Search results for: primary school education

Authors: Ritvik Chauhan, Vijay Kumar Baraik

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Crime is a rare event on earth surface. It is not simple but a complex event occurring in a spatio- temporal environment. Crime is one of the most serious security threats to human environments as it may result in harm to the individuals through the loss of property, physical and psychological injuries. The conventional studies done on different nature crime was mostly related to laws, psychological, social and political themes. The geographical areas are heterogeneous in their environmental conditions, associations between structural conditions, social organization which contributing specific crimes. The crime pattern analysis is made through theories in which criminal events occurs in persistent, identifiable patterns in a particular space and time. It will be the combined analysis of spatial factors and rational factors to the crime. In this study, we are analyzing the combined factors for the origin of crime against children. Children have always been vulnerable to victimization more because they are silent victims both physically and mentally to crimes and they even not realize what is happening with them. Their trusting nature and innocence always misused by criminals to perform crimes. The nature of crime against children is changed in past years like child rape, kidnapping &abduction, selling & buying of girls, foeticide, infanticide, prostitution, child marriage etc turned to more cruel and inhuman. This study will focus on understanding the space-time pattern of crime against children during the period 2001-2012. It also makes an attempt to explore and ascertain the association of crimes categorised against children, its rates with various geographical and socio-demographic factors through causal analysis using selected indicators (child sex-ratio, education, literacy rate, employment, income, etc.) obtained from the Census of India and other government sources. The outcome of study will help identifying the high crime regions with specified nature of crimes. It will also review the existing efforts and exploring the new plausible measure for tracking, monitoring and minimization of crime rate to meet the end goal of protecting the children from crimes committed against them.

Keywords: crime against children, geographic profiling, spatio-temporal analysis, hotspot

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Authors: Ammar Amsyar Abdul Haddi, Mohd Hasni Jaafar

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Heavy metals are elements naturally presented in the environment that can cause adverse effect to health. But not much literature was found on effects toward lung function, where impairment of lung function may lead to various lung diseases. The objective of the study is to explore the lung function impairment, urinary heavy metal level, and its associated factors among the community in Klang valley, Malaysia. Sampling was done in Kuala Lumpur suburb public and housing areas during community events throughout March 2019 till October 2019. respondents who gave the consent were given a questionnaire to answer and was proceeded with a lung function test. Urine samples were obtained at the end of the session and sent for Inductively coupled plasma mass spectrometry (ICP-MS) analysis for heavy metal cadmium (Cd) and lead (Pb) concentration. A total of 200 samples were analysed, and of all, 52% of respondents were male, Age ranging from 18 years old to 74 years old with a mean age of 38.44. Urinary samples show that 12% of the respondent (n=22) has Cd level above than average, and 1.5 % of the respondent (n=3) has urinary Pb at an above normal level. Bivariate analysis show that there was a positive correlation between urinary Cd and urinary Pb (r= 0.309; p<0.001). Furthermore, there was a negative correlation between urinary Cd level and full vital capacity (FVC) (r=-0.202, p=0.004), Force expiratory volume at 1 second (FEV1) (r = -0.225, p=0.001), and also with Force expiratory flow between 25-75% FVC (FEF25%-75%) (r= -0.187, p=0.008). however, urinary Pb did not show any association with FVC, FEV1, FEV1/FVC, or FEF25%-75%. Multiple linear regression analysis shows that urinary Cd remained significant and negatively affect FVC% (p=0.025) and FEV1% (p=0.004) achieved from the predicted value. On top of that, other factors such as education level (p=0.013) and duration of smoking(p=0.003) may influencing both urinary Cd and performance in lung function as well, suggesting Cd as a potential mediating factor between smoking and impairment of lung function. however, there was no interaction detected between heavy metal or other influencing factor in this study. In short, there is a negative linear relationship detected between urinary Cd and lung function, and urinary Cd is likely to affects lung function in a restrictive pattern. Since smoking is also an influencing factor for urinary Cd and lung function impairment, it is highly suggested that smokers should be screened for lung function and urinary Cd level in the future for early disease prevention.

Keywords: lung function, heavy metals, community

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Authors: Eugene Y. C. Wong, Daniel Y. W. Mo, Cosmo T. Y. Ng, Jessica K. Y. Chan, Leith K. Y. Chan, Henry Y. K. Lau

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The real-time planning visualisation, precise allocation and loading optimisation in air cargo load planning operations are increasingly important as more considerations are needed on dangerous cargo loading, locations of lithium batteries, weight declaration and limited aircraft capacity. The planning of the unit load devices (ULD) can often be carried out only in a limited number of hours before flight departure. A dynamic air cargo load planning system is proposed with the optimisation of cargo load plan and visualisation of planning results in virtual reality systems. The system aims to optimise the cargo load planning and visualise the simulated loading planning decision on air cargo terminal operations. Adopting simulation tools, Cave Automatic Virtual Environment (CAVE) and virtual reality technologies, the results of planning with reference to weight and balance, Unit Load Device (ULD) dimensions, gateway, cargo nature and aircraft capacity are optimised and presented. The virtual reality system facilities planning, operations, education and training. Staff in terminals are usually trained in a traditional push-approach demonstration with enormous manual paperwork. With the support of newly customized immersive visualization environment, users can master the complex air cargo load planning techniques in a problem based training with the instant result being immersively visualised. The virtual reality system is developed with three-dimensional (3D) projectors, screens, workstations, truss system, 3D glasses, and demonstration platform and software. The content will be focused on the cargo planning and loading operations in an air cargo terminal. The system can assist decision-making process during cargo load planning in the complex operations of air cargo terminal operations. The processes of cargo loading, cargo build-up, security screening, and system monitoring can be further visualised. Scenarios are designed to support and demonstrate the daily operations of the air cargo terminal, including dangerous goods, pets and animals, and some special cargos.

Keywords: air cargo load planning, optimisation, virtual reality, weight and balance, unit load device

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Authors: Ademola A. Ladele, Peace I. Aburime

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Fake and substandard agricultural inputs pose a serious stumbling block to farm productivity and subsequently improved livelihood. There is, therefore, a need to pave ways for sustainable agriculture and self-sufficiency in food production by proffering solutions to this challenge. Maize farmers' perception of sharp practices among agro-input dealers in Ibadan/Ibarapa agricultural zone in Oyo state was therefore investigated. A multi-stage random sampling technique was used to select registered maize farmers in the Ibadan/Ibarapa agricultural zone of the Oyo State Agricultural Development Programme (OYSADEP). A structured questionnaire was used to collect information on the perception of sharp practices and the effects of sharp practices. A total of seventy-five maize farmers were interviewed. A focus group discussion was organized to identify ways of curbing sharp practices to complement the survey. Data were analyzed using descriptive statistics, Chi-square, and Pearson Product Moment Correlation (PPMC). Forms of sharp practices indicated were sales of expired fertilizers, expired pesticides, expired herbicides, underweight fertilizers, adulterated fertilizers, adulterated herbicides, packs containing broken seeds, infested seeds, lack of truth in labeling/wrong labels, manipulation of measuring scales, and false declaration of hecterages covered by tractor operators. The majority had unfavorable perception of agro-input dealers on sharp practices. A significant relationship was observed between respondents’ level of education and their perception of sharp practices. There were no significant relationships between respondents’ sex, marital status and religion, and their perception of sharp practices. A significant correlation exists between the forms of sharp practices and the perceived effect on agricultural production. It is concluded that the perceived effect of sharp practices was critical and the endemic culture of sharp practices prevailed in agro-input in Ibadan/Ibarapa agricultural zone. A standard regulatory system that will certify and monitor the quality of inputs should be put in place.

