Search results for: social value of public healthcare
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14381

Search results for: social value of public healthcare

4721 A U-shaped Relationship between Body Mass Index and Dysmenorrhea: A Longitudinal Study

Authors: H. Ju, M. Jones, G. D. Mishra

Abstract:

Introduction: Limited longitudinal studies have examined the relationship between BMI and dysmenorrhea, resulting in mixed results. This study aims to investigate the long-term association between BMI and dysmenorrhea. Methods: 9,688 women from Australian Longitudinal Study on Women’s Health (ALSWH), a prospective population-based cohort study, were followed for 13 years. Data were collected through self-reported questionnaires repeatedly on all variables, including dysmenorrhea, weight and height. The longitudinal association between dysmenorrhea and BMI or BMI transition (change of BMI categories between two successive surveys) was investigated by generalized estimating equations. Results: When the women were aged 22 to 27 years, approximately 11% were obese, 7% underweight, and 25% reported dysmenorrhea. Over the study period, the prevalence of obesity doubled whereas that of underweight declined substantially. The prevalence of dysmenorrhea remained relatively stable. Compared to women with a normal weight, significantly higher odds of reporting dysmenorrhea were detected for both women who were underweight (odds ratio (OR) 1.25, 95% confidence interval (CI) 1.09, 1.43) and obese (OR 1.20, 95% CI 1.10, 1.31). Being overweight was not associated with increased risk of dysmenorrhea. Compared to women who remained at normal weight or overweight over time, significant risk was detected for women who: remained underweight or obese (OR 1.35, 95% CI 1.23, 1.49), were underweight but became normal or overweight (OR 1.29, 95% CI 1.11, 1.50), became underweight (OR 1.24, 95% CI 1.01, 1.52). However, the higher risk among obese women disappeared when they lost weight and became normal weight or overweight (OR 1.07, 95% CI 0.87, 1.30). Conclusions: A U-shaped association was revealed between dysmenorrhea and BMI, revealing higher risk of dysmenorrhea for both underweight and obese women. Further, the risk disappeared when obese women lost weight and acquired a healthier BMI. However obesity certainly poses a greater burden of disease from the public health perspective, thus requires greater effort to tackle the increasing problem at the population level. It is important to maintain a healthy weight over time for women to enjoy a better reproductive health.

Keywords: body mass index, dysmenorrhea, obesity, painful period, underweight

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4720 ISIS Resurgence in the Era of COVID-19

Authors: Stacey Pollard, Henry Baraket, Girish Ganesan, Natalie Kim

Abstract:

One year after U.S.-led coalition operations liberated ISIS-held territories in Iraq and Syria and killed ISIS core leader Abu Bakr al-Baghdadi, ISIS is resurging. Taking a page from its old playbook, the organization is capitalizing on social unrest and a rapidly deteriorating security environment—exacerbated by the COVID-19 pandemic—to reconstitute in permissive areas of Iraq and Syria. This Short examines ISIS’s pandemic-era ground and information operations through the lens of its state- and nation-making efforts to help analysts and decisionmakers better understand the imminence and scope of the threat. ISIS is rapidly overcoming U.S.-supported counterterrorism gains and, without direct pressure to reverse these advances, is poised for recovery.

Keywords: Terrorism, COVID-19, Islamic State, Instability, Iraq, Syria, Global, Resurgence

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4719 Neuroplasticity: A Fresh Begining for Life

Authors: Leila Maleki, Ezatollah Ahmadi

Abstract:

Neuroplasticity or the flexibility of the neural system is the ability of the brain to adapt to the lack or deterioration of sense and the capability of the neural system to modify itself through changing shape and function. Not only have studies revealed that neuroplasticity does not end in childhood, but also they have proven that it continues till the end of life and is not limited to the neural system and covers the cognitive system as well. In the field of cognition, neuroplasticity is defined as the ability to change old thoughts according to new conditions and the individuals' differences in using various styles of cognitive regulation inducing several social, emotional and cognitive outcomes. On the other hand, complexities of daily life necessitates cognitive neuroplasticity in order to adapt to different circumstances. The present paper attempts to discuss and define major theories and principles of neuroplasticity and elaborate on nature or nurture.

Keywords: neuroplasticity, cognitive plasticity, plasticity theories, plasticity mechanisms

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4718 Neuroplasticity: A Fresh Beginning for Life

Authors: Leila Maleki, Ezatollah Ahmadi

Abstract:

Neuroplasticity or the flexibility of the neural system is the ability of the brain to adapt to the lack or deterioration of sense and the capability of the neural system to modify itself through changing shape and function. Not only have studies revealed that neuroplasticity does not end in childhood, but also they have proven that it continues till the end of life and is not limited to the neural system and covers the cognitive system as well. In the field of cognition, neuroplasticity is defined as the ability to change old thoughts according to new conditions and the individuals' differences in using various styles of cognitive regulation inducing several social, emotional and cognitive outcomes. On the other hand, complexities of daily life necessitates cognitive neuroplasticity in order to adapt to different circumstances. The. present paper attempts to discuss and define major theories and principles of neuroplasticity and elaborate on nature or nurture.

Keywords: neuroplasticity, cognitive plasticity, plasticity theories, plasticity mechanisms

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4717 Tiger Team Strategy as a Health District Response to the COVID-19 Pandemic in Sydney, Australia during the Period between March 2020 to January 2022

Authors: Rehana Khan

Abstract:

Background: The study investigates the experiences of Tiger Teams within the Sydney Local Health District during the COVID-19 pandemic. Aim: The aims were to understand the experiences of the Tiger Team members, to evaluate the effectiveness of Tiger Teams, and to elicit any learnings for future implementation of Tiger Teams in a similar context. Methods: Tiger Team members who worked from March 2020 to January 2022 were approached, with 23 members agreeing to participate in the study. Individual interviews were undertaken by a researcher on a virtual platform. Thematic analysis was used to analyse the data. Saturation was deemed to have been reached when no new themes or subthemes arose within the final three interviews. Results: Four themes emerged: diversity worked well in Tiger Teams; fear of the unknown and challenging conversations were the main challenges of Tiger Teams; improved use of resources and more structure around the strategy of the Tiger Team model would help in future implementations; and Sydney Local Health District’s response to the pandemic was uniformly considered effective in keeping the community safe. In relation to Sydney Local Health District’s response in future pandemics, participants suggested having a pool of staff in readiness to undertake Tiger Team duties when required; prioritise staff welfare at all levels of involvement during a pandemic; maintaining transparent communication and relationship building between Executive level, Tiger Team members and clinical floor level in relation to decision making; and improve documentation, including evaluations of the COVID-19 pandemic response. Implications: The study provides constructive insights into the experiences of Tiger Team members, and these findings will help inform future planning for surge and secondment of staff in public health emergencies.

