Search results for: early childhood education and care
2168 Microalbuminuria in Patients with Hypertension Visiting Tertiary Care Centre, Western Nepal
Authors: Binaya Tamang, Buddhi R. Pokharel, Narayan Gautam, Puspa R. Dhakal, Yuresh Twayana
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Background and Objective: Microalbuminuria is often regarded as a sign of end-organ damage due to hypertension, with an increased risk for renal diseases. The present study was designed to find the prevalence of microalbuminuria in hypertensive patients by determining albumin creatinine ratio (ACR) and the association of ACR and microalbuminuria status with different stages and duration of hypertension (HTN). Also, to establish the correlation of systolic and diastolic blood pressure (SBP and DBP) with various parameters viz; ACR, urinary microalbumin (UMA), estimated glomerular filtration rate (eGFR), urinary creatinine (Ucreat), serum creatinine (Screat), and find out their significance among HTN and ACR status. Materials and Methods: A hospital-based cross-sectional study was conducted in the Department of Biochemistry in collaboration with the Department of Internal Medicine, UCMS, Bhairahawa, Nepal from April 2019 to September 2019 after obtaining ethical approval from institutional review committee (IRC), UCMS. A total of 120 hypertensive patients were enrolled whose blood, and spot urine samples were taken. eGFR was calculated by using Cockcroft-Gault formula after determining Screat while ACR was calculated after measuring Ucreat and UMA from the spot urine sample. Creatinine was estimated from modified jaffes’ reaction, whereas urinary micro albumin was done by Mispa i3 analyzer. Data were analyzed by using SPSS. 20 using p-value ≤ 0.05 as statistically significant. Results: In our study, the highest enrolled were grade II HTN (36.7%) followed by normal (33.3%), grade I (20.8%) and grade III (9.2%). Evaluating the ACR status, 19.2% were microalbuminuria, and the rest were normal. Though the ACR status (normal and microalbuminuria) was not statistically significant with HTN status (P=0.860) and the duration of HTN status (P=0.165), 5 (45.5%) out of 11 grade III HTN were microalbuminuria and the prevalence was also higher for longer duration .i.e., more than 10 years. In microalbuminuria, both the SBP (p=0.023, r=0.471) and DBP (P=0.034, r= 0.444) were strongly and positively correlated with Screat, in contrast to eGFR, which was negatively but weakly correlated. With the significant difference between the HTN group, the mean ACR (P=0.047) and UMA (P=0.02) were found to be highest among grade III patients, i.e., 84.3 ± 113.3 mg/gm. and 88.4 ± 83.9 mg/l respectively. The mean eGFR (64.2 ± 24.8 vs 77.2 ± 18.1 ml/min) was considerably lower in microalbuminuria ( p=0.026) than the normal in contrast to the SBP (160 ± 33.7 vs. 146.6 ± 19.5 mm of Hg) which was significantly higher (P=0.008). Among the different BMI category, the mean ACR was found to be significantly different (P= 0.01) with the highest value in underweight (115.2 ± 51.5 mg/gm.) and lowest in overweight (31.8 ± 4.3 mg/gm.). Conclusion: The study recommends that the microalbuminuria can be a very useful and imperative predictor of deranged kidney functions in hypertensive patients. The high value of ACR and UMA in hypertensive patients along with significant increased Screat, SBP whereas decreased eGFR in microalbuminuria patients explicitly supports the above statement.Keywords: albumin creatinine ratio, hypertension, microalbuminuria, renal disease
Procedia PDF Downloads 1372167 “It Takes a Community to Save a Child”: A Qualitative Analysis of Child Trafficking Interventions from Practitioner Perspectives
Authors: Crispin Rakibu Mbamba
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Twenty-two years after the adoption of the United Nation Trafficking Protocol, evidence suggest that child trafficking continues to rise. Community level factors, like poverty which creates the conditions for children’s vulnerability is key to the rise in trafficking cases in Ghana. Albeit, growing evidence suggestthat despite the vulnerabilities, communities have the capacity to prevent and address child trafficking issues. This study contributes to this positive agenda by exploring the ways in which communities (and the key actors) in Ghana contribute to child trafficking interventions.The study objective is explored through in-depth interviews with practitioners (including social workers) from an organization working in trafficking hotspots in Ghana. Interviews wereanalyzed thematically with the help of HyperRESEARCH software. From the in-depth interviews, three themes were identified as the ways in which communities are involved in child trafficking interventions: 1) engagement of community leaders, 2) community-led anti-trafficking committees and 3) knowledge about trafficking. Albeit the cultural differences, evidence on the instrumental role of community chiefs and leaders provide important learning on how to harness trafficking intervention measures and ensure better child protection practices. Based on the findings, we recommend the need to intensify trafficking awareness campaigns in rural communities where education is lacking to contribute to United Nations (UN) promoting Just, Peaceful and Inclusive societies’ mandate.Keywords: child trafficking, community interventions, knowledge on trafficking, human trafficking intervention
Procedia PDF Downloads 1192166 Telemedicine Versus Face-to-Face Follow up in General Surgery: A Randomized Controlled Trial
Authors: Teagan Fink, Lynn Chong, Michael Hii, Brett Knowles
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Background: Telemedicine is a rapidly advancing field providing healthcare to patients at a distance from their treating clinician. There is a paucity of high-quality evidence detailing the safety and acceptability of telemedicine for postoperative outpatient follow-up. This randomized controlled trial – conducted prior to the COVID 19 pandemic – aimed to assess patient satisfaction and safety (as determined by readmission, reoperation and complication rates) of telephone compared to face-to-face clinic follow-up after uncomplicated general surgical procedures. Methods: Patients following uncomplicated laparoscopic appendicectomy or cholecystectomy and laparoscopic or open umbilical or inguinal hernia repairs were randomized to a telephone or face-to-face outpatient clinic follow-up. Data points including patient demographics, perioperative details and postoperative outcomes (eg. wound healing complications, pain scores, unplanned readmission to hospital and return to daily activities) were compared between groups. Patients also completed a Likert patient satisfaction survey following their consultation. Results: 103 patients were recruited over a 12-month period (21 laparoscopic appendicectomies, 65 laparoscopic cholecystectomies, nine open umbilical hernia repairs, six laparoscopic inguinal hernia repairs and two laparoscopic umbilical hernia repairs). Baseline patient demographics and operative interventions were the same in both groups. Patient or clinician-reported concerns on postoperative pain, use of analgesia, wound healing complications and return to daily activities at clinic follow-up were not significantly different between the two groups. Of the 58 patients randomized to the telemedicine arm, 40% reported high and 60% reported very high patient satisfaction. Telemedicine clinic mean consultation times were significantly shorter than face-to-face consultation times (telemedicine 10.3 +/- 7.2 minutes, face-to-face 19.2 +/- 23.8 minutes, p-value = 0.014). Rates of failing to attend clinic were not significantly different (telemedicine 3%, control 6%). There was no increased rate of postoperative complications in patients followed up by telemedicine compared to in-person. There were no unplanned readmissions, return to theatre, or mortalities in this study. Conclusion: Telemedicine follow-up of patients undergoing uncomplicated general surgery is safe and does not result in any missed diagnosis or higher rates of complications. Telemedicine provides high patient satisfaction and steps to implement this modality in inpatient care should be undertaken.Keywords: general surgery, telemedicine, patient satisfaction, patient safety
