Search results for: musical involvement
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1392

Search results for: musical involvement

462 Clinical Outcomes For Patients Diagnosed With DCIS Through The Breast Screening Programme

Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester

Abstract:

Background: DCIS accounts for 20% of malignancies diagnosed by the breast screening programme and is primarily managed by surgical excision. There is variable guidance on defining excision margins, and adjuvant treatments vary widely. This study aimed to investigate the clinical outcomes for patients following surgical excision of small volume DCIS. Methods: This single-centreretrospective cohort study of 101 consecutive breast screened patients diagnosed with DCIS who underwent surgical excision. All patients diagnosed with DCIS had radiological abnormalities <15mm. Clinical, radiological, and histological data were collected from patients who had been diagnosed within a 5 year period, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Outcomes included re-excision rates, radiotherapy usage, and the presence of invasive cancer. Results: Breast conservation surgery was performed in 94.1% (n=95). Following surgical excision, 74(73.27%)patients had complete DCIS excision (>2mm margin), 4(4.0%) had margins 1-2mm, and 17(16.84%)had margins <1mm. The median size of DCIS in the specimen sample was 4mm. In 86% of patients with involved margins (n=18), the mammogram underestimated the DCIS size by a median of 12.5mm (range: 1-42mm). Of the patients with involved margins, 11(10.9%)had a re-excision, and 6 of these (50%) required two re-excisions to completely excise the DCIS. Post-operative radiotherapy was provided to 53(52.48%)patients. Four (3.97%) patients were found to have invasive ductal carcinoma on surgical excision, which was not present on core biopsy – all had high-grade DCIS. Recurrence of DCIS was seen in the same site during follow-up in 1 patient (1%), 1 year after their first DCIS diagnosis. Conclusion: Breast conservation surgery is safe in patients with DCIS, with low rates of re-excision, recurrence, and upstaging to invasive cancer. Furthermore, the median size of DCIS found in the specimens of patients who had DCIS fully removed in surgery was low, suggesting it may be possible that total removal through VAE was possible for these patients.

Keywords: surgical excision, breast conservation surgery, DCIS, Re-excision, radiotherapy, invasive cancer

Procedia PDF Downloads 129
461 The Relationship Between Cyberbullying Victimization, Parent and Peer Attachment and Unconditional Self-Acceptance

Authors: Florina Magdalena Anichitoae, Anca Dobrean, Ionut Stelian Florean

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Due to the fact that cyberbullying victimization is an increasing problem nowadays, affecting more and more children and adolescents around the world, we wanted to take a step forward analyzing this phenomenon. So, we took a look at some variables which haven't been studied together before, trying to develop another way to view cyberbullying victimization. We wanted to test the effects of the mother, father, and peer attachment on adolescent involvement in cyberbullying as victims through unconditional self acceptance. Furthermore, we analyzed each subscale of the IPPA-R, the instrument we have used for parents and peer attachment measurement, in regards to cyberbullying victimization through unconditional self acceptance. We have also analyzed if gender and age could be taken into consideration as moderators in this model. The analysis has been performed on 653 adolescents aged 11-17 years old from Romania. We used structural equation modeling, working in R program. For the fidelity analysis of the IPPA-R subscales, USAQ, and Cyberbullying Test, we have calculated the internal consistency index, which varies between .68-.91. We have created 2 models: the first model including peer alienation, peer trust, peer communication, self acceptance and cyberbullying victimization, having CFI=0.97, RMSEA=0.02, 90%CI [0.02, 0.03] and SRMR=0.07, and the second model including parental alienation, parental trust, parental communication, self acceptance and cyberbullying victimization and had CFI=0.97, RMSEA=0.02, 90%CI [0.02, 0.03] and SRMR=0.07. Our results were interesting: on one hand, cyberbullying victimization is predicted by peer alienation and peer communication through unconditional self acceptance. Peer trust directly, significantly, and negatively predicted the implication in cyberbullying. In this regard, considering gender and age as moderators, we found that the relationship between unconditional self acceptance and cyberbullying victimization is stronger in girls, but age does not moderate the relationship between unconditional self acceptance and cyberbullying victimization. On the other hand, regarding the degree of cyberbullying victimization as being predicted through unconditional self acceptance by parental alienation, parental communication, and parental trust, this hypothesis was not supported. Still, we could identify a direct path to positively predict victimization through parental alienation and negatively through parental trust. There are also some limitations to this study, which we've discussed in the end.

Keywords: adolescent, attachment, cyberbullying victimization, parents, peers, unconditional self-acceptance

Procedia PDF Downloads 202
460 Exploring the Effectiveness of End-Of-Life Patient Decision Add in the ICU

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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459 A Family Development Approach to Understanding the Transfer of Family Business Ownership

Authors: Susan Lanz, Gary T. Burke, Omid Omidvar

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The intention to transfer ownership control across family generations is acknowledged to be central to developing a theoretical understanding of how family businesses differ and are distinct as a business group. However, in practice, most business-owning families face challenges to transfer their business ownership from one family generation to the next. To date, researchers have paid little attention to how and when ownership is passed across family generations and what the dynamics of such transitions are. This is primarily due to the prevailing assumption that ownership transfer is an unimportant and legalistic issue that occurs within a wider family management succession process. Yet, the limited evidence available suggests that family ownership transfer occurs inside and outside of the management succession process and is a difficult process for business-owning families to navigate. As a result, many otherwise viable family businesses are closing, leading to unnecessary loss of jobs and knowledge. This qualitative paper examines how family members understand and navigate the ownership transfer process. This study uses an inductive qualitative research design, conducted through in-depth interviews within eight business-owning families. It draws on family development theory and shows how a wide range of family-related events and dynamics outside of family business involvement underlie and shape the ownership transfer process. The findings extend the theory on how these events trigger ownership transfer and how they shape the ownership meanings held within business-owning families. This study found that ownership transfer meanings extend beyond that of transferring the legal control and financial appropriation rights of shareholders. The study concludes there are three different stages in the process of ownership transfer -symbolic, re-balancing, and protectionist. Each stage creates distinct family social constructions of the rights of family members to hold business ownership, and each stage occurs within a specific family development phase.

