Search results for: program review principles

Authors: Elizabeth Laguaite, Alexandria Purdy

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Heart transplant recipients face psycho-physiological stressors, including pain, lengthy hospitalizations, delirium, and existential crises. They pose an increased risk for Post Traumatic Stress Disorder (PTSD) and can be a predictor of poorer mental and physical Health-Related Quality of Life (HRQOL) outcomes and increased mortality. There is limited research on the prevention of Post Traumatic Stress Symptoms (PTSS) in transplant patients. This case report focuses on a collaborative Music and Art Therapy intervention used to improve outcomes for HMH transplant recipient John (Alias). John, a 58-year-old man with congestive heart failure, was admitted to HMH in February of 2021 with cardiogenic shock, cannulated with an Intra-aortic Balloon Pump, Impella 5.5, and Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a bridge to heart and kidney transplant. He was listed as status 1 for transplant. Music Therapy and Art Therapy (MT and AT) were ordered by the physician for mood regulation, trauma processing and anxiety management. During MT/AT sessions, John reported a history of anxiety and depression exacerbated by medical acuity, shortness of breath, and lengthy hospitalizations. He expressed difficulty sleeping, pain, and existential questions. Initially seen individually by MT/AT, it was determined he could benefit from a collaborative approach due to similar thematic content within sessions. A Life Review intervention was developed by MT/AT. The purpose was for him to creatively express, reflect and process his medical narrative, including the identification of positive and negative events leading up to admission at HMH, the journey to transplant, and his hope for the future. Through this intervention, he created artworks that symbolized each event and paired them with songs, two of which were composed with the MT during treatment. As of September 2023, John has not been readmitted to the hospital and expressed that this treatment is what “got him through transplant”. MT and AT can provide opportunities for a patient to reminisce through creative expression, leading to a shift in the personal meaning of these experiences, promoting resolution, and ameliorating associated trauma. The closer to trauma it is processed, the less likely to develop PTSD. This collaborative MT/AT approach could improve long-term outcomes by reducing mortality and readmission rates for transplant patients.

Keywords: art therapy, music therapy, critical care, PTSD, trauma, transplant

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Authors: Vinay Kumar Vanjakula, Frank Adam, Nils Goseberg

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Wind power is one of the leading renewable energy generation methods. Due to abundant higher wind speeds far away from shore, the construction of offshore wind turbines began in the last decades. However, installation of offshore foundation-based (monopiles) wind turbines in deep waters are often associated with technical and financial challenges. To overcome such challenges, the concept of floating wind turbines is expanded as the basis from the oil and gas industry. The unfolding of Universal heavyweight gravity anchor (UGA) for floating based foundation for floating Tension Leg Platform (TLP) sub-structures is developed in this research work. It is funded by the German Federal Ministry of Education and Research) for a three-year (2019-2022) research program called “Offshore Wind Solutions Plus (OWSplus) - Floating Offshore Wind Solutions Mecklenburg-Vorpommern.” It’s a group consists of German institutions (Universities, laboratories, and consulting companies). The part of the project is focused on the numerical modeling of gravity anchor that involves to analyze and solve fluid flow problems. Compared to gravity-based torpedo anchors, these UGA will be towed and lowered via controlled machines (tug boats) at lower speeds. This kind of installation of UGA are new to the offshore wind industry, particularly for TLP, and very few research works have been carried out in recent years. Conventional methods for transporting the anchor requires a large transportation crane vessel which involves a greater cost. This conceptual UGA anchors consists of ballasting chambers which utilizes the concept of buoyancy forces; the inside chambers are filled with the required amount of water in a way that they can float on the water for towing. After reaching the installation site, those chambers are ballasted with water for lowering. After it’s lifetime, these UGA can be unballasted (for erection or replacement) results in self-rising to the sea surface; buoyancy chambers give an advantage for using an UGA without the need of heavy machinery. However, while lowering/rising the UGA towards/away from the seabed, it experiences difficult, harsh marine environments due to the interaction of waves and currents. This leads to drifting of the anchor from the desired installation position and damage to the lowering machines. To overcome such harsh environments problems, a numerical model is built to investigate the influences of different outer contours and other fluid governing shapes that can be installed on the UGA to overcome the turbulence and drifting. The presentation will highlight the importance of the Computational Fluid Dynamics (CFD) numerical model in OpenFOAM, which is open-source programming software.

Keywords: anchor lowering, towing, waves, currrents, computational fluid dynamics

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Authors: Ardiansyah I. Ryan, Ashsholih K. R., Fathurrohman G. R., Kurniadi M. R., Huda P. A

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The burden of brain-related disease is very high. There are a lot of brain-related diseases with limited treatment result and thus raise the burden more. The Parkinson Disease (PD), Mental Health Problem, or Paralysis of extremities treatments had risen concern, as the patients for those diseases usually had a low quality of life and low chance to recover fully. There are also many other brain or related neural diseases with the similar condition, mainly the treatments for those conditions are still limited as our understanding of the brain function is insufficient. Brain Implant Technology had given hope to help in treating this condition. In this paper, we examine the current update of the brain implant technology. Neurotechnology is growing very rapidly worldwide. The United States Food and Drug Administration (FDA) has approved the use of Deep Brain Stimulation (DBS) as a brain implant in humans. As for neural implant both the cochlear implant and retinal implant are approved by FDA too. All of them had shown a promising result. DBS worked by stimulating a specific region in the brain with electricity. This device is planted surgically into a very specific region of the brain. This device consists of 3 main parts: Lead (thin wire inserted into the brain), neurostimulator (pacemaker-like device, planted surgically in the chest) and an external controller (to turn on/off the device by patient/programmer). FDA had approved DBS for the treatment of PD, Pain Management, Epilepsy and Obsessive Compulsive Disorder (OCD). The target treatment of DBS in PD is to reduce the tremor and dystonia symptoms. DBS has been showing the promising result in animal and limited human trial for other conditions such as Alzheimer, Mental Health Problem (Major Depression, Tourette Syndrome), etc. Every surgery has risks of complications, although in DBS the chance is very low. DBS itself had a very satisfying result as long as the subject criteria to be implanted this device based on indication and strictly selection. Other than DBS, there are several brain implant devices that still under development. It was included (not limited to) implant to treat paralysis (In Spinal Cord Injury/Amyotrophic Lateral Sclerosis), enhance brain memory, reduce obesity, treat mental health problem and treat epilepsy. The potential of neurotechnology is unlimited. When brain function and brain implant were fully developed, it may be one of the major breakthroughs in human history like when human find ‘fire’ for the first time. Support from every sector for further research is very needed to develop and unveil the true potential of this technology.

Keywords: brain implant, deep brain stimulation (DBS), deep brain stimulation, Parkinson

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Authors: Sayantan Khanra, Rojers P. Joseph

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Background and Significance: This study is aimed at analyzing the role of demographic and service quality variables in the adoption and diffusion of e-government services among the users in India. The study proposes to examine the users' perception about e-Government services and investigate the key variables that are most salient to the Indian populace. Description of the Basic Methodologies: The methodology to be adopted in this study is Hierarchical Regression Analysis, which will help in exploring the impact of the demographic variables and the quality dimensions on the willingness to use e-government services in two steps. First, the impact of demographic variables on the willingness to use e-government services is to be examined. In the second step, quality dimensions would be used as inputs to the model for explaining variance in excess of prior contribution by the demographic variables. Present Status: Our study is in the data collection stage in collaboration with a highly reliable, authentic and adequate source of user data. Assuming that the population of the study comprises all the Internet users in India, a massive sample size of more than 10,000 random respondents is being approached. Data is being collected using an online survey questionnaire. A pilot survey has already been carried out to refine the questionnaire with inputs from an expert in management information systems and a small group of users of e-government services in India. The first three questions in the survey pertain to the Internet usage pattern of a respondent and probe whether the person has used e-government services. If the respondent confirms that he/she has used e-government services, then an aggregate of 15 indicators are used to measure the quality dimensions under consideration and the willingness of the respondent to use e-government services, on a five-point Likert scale. If the respondent reports that he/she has not used e-government services, then a few optional questions are asked to understand the reason(s) behind the same. Last four questions in the survey are dedicated to collect data related to the demographic variables. An indication of the Major Findings: Based on the extensive literature review carried out to develop several propositions; a research model is prescribed to start with. A major outcome expected at the completion of the study is the development of a research model that would help to understand the relationship involving the demographic variables and service quality dimensions, and the willingness to adopt e-government services, particularly in an emerging economy like India. Concluding Statement: Governments of emerging economies and other relevant agencies can use the findings from the study in designing, updating, and promoting e-government services to enhance public participation, which in turn, would help to improve efficiency, convenience, engagement, and transparency in implementing these services.