Procedia PDF Downloads 1212165 The Socioeconomic and Moral Impacts of the Syrian Refugees to Turkey
Authors: Inci Aksu Kargin
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The civil war which began in the Daraa province of Syria in March 2011, has caused thousands of Syrians to die and millions more to seek refuge in other countries such as Turkey, Lebanon, Jordan, Iraq, and Egypt. In order to understand the Syrian refugees’ living conditions and the problems they have experienced in Turkey in-depth, and to analyze how the arrival of the Syrian refugees in Turkey has affected the local people who live in Turkish-Syrian border, this study employed interviews, which were conducted with three different groups. First, 60 Syrian refugees, who have settled in Hatay and Gaziantep, were interviewed. Then, the Turkish government institutions, and NGOs, which are responsible for assisting the refugees, were interviewed. These interviews revealed that many Syrian refugees have encountered with several issues such as access to labor and housing markets as well as free healthcare and public education services. Second, 60 Turkish citizens living in Hatay and Gaziantep provinces were interviewed. These interviews shed light on the many issues (e.g., increase of unemployment, increase in the rental and sale prices of the houses, decrease in the quality of healthcare services, increase in traffic problems, problems with regard to the usage of parks and gardens) that Turkish citizens began experiencing after mass asylum claim of the Syrian refugees to Turkey. In addition to these, the existing social problems in Turkey such as child labor, begging, child brides, and illegal marriages (religious marriages) worsen.Keywords: migration, refugees, Syrian civil war, Turkey
Procedia PDF Downloads 2882164 Teaching Ethical Behaviour: Conversational Analysis in Perspective
Authors: Nikhil Kewalkrishna Mehta
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In the past researchers have questioned the effectiveness of ethics training in higher education. Also, there are observations that support the view that ethical behaviour (range of actions)/ethical decision making models used in the past make use of vignettes to explain ethical behaviour. The understanding remains in the perspective that these vignettes play a limited role in determining individual intentions and not actions. Some authors have also agreed that there are possibilities of differences in one’s intentions and actions. This paper makes an attempt to fill those gaps by evaluating real actions rather than intentions. In a way this study suggests the use of an experiential methodology to explore Berlo’s model of communication as an action along with orchestration of various principles. To this endeavor, an attempt was made to use conversational analysis in the pursuance of evaluating ethical decision making behaviour among students and middle level managers. The process was repeated six times with the set of an average of 15 participants. Similarities have been observed in the behaviour of students and middle level managers that calls for understanding that both the groups of individuals have no cognizance of their actual actions. The deliberations derived out of conversation were taken a step forward for meta-ethical evaluations to portray a clear picture of ethical behaviour among participants. This study provides insights for understanding demonstrated unconscious human behaviour which may fortuitously be termed both ethical and unethical.Keywords: ethical behaviour, unethical behavior, ethical decision making, intentions and actions, conversational analysis, human actions, sensitivity
Procedia PDF Downloads 2542163 The Impact of Breast Cancer Diagnosis on Omani Women
Authors: H. Al-Awaisi, M. H. Al-Azri, S. Al-Rasbi, M. Al-Moundhri
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Breast cancer is the most common cancer among females worldwide. It is also the most common cancer among females in Oman with 100 new breast cancer cases diagnosed every year. It has been found that breast cancer have a devastating effect on women’s life. Women diagnosed with breast cancer might develop negative attitudes towards the illness and their bodies. They might also suffer from psychological ailments such as depression. Despite the evidence on the impact of breast cancer diagnosis on women, there was no study found to explore the impact of breast cancer diagnosis among women in Oman. A phenomenological qualitative study was conducted to explore the impact of breast cancer diagnosis on Omani women. Data was collected through semi-structured individual interviews with 11 Omani women diagnosed with breast cancer. Interviews were transcribed verbatim and data were analyzed thematically. From the data, there are four main themes identified in relation to the impact of cancer diagnosis on Omani women. These are 'shock and disbelieve', 'a death sentence', “uncertain future” and “social stigma”. At the time of interviews, all participants had advanced breast cancer with some participants having metastatic disease. The impact of the word “cancer” had a profound and catastrophic effect on the women and their close relatives. In conclusion, breast cancer diagnosis was shocking and mainly perceived as a death sentence by Omani women with uncertain future and social stigma. Regardless of age, maternal status and education level, it is evident that Omani women participated in this study lacked awareness about breast cancer diagnosis, treatment and prognosis.Keywords: breast cancer, coping, diagnosis, Oman, women
Procedia PDF Downloads 5092162 A Comparative Analysis of Social Stratification in the Participation of Women in Agricultural Activity: A Case Study of District Khushab (Punjab) and D. I. Khan (KPK), Pakistan
Authors: Sohail Ahmad Umer
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Since last few decades a question is raising on the subject of the importance of women in different societies of the world particularly in the developing societies of Asia and Africa. Female population constitutes almost 50% of the total population of the world and is playing a significant role in the economy with male population. In Pakistan, a developing country of Asia with majority of Muslim population, working women role is more focused. Women of rural background who are working as voluntary workers and their working hours are neither recorded nor recognized. Agricultural statistics shows that the female participation rate is below 40% while other sources claim them below 20%. Here in present study, another effort has been made to compare the women role in two different provinces of Pakistan to analyze the participation of women in agricultural activities like sowing, picking, irrigating the fields, harvesting and threshing of crops, caring and feeding of the animals, collecting the firewood and etc,as without these activities the farming would be incomplete. One hundred villages in the district Khushab (Punjab) and one hundred villages in district D.I.Khan (KPK) were selected and 33% of the families of each village have been interviewed to study their input in agriculture work. Another important feature is the social stratification therefore the contribution by different variables like the ownership, tenancy, education and caste has also been studied.Keywords: caste, social stratification, tenancy, voluntary workers
Procedia PDF Downloads 3762161 Perceived Self-Efficacy of Children with Characteristics of Giftedness
Authors: Cristina Costa-Lobo, Ana Medeiros, Ana Campina
