Search results for: HIV/AIDS interventions

Authors: A. S. Lourens, B. Du Plooy

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Across the world, initiatives have been introduced to encourage women to enter into and remain in engineering fields. However, research has shown that many women leave engineering or suffer a loss of self-esteem and self-confidence compared to their male counterparts. To address this problem, a South African comprehensive university developed a self-leadership intervention pilot study in 2013, aimed at improving the self-efficacy of its female engineering students and increasing retention rates. This paper is a qualitative, descriptive, and interpretive study of the rationale and operational aspects of the Women in Engineering Leadership Association’s (WELA) self-leadership workshop. The objectives of this paper are to provide a framework for the design of a self-leadership workshop and to provide insight into the process of developing such a workshop specifically for women engineering students at a South African university. Finally, the paper proposes an evaluation process for the pilot workshop, which also provides a framework to improve future workshops. It is anticipated that the self-leadership development framework will be applicable to other higher education institutions wishing to improve women engineering student’s feelings of self-efficacy and therefore retention rates of women in engineering.

Keywords: co-curricular interventions, self-efficacy, self-leadership, women in engineering

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Authors: N. M. Sani, E. D. Jatau, O. S. Olonitola, M. Y. Gwarzo, P. Moodley, N. S. Mujahid

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Haemoglobin (HB) indicates anaemia level and by extension may reflect the nutritional level and perhaps the immunity of an individual. Some antiretroviral drugs like zidovudine are known to cause anaemia in People living with HIV/AIDS (PLWHA). A cross-sectional study using demographic data and blood specimen from 218 female commercial sex workers attending antiretroviral therapy (ART) clinics was conducted between December 2009 and July 2011 to assess the effect of zidovudine on haematologic and RNA viral load of female sex workers receiving antiretroviral treatment in north-western Nigeria. Anaemia is a common and serious complication of both HIV infection and its treatment. In the setting of HIV infection, anaemia has been associated with decreased quality of life, functional status, and survival. Antiretroviral therapy, particularly the highly active antiretroviral therapy (HAART), has been associated with a decrease in the incidence and severity of anaemia in HIV-infected patients who have received a HAART regimen for at least 1 year. In this study, result has shown that out of 218 patients, 26 with haemoglobin count between 5.1–10 g/dl were observed to have the highest viral load count of 300,000–350,000 copies/ml. It was also observed that most patients (190) with HB of 10.1–15.0 g/dl had viral load count of 200,000–250,000 copies/ml. An inverse relationship therefore exists, i.e. the lower the haemoglobin level, the higher the viral load count, even though the test statistics did not show any significance between the two (P=0.206). This shows that multivariate logistic regression analysis demonstrated that anaemia was associated with a CD4+ cell count below 50/µL in female sex workers with a viral load above 100,000 copies/mL who use zidovudine. Severe anaemia was less prevalent in this study population than in historical comparators; however, mild to moderate anaemia rates remain high. The study, therefore, recommends that hematological and virologic parameters be monitored closely in patients receiving first line ART regimen.

Keywords: anaemia, female sex worker, haemoglobin, Zidovudine

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Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

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Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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Authors: Bishakha Majumdar, Ranjeet Nambudiri

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Considerable dichotomy exists in research regarding the role of optimism and self-efficacy in work and career outcomes. Optimism and self-efficacy are related to performance, commitment and engagement, but also are implicated in seeing opportunities outside the firm and switching jobs. There is absence of research capturing these opposing strands of findings in the same model and providing a holistic understanding of how the expectancy beliefs operate in case of the working professional. We attempt to bridge this gap by proposing that career-decision self-efficacy and career outcome expectations affect intention to quit through the competitive mediation pathways of internal and external marketability. This model provides a holistic picture of the role of career expectancy beliefs on career outcomes, by considering perceived career opportunities both inside and outside one’s present organization. The understanding extends the application of career expectancy beliefs in the context of career decision-making by the employed individual. Further, it is valuable for reconsidering the effectiveness of hiring and retention techniques used by a firm, as selection, rewards and training programs need to be supplemented by interventions that specifically strengthen the stability pathway.

Keywords: career decision self-efficacy, career outcome expectations, marketability, intention to quit, job mobility

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Authors: Malgorzata Wojcik

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Groups are a powerful and significant part of human development. They serve as major emergent microsocial structures in children’s and youth’s ecological system. During middle and secondary school, peer groups become a particularly salient influence. While they promote a range of prosocial and positive emotional and behavioral attributes, they can also elicit negative or antisocial attributes, effectively “bringing out the worst” in some individuals. The grounded theory approach was employed to guide data collection and analysis, as it allows for a deeper understanding of the group processes and students’ perspectives on complex intragroup relations. Students’ perspectives on bullying cases were investigated by observing daily interactions among those involved and interviewing 47 students. The results complement theories of labeling in bullying by showing that all students self-label themselves and find it difficult to break patterns of behaviors related to bullying, such as supporting the bully or not defending the victim. In terms of the practical implications, the findings indicate that it could be beneficial to use non-punitive, restorative anti-bullying interventions that implement peer influence to transform bullying relations by removing behavioral labels.

