Search results for: health planning
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11928

Search results for: health planning

1098 Design-Based Elements to Sustain Participant Activity in Massive Open Online Courses: A Case Study

Authors: C. Zimmermann, E. Lackner, M. Ebner

Abstract:

Massive Open Online Courses (MOOCs) are increasingly popular learning hubs that are boasting considerable participant numbers, innovative technical features, and a multitude of instructional resources. Still, there is a high level of evidence showing that almost all MOOCs suffer from a declining frequency of participant activity and fairly low completion rates. In this paper, we would like to share the lessons learned in implementing several design patterns that have been suggested in order to foster participant activity. Our conclusions are based on experiences with the ‘Dr. Internet’ MOOC, which was created as an xMOOC to raise awareness for a more critical approach to online health information: participants had to diagnose medical case studies. There is a growing body of recommendations (based on Learning Analytics results from earlier xMOOCs) as to how the decline in participant activity can be alleviated. One promising focus in this regard is instructional design patterns, since they have a tremendous influence on the learner’s motivation, which in turn is a crucial trigger of learning processes. Since Medieval Age storytelling, micro-learning units and specific comprehensible, narrative structures were chosen to animate the audience to follow narration. Hence, MOOC participants are not likely to abandon a course or information channel when their curiosity is kept at a continuously high level. Critical aspects that warrant consideration in this regard include shorter course duration, a narrative structure with suspense peaks (according to the ‘storytelling’ approach), and a course schedule that is diversified and stimulating, yet easy to follow. All of these criteria have been observed within the design of the Dr. Internet MOOC: 1) the standard eight week course duration was shortened down to six weeks, 2) all six case studies had a special quiz format and a corresponding resolution video which was made available in the subsequent week, 3) two out of six case studies were split up in serial video sequences to be presented over the span of two weeks, and 4) the videos were generally scheduled in a less predictable sequence. However, the statistical results from the first run of the MOOC do not indicate any strong influences on the retention rate, so we conclude with some suggestions as to why this might be and what aspects need further consideration.

Keywords: case study, Dr. internet, experience, MOOCs, design patterns

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1097 Assessing the Social Impacts of a Circular Economy in the Global South

Authors: Dolores Sucozhañay, Gustavo Pacheco, Paul Vanegas

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In the context of sustainable development and the transition towards a sustainable circular economy (CE), evaluating the social dimension remains a challenge. Therefore, developing a respective methodology is highly important. First, the change of the economic model may cause significant social effects, which today remain unaddressed. Second, following the current level of globalization, CE implementation requires targeting global material cycles and causes social impacts on potentially vulnerable social groups. A promising methodology is the Social Life Cycle Assessment (SLCA), which embraces the philosophy of life cycle thinking and provides complementary information to environmental and economic assessments. In this context, the present work uses the updated Social Life Cycle Assessment (SLCA) Guidelines 2020 to assess the social performance of the recycling system of Cuenca, Ecuador, to exemplify a social assessment method. Like many other developing countries, Ecuador heavily depends on the work of informal waste pickers (recyclers), who, even contributing to a CE, face harsh socio-economic circumstances, including inappropriate working conditions, social exclusion, exploitation, etc. Under a Reference Scale approach (Type 1), 12 impact subcategories were assessed through 73 site-specific inventory indicators, using an ascending reference scale ranging from -2 to +2. Findings reveal a social performance below compliance levels with local and international laws, basic societal expectations, and practices in the recycling sector; only eight and five indicators present a positive score. In addition, a social hotspot analysis depicts collection as the most time-consuming lifecycle stage and the one with the most hotspots, mainly related to working hours and health and safety aspects. This study provides an integrated view of the recyclers’ contributions, challenges, and opportunities within the recycling system while highlighting the relevance of assessing the social dimension of CE practices. It also fosters an understanding of the social impact of CE operations in developing countries, highlights the need for a close north-south relationship in CE, and enables the connection among the environmental, economic, and social dimensions.

Keywords: SLCA, circular economy, recycling, social impact assessment

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1096 One Decade Later: The Conundrum of Unrecognized Asherman Syndrome

Authors: Maria Francesca Lavadia-Gumabao, Mary Antoinette Salvamante-Torallo

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Introduction: The fibrous intrauterine adhesions forming inside the uterus and/or cervix in Asherman syndrome can obstruct the internal cervical orifice and may present as a case of outflow tract obstruction. Asherman syndrome is often overlooked since it has no specific presentation and is undetectable by routine physical examinations or diagnostic procedures such as an ultrasound. This paper highlights the delay and elusive diagnosis of Asherman syndrome which negatively impacted the patient’s fertility and quality of life. Case presentation: A 33-year-old woman (gravida 3, para 3) who presented with secondary amenorrhea for thirteen years associated with cyclic pelvic pain and secondary infertility sought a consultation at our institution for evaluation and specialty management. The patient had no other well-established risk factors for Asherman syndrome aside from pregnancy. For more than a decade, she delayed seeking medical care. At presentation, history taking, physical examination, and ultrasound were not helpful in identifying the cause of outflow tract obstruction. Diagnostic hysteroscopy was then performed, during which extensive scarring and fibrosis completely obscured the internal cervical orifice were observed, consistent with the diagnosis of Asherman syndrome (Grade 5B). The patient then underwent ultrasound guided hysteroscopy outflow tract dilatation and responded well to the treatment as she had her menstrual period a month after the procedure and no longer had cyclic pelvic pain with a repeat ultrasound finding of an unremarkable uterus. The hispathology result of the tissues retrieved revealed myometrial fragments with associated old hemorrhage benign endometrial stromal tissues, which failed to show endometrial glands. Conclusion: The delay and elusive diagnosis of Asherman syndrome can be brought about by poor health seeking behavior of patients and difficulty in detecting this condition by routine physical examinations or diagnostic procedures such as an ultrasound. It is, therefore, necessary to include Asherman syndrome in the differential diagnosis of secondary amenorrhea and secondary infertility. With expertise in hysteroscopy, early diagnosis, proper classification in the advent of hysteroscopy, and optimal management can improve patient outcomes.

Keywords: Asherman syndrome, outflow tract obstruction, secondary amenorrhea, infertility, hysteroscopy

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1095 Ongoing Gender-Based Challenges in Post-2015 Development Agenda: A Comparative Study between Qatar and Arab States

Authors: Abdel-Samad M. Ali, Ali A. Hadi Al-Shawi

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Discrimination against women and girls impairs progress in all domains of development articulated either in the framework of Millennium Development Goals (MDGs) or in the Post-2015 Development Agenda. Paper aspires to create greater awareness among researchers and policy makers of the challenges posed by gender gaps and the opportunities created by reducing them within the Arab region. The study reveals how Arab countries are closing in on gender-oriented targets of the third and fifth MDGs. While some countries can claim remarkable achievements particularly in girls’ equality in education, there is still a long way to go to keep Arab’s commitments to current and future generations in other countries and subregions especially in the economic participation or in the political empowerment of women. No country has closed or even expected to close the economic participation gap or the political empowerment gap. This should provide the incentive to keep moving forward in the Post-2015 Agenda. Findings of the study prove that while Arab states have uneven achievements in reducing maternal mortality, Arab women remain at a disadvantage in the labour market. For Arab region especially LDCs, improving maternal health is part of the unmet agenda for the post-2015 period and still calls for intensified efforts and procedures. While antenatal care coverage is improving across the Arab region, progress is marginal in LDCs. To achieve proper realization of gender equality and empowerment of women in the Arab region in the post-2015 agenda, the study presents critical key challenges to be addressed. These challenges include: Negative cultural norms and stereotypes; violence against women and girls; early marriage and child labour; women’s limited control over their own bodies; limited ability of women to generate their own income and control assets and property; gender-based discrimination in law and in practice; women’s unequal participation in private and public decision making autonomy; and limitations in data. However, in all Arab states, gender equality must be integrated as a goal across all issues, particularly those that affect the future of a country.