Keywords: business-owning family, family development theory, ownership transfer, process

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458 An Exploratory Study of the Ghanaian Music Industry: Its Impacts on the Economy and Society

Authors: Ralph Nyadu-Addo, Francis Matambalya, Utz Dornberger

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The global music industry is a multi-billion dollar sector. The potential of Africa’s music industry is widely recognised in the socio-economic development milieu. It has impacted positively on several sectors including most especially the tourism, media and information, communication technology (ICT) among others. It is becoming increasingly clear that even in Africa (as demonstrated in Nigeria) that in addition to its intrinsic value, the sector has significant economic returns. UNCTAD observed, the creative industries offer some of the best prospects for high growth in least developed countries. The statistics from Africa may be far lower than similar sectors in developed countries but it goes to give further credence to several UNCTAD publications which say the creative industry is under researched and its potential under-estimated but holds the key to its rapid development The emerging creative economy (music in particular) has become a leading component of economic growth, employment, trade, innovation, and social cohesion in many countries. In line with these developments, the Ghana government recognizes the potential that the Creative Industries have to shape and reinforce Ghana’s economic growth. Creative sectors, particularly music, tend to rely less on sophisticated infrastructure or capital-intensive investment. Potential is particularly abundant in Africa, where musical creativity is rich, diverse, well-loved, and constantly evolving while drawing on strong traditions. The development of a popular music industry thus represents low-hanging fruit for most African economies says the World Bank. As we shift towards economic diversification using the creative industry, value is increasingly created at the intersection of arts, business and technology. Cultural and creative entrepreneurs are leading this trend. It is one of the areas where value is captured within the country as emerging trends have shown in Nigeria and Ghana among others. Yet, evidence shows that the potential of the cultural and creative sectors remains largely untapped. Furthermore, its socio-economic impact remains under-researched in many developing countries and its dynamics unknown. Despite its huge influence on music repertoire across the globe, most countries in Africa have not historically been significant markets for the international music industry. Today, that is beginning to change. Generally, reliable and adequate literature about music in the sub-region is difficult to obtain. The growing interests in academia and business cycles about a reliable data on the growing music industry in developing countries have called for an urgent need to undertake this research. Research questions: i. Who are the major stakeholders in the music value chain in Ghana? ii. How much of value is captured domestically iii. What is the economic impact of the Ghanaian music industry iv. How has the advent of ICT (internet) impacted on the music landscape? Research sources will be mainly through interviews of major stakeholders, baseline study of the industry by KPMG and content analysis of related newspapers and magazines.

Keywords: economic impact, information communications technology (ICT), music-industry, value chain

Procedia PDF Downloads 289
457 Multiple Organ Manifestation in Neonatal Lupus Erythematous: Report of Two Cases

Authors: A. Lubis, R. Widayanti, Z. Hikmah, A. Endaryanto, A. Harsono, A. Harianto, R. Etika, D. K. Handayani, M. Sampurna

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Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: neonatus lupus erythematous, maternal autoantibody, clinical characteristic, multiple organ manifestation

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456 Youth and Conflict in Pakistan: Understanding Causes and Promoting Peace

Authors: Irfan Khan

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Both the analytical methods used to understand the phenomena of peacebuilding and the ensuing viewpoints on achieving and sustaining "sustainable peace" are broad and diverse. This new field of study draws from sociology, anthropology, political theory, and political economy, psychology, international relations, and more recently, the development sciences to examine the wide range of 'conflicts' it describes. This paper emphasizes the significance of investigating the causes of juvenile disputes. It explains how police corruption encourages youth crime and why it's so important to address this issue head-on. It also examines the historical foundations and external pressures that have increased religious extremism and sectarian strife in Pakistan. The primary argument is that peace is not only a desirable 'goal' in itself but also that it may be a means to achieve political stability and long-term prosperity. Strategies for constructing peace may take many shapes, each tailored to the specifics of a given conflict, its scope, and the individuals involved. By drawing on some existing literature and applying it to the situation in Pakistan, this article proposes a viewpoint that centers on the participation of young people in the peacebuilding process. Due to their enhanced susceptibility and penchant for demanding change, young people are more likely to get involved in a conflict when economic failure and unemployment are present. The piece also emphasizes the marginalization young people experience as a result of their absence from decision-making processes and the political system. The article claims that Pakistan's rapidly growing young population presents a significant chance for a long-term "demographic dividend" in the form of improvements in peacebuilding processes. This benefit will only materialize if serious steps are taken to increase young people's voice and agency in political decision-making.

Keywords: peacebuilding, youth-led initiatives, empowerment, conflict & violence, religious extremism, political involvement, decision-making

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455 Transcriptional Evidence for the Involvement of MyD88 in Flagellin Recognition: Genomic Identification of Rock Bream MyD88 and Comparative Analysis

Authors: N. Umasuthan, S. D. N. K. Bathige, W. S. Thulasitha, I. Whang, J. Lee

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The MyD88 is an evolutionarily conserved host-expressed adaptor protein that is essential for proper TLR/ IL1R immune-response signaling. A previously identified complete cDNA (1626 bp) of OfMyD88 comprised an ORF of 867 bp encoding a protein of 288 amino acids (32.9 kDa). The gDNA (3761 bp) of OfMyD88 revealed a quinquepartite genome organization composed of 5 exons (with the sizes of 310, 132, 178, 92 and 155 bp) separated by 4 introns. All the introns displayed splice signals consistent with the consensus GT/AG rule. A bipartite domain structure with two domains namely death domain (24-103) coded by 1st exon, and TIR domain (151-288) coded by last 3 exons were identified through in silico analysis. Moreover, homology modeling of these two domains revealed a similar quaternary folding nature between human and rock bream homologs. A comprehensive comparison of vertebrate MyD88 genes showed that they possess a 5-exonic structure. In this structure, the last three exons were strongly conserved, and this suggests that a rigid structure has been maintained during vertebrate evolution. A cluster of TATA box-like sequences were found 0.25 kb upstream of cDNA starting position. In addition, putative 5'-flanking region of OfMyD88 was predicted to have TFBS implicated with TLR signaling, including copies of NFB1, APRF/ STAT3, Sp1, IRF1 and 2 and Stat1/2. Using qPCR technique, a ubiquitous mRNA expression was detected in liver and blood. Furthermore, a significantly up-regulated transcriptional expression of OfMyD88 was detected in head kidney (12-24 h; >2-fold), spleen (6 h; 1.5-fold), liver (3 h; 1.9-fold) and intestine (24 h; ~2-fold) post-Fla challenge. These data suggest a crucial role for MyD88 in antibacterial immunity of teleosts.

