issue to manage them by medical sciences. The adult neural stem cells are rare and require an invasive and painful procedure to obtain it from central nervous system. Mesenchymal stem cell (MSCs) therapies have shown remarkable application in treatment of various cell injuries and cell loss. MSCs can be derived from various sources like adult tissues, human bone marrow, umbilical cord blood and cord tissue. MSCs have similar proliferation and differentiation capability, but the human umbilical cord-derived mesenchymal stem cells (hUCMSCs) are proved to be more beneficial with respect to cell procurement, differentiation to other cells, preservation, and transplantation. Material and method: Human umbilical cord is easily obtainable and non-controversial comparative to bone marrow and other adult tissues. The umbilical cord can be collected after delivery of baby, and its tissue can be cultured using explant culture method. Cell culture medium such as DMEMF12+10% FBS and DMEMF12+Neural growth factors (bFGF, human noggin, B27) with antibiotics (Streptomycin/Gentamycin) were used to culture and differentiate mesenchymal stem cells into neural cells, respectively. The characterisations of MSCs were done with Flow Cytometer for surface markers CD90, CD73 and CD105 and colony forming unit assay. The differentiated various neural cells will be characterised by fluorescence markers for neurons, astrocytes, and oligodendrocytes; quantitative PCR for genes Nestin and NeuroD1 and Western blotting technique for gap43 protein. Result and discussion: The high quality and number of MSCs were isolated from human umbilical cord via explant culture method. The obtained MSCs were differentiated into neural cells like neurons, astrocytes and oligodendrocytes. The differentiated neural cells can be used to treat neural injuries and neural cell loss by delivering cells by non-invasive administration via cerebrospinal fluid (CSF) or blood. Moreover, the MSCs can also be directly delivered to different injured sites where they differentiate into neural cells. Therefore, human umbilical cord is demonstrated to be an inexpensive and easily available source for MSCs. Moreover, the hUCMSCs can be a potential source for neural cell therapies and neural cell regeneration for neural cell injuries and neural cell loss. This new way of research will be helpful to treat and manage neural cell damages and neurodegenerative diseases like Alzheimer and Parkinson. Still the study has a long way to go but it is a promising approach for many neural disorders for which at present no satisfactory management is available.

Keywords: bone marrow, cell therapy, explant culture method, flow cytometer, human umbilical cord, mesenchymal stem cells, neurodegenerative diseases, neuroprotective, regeneration

Procedia PDF Downloads 202