Keywords: gender, equity, millennium development goals, post-2015 development agenda

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1094 Evaluation of Buckwheat Genotypes to Different Planting Geometries and Fertility Levels in Northern Transition Zone of Karnataka

Authors: U. K. Hulihalli, Shantveerayya

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Buckwheat (Fagopyrum esculentum Moench) is an annual crop belongs to family Poligonaceae. The cultivated buckwheat species are notable for their exceptional nutritive values. It is an important source of carbohydrates, fibre, macro, and microelements such as K, Ca, Mg, Na and Mn, Zn, Se, and Cu. It also contains rutin, flavonoids, riboflavin, pyridoxine and many amino acids which have beneficial effects on human health, including lowering both blood lipid and sugar levels. Rutin, quercetin and some other polyphenols are potent carcinogens against colon and other cancers. Buckwheat has significant nutritive value and plenty of uses. Cultivation of buckwheat in Sothern part of India is very meager. Hence, a study was planned with an objective to know the performance of buckwheat genotypes to different planting geometries and fertility levels. The field experiment was conducted at Main Agriculture Research Station, University of Agriculture Sciences, Dharwad, India, during 2017 Kharif. The experiment was laid-out in split-plot design with three replications having three planting geometries as main plots, two genotypes as sub plots and three fertility levels as sub-sub plot treatments. The soil of the experimental site was vertisol. The standard procedures are followed to record the observations. The planting geometry of 30*10 cm was recorded significantly higher seed yield (893 kg/ha⁻¹), stover yield (1507 kg ha⁻¹), clusters plant⁻¹ (7.4), seeds clusters⁻¹ (7.9) and 1000 seed weight (26.1 g) as compared to 40*10 cm and 20*10 cm planting geometries. Between the genotypes, significantly higher seed yield (943 kg ha⁻¹) and harvest index (45.1) was observed with genotype IC-79147 as compared to PRB-1 genotype (687 kg ha⁻¹ and 34.2, respectively). However, the genotype PRB-1 recorded significantly higher stover yield (1344 kg ha⁻¹) as compared to genotype IC-79147 (1173 kg ha⁻¹). The genotype IC-79147 was recorded significantly higher clusters plant⁻¹ (7.1), seeds clusters⁻¹ (7.9) and 1000 seed weight (24.5 g) as compared PRB-1 (5.4, 5.8 and 22.3 g, respectively). Among the fertility levels tried, the fertility level of 60:30 NP kg ha⁻¹ recorded significantly higher seed yield (845 kg ha-1) and stover yield (1359 kg ha⁻¹) as compared to 40:20 NP kg ha-1 (808 and 1259 kg ha⁻¹ respectively) and 20:10 NP kg ha-1 (793 and 1144 kg ha⁻¹ respectively). Within the treatment combinations, IC 79147 genotype having 30*10 cm planting geometry with 60:30 NP kg ha⁻¹ recorded significantly higher seed yield (1070 kg ha⁻¹), clusters plant⁻¹ (10.3), seeds clusters⁻¹ (9.9) and 1000 seed weight (27.3 g) compared to other treatment combinations.

Keywords: buckwheat, planting geometry, genotypes, fertility levels

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1093 A Small-Scale Survey on Risk Factors of Musculoskeletal Disorders in Workers of Logistics Companies in Cyprus and on the Early Adoption of Industrial Exoskeletons as Mitigation Measure

Authors: Kyriacos Clerides, Panagiotis Herodotou, Constantina Polycarpou, Evagoras Xydas

Abstract:

Background: Musculoskeletal disorders (MSDs) in the workplace is a very common problem in Europe which are caused by multiple risk factors. In recent years, wearable devices and exoskeletons for the workplace have been trying to address the various risk factors that are associated with strenuous tasks in the workplace. The logistics sector is a huge sector that includes warehousing, storage, and transportation. However, the task associated with logistics is not well-studied in terms of MSDs risk. This study was aimed at looking into the MSDs affecting workers of logistics companies. It compares the prevalence of MSDs among workers and evaluates multiple risk factors that contribute to the development of MSDs. Moreover, this study seeks to obtain user feedback on the adoption of exoskeletons in such a work environment. Materials and Methods: The study was conducted among workers in logistics companies in Nicosia, Cyprus, from July to September 2022. A set of standardized questionnaires was used for collecting different types of data. Results: A high proportion of logistics professionals reported MSDs in one or more other body regions, the lower back being the most commonly affected area. Working in the same position for long periods, working in awkward postures, and handling an excessive load, were found to be the most commonly reported job risk factor that contributed to the development of MSDs, in this study. A significant number of participants consider the back region as the most to be benefited from a wearable exoskeleton device. Half of the participants would like to have at least a 50% reduction in their daily effort. The most important characteristics for the adoption of exoskeleton devices were found to be how comfortable the device is and its weight. Conclusion: Lower back and posture were the highest risk factors among all logistics professionals assessed in this study. A larger scale study using quantitative analytical tools may give a more accurate estimate of MSDs, which would pave the way for making more precise recommendations to eliminate the risk factors and thereby prevent MSDs. A follow-up study using exoskeletons in the workplace should be done to assess whether they assist in MSD prevention.

Keywords: musculoskeletal disorders, occupational health, safety, occupational risk, logistic companies, workers, Cyprus, industrial exoskeletons, wearable devices

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1092 Towards Competence-Based Regulatory Sciences Education in Sub-Saharan Africa: Identification of Competencies

Authors: Abigail Ekeigwe, Bethany McGowan, Loran C. Parker, Stephen Byrn, Kari L. Clase

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There are growing calls in the literature to develop and implement competency-based regulatory sciences education (CBRSE) in sub-Saharan Africa to expand and create a pipeline of a competent workforce of regulatory scientists. A defined competence framework is an essential component in developing competency-based education. However, such a competence framework is not available for regulatory scientists in sub-Saharan Africa. The purpose of this research is to identify entry-level competencies for inclusion in a competency framework for regulatory scientists in sub-Saharan Africa as a first step in developing CBRSE. The team systematically reviewed the literature following the PRISMA guidelines for systematic reviews and based on a pre-registered protocol on Open Science Framework (OSF). The protocol has the search strategy and the inclusion and exclusion criteria for publications. All included publications were coded to identify entry-level competencies for regulatory scientists. The team deductively coded the publications included in the study using the 'framework synthesis' model for systematic literature review. The World Health Organization’s conceptualization of competence guided the review and thematic synthesis. Topic and thematic codings were done using NVivo 12™ software. Based on the search strategy in the protocol, 2345 publications were retrieved. Twenty-two (n=22) of the retrieved publications met all the inclusion criteria for the research. Topic and thematic coding of the publications yielded three main domains of competence: knowledge, skills, and enabling behaviors. The knowledge domain has three sub-domains: administrative, regulatory governance/framework, and scientific knowledge. The skills domain has two sub-domains: functional and technical skills. Identification of competencies is the primal step that serves as a bedrock for curriculum development and competency-based education. The competencies identified in this research will help policymakers, educators, institutions, and international development partners design and implement competence-based regulatory science education in sub-Saharan Africa, ultimately leading to access to safe, quality, and effective medical products.

Keywords: competence-based regulatory science education, competencies, systematic review, sub-Saharan Africa

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1091 Use of Pig as an Animal Model for Assessing the Differential MicroRNA Profiling in Kidney after Aristolochic Acid Intoxication

Authors: Daniela E. Marin, Cornelia Braicu, Gina C. Pistol, Roxana Cojocneanu-Petric, Ioana Berindan Neagoe, Mihail A. Gras, Ionelia Taranu

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Aristolochic acid (AA) is a carcinogenic, mutagenic, and nephrotoxic compound commonly found in the Aristolochiaceae family of plants. AA is frequently associated with urothelial carcinoma of the upper urinary tract in human and animals and is considered as being responsible for Balkan Endemic Nephropathy. The pig provides a good animal model because the porcine urological system is very similar to that of humans, both in aspects of physiology and anatomy. MicroRNA (miRNA) are small non-coding RNAs that have an impact on a wide range of biological processes by regulating gene expression at post-transcriptional level. The objective of this study was to analyze the miRNA profiling in the kidneys of AA intoxicated swine. For this purpose, ten TOPIGS-40 crossbred weaned piglets, 4-week-old, male and females with an initial average body weight of 9.83 ± 0.5 kg were studied for 28 days. They were given ad libitum access to water and feed and randomly allotted to one of the following groups: control group (C) or aristolochic acid group (AA). They were fed a maize-soybean-meal-based diet contaminated or not with 0.25mgAA/kg. To profile miRNA in the kidneys of pigs, microarrays and bioinformatics approaches were applied to analyze the miRNA in the kidney of control and AA intoxicated pigs. After normalization, our results have shown that a total of 5 known miRNAs and 4 novel miRNAs had different profiling in the kidney of intoxicated animals versus control ones. Expression of miR-32-5p, miR-497-5p, miR-423-3p, miR-218-5p, miR-128-3p were up-regulated by 0.25mgAA/kg feed, while the expression of miR-9793-5p, miR-9835-3p, miR-9840-3p, miR-4334-5p was down-regulated. The microRNA profiling in kidney of intoxicated animals was associated with modified expression of target genes as: RICTOR, LASP1, SFRP2, DKK2, BMI1, RAF1, IGF1R, MAP2K1, WEE1, HDGF, BCL2, EIF4E etc, involved in cell division cycle, apoptosis, cell differentiation and cell migration, cell signaling, cancer etc. In conclusion, this study provides new data concerning the microRNA profiling in kidney after aristolochic acid intoxications with important implications for human and animal health.