Keywords: adoption and diffusion of e-government services, demographic variables, hierarchical regression analysis, service quality dimensions

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Authors: Eunice Gan Ghee Wu, Marcus Goh Tian Xi, Alicia Chua Si Wen, Helen Bound, Lee Liang Ying, Albert Lee

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The Map of Dialogical Inquiry provides a conceptual basis of learning processes. According to the Map, dialogical inquiry motivates complex thinking, dialogue, reflection, and learner agency. For instance, classrooms that incorporated dialogical inquiry enabled learners to construct more meaning in their learning, to engage in self-reflection, and to challenge their ideas with different perspectives. While the Map contributes to the psychology of learning, its qualitative approach makes it hard to track and compare learning processes over time for both teachers and learners. Qualitative approach typically relies on open-ended responses, which can be time-consuming and resource-intensive. With these concerns, the present research aimed to develop and validate a quantifiable measure for the Map. Specifically, the Map of Dialogical Inquiry reflects the eight different learning processes and perspectives employed during a learner’s experience. With a focus on interpersonal and emotional learning processes, the purpose of the present study is to construct and validate a scale to measure the “Relating” aspect of learning. According to the Map, the Relating aspect of learning contains four conceptual components: using intuition and empathy, seeking personal meaning, building relationships and meaning with others, and likes stories and metaphors. All components have been shown to benefit learning in past research. This research began with a literature review with the goal of identifying relevant scales in the literature. These scales were used as a basis for item development, guided by the four conceptual dimensions in the “Relating” aspect of learning, resulting in a pool of 47 preliminary items. Then, all items were administered to 200 American participants via an online survey along with other scales of learning. Dimensionality, reliability, and validity of the “Relating” scale was assessed. Data were submitted to a confirmatory factor analysis (CFA), revealing four distinct components and items. Items with lower factor loadings were removed in an iterative manner, resulting in 34 items in the final scale. CFA also revealed that the “Relating” scale was a four-factor model, following its four distinct components as described in the Map of Dialogical Inquiry. In sum, this research was able to develop a quantitative scale for the “Relating” aspect of the Map of Dialogical Inquiry. By representing learning as numbers, users, such as educators and learners, can better track, evaluate, and compare learning processes over time in an efficient manner. More broadly, this scale may also be used as a learning tool in lifelong learning.

Keywords: lifelong learning, scale development, dialogical inquiry, relating, social and emotional learning, socio-affective intuition, empathy, narrative identity, perspective taking, self-disclosure

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Authors: Babulayi B. Wilson

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Unsatisfactory performance of construction projects in both the industrialised and developing countries indicate that there could be several defects in construction projects phases. Notwithstanding the fact that some project defects are often conceived at the initiation phase of construction projects, insufficient knowledge of contract procedures has been identified as one of the major sources of construction disputes. Contract procedures are a set of rules that outlines the primary obligations and liabilities of parties involved in the implementation of a construction project. Engineering professional bodies often codify contract procedures into standard forms of contract such as the Institution of Civil Engineers (ICE, UK) and Association of Consulting Engineers (ACE, UK) and keep them under constant review by updating any clause to reflect any change in case law or relevant piece of legislation. Even so, it is the responsibility of a professional body or conditions of contract draftsperson to introduce contract-specific clauses that may be necessary for business efficacy but not covered in the chosen standard conditions of contract. In Botswana, the use of clients’ drafted and/or un-adapted for environment of use international forms of contract in conjunction with client-drafted pricing schedules is common. The product of the latter often impact negatively upon contractors’ claims and payments, in that, tender rates and prices can only be deemed to be sufficient if the chosen conditions of contract compliment the pricing schedule (use of standardised procurement documents). In addition, client drafted and the use of borrowed forms of contract such as FIDIC often conflict with domicile law resulting in costly disputes on the part of the client. It is upon the preceding text that the object of the research is to measure the level of knowledge of contract procedures amongst key stakeholders in the Botswana construction industry by requesting a representative sample from the industry and academia to respond to tutorial questions prepared from two commonly used forms of contract for civil works, that is, FIDIC (International Form of Contract) and ICE (UK). The questions were prepared under the following captions: (a) preparation of tender documents (b) obligations of the parties (c) contract administration; and (d) claims, variations, and valuation of variations. After ascertaining that the level of knowledge of contract procedures is insufficient among most practitioners in the Botswana construction industry, major procurement entities, and engineering institutions of learning; a guide to drafting a condition of a construction contract was developed and then validated through seminars and workshops. In the present, the effectiveness of the guide is not yet measured but feedback from seminars and workshops conducted indicates an appreciation of the guide by the majority of major construction industry stakeholders.

Keywords: contract procedures, conditions of contract, professional practice, construction law, forms of contract

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Authors: Pedro Gomes, Luís Sá Castelo, António Lopes, Marta Maio, Pedro Mota, Adélia Avelar, António Marques Dias

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Introduction: Total Knee Arthroplasty (TKA) has contributed to improvement of patient`s quality of life, although it has been associated with some complications including component loosening and polyethylene wear. To prevent these complications various fixation techniques have been employed. Hybrid TKA with cemented tibial and cementless femoral components have shown favourable outcomes, although it still lack of consensus in the literature. Objectives: To evaluate the clinical and radiographic results of hybrid versus cemented TKA with an average 5 years follow-up and analyse the survival rates. Methods: A retrospective study of 125 TKAs performed in 92 patients at our institution, between 2006 to 2008, with a minimum follow-up of 2 years. The same prosthesis was used in all knees. Hybrid TKA fixation was performed in 96 knees, with a mean follow-up of 4,8±1,7 years (range, 2–8,3 years) and 29 TKAs received fully cemented fixation with a mean follow-up of 4,9±1,9 years (range, 2-8,3 years). Selection for hybrid fixation was nonrandomized and based on femoral component fit. The Oxford Knee Score (OKS 0-48) was evaluated for clinical assessment and Knee Society Roentgenographic Evaluation Scoring System was used for radiographic outcome. The survival rate was calculated using the Kaplan-Meier method, with failures defined as revision of either the tibial or femoral component for aseptic failures and all-causes (aseptic and infection). Analysis of survivorship data was performed using the log-rank test. SPSS (v22) was the computer program used for statistical analysis. Results: The hybrid group consisted of 72 females (75%) and 24 males (25%), with mean age 64±7 years (range, 50-78 years). The preoperative diagnosis was osteoarthritis (OA) in 94 knees (98%), rheumatoid arthritis (RA) in 1 knee (1%) and Posttraumatic arthritis (PTA) in 1 Knee (1%). The fully cemented group consisted of 23 females (79%) and 6 males (21%), with mean age 65±7 years (range, 47-78 years). The preoperative diagnosis was OA in 27 knees (93%), PTA in 2 knees (7%). The Oxford Knee Scores were similar between the 2 groups (hybrid 40,3±2,8 versus cemented 40,2±3). The percentage of radiolucencies seen on the femoral side was slightly higher in the cemented group 20,7% than the hybrid group 11,5% p0.223. In the cemented group there were significantly more Zone 4 radiolucencies compared to the hybrid group (13,8% versus 2,1% p0,026). Revisions for all causes were performed in 4 of the 96 hybrid TKAs (4,2%) and 1 of the 29 cemented TKAs (3,5%). The reason for revision was aseptic loosening in 3 hybrid TKAs and 1 of the cemented TKAs. Revision was performed for infection in 1 hybrid TKA. The hybrid group demonstrated a 7 years survival rate of 93% for all-cause failures and 94% for aseptic loosening. No significant difference in survivorship was seen between the groups for all-cause failures or aseptic failures. Conclusions: Hybrid TKA yields similar intermediate-term results and survival rates as fully cemented total knee arthroplasty and remains a viable option in knee joint replacement surgery.

Keywords: hybrid, survival rate, total knee arthroplasty, orthopaedic surgery

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Authors: Yves Alain Ach, Sandra Rmadi Said

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An extensive review of literature in relation to brands has shown that little research has focused on the nature and determinants of the information disclosed by companies with respect to the brands they own and use. The objective of this paper is to address this issue. More specifically, the aim is to characterize the nature of the information disclosed by companies in terms of estimating the value of brands and to identify the determinants of that information according to the company’s characteristics most frequently tested by previous studies on the disclosure of information on intangible capital, by studying the practices of a sample of 37 French companies. Our findings suggest that companies prefer to communicate accounting, economic and strategic information in relation to their brands instead of providing financial information. The analysis of the determinants of the information disclosed on brands leads to the conclusion that the groups which operate internationally and have chosen a category 1 auditing firm to communicate more information to investors in their annual report. Our study points out that the sector is not an explanatory variable for voluntary brand disclosure, unlike previous studies on intangible capital. Our study is distinguished by the study of an element that has been little studied in the financial literature, namely the determinants of brand-related information. With regard to the effect of size on brand-related information disclosure, our research does not confirm this link. Many authors point out that large companies tend to publish more voluntary information in order to respond to stakeholder pressure. Our study also establishes that the relationship between brand information supply and performance is insignificant. This relationship is already controversial by previous research, and it shows that higher profitability motivates managers to provide more information, as this strengthens investor confidence and may increase managers' compensation. Our main contribution focuses on the nature of the inherent characteristics of the companies that disclose the most information about brands. Our results show the absence of a link between size and industry on the one hand and the supply of brand information on the other, contrary to previous research. Our analysis highlights three types of information disclosed about brands: accounting, economics and strategy. We, therefore, question the reasons that may lead companies to voluntarily communicate mainly accounting, economic and strategic information in relation to our study from one year to the next and not to communicate detailed information that would allow them to reconstitute the financial value of their brands. Our results can be useful for companies and investors. Our results highlight, to our surprise, the lack of financial information that would allow investors to understand a better valuation of brands. We believe that additional information is needed to improve the quality of accounting and financial information related to brands. The additional information provided in the special report that we recommend could be called a "report on intangible assets”.

