Search results for: organisational outcomes
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3629

Search results for: organisational outcomes

2789 A Study on Pattern of Acute Poisoning in Patients Admitted to Emergency Wards in a Tertiary Care Hospital

Authors: Sathvika Reddy, Devi Revathi

Abstract:

Background: In India, deliberate self-harm (DSH) with poisoning agents carries a significant impact on morbidity and mortality. Changes in the patterns of poisoning vary across various geographical locations. It is important to know the patterns in a given region in order to facilitate rapid clinical diagnosis, appropriate treatment to reduce associated morbidity and mortality. Aim and Objective: To study the patterns, treatment outcomes of acute poisoning in patients admitted to emergency wards in a tertiary care hospital and to provide poison information services. Materials and Methods: This study was conducted at M.S Ramaiah Memorial and Teaching Hospital from November 2016 to March 2017. The patient’s data was obtained from patient case sheet, interaction with health care professionals, interviewing patients and their caretakers (if possible), and were documented in a suitably designed form. Results: The study involved 131 patients with a mean age of 27.76 ± 15.5 years. Majority of the patients were in the age group 21-30 years, literates (n=53) dwelling in urban (n=113) areas belonging to upper middle class (n=50). Analgesics and antipyretics were commonly utilized in intentional drug overdosage (n=49). Envenomation constituted n=21(16.03%). Furthermore, a significant relationship was observed between marital status and self-poisoning (n=64) (P < 0.001) which commonly occurred through oral ingestion. The outcomes were correlated with the GCS and PSS system and n=85 recovered, n=17 were discharged against medical advice, and n=4 died, and n=4 were lost to follow up respectively. The poison information queries include drug overdose (n=29) and management related queries (n=22) provided majorly by residents (n=45) to update knowledge (n=11) and for better patient care (n=40). Conclusion: The trend in poisoning is dynamic. Medications were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.

Keywords: poisoning, suicides, clinical pharmacist, envenomation, poison information services

Procedia PDF Downloads 160
2788 Effectiveness of Educational and Supportive Interventions for Primiparous Women on Breastfeeding Outcomes: A Systematic Review and Meta-Analysis

Authors: Mei Sze Wong, Huanyu Mou, Wai-Tong Chien

Abstract:

Background: Breastmilk is the most nutritious food for infants to support their growth and protect them from infection. Therefore, breastfeeding promotion is an important topic for infant health; whereas, different educational and supportive approaches to interventions have been prompted and targeted at antenatal, postnatal, or both periods to promote and sustain exclusive breastfeeding. This systematic review aimed to identify the effective approaches of educational and supportive interventions to improve breastfeeding. Outcome measures were exclusive breastfeeding, partial breastfeeding, and breastfeeding self-efficacy, being analyzed in terms of ≤ 2 months, 3-5 months, and ≥ 6 months postpartum. Method: Eleven electronic databases and the reference lists of eligible articles were searched. English or Chinese articles of randomized controlled trials on educational and supportive intervention with the above breastfeeding outcomes over recent 20 years were searched. Quality appraisal and risk of bias of the studies were checked by Effective Public Health Practice Project tool and Revised Cochrane risk-of-bias tool, respectively. Results: 13 articles that met the inclusion criteria were included; and they had acceptable quality and risk of bias. The optimal structure, format, and delivery of the interventions significantly increased exclusive breastfeeding rate at ≤ 2 months and ≥ 6 months and breastfeeding self-efficacy at ≤ 2 months included: (a) delivering from antenatal to postnatal period, (b) multicomponent involving antenatal group education, postnatal individual breastfeeding coaching and telephone follow-ups, (c) both individual and group basis, (d) being guided by self-efficacy theory, and (e) having ≥ 3 sessions. Conclusion: The findings showed multicomponent theory-based interventions with ≥ 3 sessions that delivered across antenatal and postnatal period; using both face-to-face teaching and telephone follow-ups can be useful to enhance exclusive breastfeeding rate for more than 6 months and breastfeeding self-efficacy over the first two months of postpartum.

Keywords: breastfeeding self-efficacy, education, exclusive breastfeeding, primiparous, support

Procedia PDF Downloads 129
2787 The Efficacy of Psychological Interventions for Psychosis: A Systematic Review and Network Meta-Analysis

Authors: Radu Soflau, Lia-Ecaterina Oltean

Abstract:

Background: Increasing evidence supports the efficacy of psychological interventions for psychosis. However, it is unclear which one of these interventions is most likely to address negative psychotic symptoms and related outcomes. We aimed to determine the relative efficacy of psychological and psychosocial interventions for negative symptoms, overall psychotic symptoms, and related outcomes. Methods: To attain this goal, we conducted a systematic review and network meta-analysis. We searched for potentially eligible trials in PubMed, EMBASE, PsycInfo, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases up until February 08, 2022. We included randomized controlled trials that investigated the efficacy of psychological for adults with psychosis. We excluded interventions for prodromal or “at risk” individuals, as well as patients with serious co-morbid medical or psychiatric conditions (others than depressive and/or anxiety disorders). Two researchers conducted study selection and performed data extraction independently. Analyses were run using STATA network and mvmeta packages, applying a random effect model under a frequentist framework in order to compute standardized mean differences or risk ratio. Findings: We identified 47844 records and screened 29466 records for eligibility. The majority of eligible interventions were delivered in addition to pharmacological treatment. Treatment as usual (TAU) was the most frequent common comparator. Theoretically driven psychological interventions generally outperformed TAU at post-test and follow-up, displaying small and small-to-medium effect sizes. A similar pattern of results emerged in sensitivity analyses focused on studies that employed an inclusion criterion for relevant negative symptom severity. Conclusion: While the efficacy of some psychological interventions is promising, there is a need for more high-quality studies, as well as more trials directly comparing psychological treatments for negative psychotic symptoms.

Keywords: psychosis, network meta-analysis, psychological interventions, efficacy, negative symptoms

Procedia PDF Downloads 98
2786 The Use of Vasopressin in the Management of Severe Traumatic Brain Injury: A Narrative Review

Authors: Nicole Selvi Hill, Archchana Radhakrishnan

Abstract:

Introduction: Traumatic brain injury (TBI) is a leading cause of mortality among trauma patients. In the management of TBI, the main principle is avoiding cerebral ischemia, as this is a strong determiner of neurological outcomes. The use of vasoactive drugs, such as vasopressin, has an important role in maintaining cerebral perfusion pressure to prevent secondary brain injury. Current guidelines do not suggest a preferred vasoactive drug to administer in the management of TBI, and there is a paucity of information on the therapeutic potential of vasopressin following TBI. Vasopressin is also an endogenous anti-diuretic hormone (AVP), and pathways mediated by AVP play a large role in the underlying pathological processes of TBI. This creates an overlap of discussion regarding the therapeutic potential of vasopressin following TBI. Currently, its popularity lies in vasodilatory and cardiogenic shock in the intensive care setting, with increasing support for its use in haemorrhagic and septic shock. Methodology: This is a review article based on a literature review. An electronic search was conducted via PubMed, Cochrane, EMBASE, and Google Scholar. The aim was to identify clinical studies looking at the therapeutic administration of vasopressin in severe traumatic brain injury. The primary aim was to look at the neurological outcome of patients. The secondary aim was to look at surrogate markers of cerebral perfusion measurements, such as cerebral perfusion pressure, cerebral oxygenation, and cerebral blood flow. Results: Eight papers were included in the final number. Three were animal studies; five were human studies, comprised of three case reports, one retrospective review of data, and one randomised control trial. All animal studies demonstrated the benefits of vasopressors in TBI management. One animal study showed the superiority of vasopressin in reducing intracranial pressure and increasing cerebral oxygenation over a catecholaminergic vasopressor, phenylephrine. All three human case reports were supportive of vasopressin as a rescue therapy in catecholaminergic-resistant hypotension. The retrospective review found vasopressin did not increase cerebral oedema in TBI patients compared to catecholaminergic vasopressors; and demonstrated a significant reduction in the requirements of hyperosmolar therapy in patients that received vasopressin. The randomised control trial results showed no significant differences in primary and secondary outcomes between TBI patients receiving vasopressin versus those receiving catecholaminergic vasopressors. Apart from the randomised control trial, the studies included are of low-level evidence. Conclusion: Studies favour vasopressin within certain parameters of cerebral function compared to control groups. However, the neurological outcomes of patient groups are not known, and animal study results are difficult to extrapolate to humans. It cannot be said with certainty whether vasopressin’s benefits stand above usage of other vasoactive drugs due to the weaknesses of the evidence. Further randomised control trials, which are larger, standardised, and rigorous, are required to improve knowledge in this field.