Keywords: agricultural productivity, agro-input dealers, maize farmers, sharp practices

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Authors: Mark Davies, Carolyn Wallace, Christina Lloydwin, Tom Powell

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Background: Frailty is increasingly recognized as a public health problem within an aging population. It is often characterized as an accumulation of clinical symptoms with progressive decline. We contend that dehydration is potentially the missing link driving the cycle of frailty; it contributes to malnutrition and cognitive decline and is a risk factor for other conditions. Frailty may also impact on fluid intake in cognitively intact older adults, indicating the cyclical nature of dehydration contributing to increasing frailty. Aim: To examine the relationships between fluid, hydration, and frailty in older adults in order to determine what works, for whom, how, why, and in what circumstances. Methods: A Realist Synthesis was first undertaken with n=50 studies, leading to the development of a Refined Programme Theory (RPT) articulating what hydration interventions work, for whom, to what degree, in what contexts, and how & why. Within the subsequent evaluation, the RPT was further confirmed/refuted/refined following semi-structured interviews with n=8 participants (healthcare professionals and patients). The RAMESES Quality Standards were followed throughout the study. Results: The Refined Programme Theory (RPT) highlighted three factors that result in optimized hydration for frail older people, i.e., Developing an Understanding Around Hydration, Empowering Participation, and System Reconfiguration. Our RPT indicates that hydration interventions work by developing an understanding of the importance of hydration, mitigating physical & cognitive barriers, increasing the agency of the patient, using a prompting process to reinforce drinking behavior, and routinizing hydration as a dimension of overall care. Conclusion: The study indicates that a greater understanding of the importance of hydration is required for all parties. Patients also require physical and psychological support if they are to be active agents in meeting their hydration needs. At a wider ‘system’ level, organizations must work in an integrated manner introducing processes that enable continuing professional development (CPD), encourage ongoing holistic assessment, and routinize hydration support.

Keywords: frailty, dehydration, older adults, realist review, realist evaluation

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Authors: Mili Dutta, Lokender Prashad

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Introduction: Population ageing is a phenomenon that can be observed around the globe. The health-related quality of life (HRQOL) is a measurement of health status of an individual, and it describes the effect of physical and mental health disorders on the well-being of a person. The present study is aimed to describe the influence of socio-economic characteristics of elderly on their health-related quality of life in India. Methods: EQ-5D instrument and population-based EQ-5D index score has been measured to access the HRQOL among elderly. Present study utilized the Study on Global Ageing and Adult Health (SAGE) data which was conducted in 2007 in India. Multiple Logistic Regression model and Multivariate Linear Regression model has been employed. Result: In the present study, it was found that the female are more likely to have problems in mobility (OR=1.41, 95% Cl: 1.14 to 1.74), self-care (OR=1.26, 95% Cl: 1.01 to 1.56) and pain or discomfort (OR=1.50, 95% Cl: 1.16 to 1.94). Elderly residing in rural area are more likely to have problems in pain/discomfort (OR=1.28, 95% Cl: 1.01 to 1.62). More older and non-working elderly are more likely whereas higher educated and highest wealth quintile elderly are less likely to have problems in all the dimensions of EQ-5D viz. mobility, self-care, usual activity, pain/discomfort and anxiety/depression. The present study has also shown that oldest old people, residing in rural area and currently not working elderly are more likely to report low EQ-5D index score whereas elderly with high education level and high wealth quintile are more likely to report high EQ-5D index score than their counterparts. Conclusion: The present study has found EQ-5D instrument as the valid measure for assessing the HRQOL of elderly in India. The study indicates socio-economic characteristics of elderly such as female, more older people, residing in rural area, non-educated, poor and currently non-working as the major risk groups of having poor HRQOL in India. Findings of the study will be helpful for the programmes and policy makers, researchers, academician and social workers who are working in the field of ageing.

Keywords: ageing, HRQOL, India, EQ-5D, SAGE, socio-economic characteristics

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Authors: Malla Vijayeta, Y. Vijaya Kumar, N. Ramakrishna Raju, K. Satyanarayana

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Global AEC (architecture, engineering, and construction) industry has been coined as one of the most resistive domains in embracing technology. Although this digital era has been inundated with software tools like CAD, STADD, CANDY, Microsoft Project, Primavera etc. the key stakeholders have been working in siloes and processes remain fragmented. Unlike the yesteryears’ simpler project delivery methods, the current projects are of fast-track, complex, risky, multidisciplinary, stakeholder’s influential, statutorily regulative etc. pose extensive bottlenecks in preventing timely completion of projects. At this juncture, a paradigm shift surfaced in construction industry, and Building Information Modeling, aka BIM, has been a panacea to bolster the multidisciplinary teams’ cooperative and collaborative work leading to productive, sustainable and leaner project outcome. Building information modeling has been integrative, stakeholder engaging and centralized approach in providing a common platform of communication. A common misconception that BIM can be used for building/high rise projects in Indian Construction Industry, while this paper discusses of the implementation of BIM processes/methodologies in water and waste water industry. It elucidates about BIM 4D planning and constructability reviews of a Sewage Treatment Plant in India. Conventional construction planning and logistics management involves a blend of experience coupled with imagination. Even though the excerpts or judgments or lessons learnt gained from veterans might be predictive and helpful, but the uncertainty factor persists. This paper shall delve about the case study of real time implementation of BIM 4D planning protocols for one of the Sewage Treatment Plant of Dravyavati River Rejuvenation Project in India and develops a Time Liner to identify logistics planning and clash detection. With this BIM processes, we shall find that there will be significant reduction of duplication of tasks and reworks. Also another benefit achieved will be better visualization and workarounds during conception stage and enables for early involvement of the stakeholders in the Project Life cycle of Sewage Treatment Plant construction. Moreover, we have also taken an opinion poll of the benefits accrued utilizing BIM processes versus traditional paper based communication like 2D and 3D CAD tools. Thus this paper concludes with BIM framework for Sewage Treatment Plant construction which will achieve optimal construction co-ordination advantages like 4D construction sequencing, interference checking, clash detection checking and resolutions by primary engagement of all key stakeholders thereby identifying potential risks and subsequent creation of risk response strategies. However, certain hiccups like hesitancy in adoption of BIM technology by naïve users and availability of proficient BIM trainers in India poses a phenomenal impediment. Hence the nurture of BIM processes from conception, construction and till commissioning, operation and maintenance along with deconstruction of a project’s life cycle is highly essential for Indian Construction Industry in this digital era.