Keywords: bullying, peer group, victimization, class reputation

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Authors: Delband Yekta Moazami

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Background: For proper care and treatment of HIV patients and drug users, the medical staff and physicians must have a correct and positive attitude and knowledge towards such patients. We aimed to assess the attitudes in a sample of health care workers (HCW) working in different hospitals and clinics and medical students in Georgia towards HIV infected people and drug users in Tbilisi. Method: We conducted a cross-sectional study to assess attitudes of health care workers towards people living with HIV and drug users in hospitals and clinics in Tbilisi. The study was carried out from 1st of May 2020 till 30th of September 2020. Data were collected using a self-administered structured online questionnaire. With this tool we evaluated four facets of attitudes: Discrimination, Acceptance of HIV/AIDS patients, Acceptance of drug users and Fear. All data were imported and analyzed with the software SPSS 22 for windows. Results: In total data was collected from168 respondents, that among them 107 (65%) were women and majority of the participants were medical doctors. Women had more acceptance attitudes rather than men towards drug abusers. We found significant differences regarding expressing negative attitudes among HCW who were more than 50 years old comparing with other age groups in all four aspects. Medical doctors expressed more acceptances towards people with HIV and drug users comparing two other groups. Also our study revealed that the group with working experience 21 years and more, showed more discriminatory attitudes comparing other groups. Conclusion: Based on our study findings, there are significant differences regarding respondent’s attitudes based on gender, medical specialty and working experience in health care system. People struggling with HIV and drug use need nonjudgmental and positive behaviors from health care workers and physicians in order to help them for harm reduction and receiving appropriate treatment.

Keywords: hiv, addiction, attitudes, healthcare workers

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Authors: J. A. Batsis, G. G. Boateng, L. M. Seo, C. L. Petersen, K. L. Fortuna, E. V. Wechsler, R. J. Peterson, S. B. Cook, D. Pidgeon, R. S. Dokko, R. J. Halter, D. F. Kotz

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Resistance exercise bands are a core component of any physical activity strengthening program. Strength training can mitigate the development of sarcopenia, the loss of muscle mass or strength and function with aging. Yet, the adherence of such behavioral exercise strategies in a home-based setting are fraught with issues of monitoring and compliance. Our group developed a Bluetooth-enabled resistance exercise band capable of transmitting data to an open-source platform. In this work, we developed an application to capture this information in real-time, and conducted three usability studies in two mixed-aged groups of participants (n=6 each) and a group of older adults with obesity participating in a weight-loss intervention (n=20). The system was favorable, acceptable and provided iterative information that could assist in future deployment on ubiquitous platforms. Our formative work provides the foundation to deliver home-based monitoring interventions in a high-risk, older adult population.

Keywords: application, mHealth, older adult, resistance exercise band, sarcopenia

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Authors: Shreeya Umashankar

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The Supreme Court of India has emerged as the most powerful organ of State and amongst the foremost constitutional courts in the world through the instrument of Public Interest Litigation (PIL), the exercise of writ jurisdiction and the expansive interpretation of fundamental rights guaranteed by the Constitution of India. Judicial activism impinging on every facet of governance has become the norm in recent times. This paper traces the evolution of judicial activism since Independence through pronouncements of the Supreme Court. It brings out distinct phases in this evolution– the initial phase of judicial restraint, the first phase of an activist judiciary where the Supreme Court primarily was concerned with protection of fundamental rights and humane treatment of citizens; the second phase where the Supreme Court took keen interest in preservation and protection of the environment; the third phase where the Supreme Court extended its reach into the socio-economic arena and the fourth phase when issues of transparency and probity in governance led to interventions by the Supreme Court. The paper illustrates through judgements of the Supreme Court that the instrument of the PIL and the exercise of writ jurisdiction by the Supreme Court go beyond the traditional postulates of judicial processes and political theory on separation of powers between the organs of State.