Keywords: aristolochic acid, kidney, microRNA, swine

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1090 Analyzing Social and Political Constraints in Development Aid Projects in Post Conflict Region of SWAT, Pakistan

Authors: Faizan Sultan

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Non-government organizations (NGOs) in Pakistan have the potential to deliver services such as health, education, and rural development through targeting the most vulnerable communities of society. Having this significant importance, NGOs are facing numerous challenges in service delivery. So, there is a need to identify the challenges NGOs face in community development, particularly post-conflict development. The current study has analyzed the social and political constraints in development projects in the post-conflict region of the Swat district of Khyber Pakhtunkhwa. The objectives of this study are “What are the social and political constraints faced by the nongovernmental organizations in the implementation of development aid Projects in post-conflict development of Swat and to examine the challenges in coordination mechanism between government departments, NGOs, and community in reconstruction activities”. This research is based upon both the quantitative and qualitative data that is being gathered from the NGO representatives, government officials, and community members who were involved in post-conflict development interventions in the Swat region. A purposive sampling technique was used to select respondents from the community members/activists (25 in number) and government and NGO officials (10 in number). Based on analysis against our objectives, NGOs have faced numerous constraints such as Insecurity, Negative Perceptions about NGOs, restrictions on women's mobility, government policies and regulations, lack of coordination and networking, trust deficit, and political interference while implementing their project interventions. These findings concluded that constraints have affected project implementation to a greater extent, including women's participation, involvement of marginalized populations, and equal distribution of resources. In the Swat region, NGOs cannot openly discuss sensitive projects such as human rights, gender-based projects, or women empowerment as these issues are very sensitive to the local community due to their cultural values. The community may not allow their females to go outside their homes as this region is a male-dominated society. Similarly, lack of communication and poor networking for the arrangements of the project meetings were also the major constraints.

Keywords: national disaster management authority, millennium development goals, provincial disaster management authority, provincial reconstruction, rehabilitation and settlement authority

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1089 Acid Soil Amelioration Using Coal Bio-Briquette Ash and Waste Concrete in China

Authors: Y. Sakai, C. Wang

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The decrease in agricultural production due to soil deterioration has been an urgent task. Soil acidification is a potentially serious land degradation issue and it will have a major impact on agricultural productivity and sustainable farming systems. In China, acid soil is mainly distributed in the southern part, the decrease in agricultural production and heavy metal contamination are serious problems. In addition, not only environmental and health problems due to the exhaust gas such as mainly sulfur dioxide (SO₂) but also the generation of a huge amount of construction and demolition wastes with the accelerating urbanization has emerged as a social problem in China. Therefore, the need for the recycling and reuse of both desulfurization waste and waste concrete is very urgent and necessary. So we have investigated the effectiveness as acid soil amendments of both coal bio-briquette ash and waste concrete. In this paper, acid soil (AS1) in Nanjing (pH=6.0, EC=1.6dSm-1) and acid soil (AS2) in Guangzhou (pH=4.1, EC=0.2dSm-1) were investigated in soil amelioration test. Soil amendments were three coal bio-briquette ashes (BBA1, BBA2 and BBA3), the waste cement fine powders (CFP) ( < 200µm (particle diameter)), waste concrete particles (WCP) ( < 4.75mm ( < 0.6mm, 0.6-1.0mm, 1.0-2.0mm, 2.0-4.75mm)), and six mixtures with two coal bio-briquette ashes (BBA2 and BBA3), CFP, WCP( < 0.6mm) and WCP(2.0-4.75mm). In acid soil amelioration test, the three BBAs, CFP and various WCPs based on exchangeable calcium concentration were added to two acid soils. The application rates were from 0 wt% to 3.5 wt% in AS1 test and from 0 wt% to 6.0 wt% in AS2 test, respectively. Soil chemical properties (pH, EC, exchangeable and soluble ions (Na, Ca, Mg, K)) before and after mixing with soil amendments were measured. In addition, Al toxicity and the balance of salts (CaO, K₂O, MgO) in soil after amelioration was evaluated. The order of pH and exchangeable Ca concentration that is effective for acid soil amelioration was WCP(0.6mm) > CFP > WCP(2.0-4.25mm) > BB1 > BB2 > BB3. In all AS 1 and AS 2 amelioration tests using three BBAs, the pH and EC increased slightly with the increase of application rate and reached to the appropriate value range of both pH and EC in BBA1 only. Because BBA1 was higher value in pH and exchangeable Ca. After that, soil pH and EC with the increase in the application rate of BBA2, BBA3 and by using CFP, WC( < 0.6mm), WC(2.0-4.75mm) as soil amendment reached to each appropriate value range, respectively. In addition, the mixture amendments with BBA2, BBA3 CFP, WC( < 0.6mm), and WC(2.0-4.75mm) could ameliorate at a smaller amount of application rate in case of BBA only. And the exchangeable Al concentration decreased drastically with the increase in pH due to soil amelioration and was under the standard value. Lastly, the heavy metal (Cd, As, Se, Ni, Cr, Pb, Mo, B, Cu, Zn) contents in new soil amendments were under control standard values for agricultural use in China. Thus we could propose a new acid soil amelioration method using coal bio-briquette ash and waste concrete in China.

Keywords: acid soil, coal bio-briquette ash, soil amelioration, waste concrete

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1088 Beneficial Effects of Whey Protein Concentrate in Venous Thrombosis

Authors: Anna Tokajuk, Agnieszka Zakrzeska, Ewa Chabielska, Halina Car

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Whey is a by-product generated mainly in the production of cheese and casein. Powder forms of whey are used widely in the food industry as well as a high-protein food for infants, for convalescents, by athletes and especially by bodybuilders to increase muscle mass during exercise. Whey protein concentrate-80 (WPC-80) is a source of bioactive peptides with beneficial effects on the cardiovascular system. It is known that whey proteins health beneficial properties include antidiabetic, blood pressure lowering, improving cardiovascular system function, antibacterial, antiviral and other effects. To study its influence on the development of thrombosis, venous thrombosis model was performed according to the protocol featured by Reyers with modification by Chabielska and Gromotowicz. Male Wistar-Crl: WI (Han) rats from researched groups were supplemented with two doses of WPC-80 (0.3 or 0.5 g/kg) for 7, 14 or 21 days and after these periods, one-hour venous thrombosis model was performed. Control group received 0.9 % NaCl solution and was sham operated. The statistical significance of results was computed by Mann – Whitney’s test. We observed that thrombus weight was decreased in animals obtaining WPC-8080 and that was statistically significant in 14 and 21-day supplemented groups. Blood count parameters did not differ significantly in rats with and without thrombosis induction whether they were fed with WPC-80 or not. Moreover, the number of platelets (PLT) was within the normal range in each group. The examined coagulation parameters in rats of the control groups were within normal limits. After WPC-80 supplementation there was the tendency to prolonged activated partial thromboplastin time (aPTT), but in comparison, the results did not turn out significant. In animals that received WPC-80 0.3 g·kg-1 for 21 days with and without induced thrombosis, prothrombin time (PT) and an international normalized ratio (INR) was somewhat decreased, remaining within the normal range, but the nature and significance of this observation are beyond the framework of the current study. Additionally, fibrinogen and thrombin time (TT) did not differ significantly between groups. Therefore the exact effect of WPC-80 on coagulation system is still elusive and requires further thorough research including mechanisms of action. Determining the potential clinical application of WPC-80 requires the selection of the optimal dose and duration of supplementation.