Keywords: integrated BIM workflow, 4D planning with BIM, building information modeling, clash detection and visualization, constructability reviews, project life cycle

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Authors: Monika Haanpää

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Well-functioning workplaces are often characterized by good co-operation, adequate flow of information, open interaction between workers and a supportive work environment. The workplace is a mosaic of human personalities and the influx of people, who speak different languages and who are from different cultural backgrounds, may bring about new challenges and enrich this environment. However, this influx of people could also pose a problem as the adaptation of immigrant people to new terms of work may depend heavily on the level of language skills, the stage of culture shock, professional identity, and personality. Migration is not a rare phenomenon in Finland anymore; nobody is surprised to see people from different countries and different backgrounds in the schools, on the streets or in shops. However, this does not mean that immigration is an easy process for people coming from other countries. The experience of workers, with diverse language and backgrounds, has rarely been researched, particularly from the superior's point of view. In addition, the vast majority of researchers have paid more attention to multicultural kindergartens in terms of immigrant children and their families. Hence, there is a need to show the problem which exists in the recruitment of the increasing number of workers who come from different countries. Opinions about kindergartens, as multicultural workplaces, have been gathered through interviews with immigrant workers responsible for education. In addition, a questionnaire for native Finnish workers and superiors in kindergartens was carried out. The collected material has been analyzed qualitatively, focusing on topics such as: the kindergarten as a multicultural workplace, factors influencing career success of workers with diverse language and cultural backgrounds, the social relations in the multicultural workplaces and teachers’ changing professional identity. The results of the research provided a novel aspect of the multicultural workplace and emphasized a dependency of immigrant workers’ on language skills in Finnish; affecting professional success. In addition, they showed the good relations between other native Finnish co-workers and superiors. The results also illustrate why writing skills in Finnish are so important in kindergartens. Part of the investigation also questions some results of the research i.e. which is more important in the kindergarten as a multicultural workplace: personality, good professional skills or good language skills.

Keywords: kindergarten, multicultural workplace, social relations at work, work satisfaction

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Authors: Biva Samadder, Samita Manna

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India is a melting pot of races, tribes, castes and communities. The population of India can be roughly branched into the huge majority of “Civilized” Indians of the Plains and the minority of Tribal population of the hill area and the forest who constituting almost 16 percent of total population of India. The Kirat community composed of four ethnic tribes: Limbu, Lepcha, Dhimal, and Rai. These Kirat people were found to be rich in indigenous knowledge, skill and practices especially for the use on medicinal plants and livelihood purposes. The “Mundhum" is the oral scripture or the “Bible of the Limbus” which serves as the canon of the codes of the Limbu socialization, their moral values and the very orientation of their lifestyle. From birth till death the Limbus are disciplined in the life with full of religious rituals, traditions and culture governed by community norms with a rich legacy of indigenous knowledge and traditional practices. The present study has been conducted using both secondary as well as primary data by applying social methodology consisting of the social survey, questionnaire, interviews and observations in the Kalimpong Block-I of Darjeeling District of west Bengal of India, which is a heterogeneous zone in terms of its ethnic composition and where the Limbus are pre-dominantly concentrated. Due to their close contact with other caste and communities Limbus are now adjusted with the changing situation by borrowing some cultural traits from the other communities and changes that have taken place in their cultural practices, religious beliefs, economic aspects, languages and in social roles and relationships which is bringing the change in their material culture. Limbu language is placed in the Tibeto- Burman Language category. But due to the political and cultural domination of educationally sound and numerically dominant Bengali race, the different communities in this area forced to come under the one umbrella of the Nepali or Gorkhali nation (nation-people). Their respective identities had to be submerged in order to constitute as a strong force to resist Nepali domination and ensure their common survival. As Nepali is a lingua-franca of the area knowing and speaking Nepali language helps them in procuring economic and occupational facilities. Ironically, present day younger generation does not feel comfortable speaking in their own Limbu tongue. The traditional knowledge about medicinal plants, healing, and health culture is found to be wear away due to the lack of interest of young generation. Not only poverty, along with exclusion due to policies they are in the phase of extinction, but their capabilities are ignored and not documented and preserved especially in the case of Limbus who having a great cultural heritage of an oral tradition. Attempts have been made to discuss the persistence and changes in socioeconomic pattern of life in relation to the social structure, material culture, cultural practices, social relationships, indigenous technology, ethos and their values and belief system.

Keywords: changing social relationship, cultural transition, identity, indigenous knowledge, language

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Authors: Natalia Sáez, Dina Shulfman

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There is an important research gap regarding accessible pedagogical techniques for teaching foreign languages to adults with visual impairments. English as a foreign language (EFL), in particular, is needed in many countries to expand occupational opportunities and improve living standards. Within EFL research, teaching and learning prepositions have only recently gained momentum, considering that they constitute one of the most difficult structures to learn in a foreign language and are fundamental for communicating about spatial relations in the world, both on the physical and imaginary levels. Learning to use prepositions would not only facilitate communication when referring to the surrounding tangible environment but also when conveying ideas about abstract topics (e.g., justice, love, society), for which students’ sociocultural knowledge about space could play an important role. By potentiating visually impaired students’ ability to construe mental spatial imagery, this study made efforts to explore pedagogical techniques that cater to their strengths, helping them create new worlds by welcoming and expanding their sociocultural funds of knowledge as they learn to use English prepositions. Fifteen visually impaired adults living in Chile participated in the study. Their first language was Spanish, and they were learning English at the intermediate level of proficiency in an EFL workshop at La Biblioteca Central para Ciegos (The Central Library for the Blind). Within this workshop, a series of activities and interviews were designed and implemented with the intention of uncovering students’ spatial funds of knowledge when learning literal/physical uses of three English prepositions, namely “in,” “at,” and “on”. The activities and interviews also explored whether students used their original spatial funds of knowledge when learning metaphorical uses of these prepositions and if their use of spatial imagery changed throughout the learning activities. Over the course of approximately half a year, it soon became clear that the students construed mental images of space when learning both literal/physical and metaphorical uses of these prepositions. This research could inform a new approach to inclusive language education using pedagogical methods that are relevant and accessible to students with visual impairments.

Keywords: EFL, funds of knowledge, prepositions, spatial cognition, visually impaired students

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Authors: Nervana Elbakary, Sami Ouanes, Sadaf Riaz, Oraib Abdallah, Islam Mahran, Noriya Al-Khuzaei, Yassin Eltorki

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Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Most patients with MDD in the mental health setting have been labeled incorrectly as treatment-resistant where in fact they have not been subjected to an adequate trial of guideline-recommended therapy. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. Avoiding irrational practices such as subtherapeutic doses of IAD, premature switching between the ADs, and refraining from unjustified polypharmacy can help the disease to go into a remission phase We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change. This was a retrospective cross- sectional study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using two unadjusted and adjusted cox regression models. A total of 487 patients met the inclusion criteria of the study. The average age for participants was 39.1 ± 12.3 years. Patients with first experience MDD episode 255 (52%) constituted a major part of our sample comparing to the relapse group 206(42%). About 431 (88%) of the patients had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. Switching was consistently more common than combination or augmentation at any timepoint. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. Five independent variables (age, bothersome side effects, un-optimization of the dose before any change, comorbid anxiety, first onset episode) were significantly associated with the likelihood of IAD change in the unadjusted analysis. The factors statistically associated with higher hazard of IAD change in the adjusted analysis were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety. Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. The findings of this study can have direct clinical guidance for health care professionals since an optimized, evidence-based use of AD medication can improve the clinical outcomes of patients with MDD; and also, to identify high-risk factors that could worsen the survival time on IAD such as young age and comorbid anxiety

Keywords: initial antidepressant, dose optimization, major depressive disorder, comorbid anxiety, combination, augmentation, switching, premature discontinuation

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Authors: Eun Jae Ko, In Young Sung, Eui Soo Joeng