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This study refers to the appropriateness of the psychopedagogical intervention programs focused on the adjustment and psychological well-being of children with characteristics of giftedness and the interests of promoting specialized and permanent follow-up to these children. It was intended to find out the impact on perceived self-efficacy in children with characteristics of giftedness after the frequency of a psychopedagogical intervention program. For this was applied to Multidimensional Scale Perceived Self-Efficacy, in two times (pre and post program frequency), in a quasi-experimental design. Innovative data are presented in reports to the relationship of perceived self-efficacy with giftedness, highlighting the evidence of this program focusing on the development of personal, social and emotional skills, applied to 20 children with characteristics of giftedness, in Northern Portugal, in the 2014-2015 school year, have no influence on perceived self-efficacy of children with characteristics of giftedness. The main implication of this research is congruent with the conclusions of studies that point that the greatest challenge in the education of children with characteristics of giftedness is to extend the traditional investment in intellectual production and creative capital to include an equal investment in social capital and the development of competencies of executive functions, dimensions that development programs stimulate. This study appeals to the need of children with characteristics of giftedness to be targets of psychopedagogical intervention programs with the constant specialization and constant updating of the knowledge of the professionals who work with them, motivated by being individuals with such specific and ever-changing characteristics reflecting an inclusive school life.Keywords: giftedness, perceived self-efficacy, EMAEP, psychopedagogical intervention programs
Procedia PDF Downloads 2812160 Gait Analysis in Total Knee Arthroplasty
Authors: Neeraj Vij, Christian Leber, Kenneth Schmidt
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Introduction: Total knee arthroplasty is a common procedure. It is well known that the biomechanics of the knee do not fully return to their normal state. Motion analysis has been used to study the biomechanics of the knee after total knee arthroplasty. The purpose of this scoping review is to summarize the current use of gait analysis in total knee arthroplasty and to identify the preoperative motion analysis parameters for which a systematic review aimed at determining the reliability and validity may be warranted. Materials and Methods: This IRB-exempt scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist strictly. Five search engines were searched for a total of 279 articles. Articles underwent a title and abstract screening process followed by full-text screening. Included articles were placed in the following sections: the role of gait analysis as a research tool for operative decisions, other research applications for motion analysis in total knee arthroplasty, gait analysis as a tool in predicting radiologic outcomes, gait analysis as a tool in predicting clinical outcomes. Results: Eleven articles studied gait analysis as a research tool in studying operative decisions. Motion analysis is currently used to study surgical approaches, surgical techniques, and implant choice. Five articles studied other research applications for motion analysis in total knee arthroplasty. Other research applications for motion analysis currently include studying the role of the unicompartmental knee arthroplasty and novel physical therapy protocols aimed at optimizing post-operative care. Two articles studied motion analysis as a tool for predicting radiographic outcomes. Preoperative gait analysis has identified parameters than can predict postoperative tibial component migration. 15 articles studied motion analysis in conjunction with clinical scores. Conclusions: There is a broad range of applications within the research domain of total knee arthroplasty. The potential application is likely larger. However, the current literature is limited by vague definitions of ‘gait analysis’ or ‘motion analysis’ and a limited number of articles with preoperative and postoperative functional and clinical measures. Knee adduction moment, knee adduction impulse, total knee range of motion, varus angle, cadence, stride length, and velocity have the potential for integration into composite clinical scores. A systematic review aimed at determining the validity, reliability, sensitivities, and specificities of these variables is warranted.Keywords: motion analysis, joint replacement, patient-reported outcomes, knee surgery
Procedia PDF Downloads 972159 Circular Labour Migration and Its Consequences in Georgia
Authors: Manana Lobzhanidze
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Introduction: The paper will argue that labor migration is the most important problem Georgia faces today. The structure of labor migration by age and gender of Georgia is analyzed. The main driving factors of circular labor migration during the last ten years are identified. While studying migration, it is necessary to discuss the interconnection of economic, social, and demographic features, also taking into consideration the policy of state regulations in terms of education and professional training. Methodology: Different research methods are applied in the presented paper: statistical, such as selection, grouping, observation, trend, and qualitative research methods, namely; analysis, synthesis, induction, deduction, comparison ones. Main Findings: Labour migrants are filling the labor market as a low salary worker. The main positive feedback of migration from developing countries is poverty eradication, but this process is accompanied by problems, such as 'Brain Drain'. The country loses an important part of its intellectual potential, and it is invested by households or state itself. Conclusions: Labor migration is characterized to be temporary, but socio-economic problems of the country often push the labor migration in the direction of longterm and illegal migration. Countries with developed economies try to stricter migration policy and fight illegal migration with different methods; circular migration helps solve this problem. Conclusions and recommendations are included about circular labor migration consequences in Georgia and its influence on the reduction of unemployment level.Keywords: migration, circular labor migration, labor migration employment, unemployment
Procedia PDF Downloads 1842158 Building a Transformative Continuing Professional Development Experience for Educators through a Principle-Based, Technological-Driven Knowledge Building Approach: A Case Study of a Professional Learning Team in Secondary Education
Authors: Melvin Chan, Chew Lee Teo
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There has been a growing emphasis in elevating the teachers’ proficiency and competencies through continuing professional development (CPD) opportunities. In this era of a Volatile, Uncertain, Complex, Ambiguous (VUCA) world, teachers are expected to be collaborative designers, critical thinkers and creative builders. However, many of the CPD structures are still revolving in the model of transmission, which stands in contradiction to the cultivation of future-ready teachers for the innovative world of emerging technologies. This article puts forward the framing of CPD through a Principle-Based, Technological-Driven Knowledge Building Approach grounded in the essence of andragogy and progressive learning theories where growth is best exemplified through an authentic immersion in a social/community experience-based setting. Putting this Knowledge Building Professional Development Model (KBPDM) in operation via a Professional Learning Team (PLT) situated in a Secondary School in Singapore, research findings reveal that the intervention has led to a fundamental change in the learning paradigm of the teachers, henceforth equipping and empowering them successfully in their pedagogical design and practices for a 21st century classroom experience. This article concludes with the possibility in leveraging the Learning Analytics to deepen the CPD experiences for educators.Keywords: continual professional development, knowledge building, learning paradigm, principle-based
Procedia PDF Downloads 1352157 Socioeconomic Status and Mortality in Older People with Angina: A Population-Based Cohort Study in China
Authors: Weiju Zhou, Alex Hopkins, Ruoling Chen