Keywords: antithrombotic, rats, venous thrombosis, WPC-80

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1087 Functional Performance Needs of Individuals with Intellectual and Developmental Disabilities

Authors: Noor Taleb Ismael, Areej Abd Al Kareem Al Titi, Ala'a Fayez Jaber

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Objectives: To investigate self-perceived functional performance among adults with IDD who are Jordanian residential care and rehabilitation centers residents. Also, to investigate their functional abilities (i.e., motor, and cognitive). In addition, to determine the motor and cognitive predictors of their functional performance. Methods: The study utilized a cross-sectional descriptive design; the sample included 180 individuals with IDD (90 males and 90 females) aged 18 to 75 years. The inclusion criteria encompassed: 1) Adults with a confirmed IDD by their physician’s professional and 2) residents in Jordanian Residential Care and Rehabilitation Centers affiliated with the Jordanian Ministry of Social Development. The exclusion criteria were: 1) bedridden or totally dependent on their care providers; 2) who had an accident or acquired neurological conditions. Researchers conducted semi-structured interviews to complete the outcome measures that include the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure (FIM), the Montreal Cognitive Assessment (MoCA), the Mini-Mental Status Examination (MMSE), and the sociodemographic questionnaire. Data analyses consisted of descriptive statistics, analysis of frequencies, correlation, and regression analyses. Result: Individuals with IDD showed low functional performance in all daily life areas, including self-care, productivity, and leisure; there was severe cognitive impairment and poor independence and functional performance. (COPM Performance M= 1.433, SD±.57021, COPM Satisfaction M= 1.31, SD±.54, FIM M= 3.673, SD± 1.7918). Two predictive models were validated for the COPM performance and FIM total scores. First, significant predictors of high self-perceived functional performance on COPM were high scores on FIM Motor sub scores, FIM cognitive sub scores, young age, and having a high school educational level (R2=0.603, p=0.012). Second, significant predictors of high functional capacity on FIM were a high score on the COPM performance subscale, a high MMSE score, and having a cerebral palsy (CP) diagnosis (R2=0.671, p<0.001). Conclusions: Evaluating functional performance and associated factors is important in rehabilitation to provide better services and improve health and QoL for individuals with IDD. This study suggested conducting future studies targeting integrated individuals with IDD who live with their families in the communities.

Keywords: functional performance, intellectual and developmental disabilty, cognitive abilities, motor abilities

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1086 Temperamental Determinants of Eye-Hand Coordination Formation in the Special Aerial Gymnastics Instruments (SAGI)

Authors: Zdzisław Kobos, Robert Jędrys, Zbigniew Wochyński

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Motor activity and good health are sine qua non determinants of a proper practice of the profession, especially aviation. Therefore, candidates to the aviation are selected according their psychomotor ability by both specialist medical commissions. Moreover, they must past an examination of the physical fitness. During the studies in the air force academy, eye-hand coordination is formed in two stages. The future aircraft pilots besides all-purpose physical education must practice specialist training on SAGI. Training includes: looping, aerowheel, and gyroscope. Aim of the training on the above listed apparatuses is to form eye-hand coordination during the tasks in the air. Such coordination is necessary to perform various figures in the real flight. Therefore, during the education of the future pilots, determinants of the effective ways of this important parameter of the human body functioning are sought for. Several studies of the sport psychology indicate an important role of the temperament as a factor determining human behavior during the task performance and acquiring operating skills> Polish psychologist Jan Strelau refers to the basic, relatively constant personality features which manifest themselves in the formal characteristics of the human behavior. Temperament, being initially determined by the inborn physiological mechanisms, changes in the course of maturation and some environmental factors and concentrates on the energetic level and reaction characteristics in time. Objectives. This study aimed at seeking a relationship between temperamental features and eye-hand coordination formation during training on SAGI. Material and Methods: Group of 30 students of pilotage was examined in two situations. The first assessment of the eye-hand coordination level was carried out before the beginning of a 30-hour training on SAGI. The second assessment was carried out after training completion. Training lasted for 2 hours once a week. Temperament was evaluated with The Formal Characteristics of Behavior − Temperament Inventory (FCB-TI) developed by Bogdan Zawadzki and Jan Strelau. Eye-hand coordination was assessed with a computer version of the Warsaw System of Psychological Tests. Results: It was found that the training on SAGI increased the level of eye-hand coordination in the examined students. Conclusions: Higher level of the eye-hand coordination was obtained after completion of the training. Moreover, a relationship between eye-hand coordination level and selected temperamental features was statistically significant.

Keywords: temperament, eye-hand coordination, pilot, SAGI

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1085 An Evaluation of the Relationship between the Anthropometric Measurements and Blood Lipid Profiles in Adolescents

Authors: Nalan Hakime Nogay

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Childhood obesity is a significant health issue that is currently on the rise all over the world. In recent years, the relationship between childhood obesity and cardiovascular disease risk has been pointed out. The purpose of this study is to evaluate the relationship between some of the anthropometric indicators and blood lipid levels in adolescents. The present study has been conducted on a total of 252 adolescents -200 girls and 52 boys- within an age group of 12 to 18 years. Blood was drawn from each participant in the morning -after having fasted for 10 hours from the day before- to analyze their total cholesterol, HDL, LDL and triglyceride levels. Their body weight, height, waist circumference, subscapular skinfold thicknesses and triceps skinfold thicknesses measurements were taken and their individual waist/height ratios, BMI and body fat ratios were calculated. The blood lipid levels of the participants were categorized as acceptable, borderline and high in accordance with the 2011 Expert Panel Integrated Guidelines. The body fat ratios, total blood cholesterol and HDL levels of the girls were significantly higher than the boys whereas their waist circumference values were lower. The triglyceride levels, total cholesterol/HDL, LDL/HDL, triglyceride/HDL ratios of the group with the BMI ≥ 95 percentile ratio (the obese group) were higher than the groups that were considered to be overweight and normal weight as per their respective BMI values, while the HDL level of the obese group was lower; a fact that was found to be statistically significant. No significant relationship could be established, however, between the total blood cholesterol and LDL levels with their anthropometric measurements. The BMI, waist circumference, waist/height ratio, body fat ratio and triglyceride level of the group with the higher triglyceride level ( ≥ 130mg/dl) were found to be significantly higher compared to borderline (90-129 mg/dl) and the normal group (< 90 mg/dl). The BMI, waist circumference, waist/height ratio values of the group with the lower HDL level ( < 40 mg/dl) were significantly higher than the normal ( > 45 mg/dl) and borderline (40-45 mg/dl) groups. All of the anthropometric measurements of the group with the higher triglyceride/HDL ratio ( ≥ 3) were found to be significantly higher than that of the group with the lower ratio (< 3). Having a high BMI, waist/height ratio and waist circumference is related to low HDL and high blood triglyceride and triglyceride/HDL ratio. A high body fat ratio, on the other hand, is associated with a low HDL and high triglyceride/HDL ratio. Tackling childhood and adolescent obesity are important in terms of preventing cardiovascular diseases.

Keywords: adolescent, body fat, body mass index, lipid profile

Procedia PDF Downloads 263
1084 Increasing Access to Upper Limb Reconstruction in Cervical Spinal Cord Injury

Authors: Michelle Jennett, Jana Dengler, Maytal Perlman

Abstract:

Background: Cervical spinal cord injury (SCI) is a devastating event that results in upper limb paralysis, loss of independence, and disability. People living with cervical SCI have identified improvement of upper limb function as a top priority. Nerve and tendon transfer surgery has successfully restored upper limb function in cervical SCI but is not universally used or available to all eligible individuals. This exploratory mixed-methods study used an implementation science approach to better understand these factors that influence access to upper limb reconstruction in the Canadian context and design an intervention to increase access to care. Methods: Data from the Canadian Institute for Health Information’s Discharge Abstracts Database (CIHI-DAD) and the National Ambulatory Care Reporting System (NACRS) were used to determine the annual rate of nerve transfer and tendon transfer surgeries performed in cervical SCI in Canada over the last 15 years. Semi-structured interviews informed by the consolidated framework for implementation research (CFIR) were used to explore Ontario healthcare provider knowledge and practices around upper limb reconstruction. An inductive, iterative constant comparative process involving descriptive and interpretive analyses was used to identify themes that emerged from the data. Results: Healthcare providers (n = 10 upper extremity surgeons, n = 10 SCI physiatrists, n = 12 physical and occupational therapists working with individuals with SCI) were interviewed about their knowledge and perceptions of upper limb reconstruction and their current practices and discussions around upper limb reconstruction. Data analysis is currently underway and will be presented. Regional variation in rates of upper limb reconstruction and trends over time are also currently being analyzed. Conclusions: Utilization of nerve and tendon transfer surgery to improve upper limb reconstruction in Canada remains low. There are a complex array of interrelated individual-, provider- and system-level barriers that prevent individuals with cervical SCI from accessing upper limb reconstruction. In order to offer equitable access to care, a multi-modal approach addressing current barriers is required.