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Cognitive impairment is commonly encountered problem in children with various clinical diseases, including Down syndrome, autism spectrum disorder, brain injury, and others. Cognitive impairment limits participation in education and society, and this further hinders development in cognition. However, young children with cognitive impairment tend not to respond well to traditional cognitive treatments, therefore alternative treatment choices are need. As a cognitive training program, touch screen technology can easily be applied to very young children by involving visual and auditory support. Injini was developed as tablet computer based cognitive rehabilitation program for young children or individuals with severe cognitive impairment, which targeted on cognitive ages of 18 to 36 months. The aim of this study was to evaluate the efficacy of a tablet computer based cognitive rehabilitation program (Injini) for children with cognitive impairment. 38 children between cognitive ages of 18 to 36 months confirmed by cognitive evaluations were recruited and randomly assigned to the intervention group (n=20) and the control group (n=18). The intervention group received tablet computer based cognitive rehabilitation program (Injini) for 30 minutes per session, twice a week, over a period of 12 weeks, in addition to the traditional rehabilitation program. The control group received traditional rehabilitation program only. Mental score of Bayley Scales of Infant Development II (BSID II), Pediatric Evaluation of Disability Inventory (PEDI), Laboratory Temperament Assessment Battery (Lab-TAB), Early Childhood Behavior Questionnaire (ECBQ), and Goal Attainment Scale (GAS) were evaluated before and after 12 weeks of therapeutic intervention. When comparing the baseline characteristics, there was no significant difference between the two groups in the measurements of cognitive function. After 12 weeks of treatment, both group showed improvements in all measurements. However, in comparison of improvements after treatment, the intervention group showed more improvements in the mental score of BSID II, social function domain of PEDI, observation domain of Lab-TAB, and GAS, as compared to the control group. Application of the tablet computer based cognitive rehabilitation program (Injini) would be beneficial for improvement of cognitive function in young children with cognitive impairment.

Keywords: cognitive therapy, computer-assisted therapy, early intervention, tablets

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Authors: Susan Lubbers

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This study applies critical discourse analysis to the language used by educators to frame international students of Asian backgrounds in Anglo-Western universities as quiet, shy, passive and unable to think critically. Emphasis is on the self-promoted ‘internationalised’ Australian tertiary context, where negative stereotypes are commonly voiced not only in the academy but also in the media. Parallels are drawn as well with other Anglo-Western educational contexts. The study critically compares the discourse of these persistent negative stereotypes, with in-class and interview discourses of international students of Asian and Western language, cultural and educational backgrounds enrolled in a Media and Popular Culture unit in an Australian university. The focus of analysis of the student discourse is on their engagement in critical dialogic interactions on the topics of culture and interculturality. The evidence is also drawn from student interviews and focus groups and from observation of whole-class discussion participation rates. The findings of the research project provide evidence that counters the myth of student as problem. They point rather to the widespread lack of intercultural awareness of Western educators and students as being at the heart of the negative perceptions of students of Asian backgrounds. The study suggests the efficacy of an approach to developing intercultural competence that is embedded, or integrated, into tertiary programs. The presentation includes an overview of the main strategies that have been developed by the tertiary educator (author) to support the development of intercultural competence of and among the student cohort. The evidence points to the importance of developing intercultural competence among tertiary educators and students. The failure by educators to ensure that the diverse voices, ideas and perspectives of students from all cultural, educational and language backgrounds are heard in our classrooms means that our universities can hardly be regarded or promoted as genuinely internationalised. They will continue as undemocratic institutions that perpetrate persistent Western educational hegemony.

Keywords: critical discourse analysis, critical thinking, embedding, intercultural competence, interculturality, international student, internationalised education

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Authors: Olga Smilevska Spasova, Katerina Boshkovska, Gorica Popova, Mirjana Popovska

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Introduction: Pneumonia is an infection of the pulmonary parenchyma. HPIV 3 is one of four viruses that is a member of the Paramyxoviridae family designated types 1-4 that have a nonsegmented, single-stranded RNA genome with a lipid-containing envelope. They are spread from the respiratory tract by aerosolized secretions or by direct contact with secretions. Type 3 is endemic and can cause serious illness in immunocompromised patients. Illness caused by parainfluenza occurs shortly after inoculation with the virus. The level of immunoglobulin A antibody in serum is the best predictor of susceptibility to infection. Streptococcus pneumonia or pneumococcus is a Gram-positive, spherical bacteria, usually found in pairs and it is a member of the genus Streptococcus. Streptococcus pneumonia resides asymptomatically in healthy carriers typically colonizing the respiratory tract, sinuses, and nasal cavity. In individuals with weaker immune systems like young infants, pneumococcal bacterium is the most common cause of community-acquired pneumonia in the world. Case Report: The aim is to present a case of lower respiratory tract infection in an infant caused by parainfluenza virus 3, S. pneumonia and undifferentiated gram-negative bacteria that was successfully treated. The infant is with a history of recurrent episodes of wheezing in the past 3mounts.Infant of 10months presents 2weeks before admittance with high fever, runny nose, and cough. The primary pediatrician prescribed oral cefpodoxime for 10days and inhaled salbutamol. Two days before admittance in hospital the infant with high fever, cough, and difficulty breathing. At admittance, infant is pale, anxious with rapid respirations, cough, wheezing and tachycardia. On auscultation: vesicular breathing sounds with high pitched wheezing and on the right coarse crackles. Investigations: Blood analysis: RBC: 4, 7 x1012L, WBC: 8,3x109L: Neut: 42.73% Lym: 41.57%, Hgb: 9.38 g/dl MCV: 62.7fl, MCH: 20.0pg MCHC: 31.8 g/dl RDW: 18.7% Plt-307.9 x109LCRP: 2,5mg/l, serum iron-7.92umol/l, O2sat-97% on blood gas analysis, puls-125/min.X-ray of chest with hyperinflationand right pericardial consolidation. Microbiological analysis of sputum sample is positive for undifferentiated gram-negative bacteria (colonizer)–resistant to cefotaxime, ampicillin, cefoxitin, sulfamet.+trimetoprim and sensitive to amikacin, gentamicin, and ciprofloxacin. Molecular multiplex RT-PCR for 19 viruses and multiplex PCR for 7 bacteria test for respiratory pathogens positive for Parainfluenza virus 3(Ct=22.73), Streptococcus pneumonia (Ct=26.75).IED: IgG-9.31g/l, IgA-0.351g/l, IgM-0.86g/l. Therapy: Treatment was started with inhaled salbutamol, intravenous antibiotic cefotaxime as well as systemic corticosteroids. On day 7 because of slow clinical resolution of chest auscultation findings and an etiologic clue with a positive sputum sample for resistant undifferentiated gram negative bacteria, a second intravenous antibiotic was administered amikacin. The infant is discharged on day 14 with resolution of clinical findings. Conclusion: Mixed co-infections with respiratory viruses and bacteria in immunocompromised infants are likely to lead to a more severe form of community acquired pneumonia that will need hospitalization.