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Background: China has increased the gap in income between richer and poorer over the past 40 years, and the number of deaths from people with angina has been rising. It is unclear whether socioeconomic status (SES) is associated with increased mortality in older people with angina. Methods: Data from a cohort study of 2,380 participants aged ≥ 65 years, who were randomly recruited from 5-province urban communities were examined in China. The cohort members were interviewed to record socio-demographic and risk factors and document doctor-diagnosed angina at baseline and were followed them up in 3-10 years, including monitoring vital status. Multivariate Cox regression models were employed to examine all-cause mortality in relation to low SES. Results: The cohort follow-up identified 373 deaths occurred; 41 deaths in 208 angina patients. Compared to participants without angina (n=2,172), patients with angina had increased mortality (multivariate adjusted hazard ratio (HR) was 1.41, 95% CI 1.01-1.97). Within angina patients, the risk of mortality increased with low satisfactory income (2.51, 1.08-5.85) and having financial problem (4.00, 1.07-15.00), but significantly with levels of education and occupation. In non-angina participants, none of these four SES indicators were associated with mortality. There was a significant interaction effect between angina and low satisfactory income on mortality. Conclusions: In China, having low income and financial problem increase mortality in older people with angina. Strategies to improve economic circumstances in older people could help reduce inequality in angina survival.Keywords: angina, mortality, older people, socio-economic status
Procedia PDF Downloads 1212156 Blended Intensive Programmes: A Way Forward to Promote Internationalization in Higher Education
Authors: Sonja Gögele, Petra Kletzenbauer
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International strategies are ranked as one of the core activities in the development plans of Austrian universities. This has led to numerous promising activities in terms of internationalization (i.e. development of international degree programmes, increased staff and student mobility, and blended international projects). The latest innovative approach in terms of Erasmus+ are so called Blended Intensive Programmes (BIP) which combine jointly delivered teaching and learning elements of at least three participating ERASMUS universities in a virtual and short-term mobility setup. Students who participate in BIP can maintain their study plans at their home institution and include BIP as a parallel activity. This paper presents the experiences of this programme on the topic of sustainable computing hosted by the University of Applied Sciences FH JOANNEUM. By means of an online survey and face-to-face interviews with all stakeholders (20 students, 8 professors), the empirical study addresses the challenges of hosting an international blended learning programme (i.e. virtual phase and on-site intensive phase) and discusses the impact of such activities in terms of internationalization and Englishization. In this context, key roles are assigned to the development of future transnational and transdisciplinary curricula by considering innovative aspects for learning and teaching (i.e. virtual collaboration, research-based learning).Keywords: internationalization, englishization, short-term mobility, international teaching and learning
Procedia PDF Downloads 1212155 The Impact of Teacher's Emotional Intelligence on Students' Motivation to Learn
Authors: Marla Wendy Spergel
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The purpose of this qualitative study is to showcase graduated high school students’ to voice on the impact past teachers had on their motivation to learn, and if this impact has affected their post-high-school lives. Through a focus group strategy, 21 graduated high school alumni participated in three separate focus groups. Participants discussed their former teacher’s emotional intelligence skills, which influenced their motivation to learn or not. A focused review of the literature revealed that teachers are a major factor in a student’s motivation to learn. This research was guided by Bandura’s Social Cognitive Theory of Motivation and constructs related to learning and motivation from Carl Rogers’ Humanistic Views of Personality, and from Brain-Based Learning perspectives with a major focus on the area of Emotional Intelligence. Findings revealed that the majority of participants identified teachers who most motivated them to learn and demonstrated skills associated with emotional intelligence. An important and disturbing finding relates to the saliency of negative experiences. Further work is recommended to expand this line of study in Higher Education, perform a long-term study to better gain insight into long-term benefits attributable to experiencing positive teachers, study the negative impact teachers have on students’ motivation to learn, specifically focusing on student anxiety and acquired helplessness.Keywords: emotional intelligence, learning, motivation, pedagogy
Procedia PDF Downloads 1592154 BEATRICE: A Low-Cost Manipulator Arm for an Educational Planetary Rover
Authors: T. Pakulski, L. Kryza, A. Linossier
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The BEar Articulated TeleRobotic Inspection and Clasping Extremity is a lightweight, 5 DoF robotic manipulator for the Berlin Educational Assistant Rover (BEAR). BEAR is one of the educational planetary rovers developed under the Space Rover projects at the Chair of Space Technology of the Technische Universität Berlin. The projects serve to conduct research and train engineers by developing rovers for competitions like the European Rover Challenge and the DLR SpaceBot Cup. BEATRICE is the result of a cost-driven design process to deliver a simple but capable platform for a variety of competition tasks: object grasping and manipulation, inspection, instrument wielding and more. The manipulator’s simple mechatronic design, based on a combination of servomotors and stepper motors with planetary gearboxes, also makes it a practical tool for developing embedded control systems. The platform’s initial implementation relies on tele-operated control but is fully instrumented for future autonomous functionality. This paper describes BEATRICE’s development from its preliminary link model to its structural and mechatronic design, embedded control and AI and T. In parallel, it examines the influence of budget constraints and high personnel turnover commonly associated with student teams on the manipulator’s design. Finally, it comments on the utility of robot design projects for educating future engineers.Keywords: education, low-cost, manipulator, robotics, rover
Procedia PDF Downloads 2582153 Prevalence of Caesarean-Section Delivery and Its Determinants in India: Evidence for Fifth National Family Health Surveys
Authors: Daisy Saikia
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Long-term maternal health issues with Caesarean section deliveries are significant. Thus, this study aims to investigate the prevalence of caesarean section deliveries in India and to comprehend its associated predictors in light of the high caesarean section delivery rate. The study uses data from the fifth National Family Health Surveys (NFHS-5) round. Specifically, live births to women aged 15-49 in the 5 years preceding the survey. Binary logistic regression was used to check the adjusted effects of the predictor variables on caesarean section delivery. STATA/SE v16.0 was used for the data analysis with a 5% significance level. Twenty-two per cent of the live births to women were delivered by caesarean section. There was socio-economic, demographic and geographical variation in the prevalence of caesarean section delivery in India. Increasing age, body mass index, marital status, mother’s occupation and education, birth order, place of delivery, full ANC, non-tribal status, wealth quintile and region are significantly associated with caesarean section deliveries in India. Caesarean section deliveries should only be performed when essential from a medical perspective, and regions, where the rate is too high, should follow the guidelines. Additionally, it needs to be investigated whether private hospitals compel patients to have caesarean section deliveries to increase their revenue. Thus, these unnecessary deliveries must be examined immediately for safe childbirth and the wellness of both mother and child.Keywords: caesarean section, delivery, maternal health, India