Keywords: cervical spinal cord injury, nerve and tendon transfer surgery, spinal cord injury, upper extremity reconstruction

Procedia PDF Downloads 97
1083 Outpatient Pelvic Nerve and Muscle Treatment Reduces Pain and Improves Functionality for Patients with Chronic Pelvic Pain and Erectile Dysfunction

Authors: Allyson Augusta Shrikhande, Alexa Rains, Tayyaba Ahmed, Marjorie Mamsaang, Rakhi Vyas, Janaki Natarajan, Erika Moody, Christian Reutter, Kimberlee Leishear, Yogita Tailor, Sandra Sandhu-Restaino, Lora Liu, Neha James, Rosemarie Filart

Abstract:

Characterized by consistent difficulty getting and keeping an erection firm enough for intercourse, Erectile Dysfunction may affect up to 15% of adult men. Although awareness and access to treatment have improved in recent years, many patients do not actively seek diagnosis or treatment due to the stigma surrounding this condition. Patients who do seek treatment are often dissatisfied by the efficacy of the medication. The condition inhibits patients’ quality of life by worsening mental health and relationships. The purpose of this study was to test the effectiveness of an outpatient neuromuscular treatment protocol in treating the symptoms of Chronic Pelvic Pain and Erectile Dysfunction, improving pain and function. 56 patients ages 20-79 presented to an outpatient clinic for treatment of pelvic pain and Erectile Dysfunction symptoms. These symptoms had persisted for an average of 4 years. All patients underwent external ultrasound-guided hydro-dissection technique targeted at pelvic peripheral nerves in combination with pelvic floor musculature trigger-point injections. To measure the effects of this treatment, a five question Erectile Dysfunction questionnaire was completed by each patient at their first visit to a clinic and three months after treatment began. Answers were summed for a total score of 5-25, with a higher score indicating optimal function. The average score before treatment was 14.125 (SD 5.411) (a=0.05; CI 12.708-15.542), which increased by 18% to an average of 16.625 (SD 6.423) (a=0.05; CI 14.943-18.307) after treatment (P=0.0004). Secondary outcome variables included a Visual Analogue Scale (VAS) to measure pelvic pain intensity and the Functional Pelvic Pain Scale (FPPS) to measure function across multiple areas. VAS scores reduced by 51% after three months. Before treatment, the mean VAS score was 5.87, and the posttreatment mean VAS score was 2.89. Pelvic pain functionality improved by 34% after three months. Pretreatment FPPS scores averaged at 7.48, decreasing to 4.91 after treatment. These results indicate that this unique treatment was very effective at relieving pain and increasing function for patients with Erectile Dysfunction.

Keywords: chronic pelvic pain, erectile dysfunction, nonsurgical, outpatient, trigger point injections

Procedia PDF Downloads 89
1082 Opening of North Sea Route and Geopolitics in Arctic: Impact and Possibilities of Route

Authors: Nikkey Keshri

Abstract:

Arctic is a polar region located at the north of the earth. This consists of the Arctic Ocean and other parts of Canada, Russia, the United States, Denmark, Norway, Sweden, Finland, and Iceland. Arctic has vast natural resources which are exploited with modern technology, and the economic opening up of Russia has given new opportunities. All these states have connected with the Arctic region for economic activities and this effect the region ecology. The pollution problem is a serious threat to the people health living around pollution sources. Due to the prevailing worldwide sea and air currents, the Arctic area is the fallout region for long-range transport pollutants, and in some places the concentrations exceed the levels of densely populated urban areas. The Arctic is especially vulnerable to the effects of global warming, as has become apparent in the melting sea ice in recent years. Climate models predict much greater warming in the Arctic than the global average, resulting in significant international attention to the region. The global warming has an adverse impact on the climate, indigenous people, wildlife, and infrastructure. However, there are several opportunities that have emerged in the form of shipping routes, resources, and new territories. The shipping route through the Arctic is a reality and is currently navigable for a few weeks during summers. There are large deposits of oil and gas, minerals and fish and the surrounding countries with Arctic coastlines are becoming quite assertive about exercising their sovereignty over the newfound wealth. The main part of the research is that how the opening of Northern Sea Route is providing opportunities or problem in the Arctic and it is becoming geopolitically important. It focuses on the interest Arctic and non Arctic states, their present and anticipated global geopolitical aims. The Northern Sea Route might open up due to climate changes and that Iceland might benefit or has an impact from the situation. Efforts will be made to answer the research question: ‘Whether Opening of North Sea Route is providing opportunities or becoming a risk for Arctic region?’ Every research has a structure which usually called design. In this research, both Qualitative and Quantitative method is used in terms of various literature, maps, pie- charts, etc to find out the answer for the research question. The aim of this research is to find out the impact of Opening of North Sea Route over Arctic region and how this make arctic geopolitically important. The aim behind this research is to find out the impact of climate change and how the particular geographical area is being affected.

Keywords: climate change, geopolitics, international relation, Northern Sea Route

Procedia PDF Downloads 258
1081 Targetting T6SS of Klebsiella pneumoniae for Assessment of Immune Response in Mice for Therapeutic Lead Development

Authors: Sweta Pandey, Samridhi Dhyani, Susmita Chaudhuri

Abstract:

Klebsiella pneumoniae bacteria is a global threat to human health due to an increase in multi-drug resistance among strains. The hypervirulent strains of Klebsiella pneumoniae is a major trouble due to their association with life-threatening infections in a healthy population. One of the major virulence factors of hyper virulent strains of Klebsiella pneumoniae is the T6SS (Type six secretary system) which is majorly involved in microbial antagonism and causes interaction with the host eukaryotic cells during infections. T6SS mediates some of the crucial factors for establishing infection by the bacteria, such as cell adherence, invasion, and subsequent in vivo colonisation. The antibacterial activity and the cell invasion property of the T6SS system is a major requirement for the establishment of K. pneumoniae infections within the gut. The T6SS can be an appropriate target for developing therapeutics. The T6SS consists of an inner tube comprising hexamers of Hcp (Haemolysin -regulated protein) protein, and at the top of this tube sits VgrG (Valine glycine repeat protein G); the tip of the machinery consists of PAAR domain containing proteins which act as a delivery system for bacterial effectors. For this study, immune response to recombinant VgrG protein was generated to establish this protein as a potential immunogen for the development of therapeutic leads. The immunogenicity of the selected protein was determined by predicting the B cell epitopes by the BCEP analysis tool. The gene sequence for multiple domains of VgrG protein (phage_base_V, T6SS_Vgr, DUF2345) was selected and cloned in pMAL vector in E. coli. The construct was subcloned and expressed as a fusion protein of 203 residue protein with mannose binding protein tag (MBP) to enhance solubility and purification of this protein. The purified recombinant VgrG fusion protein was used for mice immunisation. The antiserum showed reactivity with the recombinant VgrG in ELISA and western blot. The immunised mice were challenged with K. pneumoniae bacteria and showed bacterial clearance in immunised mice. The recombinant VgrG protein can further be used for studying downstream signalling of VgrG protein in mice during infection and for therapeutic MAb development to eradicate K. pneumoniae infections.

Keywords: immune response, Klebsiella pneumoniae, multi-drug resistance, recombinant protein expression, T6SS, VgrG

Procedia PDF Downloads 102
1080 Estimating the Ladder Angle and the Camera Position From a 2D Photograph Based on Applications of Projective Geometry and Matrix Analysis

Authors: Inigo Beckett

Abstract:

In forensic investigations, it is often the case that the most potentially useful recorded evidence derives from coincidental imagery, recorded immediately before or during an incident, and that during the incident (e.g. a ‘failure’ or fire event), the evidence is changed or destroyed. To an image analysis expert involved in photogrammetric analysis for Civil or Criminal Proceedings, traditional computer vision methods involving calibrated cameras is often not appropriate because image metadata cannot be relied upon. This paper presents an approach for resolving this problem, considering in particular and by way of a case study, the angle of a simple ladder shown in a photograph. The UK Health and Safety Executive (HSE) guidance document published in 2014 (INDG455) advises that a leaning ladder should be erected at 75 degrees to the horizontal axis. Personal injury cases can arise in the construction industry because a ladder is too steep or too shallow. Ad-hoc photographs of such ladders in their incident position provide a basis for analysis of their angle. This paper presents a direct approach for ascertaining the position of the camera and the angle of the ladder simultaneously from the photograph(s) by way of a workflow that encompasses a novel application of projective geometry and matrix analysis. Mathematical analysis shows that for a given pixel ratio of directly measured collinear points (i.e. features that lie on the same line segment) from the 2D digital photograph with respect to a given viewing point, we can constrain the 3D camera position to a surface of a sphere in the scene. Depending on what we know about the ladder, we can enforce another independent constraint on the possible camera positions which enables us to constrain the possible positions even further. Experiments were conducted using synthetic and real-world data. The synthetic data modeled a vertical plane with a ladder on a horizontally flat plane resting against a vertical wall. The real-world data was captured using an Apple iPhone 13 Pro and 3D laser scan survey data whereby a ladder was placed in a known location and angle to the vertical axis. For each case, we calculated camera positions and the ladder angles using this method and cross-compared them against their respective ‘true’ values.