Keywords: HPIV- 3, infant, pneumonia, S. pneumonia, x-ray chest

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Authors: Mahyar MehrAfarin

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The Sistan region in eastern Iran is a significant archaeological area in Iran and the Middle East, encompassing 10,000 square kilometers. Previous archeological field surveys have identified 1662 ancient sites dating from prehistoric periods to the Islamic period. Research Aim: This article aims to explore the utilization of modern technologies and computers in archaeological field surveys in Sistan, Iran, and the benefits derived from their implementation. Methodology: The research employs a descriptive-analytical approach combined with field methods. New technologies and software, such as GPS, drones, magnetometers, equipped cameras, satellite images, and software programs like GIS, Map source, and Excel, were utilized to collect information and analyze data. Findings: The use of modern technologies and computers in archaeological field surveys proved to be essential. Traditional archaeological activities, such as excavation and field surveys, are time-consuming and costly. Employing modern technologies helps in preserving ancient sites, accurately recording archaeological data, reducing errors and mistakes, and facilitating correct and accurate analysis. Creating a comprehensive and accessible database, generating statistics, and producing graphic designs and diagrams are additional advantages derived from the use of efficient technologies in archaeology. Theoretical Importance: The integration of computers and modern technologies in archaeology contributes to interdisciplinary collaborations and facilitates the involvement of specialists from various fields, such as geography, history, art history, anthropology, laboratory sciences, and computer engineering. The utilization of computers in archaeology spanned across diverse areas, including database creation, statistical analysis, graphics implementation, laboratory and engineering applications, and even artificial intelligence, which remains an unexplored area in Iranian archaeology. Data Collection and Analysis Procedures: Information was collected using modern technologies and software, capturing geographic coordinates, aerial images, archeogeophysical data, and satellite images. This data was then inputted into various software programs for analysis, including GIS, Map source, and Excel. The research employed both descriptive and analytical methods to present findings effectively. Question Addressed: The primary question addressed in this research is how the use of modern technologies and computers in archeological field surveys in Sistan, Iran, can enhance archaeological data collection, preservation, analysis, and accessibility. Conclusion: The utilization of modern technologies and computers in archaeological field surveys in Sistan, Iran, has proven to be necessary and beneficial. These technologies aid in preserving ancient sites, accurately recording archaeological data, reducing errors, and facilitating comprehensive analysis. The creation of accessible databases, statistics generation, graphic designs, and interdisciplinary collaborations are further advantages observed. It is recommended to explore the potential of artificial intelligence in Iranian archaeology as an unexplored area. The research has implications for cultural heritage organizations, archaeology students, and universities involved in archaeological field surveys in Sistan and Baluchistan province. Additionally, it contributes to enhancing the understanding and preservation of Iran's archaeological heritage.

Keywords: Iran, sistan, archaeological surveys, computer use, modern technologies

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Authors: Yueh Hsiu Giffen Cheng, Teng Jung Wang

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According to the study of British national advisory council on creative and cultural education（NACCCE, what the present and the future need awesome innovative and creative people from the perspective of commercial human resources. Therefore, we can know from above, creativity plays an important role in today’s enterprise indeed. Besides, many companies are aimed at developing team work as their main goal, so “creativity” and “teamwork” become more and more important factors to succeed and team creativity also turn into an important issue gradually. Then, the study takes in-depth interviews of design companies’ leaders and uses self-designed questionnaire regarding affecting team creativity to conduct cross-analysis. The results show that for those creative-oriented integrated design companies, their design strategies don’t begin until data collection and their scripts are usually the best way to inspire creativity. Besides, passing down a legacy of experiences are their common educational training. Most important of all, their organizational resources and leaders can assist all the team to learn and grow effectively and the good interaction between the leader and the member can also bring work flexibility and efficiency. In short, the leader’s expectation of members’ performance can cause them to encourage each other to progress. Moreover, the analysis of questionnaire indicates that members who are open-minded and leaders who have transformational leadership style can both help to establish a good team interaction. Furthermore, abundant resources and training system are also good approaches to establish a harmonious relationship. Finally, through integrating the outcomes of interviews and questionnaires, we can infer that those integrated design companies’ circumstances of design progress are mainly from their leaders’ guidance. In addition, the analysis of design problems are focused on their creative strategies and their scripts and sketches can also inspire their creativity. In sum, the feature of all team is influenced by 4 factors: leaders who have transformational leadership style, open-minded members, flexible working environment, resources and interactive relationship. Ultimately, the study hopes that the result above can apply to the design-related industries or help general companies elevate the team creativity.

Keywords: creativity, team creativity, integrated design companies, design process

Procedia PDF Downloads 340

Authors: Fatima Muhammad Shitu

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In language learning, Second language learners like their native speaker counter parts, commit errors in their attempt to achieve competence in the target language. The realm of Collocation has to do with meaning relation between lexical items. In all human language, there is a kind of ‘natural order’ in which words are arranged or relate to one another in sentences so much so that when a word occurs in a given context, the related or naturally co -occurring word will automatically come to the mind. It becomes an error, therefore, if students inappropriately pair or arrange such ‘naturally’ co – occurring lexical items in a text. It has been observed that most of the second language learners in this research group commit collocational errors. A study of this kind is very significant as it gives insight into the kinds of errors committed by learners. This will help the language teacher to be able to identify the sources and causes of such errors as well as correct them thereby guiding, helping and leading the learners towards achieving some level of competence in the language. The aim of the study is to understand the nature of these errors as stumbling blocks to effective essay writing. The objective of the study is to identify the errors, analyse their structural compositions so as to determine whether there are similarities between students in this regard and to find out whether there are patterns to these kinds of errors which will enable the researcher to understand their sources and causes. As a descriptive research, the researcher samples some nine hundred essays collected from three hundred undergraduate learners of English as a second language in the Federal College of Education, Kano, North- West Nigeria, i.e. three essays per each student. The essays which were given on three different lecture times were of similar thematic preoccupations (i.e. same topics) and length (i.e. same number of words). The essays were written during the lecture hour at three different lecture occasions. The errors were identified in a systematic manner whereby errors so identified were recorded only once even if they occur severally in students’ essays. The data was collated using percentages in which the identified number of occurrences were converted accordingly in percentages. The findings from the study indicates that there are similarities as well as regular and repeated errors which provided a pattern. Based on the pattern identified, the conclusion is that students’ collocational errors are attributable to poor teaching and learning which resulted in wrong generalisation of rules.

Keywords: collocations, errors, second language learning, ESL students

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Authors: Olayeye Olubunmi Shola

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Amidst increasing global environmental concerns, sustainable urban planning has emerged as a vital strategy in counteracting the negative impacts of urbanization on the environment. However, the emphasis on sustainability often disregards crucial elements of fairness and equal participation within urban settings. This abstract presents a comprehensive overview of the challenges, objectives, significance, and methodologies for addressing social inequalities in the development of eco-cities, with a specific focus on Abuja, Nigeria. Sustainable urban planning, particularly in the context of developing eco-cities, aims to construct cities prioritizing environmental sustainability and resilience. Nonetheless, a significant gap exists in addressing the enduring social disparities within these initiatives. Equitable distribution of resources, access to services, and social inclusivity are essential components that must be integrated into urban planning frameworks for cities that are genuinely sustainable and habitable. Abuja, the capital city of Nigeria, provides a distinctive case for examining the intersection of sustainability and social justice in urban planning. Despite the urban development, Abuja grapples with challenges such as socio-economic disparities, unequal access to essential services, and inadequate housing among its residents. Recognizing and redressing these disparities within the framework of eco-city development is critical for nurturing an inclusive and sustainable urban environment. The primary aim of this study is to scrutinize and pinpoint the social discrepancies within Abuja's initiatives for eco-city development. Specific objectives include: Evaluating the current socio-economic landscape of Abuja to identify disparities in resource, service, and infrastructure access. Comprehending the existing sustainable urban planning initiatives and their influence on social fairness. Suggesting strategies and recommendations to improve fairness and inclusivity within Abuja's plans for eco-city development. This research holds substantial importance for urban planning practices and policy formulation, not only in Abuja but also on a global scale. By highlighting the crucial role of social equity and inclusivity in the development of eco-cities, this study aims to provide insights that can steer more comprehensive, people-centered urban planning practices. Addressing social disparities within sustainability initiatives is crucial for achieving genuinely sustainable and fair urban spaces. The study will employ qualitative and quantitative methodologies. Data collection will involve surveys, interviews, and observations to capture the diverse experiences and perspectives of various social groups within Abuja. Furthermore, quantitative data on infrastructure, service access, and socio-economic indicators will be collated from government reports, academic sources, and non-governmental organizations. Analytical tools such as Geographic Information Systems (GIS) will be utilized to map and visualize spatial disparities in resource allocation and service access. Comparative analyses and case studies of successful interventions in other cities will be conducted to derive applicable strategies for Abuja's context. In conclusion, this study aims to contribute to the discourse on sustainable urban planning by advocating for equity and inclusivity in the development of eco-cities. By centering on Abuja as a case study, it aims to provide practical insights and solutions for the creation of more fair and sustainable urban environments.