Procedia PDF Downloads 842152 Rural Education in Saudi Arabia School Leaders’ and Teachers’ Experiences and Perceptions
Authors: Emad Matar Alotaibi
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In line with other Arabic countries, Saudi Arabia is currently undergoing large scale school reform in response to key factors brought about by globalization. While there is a growing body of research exploring these systemic changes in urban environments, there is very little published research regarding rural schools. In fact, rural schools are still under-examined globally comparing to their urban and suburban counterparts over a range of reform dimensions. In Saudi Arabia, there are around 1128 rural areas that contain about 3200 schools. Several challenges face rural schools, especially in relation to recruitment, retention, and professional development opportunities for teachers and school leaders. However, there is very little in depth research which explores these issues “on the ground”. The aim of this research is fill this knowledge gap and explore teachers’ and leaders’ perceptions and experiences of working in rural schools in KSA. In Saudi Arabia, there is a growing body of research into school leadership. However, there is very little published research specifically exploring rural schools. By using an in-depth case study approach and adopting an analytical framework based on the interlinking concepts of leadership practices, culture, and CPD, this study offers and significant and original contribution to knowledge in this area. This study also will adopt a qualitative multiple case studies, which is going to employ semi-structured interviews, focus groups, and documentary analysis.Keywords: leadership practice, school culture, continuing professional development, rural school
Procedia PDF Downloads 842151 Enhance Concurrent Design Approach through a Design Methodology Based on an Artificial Intelligence Framework: Guiding Group Decision Making to Balanced Preliminary Design Solution
Authors: Loris Franchi, Daniele Calvi, Sabrina Corpino
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This paper presents a design methodology in which stakeholders are assisted with the exploration of a so-called negotiation space, aiming to the maximization of both group social welfare and single stakeholder’s perceived utility. The outcome results in less design iterations needed for design convergence while obtaining a higher solution effectiveness. During the early stage of a space project, not only the knowledge about the system but also the decision outcomes often are unknown. The scenario is exacerbated by the fact that decisions taken in this stage imply delayed costs associated with them. Hence, it is necessary to have a clear definition of the problem under analysis, especially in the initial definition. This can be obtained thanks to a robust generation and exploration of design alternatives. This process must consider that design usually involves various individuals, who take decisions affecting one another. An effective coordination among these decision-makers is critical. Finding mutual agreement solution will reduce the iterations involved in the design process. To handle this scenario, the paper proposes a design methodology which, aims to speed-up the process of pushing the mission’s concept maturity level. This push up is obtained thanks to a guided negotiation space exploration, which involves autonomously exploration and optimization of trade opportunities among stakeholders via Artificial Intelligence algorithms. The negotiation space is generated via a multidisciplinary collaborative optimization method, infused by game theory and multi-attribute utility theory. In particular, game theory is able to model the negotiation process to reach the equilibria among stakeholder needs. Because of the huge dimension of the negotiation space, a collaborative optimization framework with evolutionary algorithm has been integrated in order to guide the game process to efficiently and rapidly searching for the Pareto equilibria among stakeholders. At last, the concept of utility constituted the mechanism to bridge the language barrier between experts of different backgrounds and differing needs, using the elicited and modeled needs to evaluate a multitude of alternatives. To highlight the benefits of the proposed methodology, the paper presents the design of a CubeSat mission for the observation of lunar radiation environment. The derived solution results able to balance all stakeholders needs and guaranteeing the effectiveness of the selection mission concept thanks to its robustness in valuable changeability. The benefits provided by the proposed design methodology are highlighted, and further development proposed.Keywords: concurrent engineering, artificial intelligence, negotiation in engineering design, multidisciplinary optimization
Procedia PDF Downloads 1402150 The Impacts of the COVID-19 Pandemic on Social Activities and Residential Areas
Authors: Asghar Motea Noparvar
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According to the World Health Organization (WHO), the coronavirus disease (COVID-19), which has been characterized as a pandemic since December 2019, is attacking societies in terms of different ways. It means that this is much more than a crisis that is related to human health. It is a human, economic and social crisis. Since December 2019, not only some significant transformations have happened in human life, but also there has been some mental health, daily life activities, and even urban space changes. The purpose of this study is to mention some tangible transformations in society by applying two main restrictions such as “lock down” and “social distancing,” and how people took refuge in their homes and fit every activity there. How this pandemic has been transforming human life and social activities is the main issue of this study. In order to gather the information, review the impacts of COVID-19 on social life by revising the literature and considering the “Risk Society” theory, which is gotten credited by a German sociologist, Ulrich Beck. Additionally, COVID-19 not only had a direct impact on health but also had significant impacts on the economy, education, tourism, the environment, and the construction industry. Therefore, the pandemic caused a disruption in the whole urban system. In this study, the main focused point is the transformation of activities and residential areas. In order to achieve this finding, the literature review is analyzed in the case of COVID-19 and its impacts on social life. To sum up, it can be concluded that a pandemic can change social life along with other transformations that it is able to do.Keywords: infectious disease, COVID-19, social activities, residential areas, transformation
Procedia PDF Downloads 932149 A Study on the Application of Generative AI Tools for Chinese Writing Feedback in Non-Fiction Writing Instruction
Authors: Stephanie Liu Lu
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The course "University Chinese," an essential component of the curriculum in Hong Kong's higher education institutions, plays a crucial role in enhancing students' creative expression, narrative construction, argumentative prowess, and literary skills through its focus on non-fiction writing. Despite its significance, the comprehensive syllabus, coupled with limited classroom time, often restricts adequate practice opportunities and leads to delayed feedback, negatively impacting students' preparation for assessments. This paper investigates the potential of generative artificial intelligence (AI) tools, such as ChatGPT and POE, to provide personalized and immediate feedback for writing tasks. The primary goal of this research is to evaluate student receptiveness to AI-generated feedback and compare it to traditional feedback provided solely by human instructors. To achieve this, participants will be systematically divided into two groups: one receiving feedback from both instructors and AI tools, and a control group that receives feedback exclusively from instructors. The study will thoroughly analyze the revisions made to texts after receiving feedback, focusing particularly on enhancements in the quality of content and language proficiency across three dimensions: content/theme, language, and structural logic. This investigation aims to determine whether AI tools can enhance the efficiency of teaching practices, encourage autonomous learning, and significantly improve the overall quality of students' written work.Keywords: AI-generated feedback, Chinese writing, non-fiction writing, student receptiveness