Keywords: MyD88, innate immunity, flagellin, genomic analysis

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454 Clinical Relevance of TMPRSS2-ERG Fusion Marker for Prostate Cancer

Authors: Shalu Jain, Anju Bansal, Anup Kumar, Sunita Saxena

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Objectives: The novel TMPRSS2:ERG gene fusion is a common somatic event in prostate cancer that in some studies is linked with a more aggressive disease phenotype. Thus, this study aims to determine whether clinical variables are associated with the presence of TMPRSS2:ERG-fusion gene transcript in Indian patients of prostate cancer. Methods: We evaluated the clinical variables with presence and absence of TMPRSS2:ERG gene fusion in prostate cancer and BPH association of clinical patients. Patients referred for prostate biopsy because of abnormal DRE or/and elevated sPSA were enrolled for this prospective clinical study. TMPRSS2:ERG mRNA copies in samples were quantified using a Taqman chemistry by real time PCR assay in prostate biopsy samples (N=42). The T2:ERG assay detects the gene fusion mRNA isoform TMPRSS2 exon1 to ERG exon4. Results: Histopathology report has confirmed 25 cases as prostate cancer adenocarcinoma (PCa) and 17 patients as benign prostate hyperplasia (BPH). Out of 25 PCa cases, 16 (64%) were T2: ERG fusion positive. All 17 BPH controls were fusion negative. The T2:ERG fusion transcript was exclusively specific for prostate cancer as no case of BPH was detected having T2:ERG fusion, showing 100% specificity. The positive predictive value of fusion marker for prostate cancer is thus 100% and the negative predictive value is 65.3%. The T2:ERG fusion marker is significantly associated with clinical variables like no. of positive cores in prostate biopsy, Gleason score, serum PSA, perineural invasion, perivascular invasion and periprostatic fat involvement. Conclusions: Prostate cancer is a heterogeneous disease that may be defined by molecular subtypes such as the TMPRSS2:ERG fusion. In the present prospective study, the T2:ERG quantitative assay demonstrated high specificity for predicting biopsy outcome; sensitivity was similar to the prevalence of T2:ERG gene fusions in prostate tumors. These data suggest that further improvement in diagnostic accuracy could be achieved using a nomogram that combines T2:ERG with other markers and risk factors for prostate cancer.

Keywords: prostate cancer, genetic rearrangement, TMPRSS2:ERG fusion, clinical variables

Procedia PDF Downloads 440
453 A Relationship Model That Illustrates the Effect of Humorous Packaging Designs on Brand Awareness and Brand Attitude

Authors: Shu-Yuan Lin, Tung-Chin Chou

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As products become increasingly similar in competitive markets, achieving product segmentation and differentiation through packaging design has become the primary task when designing retail product packaging. When the main focus of brand marketing is no longer the product itself, emotional marketing, such as the use of humorous packaging designs, may be employed to successfully promote the brand. Such efforts will capture the hearts of consumers, generate discussions, and allow the brand to leave a deep impression in consumers. In this study, snack packaging was used to develop a relationship model that illustrated the effect of humorous packaging designs on brand awareness and brand attitude. The study was divided into three stages: In the first stage, in-depth interviews and focus group interviews were conducted with experts to construct 24 indicators for assessing humorous packaging designs. In the second stage, survey questionnaires were distributed to a young consumer group; the results showed that the group had a high and low product involvement with chocolate and dried shredded squid, respectively. Humorous packaging designs were subsequently created for two snack types to produce a study sample of 12 different packaging. In the third stage, packaging designs were evaluated by obtaining scores for the consumers’ brand awareness, brand attitude, and perceived effects of the packaging designs. Finally, a relationship model was developed to show the effect of humorous packaging designs on brand awareness and brand attitude, confirming that two perceived effects of humorous packaging designs (i.e., ‘pleasant and emotionally healing’ and ‘connected to people’s daily life’) exhibited a significant and positive effect on ‘perceived brand value,’ where the effect of ‘pleasant and emotionally healing’ was the most significant. In addition, ‘pleasant and emotionally healing’ exerted a significant and positive effect on ‘brand purchase intention.’ Furthermore, packaging designs with humorous elements helped foster brand awareness.

Keywords: brand awareness, brand attitude, humorous design, packaging design

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452 Evaluation of the Impact of Community Based Disaster Risk Management Applied In Landslide Prone Area; Reference to Badulla District

Authors: S. B. D. Samarasinghe, Malini Herath

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Participatory planning is a very important process for decision making and choosing the best alternative options for community welfare, development of the society and its interactions among community and professionals. People’s involvement is considered as the key guidance in participatory planning. Presently, Participatory planning is being used in many fields. It's not only limited to planning but also to disaster management, poverty, housing, etc. In the past, Disaster management practice was a top-down approach, but it raised many issues as it was converted to a bottom-up approach. There are several approaches that can aid disaster management. Community-Based Disaster Risk Management (CBDRM) is a very successful participatory approach to risk management that is often successfully applied by other disaster-prone countries. In the local context, CBDRM has been applied to prevent Diseases as well as to prevent disasters such as landslides, tsunamis and floods. From three years before, Sri Lanka has initiated the CBDRM approach to minimize landslide vulnerability. Hence, this study mainly focuses on the impact of CBDRM approaches on landslide hazards. Also to identify their successes and failures from both implementing parties and community. This research is carried out based on a qualitative method combined with a descriptive research approach. A successful framework was prepared via a literature review. Case studies were selected considering landslide CBDRM programs which were implemented by Disaster Management Center and National Building Research Organization in Badulla. Their processes were evaluated. Data collection is done through interviews and informal discussions. Then their ideas were quantified by using the Relative Effectiveness index. The resulting numerical value was used to rank the program effectiveness and their success, failures and impacting factors. Results show that there are several failures among implementing parties and the community. Overcoming those factors can make way for better conduction of future CBDRM programs.

Keywords: community-based disaster risk management, disaster management, preparedness, landslide

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451 Training Student Teachers to Work in Partnership with Parents of Students with Special Needs

Authors: Alicia Greenbank, Efrat Bengio

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The aim of this research was to examine the efficacy of the first course in Israel, whose objective is to train student teachers in the special education department to work cooperatively with parents of children with special needs. Studies often highlight the importance of cooperation between teachers and parents of students with special needs. Israel’s Special Education Law defines parents as complete partners, and the Ministry of Education encourages and even requires that partnership be present. Yet this partnership is difficult to achieve many kindergarten teachers, and teachers have a lot of difficulties establishing and managing a pattern of cooperation with their students’ parents. Often we see different perspectives on the child's development and needs, distrust, lack of appreciation, and communication difficulties on both sides – parents & teachers. The course describes a method of instilling the need for cooperation at an early stage of teacher training-in the teacher training program. 22 students in the special education program for early childhood education in the fourth year of learning took part in the course. The fourth-year is the experiential training year and the first time that students have worked in a school. The course consisted of 14 sessions. Seven parents of students with different disabilities participated at 6 of the sessions. The changes in the students' attitudes towards partnership and their ability to manage this partnership were carried out by examining the reports written by the students before the meetings with the parents and the reflections they wrote after each meeting with the parents and at the end of the course. Three themes emerged from the narrative analysis, corresponding to the three preconditions for joint activities with parents — Approach, Attitude, Appropriate Atmosphere, according to the Four A’s Model. The findings showed that a course combining meetings with parents of children with special needs offers many benefits for teacher training. The course raised student awareness of the question partnership, changed students’ approaches and attitudes towards the parents, stressed the importance of partnership, and provided students with tools for working with parents through the school. Based on the findings of this study, courses in this format can be applied in order to cooperate between teachers and parents, for example, parents of gifted children with special needs.