Keywords: fundamental rights, judicial activism, public interest litigation, Supreme Court of India

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Authors: K. S. Sivakumaran, T. Thanga, B. Halabieh

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The end panels of a large rectangular industrial duct, which experience significant internal pressures, also experience considerable transverse shear due to transfer of gravity loads to the supports. The current design practice of such thin plate panels for shear load is based on methods used for the design of plate girder webs. The structural arrangements, the loadings and the resulting behavior associated with the industrial duct end panels are, however, significantly different than those of the web of a plate girder. The large aspect ratio of the end panels gives rise to multiple bands of tension fields, whereas the plate girder web design is based on one tension field. In addition to shear, the industrial end panels are subjected to internal pressure which in turn produces significant membrane action. This paper reports a study which was undertaken to review the current industrial analysis and design methods and to propose a comprehensive method of designing industrial duct end panels for shear resistance. In this investigation, a nonlinear finite element model was developed to simulate the behavior of industrial duct end panel subjected to transverse shear and internal pressures. The model considered the geometric imperfections and constitutive relations for steels. Six scale independent dimensionless parameters that govern the behavior of such end panel were identified and were then used in an extensive parametric study. It was concluded that the plate slenderness dominates the shear strength of stockier end panels, and whereas, the aspect ratio and plate slenderness influence the shear strength of slender end panels. Based on these studies, this paper proposes design aids for estimating the shear strength of rectangular duct end panels.

Keywords: thin plate, transverse shear, tension field, finite element analysis, parametric study, design

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Authors: Ali Babajanzade, Hossein Bozorgian

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Cognitive load plays an important role in learning in general and L2 listening comprehension in particular. This study is an attempt to investigate the effect of metacognitive strategy intervention through dialogic interaction (MSIDI) on L2 listeners’ cognitive load. A mixed-method design with 50 participants of male and female Iranian lower-intermediate learners between 20 to 25 years of age was used. An experimental group (n=25) received weekly interventions based on metacognitive strategy intervention through dialogic interaction for ten sessions. The second group, which was control (n=25), had the same listening samples with the regular procedure without a metacognitive intervention program in each session. The study used three different instruments: a) a modified version of the cognitive load questionnaire, b) digit span tests, and c) focused group interviews to investigate listeners’ level of cognitive load throughout the process. Results testified not only improvements in listening comprehension in MSIDI but a radical shift of cognitive load rate within this group. In other words, listeners experienced a lower level of cognitive load in MSIDI in comparison with their peers in the control group.

Keywords: cognitive load theory, human mental functioning, metacognitive theory, listening comprehension, sociocultural theory

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Authors: Nasir Haruna Soba

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In addition to sustaining poverty and inequality, the issue of out-of-school children impedes efforts to accomplish the sustainable development goals (SDGs), especially Goal 4, which is to guarantee inclusive, egalitarian, and high-quality education for everyone. However, a number of social, cultural, and infrastructure barriers mean that millions of children in Nigeria are denied this privilege. This paper presents the findings of a case study conducted in Nigeria. The findings of this study revealed that out of school children in Nigeria are the most common causes of poverty; inadequate school facilities, long distances to schools, and poor road networks make it difficult for children, especially in rural areas, to access education. Social Disparities: Social inequality is sustained by differences in education, especially when it comes to financing, governance, and coordination amongst stakeholders. These differences are especially pronounced along gender and socioeconomic lines. The study recommended that policymakers and stakeholders should consider addressing the root causes, enhancing existing interventions, and implementing targeted policy measures. Nigeria can make significant strides towards ensuring inclusive and quality education for all children, thereby fostering sustainable development and reducing poverty.

Keywords: poverty, inequality, funding, education, development

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Authors: Emma Whewell, Lee Waters, Mark Wall

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This paper is a mixed methods investigation into the perceived barriers to attainment and progression. Initially entry level data was analysed to identify some of the key characteristics of the student cohort- for example entry route, age and ethnic background. Secondly, a phenomenological case study of the lived experiences of 15 level 5 sport and exercise students was conducted. It aimed to understand the complexities of success in higher education, far beyond entry qualifications, indices of deprivation and POLAR characteristics, to offer a first-hand account of student perceptions and interpretations of the barriers they face in progression, retention and completion on their programme. Using focus groups and interviews with students from a range of indices we offer a set of rich case studies exploring the interpretations of our students’ lived experiences and challenges. Findings demonstrate a complex set of circumstances that centre on managing workload, use of support services and aspirations of students that conflict with university priorities. Conclusions centre on the role of academic and pastoral support, assumptions about priorities of students and practical interventions to support achievement.

Keywords: access and participation, higher education, progression and retention, barriers

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Authors: Marcel Chevalier, Léo Dupont, Sylvain Marié, Frédérique Roffet, Elena Stolyarova, William Templier, Costin Vasile

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Industrial end-users are currently facing an increasing need to reduce the risk of unexpected failures and optimize their maintenance. This calls for both short-term analysis and long-term ageing anticipation. At Schneider Electric, we tackle those two issues using both machine learning and first principles models. Machine learning models are incrementally trained from normal data to predict expected values and detect statistically significant short-term deviations. Ageing models are constructed by breaking down physical systems into sub-assemblies, then determining relevant degradation modes and associating each one to the right kinetic law. Validating such anomaly detection and maintenance models is challenging, both because actual incident and ageing data are rare and distorted by human interventions, and incremental learning depends on human feedback. To overcome these difficulties, we propose to simulate physics, systems, and humans -including asset maintenance operations- in order to validate the overall approaches in accelerated time and possibly choose between algorithmic alternatives.