Procedia PDF Downloads 82148 Using Lysosomal Immunogenic Cell Death to Target Breast Cancer via Xanthine Oxidase/Micro-Antibody Fusion Protein
Authors: Iulianna Taritsa, Kuldeep Neote, Eric Fossel
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Lysosome-induced immunogenic cell death (LIICD) is a powerful mechanism of targeting cancer cells that kills circulating malignant cells and primes the host’s immune cells against future remission. Current immunotherapies for cancer are limited in preventing recurrence – a gap that can be bridged by training the immune system to recognize cancer neoantigens. Lysosomal leakage can be induced therapeutically to traffic antigens from dying cells to dendritic cells, which can later present those tumorigenic antigens to T cells. Previous research has shown that oxidative agents administered in the tumor microenvironment can initiate LIICD. We generated a fusion protein between an oxidative agent known as xanthine oxidase (XO) and a mini-antibody specific for EGFR/HER2-sensitive breast tumor cells. The anti-EGFR single domain antibody fragment is uniquely sourced from llama, which is functional without the presence of a light chain. These llama micro-antibodies have been shown to be better able to penetrate tissues and have improved physicochemical stability as compared to traditional monoclonal antibodies. We demonstrate that the fusion protein created is stable and can induce early markers of immunogenic cell death in an in vitro human breast cancer cell line (SkBr3). Specifically, we measured overall cell death, as well as surface-expressed calreticulin, extracellular ATP release, and HMGB1 production. These markers are consensus indicators of ICD. Flow cytometry, luminescence assays, and ELISA were used respectively to quantify biomarker levels between treated versus untreated cells. We also included a positive control group of SkBr3 cells dosed with doxorubicin (a known inducer of LIICD) and a negative control dosed with cisplatin (a known inducer of cell death, but not of the immunogenic variety). We looked at each marker at various time points after cancer cells were treated with the XO/antibody fusion protein, doxorubicin, and cisplatin. Upregulated biomarkers after treatment with the fusion protein indicate an immunogenic response. We thus show the potential for this fusion protein to induce an anticancer effect paired with an adaptive immune response against EGFR/HER2+ cells. Our research in human cell lines here provides evidence for the success of the same therapeutic method for patients and serves as the gateway to developing a new treatment approach against breast cancer.Keywords: apoptosis, breast cancer, immunogenic cell death, lysosome
Procedia PDF Downloads 2012147 Influencing Factors for Job Satisfaction and Turnover Intention of Surgical Team in the Operating Rooms
Authors: Shu Jiuan Chen, Shu Fen Wu, I. Ling Tsai, Chia Yu Chen, Yen Lin Liu, Chen-Fuh Lam
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Background: Increased emotional stress in workplace and depressed job satisfaction may significantly affect the turnover intention and career life of personnel. However, very limited studies have reported the factors influencing the turnover intention of the surgical team members in the operating rooms, where extraordinary stress is normally exit in this isolated medical care unit. Therefore, this study aimed to determine the environmental and personal characteristic factors that might be associated with job satisfaction and turnover intention in the non-physician staff who work in the operating rooms. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses, nurse anesthetists, surgeon assistants, orderly and other non-physician staff. Numerical and categorical data were analyzed using unpaired t-test and Chi-square test, as appropriate (SPSS, version 20.0). Results: A total of 167 effective questionnaires were collected from 200 eligible, non-physician personnel who worked in the operating room (response rate 83.5%). The overall satisfaction of all responders was 45.64 ± 7.17. In comparison to those who had more than 4-year working experience in the operating rooms, the junior staff ( ≤ 4-year experience) reported to have significantly higher satisfaction in workplace environment and job contentment, as well as lower intention to quit (t = 6.325, P =0.000). Among the different specialties of surgical team members, nurse anesthetists were associated with significantly lower levels of job satisfaction (P=0.043) and intention to stay (x² = 8.127, P < 0.05). Multivariate regression analysis demonstrates job title, seniority, working shifts and job satisfaction are the significant independent predicting factors for quit jobs. Conclusion: The results of this study highlight that increased work seniorities ( > 4-year working experience) are associated with significantly lower job satisfaction, and they are also more likely to leave their current job. Increased workload in supervising the juniors without appropriate job compensation (such as promotions in job title and work shifts) may precipitate their intention to quit. Since the senior staffs are usually the leaders and core members in the operating rooms, the retention of this fundamental manpower is essential to ensure the safety and efficacy of surgical interventions in the operating rooms.Keywords: surgical team, job satisfaction, resignation intention, operating room
Procedia PDF Downloads 2552146 The Development of Explicit Pragmatic Knowledge: An Exploratory Study
Authors: Aisha Siddiqa
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The knowledge of pragmatic practices in a particular language is considered key to effective communication. Unlike one’s native language where this knowledge is acquired spontaneously, more conscious attention is required to learn second language pragmatics. Traditional foreign language (FL) classrooms generally focus on the acquisition of vocabulary and lexico-grammatical structures, neglecting pragmatic functions that are essential for effective communication in the multilingual networks of the modern world. In terms of effective communication, of particular importance is knowledge of what is perceived as polite or impolite in a certain language, an aspect of pragmatics which is not perceived as obligatory but is nonetheless indispensable for successful intercultural communication and integration. While learning a second language, the acquisition of politeness assumes more prominence as the politeness norms and practices vary according to language and culture. Therefore, along with focusing on the ‘use’ of politeness strategies, it is crucial to examine the ‘acquisition’ and the ‘acquisitional development’ of politeness strategies by second language learners, particularly, by lower proficiency leaners as the norms of politeness are usually focused in lower levels. Hence, there is an obvious need for a study that not only investigates the acquisition of pragmatics by young FL learners using innovative multiple methods; but also identifies the potential causes of the gaps in their development. The present research employs a cross sectional design to explore the acquisition of politeness by young English as a foreign language learners (EFL) in France; at three levels of secondary school learning. The methodology involves two phases. In the first phase a cartoon oral production task (COPT) is used to elicit samples of requests from young EFL learners in French schools. These data are then supplemented by a) role plays, b) an analysis of textbooks, and c) video recordings of classroom activities. This mixed method approach allows us to explore the repertoire of politeness strategies the learners possess and delve deeper into the opportunities available to learners in classrooms to learn politeness strategies in requests. The paper will provide the results of the analysis of COPT data for 250 learners at three different stages of English as foreign language development. Data analysis is based on categorization of requests developed in CCSARP project. The preliminary analysis of the COPT data shows that there is substantial evidence of pragmalinguistic development across all levels but the developmental process seems to gain momentum in the second half of the secondary school period as compared to the early period at school. However, there is very little evidence of sociopragmatic development. The study aims to document the current classroom practices in France by looking at the development of young EFL learner’s politeness strategies across three levels of secondary schools.Keywords: acquisition, English, France, interlanguage pragmatics, politeness