Keywords: Tiger Team, pandemic response, future planning, COVID-19

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4716 Performance Assessment of Ventilation Systems for Operating Theatres

Authors: Clemens Bulitta, Sasan Sadrizadeh, Sebastian Buhl

Abstract:

Introduction: Ventilation technology in operating theatres (OT)is internationally regulated by dif-ferent standards, which define basic specifications for technical equipment and many times also the necessary operating and performance parameters. This confronts the operators of healthcare facilities with the question of finding the best ventilation and air conditioning system for the OT in order to achieve the goal of a large and robust surgicalworkzone with appropriate air quality and climate for patient safety and occupational health. Additionally, energy consumption and the potential need for clothing that limits transmission of bacteria must be considered as well as the total life cycle cost. However, the evaluation methodology of ventilation systems regarding these matters are still a topic of discussion. To date, there are neither any uniform standardized specifications nor any common validation criteria established. Thus, this study aimed to review data in the literature and add ourown research results to compare and assess the performance of different ventilations systems regarding infection preventive effects, energy efficiency, and staff comfort. Methods: We have conducted a comprehensive literature review on OT ventilation-related topics to understand the strengths and limitations of different ventilation systems. Furthermore, data from experimental assessments on OT ventilation systems at the University of Amberg-Weidenin Germany were in-cluded to comparatively assess the performance of Laminar Airflow (LAF), Turbulent Mixing Air-flow(TMA), and Temperature-controlled Airflow (TcAF) with regards to patient and occupational safety as well as staff comfort including indoor climate.CFD simulations from the Royal Institute of Technology in Sweden (KTH) were also studied to visualize the differences between these three kinds of ventilation systems in terms of the size of the surgical workzone, resilience to obstacles in the airflow, and energy use. Results: A variety of ventilation concepts are in use in the OT today. Each has its advantages and disadvantages, and thus one may be better suited than another depend-ing on the built environment and clinical workflow. Moreover, the proper functioning of OT venti-lation is also affected by multiple external and internal interfering factors. Based on the available data TcAF and LAF seem to provide the greatest effects regarding infection control and minimizing airborne risks for surgical site infections without the need for very tight surgical clothing systems. Resilience to obstacles, staff comfort, and energy efficiency seem to be favourable with TcAF. Conclusion: Based on literature data in current publications and our studies at the Technical Uni-versity of Applied Sciences Amberg-Weidenand the Royal Institute of Technoclogy, LAF and TcAF are more suitable for minimizing the risk for surgical site infections leading to improved clin-ical outcomes. Nevertheless, regarding the best management of thermal loads, atmosphere, energy efficiency, and occupational safety, overall results and data suggest that TcAF systems could pro-vide the economically most efficient and clinically most effective solution under routine clinical conditions.

Keywords: ventilation systems, infection control, energy efficiency, operating theatre, airborne infection risks

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4715 Identification of Autism Spectrum Disorders in Day-Care Centres

Authors: Kenneth Larsen, Astrid Aasland, Synnve Schjølberg, Trond Diseth

Abstract:

Autism Spectrum Disorders (ASD) are neurodevelopmental disorders emerging in early development characterized by impairment in social communication skills and a restricted, repetitive and stereotyped patterns of behavior and interests. Early identification and interventions potentially improve development and quality of life of children with ASD. Symptoms of ASD are apparent through the second year of life, yet diagnostic age are still around 4 years of age. This study explored whether symptoms associated with ASD are possible to identify in typical Norwegian day-care centers in the second year of life. Results of this study clearly indicates that most described symptoms also are identifiable by day-care staff, and that a short observation list of 5 symptoms clearly identify children with ASD from a sample of normal developing peers.

Keywords: autism, early identification, day-care, screening

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4714 "At 60 – Old Age, at 70 – the Hoary Head": The Perceived Meaning of Bringing a Foreign Caregiver into the Home in the Haredi Society – Challenges and Barriers to Culturally-Sensitive Intervention

Authors: Amit Zriker, Anat Freund

Abstract:

The aim of the study was to conduct a thorough examination into the multiple complexities of bringing a foreign caregiver into the home to care for older adults in the Haredi society, by relating to the perspectives of the older adult and his family members. Research questions were: What is the meaning of bringing a foreign caregiver into the home in Haredi society, from the point of view of the older adult’s family members, and what are the implications of these meanings in the context of developing social policies and interventions? The current study was a qualitative-phenomenological study, which relates to “the lived experience” of those involved in the studied phenomenon. In the framework of the study, the participants included 15 adult Haredi sons and daughters of elderly impaired parents who receive homecare from a foreign caregiver. Data collection was carried out using in-depth, semi-structured interviews; the interview guidelines are comprised of the following content worlds: the meanings of aging in Haredi families; the decision-making process in relation to providing home care assistance for elderly impaired parents; making decisions regarding bringing a foreign caregiver into the home to care for an elderly parent; the daily routine after bringing in a foreign caregiver; bringing in a foreign caregiver vs. the society and vs. the Haredi establishment; and more. The issue of bringing a foreign caregiver into the home in the context of a faith-based society has received only scant and partial research attention to date. Nevertheless, in light of the growing elderly population in the Haredi society in Israel, and in closed, faith-based societies, in general; there is a growing need to bring foreign caregivers into the home as a possible solution to the “aging-in-place” problem in these societies. The separatist nature, and the collectivist and faith-based lifestyle of the Haredi society present unique challenges and needs in the process of employing a foreign caregiver. Moreover, the foreign caregiver also brings his/her own cultural world to the encounter, meaning, this process involves the elderly impaired individual, his/her family members, as well as the foreign caregiver. Therefore, it is important to understand their attitudes, perceptions and interactions, in order to create a good fit among all involved parties. The innovation and uniqueness of the current study is in its in-depth exploration of a phenomenon through an emotional-cultural lens. The study findings also contribute to the creation of social policy in the field of nursing, which will be adapted and culturally sensitive to Haredi society, and other faith-based societies.