Keywords: brand related information, brand value, information disclosure, determinants

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Authors: Mai Sirhan, Arieh Sidess

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Asphaltic mixture is a heterogeneous material composed of three main components: aggregates; bitumen and air voids. The professional experience and scientific literature categorize asphaltic mixture as a viscoelastic material, whose behavior is determined by temperature and loading rate. Properties characterization of the asphaltic mixture used under the service conditions is done by compacting and testing cylindric asphalt samples in the laboratory. These samples must resemble in a high degree internal structure of the mixture achieved in service, and the mechanical characteristics of the compacted asphalt layer in the pavement. The laboratory samples are usually compacted in temperatures between 140 and 160 degrees Celsius. In this temperature range, the asphalt has a low degree of strength. The laboratory samples are compacted using the dynamic or vibrational compaction methods. In the compaction process, the aggregates tend to align themselves in certain directions that lead to anisotropic behavior of the asphaltic mixture. This issue has been studied in the Strategic Highway Research Program (SHRP) research, that recommended using the gyratory compactor based on the assumption that this method is the best in mimicking the compaction in the service. In Israel, the Netivei Israel company is considering adopting the Gyratory Method as a replacement for the Marshall method used today. Therefore, the compatibility of the Gyratory Method for the use with Israeli asphaltic mixtures should be investigated. In this research, we aimed to examine the impact of the compaction method used on the mechanical characteristics of the asphaltic mixtures and to evaluate the degree of anisotropy in relation to the compaction method. In order to carry out this research, samples have been compacted in the vibratory and gyratory compactors. These samples were cylindrically cored both vertically (compaction wise) and horizontally (perpendicular to compaction direction). These models were tested under dynamic modulus and permanent deformation tests. The comparable results of the tests proved that: (1) specimens compacted by the vibratory compactor had higher dynamic modulus values than the specimens compacted by the gyratory compactor (2) both vibratory and gyratory compacted specimens had anisotropic behavior, especially in high temperatures. Also, the degree of anisotropy is higher in specimens compacted by the gyratory method. (3) Specimens compacted by the vibratory method that were cored vertically had the highest resistance to rutting. On the other hand, specimens compacted by the vibratory method that were cored horizontally had the lowest resistance to rutting. Additionally (4) these differences between the different types of specimens rise mainly due to the different internal arrangement of aggregates resulting from the compaction method. (5) Based on the initial prediction of the performance of the flexible pavement containing an asphalt layer having characteristics based on the results achieved in this research. It can be concluded that there is a significant impact of the compaction method and the degree of anisotropy on the strains that develop in the pavement, and the resistance of the pavement to fatigue and rutting defects.

Keywords: anisotropy, asphalt compaction, dynamic modulus, gyratory compactor, mechanical properties, permanent deformation, vibratory compactor

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Authors: Muhammad Yasir Tarar

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Background: Intraarticular steroid injections are an effective option in alleviating the symptoms of conditions like osteoarthritis, rheumatoid arthritis, crystal arthropathy, and rotator cuff tendinopathy. Most of these injections are conducted in the elderly who are on polypharmacy, including anticoagulants at times. Up to 6% of patients aged 80-84 years have been reported to be taking Warfarin. The literature availability on safety quotient for patients undergoing intraarticular injections on Warfarin is scarce. It has remained debatable over the years which approach is safe for these patients. Continuing warfarin has a theoretical bleeding risk, and stopping it can lead to even severe life-threatening thromboembolic events in high-risk patients. Objectives: To evaluate the risk of bleeding complications in patients on warfarin undergoing intraarticular injections or arthrocentesis. Study Design & Methods: A literature search of MEDLINE (1946 to present), EMBASE (1974 to present), and Cochrane CENTRAL (1988 to present) databases were conducted using any combination of the keywords, Injection, Knee, Shoulder, Joint, Intraarticular, arthrocentesis, Warfarin, and Anticoagulation in November 2020 for articles published in any language with no publication year limit. The study inclusion criteria included reporting on the rate of bleeding complications following injection of the knee or shoulder in patients on warfarin treatment. Randomized control trials and prospective and retrospective study designs were included. An electronic standardized Performa for data extraction was made. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) the methodology was used. The articles were appraised using the methodological index for nonrandomized studies. The Cochrane Risk of Bias Tool used to assess the risk of bias in included RCTs and the MINORS tool for assessment of bias in observational studies. Results: The search of databases resulted in a total of 852 articles. Relevant articles as per the inclusion criteria were shortlisted, 7 articles deemed suitable to be include. A total of 1033 joints sample size was undertaken with specified knee and shoulder joints of a total of 820. Only 6 joints had bleeding complications, 5 early bleeding at the time of injection or aspiration, and one late bleeding complication with INR of 5, additionally, 2 patients complained of bruising, 3 of pain, and 1 managed for infection. Conclusions: The results of the metanalysis show that it is relatively safe to perform intraarticular injections in patients on Warfarin regardless of the INR range.

Keywords: arthrocentesis, warfarin, bleeding, injection

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Authors: Lee Boudreau, Ash Kumar Khaitu, Laura A. S. MacDonald

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In April 2015, a magnitude 7.8 earthquake struck Nepal, killing, injuring, and displacing thousands of people. The earthquake also damaged water and sanitation service networks, leading to a high risk of diarrheal disease and the associated negative health impacts. In response to the disaster, the Environment and Public Health Organization (ENPHO), a Kathmandu-based non-governmental organization, worked with the Centre for Affordable Water and Sanitation Technology (CAWST), a Canadian education, training and consulting organization, to develop two training programs to educate volunteers on water, sanitation, and hygiene (WASH) needs. The first training program was intended for acute response, with the second focusing on longer term recovery. A key focus was to equip the volunteers with the knowledge and skills to formulate useful WASH advice in the unanticipated circumstances they would encounter when working in affected areas. Within the first two weeks of the disaster, a two-day acute response training was developed, which focused on enabling volunteers to educate those affected by the disaster about local WASH issues, their link to health, and their increased importance immediately following emergency situations. Between March and October 2015, a total of 19 training events took place, with over 470 volunteers trained. The trained volunteers distributed hygiene kits and liquid chlorine for household water treatment. They also facilitated health messaging and WASH awareness activities in affected communities. A three-day recovery phase training was also developed and has been delivered to volunteers in Nepal since October 2015. This training focused on WASH issues during the recovery and reconstruction phases. The interventions and recommendations in the recovery phase training focus on long-term WASH solutions, and so form a link between emergency relief strategies and long-term development goals. ENPHO has trained 226 volunteers during the recovery phase, with training ongoing as of April 2016. In the aftermath of the earthquake, ENPHO found that its existing pool of volunteers were more than willing to help those in their communities who were more in need. By training these and new volunteers, ENPHO was able to reach many more communities in the immediate aftermath of the disaster; together they reached 11 of the 14 earthquake-affected districts. The collaboration between ENPHO and CAWST in developing the training materials was a highly collaborative and iterative process, which enabled the training materials to be developed within a short response time. By training volunteers on basic WASH topics during both the immediate response and the recovery phase, ENPHO and CAWST have been able to link immediate emergency relief to long-term developmental goals. While the recovery phase training continues in Nepal, CAWST is planning to decontextualize the training used in both phases so that it can be applied to other emergency situations in the future. The training materials will become part of the open content materials available on CAWST’s WASH Resources website.

Keywords: water and sanitation, emergency response, education and training, building resilience

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Authors: Sara Matsuzaka

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At the center of emerging policy debates on the rights of transgender individuals in public accommodations is the collision of gender binary views with transgender perspectives that challenge conventional gender norms. The results of such socio-political debates could have significant ramifications for the policies and infrastructures of public and private institutions nationwide, including within the addiction treatment field. Despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in addiction treatment programs. Inpatient addiction treatment centers were originally designed to treat heterosexual cisgender populations and, as such, feature gender segregated housing, bathrooms, and counseling sessions. Such heteronormative structural barriers, combined with exposures to stigmatic al attitudes, may dissuade transgender populations from benefiting from the addiction treatment they so direly need. A literature review is performed to explore the mechanisms by which gender segregation alienates transgender populations within inpatient addiction treatment. The constituent parts of the current debate on the rights of transgender individuals in public accommodations are situated the context of inpatient addiction treatment facilities. Minority Stress Theory is used as a theoretical framework for understanding substance abuse issues among transgender populations as a maladaptive behavioral response for coping with chronic stressors related to gender minority status and intersecting identities. The findings include that despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in and benefiting from addiction treatment. These barriers are present in the form of anticipated or real interpersonal stigma and discrimination by service providers and structural stigma in the form of policy and programmatic components in addiction treatment that marginalize transgender populations. Transphobic manifestations within addiction treatment may dissuade transgender individuals from seeking help, if not reinforce a lifetime of stigmatic experience, potentially exacerbating their substance use issues. Conclusive recommendations for social workers and addiction treatment professionals include: (1) dismantling institutional policies around gender segregation that alienate transgender individuals, (2) developing policies that provide full protections for transgender clients against discrimination based on their gender identity, and (3) implementing trans-affirmative cultural competency training requirements for all staff. Directions for future research are provided.