Keywords: degradation models, ageing, anomaly detection, soft sensor, incremental learning

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Authors: Yvonne Ayerki Lamptey

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The expanding informal sector in developing countries and in Ghana in particular from the 1980s has now been aggravated by the growing population and downsizing in both the public and private sectors, with displaced workers finding alternative livelihoods in the informal sector. Youth and graduate unemployment also swell the numbers and further promote the continuity of the sector. Formal workers and institutions facilitate the growth and complicate demarcations between informality within the formal and informal sectors. In spite of its growth and increasing importance, the informal economy does not feature in policy debates and has often been neglected by the Ghana government. The phenomenon has evolved with modernity into myriad unimaginable forms. Indeed, actors within the sector often clash with the interventions provided by policy makers - because neither the operatives nor the activities they perform can be clearly defined. This study uses in-depth interviews to explore the behavioural nature of the informal workers in Ghana to understand how the operatives describe and perceive the sector, and to identify the factors that influence their drive to stay within the sector. This paper concludes that the operatives clearly distinguish between the formal and informal sectors and identify the characteristics and conditions that constitute the informal sector. Other workers are trapped between formality and informality. The findings also enumerate the push and pull factors contributing to the growth of the sector.

Keywords: informal employment, informal sector, informal work, informality

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Authors: Fariha Akhter Chowdhury, Sabrina Mahboob, Anamika Saha, Afrin Jahan, Mohammad Nurul Islam

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Urinary tract infection (UTI) is frequently experienced by the female population where the prevalence increases with aging. Escherichia coli, one of the most common UTI causing organisms, retains glutathione defense mechanism that aids the organism to withstand the harsh physiological environment of urinary tract, host oxidative immune response and even to affect antibiotic-mediated cell death and the emergence of resistance. In this study, we aimed to investigate the glutathione reductase activity of uropathogenic E. coli (UPEC) by observing the reduced glutathione (GSH) level alteration under stressful condition. Urine samples of 58 patients with UTI were collected. Upon isolation and identification, 88% of the samples presented E. coli as UTI causing organism among which randomly selected isolates (n=9), obtained from urine samples of female patients, were considered for this study. E. coli isolates were grown under normal and stressful conditions where H₂O₂ was used as the stress-inducing agent. GSH level estimation of the isolates in both conditions was carried out based on the colorimetric measurement of 5,5'-dithio-bis (2-nitrobenzoic acid) (DTNB) and GSH reaction product using microplate reader assay. The GSH level of isolated E. coli sampled from adult patients decreased under stress compared to normal condition (p = 0.011). On the other hand, GSH production increased markedly in samples that were collected from elderly subjects (p = 0.024). A significant partial correlation between age and change of GSH level was found as well (p = 0.007). This study may help to reveal ways for better understanding of E. coli pathogenesis of UTI prevalence in elderly patients.

Keywords: Escherichia coli, glutathione reductase activity, oxidative stress, reduced glutathione (GSH), urinary tract infection (UTI)

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Authors: Yih-Jer Wu, Ling-Lang Huang

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Shared decision-making (SDM) is a critical aspect of determining optimal medical strategies. However, current patient decision aids (PDAs) often prioritize evidence-based discussions over value-based considerations. Despite its significance, there is limited research addressing the 'value gap' between patients and healthcare providers. To address this gap, we developed the 'Patient-Doctor Relationship Questionnaire,' consisting of 12 questions. To explore potential variations in the patient-doctor value gap across different medical specialties, we conducted interviews with physicians, surgeons, and their respective patients, utilizing the questionnaire. Between 2020 and 2022, we interviewed a total of 144 patients and 19 doctors. Among the 12 questions, physicians demonstrated significant patient-doctor value gaps in 5 questions, while surgeons in 3 questions. Only one question turned out significant gaps in both physicians and surgeons. When asking both doctors and their patients to choose one from the following 6 answers (1. No issue significant; 2. Not knowing how to make a medical decision; 3. Not confident in the doctor’s clinical judgment; 4. Not knowing how to articulate one’s own condition; 5. Unable to afford medical expenses; 6. Not understanding what doctors explain) in response to the question “what the most significant issue is in the medical consultation”, over 50% of doctors chose “Not knowing how to make a medical decision” (physicians vs. patients, 50% vs. 11%, p=0.046; surgeon vs. patients, 83% vs. 29%, p=0.001), while significantly more patients chose “No issue significant” (10% vs. 52%, p=0.002; 0% vs. 33%, p<0.001, respectively). Our findings indicate that value gaps do exist between patients and doctors and that most patients in Taiwan "fully trust" their doctors' recommendations for medical decisions. However, when treatment outcomes are far from ideal, this overinflated "trust" may turn into frustration, which could become the catalyst for medical disputes. Doctors should spend more time having more effective communication with their patients, particularly regarding potentially dissatisfactory treatment outcomes. This study underscores the substantial variability in the patient-doctor value gap, often overlooked in SDM. Patients from different clinical backgrounds may hold values distinct from those of their healthcare providers. Bridging this value gap is imperative for achieving genuine and effective SDM.