Keywords: culturally-sensitive intervention, faith-based society, foreign caregiver, Haredi society

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4713 Challenges and Success Factors in Introducing Information Systems for Students' Online Registration

Authors: Stanley Fore, Sharon Chipeperekwa

Abstract:

The start of the 2011 academic year in South Africa saw a number of Institutions of Higher Learning introducing online registration for their students. The efficiency and effectiveness of Information Systems are increasingly becoming a necessity and not an option for many organizations. An information system should be able to allow end users to access information easily and navigate with ease. The selected University of Technology (UoT) in this research is one of the largest public institution of higher learning in the Western Cape Province and boasts of an enrolment of more than 30000 students per academic year. An observation was made that, during registration students’ stand in long queues waiting to register or for assistance to register. The system tends to ‘freeze’ whilst students are registering and students are in most cases unfamiliar with the system interface. They constantly have to enquire what to do next when going through online registration process. A mixed method approach will be adopted which comprises of quantitative and qualitative approaches. The study uses constructs of the updated DeLone and McLean IS success model (2003) to analyse and explain the student’s perceptions of the online registration system. The research was undertaken to establish the student’s perceptions of the online registration system. This research seeks to identify and analyse the challenges and success factors of introducing an online registration system whilst highlighting the extent to which this system has been able to solve the numerous problems associated with the manual era. The study will assist management and those responsible for managing the current system to determine how well the system is working or not working to achieve user satisfaction. It will also assist them going forward on what to consider before, during and after implementation of an information system. Respondents will be informed of the objectives of the research, and their consent to participate will be sought. Ethical considerations that will be applied to this study include; informed consent and protection from harm, right to privacy and involvement of the research.

Keywords: online registration, information systems, University of Technology, end-users

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4712 Assessment Proposal to Establish the First Geo-Park in Egypt at Abu-Roash Area, Cairo

Authors: Kholoud Abdelmaksoud, Mahmoud Emam, Wael Al-Metwaly

Abstract:

Egypt is known as cradle of civilization due to its ancient history and archeological sites, but Egypt possess also a cradle of Geo-sites, which qualify it to be listed as one of the most important Geo-heritage sites all over the country. Geology and landscape in Abu-Roash area is considered as one of the most important geological places (geo-sites) inside Cairo which help us to know and understand geology and geologic processes, so the area is used mainly for geological education purposes, also the area contain an archeological sites; pyramid complex, tombs, and Coptic monastery which give the area unique importance. Abu-Roash area is located inside Cairo 9 km north of the Giza Pyramids, which make the accessibility to the area easy and safe, the geology of Abu-Roash constitutes a complex Cretaceous sedimentary succession mass with showing outstanding tectonic features (Syrian Arc system event), these features are considered as a Geo-heritage, which will be the main designation of ‘Geo-parks’ establishing. The research is dealing with the numerous geo-sites found in the area, and its geologic and archeological importance, the relation between geo-sites and archeology, also the research proposed a detailed maps for these sites depicting Geo-routes and the hazardous places surrounding Abu-Roash area. The research is proposing a new proposal not applied in Egypt before, establishing a Geo-park, to promote this unique geo-heritage from hazardous factors and anthropogenic effects, also it will offer geo-educational opportunities to the general public and to the scientific community, enhancement of Geo-tourism which will be linked easily with the Ancient Egyptian tourism, it will also provide a significant economic benefit to Abu-Roash residential area. Finally, the research recommends that The United Nations Educational, Scientific and Cultural Organizations promote conservation of geological and geo-morphological heritage to list this area for its importance under the umbrella of geo-parks.

Keywords: geo-park, geo-sites, Abu-roash, archaeological sites, geo-tourism

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4711 The Interplay between Autophagy and Macrophages' Polarization in Wound Healing: A Genetic Regulatory Network Analysis

Authors: Mayada Mazher, Ahmed Moustafa, Ahmed Abdellatif

Abstract:

Background: Autophagy is a eukaryotic, highly conserved catabolic process implicated in many pathophysiologies such as wound healing. Autophagy-associated genes serve as a scaffolding platform for signal transduction of macrophage polarization during the inflammatory phase of wound healing and tissue repair process. In the current study, we report a model for the interplay between autophagy-associated genes and macrophages polarization associated genes. Methods: In silico analysis was performed on 249 autophagy-related genes retrieved from the public autophagy database and gene expression data retrieved from Gene Expression Omnibus (GEO); GSE81922 and GSE69607 microarray data macrophages polarization 199 DEGS. An integrated protein-protein interaction network was constructed for autophagy and macrophage gene sets. The gene sets were then used for GO terms pathway enrichment analysis. Common transcription factors for autophagy and macrophages' polarization were identified. Finally, microRNAs enriched in both autophagy and macrophages were predicated. Results: In silico prediction of common transcription factors in DEGs macrophages and autophagy gene sets revealed a new role for the transcription factors, HOMEZ, GABPA, ELK1 and REL, that commonly regulate macrophages associated genes: IL6,IL1M, IL1B, NOS1, SOC3 and autophagy-related genes: Atg12, Rictor, Rb1cc1, Gaparab1, Atg16l1. Conclusions: Autophagy and macrophages' polarization are interdependent cellular processes, and both autophagy-related proteins and macrophages' polarization related proteins coordinate in tissue remodelling via transcription factors and microRNAs regulatory network. The current work highlights a potential new role for transcription factors HOMEZ, GABPA, ELK1 and REL in wound healing.

Keywords: autophagy related proteins, integrated network analysis, macrophages polarization M1 and M2, tissue remodelling

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4710 Psychopathic Disorders and Judges Sentencing: Can Neurosciences Change this Aggravating Factor in a Mitigating Factor?

Authors: Kevin Moustapha

Abstract:

Psychopathy is perceived today as being «the most important concept in the criminal justice system» and as «the most important legal notion of the early 21 th century». The explosion of research related to psychopathy seems to perfectly illustrate this trend. Traditionally, many studies tend to focus on links between insanity defense and psychopathy. That is why our purpose in this article is to analyze psychopathic disorders in the scope of judges sentencing in Canada. Indeed, in every Canadian case related to dangerous offenders, judges must balance between fairness and protection of the individuals rights of the accused and protection of society from dangerous predators who may commit future acts of physical or sexual violence. Increasingly, psychopathic disorders are taking an important part in judge sentencing, especially in Canada. This phenomenon can be illustrated by the high proportion of psychopath offenders incarcerated in North American prisons. Many decisions in Canadians courtrooms seem to point out that psychopathy is often used as a strong argument by the judges to preserve public safety. The fact that psychopathy is often associated with violence, recklessness and recidivism, it could explain why many judges consider psychopathic disorders as an aggravating factor. Generally, the judge reasoning is based on article 753 of Canadian Criminal Code related to dangerous offenders, which is used for individuals who show a pattern of repetitive and persistent aggressive behaviour. However, with cognitive neurosciences, the psychopath’s situation in courtrooms would probably change. Cerebral imaging and news data provided by the neurosciences show that emotional and volitional functions in psychopath’s brains are impaired. Understanding these new issues could enable some judges to recognize psychopathic disorders as a mitigating factor. Two important questions ought to be raised in this article: can exploring psychopaths ‘brains really change the judge sentencing in Canadian courtrooms? If yes, can judges consider psychopathy more as a mitigating factor than an aggravating factor?