Keywords: Partnership with parents in special education, parents of children with disabilities, parents of children with special needs, parents’ involvement in special education

Procedia PDF Downloads 185
450 Conjugal Relationship and Reproductive Decision-Making among Couples in Southwest Nigeria

Authors: Peter Olasupo Ogunjuyigbe, Sarafa Shittu

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This paper emphasizes the relevance of conjugal relationship and spousal communication towards enhancing men’s involvement in contraceptive use among the Yorubas of South Western Nigeria. An understanding of males influence and the role they play in reproductive decision making can throw better light on mechanisms through which egalitarianness of husband/wife decision making influences contraceptive use. The objective of this study was to investigate how close conjugal relationships can be a good indicator of joint decision making among couples using data derived from a survey conducted in three states of South Western Nigeria. The study sample consisted of five hundred and twenty one (521) male respondents aged 15-59 years and five hundred and forty seven (547) female respondents aged 15-49 years. The study used both quantitative and qualitative approached to elicit information from the respondents. In order that the study would be truly representative of the towns, each of the study locations in the capital cities was divided into four strata: The traditional area, the migrant area, the mixed area (i.e. traditional and migrant), and the elite area. In the rural areas, selection of the respondents was by simple random sampling technique. However, the random selection was made in such a way that all the different parts of the locations were represented. Generally, the data collected were analysed at univariate, bivariate, and multivariate levels. Logistic regression models were employed to examine the interrelationships between male reproductive behaviour, conjugal relationship and contraceptive use. The study indicates that current use of contraceptive is high among this major ethnic group in Nigeria because of the improved level of communication among couples. The problem, however, is that men still have lower exposure rate when it comes to question of family planning information, education and counseling. This has serious implications on fertility regulation in Nigeria.

Keywords: behavior, conjugal, communication, counseling, spouse

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449 An Experience of HIV Testing and Counseling Services at a Tertiary Care Center of Bangladesh

Authors: S. M. Rashed Ul Islam, Shahina Tabassum, Afsana Anwar Miti

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Objective: HIV testing and counseling center (HTC) is an important component of the HIV/AIDS detection, prevention and control interventions. The service was first initiated at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) since the first case detection in 1989. The present study aimed to describe the demographic profile among the attendees tested HIV positive. Methods: The present study was carried out among 219 HIV positive cases detected through screening at the Department of Virology of BSMMU during the year of 2012-2016. Data were collected through pre-structured written questionnaire during the counseling session. Data were expressed as frequency and percentages and analyzed using SPSS v20.0 program. Results: Out of 219 HIV cases detected, 77.6% were males, and 22.4% were females with a mean age (mean±SD) of 35.46±9.46 years. Among them, 70.7% belonged to the 26-45 age groups representing the sexually active age. The majority of the cases were married (86.3%) and 49.8% had primary level of education whereas, 8.7% were illiterate. Nearly 42% of cases were referred from Chittagong division (south-east part of the country) followed by Dhaka division (35.6%). The bulk of study population admitted to involvement in high-risk behaviour (90%) in the past and 42% of them had worked overseas. The Pearson Chi-square (χ2) analysis revealed significant relationship of gender with marital (χ2=7.88 at 2% level) and occupation status (χ2=120.48 at 6% level); however, no association was observed with risk behaviour and educational status. Recommendations: HIV risk behavior was found to be a prime source for HIV infection among the study population. So, there is need for health education and awareness program to bring about behavioral changes to halt the yearly increase of new cases in the country with special attention to our overseas workers on HIV/AIDS risk and safety.

Keywords: Bangladesh, health education, HIV testing and counseling (HTC), HIV/AIDS, risk behavior

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448 The Strategic Roles of Women in Small Family Businesses: Evidence from Two Emerging Economies in West Africa

Authors: Bamidele Wale-Oshinowo, Doris Akyere Boateng, Lebura Sorbarikor

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Women play significant roles when it comes to the survival of family businesses; however, their efforts are less acknowledged across the developing world. In the case where these businesses are started by husbands, women in many instances work as hard as the men to build up the business. In spite of this, the benefits women receive are not equal to their inputs. For instance, the profits accruing from ownership of these businesses are mainly enjoyed by husbands, as they are deemed to be the legal owners of family businesses in most developing economies. Though the number of women involvement in the ownership, management, and direction of family businesses keeps increasing over the years, their efforts sometimes are ‘invisible’ and not rewarded. Using a phenomenological approach, this study purposively selected 20 businesswomen each from Ghana and Nigeria for in-depth interviews on the different roles they play in ensuring the success of their family businesses (FBs). This study also explored the challenges and opportunities that these women have within their family businesses. Among the major findings of this study is the important strategic direction that women give in terms of providing both tangible and intangible resources such as transfer of transit knowledge to the next generation. Women were also found to play a significant role in the implementation of entrepreneurial orientation within small family businesses in Ghana and Nigeria. However, the study revealed that women experience various challenges as stakeholders in family businesses, among which are: work-life balance issues, succession issues, and culture-related presuppositions about gender roles both within the business and in their families. In the light of the study’s findings, critical recommendations made include encouraging founders and/or owners of family businesses to create a conducive and viable platform for women to grow into key leadership positions within Family businesses; doing this would impact strongly on the growth rate of these form of businesses within the African Region.

Keywords: emerging economies, control, management, resources, strategy, women

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447 The Effects of Future Priming on Resource Concern

Authors: Calvin Rong, Regina Agassian, Mindy Engle-Friedman

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Climate changes, including rising sea levels and increases in global temperature, can have major effects on resource availability, leading to increased competition for resources and rising food prices. The abstract nature and often delayed consequences of many ecological problems cause people focus on immediate, specific, and personal events and circumstances that compel immediate and emotional involvement. This finding may be explained by the challenges humans have in imagining themselves in the future, a shortcoming that interferes with decision-making involving far-off rewards, and leads people to indicate a lower concern toward the future than to present circumstances. The present study sought to assess whether priming people to think of themselves in the future might strengthen the connection to their future selves and stimulate environmentally-protective behavior. We hypothesize that priming participants to think about themselves in the future would increase concern for the future environment. 45 control participants were primed to think about themselves in the present, and 42 participants were primed to think about themselves in the futures. After priming, the participants rated their concern over access to clean water, food, and energy on a scale of 1 to 10. They also rated their predicted care levels for the environment at age points 40, 50, 60, 70, 80, and 90 on a scale of 1(not at all) to 10 (very much). Predicted care levels at age 90 for the experimental group was significantly higher than for the control group. Overall the experimental group rated their concern for resources higher than the control. In comparison to the control group (M=7.60, SD=2.104) participants in the experimental group had greater concern for clean water (M=8.56, SD=1.534). In comparison to the control group (M=7.49, SD=2.041) participants in the experimental group were more concerned about food resources (M=8.41, SD=1.830). In comparison to the control group (M=7.22, SD=1.999) participants in the experimental group were more concerned about energy resources (M=8.07, SD=1.967). This study assessed whether a priming strategy could be used to encourage pro-environmental practices that protect limited resources. Future-self priming helped participants see past short term issues and focus on concern for the future environment.