Keywords: fairness, sustainability, geographical information system, equity

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Authors: Apurva Sapra

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The aim of this research was to study and compare the nature of expected, feared and hoped-for selves in institutionalized adolescent boys in two residential settings – an observation home with children in conflict with the law, and a children’s home with children in need of care and protection. The study uses a concurrent mixed methods design, in which eight adolescent boys from each group, aged 13-17, were asked to respond to a questionnaire, followed by an in-depth interview. The questionnaire looked into the total scores on current, probable and hoped-for/feared positive and negative self-descriptors. Possible selves of both groups were found to be influenced by their unique histories, such as with their experience of violence, interaction with the police and emphasis given on education. Expected selves and hoped-for selves were similar within the two groups. However, they were more concrete and attainable in the observation home and more ambitious in the children’s home. Quantitative results showed that on the positive self-descriptors, the participants in the observation home had a slightly lower total score on the current parameter as on the probable and hoped-for parameters. The participants in the children’s home showed similar results on current and probable positive self-descriptors, with higher scores on the hoped-for parameter. For most of the negative self-descriptors, the current score for the observation home group was lower than the expected score, and for the children’s home group, they were feared slightly more than they were expected. Along with the nature of possible selves, the study also looked into threats and support to desired and feared possible selves, as well as strategies to attain the desired possible selves and avoid feared possible selves. While threats to possible selves were identified as external and internal in both groups, the participants in the children’s home tended to identify threats as external. The categories of support were similar across the two groups, although the nature of support provided differed. Strategies adopted by participants in the observation home could be clearly divided as past, present and future strategies, while those adopted by participants in the children’s home had an overlap with past and future strategies. The institution was perceived as having a negative influence for the future in the observation home group, but positive in the children’s home group. Limitations of the study and recommendations for future research, policy setting and the counselling profession are discussed.

Keywords: adolescents, expected self, feared self, hoped-for self, institutions, possible selves

Procedia PDF Downloads 218

Authors: Imdad Ullah Khan, Yongseok Yoon, Kyeung Uk Choi, Kwang Rae Jo, Namyul Kim, Eunbee Lee, Wan Hee Kim, Oh-Kyeong Kweon

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The primary spinal cord injury (SCI) causes mechanical damage to the neurons and blood vessels. It leads to secondary SCI, which activates multiple pathological pathways, which expand neuronal damage at the injury site. It is characterized by vascular disruption, ischemia, excitotoxicity, oxidation, inflammation, and apoptotic cell death. It causes nerve demyelination and disruption of axons, which perpetuate a loss of impulse conduction through the injured spinal cord. It also leads to the production of myelin inhibitory molecules, which with a concomitant formation of an astroglial scar, impede axonal regeneration. The pivotal role regarding the neuronal necrosis is played by oxidation and inflammation. During an early stage of spinal cord injury, there occurs an abundant expression of reactive oxygen species (ROS) due to defective mitochondrial metabolism and abundant migration of phagocytes (macrophages, neutrophils). ROS cause lipid peroxidation of the cell membrane, and cell death. Abundant migration of neutrophils, macrophages, and lymphocytes collectively produce pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-1beta (IL-1β), matrix metalloproteinase, superoxide dismutase, and myeloperoxidases which synergize neuronal apoptosis. Therefore, it is crucial to control inflammation and oxidation injury to minimize the nerve cell death during secondary spinal cord injury. Therefore, in response to oxidation and inflammation, heme oxygenase-1 (HO-1) is induced by the resident cells to ameliorate the milieu. In the meanwhile, neurotrophic factors are induced to promote neuroregeneration. However, it seems that anti-stress enzyme (HO-1) and neurotrophic factor (BDNF) do not significantly combat the pathological events during secondary spinal cord injury. Therefore, optimum healing can be induced if anti-inflammatory and neurotrophic factors are administered in a higher amount through an exogenous source. During the first experiment, the inflammation and neuroregeneration were selectively targeted. HO-1 expressing MSCs (HO-1 MSCs) and BDNF expressing MSCs (BDNF MSC) were co-transplanted in one group (combination group) of dogs with subacute spinal cord injury to selectively control the expression of inflammatory cytokines by HO-1 and induce neuroregeneration by BDNF. We compared the combination group with the HO-1 MSCs group, BDNF MSCs group, and GFP MSCs group. We found that the combination group showed significant improvement in functional recovery. It showed increased expression of neural markers and growth-associated proteins (GAP-43) than in other groups, which depicts enhanced neuroregeneration/neural sparing due to reduced expression of pro-inflammatory cytokines such as TNF-alpha, IL-6 and COX-2; and increased expression of anti-inflammatory markers such as IL-10 and HO-1. Histopathological study revealed reduced intra-parenchymal fibrosis in the injured spinal cord segment in the combination group than in other groups. Thus it was concluded that selectively targeting the inflammation and neuronal growth with the combined use of HO-1 MSCs and BDNF MSCs more favorably promote healing of the SCI. HO-1 MSCs play a role in controlling the inflammation, which favors the BDNF induced neuroregeneration at the injured spinal cord segment of dogs.

Keywords: HO-1 MSCs, BDNF MSCs, neuroregeneration, inflammation, anti-inflammation, spinal cord injury, dogs