Keywords: catecholamines, cerebral perfusion pressure, traumatic brain injury, vasopressin, vasopressors

Procedia PDF Downloads 66
2785 Montelukast Doesn’t Decrease the Risk of Cardiovascular Disease in Asthma Patients in Taiwan

Authors: Sheng Yu Chen, Shi-Heng Wang

Abstract:

Aim: Based on human, animal experiments, and genetic studies, cysteinyl leukotrienes, LTC4, LTD4, and LTE4, are inflammatory substances that are metabolized by 5-lipooxygenase from arachidonic acid, and these substances trigger asthma. In addition, the synthetic pathway of cysteinyl leukotriene is relevant to the increase in cardiovascular diseases such as myocardial ischemia and stroke. Given the situation, we aim to investigate whether cysteinyl leukotrienes receptor antagonist (LTRA), montelukast which cures those who have asthma has potential protective effects on cardiovascular diseases. Method: We conducted a cohort study, and enrolled participants which are newly diagnosed with asthma (ICD-9 CM code 493. X) between 2002 to 2011. The data source is from Taiwan National Health Insurance Research Database Patients with a previous history of myocardial infarction or ischemic stroke were excluded. Among the remaining participants, every montelukast user was matched with two randomly non-users by sex, and age. The incident cardiovascular diseases, including myocardial infarction and ischemic stroke, were regarded as outcomes. We followed the participants until outcomes come first or the end of the following period. To explore the protective effect of montelukast on the risk of cardiovascular disease, we use multivariable Cox regression to estimate the hazard ratio with adjustment for potential confounding factors. Result: There are 55876 newly diagnosed asthma patients who had at least one claim of inpatient admission or at least three claims of outpatient records. We enrolled 5350 montelukast users and 10700 non-users in this cohort study. The following mean (±SD) time of the Montelukast group is 5 (±2.19 )years, and the non-users group is 6.2 5.47 (± 2.641) years. By using multivariable Cox regression, our analysis indicated that the risk of incident cardiovascular diseases between montelukast users (n=43, 0.8%) and non-users (n=111, 1.04%) is approximately equal. [adjusted hazard ratio 0.992; P-value:0.9643] Conclusion: In this population-based study, we found that the use of montelukast is not associated with a decrease in incident MI or IS.

Keywords: asthma, inflammation, montelukast, insurance research database, cardiovascular diseases

Procedia PDF Downloads 78
2784 Finite Element Analysis of Shape Memory Alloy Stents in Coronary Arteries

Authors: Amatulraheem Al-Abassi, K. Khanafer, Ibrahim Deiab

Abstract:

The coronary artery stent is a promising technology that can treat various coronary diseases. Materials used for manufacturing medical stents should have high biocompatible properties. Stent alloys, in particular, are remarkably promising good clinical outcomes, however, there is threaten of restenosis (reoccurring of artery narrowing due to fatty plaque), stent recoiling, or in long-term the occurrence of stent fracture. However, stents that are made of Nickel-titanium (Nitinol) can bare extensive plastic deformation and resist restenosis. This shape memory alloy has outstanding mechanical properties. Nitinol is a unique shape memory alloy as it has unique mechanical properties such as; biocompatibility, super-elasticity, and recovery to original shape under certain loads. Stent failure may cause complications in vascular diseases and possibly blockage of blood flow. Thus, studying the behaviors of the stent under different medical conditions will help the doctors and cardiologists to predict when it is necessary to change the stent in order to prevent any severe morbidity outcomes. To the best of our knowledge, there are limited published papers that analyze the stent behavior with regards to the contact surfaces of plaque layer and blood vessel. Thus, stent material properties will be discussed in this investigation to highlight the mechanical and clinical differences between various stents. This research analyzes the performance of Nitinol stent in well-known stent design to determine its bearing with stress and its dislocation in blood vessels, in comparison to stents made of different biocompatible materials. In addition, a study of its performance will be represented in the system. Finite Element Analysis is the core of this study. Thus, a physical representative model will be discussed to show the distribution of stress and strain along the interaction surface between the stent and the artery. The reaction of vascular tissue to the stent will be evaluated to predict the possibility of restenosis within the treated area.

Keywords: shape memory alloy, stent, coronary artery, finite element analysis

Procedia PDF Downloads 199
2783 Predictive Value Modified Sick Neonatal Score (MSNS) On Critically Ill Neonates Outcome Treated in Neonatal Intensive Care Unit (NICU)

Authors: Oktavian Prasetia Wardana, Martono Tri Utomo, Risa Etika, Kartika Darma Handayani, Dina Angelika, Wurry Ayuningtyas

Abstract:

Background: Critically ill neonates are newborn babies with high-risk factors that potentially cause disability and/or death. Scoring systems for determining the severity of the disease have been widely developed as well as some designs for use in neonates. The SNAPPE-II method, which has been used as a mortality predictor scoring system in several referral centers, was found to be slow in assessing the outcome of critically ill neonates in the Neonatal Intensive Care Unit (NICU). Objective: To analyze the predictive value of MSNS on the outcome of critically ill neonates at the time of arrival up to 24 hours after being admitted to the NICU. Methods: A longitudinal observational analytic study based on medical record data was conducted from January to August 2022. Each sample was recorded from medical record data, including data on gestational age, mode of delivery, APGAR score at birth, resuscitation measures at birth, duration of resuscitation, post-resuscitation ventilation, physical examination at birth (including vital signs and any congenital abnormalities), the results of routine laboratory examinations, as well as the neonatal outcomes. Results: This study involved 105 critically ill neonates who were admitted to the NICU. The outcome of critically ill neonates was 50 (47.6%) neonates died, and 55 (52.4%) neonates lived. There were more males than females (61% vs. 39%). The mean gestational age of the subjects in this study was 33.8 ± 4.28 weeks, with the mean birth weight of the subjects being 1820.31 ± 33.18 g. The mean MSNS score of neonates with a deadly outcome was lower than that of the lived outcome. ROC curve with a cut point MSNS score <10.5 obtained an AUC of 93.5% (95% CI: 88.3-98.6) with a sensitivity value of 84% (95% CI: 80.5-94.9), specificity 80 % (CI 95%: 88.3-98.6), Positive Predictive Value (PPV) 79.2%, Negative Predictive Value (NPV) 84.6%, Risk Ratio (RR) 5.14 with Hosmer & Lemeshow test results p>0.05. Conclusion: The MSNS score has a good predictive value and good calibration of the outcomes of critically ill neonates admitted to the NICU.