Keywords: climate change, future, priming, global warming

Procedia PDF Downloads 251
446 Creating Entrepreneurs through Contribution of Individuals and Corporations: An Insight on Persons with Disabilities in Bangladesh

Authors: Saptarshi Dhar, Tahira Farzana

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In Bangladesh, particularly in rural areas, persons with disabilities are generally isolated from the mainstream and are pushed to the margins of society. They are seen as an individual problem, not as a social responsibility. As a result, persons with disabilities face challenges to actively participate in social and economic activities. The country is experiencing a steady economic and per capita growth over the past few years and entrepreneurial opportunities are also increasing. However, involvement of persons with disabilities in entrepreneurship is yet to increase. The aim of this paper is to explore the issue of entrepreneurship for persons with disabilities through contribution of individuals and corporations in the context of social responsibility. The paper is exploratory in nature and is approached through a three-month research project 'Shwanirbhor' run by the authors in Pakshi area of Pabna District in Bangladesh. The authors collected data through semi structured questionnaire, interviews and focus group discussions. Through the project, persons with disabilities were provided with financial capital (collected through contribution of individuals and corporations), business plans and advisory assistance on a need basis to help them start entrepreneurial ventures. The findings of the study indicate that in terms of contribution toward a social cause, individuals and corporations have positive attitude and are willing to offer monetary and nonmonetary assistance. When provided with entrepreneurial opportunity, persons with disabilities showed motivation in joining entrepreneurship to improve their economic standing and to be financially independent. In addition to that, the study also found that factors such as social inclusion and acceptance, economic empowerment, breaking the social and family barrier are also the reasons that drive persons with disabilities into embracing entrepreneurship. Moreover, while starting and running the entrepreneurial activities, they face constraints that range from personal, environmental, operational and infrastructural to informational barriers. The paper also proposes a strategy framework for entrepreneurship creation in Bangladesh which could be supportive for policy development for persons with disabilities.

Keywords: Bangladesh, entrepreneurship, persons with disabilities (PWD), social responsibility

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445 Driving and Hindering Forces for the Care of Older People: experiences of Brazilian Family Caregivers

Authors: Adriane Amend, Leidiene Ferreira Santos, Daniella Pires Nunes

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The experience of assuming or caring for older persons dependents by relatives is a complex task that encompasses or affective involvement, the demand for technical activities and or psychological support. It would be necessary to understand the situations related to the caregiver, the person and the environment, which help the family difficulty, as a caregiver to lead this role. Objective: To identify the forces that drive and restrict the care process of family caregivers of the older adults. Method: Descriptive and exploratory research, with a qualitative approach, which has as a reference the Force Field Theory. Five family caregivers of older adult’s dependents residing in the city of Palmas, Tocantins, Brazil will participate. The data were collected from December 2021 to February 2022, through a semi-structured individual interview, and submitted to content analysis. Results: As forces that drive or process of caring for family caregivers were: the account of compassionate attitudes and patience of the caregiver (I); to the collaboration of the other person to the care and to the body structure of the same (Other); and the supports of other people not cared for and structural, such as adaptations in the room, read and bathroom, as in the presence of air conditioners (Environment). Among the restrictive forces of care we mention difficulties in delegating care to another person, or stress of care and other personal demands (I); imposition of the older person about care and e a transfer from bed to hip (Other); e lack of accessibility of the house and absence of air conditioning and hospital bed (Environment). Conclusion: The results show that there are driving forces with the caregiver's attitude and feelings, a bond as an idol and support for the caregiver and the environment. On the other hand, conflicting ties, absence of physical structure and daily and continuous care shifts, can significantly compromise well-being or the cycle of older adult, caregiver and care.

Keywords: caregivers, frail elderly, perception, geriatric nursing

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444 Factors Affecting Women's Participation in Social, Political and Economic Decision-Making Positions at Kelemwollega Zone, Western Ethiopia

Authors: T. Aragaw, P. Gari

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In spite of social, political, and economic marginalization, women are still considered as the backbone of Ethiopia, one of the least developed countries in the world. The general purpose of this study was to assess factors that affect participation of women in politics, social and economic decisions at Kelem-Wollega Administrative Zone of Oromia Regional State, Ethiopia. Data used in this paper is mainly primary, and a few secondary data were incorporated. Respondents were selected using a systematic random sampling method and were placed questionnaires containing open-ended and closed-ended. Focus group discussion was also used for the study subjects in two offices. According to the information collected from the KWAZ Development and Social Service Office, a total of 18,473 tax-paying employees are present in the Zone, which is 14% of the total population of the Zone. Among the total number of employees in the Zone, 2,617 have been recruited for this study based on the criteria stated. This showed 1.8% of them were comprised of several churches and religious owned integrated development projects in the KWAZ. The 2,103 (80.34%) study participants responded personally, and they completed and returned the questionnaire to the researchers. The study revealed that in public institutions existed in KWAZ, the majority of women were having an educational status of diploma and lower, practicing lower non-decision making and leadership positions. Conclusion: Major barriers hindering women include: Socio-cultural attitudes, lack of necessary experience, education, the burden of domestic responsibilities, and lack of role models of women leaders in the Zone. Empowerment of women via social organizations, critical involvement of the government, and Affirmative action for women is critical. Further research is needed on the scope and challenges in implementing the strategies.

Keywords: women, affirmative action, leadership, empowerment, Ethiopia

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443 Different Types of Amyloidosis Revealed with Positive Cardiac Scintigraphy with Tc-99M DPD-SPECT

Authors: Ioannis Panagiotopoulos, Efstathios Kastritis, Anastasia Katinioti, Georgios Efthymiadis, Argyrios Doumas, Maria Koutelou