Keywords: criminal law, judges sentencing, neurosciences, psychopathy

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4709 Prevalence of Emotional Problems among Adolescent Students of Corporation Schools in Chennai

Authors: Vithya Veeramani, Karunanidhi Subbaiah

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Emotional problems were found to be the predominant cause of suicide and second leading cause of death among adolescents in India. Emotional problems seem to be the underlying cause for various other severe psycho-social problems experienced in adolescence and also in later years of life. The Corporation schools in Chennai city are named as Chennai High School or Chennai Higher Secondary School run by the Corporation of Chennai. These schools fulfill the educational needs of students who hail from lower socio-economic status living in slums of the Chennai city. Adolescent students of Chennai schools tend to lack basic needs like food, clothes, shelter, etc. Some of the other significant problems faced by them are broken family, lack of parental support, frequent quarrel between parents, alcoholic parents, drug abuse and substance abuse among parents and neighbors, extended family, illiterate parents, deprivation of love and care, and lack of sense of belongingness. This prevailing condition may affect them emotionally and could lead to maladaptive behaviour, aggressiveness, poor interpersonal relationship with others, school refusal behaviour, school drop-out, suicide, etc. Therefore, it is very important to investigate the emotional problems faced by the adolescent students studying in Chennai schools, Chennai. A cross-sectional survey design was used to find the prevalence of emotional problems among adolescent students. Cluster sampling technique was used to select the schools for the present study considering the school as a cluster. In total, there are 15 zones, under the control of Chennai Corporation, of which only 7 zones have Corporation Schools in Chennai city, comprising of 32 Chennai Higher Secondary Schools and 38 Chennai High Schools. Out of these 70 schools, 29 schools comprising of 17 high schools and 12 higher secondary schools were selected randomly using lottery method. A sample of 2594 adolescent students from 9th standard and 11th standard was chosen for the study. Percentage analysis was done to find out the prevalence rate of emotional problems among adolescents students studying in Chennai Schools. Results of the study revealed that, out of 2594 students surveyed, 21.04% adolescent students were found to have academic problems (n = 546), 15.99% adolescent students had social problems (n = 415), behaviour problems was found to be prevalent among 12.87% adolescent students (n = 334), depression was prevalent among 15.88% adolescent students (n = 412) and anxiety was prevalent among 14.42% adolescent students (n = 374). Prevalence of emotional problems among male and female revealed that academic problems were more prevalent compared to other problems. Behaviour problems were least prevalent among boys and anxiety was least prevalent among girls than other problems. The overall prevalence rate of emotional problems was found to be on an increasing trend among adolescent students of low socio-economic status in Chennai city. The findings indicated the need for intervention to prevent and rehabilitate these adolescent students.

Keywords: adolescents, corporation schools, emotional problems, prevalence

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4708 A Call for Justice and a New Economic Paradigm: Analyzing Counterhegemonic Discourses for Indigenous Peoples' Rights and Environmental Protection in Philippine Alternative Media

Authors: B. F. Espiritu

Abstract:

This paper examines the resistance of the Lumad people, the indigenous peoples in Mindanao, Southern Philippines, and of environmental and human rights activists to the Philippine government's neoliberal policies and their call for justice and a new economic paradigm that will uphold peoples' rights and environmental protection in two alternative media online sites. The study contributes to the body of knowledge on indigenous resistance to neoliberal globalization and the quest for a new economic paradigm that upholds social justice for the marginalized in society, empathy and compassion for those who depend on the land for their survival, and environmental sustainability. The study analyzes the discourses in selected news articles from Davao Today and Kalikasan (translated to English as 'Nature') People's Network for the Environment’s statements and advocacy articles for the Lumad and the environment from 2018 to February 2020. The study reveals that the alternative media news articles and the advocacy articles contain statements that expose the oppression and violation of human rights of the Lumad people, farmers, government environmental workers, and environmental activists as shown in their killings, illegal arrest and detention, displacement of the indigenous peoples, destruction of their schools by the military and paramilitary groups, and environmental plunder and destruction with the government's permit for the entry and operation of extractive and agribusiness industries in the Lumad ancestral lands. Anchored on Christian Fuch's theory of alternative media as critical media and Bert Cammaerts' theorization of alternative media as counterhegemonic media that are part of civil society and form a third voice between state media and commercial media, the study reveals the counterhegemonic discourses of the news and advocacy articles that oppose the dominant economic system of neoliberalism which oppresses the people who depend on the land for their survival. Furthermore, the news and advocacy articles seek to advance social struggles that transform society towards the realization of cooperative potentials or a new economic paradigm that upholds economic democracy, where the local people, including the indigenous people, are economically empowered their environment and protected towards the realization of self-sustaining communities. The study highlights the call for justice, empathy, and compassion for both the people and the environment and the need for a new economic paradigm wherein indigenous peoples and local communities are empowered towards becoming self-sustaining communities in a sustainable environment.

Keywords: alternative media, environmental sustainability, human rights, indigenous resistance

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4707 A Randomised Controlled Trial on the Nurse-Led Smartphone-Based Self-Management Programme for Type 2 Diabetes Patients with Poor Glycemic Control

Authors: Wenru Wang

Abstract:

Over the past decades, Asia has emerged as the ‘diabetes epicentre’ in the world due to rapid economic development, urbanization and nutrition transition. There is an urgent need to develop more effective and cost-effective care management strategies in response to this rising diabetes epidemic. This study aims to develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes among type 2 diabetes patients with poor glycemic control in Singapore. We proposed a randomized controlled trial with pre- and repeated post-tests control group design. A total of 128 type 2 diabetes patients with poor glycemic control will be recruited from the diabetes clinic of an acute public hospital in Singapore through convenience sampling. Study participants will be either randomly allocated to the experimental group or control group. Outcome measures used will include the 10-item General Self-Efficacy Scale, 11-item Revised Summary of Diabetes Self-care Activities, and 19-item Diabetes-Dependent Quality of Life. Data will be collected at 3-time points: baseline, three months and six months from the baseline, respectively. It is expected that this programme will be an alternative offered to diabetes patients to master their self-care management skills, in addition to the existing diabetes service provided in diabetes clinics in Singapore hospitals. Also, the self-supporting and less resource-intensive nature of this programme, through the use of smartphone app as a mode of intervention delivery, will greatly reduce nurses’ direct contact time with patients and allow more time to be allocated to those who require more attention. The study has been registered with clinicaltrials.gov. The trial registration number is NCT03088475.