Keywords: image analysis, projective geometry, homography, photogrammetry, ladders, Forensics, Mathematical modeling, planar geometry, matrix analysis, collinear, cameras, photographs

Procedia PDF Downloads 52
1079 Innovations in the Implementation of Preventive Strategies and Measuring Their Effectiveness Towards the Prevention of Harmful Incidents to People with Mental Disabilities who Receive Home and Community Based Services

Authors: Carlos V. Gonzalez

Abstract:

Background: Providers of in-home and community based services strive for the elimination of preventable harm to the people under their care as well as to the employees who support them. Traditional models of safety and protection from harm have assumed that the absence of incidents of harm is a good indicator of safe practices. However, this model creates an illusion of safety that is easily shaken by sudden and inadvertent harmful events. As an alternative, we have developed and implemented an evidence-based resilient model of safety known as C.O.P.E. (Caring, Observing, Predicting and Evaluating). Within this model, safety is not defined by the absence of harmful incidents, but by the presence of continuous monitoring, anticipation, learning, and rapid response to events that may lead to harm. Objective: The objective was to evaluate the effectiveness of the C.O.P.E. model for the reduction of harm to individuals with mental disabilities who receive home and community based services. Methods: Over the course of 2 years we counted the number of incidents of harm and near misses. We trained employees on strategies to eliminate incidents before they fully escalated. We trained employees to track different levels of patient status within a scale from 0 to 10. Additionally, we provided direct support professionals and supervisors with customized smart phone applications to track and notify the team of changes in that status every 30 minutes. Finally, the information that we collected was saved in a private computer network that analyzes and graphs the outcome of each incident. Result and conclusions: The use of the COPE model resulted in: A reduction in incidents of harm. A reduction the use of restraints and other physical interventions. An increase in Direct Support Professional’s ability to detect and respond to health problems. Improvement in employee alertness by decreasing sleeping on duty. Improvement in caring and positive interaction between Direct Support Professionals and the person who is supported. Developing a method to globally measure and assess the effectiveness of prevention from harm plans. Future applications of the COPE model for the reduction of harm to people who receive home and community based services are discussed.

Keywords: harm, patients, resilience, safety, mental illness, disability

Procedia PDF Downloads 447
1078 Effects of Roasting as Preservative Method on Food Value of the Runner Groundnuts, Arachis hypogaea

Authors: M. Y. Maila, H. P. Makhubele

Abstract:

Roasting is one of the oldest preservation method used in foods such as nuts and seeds. It is a process by which heat is applied to dry foodstuffs without the use of oil or water as a carrier. Groundnut seeds, also known as peanuts when sun dried or roasted, are among the oldest oil crops that are mostly consumed as a snack, after roasting in many parts of South Africa. However, roasting can denature proteins, destroy amino acids, decrease nutritive value and induce undesirable chemical changes in the final product. The aim of this study, therefore, was to evaluate the effect of various roasting times on the food value of the runner groundnut seeds. A constant temperature of 160 °C and various time-intervals (20, 30, 40, 50 and 60 min) were used for roasting groundnut seeds in an oven. Roasted groundnut seeds were then cooled and milled to flour. The milled sundried, raw groundnuts served as reference. The proximate analysis (moisture, energy and crude fats) was performed and the results were determined using standard methods. The antioxidant content was determined using HPLC. Mineral (cobalt, chromium, silicon and iron) contents were determined by first digesting the ash of sundried and roasted seed samples in 3M Hydrochloric acid and then determined by Atomic Absorption Spectrometry. All results were subjected to ANOVA through SAS software. Relative to the reference, roasting time significantly (p ≤ 0.05) reduced moisture (71%–88%), energy (74%) and crude fat (5%–64%) of the runner groundnut seeds, whereas the antioxidant content was significantly (p ≤ 0.05) increased (35%–72%) with increasing roasting time. Similarly, the tested mineral contents of the roasted runner groundnut seeds were also significantly (p ≤ 0.05) reduced at all roasting times: cobalt (21%–83%), chromium (48%–106%) and silicon (58%–77%). However, the iron content was significantly (p ≤ 0.05) unaffected. Generally, the tested runner groundnut seeds had higher food value in the raw state than in the roasted state, except for the antioxidant content. Moisture is a critical factor affecting the shelf life, texture and flavor of the final product. Loss of moisture ensures prolonged shelf life, which contribute to the stability of the roasted peanuts. Also, increased antioxidant content in roasted groundnuts is essential in other health-promoting compounds. In conclusion, the overall reduction in the proximate and mineral contents of the runner groundnuts seeds due to roasting is sufficient to suggest influences of roasting time on the food value of the final product and shelf life.

Keywords: dry roasting, legume, oil source, peanuts

Procedia PDF Downloads 287
1077 Out of the Closet: Transgressive Representations of Queer Intimacy in Filipino Mainstream Media

Authors: Darel Magramo

Abstract:

This study argues that media representations of queer intimacies can be transgressive. Representations of queerness in local and international media can be a reflection of the culture where the media product belongs to and these representations can be peculiar and intolerable to different communities. Since these representations of queerness in any media product are rare and unacceptable it can be seen as transgressive in a way that it goes beyond the norms of a particular community and violates the common perceptions about gender and sexuality. Examining media representations of the queer community in a predominantly Catholic country means breaking the religious belief, principles, and stereotypes about homosexuality and same-sex relationship. Using a mainstream media and gender theory this study examined whether and how one particular Filipino mainstream media representation of queer intimacies can enact such transgression. Over the past years Original Pinoy Music (Original Filipino Music) or OPM has produced chart-topping and controversial hit songs which includes: This guy is in love with you pare (pare refers to a guy or men) released in 2002: Nagmahal ako ng bakla (I fell in love with a gay) released in 2009: and lastly Pare mahal mo raw ako (Man, you love me?) released in 2014. By examining these songs, this study outlines tropes on how OPM songs present transgression in queer intimacy including the image of love for money only to gaiety and satisfaction which presents how an openly gay man makes a cisgender man falls in love for him by satisfying him through his humorous antics, this is one way of showing transgression in queer relationship in Philippine context by going beyond the common stereotype of a cisgender man falling in love to a gay man for his wealth to falling in love genuinely because of gaiety and satisfaction in the relationship. This study also identifies how media created a new way of presenting gay and homosexual relationship - from the stereotypes of gays having illnesses and mental health problems, mainstream media continues to present that queer relationship is not all about love and sexual desire but also it promotes acceptance and love towards people in the community. A queer relationship does not only revolve in the idea of having a same-sex relationship but the idea that queer relationship is also between friends and other people of the community by manifesting acceptance and love. Amidst the conservative culture of the Philippines, mainstream media continues to progress and develop ways on how to present gender and sexuality in different media products. These representations create a transgressive way of showing acceptance and understanding towards identities particularly homosexuality and queer relationships.