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Introduction: Transthyretin amyloidosis (ATTR) is a rare but serious infiltrative disease. Myocardial scintigraphy with DPD has emerged as the most effective, non-invasive, highly sensitive, and highly specific diagnostic method for cardiac ATTR amyloidosis. However, there are cases in which additional laboratory investigations reveal AL amyloidosis or other diseases despite a positive DPD scintigraphy. We describe the experience from the Onassis Cardiac Surgery Center and the monitoring center for infiltrative myocardial diseases of the cardiology clinic at AHEPA. Materials and Methods: All patients with clinical suspicion of cardiac or extracardiac amyloidosis undergo a myocardial scintigraphy scan with Tc-99m DPD. In this way, over 500 patients have been examined. Further diagnostic approach based on clinical and imaging findings includes laboratory investigation and invasive techniques (e.g., biopsy). Results: Out of 76 patients in total with positive myocardial scintigraphy Grade 2 or 3 according to the Perugini scale, 8 were proven to suffer from AL Amyloidosis during the investigation of paraproteinemia. Among these patients, 3 showed Grade 3 uptake, while the rest were graded as Grade 2, or 2 to 3. Additionally, one patient presented diffuse and unusual radiopharmaceutical uptake in soft tissues throughout the body without cardiac involvement. These findings raised suspicions, leading to the analysis of κ and λ light chains in the serum, as well as immunostaining of proteins in the serum and urine of these specific patients. The final diagnosis was AL amyloidosis. Conclusion: The value of DPD scintigraphy in the diagnosis of cardiac amyloidosis from transthyretin is undisputed. However, positive myocardial scintigraphy with DPD should not automatically lead to the diagnosis of ATTR amyloidosis. Laboratory differentiation between ATTR and AL amyloidosis is crucial, as both prognosis and therapeutic strategy are dramatically altered. Laboratory exclusion of paraproteinemia is a necessary and essential step in the diagnostic algorithm of ATTR amyloidosis for all positive myocardial scintigraphy with diphosphonate tracers since >20% of patients with Grade 3 and 2 uptake may conceal AL amyloidosis.

Keywords: AL amyloidosis, amyloidosis, ATTR, myocardial scintigraphy, Tc-99m DPD

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442 An Elaborated Software Solution: The Tennis Ranking System

Authors: Dionysios Kakaroumpas, Jesseka Farago, Stephen Webber

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Athletes and spectators depend on the tennis ranking system to represent the truest caliber of athletic prowess; a careful look at the current ranking system though, reveals its main weakness: it undermines expectations of fans and players. Our study proposes several key changes to the existing ranking formula that provide a fair and accurate approach to measure player performance. The study proposes a modification of the system to value: participation, continued advancement, and overall achievement. The new ranking formula facilitates closing the trust gap, encouraging competition equality, engaging the fan base, attracting investment, and promoting tennis involvement worldwide. To probe the crux of our main contention we performed week-by-week comparisons between results procured from the current and proposed formulae. After performing this rigorous case-study of top players of each gender, the findings strongly indicated that there is identifiable inflation in the ranks and enhanced the conviction that the current system should be updated. The new system is accompanied by a web-based software package freely available to anyone involved or interested in tennis rankings. The software package is designed to automatically calculate new player rankings based on a responsive, multi-faceted formula that also generates projected point scenarios and provides separate rankings for the three different court surfaces. By taking a critical look at the current tennis ranking system with consideration to the perspective of fans, players, and businesses involved, an upgrade is in order for it to maintain the balance of trust between fans and the evaluation process. In closure, this proposed solution increases fair play competition, eliminates rank inflation, and better engages fans, players, and sponsors by bringing in a new era of professional tennis.

Keywords: measurement and evaluation, rules and regulations, sports management and marketing, tennis ranking system

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441 Dutch Disease and Industrial Development: An Investigation of the Determinants of Manufacturing Sector Performance in Nigeria

Authors: Kayode Ilesanmi Ebenezer Bowale, Dominic Azuh, Busayo Aderounmu, Alfred Ilesanmi

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There has been a debate among scholars and policymakers about the effects of oil exploration and production on industrial development. In Nigeria, there were many reforms resulting in an increase in crude oil production in the recent past. There is a controversy on the importance of oil production in the development of the manufacturing sector in Nigeria. Some scholars claim that oil has been a blessing to the development of the manufacturing sector, while others regard it as a curse. The objective of the study is to determine if empirical analysis supports the presence of Dutch Disease and de-industrialisation in the Nigerian manufacturing sector between 2019- 2022. The study employed data that were sourced from World Development Indicators, Nigeria Bureau of Statistics, and the Central Bank of Nigeria Statistical Bulletin on manufactured exports, manufacturing employment, agricultural employment, and service employment in line with the theory of Dutch Disease using the unit root test to establish their level of stationarity, Engel and Granger cointegration test to check their long-run relationship. Autoregressive. Distributed Lagged bound test was also used. The Vector Error Correction Model will be carried out to determine the speed of adjustment of the manufacturing export and resource movement effect. The results showed that the Nigerian manufacturing industry suffered from both direct and indirect de-industrialisation over the period. The findings also revealed that there was resource movement as labour moved away from the manufacturing sector to both the oil sector and the services sector. The study concluded that there was the presence of Dutch Disease in the manufacturing industry, and the problem of de-industrialisation led to the crowding out of manufacturing output. The study recommends that efforts should be made to diversify the Nigerian economy. Furthermore, a conducive business environment should be provided to encourage more involvement of the private sector in the agriculture and manufacturing sectors of the economy.

Keywords: Dutch disease, resource movement, manufacturing sector performance, Nigeria

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440 Reflections on the Trajectory of an Online Literature Cafe through Its Music and Arts Activities

Authors: Mariko Hara, Mari Aoki, Takako Ito, Masao Sugita

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Social distancing measures due to the COVID-19 crisis had a severe impact on music and art practices based in community settings. They had to re-think how to connect with their dispersed community using online tools. As the social distancing continues, there is an urgent need to investigate the possibilities of online community music and art practices. Are they sustainable actions that can have positive impacts on the community and the quality of lives of people over time? The Online Lindgren Café (hereafter ‘OLC’) is a monthly online literature event which started in June 2020. In the OLC, up to 14 members meet online to discuss the works of Astrid Lindgren and similar authors. Members come from various places in Japan and Norway, with a variety of expertise from music therapy, music education, psychotherapy, music sociology, storytelling, and theatre, and their family members join them. In these meetings, music and arts activities emerged in response to interests among the members. The resources and experiences of the members helped to develop these activities further. This paper first introduces one of the music and art activities in one specific event, a collaborative picture book-making with music, which was initiated and led by the second author. The third author chose the music, and the activity itself was recorded. This is followed by the description of a reflecting event, where the recording of the collaborative picture book-making activity was shared to facilitate further creations (drawings, haiku, and fabric weaving) as well as group reflections on the trajectories of the Online Lindgren Café. Finally, we will discuss the preliminary findings using the data collected at the reflecting event. Key findings suggest that the resource-driven approach of the OLC leveled the relationships among the intergenerational, multi-cultural, and interdisciplinary members. This enabled the members to set aside their professional and/or predominant identities, which allowed them to discover their own and others’ resources. The relaxed, unstructured, and liminal phenomenon at OLC can be regarded as a form of communitas, where members gain a sense of liberation and belonging in a different way from in-person communications. Participation from one’s home, as well as a video conferencing function that allowed the members to position themselves among the other participants in equal-sized windows, seems to have enabled members to feel safe to express themselves openly at the same time feel a sense of belonging. Furthermore, in the OLC, music and arts activities acted to inclusively connect and re-connect dispersed, intergenerational members with each other. For instance, in a music and drawing activity, music acted as a means for each member to engage in their own ‘drawing space’ while still feeling connected with the others. The positive experiences from these activities inspired the members to use similar approaches outside of the OLC. The finding suggests that, because of its resource-driven approach supported by the music and arts activities, the OLC could be developed further as a permeable and sustainable action even after any current social distancing measures are lifted.