Keywords: critically ill neonate, outcome, MSNS, NICU, predictive value

Procedia PDF Downloads 65
2782 Sustainable Tourism and Heritage in Sığacık/Seferihisar

Authors: Sibel Ecemiş Kılıç, Muhammed Aydoğan

Abstract:

The rapid development of culture tourism has drawn attention to conserving cultural values especially by developing countries that would like to benefit from the economic contribution this type of tourism attracts. Tourism can have both positive and negative outcomes for historical settlements and their residents. The accommodation-purposed rehabilitation and revitalization project in “Sigacik Old City Zone” are to be discussed with spatial, economic, social and organizational dimensions. It is aimed to evaluate the relationship between the development of tourism and sustainable heritage conservation.

Keywords: Sığacık, urban conservation, sustainable tourism, Seferihisar

Procedia PDF Downloads 501
2781 Pedagogy of Possibility: Exploring the TVET of Southern African Workers on Foreign Vessels Mediated by Ubiquitous Google and Microsoft apps

Authors: Robin Ferguson

Abstract:

The context which this paper explores is the provision of Technical Vocational Education and Training (TVET) of southern African workers at sea on local and foreign vessels using a blended learning approach. The pedagogical challenge of providing quality education in this context is that multiple African and foreign languages and cultural norms are found amongst the all-male crew; and there are widely differing levels of education, low levels of digital literacy and limited connectivity. The methodology used is a nested case study. The study describes the mechanisms used to provide ongoing, real-time workplace TVET on two foreign vessels. Some training was done in person when the vessels came into port, however, the majority of the TVET was achieved from shore to ship using a combination of commonly available Google and Microsoft Apps and WhatsApp. Voice, video and text in multiple languages were used to accommodate different learning styles. The learning was supported by the development of learning networks using social media. This paper also reflects on the shore-based organisational change processes required to support sea learning. The conceptual framework used is the Theory of Practice Architectures (TPA) as is provides a site-ontological perspective of the sayings/thinkings, doings and relatings of this workplace training which is multiplanar as it plays out at sea and ashore, in-person and on-line. Using TPA, the overarching practice architectures and supporting structures which confound or enable these learning practices are revealed. The contribution which this paper makes is an insight into an innovative vocational pedagogy which promotes ICT-mediated learning amongst workers who suffer from low levels of literacies and limited ICT-access and who work and live in remote places. It is a pedagogy of possibility which crosses the digital divide.

Keywords: theory of practice architecture, microsoft, google, whatsapp, vocational pedagogy, mariners, distributed workplaces

Procedia PDF Downloads 76
2780 Teaching English in Low Resource-Environments: Problems and Prospects

Authors: Gift Chidi-Onwuta, Iwe Nkem Nkechinyere, Chikamadu Christabelle Chinyere

Abstract:

The teaching of English is a resource-driven activity that requires rich resource-classroom settings for the delivery of effective lessons and the acquisition of interpersonal skills for integration in a target-language environment. However, throughout the world, English is often taught in low-resource classrooms. This paper is aimed to reveal the common problems associated with teaching English in low-resource environments and the prospects for teachers who found themselves in such undefined teaching settings. Self-structured and validated questionnaire in a closed-ended format, open question format and scaling format was administered to teachers across five countries: Nigeria, Cameroun, Iraq, Turkey, and Sudan. The study adopts situational language teaching theory (SLTT), which emphasizes a performance improvement imperative. This study inclines to this model because it maintains that learning must be fun and enjoyable like playing a favorite sport, just as in real life. Since teaching resources make learning engaging, we found this model apt for the current study. The perceptions of teachers about accessibility and functionality of teaching material resources, the nature of teaching outcomes in resource-less environments, their levels of involvement in improvisation and the prospects associated with resource limitations were sourced. Data were analysed using percentages and presented in frequency tables. Results: showed that a greater number of teachers across these nations do not have access to sufficient productive resource materials that can aid effective English language teaching. Teaching outcomes, from the findings, are affected by low material resources; however, results show certain advantages to teaching English with limited resources: flexibility and autonomy with students and creativity and innovation amongst teachers. Results further revealed group work, story, critical thinking strategy, flex, cardboards and flashcards, dictation and dramatization as common teaching strategies, as well as materials adopted by teachers to overcome low resource-related challenges in classrooms.

Keywords: teaching materials, low-resource environments, English language teaching, situational language theory

Procedia PDF Downloads 128
2779 Systematic and Meta-Analysis of Navigation in Oral and Maxillofacial Trauma and Impact of Machine Learning and AI in Management

Authors: Shohreh Ghasemi

Abstract:

Introduction: Managing oral and maxillofacial trauma is a multifaceted challenge, as it can have life-threatening consequences and significant functional and aesthetic impact. Navigation techniques have been introduced to improve surgical precision to meet this challenge. A machine learning algorithm was also developed to support clinical decision-making regarding treating oral and maxillofacial trauma. Given these advances, this systematic meta-analysis aims to assess the efficacy of navigational techniques in treating oral and maxillofacial trauma and explore the impact of machine learning on their management. Methods: A detailed and comprehensive analysis of studies published between January 2010 and September 2021 was conducted through a systematic meta-analysis. This included performing a thorough search of Web of Science, Embase, and PubMed databases to identify studies evaluating the efficacy of navigational techniques and the impact of machine learning in managing oral and maxillofacial trauma. Studies that did not meet established entry criteria were excluded. In addition, the overall quality of studies included was evaluated using Cochrane risk of bias tool and the Newcastle-Ottawa scale. Results: Total of 12 studies, including 869 patients with oral and maxillofacial trauma, met the inclusion criteria. An analysis of studies revealed that navigation techniques effectively improve surgical accuracy and minimize the risk of complications. Additionally, machine learning algorithms have proven effective in predicting treatment outcomes and identifying patients at high risk for complications. Conclusion: The introduction of navigational technology has great potential to improve surgical precision in oral and maxillofacial trauma treatment. Furthermore, developing machine learning algorithms offers opportunities to improve clinical decision-making and patient outcomes. Still, further studies are necessary to corroborate these results and establish the optimal use of these technologies in managing oral and maxillofacial trauma

Keywords: trauma, machine learning, navigation, maxillofacial, management

Procedia PDF Downloads 55
2778 Climbing up to Safety and Security: The Facilitation of an NGO Awareness Culture

Authors: Mirad Böhm, Diede De Kok

Abstract:

It goes without saying that for many NGOs a high level of safety and security are crucial issues, which often necessitates the support of military personnel to varying degrees. The relationship between military and NGO personnel is usually a difficult one and while there has been progress, clashes naturally still occur owing to different interpretations of mission objectives amongst many other challenges. NGOs tend to view safety and security as necessary steps towards their goal instead of fundamental pillars of their core ‘business’. The military perspective, however, considers them primary objectives; thus, frequently creating a different vision of how joint operations should be conducted. This paper will argue that internalizing safety and security into the NGO organizational culture is compelling in order to ensure a more effective cooperation with military partners and, ultimately, to achieve their goals. This can be accomplished through a change in perception of safety and security concepts as a fixed and major point on the everyday agenda. Nowadays, there are several training programmes on offer addressing such issues but they primarily focus on the individual level. True internalization of these concepts should reach further by encompassing a wide range of NGO activities, beginning with daily proceedings in office facilities far from conflict zones including logistical and administrative tasks such as budgeting, and leading all the way to actual and potentially hazardous missions in the field. In order to effectuate this change, a tool is required to help NGOs realize, firstly, how they perceive and define safety and security, and secondly, how they can adjust this perception to their benefit. The ‘safety culture ladder’ is a concept that suggests what organizations can and should do to advance their safety. While usually applied to private industrial scenarios, this work will present the concept as a useful instrument to visualize and facilitate the internalization process NGOs ought to go through. The ‘ladder’ allows them to become more aware of the level of their safety and security measures, and moreover, cautions them to take these measures proactively rather than reactively. This in turn will contribute to a rapprochement between military and NGO priority setting in regard to what constitutes a safe working environment.