Keywords: addiction treatment, gender segregation, stigma, transgender

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Authors: Ammar Asma, Bouafia Nabiha, Ben Cheikh Asma, Ezzi Olfa, Mahjoub Mohamed, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Ventilator-associated pneumonia (VAP) is currently recognized as one of the most relevant causes of morbidity and mortality among intensive care unit (ICU) patients worldwide. Identifying modifiable risk factors for VAP could be helpful for future controlled interventional studies aiming at improving prevention of VAP. The purposes of this study were to determine the incidence and risk factors for VAP in in a Tunisian medical ICU. Materials / Methods: A retrospective case-control study design based on the prospective database collected over a 14-month period from September 15th, 2015 through November 15th, 2016 in an 8-bed medical ICU. Patients under ventilation for over 48 h were included. The number of cases was estimated by Epi-info Software with the power of statistical test equal to 90 %. Each case patient was successfully matched to two controls according to the length of mechanical ventilation (MV) before VAP for cases and the total length of MV in controls. VAP in the ICU was defined according to American Thoracic Society; Infectious Diseases Society of America guidelines. Early onset or late-onset VAP were defined whether the infectious process occurred within or after 96 h of ICU admission. Patients’ risk factors, causes of admission, comorbidities and respiratory specimens collected were reviewed. Univariate and multivariate analyses were performed to determine variables associated with VAP with a p-value < 0.05. Results: During the period study, a total of 169 patients under mechanical ventilation were considered, 34 patients (20.11%) developed at least one episode of VAP in the ICU. The incidence rate for VAP was 14.88/1000 ventilation days. Among these cases, 9 (26.5 %) were early-onset VAP and 25 (73.5 %) were late-onset VAP. It was a certain diagnosis in 66.7% of cases. Tracheal aspiration was positive in 80% of cases. Multi-drug resistant Acinerobacter baumanii was the most common species detected in cases; 67.64% (n=23). The rate of mortality out of cases was 88.23% (n= 30). In univariate analysis, the patients with VAP were statistically more likely to suffer from cardiovascular diseases (p=0.035) and prolonged duration of sedation (p=0.009) and tracheostomy (p=0.001), they also had a higher number of re-intubation (p=0.017) and a longer total time of intubation (p=0.012). Multivariate analysis showed that cardiovascular diseases (OR= 4.44; 95% IC= [1.3 - 14]; p=0.016), tracheostomy (OR= 4.2; 95% IC= [1.16 -15.12]; p= 0.028) and prolonged duration of sedation (OR=1.21; 95% IC= [1.07, 1.36]; p=0.002) were independent risk factors for the development of VAP. Conclusion: VAP constitutes a therapeutic challenge in an ICU setting, therefore; strategies that effectively prevent VAP are needed. An infection control-training program intended to all professional heath care in this unit insisting on bundles and elaboration of procedures are planned to reduce effectively incidence rate of VAP.

Keywords: case control study, intensive care unit, risk factors, ventilator associated pneumonia

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Authors: Abiodun Olayinka, Daniel Dzidzienyo, Pangirayi Tongoona, Samuel Offei, Edwige Gaby Nkouaya Mbanjo, Chiedozie Egesi, Ismail Yusuf Rabbi

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Cassava (Manihot esculenta Crantz) is a major source of starch for various industrial applications. However, the traditional cultivation and harvesting methods of cassava are labour-intensive and inefficient, limiting the supply of fresh cassava roots for industrial starch production. To achieve improved productivity and quality of fresh cassava roots through mechanized cultivation, cassava cultivars with compact plant architecture and moderate plant height are needed. Plant architecture-related traits, such as plant height, harvest index, stem diameter, branching angle, and lodging tolerance, are critical for crop productivity and suitability for mechanized cultivation. However, the genetics of cassava plant architecture remain poorly understood. This study aimed to identify the genetic bases of the relationships between plant architecture traits and productivity-related traits, particularly starch content. A panel of 453 clones developed at the International Institute of Tropical Agriculture, Nigeria, was genotyped and phenotyped for 18 plant architecture and productivity-related traits at four locations in Nigeria. A genome-wide association study (GWAS) was conducted using the phenotypic data from a panel of 453 clones and 61,238 high-quality Diversity Arrays Technology sequencing (DArTseq) derived Single Nucleotide Polymorphism (SNP) markers that are evenly distributed across the cassava genome. Five significant associations between ten SNPs and three plant architecture component traits were identified through GWAS. We found five SNPs on chromosomes 6 and 16 that were significantly associated with shoot weight, harvest index, and total yield through genome-wide association mapping. We also discovered an essential candidate gene that is co-located with peak SNPs linked to these traits in M. esculenta. A review of the cassava reference genome v7.1 revealed that the SNP on chromosome 6 is in proximity to Manes.06G101600.1, a gene that regulates endodermal differentiation and root development in plants. The findings of this study provide insights into the genetic basis of plant architecture and yield in cassava. Cassava breeders could leverage this knowledge to optimize plant architecture and yield in cassava through marker-assisted selection and targeted manipulation of the candidate gene.

Keywords: Manihot esculenta Crantz, plant architecture, DArtseq, SNP markers, genome-wide association study

Procedia PDF Downloads 55

Authors: Glauberto S. Quirino, Emanuelly V. Pereira, Amana S. Figueiredo, Antonia T. F. Santos, Paulo R. A. Firmino, Denise F. F. Barbosa, Caroline B. Q. Aquino, Eveliny S. Martins, Cinthia G. P. Calou, Ana K. B. Pinheiro

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Introduction: During pregnancy there are adjustments in the physical, emotional, existential and sexual areas, which may contribute to changes in sexual behavior. The objective was to analyze the sexual behavior of pregnant women. Methods: Quantitative, exploratory-descriptive study, approved by the Ethics and Research Committee of the Regional University of Cariri. For data collection, it was used the Sexuality Questionnaire in Gestation and Sexual Quotient - Female Version. It was carried out in public institutions in the urban and rural areas of three municipalities of the Metropolitan Region of Cariri, south of Ceará, Brazil from February to September 2016. The sampling was proportional stratified by convenience. A total of 815 pregnant women who were literate and aged 20 years or over were broached. 461 pregnant women were excluded because of high risk, adolescence, saturation of the extract, incomplete filling of the instrument, mental and physical handicap, without sexual partner, and the sample was 354 pregnant. The data were grouped, organized and analyzed in the statistical program R Studio (version 386 3.2.4). Descriptive frequency statistics and non-parametric tests were used to analyze the variables, and the results were shown in graphs and tables. Results: The women presented a minimum age of 20, maximum 35 and average of 26.9 years, predominantly urban area residents, with a monthly income of up to one minimum wage (US$ 275,00), high school, catholic, with fixed partner, heterosexuals, multiparous, multiple sexual partners throughout life and with the beginning of sexual life in adolescence (median age 17 years). There was a reduction in sexual practices (67%) and when they were performed, they were more frequent in the first trimester (79.7%) and less frequent in the third trimester (30.5%). Preliminary sexual practices did not change and were more frequent in the second trimester (46.6%). Throughout the gestational trimesters, the partner was referred as the main responsible for the sexual initiative. The women performed vaginal sex (97.7%) and provided greater pleasure (42.8%) compared to non-penetrative sex (53.9%) (oral sex and masturbation). There was also a reduction in the sexual disposition of pregnant women (90.7%) and partner (72.9%), mainly in the first trimester (78.8%), and sexual positions. Sexual performance ranged from regular to good (49.7%). Level of schooling, marital status, sexual orientation of the pregnant woman and the partner, sexual practices and positions, preliminaries, frequency of sexual practices and importance attributed to them were variables that influenced negatively sexual performance and satisfaction. It is concluded that pregnancy negatively changes the sexual behavior of the women and it is suggested to further investigations and approach of the partner, in order to clarify the influence of these variables on the sexual function and subsidize intervention strategies, with a view to the integrality of sexual and reproductive health.