Keywords: communitas, COVID-19, musical affordances, online community of practices, resource-driven approach

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439 LTF Expression Profiling Which is Essential for Cancer Cell Proliferation and Metastasis, Correlating with Clinical Features, as Well as Early Stages of Breast Cancer

Authors: Azar Heidarizadi, Mahdieh Salimi, Hossein Mozdarani

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Introduction: As a complex disease, breast cancer results from several genetic and epigenetic changes. Lactoferrin, a member of the transferrin family, is reported to have a number of biological functions, including DNA synthesis, immune responses, iron transport, etc., any of which could play a role in tumor progression. The aim of this study was to investigate the bioinformatics data and experimental assay to find the pattern of promoter methylation and gene expression of LTF in breast cancer in order to study its potential role in cancer management. Material and Methods: In order to evaluate the methylation status of the LTF promoter, we studied the MS-PCR and Real-Time PCR on samples from patients with breast cancer and normal cases. 67 patient samples were conducted for this study, including tumoral, plasma, and normal tissue adjacent samples, as well as 30 plasma from normal cases and 10 tissue breast reduction cases. Subsequently, bioinformatics analyses such as cBioPortal databases, string, and genomatix were conducted to disclose the prognostic value of LTF in breast cancer progression. Results: The analysis of LTF expression showed an inverse relationship between the expression level of LTF and the stages of tissues of breast cancer patients (p<0.01). In fact, stages 1 and 2 had a high expression in LTF, while, in stages 3 and 4, a significant reduction was observable (p < 0.0001). LTF expression frequently alters with a decrease in the expression in ER⁺, PR⁺, and HER2⁺ patients (P < 0.01) and an increase in the expression in the TNBC, LN¯, ER¯, and PR- patients (P < 0.001). Also, LTF expression is significantly associated with metastasis and lymph node involvement factors (P < 0.0001). The sensitivity and specificity of LTF were detected, respectively. A negative correlation was detected between the results of level expression and methylation of the LTF promoter. Conclusions: The altered expression of LTF observed in breast cancer patients could be considered as a promotion in cell proliferation and metastasis even in the early stages of cancer.

Keywords: LTF, expression, methylation, breast cancer

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438 Whole Exome Sequencing Data Analysis of Rare Diseases: Non-Coding Variants and Copy Number Variations

Authors: S. Fahiminiya, J. Nadaf, F. Rauch, L. Jerome-Majewska, J. Majewski

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Background: Sequencing of protein coding regions of human genome (Whole Exome Sequencing; WES), has demonstrated a great success in the identification of causal mutations for several rare genetic disorders in human. Generally, most of WES studies have focused on rare variants in coding exons and splicing-sites where missense substitutions lead to the alternation of protein product. Although focusing on this category of variants has revealed the mystery behind many inherited genetic diseases in recent years, a subset of them remained still inconclusive. Here, we present the result of our WES studies where analyzing only rare variants in coding regions was not conclusive but further investigation revealed the involvement of non-coding variants and copy number variations (CNV) in etiology of the diseases. Methods: Whole exome sequencing was performed using our standard protocols at Genome Quebec Innovation Center, Montreal, Canada. All bioinformatics analyses were done using in-house WES pipeline. Results: To date, we successfully identified several disease causing mutations within gene coding regions (e.g. SCARF2: Van den Ende-Gupta syndrome and SNAP29: 22q11.2 deletion syndrome) by using WES. In addition, we showed that variants in non-coding regions and CNV have also important value and should not be ignored and/or filtered out along the way of bioinformatics analysis on WES data. For instance, in patients with osteogenesis imperfecta type V and in patients with glucocorticoid deficiency, we identified variants in 5'UTR, resulting in the production of longer or truncating non-functional proteins. Furthermore, CNVs were identified as the main cause of the diseases in patients with metaphyseal dysplasia with maxillary hypoplasia and brachydactyly and in patients with osteogenesis imperfecta type VII. Conclusions: Our study highlights the importance of considering non-coding variants and CNVs during interpretation of WES data, as they can be the only cause of disease under investigation.

Keywords: whole exome sequencing data, non-coding variants, copy number variations, rare diseases

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437 Diagnostic Properties of Exercise or Pharmacological Stress Myocardial Perfusion Scintigraphy in Per-Vessel Basis: A Clinical Validation Study

Authors: Ahmadreza Bagheri, Seyyed S. Eftekhari, Shervin Rashidinia

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Background: Various stress tests have been proposed yet to assess patients with suspected coronary artery disease. However, their diagnostic properties in terms of sensitivity, specificity, and accuracy are variable and their applicability remained somewhat vague. The aim of this study is to validate per-vessel diagnostic properties of 3 types of stress myocardial perfusion scintigraphy in gated SPECT (Single-Photon Emission Computed Tomography) using either exercise or pharmacological stress testing with dipyridamole or dobutamine. Materials and Methods: Hospital records of 314 patients who referred to Imam Khomeini hospital of Tehran between September 2015 and January 2017 were completely reviewed in this study. All patients underwent coronary angiography within 3 months after stress myocardial perfusion scan. Eventually, the results were analyzed in per-vessel basis to find the proper modality for each involved vessel or scanned site. Results: The mean age of patients was 62.15 ± 4.94 years (30-85) and 35.03% were women. The overall sensitivity, specificity, and accuracy were calculated as 56.59%, 54.24%, and 55.09%, respectively. These values were 56.43% and 53.25%, 54.46% and 47.36%, 56.75% and 54.83% for dipyridamole and exercise, respectively. Ischemia of the anterior wall through exercise stress testing has the highest diagnostic accuracy in detecting LAD (Left Anterior Descending artery) involvement. Inferior wall hypokinesia and anterolateral wall ischemia during exercise stress testing have the highest diagnostic accuracy in detecting RCA (Right Coronary Artery) and LCX artery (Left Circumflex Artery) stenosis, respectively. Conclusion: Stress myocardial perfusion scan should be carried out on the basis of the findings of the preliminary investigations on suspicion of a specific coronary artery or involved myocardial wall.