Keywords: NGO-military cooperation, organisational culture, safety and security awareness, safety culture ladder

Procedia PDF Downloads 330
2777 Enhancing Healthcare Delivery in Low-Income Markets: An Exploration of Wireless Sensor Network Applications

Authors: Innocent Uzougbo Onwuegbuzie

Abstract:

Healthcare delivery in low-income markets is fraught with numerous challenges, including limited access to essential medical resources, inadequate healthcare infrastructure, and a significant shortage of trained healthcare professionals. These constraints lead to suboptimal health outcomes and a higher incidence of preventable diseases. This paper explores the application of Wireless Sensor Networks (WSNs) as a transformative solution to enhance healthcare delivery in these underserved regions. WSNs, comprising spatially distributed sensor nodes that collect and transmit health-related data, present opportunities to address critical healthcare needs. Leveraging WSN technology facilitates real-time health monitoring and remote diagnostics, enabling continuous patient observation and early detection of medical issues, especially in areas with limited healthcare facilities and professionals. The implementation of WSNs can enhance the overall efficiency of healthcare systems by enabling timely interventions, reducing the strain on healthcare facilities, and optimizing resource allocation. This paper highlights the potential benefits of WSNs in low-income markets, such as cost-effectiveness, increased accessibility, and data-driven decision-making. However, deploying WSNs involves significant challenges, including technical barriers like limited internet connectivity and power supply, alongside concerns about data privacy and security. Moreover, robust infrastructure and adequate training for local healthcare providers are essential for successful implementation. It further examines future directions for WSNs, emphasizing innovation, scalable solutions, and public-private partnerships. By addressing these challenges and harnessing the potential of WSNs, it is possible to revolutionize healthcare delivery and improve health outcomes in low-income markets.

Keywords: wireless sensor networks (WSNs), healthcare delivery, low-Income markets, remote patient monitoring, health data security

Procedia PDF Downloads 31
2776 Autophagy Suppresses Bladder Tumor Formation in a Mouse Orthotopic Bladder Tumor Formation Model

Authors: Wan-Ting Kuo, Yi-Wen Liu, Hsiao-Sheng Liu

Abstract:

Annual incidence of bladder cancer increases in the world and occurs frequently in the male. Most common type is transitional cell carcinoma (TCC) which is treated by transurethral resection followed by intravesical administration of agents. In clinical treatment of bladder cancer, chemotherapeutic drugs-induced apoptosis is always used in patients. However, cancers usually develop resistance to chemotherapeutic drugs and often lead to aggressive tumors with worse clinical outcomes. Approximate 70% TCC recurs and 30% recurrent tumors progress to high-grade invasive tumors, indicating that new therapeutic agents are urgently needed to improve the successful rate of overall treatment. Nonapoptotic program cell death may assist to overcome worse clinical outcomes. Autophagy which is one of the nonapoptotic pathways provides another option for bladder cancer patients. Autophagy is reported as a potent anticancer therapy in some cancers. First of all, we established a mouse orthotopic bladder tumor formation model in order to create a similar tumor microenvironment. IVIS system and micro-ultrasound were utilized to noninvasively monitor tumor formation. In addition, we carried out intravesical treatment in our animal model to be consistent with human clinical treatment. In our study, we carried out intravesical instillation of the autophagy inducer in mouse orthotopic bladder tumor to observe tumor formation by noninvasive IVIS system and micro-ultrasound. Our results showed that bladder tumor formation is suppressed by the autophagy inducer, and there are no significant side effects in the physiology of mice. Furthermore, the autophagy inducer upregulated autophagy in bladder tissues of the treated mice was confirmed by Western blot, immunohistochemistry, and immunofluorescence. In conclusion, we reveal that a novel autophagy inducer with low side effects suppresses bladder tumor formation in our mouse orthotopic bladder tumor model, and it provides another therapeutic approach in bladder cancer patients.

Keywords: bladder cancer, transitional cell carcinoma, orthotopic bladder tumor formation model, autophagy

Procedia PDF Downloads 171
2775 Modelling Retirement Outcomes: An Australian Case Study

Authors: Colin O’Hare, Zili Zho, Thomas Sneddon

Abstract:

The Australian superannuation system has received high praise for its participation rates and level of funding in retirement yet it is only 25 years old. In recent years, with increasing longevity and persistent lower rates of investment return, how adequate will the funds accumulated through a superannuation system be? In this paper we take Australia as a case study and build a stochastic model of accumulation and decummulation of funds and determine the expected number of years a fund may last an individual in retirement.

Keywords: component, mortality, stochastic models, superannuation

Procedia PDF Downloads 241
2774 Evaluation of a Higher Diploma in Mental Health Nursing Using Qualitative and Quantitative Methods: Effects on Student Behavior, Attitude and Perception

Authors: T. Frawley, G. O'Kelly

Abstract:

The UCD School of Nursing, Midwifery and Health Systems Higher Diploma in Mental Health (HDMH) nursing programme commenced in January 2017. Forty students successfully completed the programme. Programme evaluation was conducted from the outset. Research ethics approval was granted by the UCD Human Research Ethics Committee – Sciences in November 2016 (LS-E-16-163). Plan for Sustainability: Each iteration of the programme continues to be evaluated and adjusted accordingly. Aims: The ultimate purpose of the HDMH programme is to prepare registered nurses (registered children’s nurse (RCN), registered nurse in intellectual disability (RNID) and registered general nurse (RGN)) to function as effective registered psychiatric nurses in all settings which provide care and treatment for people experiencing mental health difficulties. Curriculum evaluation is essential to ensure that the programme achieves its purpose, that aims and expected outcomes are met and that required changes are highlighted for the programme’s continuing positive development. Methods: Both quantitative and qualitative methods were used in the evaluation. A series of questionnaires were used (the majority pre and post programme) to determine student perceptions of the programme, behaviour and attitudinal change from commencement to completion. These included the student assessment of learning gains (SALG); mental health knowledge schedule (MAKS); mental health clinician attitudes scale (MICA); reported and intended behaviour scale (RIBS); and community attitudes towards the mentally ill (CAMI). In addition, student and staff focus groups were conducted. Evaluation methods also incorporated module feedback. Outcome/Results: The evaluation highlighted a very positive response in relation to the achievement of programme outcomes and preparation for future work as registered psychiatric nursing. Some areas were highlighted for further development, which have been taken cognisance of in the 2019 iteration of the programme.