Keywords: share-decision making, value gaps, communication, doctor-patient relationship

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Authors: Martha Hough RN

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Background: New nursing graduates lack the critical thinking skills required to provide safe nursing care. Critical thinking is essential in providing safe, competent, and skillful nursing interventions. Educational institutions must provide a curriculum that improves nursing students' critical thinking abilities. In addition, the recent pandemic resulted in nursing students who previously received in-person clinical but now most clinical has been converted to remote learning, increasing the use of simulations. Unfolding medium and high-fidelity simulations and Socratic questioning are used in many simulations debriefing sessions. Methodology: Google Scholar was researched with the keywords: critical thinking of nursing students with unfolding simulation, which resulted in 22,000 articles; three were used. A second search was implemented with critical thinking of nursing students Socratic questioning, which resulted in two articles being used. Conclusion: Unfolding simulations increase nursing students' critical thinking, especially during the briefing (pre-briefing and debriefing) phases, where most learning occurs. In addition, the use of Socratic questions during the briefing phases motivates other questions, helps the student analyze and critique their thinking, and assists educators in probing students' thinking, which further increases critical thinking.

Keywords: briefing, critical thinking, Socratic thinking, unfolding simulations

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Authors: Ntandoyenkosi Moyo

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Majority of rural Eastern Cape villages of South Africa households do not have access to safe water supply. Due to changes in climatic conditions for example higher temperatures, these sources become not reliable in supplying adequate and safe water to the population. These rural populations due to the drying up of water resources have to find other alternative ways to get water. Climate change has an impact on the reliability of water resources and this has an impact on rural communities. This study seeks to establish what alternative ways do people use when affected by unfavorable conditions like less rainfall and increased temperatures. The study also seeks to investigate any local and provincial intervention in the provision of water to the village. Interventions can be in the form of programmes or initiatives that involve water supply strategies. The community should participate fully in making sure that their place is serviced. The study will identify households with improved sources (JOJO tanks) and those with unimproved sources (rivers) and investigate what alternatives they resort to when their sources dry up. The study also investigates community views on whether they have any challenges of water supply (reliability and adequacy) as required by section 27(1) (b) of the constitution which states that everyone should have access to safe and clean water.

Keywords: rural water resources, temperature, improved sources, unimproved sources

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Authors: A. Shebani, C. Pislaru

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Wear of materials is an everyday experience and has been observed and studied for long time. The prediction of wear is a fundamental problem in the industrial field, mainly correlated to the planning of maintenance interventions and economy. Pin-on-disc test is the most common test which is used to study the wear behaviour. In this paper, the pin-on-disc (AEROTECH UNIDEX 11) is used for the investigation of the effects of normal load and hardness of material on the wear under dry and sliding conditions. In the pin-on-disc rig, two specimens were used; one, a pin which is made of steel with a tip, is positioned perpendicular to the disc, where the disc is made of aluminium. The pin wear and disc wear were measured by using the following instruments: The Talysurf instrument, a digital microscope, and the alicona instrument; where the Talysurf profilometer was used to measure the pin/disc wear scar depth, and the alicona was used to measure the volume loss for pin and disc. After that, the Archard model, American Society for Testing and Materials model (ASTM), and neural network model were used for pin/disc wear modelling and the simulation results are implemented by using the Matlab program. This paper focuses on how the alicona can be considered as a powerful tool for wear measurements and how the neural network is an effective algorithm for wear estimation.

Keywords: wear modelling, Archard Model, ASTM Model, Neural Networks Model, Pin-on-disc Test, Talysurf, digital microscope, Alicona

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Authors: Jillian Gardner, Hilde D. Miniggio

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The increasing prevalence of obesity has driven the pursuit of alternative weight loss strategies, such as jaw wiring (or ‘slimming wires’), a technique known in the medical community as maxillomandibular fixation, which has evolved beyond its original intention of treating temporomandibular joint disorders. Individuals have increasingly sought and utilized the procedure for weight loss purposes. Although legal in South Africa, this trend presents dentists with ethical dilemmas, as they face requests for interventions that prioritize aesthetic preferences over medical necessity. Drawing on scholarly literature and the four principles framework of Beauchamp and Childress, this ethical analysis offers guidance for dentists facing the ethical dilemma of patient requests for jaw wiring as a weight management intervention. The ethical analysis concludes that dentists who refuse autonomous requests to perform jaw wiring for purely weight loss purposes are ethically justified within the principlist framework in overriding these requests when the principles of non-maleficence and beneficence are at stake. The well-being and health of the patient, as well as societal and professional obligations, justify the refusal to perform jaw wiring purely for weight loss.