Keywords: dipyridamole, dobutamine, single-photon emission computed tomography, stress myocardial perfusion scintigraphy

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436 Changes in Pulmonary Functions in Diabetes Mellitus Type 2

Authors: N. Anand, P. S. Nayyer, V. Rana, S. Verma

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Background: Diabetes mellitus is a group of disorders characterized by hyperglycemia and associated with microvascular and macrovascular complications. Among the lesser known complications is the involvement of respiratory system. Changes in pulmonary volume, diffusion and elastic properties of lungs as well as the performance of the respiratory muscles lead to a restrictive pattern in lung functions. The present study was aimed to determine the changes in various parameters of pulmonary function tests amongst patients with Type 2 Diabetes Mellitus and also try to study the effect of duration of Diabetes Mellitus on pulmonary function tests. Methods: It was a cross sectional study performed at Dr Baba Saheb Ambedkar Hospital and Medical College in, Delhi, A Tertiary care referral centre which included 200 patients divided into 2 groups. The first group included diagnosed patients with diabetes and the second group included controls. Cases and controls symptomatic for any acute or chronic Respiratory or Cardiovascular illness or a history of smoking were excluded. Both the groups were subjected to spirometry to evaluate for the pulmonary function tests. Result: The mean Forced Vital Capacity (FVC), Forced Expiratory Volume in first second (FEV1), Peak Expiratory Flow Rate(PEFR) was found to be significantly decreased ((P < 0.001) as compared to controls while the mean ratio of Forced Expiratory Volume in First second to Forced Vital Capacity was not significantly decreased( p>0.005). There was no correlation seen with duration of the disease. Conclusion: Forced Vital Capacity (FVC), Forced Expiratory Volume in first second (FEV1), Peak Expiratory Flow Rate(PEFR) were found to be significantly decreased in patients of Diabetes mellitus while ratio of Forced Expiratory Volume in First second to Forced Vital Capacity (FEV1/FVC) was not significantly decreased. The duration of Diabetes mellitus was not found to have any statistically significant effect on Pulmonary function tests (p > 0.005).

Keywords: diabetes mellitus, pulmonary function tests, forced vital capacity, forced expiratory volume in first second

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435 Sustainability in Community-Based Forestry Management: A Case from Nepal

Authors: Tanka Nath Dahal

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Community-based forestry is seen as a promising instrument for sustainable forest management (SFM) through the purposeful involvement of local communities. Globally, forest area managed by local communities is on the rise. However, transferring management responsibilities to forest users alone cannot guarantee the sustainability of forest management. A monitoring tool, that allows the local communities to track the progress of forest management towards the goal of sustainability, is essential. A case study, including six forest user groups (FUGs), two from each three community-based forestry models—community forestry (CF), buffer zone community forestry (BZCF), and collaborative forest management (CFM) representing three different physiographic regions, was conducted in Nepal. The study explores which community-based forest management model (CF, BZCF or CFM) is doing well in terms of sustainable forest management. The study assesses the overall performance of the three models towards SFM using locally developed criteria (four), indicators (26) and verifiers (60). This paper attempts to quantify the sustainability of the models using sustainability index for individual criteria (SIIC), and overall sustainability index (OSI). In addition, rating to the criteria and scoring of the verifiers by the FUGs were done. Among the four criteria, the FUGs ascribed the highest weightage to institutional framework and governance criterion; followed by economic and social benefits, forest management practices, and extent of forest resources. Similarly, the SIIC was found to be the highest for the institutional framework and governance criterion. The average values of OSI for CFM, CF, and BZCF were 0.48, 0.51 and 0.60 respectively; suggesting that buffer zone community forestry is the more sustainable model among the three. The study also suggested that the SIIC and OSI help local communities to quantify the overall progress of their forestry practices towards sustainability. The indices provided a clear picture of forest management practices to indicate the direction where they are heading in terms of sustainability; and informed the users on issues to pay attention to enhancing the sustainability of their forests.

Keywords: community forestry, collaborative management, overall sustainability, sustainability index for individual criteria

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434 Urban Ecotourism Development in Borderlands: An Exploratory Study of Xishuangbanna Dai Autonomous Prefecture, China

Authors: Min Liu, Thanapauge Chamaratana

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Integrating ecotourism into urban borderlands holds significant potential for promoting sustainable development, enhancing cross-border cooperation, and preserving cultural and natural heritage. This study aims to evaluate the current status and strategic measures for sustainable ecotourism development in the border urban areas of Xishuangbanna, leveraging the unique opportunities and challenges presented by its policy and geographical location. Employing a qualitative research approach, the exploratory study utilizes documentary research, observation, and in-depth interviews with 20 key stakeholders, including local government officials, tourism operators, community members, and tourists. Content analysis is conducted to interpret the collected data. The findings reveal that Xishuangbanna holds significant potential for ecotourism due to its rich biodiversity, cultural heritage, and strategic location along the Belt and Road Initiative route. The integration of ecotourism can drive economic growth, create employment opportunities, and foster a deeper appreciation for conservation efforts. By promoting ecotourism practices, the region can attract environmentally conscious travelers, thereby contributing to global sustainability goals. However, challenges such as inadequate infrastructure, limited community involvement, and environmental concerns are also identified. The study recommends enhancing ecotourism development in urban borderlands through integrated planning, stakeholder collaboration, and sustainable practices. These measures are essential to ensure long-term benefits for both the local community and the environment. Moreover, the study underscores the importance of a holistic approach to ecotourism development, which balances economic, social, and environmental priorities to achieve sustainable outcomes for urban borderlands.

Keywords: ecotourism, sustainable tourism, urban, borderland

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433 Unraveling the Political Complexities of the Textile and Clothing Waste Ecosystem; A Case Study on Melbourne Metropolitan Civic Waste Management Practices

Authors: Yasaman Samie

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The ever-increasing rate of textile and clothing (T&C) waste generation and the common ineffective waste management practices have been for long a challenge for civic waste management. This challenge stems from not only the complexity in the T&C material components but also the heterogeneous nature of the T&C waste management sector and the disconnection between the stakeholders. To date, there is little research that investigates the importance of a governmental structure and its role in T&C waste managerial practices and decision makings. This paper reflects on the impacts and involvement of governments, the Acts, and legislation on the effectiveness of T&C waste management practices, which are carried out by multiple players in a city context. In doing so, this study first develops a methodical framework for holistically analyzing a city’s T&C waste ecosystem. Central to this framework are six dimensions: social, environmental, economic, political, cultural, and educational, as well as the connection between these dimensions such as Socio-Political and Cultural-Political. Second, it delves into the political dimension and its interconnections with varying aspects of T&C waste. In this manner, this case-study takes metropolitan Melbourne as a case and draws on social theories of Actor-Network Theory and the principals of supply chain design and planning. Data collection was through two rounds of semi-structured interviews with 18 key players of T&C waste ecosystem (including charities, city councils, private sector providers and producers) mainly within metropolitan Melbourne and also other Australian and European cities. Research findings expand on the role of the politics of waste in facilitating a proactive approach to T&C waste management in the cities. That is achieved through a revised definition for T&C waste and its characteristics, discussing the varying perceptions of value in waste, prioritizing waste types in civic waste management practices and how all these aspects shall be reflected in the in-placed acts and legislations.

Keywords: civic waste management, multi-stakeholder ecosystem, textile and clothing waste, waste and governments

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