Procedia PDF Downloads 4272145 Participation of Women in the Brazilian Paralympic Sports
Authors: Ana Carolina Felizardo Da Silva
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People with disabilities are those who have limitations of a physical, mental, intellectual or sensory nature and who, therefore, should not be excluded or marginalized. In Brazil, the Brazilian Law for the Inclusion of People with Disabilities defines that people with disabilities have the right to culture, sport, tourism and leisure on an equal basis with other people. Sport for people with disabilities, in its genesis, had a character aimed at rehabilitating men and soldiers, that is, the male figure who returned wounded from war and needed care. By gaining practitioners, the marketing issue emerges and, successively, high performance, what we call Paralympic sport. We found that sport for people with disabilities was designed for men, corroborating the social idea that sport is a masculine and masculinizing environment. In this way, the inclusion of women with disabilities in sports becomes a double challenge because they are women and have a disability. From data collected from official documents of the International Paralympic Committee, it is found that the first report on the participation of women in the Paralympic Games was in 1948, in England, in Stoke Mandeville, a championship considered the firstborn of the games, later, became called the “Paralympic Games”. However, due to the lack of information, the return of the appearance of women participating in the Paralympics took place after long 40 years, in 1984, which demonstrates a large gap of records on the official website referring to women in the games. Despite the great challenge, the number of women has been growing substantially. When collecting data from participants of all 16 editions of the Paralympic Games, in its last edition, held in Tokyo, out of 4,400 competing athletes, 1,853 were women, which represents 42% of the total number of athletes. In this same edition, we had the largest delegation of Brazilian women, represented by 96 athletes out of a total of 260 Brazilian athletes. It is estimated that in the next edition, to be taken place in Paris in 2024, the participation of women will equal or surpass that of men. The certain invisibility of women participating in the Paralympic Games is noticed when we access the database of the Brazilian Paralympic Committee website. It is possible to identify all women medalists of a given edition. On the other side, participating female athletes who did not medal are not registered on the site. Regarding the participation of Brazilian women in the Paralympics, there was a considerable growth in the last two editions, in 2012 there were only 69 women participating, going to 102 in 2016 and 96 in 2021. The same happened in relation to the medalists, going from 8 Brazilians in 2012 to 33 in 2016 and 27 in 2021. In this sense, the present study, aims to analyze how Brazilian women participate in the Paralympics, giving visibility and voice to female athletes. Structured interviews are being carried out with the participants of the games, identifying the difficulties and potentialities of participating with athletes in the competition. The analysis will be carried out through Bardin’s content analysis.Keywords: paralympics, sport for people with disabilities, woman, woman in sport
Procedia PDF Downloads 812144 Improving Vietnamese High School Students’ Writing Ability Through the Use of Electronic Portfolios
Authors: Du T. Tran, Anh M. N. Nguyen
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Writing skill is one of the productive abilities and plays a vital role in encouraging communication. Although certain hurdles limit students from enhancing their writing skills, the introduction and widespread use of internet technology impact their education significantly. In this context, the research aims to investigate the effects of electronic portfolios (e-portfolios) on English as a foreign language (EFL) high school students’ writing ability, learners’ and instructors’ attitudes towards the use of e-portfolios in writing classes at high schools in Binh Duong province. The sample includes 15 teachers and 300 twelfth graders at 03 high schools in Binh Duong province. Facebook was chosen as an e-portfolio platform where the students created and developed their personal e-portfolios. The data were collected both quantitatively and qualitatively through mixed methods using the tools of a pre-test, a post-test (for students), questionnaires (for both teachers and students), and a semi-structured interview (for teachers in charge of the course). The survey results show that e-portfolios considerably impact EFL high school students writing abilities. The research findings also reveal challenges and technological drawbacks. For the optimal use of e-portfolios in writing courses in particular and for other language courses in general, recommendations are made for school managers, instructors, and learners to optimize the effects and for further research to shed more light on the topicKeywords: attitudes, electronic portfolios, English writing ability, Vietnamese high school students
Procedia PDF Downloads 832143 Poverty Status and Determinants of Income Diversification among Rural Households of Pakistan
Authors: Saba Javed, Abdul Majeed Nadeem, Imran Qaiser, Muhammad Asif Kamran, Azka Amin
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This study is designed to determine the poverty status and determinants of income diversification in rural areas of Pakistan using cross sectional data of Pakistan Social and Living Standards Measurement (PSLM) for 2010-2011. The variables used for measuring income diversification are demographic indicators, poverty status, and income of households. Foster-Greer-Thorbecke (FGT) poverty measures show that 43.1% poor and 56.9% non-poor resided in rural areas of Pakistan. A Tobit model was employed to examine the determinants of livelihood diversification among households. The result showed that age, gender, marital status, household size and province have significant impact on income diversification. The data show that non-poor and female headed household with higher family size diversify more as compared to poor, male headed household with small size of family members. The place of residence (province used as proxy for place) also plays important role for income diversification as Sindh Province was found more diversified as compared to Punjab and Khyber Pakhtoon Kha (KPK). It is recommended to improve the ways of income diversification among rural household to reduce poverty among them. This can be done by more investment in education with universal access for poor and remote localities households.Keywords: poverty, income diversification, rural Pakistan, Tobit regression model, FGT
Procedia PDF Downloads 3572142 In-Plume H₂O, CO₂, H₂S and SO₂ in the Fumarolic Field of La Fossa Cone (Vulcano Island, Aeolian Archipelago)