Keywords: learning gains, mental health, nursing, stigma

Procedia PDF Downloads 135
2773 Validity and Reliability of Assessment of Language-Related Functional Activities: Evidence from Arab Aphasics

Authors: Sadeq Al Yaari, Nassr Almaflehi, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

Abstract:

Background: Assessment of language-related functional activities (ALFA) is of vital importance in assessing aphasics’ performance of both sexes. However, the validity and reliability of this language therapeutic test has never been validated in the Arabic medical literature. Purpose: The aim of this study was to validate the test by assessing the language-related functional activities of 100 gender aphasics based in a medical faculty. Design: ALFA Pre-and-posttest was administered twice in three weeks to test the language-related functional activities of 100 gender aphasics. Settings: Al Khars hospital in Al Ahsa’a, Kingdom of Saudi Arabia (KSA). Participants: Sixteen to eight-year-old participants (N = 100 men and women) were enrolled in this experiment. Again, the purpose was to assess their language-related functional activities using ALFA. Procedures: The first step was to translate the English version of ALFA test into the mother tongue of the patients (Arabic). Secondly, the translated text is reviewed and edited by three specialists of Arabic language. Having the test standardized, the third step was to assess language-related functional activities of the participants in natural environment. Assessment took place in three weeks. In the first week, a pre-test was administered to the participants at hand and after two weeks, a post-test was administered to identify whether or not significant differences between the two tests (pre-and-posttest) could be observed. Interventions: Outcomes of the results obtained from the analyses were broadly discussed. Linguistic and statistical comparisons were held to illustrate the findings of this study. Main outcomes and Results: The analysis of the obtained results indicated that the performance of the aphasic participants in the post-test did not differ from that of the pre-test (, respectively). Conclusions & Implications: ALFA was proved to be a valid and reliable test. Moreover, outlined results pointed out the importance of assessing not only gender aphasics’ language, but also their language-related functional activities. Further research is needed to explore how gender aphasics’ verbal and non-verbal performances interact.

Keywords: ALFA, language test, Arab aphasics, validity, reliability, psychoneurolinguistics.

Procedia PDF Downloads 42
2772 Comparing Trastuzumab-Related Cardiotoxicity between Elderly and Younger Patients with Breast Cancer: A Prospective Cohort Study

Authors: Afrah Aladwani, Alexander Mullen, Mohammad AlRashidi, Omamah Alfarisi, Faisal Alterkit, Abdulwahab Aladwani, Asit Kumar, Emad Eldosouky

Abstract:

Introduction: Trastuzumab is a HER-2 targeted humanized monoclonal antibody that significantly improves the therapeutic outcomes of metastatic and non-metastatic breast cancer. However, it is associated with increased risk of cardiotoxicity that ranges from mild decline in the cardiac ejection fraction to permanent cardiomyopathy. Concerns have been raised in treating eligible older patients. This study compares trastuzumab outcomes between two age cohorts in the Kuwait Cancer Control Centre (KCCC). Methods: In a prospective comparative observational study, 93 HER-2 positive breast cancer patients undergoing different chemotherapy protocols + trastuzumab were included and divided into two cohorts based on their age (˂60 and ≥60 years old). The baseline left ventricular ejection fraction (LVEF) was assessed and monitored every three months during trastuzumab treatment. Event of cardiotoxicity was defined as ≥10% decline in the LVEF from the baseline. The lower accepted normal limit of the LVEF was 50%. Results: The median baseline LVEF was 65% in both age cohorts (IQR 8% and 9% for older and younger patients respectively). Whereas, the median LVEF post-trastuzumab treatment was 51% and 55% in older and younger patients respectively (IQR 8%; p-value = 0.22), despite the fact that older patients had significantly lower exposure to anthracyclines compared to younger patients (60% and 84.1% respectively; p-value ˂0.001). 86.7% and 55.6% of older and younger patients, respectively, developed ≥10% decline in their LVEF from the baseline. Among those, only 29% of older and 27% of younger patients reached a LVEF value below 50% (p-value = 0.88). Statistically, age was the only factor that significantly correlated with trastuzumab induced cardiotoxicity (OR 4; p-value ˂0.012), but it did not increase the requirement for permanent discontinuation of treatment. A baseline LVEF value below 60% contributed to developing a post-treatment value below normal ranges (50%). Conclusion: Breast cancer patients aged 60 years and above in Kuwait were at 4-fold higher risk of developing ≥10% decline in their LVEF from the baseline than younger patients during trastuzumab treatment. Surprisingly, previous exposure to anthracyclines and multiple comorbidities were not associated with significant increased risk of cardiotoxicity.

Keywords: breast cancer, elderly, Trastuzumab, cardiotoxicity

Procedia PDF Downloads 203
2771 The Effect of Intimate Partner Violence Prevention Program on Knowledge and Attitude of Victims

Authors: Marzieh Nojomi, Azadeh Mottaghi, Arghavan Haj-Sheykholeslami, Narjes Khalili, Arash Tehrani Banihashemi

Abstract:

Background and objectives: Domestic violence is a global problem with severe consequences throughout the life of the victims. Iran’s Ministry of Health has launched an intimate partner violence (IPV) prevention program, integrated in the primary health care services since 2016. The present study is a part of this national program’s evaluation. In this section, we aimed to examine spousal abuse victims’ knowledge and attitude towards domestic violence before and after receivingthese services. Methods: To assess the knowledge and attitudes of victims, a questionnaire designed by Ahmadzadand colleagues in 2013 was used. This questionnaire includes 15 questions regarding knowledge in the fields of definition, epidemiology, and effects on children, outcomes, and prevention of domestic violence. To assess the attitudes, this questionnaire has 10 questions regarding the attitudes toward the causes, effects, and legal or protective support services of domestic violence. To assess the satisfaction and the effect of the program on prevention or reduction of spousal violence episodes, two more questions were also added. Since domestic violence prevalence differs in different parts of the country, we chose nine areas with the highest, the lowest, and moderate prevalence of IPVfor the study. The link to final electronic version of the questionnaire was sent to the randomly selected public rural or urban health centers in the nine chosen areas. Since the study had to be completed in one month, we used newly identified victims as pre-intervention group and people who had at least received one related service from the program (like psychiatric consultation, education about safety measures, supporting organizations and etc.) during the previous year, as our post- intervention group. Results: A hundred and ninety-two newly identified IPV victims and 267 victims who had at least received one related program service during the previous year entered the study. All of the victims were female. Basic characteristics of the two groups, including age, education, occupation, addiction, spouses’ age, spouses’ addiction, duration of the current marriage, and number of children, were not statistically different. In knowledge questions, post- intervention group had statistically better scores in the fields of domestic violence outcomes and its effects on children; however, in the remaining areas, the scores of both groups were similar. The only significant difference in the attitude across the two groups was in the field of legal or protective support services. From the 267 women who had ever received a service from the program, 91.8% were satisfied with the services, and 74% reported a decrease in the number of violent episodes. Conclusion: National IPV prevention program integrated in the primary health care services in Iran is effective in improving the knowledge of victims about domestic violence outcomes and its effects on children. Improving the attitude and knowledge of domestic violence victims about its causes and preventive measures needs more effective interventions. This program can reduce the number of IPV episodes between the spouses, and satisfaction among the service users is high.