Keywords: obstetric nursing, pregnant women, sexual behavior, women's health

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Authors: Mustafa M. Donma, Orkide Donma

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Iron is physiologically essential. However, it also participates in the catalysis of free radical formation reactions. Its deficiency is associated with amplified health risks. This trace element establishes some links with another physiological process related to cell death, apoptosis. Both iron deficiency and iron overload are closely associated with apoptosis. Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) has the ability to trigger apoptosis and plays a dual role in the physiological versus pathological inflammatory responses of tissues. The aim of this study was to investigate the status of these parameters as well as the associations among them in children with obesity, a low-grade inflammatory state. The study was performed on groups of children with normal body mass index (N-BMI) and obesity. Forty-three children were included in each group. Based upon age- and sex-adjusted BMI percentile tables prepared by World Health Organization, children whose values varied between 85 and 15 were included in N-BMI group. Children whose BMI percentile values were between 99 and 95 comprised obese (OB) group. Institutional ethical committee approval and informed consent forms were taken prior to the study. Anthropometric measurements (weight, height, waist circumference, hip circumference, head circumference, neck circumference) and blood pressure values (systolic blood pressure and diastolic blood pressure) were recorded. Routine biochemical analysis including serum iron, total iron binding capacity (TIBC), transferrin saturation percent (Tf Sat %), and ferritin were performed. Soluble tumor necrosis factor-like weak inducer of apoptosis levels were determined by enzyme-linked immunosorbent assay. Study data was evaluated using appropriate statistical tests performed by the statistical program SPSS. Serum iron levels were 91±34 mcrg/dl and 75±31 mcrg/dl in N-BMI and OB children, respectively. The corresponding values for TIBC, Tf Sat %, ferritin were 265 mcrg/dl vs 299 mcrg/dl, 37.2±19.1 % vs 26.7±14.6 %, and 41±25 ng/ml vs 44±26 ng/ml. in N-BMI and OB groups, sTWEAK concentrations were measured as 351 ng/L and 325 ng/L, respectively (p>0.05). Correlation analysis revealed significant associations between sTWEAK levels and iron related parameters (p<0.05) except ferritin. In conclusion, iron contributes to apoptosis. Children with iron deficiency have decreased apoptosis rate in comparison with that of healthy children. sTWEAK is inducer of apoptosis. Obese children had lower levels of both iron and sTWEAK. Low levels of sTWEAK are associated with several types of cancers and poor survival. Although iron deficiency state was not observed in this study, the correlations detected between decreased sTWEAK and decreased iron as well as Tf Sat % values were valuable findings, which point out decreased apoptosis. This may induce a proinflammatory state, potentially leading to malignancies in the future lives of obese children.

Keywords: apoptosis, children, iron-related parameters, obesity, soluble tumor necrosis factor-like weak inducer of apoptosis

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Authors: Francisca Alves, Diana Figueiredo, Paula Vagos, Luiza Lima, Maria do Céu Salvador, Daniel Rijo

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In recent years, Acceptance and Commitment Therapy (ACT) has been shown to be effective in the treatment of numerous anxiety disorders, including social anxiety disorder (SAD). However, limited evidence exists on its therapeutic gains for adolescents with SAD. The current work presents a weekly 10-session manualized online ACT approach to adolescent SAD, being the first study to do so in a clinical sample of adolescents. The intervention ACT@TeenSAD addresses the six proposed processes of psychological inflexibility (i.e., experiential avoidance, cognitive fusion, lack of values clarity, unworkable action, dominance of the conceptualized past and future, attachment to the conceptualized self) in social situations relevant to adolescents (e.g., doing a presentation). It is organized into four modules. The first module explores the role of psychological (in)flexibility in SAD (session 1 and 2), addressing psychoeducation (i.e., functioning of the mind) according to ACT, the development of an individualized model, and creative hopelessness. The second module focuses on the foundation of psychological flexibility (session 3, 4, and 5), specifically on the development and practice of strategies to promote clarification of values, contact with the present moment, the observing self, defusion, and acceptance. The third module encompasses psychological flexibility in action (sessions 6, 7, 8, and 9), encouraging committed action based on values in social situations relevant to the adolescents. The fourth modules’ focus is the revision of gains and relapse prevention (session 10). This intervention further includes two booster sessions after therapy has ended (3 and 6-month follow-up) that aim to review the continued practice of learned abilities and to plan for their future application to potentially anxious social events. As part of an ongoing clinical trial, the intervention will be assessed on its feasibility with adolescents diagnosed with SAD and on its therapeutic efficacy based on a longitudinal design including pretreatment, posttreatment, 3 and 6-month follow-up. If promising, findings may support the online delivery of ACT interventions for SAD, contributing to increased treatment availability to adolescents. This availability of an effective therapeutic approach will be helpful not only in relation to adolescents who face obstacles (e.g., distance) when attending to face-to-face sessions but also particularly to adolescents with SAD, who are usually more reluctant to look for specialized treatment in public or private health facilities.

Keywords: acceptance and commitment therapy, social anxiety disorder, adolescence, manualized online approach

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Authors: Dean Sinković, Tea Golja, Morena Paulišić

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Upon the end of the vicious war in former Yugoslavia in 1995, international development community widely promoted microfinance as the key development framework to eradicate poverty, create jobs, increase income. Widespread claims were made that microfinance institutions would play vital role in creating a bedrock for sustainable ‘bottom-up’ economic development trajectory, thus, helping newly formed states to find proper way from economic post-war depression. This uplifting neoliberal narrative has no empirical support in the Republic of Croatia. Firstly, the type of enterprises created via microfinance sector are small, unskilled, labor intensive, no technology and with huge debt burden. This results in extremely high failure rates of microenterprises and poor individuals plunging into even deeper poverty, acute indebtedness and social marginalization. Secondly, evidence shows that microcredit is exact reflection of dangerous and destructive sub-prime lending model with ‘boom-to-bust’ scenarios in which benefits are solely extracted by the tiny financial and political elite working around the microfinance sector. We argue that microcredit providers are not proper financial structures through which developing countries should look way out of underdevelopment and poverty. In order to achieve sustainable long-term growth goals, public policy needs to focus on creating, supporting and facilitating the small and mid-size enterprises development. These enterprises should be technically sophisticated, capable of creating new capabilities and innovations, with managerial expertise (skills formation) and inter-connected with other organizations (i.e. clusters, networks, supply chains, etc.). Evidence from South-East Europe suggest that such structures are not created via microfinance model but can be fostered through various forms of social enterprises. Various legal entities may operate as social enterprises: limited liability private company, limited liability public company, cooperative, associations, foundations, institutions, Mutual Insurances and Credit union. Our main hypothesis is that cooperatives are potential agents of social and economic transformation and community development in the region. Financial cooperatives are structures that can foster more efficient allocation of financial resources involving deeper democratic arrangements and more socially just outcomes. In Croatia, pioneers of the first social enterprises were civil society organizations whilst forming a separated legal entity. (i.e. cooperatives, associations, commercial companies working on the principles of returning the investment to the founder). Ever since 1995 cooperatives in Croatia have not grown by pursuing their own internal growth but mostly by relying on external financial support. The greater part of today’s registered cooperatives tend to be agricultural (39%), followed by war veterans cooperatives (38%) and others. There are no financial cooperatives in Croatia. Due to the above mentioned we look at the historical developments and the prevailing social enterprises forms and discuss their advantages and disadvantages as potential agents for social and economic transformation and community development in the region. There is an evident lack of understanding of this business model and of its potential for social and economic development followed by an unfavorable institutional environment. Thus, we discuss the role of governance and management in the formation of social enterprises in Croatia, stressing the challenges for the governance of the country’s social enterprise movement.

Keywords: financial cooperatives, governance and management models, microfinance institutions, social enterprises

Procedia PDF Downloads 259

Authors: Monika Trzaskowska, Dorota Zielinska, Anna Lepecka, Katarzyna Neffe-Skocinska, Beata Bilska, Marzena Tomaszewska, Danuta Kolozyn-Krajewska

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Microbiological quality and food safety are important food characteristics. Regulation (EU) No 1169/2011 of the European Parliament and of the Council on the provision of food information to consumers introduces the obligation to provide information on the 'use-by' date or the date of minimum durability (DMD). The second term is the date until which the properly stored or transported foodstuff retains its physical, chemical, microbiological and organoleptic properties. The date should be preceded by 'best before'. It is used for durable products, e.g., pasta. In relation to reducing food losses, the question may be asked whether products with the date of minimum durability currently declared retain quality and safety beyond this. The aim of the study was to assess the sensory quality and microbiological safety of selected cereal products, i.e., pasta and millet after DMD. The scope of the study was to determine the markers of microbiological quality, i.e., the total viable count (TVC), the number of bacteria from the Enterobacteriaceae family and the number of yeast and mold (TYMC) on the last day of DMD and after 1 and 3 months of storage. In addition, the presence of Salmonella and Listeria monocytogenes was examined on the last day of DMD. The sensory quality of products was assessed by quantitative descriptive analysis (QDA), the intensity of 14 differentiators and overall quality were defined and determined. In the tested samples of millet and pasta, no pathogenic bacteria Salmonella and Listeria monocytogenes were found. The value of the distinguishing features of selected quality and microbiological safety indicators on the last DMD day was in the range of about 3-1 log cfu/g. This demonstrates the good microbiological quality of the tested food. Comparing the products, a higher number of microorganisms was found in the samples of millet. After 3 months of storage, TVC decreased in millet, while in pasta, it was found to increase in value. In both products, the number of bacteria from the Enterobacretiaceae family decreased. In contrast, the number of TYMCs increased in samples of millet, and in pasta decreased. The intensity of sensory characteristic in the studied period varied. It remained at a similar level or increased. Millet was found to increase the intensity and flavor of 'cooked porridge' 3 months after DMD. Similarly, in the pasta, the smell and taste of 'cooked pasta' was more intense. To sum up, the researched products on the last day of the minimum durability date were characterized by very good microbiological and sensory quality, which was maintained for 3 months after this date. Based on these results, the date of minimum durability of tested products could be extended. The publication was financed on the basis of an agreement with the National Center for Research and Development No. Gospostrateg 1/385753/1/NCBR/2018 for the implementation and financing of the project under the strategic research and development program 'social and economic development of Poland in the conditions of globalizing markets – GOSPOSTRATEG - acronym PROM'.