Keywords: gender studies, homosexuality, media representations, queer intimacy

Procedia PDF Downloads 160
1076 Improving the Detection of Depression in Sri Lanka: Cross-Sectional Study Evaluating the Efficacy of a 2-Question Screen for Depression

Authors: Prasad Urvashi, Wynn Yezarni, Williams Shehan, Ravindran Arun

Abstract:

Introduction: Primary health services are often the first point of contact that patients with mental illness have with the healthcare system. A number of tools have been developed to increase detection of depression in the context of primary care. However, one challenge amongst many includes utilizing these tools within the limited primary care consultation timeframe. Therefore, short questionnaires that screen for depression that are just as effective as more comprehensive diagnostic tools may be beneficial in improving detection rates of patients visiting a primary care setting. Objective: To develop and determine the sensitivity and specificity of a 2-Question Questionnaire (2-QQ) to screen for depression in in a suburban primary care clinic in Ragama, Sri Lanka. The purpose is to develop a short screening tool for depression that is culturally adapted in order to increase the detection of depression in the Sri Lankan patient population. Methods: This was a cross-sectional study involving two steps. Step one: verbal administration of 2-QQ to patients by their primary care physician. Step two: completion of the Peradeniya Depression Scale, a validated diagnostic tool for depression, the patient after their consultation with the primary care physician. The results from the PDS were then correlated to the results from the 2-QQ for each patient to determine sensitivity and specificity of the 2-QQ. Results: A score of 1/+ on the 2-QQ was most sensitive but least specific. Thus, setting the threshold at this level is effective for correctly identifying depressed patients, but also inaccurately captures patients who are not depressed. A score of 6 on the 2-QQ was most specific but least sensitive. Setting the threshold at this level is effective for correctly identifying patients without depression, but not very effective at capturing patients with depression. Discussion: In the context of primary care, it may be worthwhile setting the 2-QQ screen at a lower threshold for positivity (such as a score of 1 or above). This would generate a high test sensitivity and thus capture the majority of patients that have depression. On the other hand, by setting a low threshold for positivity, patients who do not have depression but score higher than 1 on the 2-QQ will also be falsely identified as testing positive for depression. However, the benefits of identifying patients who present with depression may outweigh the harms of falsely identifying a non-depressed patient. It is our hope that the 2-QQ will serve as a quick primary screen for depression in the primary care setting and serve as a catalyst to identify and treat individuals with depression.

Keywords: depression, primary care, screening tool, Sri Lanka

Procedia PDF Downloads 257
1075 Effects of the Affordable Care Act On Preventive Care Disparities

Authors: Cagdas Agirdas

Abstract:

Background: The Affordable Care Act (ACA) requires non-grandfathered private insurance plans, starting with plan years on or after September 23rd, 2010, to provide certain preventive care services without any cost sharing in the form of deductibles, copayments or co-insurance. This requirement may affect racial and ethnic disparities in preventive care as it provides the largest copay reduction in preventive care. Objectives: We ask whether the ACA’s free preventive care benefits are associated with a reduction in racial and ethnic disparities in the utilization of four preventive services: cholesterol screenings, colonoscopies, mammograms, and pap smears. Methods: We use a data set of over 6,000 individuals from the 2009, 2010, and 2013 Medical Expenditure Panel Surveys (MEPS). We restrict our data set only to individuals who are old enough to be eligible for each preventive service. Our difference-in-differences logistic regression model classifies privately-insured Hispanics, African Americans, and Asians as the treatment groups and 2013 as the after-policy year. Our control group consists of non-Hispanic whites on Medicaid as this program already covered preventive care services for free or at a low cost before the ACA. Results: After controlling for income, education, marital status, preferred interview language, self-reported health status, employment, having a usual source of care, age and gender, we find that the ACA is associated with increases in the probability of the median, privately-insured Hispanic person to get a colonoscopy by 3.6% and a mammogram by 3.1%, compared to a non-Hispanic white person on Medicaid. Similarly, we find that the median, privately-insured African American person’s probability of receiving these two preventive services improved by 2.3% and 2.4% compared to a non-Hispanic white person on Medicaid. We do not find any significant improvements for any racial or ethnic group for cholesterol screenings or pap smears. Furthermore, our results do not indicate any significant changes for Asians compared to non-Hispanic whites in utilizing the four preventive services. These reductions in racial/ethnic disparities are robust to reconfigurations of time periods, previous diagnosis, and residential status. Conclusions: Early effects of the ACA’s provision of free preventive care are significant for Hispanics and African Americans. Further research is needed for the later years as more individuals became aware of these benefits.

Keywords: preventive care, Affordable Care Act, cost sharing, racial disparities

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1074 Preparedness Level of European Cultural Institutions and Catering Establishments Within the Sanitary and Epidemiological Dimension During the COVID-19 Pandemic

Authors: Magdalena Barbara Kaziuk

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Introduction: In December 2019, the first case of an acute infectious disease of the respiratory system caused by the SARS-CoV-2 virus was recorded in Wuhan in Central China. On March 11, 2020, the World Health Organization restrictions, among others, in the travel industry. Aim: The aim of the study was the assessment of the preparedness of European cultural institutions and catering establishments within the sanitary and epidemiological dimension during the COVID-19 pandemic by Polish tourists and their sense of safety in selected destinations. Material and methods: The study involved 300 Polish tourists (125 females, 175 males, age 46.5+/-12.9 years) who traveled during the COVID-19 pandemic to Southern European countries. 5 most popular travel destinations were selected: Italy, Austria, Greece, Croatia, and Mediterranean islands. The tourists assessed cultural institutions and catering establishments with the use of a proprietary questionnaire which concerned the preparedness regarding the sanitary and epidemiological requirements and the tourists' sense of safety. The number of respondents was deliberate - 60 persons per each country. Results: The more stringent sanitary regimes, the higher the sense of safety in the study group of females aged 45-50 (p<0.005), while the more stringent sanitary and epidemiological issues are implemented, the shorter the stay (p<0.001). Less stringent restrictions resulted in increased sense of freedom and mental rest in the group of studied males (p<0.005). Conclusions: The respondents' opinions revealed that the highest level of safety with regard to sanitary and epidemiological requirements (masks covering mouth and nose worn by both personnel and society, the necessity to present the COVID passport, the possibility to disinfect hands) was observed in Austria and Italy, while shorter length of the stay in these countries resulted from high prices, particularly in catering establishments. According to the respondents, less stringent restrictions, among others lack of the necessity to own the COVID passport, were linked to Croatia and Mediterranean islands. The sense of safety was satisfying, while the sense of freedom and mental rest was high. declared a string of COVID-19 cases a pandemic. Most countries implemented numerous sanitary and epidemiological

Keywords: sanitary and epidemiological regimes, tourist facilities, COVID-19 pandemic, sense of safety

Procedia PDF Downloads 124
1073 Developing Optical Sensors with Application of Cancer Detection by Elastic Light Scattering Spectroscopy

Authors: May Fadheel Estephan, Richard Perks

Abstract:

Context: Cancer is a serious health concern that affects millions of people worldwide. Early detection and treatment are essential for improving patient outcomes. However, current methods for cancer detection have limitations, such as low sensitivity and specificity. Research Aim: The aim of this study was to develop an optical sensor for cancer detection using elastic light scattering spectroscopy (ELSS). ELSS is a noninvasive optical technique that can be used to characterize the size and concentration of particles in a solution. Methodology: An optical probe was fabricated with a 100-μm-diameter core and a 132-μm centre-to-centre separation. The probe was used to measure the ELSS spectra of polystyrene spheres with diameters of 2, 0.8, and 0.413 μm. The spectra were then analysed to determine the size and concentration of the spheres. Findings: The results showed that the optical probe was able to differentiate between the three different sizes of polystyrene spheres. The probe was also able to detect the presence of polystyrene spheres in suspension concentrations as low as 0.01%. Theoretical Importance: The results of this study demonstrate the potential of ELSS for cancer detection. ELSS is a noninvasive technique that can be used to characterize the size and concentration of cells in a tissue sample. This information can be used to identify cancer cells and assess the stage of the disease. Data Collection: The data for this study were collected by measuring the ELSS spectra of polystyrene spheres with different diameters. The spectra were collected using a spectrometer and a computer. Analysis Procedures: The ELSS spectra were analysed using a software program to determine the size and concentration of the spheres. The software program used a mathematical algorithm to fit the spectra to a theoretical model. Question Addressed: The question addressed by this study was whether ELSS could be used to detect cancer cells. The results of the study showed that ELSS could be used to differentiate between different sizes of cells, suggesting that it could be used to detect cancer cells. Conclusion: The findings of this research show the utility of ELSS in the early identification of cancer. ELSS is a noninvasive method for characterizing the number and size of cells in a tissue sample. To determine cancer cells and determine the disease's stage, this information can be employed. Further research is needed to evaluate the clinical performance of ELSS for cancer detection.