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Authors: Ashleigh Williams

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Micro- and nanoplastics’ (MNLPs) omnipresence and ecological accumulation is evident when surveying recent environmental impact studies. For example, in 2014 it was estimated that at least 52.3 trillion plastic microparticles are floating at sea, and scientists have even found plastics present remote Arctic ice and snow (5,6). Plastics have even found their way into precipitation, with more than 1000 tons of microplastic rain precipitating onto the Western United States in 2020. Even more recent studies evaluating the chemical safety of reusable plastic bottles found that hundreds of chemicals leached into the control liquid in the bottle (ddH2O, ph = 7) during a 24-hour time period. A consequence of the increased abundance in plastic waste in the air, land, and water every year is the bioaccumulation of MNLPs in ecosystems and trophic niches of the animal food chain, which could potentially cause increased direct and indirect exposure of humans to MNLPs via inhalation, ingestion, and dermal contact. Though the detrimental, toxic effects of MNLPs have been established in marine biota, much less is known about the potentially hazardous health effects of chronic MNLP ingestion in humans. Recent data indicate that long-term exposure to MNLPs could cause possible inflammatory and dysbiotic effects. However, toxicity seems to be largely dose-, as well as size-dependent. In addition, the transcytotic uptake of MNLPs through the intestinal epithelia in humans remain relatively unknown. To this point, the goal of the current study was to investigate the mechanisms of micro- and nanoplastic uptake and transcytosis of Polystyrene (PE) in human stem-cell derived, physiologically relevant in vitro intestinal model systems, and to compare the relative effect of particle size (30 nm, 100 nm, 500 nm and 1 µm), and concentration (0 µg/mL, 250 µg/mL, 500 µg/mL, 1000 µg/mL) on polystyrene MNLP uptake, transcytosis and intestinal epithelial model integrity. Observational and quantitative data obtained from confocal microscopy, immunostaining, transepithelial electrical resistance (TEER) measurements, cryosectioning, and ELISA cytokine assays of the proinflammatory cytokines Interleukin-6 and Interleukin-8 were used to evaluate the localization and transcytosis of polystyrene MNPs and its impact on epithelial integrity in human-derived intestinal in vitro model systems. The effect of Microfold (M) cell induction on polystyrene micro- and nanoparticle (MNP) uptake, transcytosis, and potential inflammation was also assessed and compared to samples grown under standard conditions. Microfold (M) cells, link the human intestinal system to the immune system and are the primary cells in the epithelium responsible for sampling and transporting foreign matter of interest from the lumen of the gut to underlying immune cells. Given the uptake capabilities of Microfold cells to interact both specifically and nonspecific to abiotic and biotic materials, it was expected that M- cell induced in vitro samples would have increased binding, localization, and potentially transcytosis of Polystyrene MNLPs across the epithelial barrier. Experimental results of this study would not only help in the evaluation of the plastic toxicity, but would allow for more detailed modeling of gut inflammation and the intestinal immune system.

Keywords: nanoplastics, enteroids, intestinal barrier, tissue engineering, microfold (M) cells

Procedia PDF Downloads 68

Authors: Valerie Follonier, Henrike Hamelmann, Jean-Michel Jullien

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The Distance Learning University in Switzerland (UniDistance) is offering bachelor and master courses as well as further education programs. The professors and their assistants work at traditional Swiss universities and are giving their courses at UniDistance following a blended learning and flipped classroom approach. A standardized course evaluation by the students has been established as a component of a quality improvement process. The students’ feedback enables the stakeholders to identify areas of improvement, initiate professional development for the teaching teams and thus continuously augment the quality of instruction. This paper describes the evaluation process, the tools involved and how the approach involving all stakeholders helps forming a culture of quality in teaching. Additionally, it will present the first evaluation results following the new process. Two software tools have been developed to support all stakeholders in the process of the semi-annual formative evaluation. The first tool allows to create the survey and to assign it to the relevant courses and students. The second tool presents the results of the evaluation to the stakeholders, providing specific features for the teaching teams, the dean, the directorate and EDUDL+ (Educational development unit distance learning). The survey items were selected in accordance with the e-learning strategy of the institution and are formulated to support the professional development of the teaching teams. By reviewing the results the teaching teams become aware of the opinion of the students and are asked to write a feedback for the attention of their dean. The dean reviews the results of the faculty and writes a general report about the situation of the faculty and the possible improvements intended. Finally, EDUDL+ writes a final report summarising the evaluation results. A mechanism of adjustable warnings allows it to generate quality indicators for each module. These are summarised for each faculty and globally for the whole institution in order to increase the vigilance of the responsible. The quality process involves changing the indicators regularly to focus on different areas each semester, to facilitate the professional development of the teaching teams and to progressively augment the overall teaching quality of the institution.

Keywords: continuous improvement process, course evaluation, distance learning, software tools, teaching quality

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Authors: Ravinder Singh, Pratima Syal

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Background: The rising prevalence and incidence of Acute Pancreatitis (AP) and its associated metabolic variables known as metabolic syndrome (MetS) are common medical conditions with catastrophic consequences and substantial treatment costs. The correlation between MetS and AP, as well as their impact on Health Related Quality of Life (HRQoL) is uncertain, and because there are so few published studies, further research is needed. As a result, we planned this study to determine the relationship between MetS components impact on HRQoL in AP patients. Patients and Methods: A prospective, observational study involving the recruitment of patients with AP with and without MetS was carried out in tertiary care hospital of North India. Patients were classified with AP if they were diagnosed with two or more components of the following criteria, abdominal pain, serum amylase and lipase levels two or more times normal, imaging trans-abdominal ultrasound, computed tomography, or magnetic resonance. The National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III) criterion was used to diagnose the MetS. The various socio-demographic variables were also taken into consideration for the calculation of statistical significance (P≤.05) in AP patients. Finally, the correlation between AP and MetS, along with their impact on HRQoL was assessed using Student's t test, Pearson Correlation Coefficient, and Short Form-36 (SF-36). Results: AP with MetS (n = 100) and AP without MetS (n = 100) patients were divided into two groups. Gender, Age, Educational Status, Tobacco use, Body Mass Index (B.M.I), and Waist Hip Ratio (W.H.R) were the socio-demographic parameters found to be statistically significant (P≤.05) in AP patients with MetS. Also, all the metabolic variables were also found to statistically significant (P≤.05) and found to be increased in patients with AP with MetS as compared to AP without MetS except HDL levels. Using the SF-36 form, a greater significant decline was observed in physical component summary (PCS) and mental component summary (MCS) in patients with AP with MetS as compared to patients without MetS (P≤.05). Furthermore, a negative association between all metabolic variables with the exception of HDL, and AP was found to be producing deterioration in PCS and MCS. Conclusion: The study demonstrated that patients with AP with MetS had a worse overall HRQOL than patients with AP without MetS due to number of socio-demographic and metabolic variables having direct correlation impacting physical and mental health of patients.

Keywords: metabolic disorers, QOL, cost effectiveness, pancreatitis

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Authors: Dinka Fikadu, Mulugeta Shegaze

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Background: Currently in health facility, provider-initiated human immunodeficiency virus testing is the key entry point to prevention, care, treatment and support services, but most people remains unaware of their HIV status due to various reasons. In many high-prevalence countries, fewer than one in ten people with HIV are aware of their HIV status. HIV, the virus that causes AIDS, “acquired immunodeficiency syndrome, "has become one of the world’s most serious health and development challenges. Reaching individuals with HIV who do not know their serostatus is a global public health priority. Objective: To assess utilization of provider initiated HIV testing and counseling and associated factors among adult outpatient department patients. Methods: Health facility based cross sectional study was conducted among 392 adult outpatient department patients in Wonchi woreda from February 24 to March 24 /2013. The study participant was recruited patients from all adult outpatient department patients of all four public health facilities of wonchi woreda using systematic sampling. A structured interviewer administered questionnaire was used to elicit all important variables from the study participants and multiple logistic regression analysis was used. Result: A total of 371 adult outpatient department patients aged between 15 to 64 years were actively participated in the study and 291(78.4%) of them utilized provider initiated HIV testing and counseling and 80(21.6%) of them refused. Knowledge on HIV is low in the study population; majority of the participants didn’t have comprehensive knowledge (64.7%) and (35.3%) fail to reject misconception about means of HIV transmission and prevention. Utilization of provider-initiated HIV testing and counseling were associated with divorced/widowed marital status[AOR (95%CI) = 0.32(0.15, 0.69)], being male sex [AOR (95%CI) =1.81(1.01, 3.24)], having comprehensive knowledge on HIV [AOR (95%CI) =0.408(0.220,0.759)],having awareness about provider initiated HIV testing and counseling [AOR(95%CI) =2.89(1.48,5.66)] and receiving test on HIV before[AOR (95%CI)=4.15(2.30, 7.47)]. Conclusion: Utilization of provider initiated HIV testing and counseling among adult outpatient departments in wonchi woreda public health facility was [(78.4%)].Strengthening health information through mass media and peer education on HIV to address barrier to testing in the community such as low awareness on PITC, to increase up take of PITC among adult OPD patients.