Keywords: ethics, jaw wiring, maxillomandibular fixation, principlism, weight loss

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Authors: Gaby Fahmy

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The last decades have seen a rise in metabolic disorders like diabetes, obesity, and fatty liver disease around the world. Environmental factors, especially nutrition, have contributed to this increase. Additionally, pre-conceptional parental nutritional choices have been shown to result in epigenetic modifications affecting gene expression during the developmental process in-utero. These epigenetic modifications have also been seen to extend to the following offspring in a trans-generational effect. This further highlights the significance and relevance of epigenetics and epigenetic tags, which were previously thought to be stripped in newly formed embryos. Suitable prenatal nutrition may partially counteract adverse outcomes caused by exposures to environmental contaminants, ultimately resulting in improved metabolic profiles like body weight and glucose homeostasis. This was seen in patients who were given dietary interventions like restrictive caloric intake, intermittent fasting, and time-restricted feeding. Changes in nutrition are pivotal in the regulation of epigenetic modifications that are transgenerational. For example, dietary choices such as fatty foods vs. vegetables and nuts in fathers were shown to significantly affect sperm motility and volume. This was pivotal in understanding the importance of paternal inheritance. Further research in the field is needed as it remains unclear how many generations are affected by these changes.

Keywords: epigenetics, transgenerational, diet, fasting

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Authors: Mozhgan Aliakbari, Sara Moridpour

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In recent years, much attention has been given to truck drivers’ fatigue management. Long working hours negatively influence truck drivers’ physiology, health, and safety. However, there is little empirical research in the heavy vehicle transport sector in Australia to identify the influence of working hours’ management on drivers’ fatigue and consequently, on the risk of crashes and injuries. There is no national legislation regulating the number of hours or kilometres travelled by truck drivers. Consequently, it is almost impossible to define a standard number of hours or kilometres for truck drivers in a safety management system. This paper reviews the existing studies concerning safe system interventions such as tachographs in relation to fatigue caused by long working hours. This paper also reviews the literature to identify the influence of frequency of rest breaks on the reduction of work-related road transport accidents involving trucks. A framework is presented to manage truck drivers’ fatigue, which may result in the reduction of injuries and fatalities involving heavy vehicles.

Keywords: fatigue, time management, trucks, traffic safety

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Authors: Lloyd A. Taylor

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An increase in the prevalence of Attention Deficit-Hyperactivity Disorder (ADHD) highlights the need to consider factors that may be exacerbating symptom presentation. Traditional diagnostic criteria provide a little framework for healthcare providers to consider as they attempt to diagnose and treat children with behavioral problems. In fact, aside from exclusion criteria, limited alternative considerations are available, and approaches fail to consider the impact of outside factors that could increase or decrease the likelihood of appropriate diagnosis and success of interventions. This paper will consider specific systems-based factors that influence behavior and intervention successes that, when not considered, could account for the upsurge of diagnoses. These include understanding (1) challenges in the healthcare system, (2) the influence and impact of educators and the educational system, (3) technology use, and (4) patient and parental attitudes about the diagnosis of ADHD. These factors must be considered both individually and as a whole when considering both the increase in diagnoses and the subsequent increases in prescriptions for psychostimulant medication. A theoretical model based on a risk management approach will be presented. Finally, data will be presented that demonstrates pediatric provider satisfaction with this approach to diagnoses and treatment of ADHD as it relates to practice trends.

Keywords: ADHD, diagnostic criteria, risk management model, pediatricians

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Authors: Yasser Aboel-Magd

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This research addresses the critical issue of accessibility for individuals with special needs and the broader implications of disability on one's ability to lead an independent and integrated life within society. It highlights the consequences of injury, illness, or disability not only on the physical level but also on psychological, social, educational, economic, and functional aspects of life. The study emphasizes the importance of inclusive design in urban spaces, reflecting on how a society's treatment of individuals with disabilities serves as a measure of its progress. The research delves into the challenges faced by people with special needs in the Kingdom, where, despite advancements in various sectors, there is a noticeable lack of accommodating public opportunities for this significant demographic. It argues for the necessity of a Saudi building code that considers the needs of a diverse population during the design phase. The paper discusses the role of urban space as a fundamental element in urban formation and its impact on the societal integration of individuals with special needs. The study explores a variety of inclusive design principles, ranging from physical features like ramps and tactile paving to digital and cognitive accessibility measures such as screen readers, closed captions, plain language, and visual aids. It also considers the impact of wayfinding and appropriate lighting design on the orientation and assistance of individuals within urban spaces at the lowest cost. The researchers connect inclusive design with sustainable practices, advocating for environments that are not only environmentally friendly but also adaptable and lasting. The paper concludes with the assertion that the integration of accessibility, universal design, and sustainability signifies a society's commitment to inclusivity and the empowerment of all individuals, paving the way for a future where everyone can participate fully and independently in society.