Keywords: date of minimum durability, food losses, food quality and safety, millet, pasta

Procedia PDF Downloads 153

Authors: Reemiah Alotaibi, Muthu Ramachandran, Ah-Lian Kor, Amin Hosseinian-Far

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In the past decade, developers of Web 2.0 technologies have shown increasing interest in the topic of e-government. There has been a rapid growth in social media technology because of its significant role in backing up some essential social needs. Its importance and power is derived from its capacity to support two-way communication. Governments are curious to get engaged in these websites, hoping to benefit from the new forms of communication and interaction offered by such technology. Greater participation by the public can be viewed as a chief indicator of effective government communication. Yet, the level of public participation in government 2.0 is not quite satisfactory. In general, it is still at the early stage in most developing countries, including Saudi Arabia. Although it is a fact that Saudi people are among the most active in using social media, the number of people who use social media to communicate with the public institutions is not high. Furthermore, most of the governmental organisations are not using social media tools to communicate with the public. They use these platforms to disseminate information. Our study focuses on the factors affecting citizens’ adoption of social media in Saudi Arabia. Our research question is: what are the factors affecting Saudi citizens’ use of social media to communicate with the government? To answer this research question, the research aims to validate the UTAUT model for examining social media tools from the citizen perspective. An amendment will be proposed to fit the adoption of social media platforms as a communication channel in government by using a developed conceptual model which integrates constructs from the UTAUT model and others external variables based on the literature review. The set of potential factors that affect these citizens' decisions to adopt social media to communicate with their government has been identified as perceived encouragement, trust and cultural influence. The connection between the above-mentioned constructs from the basis for the research hypothesis will be examined in the light of a quantitative methodology. Data collection will be performed through a survey targeting a number of Saudi citizens who are social media users. The data collected from the primary survey will later be analysed by using statistical methods. The outcomes of this research project are argued to have potential contributions to the fields of social media and e-Government adoption, both on the theoretical and practical levels. It is believed that this research project is the first of its type that attempts to identify the factors that affect citizens’ adoption of social media to communicate with the government. The importance of identifying these factors stems from the potential use of them to enhance the government’s implementation of social media and help in making more accurate decisions and strategies based on comprehending the most important factors that affect citizens’ decisions.

Keywords: social media, adoption, citizen, UTAUT model

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Authors: Pamela Ventola, Laurel Bales, Sara Florczyk

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Background: Fully remote or hybrid administration of clinical outcome measures in rare neurodevelopmental disorders trials is increasing due to the ongoing pandemic and recognition that remote assessments reduce the burden on families. Many assessments in rare neurodevelopmental disorders trials are complex; however, remote/hybrid trials readily allow for the use of centralized raters to administer and score the scales. The use of centralized raters has many benefits, including reducing site burden; however, a specific impact on data quality has not yet been determined. Purpose: The current study has two aims: a) evaluate differences in data quality between administration of a standardized clinical interview completed by centralized raters compared to those completed by site raters and b) evaluate improvement in accuracy of scoring standardized developmental assessments when scored centrally compared to when scored by site raters. Methods: For aim 1, the Vineland-3, a widely used measure of adaptive functioning, was administered by site raters (n= 52) participating in one of four rare disease trials. The measure was also administered as part of two additional trials that utilized central raters (n=7). Each rater completed a comprehensive training program on the assessment. Following completion of the training, each clinician completed a Vineland-3 with a mock caregiver. Administrations were recorded and reviewed by a neuropsychologist for administration and scoring accuracy. Raters were able to certify for the trials after demonstrating an accurate administration of the scale. For site raters, 25% of each rater’s in-study administrations were reviewed by a neuropsychologist for accuracy of administration and scoring. For central raters, the first two administrations and every 10th administration were reviewed. Aim 2 evaluated the added benefit of centralized scoring on the accuracy of scoring of the Bayley-3, a comprehensive developmental assessment widely used in rare neurodevelopmental disorders trials. Bayley-3 administrations across four rare disease trials were centrally scored. For all administrations, the site rater who administered the Bayley-3 scored the scale, and a centralized rater reviewed the video recordings of the administrations and also scored the scales to confirm accuracy. Results: For aim 1, site raters completed 138 Vineland-3 administrations. Of the138 administrations, 53 administrations were reviewed by a neuropsychologist. Four of the administrations had errors that compromised the validity of the assessment. The central raters completed 180 Vineland-3 administrations, 38 administrations were reviewed, and none had significant errors. For aim 2, 68 administrations of the Bayley-3 were reviewed and scored by both a site rater and a centralized rater. Of these administrations, 25 had errors in scoring that were corrected by the central rater. Conclusion: In rare neurodevelopmental disorders trials, sample sizes are often small, so data quality is critical. The use of central raters inherently decreases site burden, but it also decreases rater variance, as illustrated by the small team of central raters (n=7) needed to conduct all of the assessments (n=180) in these trials compared to the number of site raters (n=53) required for even fewer assessments (n=138). In addition, the use of central raters dramatically improves the quality of scoring the assessments.

Keywords: neurodevelopmental disorders, clinical trials, rare disease, central raters, remote trials, decentralized trials

Procedia PDF Downloads 152

Authors: Marcin Zielinski, Marcin Debowski, Paulina Rusanowska, Magda Dudek

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As a result of sonification, the destruction of complex biomass structures results in an increase in the biogas yield from the conditioned material. First, the amount of organic matter released into the solution due to disintegration was determined. This parameter was determined by changes in the carbon content in liquid phase of the conditioned substrate. The amount of carbon in the liquid phase increased with the prolongation of the sonication time to 16 min. Further increase in the duration of sonication did not cause a statistically significant increase in the amount of organic carbon in the liquid phase. The disintegrated material was then used for respirometric measurements for determination of the impact of the conditioning process used on methane fermentation effectiveness. The relationship between the amount of energy introduced into the lignocellulosic substrate and the amount of biogas produced has been demonstrated. Statistically significant increase in the amount of biogas was observed until sonication of 16 min. Further increase in energy in the conditioning process did not significantly increase the production of biogas from the treated substrate. The biogas production from the conditioned substrate was 17% higher than from the reference biomass at that time. The ultrasonic disintegration method did not significantly affect the observed biogas composition. In all series, the methane content in the produced biogas from the conditioned substrate was similar to that obtained with the raw substrate sample (51.1%). Another method of substrate conditioning was hydrothermal depolymerization. This method consists in application of increased temperature and pressure to substrate. These phenomena destroy the structure of the processed material, the release of organic compounds to the solution, which should lead to increase the amount of produced biogas from such treated biomass. The hydrothermal depolymerization was conducted using an innovative microwave heating method. Control measurements were performed using conventional heating. The obtained results indicate the relationship between depolymerization temperature and the amount of biogas. Statistically significant value of the biogas production coefficients increased as the depolymerization temperature increased to 150°C. Further raising the depolymerization temperature to 180°C did not significantly increase the amount of produced biogas in the respirometric tests. As a result of the hydrothermal depolymerization obtained using microwave at 150°C for 20 min, the rate of biogas production from the Sida silage was 780 L/kg VS, which accounted for nearly 50% increase compared to 370 L/kg VS obtained from the same silage but not depolymerised. The study showed that by microwave heating it is possible to effectively depolymerized substrate. Significant differences occurred especially in the temperature range of 130-150ºC. The pre-treatment of Sida hermaphrodita silage (biogas substrate) did not significantly affect the quality of the biogas produced. The methane concentration was about 51.5% on average. The study was carried out in the framework of the project under program BIOSTRATEG funded by the National Centre for Research and Development No. 1/270745/2/NCBR/2015 'Dietary, power, and economic potential of Sida hermaphrodita cultivation on fallow land'.