Keywords: elastic light scattering spectroscopy, polystyrene spheres in suspension, optical probe, fibre optics

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1072 Preserving Wetlands: Legal and Ecological Challenges in the Face of Degradation: The Case Study of Miankaleh, Iran

Authors: Setareh Orak

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Wetlands are essential guardians of global ecosystems, yet they remain vulnerable to increasing human interference and environmental stress. The Miankaleh wetland in northern Iran, designated as a Ramsar Convention site, represents a critical habitat known for its rich biodiversity and essential ecological functions. Despite the existence of national and international environmental laws aimed at preserving such critical ecosystems, the regulatory frameworks in place often fall short in terms of enforcement, monitoring, and overall effectiveness. Unfortunately, this wetland is undergoing severe degradation due to overexploitation, industrial contamination, unsustainable tourism, and land-use alterations. This study aims to assess the strengths and limitations of these regulations and examine their practical impacts on Miankaleh’s ecological health. Adopting a multi-method research approach, this study relies on a combination of case study analysis, legal and literature reviews, environmental data examination, stakeholder interviews, and comparative assessments. Through these methodologies, we scrutinize current national policies, international conventions, and their enforcement mechanisms, revealing the primary areas where they fail to protect Miankaleh effectively. The analysis is supported by two satellite maps linked to our tables, offering detailed visual representations of changes in land use, vegetation, and pollution sources over recent years. By connecting these visual data with quantitative measures, the study provides a comprehensive perspective on how human activities and regulatory shortcomings are contributing to environmental degradation. In conclusion, this study’s insights into the limitations of current environmental legislation and its recommendations for enhancing both policy and public engagement underscore the urgent need for integrated, multi-level efforts in conserving the Miankaleh wetland. Through strengthened legal frameworks, better enforcement, increased public awareness, and international cooperation, the hope is to establish a model of conservation that not only preserves Miankaleh but also serves as a template for protecting similar ecologically sensitive areas worldwide.

Keywords: wetlands, tourism, industrial pollution, land use changes, Ramsar convention

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1071 High Altitude Glacier Surface Mapping in Dhauliganga Basin of Himalayan Environment Using Remote Sensing Technique

Authors: Aayushi Pandey, Manoj Kumar Pandey, Ashutosh Tiwari, Kireet Kumar

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Glaciers play an important role in climate change and are sensitive phenomena of global climate change scenario. Glaciers in Himalayas are unique as they are predominantly valley type and are located in tropical, high altitude regions. These glaciers are often covered with debris which greatly affects ablation rate of glaciers and work as a sensitive indicator of glacier health. The aim of this study is to map high altitude Glacier surface with a focus on glacial lake and debris estimation using different techniques in Nagling glacier of dhauliganga basin in Himalayan region. Different Image Classification techniques i.e. thresholding on different band ratios and supervised classification using maximum likelihood classifier (MLC) have been used on high resolution sentinel 2A level 1c satellite imagery of 14 October 2017.Here Near Infrared (NIR)/Shortwave Infrared (SWIR) ratio image was used to extract the glaciated classes (Snow, Ice, Ice Mixed Debris) from other non-glaciated terrain classes. SWIR/BLUE Ratio Image was used to map valley rock and Debris while Green/NIR ratio image was found most suitable for mapping Glacial Lake. Accuracy assessment was performed using high resolution (3 meters) Planetscope Imagery using 60 stratified random points. The overall accuracy of MLC was 85 % while the accuracy of Band Ratios was 96.66 %. According to Band Ratio technique total areal extent of glaciated classes (Snow, Ice ,IMD) in Nagling glacier was 10.70 km2 nearly 38.07% of study area comprising of 30.87 % Snow covered area, 3.93% Ice and 3.27 % IMD covered area. Non-glaciated classes (vegetation, glacial lake, debris and valley rock) covered 61.93 % of the total area out of which valley rock is dominant with 33.83% coverage followed by debris covering 27.7 % of the area in nagling glacier. Glacial lake and Debris were accurately mapped using Band ratio technique Hence, Band Ratio approach appears to be useful for the mapping of debris covered glacier in Himalayan Region.

Keywords: band ratio, Dhauliganga basin, glacier mapping, Himalayan region, maximum likelihood classifier (MLC), Sentinel-2 satellite image

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1070 Gut Microbiota in Patients with Opioid Use Disorder: A 12-week Follow up Study

Authors: Sheng-Yu Lee

Abstract:

Aim: Opioid use disorder is often characterized by repetitive drug-seeking and drug-taking behaviors with severe public health consequences. Animal model showed that opioid-induced perturbations in the gut microbiota causally relate to neuroinflammation, deficits in reward responding, and opioid tolerance, possibly due to changes in gut microbiota. Therefore, we propose that the dysbiosis of gut microbiota can be associated with pathogenesis of opioid dependence. In this current study, we explored the differences in gut microbiota between patients and normal controls and in patients before and after initiation of methadone treatment program for 12 weeks. Methods: Patients with opioid use disorder between 20 and 65 years were recruited from the methadone maintenance outpatient clinic in 2 medical centers in the Southern Taiwan. Healthy controls without any family history of major psychiatric disorders (schizophrenia, bipolar disorder and major depressive disorder) were recruited from the community. After initial screening, 15 patients with opioid use disorder joined the study for initial evaluation (Week 0), 12 of them completed the 12-week follow-up while receiving methadone treatment and ceased heroin use (Week 12). Fecal samples were collected from the patients at baseline and the end of 12th week. A one-time fecal sample was collected from the healthy controls. The microbiota of fecal samples were investigated using 16S rRNA V3V4 amplicon sequencing, followed by bioinformatics and statistical analyses. Results: We found no significant differences in species diversity in opioid dependent patients between Week 0 and Week 12, nor compared between patients at both points and controls. For beta diversity, using principal component analysis, we found no significant differences between patients at Week 0 and Week 12, however, both patient groups showed significant differences compared to control (P=0.011). Furthermore, the linear discriminant analysis effect size (LEfSe) analysis was used to identify differentially enriched bacteria between opioid use patients and healthy controls. Compared to controls, the relative abundance of Lactobacillaceae Lactobacillus (L. Lactobacillus), Megasphaera Megasphaerahexanoica (M. Megasphaerahexanoica) and Caecibacter Caecibactermassiliensis (C Caecibactermassiliensis) were increased in patients at Week 0, while Coriobacteriales Atopobiaceae (C. Atopobiaceae), Acidaminococcus Acidaminococcusintestini (A. Acidaminococcusintestini) and Tractidigestivibacter Tractidigestivibacterscatoligenes (T. Tractidigestivibacterscatoligenes) were increased in patients at Week 12. Conclusion: In conclusion, we suggest that the gut microbiome community maybe linked to opioid use disorder, such differences may not be altered even after 12-week of cessation of opioid use.

Keywords: opioid use disorder, gut microbiota, methadone treatment, follow up study

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1069 Syngas From Polypropylene Gasification in a Fluidized Bed

Authors: Sergio Rapagnà, Alessandro Antonio Papa, Armando Vitale, Andre Di Carlo

Abstract:

In recent years the world population has enormously increased the use of plastic products for their living needs, in particular for transporting and storing consumer goods such as food and beverage. Plastics are widely used in the automotive industry, in construction of electronic equipment, clothing and home furnishings. Over the last 70 years, the annual production of plastic products has increased from 2 million tons to 460 million tons. About 20% of the last quantity is mismanaged as waste. The consequence of this mismanagement is the release of plastic waste into the terrestrial and marine environments which represents a danger to human health and the ecosystem. Recycling all plastics is difficult because they are often made with mixtures of polymers that are incompatible with each other and contain different additives. The products obtained are always of lower quality and after two/three recycling cycles they must be eliminated either by thermal treatment to produce heat or disposed of in landfill. An alternative to these current solutions is to obtain a mixture of gases rich in H₂, CO and CO₂ suitable for being profitably used for the production of chemicals with consequent savings fossil sources. Obtaining a hydrogen-rich syngas can be achieved by gasification process using the fluidized bed reactor, in presence of steam as the fluidization medium. The fluidized bed reactor allows the gasification process of plastics to be carried out at a constant temperature and allows the use of different plastics with different compositions and different grain sizes. Furthermore, during the gasification process the use of steam increase the gasification of char produced by the first pyrolysis/devolatilization process of the plastic particles. The bed inventory can be made with particles having catalytic properties such as olivine, capable to catalyse the steam reforming reactions of heavy hydrocarbons normally called tars, with a consequent increase in the quantity of gases produced. The plant is composed of a fluidized bed reactor made of AISI 310 steel, having an internal diameter of 0.1 m, containing 3 kg of olivine particles as a bed inventory. The reactor is externally heated by an oven up to 1000 °C. The hot producer gases that exit the reactor, after being cooled, are quantified using a mass flow meter. Gas analyzers are present to measure instantly the volumetric composition of H₂, CO, CO₂, CH₄ and NH₃. At the conference, the results obtained from the continuous gasification of polypropylene (PP) particles in a steam atmosphere at temperatures of 840-860 °C will be presented.

Keywords: gasification, fluidized bed, hydrogen, olivine, polypropyle

Procedia PDF Downloads 27