Authors: Cinzia Federico, Gaetano Giudice, Salvatore Inguaggiato, Marco Liuzzo, Maria Pedone, Fabio Vita, Christoph Kern, Leonardo La Pica, Giovannella Pecoraino, Lorenzo Calderone, Vincenzo Francofonte
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The periods of increased fumarolic activity at La Fossa volcano have been characterized, since early 80's, by changes in the gas chemistry and in the output rate of fumaroles. Excepting the direct measurements of the steam output from fumaroles performed from 1983 to 1995, the mass output of the single gas species has been recently measured, with various methods, only sporadically or for short periods. Since 2008, a scanning DOAS system is operating in the Palizzi area for the remote measurement of the in-plume SO₂ flux. On these grounds, the need of a cross-comparison of different methods for the in situ measurement of the output rate of different gas species is envisaged. In 2015, two field campaigns have been carried out, aimed at: 1. The mapping of the concentration of CO₂, H₂S and SO₂ in the fumarolic plume at 1 m from the surface, by using specific open-path diode tunable lasers (GasFinder Boreal Europe Ltd.) and an Active DOAS for SO₂, respectively; these measurements, coupled to simultaneous ultrasonic wind speed and meteorological data, have been elaborated to obtain the dispersion map and the output rate of single species in the overall fumarolic field; 2. The mapping of the concentrations of CO₂, H₂S, SO₂, H₂O in the fumarolic plume at 0.5 m from the soil, by using an integrated system, including IR spectrometers and specific electrochemical sensors; this has provided the concentration ratios of the analysed gas species and their distribution in the fumarolic field; 3. The in-fumarole sampling of vapour and measurement of the steam output, to validate the remote measurements. The dispersion map of CO₂, obtained from the tunable laser measurements, shows a maximum CO₂ concentration at 1m from the soil of 1000 ppmv along the rim, and 1800 ppmv in the inner slopes. As observed, the largest contribution derives from a wide fumarole of the inner-slope, despite its present outlet temperature of 230°C, almost 200°C lower than those measured at the rim fumaroles. Actually, fumaroles in the inner slopes are among those emitting the largest amount of magmatic vapour and, during the 1989-1991 crisis, reached the temperature of 690°C. The estimated CO₂ and H₂S fluxes are 400 t/d and 4.4 t/d, respectively. The coeval SO₂ flux, measured by the scanning DOAS system, is 9±1 t/d. The steam output, recomputed from CO₂ flux measurements, is about 2000 t/d. The various direct and remote methods (as described at points 1-3) have produced coherent results, which encourage to the use of daily and automatic DOAS SO₂ data, coupled with periodic in-plume measurements of different acidic gases, to obtain the total mass rates.Keywords: DOAS, fumaroles, plume, tunable laser
Procedia PDF Downloads 4002141 Mitigating Climate Change Issues: International Students' Perceptions on Energy Conservation and Effective Transportation
Authors: Indrapriya Kularatne, Olufemi Omisakin
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Climate change mitigation is one of the most complex challenges that humanity has ever faced in the context of global environmental protection. This a multifaceted challenge that needs immediate, targeted and concentrated actions at global, national and local levels. Individual actions play a crucial role in mitigating climate change. New Zealand attracts a significant number of international students annually for higher education. Therefore, it is critical to understand what international students are bringing into the country in terms of their practices for mitigating climate change challenges. This exploratory research aims to investigate international students' perceptions on mitigating climate change issues. The study focuses particularly on the areas of energy conservation and effective transportation. A specific questionnaire was developed covering the areas of energy conserving practices, use of energy efficient products, use of environmentally friendly transportation methods and practices to reduce vehicle usage. The quantitative data was collected from nearly 240 participants using the Qualtrics online system. The research findings provide valuable insights into international students' perceptions of sustainability and environmental protection actions, particularly in the areas of energy conservation and effective transportation. These insights can contribute to ongoing efforts to mitigate climate change issues and promote sustainable development practices in New Zealand.Keywords: climate change, energy conservation, effective transportation, perceptions
Procedia PDF Downloads 692140 'It Is a Sin to Be in Love with a Disabled Woman': Stigma, Rejection and Intersections of Womanhood and Violence among Physically Disabled Women Living in South Africa
Authors: Ingrid Van Der Heijden, Naeemah Abrahams, Jane Harries
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Background: Commonly, womanhood is defined as the qualities considered to be natural to or characteristic of a woman. However, womanhood is not a static concept; it is contextual and negotiable. For women with disabilities, gender roles or ‘qualities’ of womanhood are often overstated or contradicted because of assumptions of weakness, passivity, asexuality and infertility. Currently, little is known about how disability stigma intersects with notions of womanhood to make women with disabilities vulnerable to violence, or how women navigate this intersection to prevent or protect themselves from violence. Objective: To describe how the stigmatized constructions of womanhood and disability promote women with physical disabilities’ exposure to or protection from violence. Methods: Qualitative data for this paper comes from a doctoral study involving women with disabilities living in Cape Town, South Africa. It presents data from repeat in-depth interviews with 30 women with a range of physical impairments. Women attending protective workshops, rehabilitative centers and residential care facilities for people living with disabilities were invited to participate. Consent procedures and interviews were conducted by the first author (who is herself a woman living with a physical disability), and a female research assistant/translator who is a qualified occupational therapist. Reasonable accommodation is central to the methodology and the study as a whole. Findings: Descriptive and thematic analyses reveal how stigma and local constructions around womanhood, as well as women’s self-image and physical limitations, promotes women’s exposure to psychological, physical and sexual violence. It reveals how disabled women feel they are presumed incapable of living up to expectations of a ‘proper’ woman. This plays out as psychological violence, with women reporting that they feel ‘devalued,' ‘rejected’ and deprived of lasting intimate relationships. Furthermore, forms of psychological violence perpetuate physical and sexual violence. Women also discuss using strategies to prevent violence; by refusing to date, avoiding certain places or avoiding isolation, creating awareness, hiding their physical impairments, and exaggerating their ‘femininity.' Implications: Service providers need to be made aware of women’s violence experiences, and provide a range of accessible psychological and mental health services to women living with disabilities, as well as raising awareness around disability, and violence prevention, among caregivers, men, and women. Violence awareness and prevention interventions need to involve disability experts, researchers and people with disabilities.Keywords: disability, gender, stigma, violence awareness and prevention interventions
Procedia PDF Downloads 3532139 Staphylococcus Aureus Septic Arthritis and Necrotizing Fasciitis in a Patient With Undiagnosed Diabetes Mellitus.
Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto
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Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus
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