Keywords: type 2 diabetes, poor glycaemic control, nurse-led, smartphone-based, self-management, health-relevant outcomes

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4706 Language Maintenance and Literacy of Madurese in Probolinggo City

Authors: Maria Ulfa, Nur Awaliyah Putri

Abstract:

Madurese is known as Malayo-Sumbawan Austronesian language which is used by Madurese people in Madura Island, Indonesia. However, there was a massive migration of Madurese people due to Dutch colonization. The Madurese people were brought by force for cultivation system to the eastern salient north coast or called as Tapal Kuda that spread in region covers the regencies of Probolinggo, Lumajang, Jember, Situbondo, Bondowoso, and Banyuwangi, the eastern part of the Pasuruan Regency, as well as the city of Probolinggo. The city of Probolinggo has unique characteristic regarding the ethnic and language variation. Several ethnics can be found in this city, such as Madurese, Javanese, Tengger, Arabic, Mandhalungan, Osing, and Chinese. Hence, the hybrid culture happens in Probolinggo, they called the culture as Pendhalungan which is the combination of culture among Madurese and Javanese. Among those ethnics, Madurese is the strongest ethnic that still maintains their identity, such as their ethnic language. The massive growth of Madurese in Probolinggo city, East Java is interesting to be analyzed. The object of this study is to discover language ideology and literacy of Madurese to maintain their ethnic language in Probolinggo city, East Java. The researchers used the theory of language maintenance practice based on three types of practices social language, social literacy, and peripheral ritualized practices. The approach of this study was qualitative research with ethnography method. In order to collect the data, researchers used observation and interview techniques. The amount of informants were 20 families which consist of mother, father and children in 5 sub-districts in Probolinggo city and they were interviewed regarding language ideology and literacy of Madurese. In supporting the data, researchers employed the Madurese speakers outside family scope like in school, office, and market. The result of the study revealed that Madurese has been preserved heritably to young generations by ethnics of Madura in Probolinggo city. Primarily the language is being taught in the earlier age of their children as L1 and used as ethnic identity. The parents teach them with simple sentences that grammatically correct. This language literacy is applied to maintain ethnic language as their ethnicity marker since they inhabit in Javanese ethnic area. In fact, it is not the only ideology of Madurese ethnic but also the influence of economic situation like in trading communication. The usage of Madurese in the trading scope is very beneficial since people can bargain the goods cheaper and easier because most of the traders are from Madurese ethnic. In this situation, linguistic phenomena such as code mixing and code switching between Madurese and Javanese are emerged as the trading communication. From the result, it can be concluded that solidarity exists among Madurese people in many scopes.

Keywords: language literacy, language maintenance, Madurese, Probolinggo City

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4705 Empowering Teachers to Bolster Vocational Education in Cameroon

Authors: Ambissah Asah Brigitte

Abstract:

This research is guided by observations in the types of education offered at the secondary level in Cameroon. The secondary education system in Cameroon comprises two types of education, including General Education and Technical and Vocational Education. Although General Education and, Technical and Vocational Education are given equal importance by public authorities, General Education remains on the thriving trend, enjoying the greatest enrolment. In the meantime, Technical and Vocational Education is still to reach the adequate momentum expected to fostering the country’s full-fledged development, as specified in the National Development Strategy, which is the blue print of State policies in Cameroon for the 2020-2030 decade. Vocational Education is credited for its ability to foster a country’s development, since it teaches students the precise skills and knowledge needed to carry out a specific craft, technical skill or trade. Yet, formal training on Vocational Education for teachers offers a pale face in secondary education. This limits the ability of the educational system to nurture vocations and provide the country’s economy with the manpower necessary to achieving development goals. This article seeks to analyse how concretely does the institutional framework spur vocational skills in secondary school teachers. It overviews the instruments instituting Vocational Education at the secondary level in Cameroon, then assesses their effective implementation on the ground. Questionnaires addressed to both active teachers and vocational education policy-makers serve to collect data which are analysed using descriptive statistics. The final objective is to contribute in the debate urging to rethink the role of teachers in bolstering Vocational Education, which is the cornerstone of industrial development. This is true everywhere in the world. In Cameroon and in Africa in general, teachers must be empowered in this field with specific sets of competencies they will need to pass on to learners. They equally need to be given opportunities to acquire and adapt their knowledge and teaching skills accordingly.

Keywords: vocational education, cameroon, institutional framework, national development, competencies and skills

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4704 Seroprevalence and Potential Risk Factors of Bovine Brucellosis under Diverse Production Systems in Central Punjab, Paksitan

Authors: A. Khan, I. Khan, M. Younus, S. E. Haque, U. Waheed, H. Neubauer, A. A. Anjum, S. A. Muhammad, A. Idrees T. Abbas, S. Raza, M. A. Ali, M. Farooq, M. Mahmood, A. Hussain, H. Danish, U. Tayyab, M. Zafar, M. Aslam.

Abstract:

Brucellosis is one of the major problems of milk producing animals in our country which deteriorate the health of livestock. It is a disease of zoonotic significance which is capable of producing disease in humans leading to infertility, orchitis, abortions, and synovitis. In this particular study, milk and serum samples of cattle and buffalo (n=402) were collected from different districts of Punjab including Narowal, Gujranwala and Gujrat. Milk samples were analyzed by Milk Ring Test (MRT), while serum samples were tested through Rose Bengal Plate agglutination Test (RBPT) and Indirect Enzyme Linked Immunosorbant Assay (i-ELISA). The sample tested with MRT were 9.5% positive, including cattle 9.6% and buffalo 9.3%. While using the RBPT test for the detection of serum samples and for screening purpose it was observed that 16.4% animals were seropositive, cattle were 18.8% and buffalo were 13.9% seropositive. The higher prevalence of brucellosis indicates the danger of the disease to human population. The serum samples positive by RBPT were further confirmed by the use of most specific and sensitive serological test known as i-ELISA. 11.4% animals were confirmed as seropositive by i-ELISA including cattle 13.5% seropositive and buffalo 9.3%. The results indicated high seroprevalence of brucellosis in cattle as compared to buffalos. Different risk factors were also studied to know the association between disease and their spread. Advanced age, larger herds, history of abortion and pregnancy of the animals is considered to be the important factors for the prevalence and spread of the hazardous zoonotic disease. It is a core issue of developing countries like Pakistan and has major public health impact.