Keywords: intimate partner violence, assessment, health services, efficacy

Procedia PDF Downloads 133
2770 A Realist Review of Interventions Targeting Maternal Health in Low- and Middle-income Countries

Authors: Julie Mariam Abraham, G. J. Melendez-Torres

Abstract:

Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

Procedia PDF Downloads 75
2769 The Relationship Between Teachers’ Attachment Insecurity and Their Classroom Management Efficacy

Authors: Amber Hatch, Eric Wright, Feihong Wang

Abstract:

Research suggests that attachment in close relationships affects one’s emotional processes, mindfulness, conflict-management behaviors, and interpersonal interactions. Attachment insecurity is often associated with maladaptive social interactions and suboptimal relationship qualities. Past studies have considered how the nature of emotion regulation and mindfulness in teachers may be related to student or classroom outcomes. Still, no research has examined how the relationship between such internal experiences and classroom management outcomes may also be related to teachers’ attachment insecurity. This study examined the interrelationships between teachers’ attachment insecurity, mindfulness tendencies, emotion regulation abilities, and classroom management efficacy as indexed by students’ classroom behavior and teachers’ response effectiveness. Teachers’ attachment insecurity was evaluated using the global ECRS-SF, which measures both attachment anxiety and avoidance. The present study includes a convenient sample of 357 American elementary school teachers who responded to a survey regarding their classroom management efficacy, attachment in/security, dispositional mindfulness, emotion regulation strategies, and difficulties in emotion regulation, primarily assessed via pre-existing instruments. Good construct validity was demonstrated for all scales used in the survey. Sample demographics, including gender (94% female), race (92% White), age (M = 41.9 yrs.), years of teaching experience (M = 15.2 yrs.), and education level were similar to the population from which it was drawn, (i.e., American elementary school teachers). However, white women were slightly overrepresented in our sample. Correlational results suggest that teacher attachment insecurity is associated with poorer classroom management efficacy as indexed by students’ disruptive behavior and teachers’ response effectiveness. Attachment anxiety was a much stronger predictor of adverse student behaviors and ineffective teacher responses to adverse behaviors than attachment avoidance. Mindfulness, emotion regulation abilities, and years of teaching experience predicted positive classroom management outcomes. Attachment insecurity and mindfulness were more strongly related to frequent adverse student behaviors, while emotion regulation abilities were more strongly related to teachers’ response effectiveness. The teaching experience was negatively related to attachment insecurity and positively related to mindfulness and emotion regulation abilities. Although the data were cross-sectional, path analyses revealed that attachment insecurity is directly related to classroom management efficacy. Through two routes, this relationship is further mediated by emotion regulation and mindfulness in teachers. The first route of indirect effect suggests double mediation by teacher’s emotion regulation and then teacher mindfulness in the relationship between teacher attachment insecurity and classroom management efficacy. The second indirect effect suggests mindfulness directly mediated the relationship between attachment insecurity and classroom management efficacy, resulting in improved model fit statistics. However, this indirect effect is much smaller than the double mediation route through emotion regulation and mindfulness in teachers. Given the significant predication of teacher attachment insecurity, mindfulness, and emotion regulation on teachers’ classroom management efficacy both directly and indirectly, the authors recommend improving teachers’ classroom management efficacy via a three-pronged approach aiming at enhancing teachers’ secure attachment and supporting their learning adaptive emotion regulation strategies and mindfulness techniques.

Keywords: Classroom management efficacy, student behavior, teacher attachment, teacher emotion regulation, teacher mindfulness

Procedia PDF Downloads 81
2768 Investigating the Impact of Migration Background on Pregnancy Outcomes During the End of Period of COVID-19 Pandemic: A Mixed-Method Study

Authors: Charlotte Bach, Albrecht Jahn, Mahnaz Motamedi, Maryam Karimi-Ghahfarokhi

Abstract:

Background: Maternal and infant deaths are most prevalent in the first month after birth, emphasizing the critical need for quality healthcare services during this period. Immigrant women, who are more susceptible to adverse pregnancy outcomes, often face neglect in accessing proper healthcare. The lack of adequate postpartum care significantly contributes to mortality rates. Therefore, utilizing maternal health care services and implementing postpartum care is crucial in reducing maternal and child mortality. Aims: This study aims to evaluate the assessment of pre- and postnatal care among women with and without migration background. In addition, the study explores the impact of COVID-19 procedures on women's experiences during pregnancy, birth, and the postpartum period. Methods: This research employs a cross-sectional Mixed-Method design. Data collection was facilitated through structured questionnaires administered to participants, alongside the utilization of patient bases, including Maternity and child medical records. Following the assumption that the investigator aimed to gain comprehensive insights, qualitative sampling focused on individuals with substantial experiences related to COVID-19, regarded as rich cases. Results: our study highlighted the influence of educational level, marital status, and consensual partnerships on the likelihood of Cesarean deliveries. Regarding breastfeeding practices, migrant women exhibited higher rates of breastfeeding initiation and continuation. Contraception utilization revealed interesting patterns, with non-migrants displaying higher odds of contraceptive use. The qualitative component of our research adds depth to the exploration of women's experiences during the COVID-19 pandemic, revealing nuanced challenges related to anxiety, hospital restrictions, breastfeeding support, and postnatal ward routines. Conclusion: Dissimilarity among studies toward cesarean rate between migrants and non-migrants underscores the importance of targeted interventions considering the diverse needs of distinct population groups. It also acknowledges potential cultural, contextual, and healthcare system influences on the association between mode of delivery and infant feeding practices. Studies acknowledge the influence of contextual variables on contraceptive preferences among migrants and non-migrants, emphasizing the need for tailored healthcare policies. The findings contribute to existing research, highlighting the need for a nuanced understanding of the impact of birth preparation courses on maternal and infant outcomes. Furthermore, they emphasize the universality of certain maternity care experiences, regardless of pandemic contexts, reinforcing the importance of patient-centred approaches in healthcare delivery.

Keywords: migration background, pregnancy outcome, covid-19, postpartum

Procedia PDF Downloads 49
2767 Developing a Framework for Open Source Software Adoption in a Higher Education Institution in Uganda. A case of Kyambogo University

Authors: Kafeero Frank

Abstract:

This study aimed at developing a frame work for open source software adoption in an institution of higher learning in Uganda, with the case of KIU as a study area. There were mainly four research questions based on; individual staff interaction with open source software forum, perceived FOSS characteristics, organizational characteristics and external characteristics as factors that affect open source software adoption. The researcher used causal-correlation research design to study effects of these variables on open source software adoption. A quantitative approach was used in this study with self-administered questionnaire on a purposively and randomly sampled sample of university ICT staff. Resultant data was analyzed using means, correlation coefficients and multivariate multiple regression analysis as statistical tools. The study reveals that individual staff interaction with open source software forum and perceived FOSS characteristics were the primary factors that significantly affect FOSS adoption while organizational and external factors were secondary with no significant effect but significant correlation to open source software adoption. It was concluded that for effective open source software adoption to occur there must be more effort on primary factors with subsequent reinforcement of secondary factors to fulfill the primary factors and adoption of open source software. Lastly recommendations were made in line with conclusions for coming up with Kyambogo University frame work for open source software adoption in institutions of higher learning. Areas of further research recommended include; Stakeholders’ analysis of open source software adoption in Uganda; Challenges and way forward. Evaluation of Kyambogo University frame work for open source software adoption in institutions of higher learning. Framework development for cloud computing adoption in Ugandan universities. Framework for FOSS development in Uganda IT industry

Keywords: open source software., organisational characteristics, external characteristics, cloud computing adoption

Procedia PDF Downloads 68
2766 Exploring Suicidal Behaviors among Transgender and Gender Nonconforming Youth in China

Authors: Krystal Wang, Chongzheng Wei, Runsen Chen, Shufang Sun

Abstract:

Suicide is a global public mental health issue and is the tenth leading cause of death globally. Approximately 75% of suicides occur in low- and middle-income countries (LMIC). Compared to the general population, transgender and gender nonconforming (TGNC) young people have higher suicidal risks. Research has shown that the prevalence of suicidal behaviors among TGNC populations was high in both the United States and China. However, studies were mostly embedded within Western cultures. Limited data and research were available to assess suicidal behaviors among TGNC youth in LMIC countries and to consider various types of TGNC youth. The goal of the current project is to 1) investigate the prevalence of lifetime and past-year suicidal ideations, plans, and attempts among Chinese TGNC youth, 2) explore the relationship between gender identity and suicidal outcomes among TGNC youth in China, 3) identify individual, school, and family level risk and protective factors for suicidal behaviors. The study used data from a cross-sectional survey conducted by Beijing LGBTQ Center in 2021. The survey was the largest TGNC population study in China to understand the health conditions of TGNC individuals. Of the 7612 individuals who completed the survey, a total of 5632 youth (aged 10 to 19) was included in the final analysis. 2259 (40.11%) participants were categorized as transfeminine youth, 1034 (18.36%) as transmasculine youth, 1169 (20.76%) as nonbinary youth AFAB, 568 (10.09%) as nonbinary youth AMAB, 344 (6.11%) as questioning youth AFAB and 258 (4.58%) as questioning youth AMAB. Suicidal behaviors were assessed by asking about lifetime suicidal ideation and attempts, past 12 months suicidal ideation, plan and attempts, and suicidal methods. To achieve the aims, we conducted statistical analysis in Stata/SE 17.0 to 1) describe the prevalence of suicidal outcomes and 2) assess the relationship between gender identity and suicidal outcomes by performing crosstabs, bivariate and multivariate logistic regressions, and adjusting for covariates. The lifetime prevalence of suicidal ideations and attempts for the whole sample was 85.13% and 51.7%. Transfeminine youth had a significantly higher risk for lifetime suicidal ideations (Odds Ratios (OR) = 1.67, CI:1.28,2.18) and attempts than transmasculine youth (OR=1.66, CI: 1.35,2.03), adjusting for age and past year binge drinking, known risk factors of suicide behavior. Past-year prevalence of suicidal behaviors was also high among TGNC youth, with 75.69% in suicidal ideation, 88.77% in suicidal plans, and 57.96% in suicidal attempts. Transfeminine youth, among six subgroups, had the highest risk for past-year suicidal ideations and attempts compared to transmasculine youth. Non-binary youth, regardless of sex assigned at birth, also had a significantly higher risk for suicidal ideations. The prevalence of lifetime and past-year suicidal behaviors was alarming among TGNC youth in China. Among different categories of TGNC youth, transfeminine youth reported the most elevated suicidal risk. The findings indicated a compelling need for researchers and practitioners to address the mental health risks for this specific group and target interventions for TGNC youth in China.

Keywords: child and adolescent mental health, gender minority health, cross-cultural perspective, preventing suicide in youth

Procedia PDF Downloads 72
2765 Evaluating the Impact of a Child Sponsorship Program on Paediatric Health and Development in Calauan, Philippines: A Retrospective Audit

Authors: Daniel Faraj, Arabella Raupach, Charlotte Hespe, Helen Wilcox, Kristie-Lee Anning

Abstract:

Aim: International child sponsorship programs comprise a considerable proportion of global aid accessible to the general population. Team Philippines (TP), a healthcare and welfare initiative run in association with the University of Notre Dame Sydney since 2013, leads a holistic sponsorship program for thirty children from Calauan, Philippines. To date, empirical research has not been performed on the overall success and impact of the TP child sponsorship program. As such, this study aims to evaluate its effectiveness in improving pediatric outcomes. Methods: Study cohorts comprised thirty sponsored and twenty-nine age- and gender-matched non-sponsored children. Data were extracted from the TP Medical Director database and lifestyle questionnaires for July-November 2019. Outcome measures included anthropometry, markers of medical health, dental health, exercise, and diet. Statistical analyses were performed in SPSS. Results: Sponsorship resulted in fewer medical diagnoses and prescription medications, superior dental health, and improved diet. Further, sponsored children may show a clinically significant trend toward improved physical health. Sponsorship did not affect growth and development metrics or levels of physical activity. Conclusions: The TP child sponsorship program significantly impacts positive pediatric health outcomes in the Calauan community. The strength of the program lies in its holistic, sustainable, and community-based model, which is enabled by effective international child sponsorship. This study further supports the relationship between supporting early livelihood and improved health in the pediatric population.

Keywords: child health, public health, health status disparities, healthcare disparities, social determinants of health, morbidity, community health services, culturally competent care, medically underserved areas, population health management, Philippines

Procedia PDF Downloads 105
2764 Beyond Information Failure and Misleading Beliefs in Conditional Cash Transfer Programs: A Qualitative Account of Structural Barriers Explaining Why the Poor Do Not Invest in Human Capital in Northern Mexico

Authors: Francisco Fernandez de Castro

Abstract:

The Conditional Cash Transfer (CCT) model gives monetary transfers to beneficiary families on the condition that they take specific education and health actions. According to the economic rationale of CCTs the poor need incentives to invest in their human capital because they are trapped by a lack of information and misleading beliefs. If left to their own decision, the poor will not be able to choose what is in their best interests. The basic assumption of the CCT model is that the poor need incentives to take care of their own education and health-nutrition. Due to the incentives (income cash transfers and conditionalities), beneficiary families are supposed to attend doctor visits and health talks. Children would stay in the school. These incentivized behaviors would produce outcomes such as better health and higher level of education, which in turn will reduce poverty. Based on a grounded theory approach to conduct a two-year period of qualitative data collection in northern Mexico, this study shows that this explanation is incomplete. In addition to the information failure and inadequate beliefs, there are structural barriers in everyday life of households that make health-nutrition and education investments difficult. In-depth interviews and observation work showed that the program takes for granted local conditions in which beneficiary families should fulfill their co-responsibilities. Data challenged the program’s assumptions and unveiled local obstacles not contemplated in the program’s design. These findings have policy and research implications for the CCT agenda. They bring elements for late programming due to the gap between the CCT strategy as envisioned by policy designers, and the program that beneficiary families experience on the ground. As for research consequences, these findings suggest new avenues for scholarly work regarding the causal mechanisms and social processes explaining CCT outcomes.

Keywords: conditional cash transfers, incentives, poverty, structural barriers

Procedia PDF Downloads 112
2763 The Positive Effects of Social Distancing on Individual Work Outcomes in the Context of COVID-19

Authors: Fan Wei, Tang Yipeng

Abstract:

The outbreak of COVID-19 in early 2020 has been raging around the world, which has severely affected people's work and life. In today's post-pandemic era, although the pandemic has been effectively controlled, people still need to maintain social distancing at all times to prevent the further spread of the virus. Based on this, social distancing in the context of the pandemic has aroused widespread attention from scholars. At present, most studies exploring the influencing factors of social distancing are studying the negative impact of social distancing on the physical and mental state of special groups from the inter-individual level, and their more focus on the forced complete social distancing during the severe period of the pandemic. Few studies have focused on the impact of social distancing on working groups in the post-pandemic era from the within-individual level. In order to explore this problem, this paper constructs a cross-level moderating model based on resource conservation theory from the perspective of psychological resources. A total of 81 subjects were recruited to fill in the three-stage questionnaires each day for 10 working days, and 661valid questionnaires were finally obtained. Through the empirical tests, the following conclusions were finally obtained: (1) At the within-individual level, daily social distancing is positively correlated with the second day’s recovery, and the individual’s low sociability regulates the relationship between social distancing and recovery. The indirect effect of daily social distancing through recovery has positive relationship employees’ work engagement and work-goal progress only when the individual has low sociability. For individuals with high sociability, none of these paths are significant. (2) At the within-individual level, there is a significant relationship between individual's recovery and work engagement and work-goal progress, indicating that the recovery of resources can produce positive work outcomes. According to the results, this study believes that in the post-pandemic era, social distancing can not only effectively prevent and control the pandemic but also have positive impacts. Employees can use the time and energy originally saved for social activities through social distancing to invest in things that can provide resources and help them recover.