Keywords: accessibility, inclusive design, Saudi building code, disability inclusion, socioeconomic progress

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Authors: Ejoke U. P., Smitha Dev., Madwuke Ann, DuPlessis E. D.

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The study examines the relationship between psychological capital (PsyCap) and social well-being among international faculty members in the United Arab Emirates (UAE). The UAE has become a significant destination for global academic talent, yet challenges related to social integration, acceptance, and overall well-being persist among its international faculty. The study focuses on the predictive role of PsyCap, encompassing hope, efficacy, resilience, and optimism, in determining various dimensions of social well-being, including social integration, acceptance, contribution, actualization, and coherence. Additionally, the research investigates the potential moderating or mediating effects of institutional support and Faculty Job-Status position on the relationship between PsyCap and social well-being. Through structural equation modeling, we found that institutional support mediated the positive relationship between PsyCap and SWB and the permanent Faculty job-status position type strengthens the relationship between PsyCap and SWB. Our findings uncover the pathways through which PsyCap influences the social well-being outcomes of international faculty in the UAE. The findings will contribute to the development of tailored interventions and support systems aimed at enhancing the integration experiences and overall well-being of international faculty within the UAE academic community. Thus, fostering a more inclusive and thriving academic environment in the UAE.

Keywords: faculty job-status, institutional-faculty, psychological capital, social well-being, UAE

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Authors: Roula Kitsiou, Sofia Tsioli, Eleni Gana

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The current sociopolitical realities (displacement, encampment, and resettlement) refugees experience in Greece are a quite complex issue. Their educational and social ‘integration’ is characterized by transition, insecurity, and constantly changing needs. Based on the current research data, technology and more specifically mobile phones are one of the most important resources for refugees, regardless of their levels of conventional literacy. The proposed paper discusses the challenges encountered during the design and implementation of the educational Action 16 ‘Language Education for Adult Refugees’. Action 16 is one of the 24 Actions of the Project PRESS (Provision of Refugee Education and Support Scheme), funded by the Hellenic Open University (2016-2017). Project PRESS had two main objectives: a) to address the educational and integration needs of refugees in transit, who currently reside in Greece, and b) implement research-based educational interventions in online and offline sites. In the present paper, the focus is on reflection and discussion about the challenges and the potential of integrating technology in language learning for a target-group with many specific needs, which have been recorded in field notes among other research tools (ethnographic data) used in the context of PRESS. Action 16, explores if and how technology enhanced language activities in real-time and place mediated through teachers, as well as an autonomous computer-mediated learning space (moodle platform and application) builds on and expands the linguistic, cultural and digital resources and repertoires of the students by creating collaborative face-to-face and digital learning spaces. A broader view on language as a dynamic puzzle of semiotic resources and processes based on the concept of translanguaging is adopted. Specifically, designing the blended learning environment we draw on the construct of translanguaging a) as a symbolic means to valorize students’ repertoires and practices, b) as a method to reach to specific applications of a target-language that the context brings forward (Greek useful to them), and c) as a means to expand refugees’ repertoires. This has led to the creation of a learning space where students' linguistic and cultural resources can find paths to expression. In this context, communication and learning are realized by mutually investing multiple aspects of the team members' identities as educational material designers, teachers, and students on the teaching and learning processes. Therefore, creativity, humour, code-switching, translation, transference etc. are all possible means that can be employed in order to promote multilingual communication and language learning towards raising intercultural awareness in a critical digital pedagogy context. The qualitative analysis includes critical reflection on the developed educational material, team-based reflexive discussions, teachers’ reports data, and photographs from the interventions. The endeavor to involve women and men with a refugee background into a blended learning experience was quite innovative especially for the Greek context. It reflects a pragmatist ethos of the choices made in order to respond to the here-and-now needs of the refugees, and finally it was a very challenging task that has led all actors involved into Action 16 to (re)negotiations of subjectivities and products in a creative and hopeful way.