Keywords: humans, bovines, infertility, orchitis, abortions, seroprevalence, brucellosis

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4703 A Study on the Prevalence and Microbiological Profile of Nosocomial Infections in the ICU of a Tertiary Care Hospital in Eastern India

Authors: Pampita Chakraborty, Sukumar Mukherjee

Abstract:

This study was done to determine the prevalence of nosocomial infections in the ICU and to identify the common microorganisms causing these infections and their antimicrobial sensitivity pattern. Nosocomial infection or hospital-acquired infection is a localized or a systemic condition resulting from an adverse reaction to the presence of infectious agents. Nosocomial infections are not present or incubating when the patient is admitted to hospital or other health care facility. They are caused by pathogens that easily spread through the body. Many hospitalized patients have compromised immune systems, so they are less able to fight off infections. These infections occur worldwide, both in the developed and developing the world. They are a significant burden to patients and public health. They are a major cause of death and increased morbidity in hospitalized patients, which is a matter of serious concern today. This study was done during the period of one year (2012-2013) in the ICU of the tertiary care hospital in eastern India. Prevalence of nosocomial infection was determined; site of infection and the pattern of microorganisms were identified along with the assessment of antibiotic susceptibility profile. Patients who developed an infection after 48 hours of admission to the ICU were included in the study. A total of 324 ICU patients were analyzed, of these 79 patients were found to have developed a nosocomial infection (24.3% prevalence). Urinary tract infection was found to be more predominant followed by respiratory tract infection and soft tissue infection. The most frequently isolated microorganism was E. coli, Pseudomonas aeruginosa, Klebsiella pneumoniae followed by other organisms respectively. Antibiotic susceptibility test of these isolates was done against commonly used antibiotics. Patients admitted to the ICU are especially susceptible to nosocomial infections. Despite adequate antimicrobial treatment, nosocomial ICU infections can significantly affect ICU stay and can cause an increase in patient’s morbidity and mortality. Adherence to infection protocol, proper monitoring and the judicious use of antibiotics are important in preventing such infections on a regular basis.

Keywords: antibiotic susceptibility, intensive care unit, nosocomial infection, nosocomial pathogen

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4702 Study on Eco-Feedback of Thermal Comfort and Cost Efficiency for Low Energy Residence

Authors: Y. Jin, N. Zhang, X. Luo, W. Zhang

Abstract:

China with annual increasing 0.5-0.6 billion squares city residence has brought in enormous energy consumption by HVAC facilities and other appliances. In this regard, governments and researchers are encouraging renewable energy like solar energy, geothermal energy using in houses. However, high cost of equipment and low energy conversion result in a very low acceptable to residents. So what’s the equilibrium point of eco-feedback to reach economic benefit and thermal comfort? That is the main question should be answered. In this paper, the objective is an on-site solar PV and heater house, which has been evaluated as a low energy building. Since HVAC system is considered as main energy consumption equipment, the residence with 24-hour monitoring system set to measure temperature, wind velocity and energy in-out value with no HVAC system for one month of summer and winter. Thermal comfort time period will be analyzed and confirmed; then the air-conditioner will be started within thermal discomfort time for the following one summer and winter month. The same data will be recorded to calculate the average energy consumption monthly for a purpose of whole day thermal comfort. Finally, two analysis work will be done: 1) Original building thermal simulation by computer at design stage with actual measured temperature after construction will be contrastive analyzed; 2) The cost of renewable energy facilities and power consumption converted to cost efficient rate to assess the feasibility of renewable energy input for residence. The results of the experiment showed that a certain deviation exists between actual measured data and simulated one for human thermal comfort, especially in summer period. Moreover, the cost-effectiveness is high for a house in targeting city Guilin now with at least 11 years of cost-covering. The conclusion proves that an eco-feedback of a low energy residence is never only consideration of its energy net value, but also the cost efficiency that is the critical factor to push renewable energy acceptable by the public.

Keywords: cost efficiency, eco-feedback, low energy residence, thermal comfort

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4701 Congenital Heart Defect(CHD) “The Silent Crises”; The Need for New Innovative Ways to Save the Ghanaian Child - A Retrospective Study

Authors: Priscilla Akua Agyapong

Abstract:

Background: In a country of nearly 34 million people, Ghana suffers from rapidly growing pediatric CHD cases and not enough pediatric specialists to attend to the burgeoning needs of these children. Most of the cases are either missed or diagnosed late, resulting in increased mortality. According to the National Cardiothoracic Centre, 1 in every 100,000 births in Ghana has CHD; however, there is limited data on the clinical presentation and its management, one of the many reasons I decided to do this case study coupled with the loss my 2 month old niece to multiple Ventricular Septal Defect 3 years ago due late diagnoses. Method: A retrospective cohort study was performed at the child health clinic of one of Ghana’s public tertiary Institutions using data from their electronic health record (EHR) from February 2021 to April 2022. All suspected or provisionally diagnosed cases were included in the analysis. Results: Records of over 3000 children were reviewed with an approximate male to female ratio of 1:1.53 cases diagnosed during the period of study, most of whom were less than 5 years of age. 25 cases had complete clinical records, with acyanotic septal defects being the most diagnosed. 62.5% of the cases were ventricular septal defects, followed by Patent Ductus Arteriosus (23%) and Atrial Septal Defects (4.5%). Tetralogy of Fallot was the most predominant and complex cyanotic CHD with 10%. Conclusion: The indeterminate coronary anatomy of infants makes it difficult to use only echocardiography and other conventional clinical methods in screening for CHDs. There are rising modernizations and new innovative ways that can be employed in Ghana for early detection, hence preventing the delay of a potential surgical repair. It is, therefore, imperative to create the needed awareness about these “SILENT CRISES” and help save the Ghanaian child’s life.

Keywords: congenital heart defect(CHD), ventricular septal defect(VSD), atrial septal defect(ASD), patent ductus arteriosus(PDA)

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4700 Investigation of Enterotoxigenic Staphylococcus aureus in Kitchen of Catering

Authors: Çiğdem Sezer, Aksem Aksoy, Leyla Vatansever

Abstract:

This study has been done for the purpose of evaluation of public health and identifying of enterotoxigenic Staphyloccocus aureus in kitchen of catering. In the kitchen of catering, samples have been taken by swabs from surface of equipments which are in the salad section, meat section and bakery section. Samples have been investigated with classical cultural methods in terms of Staphyloccocus aureus. Therefore, as a 10x10 cm area was identified (salad, cutting and chopping surfaces, knives, meat grinder, meat chopping surface) samples have been taken with sterile swabs with helping FTS from this area. In total, 50 samples were obtained. In aseptic conditions, Baird-Parker agar (with egg yolk tellurite) surface was seeded with swabs. After 24-48 hours of incubation at 37°C, the black colonies with 1-1.5 mm diameter and which are surrounded by a zone indicating lecithinase activity were identified as S. aureus after applying Gram staining, catalase, coagulase, glucose and mannitol fermentation and termonuclease tests. Genotypic characterization (Staphylococcus genus and S.aureus species spesific) of isolates was performed by PCR. The ELISA test was applied to the isolates for the identification of staphylococcal enterotoxins (SET) A, B, C, D, E in bacterial cultures. Measurements were taken at 450 nm in an ELISA reader using an Ridascreen-Total set ELISA test kit (r-biopharm R4105-Enterotoxin A, B, C, D, E). The results were calculated according to the manufacturer’s instructions. A total of 50 samples of 97 S. aureus was isolated. This number has been identified as 60 with PCR analysis. According to ELISA test, only 1 of 60 isolates were found to be enterotoxigenic. Enterotoxigenic strains were identified from the surface of salad chopping and cutting. In the kitchen of catering, S. aureus identification indicates a significant source of contamination. Especially, in raw consumed salad preparation phase of contamination is very important. This food can be a potential source of food-borne poisoning their terms, and they pose a significant risk to consumers have been identified.