Keywords: disintegration, biogas, methane fermentation, Virginia fanpetals, biomass

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Authors: P. Uma Devi, S. Sujith, K. Rahul, T. S. Dipu, V. Anil Kumar , Vidya Menon

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Introduction: Candida is an important cause of bloodstream infections (BSIs), causing significant mortality and morbidity. The epidemiology of Candida infection is also changing, mainly in relation to the number of episodes caused by species Candida non-albicans. However, in India, the true burden of candidemia is not clear. Thus, this study was conducted to evaluate the clinical characteristics, species distribution, antifungal susceptibility and outcome of candidemia at our hospital. Methodology: Between January 2012 and April 2014, adult patients with at least one positive blood culture for Candida species were identified through the microbiology laboratory database (for each patient only the first episode of candidemia was recorded). Patient data was collected by retrospective chart review of clinical characteristics including demographic data, risk factors; species distribution, resistance to antifungals and survival. Results: A total of 165 episodes of Candida BSI were identified, with 115 episodes occurring in adult patients. Most of the episodes occurred in males (69.6%). Nearly 82.6% patients were between 41 to 80 years and majority of the patients were in the intensive care unit (65.2%) at the time of diagnosis. On admission, 26.1% and 18.3% patients had pneumonia and urinary tract infection, respectively. Majority of the candidemia episodes were found in the general medicine department (23.5%) followed by gastrointestinal surgery (13.9%) and medical oncology & haematology (13%). Risk factors identified were prior hospitalization within one year (83.5%), antibiotic therapy within the last one month (64.3%), indwelling urinary catheter (63.5%), central venous catheter use (59.1%), diabetes mellitus (53%), severe sepsis (45.2%), mechanical ventilation (43.5%) and surgery (36.5%). C. tropicalis (30.4%) was the leading cause of infection followed by C. parapsilosis (28.7%) and C. albicans (13%). Other non-albicans species isolated included C. haemulonii (7.8%), C. glabrata (7%), C. famata (4.3%) and C. krusei (1.7%). Antifungal susceptibility to fluconazole was 87.9% (C. parapsilosis), 100% (C. tropicalis) and 93.3% (C. albicans). Mortality was noted in 51 patients (44.3%). Early mortality (within 7 days) was noted in 32 patients while late mortality (between 7 and 30 days) was noted in 19 patients. Conclusion: In recent years, candidemia has been flourishing in critically ill patients. Comparison of data from our own hospital from 2005 shows a doubling of the incidence. Rapid changes in the rate of infection, potential risk factors, and emergence of non-albicans Candida demand continued surveillance of this serious BSI. High index of suspicion and sensitive diagnostics are essential to improve outcomes in resource limited settings with emergence of non-albicans Candida.

Keywords: antifungal susceptibility, candida albicans, candidemia, non-albicans candida

Procedia PDF Downloads 443

Authors: Abdul-Ganiyu Fuseini, Bernice Redley, Helen Rawson, Lenore Lay, Debra Kerr

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Aim: The study aimed to develop and validate a culturally appropriate patient-reported outcome measure for measuring dignity for older adults during acute hospital admissions. Design: A three-phased mixed-method sequential exploratory design was used. Methods: Concept elicitation and generation of items for the scale was informed by older adults’ perspectives about dignity during acute hospitalization and a literature review. Content validity evaluation and pre-testing were undertaken using standard instrument development techniques. A cross-sectional survey design was conducted involving 270 hospitalized older adults for evaluation of construct and convergent validity, internal consistency reliability, and test–retest reliability of the scale. Analysis was performed using Statistical Package for the Social Sciences, version 25. Reporting of the study was guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results: We established the 15-item Hospitalized Older Adults’ Dignity Scale that has a 5-factor structure: Shared Decision-Making (3 items); Healthcare Professional-Patient Communication (3 items); Patient Autonomy (4 items); Patient Privacy (2 items); and Respectful Care (3 items). Excellent content validity, adequate construct and convergent validity, acceptable internal consistency reliability, and good test-retest reliability were demonstrated. Conclusion: We established the Hospitalized Older Adults Dignity Scale as a valid and reliable scale to measure dignity for older adults during acute hospital admissions. Future studies using confirmatory factor analysis are needed to corroborate the dimensionality of the factor structure and external validity of the scale. Routine use of the scale may provide information that informs the development of strategies to improve dignity-related care in the future. Impact: The development and validation of the Hospitalized Older Adults Dignity Scale will provide healthcare professionals with a feasible and reliable scale for measuring older adults’ dignity during acute hospitalization. Routine use of the scale may enable the capturing and incorporation of older patients’ perspectives about their healthcare experience and provide information that informs the development of strategies to improve dignity-related care in the future.

Keywords: dignity, older adults, hospitalisation, scale, patients, dignified care, acute care

Procedia PDF Downloads 81

Authors: Lola Vivour-Adeniyi, Oluwatoyosi Abikoye

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Gender-Based Violence has persistently been an enduring epidemic rooted in various homes and cultures worldwide throughout history. Despite numerous multifaceted approaches aiming to eliminate gender disparity by empowering girls with independent, survival, or entrepreneurial skills, positive transformation efforts for boys are often neglected. This gap, particularly in West Africa, hinders the reshaping of generational perceptions of men's roles in eradicating all forms of violence against women, creating an imbalance in providing holistic, sustainable solutions in our society. In response to this, the Lagos State Domestic and Sexual Violence Agency established the Kings Club initiative in 2018 in Lagos, Nigeria, aligning with UN SDG 5 on 'gender equality and the empowerment of all women and girls.' This initiative aims to debunk sociocultural misconceptions, educate on sexual and Gender Violence issues, and promote positive masculinity among schoolboys. The objective is to foster a balance in the behavioral and attitudinal mindsets of young boys, contributing to the success of an equitable society for all in the eradication of gender disparity. The ongoing project demonstrates an annual 89% success rate in behavioral and attitudinal mindset shifts among schoolboys by employing qualitative assessments of participants aged 10–17. The paper uses data from 161 secondary school students drawn from 15 schools in Lagos State Education District 6, exposed to modules on Sexual and Reproductive Rights and Health, Masculinity, Sexual and Gender-Based Violence, Anger Management, and transitioning from boy to man in a 6-week program, with observations and feedback analyses. The paper evaluates changes in attitudes, behaviors, and gender role perceptions among the boys who are now pioneers of the Kings' Club in their respective schools, serving as positive influencers among their peers in schools and at home. The paper's findings provide a nuanced understanding of cultural dynamics shaping male masculinity in West Africa and offer valuable insights into the effectiveness of innovative interventions to end all forms of violence against women. In conclusion, by intentionally reshaping young boys alongside girls, who represent the future, we stand a chance to create culturally sensitive societal norms that bridge the gap of gender inequity and end all forms of violence against women. The paper posits that its outcomes hold research significance, providing targeted interventions in male masculinity in patriarchal societies.

Keywords: cultural dynamics, gender equality, gender-based violence, positive masculinity

Procedia PDF Downloads 65

Authors: Kristina Colovic, Mari Janikian, Nikolaos Takis, Fotini-Sonia Apergi

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A considerable number of Afghan asylum seekers in Greece are still waiting for answers about their future and status for personal, social and societal advancement. Most have been trapped in a stalemate of continuously postponed or temporarily progressed levels of integration into the EU/Greek process of asylum. Limited quantitative research exists investigating the psychological effects of long-term displacement among Afghans refugees in Greece. The purpose of this study is to investigate factors that are associated with and predict psychological distress symptoms among this population. Data from a sample of native Afghan nationals (N > 70) living in Greece for approximately the last ten years will be collected from May to July 2016. Criteria for participation include the following: being 18 years of age or older, and emigration from Afghanistan to Greece from 2003 onwards (i.e., long-term refugees or part of the 'old system of asylum'). Snowball sampling will be used to recruit participants, as this is considered the most effective option when attempting to study refugee populations. Participants will complete self-report questionnaires, consisting of the Afghan Symptom Checklist (ASCL), a culturally validated measure of psychological distress, the World Health Organization Quality of Life scale (WHOQOL-BREF), an adapted version of the Comprehensive Trauma Inventory-104 (CTI-104), and a modified Psychological Acculturation Scale. All instruments will be translated in Greek, through the use of forward- and back-translations by bilingual speakers of English and Greek, following WHO guidelines. A pilot study with 5 Afghan participants will take place to check for discrepancies in understanding and for further adapting the instruments as needed. Demographic data, including age, gender, year of arrival to Greece and current asylum status will be explored. Three different types of analyses (descriptive statistics, bivariate correlations, and multivariate linear regression) will be used in this study. Descriptive findings for respondent demographics, psychological distress symptoms, traumatic life events and quality of life will be reported. Zero-order correlations will assess the interrelationships among demographic, traumatic life events, psychological distress, and quality of life variables. Lastly, a multivariate linear regression model will be estimated. The findings from the study will contribute to understanding the determinants of acculturation, distress and trauma on daily functioning for Afghans in Greece. The main implications of the current study will be to advocate for capacity building and empower communities through effective program evaluation and design for mental health services for all refugee populations in Greece.