Keywords: social distancing, recovery, work engagement, work goal progress, sociability

Procedia PDF Downloads 128
2762 E-Government Development in Nigeria, 'Bank Verification No': An Anti-Corruption Tool

Authors: Ernest C. Nwadinobi, Amanda Peart, Carl Adams

Abstract:

The leading countries like the USA, UK and some of the European countries have moved their focus away from just developing the e-government platform towards just the electronic services which aim at providing access to information to its citizens or customers, but they have gone to make significant backroom changes that can accommodate this electronic service being provided to its customers or citizens. E-government has moved from just providing electronic information to citizens and customers alike to serving their needs. In developing countries like Nigeria, the enablement of e-government is being used as an anti-corruption tool. The introduction of the Bank verification number (BVN) scheme by the Central Bank of Nigeria, has helped the government in not just saving money but also protecting customer’s transaction and enhancing confidence in the banking sector. This has helped curtail the high rate of cyber and financial crime that has been part of the system. The use of BVN as an anti-corruption tool in Nigeria came at a time there was need for openness, accountability, and discipline, after years of robbing the treasury and recklessness in handling finances. As there has not been a defined method for measuring the strength or success of e-government development, in this case BVN, in Nigeria, progress will remain at the same level. The implementation strategy of the BVN in Nigeria has mostly been a quick fix, quick win solution. In fact, there is little or no indication to show evidence of a framework for e-government. Like other leading countries, there is the need for proper implementation of strategy and framework especially towards a customer orientated process, which will accommodate every administrative body of the government institution including private business rather than focusing on a non-flexible organisational structure. The development of e-government must have a strategy and framework for it to work, and this strategy must enclose every public administration and will not be limited to any individual bodies or organization. A defined framework or monitoring method must be put in place to help evaluate and benchmark government development in e-government. This framework must follow the same concept or principles. In censorious analyses of the existing methods, this paper will denote areas that must be included in the existing approach to be able to channel e-government development towards its defined strategic objectives.

Keywords: Bank Verification No (BVN), quick-fix, anti-corruption, quick-win

Procedia PDF Downloads 156
2761 Health and Greenhouse Gas Emission Implications of Reducing Meat Intakes in Hong Kong

Authors: Cynthia Sau Chun Yip, Richard Fielding

Abstract:

High meat and especially red meat intakes are significantly and positively associated with a multiple burden of diseases and also high greenhouse gas (GHG) emissions. This study investigated population meat intake patterns in Hong Kong. It quantified the burden of disease and GHG emission outcomes by modeling to adjust Hong Kong population meat intakes to recommended healthy levels. It compared age- and sex-specific population meat, fruit and vegetable intakes obtained from a population survey among adults aged 20 years and over in Hong Kong in 2005-2007, against intake recommendations suggested in the Modelling System to Inform the Revision of the Australian Guide to Healthy Eating (AGHE-2011-MS) technical document. This study found that meat and meat alternatives, especially red meat intakes among Hong Kong males aged 20+ years and over are significantly higher than recommended. Red meat intakes among females aged 50-69 years and other meat and alternatives intakes among aged 20-59 years are also higher than recommended. Taking the 2005-07 age- and sex-specific population meat intake as baselines, three counterfactual scenarios of adjusting Hong Kong adult population meat intakes to AGHE-2011-MS and Pre-2011 AGHE recommendations by the year 2030 were established. Consequent energy intake gaps were substituted with additional legume, fruit and vegetable intakes. To quantify the consequent GHG emission outcomes associated with Hong Kong meat intakes, Cradle-to-ready-to-eat lifecycle assessment emission outcome modelling was used. Comparative risk assessment of burden of disease model was used to quantify the health outcomes. This study found adjusting meat intakes to recommended levels could reduce Hong Kong GHG emission by 17%-44% when compared against baseline meat intake emissions, and prevent 2,519 to 7,012 premature deaths in males and 53 to 1,342 in females, as well as multiple burden of diseases when compared to the baseline meat intake scenario. Comparing lump sum meat intake reduction and outcome measures across the entire population, and using emission factors, and relative risks from individual studies in previous co-benefit studies, this study used age- and sex-specific input and output measures, emission factors and relative risks obtained from high quality meta-analysis and meta-review respectively, and has taken government dietary recommendations into account. Hence evaluations in this study are of better quality and more reflective of real life practices. Further to previous co-benefit studies, this study pinpointed age- and sex-specific population and meat-type-specific intervention points and leverages. When compared with similar studies in Australia, this study also showed that intervention points and leverages among populations in different geographic and cultural background could be different, and that globalization also globalizes meat consumption emission effects. More regional and cultural specific evaluations are recommended to promote more sustainable meat consumption and enhance global food security.

Keywords: burden of diseases, greenhouse gas emissions, Hong Kong diet, sustainable meat consumption

Procedia PDF Downloads 308
2760 Laparoscopic Uterovaginal Anastomosis in Cervicovaginal Agenesis

Authors: Anamika Choudhary, Neha Qurrat Ain

Abstract:

Background: Congenital agenesis of uterine cervix is a rare anomaly often associated with partial or complete agenesis of vagina. Here is a case report of a 14 year old girl who presented with primary amenorrhea and cyclical abdominal pain since last one year with suprapubic mass palpable. On examination complete absence of a vagina was found, and ultrasound along with magnetic resonance imaging (MRI) suggested cervicovaginal agenesis associated with cryptomenorrhea, which resulted in hematometra and b/l hematosalpinx with pelvic endometriosis. After proper counseling regarding anastomosis failure and the need for future laprotomy or hysterectomy, the patient planned for laparoscopic uterovaginal anastomosis with modified McIndoe vaginoplasty with split skin graft. Case Summary: Chief complaint: The 14 year old girl presented with primary amenorrhea and cyclical abdominal pain. Diagnosis:On history, examination and investigations we made differential diagnoses of cervicovaginal agenesis, cervicovaginal atresia. Post operatively, we concluded it’s a cervicovaginal agenesis. Intervention: Laparoscopic uterovaginal anastomosis was done, and neovagina was created using split skin graft from the thigh and silicone stent. The graft was kept patent, and restenosis was prevented using a dental mould as vaginal dilator. Outcome: Postoperatively 1 year follow-up has been done. We have observed successful uterovaginal anastomosis and good uptake of graft. We also observed the resumption of normal menstrual bleeding. Currently, there has been no restenosis, abnormal vaginal discharge and decreased dysmenorrhea. Conclusion: Laparoscopic-assisted uterovaginal anastomosis can be the treatment of choice in patients with cervical agenesis and atresia instead of hysterectomy, thereby preserving the reproductive function. This conservative approach has better outcomes, as stated in the procedure below. The procedure is successful insofar as the resumption of menstrual function. However, long-term reproductive outcomes, progression of endometriosis, functioning of fallopian tubes, and sexual life in these girls will require further follow-up.

Keywords: cervicovaginal agenesis, uterovaginal anastomosis, dental mould, silicon stent

Procedia PDF Downloads 15