Keywords: Staphylococcus aureus, enterotoxin, catering, kitchen, health

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4699 Satisfaction Among Preclinical Medical Students with Low-Fidelity Simulation-Based Learning

Authors: Shilpa Murthy, Hazlina Binti Abu Bakar, Juliet Mathew, Chandrashekhar Thummala Hlly Sreerama Reddy, Pathiyil Ravi Shankar

Abstract:

Simulation is defined as a technique that replaces or expands real experiences with guided experiences that interactively imitate real-world processes or systems. Simulation enables learners to train in a safe and non-threatening environment. For decades, simulation has been considered an integral part of clinical teaching and learning strategy in medical education. The several types of simulation used in medical education and the clinical environment can be applied to several models, including full-body mannequins, task trainers, standardized simulated patients, virtual or computer-generated simulation, or Hybrid simulation that can be used to facilitate learning. Simulation allows healthcare practitioners to acquire skills and experience while taking care of patient safety. The recent COVID pandemic has also led to an increase in simulation use, as there were limitations on medical student placements in hospitals and clinics. The learning is tailored according to the educational needs of students to make the learning experience more valuable. Simulation in the pre-clinical years has challenges with resource constraints, effective curricular integration, student engagement and motivation, and evidence of educational impact, to mention a few. As instructors, we may have more reliance on the use of simulation for pre-clinical students while the students’ confidence levels and perceived competence are to be evaluated. Our research question was whether the implementation of simulation-based learning positively influences preclinical medical students' confidence levels and perceived competence. This study was done to align the teaching activities with the student’s learning experience to introduce more low-fidelity simulation-based teaching sessions for pre-clinical years and to obtain students’ input into the curriculum development as part of inclusivity. The study was carried out at International Medical University, involving pre-clinical year (Medical) students who were started with low-fidelity simulation-based medical education from their first semester and were gradually introduced to medium fidelity, too. The Student Satisfaction and Self-Confidence in Learning Scale questionnaire from the National League of Nursing was employed to collect the responses. The internal consistency reliability for the survey items was tested with Cronbach’s alpha using an Excel file. IBM SPSS for Windows version 28.0 was used to analyze the data. Spearman’s rank correlation was used to analyze the correlation between students’ satisfaction and self-confidence in learning. The significance level was set at p value less than 0.05. The results from this study have prompted the researchers to undertake a larger-scale evaluation, which is currently underway. The current results show that 70% of students agreed that the teaching methods used in the simulation were helpful and effective. The sessions are dependent on the learning materials that are provided and how the facilitators engage the students and make the session more enjoyable. The feedback provided inputs on the following areas to focus on while designing simulations for pre-clinical students. There are quality learning materials, an interactive environment, motivating content, skills and knowledge of the facilitator, and effective feedback.

Keywords: low-fidelity simulation, pre-clinical simulation, students satisfaction, self-confidence

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4698 Language and Political Manipulation: A Critical Analysis of Okediran's Tenants of the House

Authors: Moses Joseph

Abstract:

Language is a veritable tool in the hands of politicians. They use it to shape social realities; create new meanings and ultimately to acquire, exercise and sustain power in the society. Language and politics both share a symbiotic relationship. The former is the medium through which members of the society communicate and cohabitate while the later is used to gain and exercise power in the society. Language therefore is the epicenter of every human activity and politicians explore, deploy and manipulate it to advance their personal interests. This paper examines the ideological use of language in Okediran’s Tenants of the House. The study further shows that language is used as an instrument of political domination and manipulation through the display of emotiveness. The study concludes that politicians do not innocently use language but deliberately employ them to foreground their ideological position.

Keywords: language, ideology, political domination, manipulation

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4697 A Question of Ethics and Faith

Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

Abstract:

An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavoured to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learner. Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: medical education, clinical education, andragogy, pedagogy

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4696 Hygrothermal Interactions and Energy Consumption in Cold Climate Hospitals: Integrating Numerical Analysis and Case Studies to Investigate and Analyze the Impact of Air Leakage and Vapor Retarding

Authors: Amir E. Amirzadeh, Richard K. Strand

Abstract:

Moisture-induced problems are a significant concern for building owners, architects, construction managers, and building engineers, as they can have substantial impacts on building enclosures' durability and performance. Computational analyses, such as hygrothermal and thermal analysis, can provide valuable information and demonstrate the expected relative performance of building enclosure systems but are not grounded in absolute certainty. This paper evaluates the hygrothermal performance of common enclosure systems in hospitals in cold climates. The study aims to investigate the impact of exterior wall systems on hospitals, focusing on factors such as durability, construction deficiencies, and energy performance. The study primarily examines the impact of air leakage and vapor retarding layers relative to energy consumption. While these factors have been studied in residential and commercial buildings, there is a lack of information on their impact on hospitals in a holistic context. The study integrates various research studies and professional experience in hospital building design to achieve its objective. The methodology involves surveying and observing exterior wall assemblies, reviewing common exterior wall assemblies and details used in hospital construction, performing simulations and numerical analyses of various variables, validating the model and mechanism using available data from industry and academia, visualizing the outcomes of the analysis, and developing a mechanism to demonstrate the relative performance of exterior wall systems for hospitals under specific conditions. The data sources include case studies from real-world projects and peer-reviewed articles, industry standards, and practices. This research intends to integrate and analyze the in-situ and as-designed performance and durability of building enclosure assemblies with numerical analysis. The study's primary objective is to provide a clear and precise roadmap to better visualize and comprehend the correlation between the durability and performance of common exterior wall systems used in the construction of hospitals and the energy consumption of these buildings under certain static and dynamic conditions. As the construction of new hospitals and renovation of existing ones have grown over the last few years, it is crucial to understand the effect of poor detailing or construction deficiencies on building enclosure systems' performance and durability in healthcare buildings. This study aims to assist stakeholders involved in hospital design, construction, and maintenance in selecting durable and high-performing wall systems. It highlights the importance of early design evaluation, regular quality control during the construction of hospitals, and understanding the potential impacts of improper and inconsistent maintenance and operation practices on occupants, owner, building enclosure systems, and Heating, Ventilation, and Air Conditioning (HVAC) systems, even if they are designed to meet the project requirements.