Keywords: Afghan refugees, evaluation, Greece, mental health, quality of life

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Authors: Muhammad Kashif Fida

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In the bank, teller’s job (cash officer) is highly important and critical as at one end it requires soft and brisk customer services and on the other side, handling cash with integrity. It is always challenging for recruiters to hire competent and trustworthy tellers. According to author’s knowledge, there is no comprehensive test available that may provide assistance in recruitment in Pakistan. So there is a dire need of a psychometric battery that could provide support in recruitment of potential candidates for the teller’ position. So, the aim of the present study was to construct ABL-Teller Aptitude Test (ABL-TApT). Three major phases have been designed by following American Psychological Association’s guidelines. The first phase was qualitative, indicators of the test have been explored by content analysis of the a) teller’s job descriptions (n=3), b) interview with senior tellers (n=6) and c) interview with HR personals (n=4). Content analysis of above yielded three border constructs; i). Personality, ii). Integrity/honesty, iii). Professional Work Aptitude. Identified indicators operationalized and statements (k=170) were generated using verbatim. It was then forwarded to the five experts for review of content validity. They finalized 156 items. In the second phase; ABL-TApT (k=156) administered on 323 participants through a computer application. The overall reliability of the test shows significant alpha coefficient (α=.81). Reliability of subscales have also significant alpha coefficients. Confirmatory Factor Analysis (CFA) performed to estimate the construct validity, confirms four main factors comprising of eight personality traits (Confidence, Organized, Compliance, Goal-oriented, Persistent, Forecasting, Patience, Caution), one Integrity/honesty factor, four factors of professional work aptitude (basic numerical ability and perceptual accuracy of letters, numbers and signature) and two factors for customer services (customer services, emotional maturity). Values of GFI, AGFI, NNFI, CFI, RFI and RMSEA are in recommended range depicting significant model fit. In third phase concurrent validity evidences have been pursued. Personality and integrity part of this scale has significant correlations with ‘conscientiousness’ factor of NEO-PI-R, reflecting strong concurrent validity. Customer services and emotional maturity have significant correlations with ‘Bar-On EQI’ showing another evidence of strong concurrent validity. It is concluded that ABL-TAPT is significantly reliable and valid battery of tests, will assist in objective recruitment of tellers and help recruiters in finding a more suitable human resource.

Keywords: concurrent validity, construct validity, content validity, reliability, teller aptitude test, objective recruitment

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Authors: Steven G. Sclan

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Background: Since December 2019, the world has been afflicted by the spread of the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2), which is responsible for the condition referred to as Covid-19. The illness has had a cataclysmic impact on the political, social, economic, and overall well-being of the population of the entire globe. While Covid-19 has had a substantial universal fatality impact, it may have an even greater effect on the socioeconomic, medical well-being, and healthcare planning for remaining societies. Significance: As these numbers illustrate, many more persons survive the infection than die from it, and many of those patients have noted ongoing, persistent symptoms after successfully enduring the acute phase of the illness. Recognition and understanding of these symptoms are crucial for developing and arranging efficacious models of care for all patients (whether or not having been hospitalized) surviving acute covid illness and plagued by post-acute symptoms. Furthermore, regarding Covid infection in children (< 18 y/o), although it may be that Covid “+” children are not major vectors of infective transmission, it now appears that many more children than initially thought are carrying the virus without accompanying obvious symptomatic expression. It seems reasonable to wonder whether viral effects occur in children – those children who are Covid “+” and now asymptomatic – and if, over time, they might also experience similar symptoms. An even more significant question is whether Covid “+” asymptomatic children might manifest increased multiple health problems as they grow – i.e., developmental complications (e.g., physical/medical, metabolic, neurobehavioral, etc.) – in comparison to children who had been consistently Covid “ - ” during the pandemic. Topics Addressed and Theoretical Importance: This review is important because of the description of both quantitative and qualitative methods for clinical and biomedical research. Topics reviewed will consider the importance of well-designed, comprehensive (i.e., quantitative and qualitative methods) longitudinal studies of Post Covid-19 symptoms in both adults and children. Also reviewed will be general characteristics of longitudinal studies and a presentation of a model for a proposed study. Also discussed will be the benefit of longitudinal studies for the development of efficacious interventions and for the establishment of cogent, practical, and efficacious community healthcare service planning for post-acute covid patients. Conclusion: Results of multi-dimensional, longitudinal studies will have important theoretical implications. These studies will help to improve our understanding of the pathophysiology of long COVID and will aid in the identification of potential targets for treatment. Such studies can also provide valuable insights into the long-term impact of COVID-19 on public health and socioeconomics.

Keywords: COVID-19, post-COVID-19, long COVID, longitudinal research, quantitative research, qualitative research

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Authors: Ebenezer Joseph

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Chess is a useful tool to enhance general and specific cognitive functioning in children. The present study aims to assess the impact of chess on cognitive in children and to measure the differential impact of socio-demographic factors like age and gender of the child on the effectiveness of the chess intervention.This research study used an experimental design to study the impact of the Training in Chess on the intelligence of children. The Pre-test Post-test Control Group Design was utilized. The research design involved two groups of children: an experimental group and a control group. The experimental group consisted of children who participated in the one-year Chess Training Intervention, while the control group participated in extra-curricular activities in school. The main independent variable was training in chess. Other independent variables were gender and age of the child. The dependent variable was the cognitive functioning of the child (as measured by IQ, working memory index, processing speed index, perceptual reasoning index, verbal comprehension index, numerical reasoning, verbal reasoning, non-verbal reasoning, social intelligence, language, conceptual thinking, memory, visual motor and creativity). The sample consisted of 200 children studying in Government and Private schools. Random sampling was utilized. The sample included both boys and girls falling in the age range 6 to 16 years. The experimental group consisted of 100 children (50 from Government schools and 50 from Private schools) with an equal representation of boys and girls. The control group similarly consisted of 100 children. The dependent variables were assessed using Binet-Kamat Test of Intelligence, Wechsler Intelligence Scale for Children - IV (India) and Wallach Kogan Creativity Test. The training methodology comprised Winning Moves Chess Learning Program - Episodes 1–22, lectures with the demonstration board, on-the-board playing and training, chess exercise through workbooks (Chess school 1A, Chess school 2, and tactics) and working with chess software. Further students games were mapped using chess software and the brain patterns of the child were understood. They were taught the ideas behind chess openings and exposure to classical games were also given. The children participated in mock as well as regular tournaments. Preliminary analysis carried out using independent t tests with 50 children indicates that chess training has led to significant increases in the intelligent quotient. Children in the experimental group have shown significant increases in composite scores like working memory and perceptual reasoning. Chess training has significantly enhanced the total creativity scores, line drawing and pattern meaning subscale scores. Systematically learning chess as part of school activities appears to have a broad spectrum of positive outcomes.

Keywords: chess, intelligence, creativity, children

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Authors: Giovanna Bimonte, Luigi Senatore, Francesco Saverio Tortoriello, Ilaria Veronesi

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The education process considers capabilities not only to be seen as a means to a certain end but rather as an effective purpose. Sen's capability approach challenges human capital theory, which sees education as an ordinary investment undertaken by individuals. A complex reality requires complex thinking capable of interpreting the dynamics of society's changes to be able to make decisions that can be rational for private, ethical and social contexts. Education is not something removed from the cultural and social context; it exists and is structured within it. In Italy, the "Mathematical High School Project" is a didactic research project is based on additional laboratory courses in extracurricular hours where mathematics intends to bring itself in a dialectical relationship with other disciplines as a cultural bridge between the two cultures, the humanistic and the scientific ones, with interdisciplinary educational modules on themes of strong impact in younger life. This interdisciplinary mathematics presents topics related to the most advanced technologies and contemporary socio-economic frameworks to demonstrate how mathematics is not only a key to reading but also a key to resolving complex problems. The recent developments in mathematics provide the potential for profound and highly beneficial changes in mathematics education at all levels, such as in socio-economic decisions. The research project is built to investigate whether repeated interactions can successfully promote cooperation among students as rational choice and if the skill, the context and the school background can influence the strategies choice and the rationality. A Laboratory on Game Theory as mathematical theory was conducted in the 4th year of the Mathematical High Schools and in an ordinary scientific high school of the Scientific degree program. Students played two simultaneous games of repeated Prisoner's Dilemma with an indefinite horizon, with two different competitors in each round; even though the competitors in each round will remain the same for the duration of the game. The results highlight that most of the students in the two classes used the two games with an immunization strategy against the risk of losing: in one of the games, they started by playing Cooperate, and in the other by the strategy of Compete. In the literature, theoretical models and experiments show that in the case of repeated interactions with the same adversary, the optimal cooperation strategy can be achieved by tit-for-tat mechanisms. In higher education, individual capacities cannot be examined independently, as conceptual framework presupposes a social construction of individuals interacting and competing, making individual and collective choices. The paper will outline all the results of the experimentation and the future development of the research.

Keywords: game theory, interdisciplinarity, mathematics education, mathematical high school

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