Keywords: blended learning, integration, language education, refugees

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Authors: Shan-Ken Chien

Abstract:

This research aims to share the application of the Music and Narrative Curriculum developed through a college community service-learning course to a special education classroom in a local secondary school. The development of the Music and Narrative Curriculum stems from the music appreciation courses that the author has taught at the university. The curriculum structure consists of three instructional phases, each with three core literacy. This study will show the implementation of an eighteen-week general music education course, including classroom training on the university campus and four intervention music lessons in a special education classroom. Students who participated in the Music and Narrative Curriculum came from two different parts. One is twenty-five college students enrolling in Music Literacy and Community Service-Learning, and the other one is nine junior high school students with intellectual disabilities (ID) in a special education classroom. This study measures two parts. One is the effectiveness of the Music and Narrative Curriculum in applying four interventions in music lessons in a special education classroom, and the other is measuring college students' service-learning experiences and growth outcomes.

Keywords: college service-learning, general music education, music literacy, narrative skills, students with special needs

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Authors: Julie Wittmannová, Petr Šeda

Abstract:

Quality of life measurements (QLF) help to evaluate interventions programs in different groups of persons with special needs. Our presentation deals with QLF of persons with addiction in relation to the physical activity (PA), type of addiction, age, gender and other variables. The aim of presentation is to summarize the basic findings and offer thoughts for questions arose. Methods: SQUALA (Subjective Quality of Life Analysis); SEIQoL (Schedule for the Evaluation of Individual Quality of Life); questionnaire of own construction. The results are evaluated by Mann­Whitney U test and Kruskall­Wallis ANOVA test (p ≤ 0,05). Sample of 64 participants – clients of aftercare center, aged 18 plus. Findings: Application of the methods SQUALA and SEIQoL in the chosen population seems appropriate, the obtaining information regarding the QLF correlate to intervention program topics, the need of an activelifestyle and health related topics in persons with addiction is visible. Conclusions or Implications: The subjective evaluation of quality of life of Aftercare clients is an important part of evaluation process, especially used to evaluate satisfaction with offered services and programs. Techniques SQUALA and SEIQoL gave us the desired outcomes.

Keywords: adapted physical activity, addiction, quality of life, physical activity, aftercare

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Authors: Mualla McManus, Jenna Luche Thaye

Abstract:

World Health Organisation International Classification of Disease codes were created to define disease including infections in order to guide and educate diagnosticians. Most infectious diseases such as syphilis are clearly defined by their ICD 10 codes and aid/help to educate the clinicians in syphilis diagnosis and treatment globally. However, current ICD 10 codes for relapsing fever Borreliosis and Lyme disease are less clearly defined and can impede appropriate diagnosis especially if the clinician is not familiar with the symptoms of these infectious diseases. This is despite substantial number of scientific articles published in peer-reviewed journals about relapsing fever and Lyme disease. In the USA there are estimated 380,000 people annually contacting Lyme disease, more cases than breast cancer and 6x HIV/AIDS cases. This represents estimated 0.09% of the USA population. If extrapolated to the global population (7billion), 0.09% equates to 63 million people contracting relapsing fever or Lyme disease. In many regions, the rate of contracting some form of infection from tick bite may be even higher. Without accurate and appropriate diagnostic codes, physicians are impeded in their ability to properly care for their patients, leaving those patients invisible and marginalized within the medical system and to those guiding public policy. This results in great personal hardship, pain, disability, and expense. This unnecessarily burdens health care systems, governments, families, and society as a whole. With accurate diagnostic codes in place, robust data can guide medical and public health research, health policy, track mortality and save health care dollars. Better defined ICD codes are the way forward in educating the diagnosticians about relapsing fever and Lyme diseases.

Keywords: WHO ICD codes, relapsing fever, Lyme diseases, World Health Organisation

Procedia PDF Downloads 184

Authors: Xiaodong Li, Peng Gao, Chao-Jung Huang, Shiying Hao, Xuefeng B. Ling, Yongxia Han, Yaqi Zhang, Le Zheng, Chengyin Ye, Modi Liu, Minjie Xia, Changlin Fu, Bo Jin, Karl G. Sylvester, Eric Widen

Abstract:

Predicting the risk of Pancreatic Adenocarcinoma (PA) in advance can benefit the quality of care and potentially reduce population mortality and morbidity. The aim of this study was to develop and prospectively validate a risk prediction model to identify patients at risk of new incident PA as early as 3 months before the onset of PA in a statewide, general population in Maine. The PA prediction model was developed using Deep Neural Networks, a deep learning algorithm, with a 2-year electronic-health-record (EHR) cohort. Prospective results showed that our model identified 54.35% of all inpatient episodes of PA, and 91.20% of all PA that required subsequent chemoradiotherapy, with a lead-time of up to 3 months and a true alert of 67.62%. The risk assessment tool has attained an improved discriminative ability. It can be immediately deployed to the health system to provide automatic early warnings to adults at risk of PA. It has potential to identify personalized risk factors to facilitate customized PA interventions.

Keywords: cancer prediction, deep learning, electronic health records, pancreatic adenocarcinoma

Procedia PDF Downloads 146