Keywords: hygrothermal analysis, building enclosure, hospitals, energy efficiency, optimization and visualization, uncertainty and decision making

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4695 Marketing Implications and the Dynamics of Changing Gender Roles in Families

Authors: Kehinde Emmanuel Atanlusi

Abstract:

It is impossible to stifle the gust of social change as it makes its way through institutionalised hierarchies on its way to expressing itself. This advancement might also have repercussions for institutions, families, and politics, so modifying the norms and establishing new societal ideals. In the following paragraphs, it will explore how gender roles in the family have changed over time, how this has affected consumption, and how marketing has been influenced by these changes. It was decided to use the empirical research method, which led to several discoveries, one of which was that marketing in the pre-modern era was predicated on metanarratives and gender stereotypes. However, these aspects of marketing have undergone significant transformations in the post-modern era, which led to the formation of an assumption regarding what future marketing trends will be like. In spite of the fact that post-modern marketing methods have a number of drawbacks, it was suggested that these strategies be embraced and updated in the future in order to expand consumer bases and target audiences.

Keywords: Marketing, Gender Roles, Advertising, Decentralisation, Fragmentation

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4694 Disease Trajectories in Relation to Poor Sleep Health in the UK Biobank

Authors: Jiajia Peng, Jianqing Qiu, Jianjun Ren, Yu Zhao

Abstract:

Background: Insufficient sleep has been focused on as a public health epidemic. However, a comprehensive analysis of disease trajectory associated with unhealthy sleep habits is still unclear currently. Objective: This study sought to comprehensively clarify the disease's trajectory in relation to the overall poor sleep pattern and unhealthy sleep behaviors separately. Methods: 410,682 participants with available information on sleep behaviors were collected from the UK Biobank at the baseline visit (2006-2010). These participants were classified as having high- and low risk of each sleep behavior and were followed from 2006 to 2020 to identify the increased risks of diseases. We used Cox regression to estimate the associations of high-risk sleep behaviors with the elevated risks of diseases, and further established diseases trajectory using significant diseases. The low-risk unhealthy sleep behaviors were defined as the reference. Thereafter, we also examined the trajectory of diseases linked with the overall poor sleep pattern by combining all of these unhealthy sleep behaviors. To visualize the disease's trajectory, network analysis was used for presenting these trajectories. Results: During a median follow-up of 12.2 years, we noted 12 medical conditions in relation to unhealthy sleep behaviors and the overall poor sleep pattern among 410,682 participants with a median age of 58.0 years. The majority of participants had unhealthy sleep behaviors; in particular, 75.62% with frequent sleeplessness, and 72.12% had abnormal sleep durations. Besides, a total of 16,032 individuals with an overall poor sleep pattern were identified. In general, three major disease clusters were associated with overall poor sleep status and unhealthy sleep behaviors according to the disease trajectory and network analysis, mainly in the digestive, musculoskeletal and connective tissue, and cardiometabolic systems. Of note, two circularity disease pairs (I25→I20 and I48→I50) showed the highest risks following these unhealthy sleep habits. Additionally, significant differences in disease trajectories were observed in relation to sex and sleep medication among individuals with poor sleep status. Conclusions: We identified the major disease clusters and high-risk diseases following participants with overall poor sleep health and unhealthy sleep behaviors, respectively. It may suggest the need to investigate the potential interventions targeting these key pathways.

Keywords: sleep, poor sleep, unhealthy sleep behaviors, disease trajectory, UK Biobank

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4693 Assessment of the Groundwater Agricultural Pollution Risk: Case of the Semi-Arid Region (Batna-East Algeria)

Authors: Dib Imane, Chettah Wahid, Khedidja Abdelhamid

Abstract:

The plain of Gadaïne - Ain Yaghout, located in the wilaya of Batna (Eastern Algeria), experiences intensive human activities, particularly in agricultural practices which are accompanied by an increasing use of chemical fertilizers and manure. These activities lead to a degradation of the quality of water resources. In order to protect the quality of groundwater in this plain and formulate effective strategies to mitigate or avoid any contamination of groundwater, a risk assessment using the European method known as “COSTE Action 620” was applied to the mio-. plio-quaternary aquifer of this plain. Risk assessment requires the identification of existing dangers and their potential impact on groundwater by using a system of evaluation and weighting. In addition, it also requires the integration of the hydrogeological factors that influence the movement of contaminants by means of the intrinsic vulnerability maps of groundwater, which were produced according to the modified DRASTIC method. The overall danger on the plain ranges from very low to high. Farms containing stables, houses detached from the public sewer system, and sometimes manure piles were assigned a weighting factor expressing the highest degree of harmfulness; this created a medium to high danger index. Large areas for agricultural practice and grazing are characterized, successively, by low to very low danger. Therefore, the risks present at the study site are classified according to a range from medium to very high-risk intensity. These classes successively represent 3%, 49%, and 0.2% of the surface of the plain. Cultivated land and farms present a high to very high level of risk successively. In addition, with the exception of the salt mine, which presents a very high level of risk, the gas stations and cemeteries, as well as the railway line, represent a high level of risk.

Keywords: semi-arid, quality of water resources, risk assessment, vulnerability, contaminants

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4692 Green Accounting and Firm Performance: A Bibliometric Literature Review

Authors: Francesca di Donato, Sara Trucco

Abstract:

Green accounting is a growing topic of interest. Indeed, nowadays, most firms affect the environment; therefore, companies are seeking the best way to disclose environmental information. Furthermore, companies are increasingly committed to improving the environment, and the topic is gaining more importance to the public, governments, and policymakers. Green accounting is a type of accounting that considers environmental costs and their impact on the financial performance of firms. Thus, the motivation of the current research is to investigate the state-of-the-art literature on the relationship between green accounting and firm performance since the birth of the topic of green accounting and to investigate gaps in the literature that represent fruitful terrain for future research. In doing so, this study provides a bibliometric literature review of existing evidence related to the link between green accounting and firm performance since 2000. The search, based on the most relevant databases for scientific journals (which are Scopus, Emerald, Web of Science, Google Scholar, and Econlit), returned 1917 scientific articles. The articles were manually reviewed in order to identify only the relevant studies in the field by excluding articles with titles and abstracts out of scope. The final sample was composed of 107 articles. A content analysis was carried out on the final sample of articles; in doing so, a classification system has been proposed. Findings show the most relevant environmental costs and issues considered in previous studies and how green accounting may be linked to the financial and non-financial performance of a firm. The study also offers suggestions for future research in this domain. This study has several practical implications. Indeed, the topic of green accounting may be applied to different sectors and different types of companies. Therefore, this study may help managers to better understand the most relevant environmental information to disclose and how environmental issues may be managed to improve the performance of the firms. Moreover, the bibliometric literature review may be of interest to those stakeholders who are interested in the historical evolution of the topic.

Keywords: bibliometric literature review, firm performance, green accounting, literature review

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