Keywords: utilization, human immune deficiency, testing, provider, initiate

Procedia PDF Downloads 277

Authors: Brid Dinnee, Jessica Taylor, Joseph Hartland, Michael Natarajan

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Background:The third stage of labour (TSL) can be complicated by Post-Partum Haemorrhage (PPH), which can have a significant impact on maternal mortality and morbidity. In Africa, 33.9% of maternal deaths are attributable to PPH1. In order to minimise this figure, current recommendations for the developing world are that all women have active management of the third stage of labour (AMTSL). The aim of this project was to examine TSL practice in a rural Ugandan Hospital, highlight any deviation from best practice and identify barriers to change in resource limited settings as part of a 4th year medical student External Student Selected Component field trip. Method: Five key elements from the current World Health Organisation (WHO) guidelines on AMTSL were used to develop an audit tool. All daytime vaginal deliveries over a two week period in July 2016 were audited. In addition to this, a retrospective comparison of PPH rates, between 2006 (when ubiquitous use of intramuscular oxytocin for management of TSL was introduced) and 2015 was performed. Results: Eight vaginal deliveries were observed; at all of which intramuscular oxytocin was administered and controlled cord traction used. Against WHO recommendation, all umbilical cords were clamped within one minute, and no infants received early skin-to-skin contact. In only one case was uterine massage performed after placental delivery. A retrospective comparison of data rates identified a 40% reduction in total number of PPHs from November 2006 to November 2015. Maternal deaths per delivery reduced from 2% to 0.5%. Discussion: Maternal mortality and PPH are still major issues in developing countries. Maternal mortality due to PPH can be reduced by good practices regarding TSL, but not all of these are used in low-resource settings. There is a notable difference in outcomes between the developed and developing world. At Kitovu Hospital, there has been a reduction in maternal mortality and number of PPHs following introduction of IM Oxytocin administration. In order to further improve these rates, staff education and further government funding is key.

Keywords: post-partum haemorrhage, PPH, third stage labour, Uganda

Procedia PDF Downloads 182

Authors: Artem Kim, Clara Savary, Christele Dubourg, Wilfrid Carre, Houda Hamdi-Roze, Valerie Dupé, Sylvie Odent, Marie De Tayrac, Veronique David

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Holoprosencephaly (HPE) is a rare congenital brain malformation resulting from the incomplete separation of the two cerebral hemispheres. It is characterized by a wide phenotypic spectrum and a high degree of locus heterogeneity. Genetic defects in 16 genes have already been implicated in HPE, but account for only 30% of cases, suggesting that a large part of genetic factors remains to be discovered. HPE has been recently redefined as a complex multigenic disorder, requiring the joint effect of multiple mutational events in genes belonging to one or several developmental pathways. The onset of HPE may result from accumulation of the effects of multiple rare variants in functionally-related genes, each conferring a moderate increase in the risk of HPE onset. In order to decipher the genetic basis of HPE, unconventional patterns of inheritance involving multiple genetic factors need to be considered. The primary objective of this study was to uncover possible disease causing combinations of multiple rare variants underlying HPE by performing trio-based Whole Exome Sequencing (WES) of familial cases where no molecular diagnosis could be established. 39 families were selected with no fully-penetrant causal mutation in known HPE gene, no chromosomic aberrations/copy number variants and without any implication of environmental factors. As the main challenge was to identify disease-related variants among a large number of nonpathogenic polymorphisms detected by WES classical scheme, a novel variant prioritization approach was established. It combined WES filtering with complementary gene-level approaches: transcriptome-driven (RNA-Seq data) and clinically-driven (public clinical data) strategies. Briefly, a filtering approach was performed to select variants compatible with disease segregation, population frequency and pathogenicity prediction to identify an exhaustive list of rare deleterious variants. The exome search space was then reduced by restricting the analysis to candidate genes identified by either transcriptome-driven strategy (genes sharing highly similar expression patterns with known HPE genes during cerebral development) or clinically-driven strategy (genes associated to phenotypes of interest overlapping with HPE). Deeper analyses of candidate variants were then performed on a family-by-family basis. These included the exploration of clinical information, expression studies, variant characteristics, recurrence of mutated genes and available biological knowledge. A novel bioinformatics pipeline was designed. Applied to the 39 families, this final integrated workflow identified an average of 11 candidate variants per family. Most of candidate variants were inherited from asymptomatic parents suggesting a multigenic inheritance pattern requiring the association of multiple mutational events. The manual analysis highlighted 5 new strong HPE candidate genes showing recurrences in distinct families. Functional validations of these genes are foreseen.

Keywords: complex genetic disorder, holoprosencephaly, multiple rare variants, whole exome sequencing

Procedia PDF Downloads 186

Authors: Shuo Li, Yannick Coffinier, Chann Lagadec, Fabrizio Cleri, Katsuhiko Nishiguchi, Akira Fujiwara, Soo Hyeon Kim, Nicolas Clément

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The need for single cell detection and analysis techniques has increased in the past decades because of the heterogeneity of individual living cells, which increases the complexity of the pathogenesis of malignant tumors. In the search for early cancer detection, high-precision medicine and therapy, the technologies most used today for sensitive detection of target analytes and monitoring the variation of these species are mainly including two types. One is based on the identification of molecular differences at the single-cell level, such as flow cytometry, fluorescence-activated cell sorting, next generation proteomics, lipidomic studies, another is based on capturing or detecting single tumor cells from fresh or fixed primary tumors and metastatic tissues, and rare circulating tumors cells (CTCs) from blood or bone marrow, for example, dielectrophoresis technique, microfluidic based microposts chip, electrochemical (EC) approach. Compared to other methods, EC sensors have the merits of easy operation, high sensitivity, and portability. However, despite various demonstrations of low limits of detection (LOD), including aptamer sensors, arrayed EC sensors for detecting single-cell have not been demonstrated. In this work, a new technique based on 20-nm-thick nanopillars array to support cells and keep them at ideal recognition distance for redox-labeled aptamers grafted on the surface. The key advantages of this technology are not only to suppress the false positive signal arising from the pressure exerted by all (including non-target) cells pushing on the aptamers by downward force but also to stabilize the aptamer at the ideal hairpin configuration thanks to a confinement effect. With the first implementation of this technique, a LOD of 13 cells (with5.4 μL of cell suspension) was estimated. In further, the nanosupported cell technology using redox-labeled aptasensors has been pushed forward and fully integrated into a single-cell electrochemical aptasensor array. To reach this goal, the LOD has been reduced by more than one order of magnitude by suppressing parasitic capacitive electrochemical signals by minimizing the sensor area and localizing the cells. Statistical analysis at the single-cell level is demonstrated for the recognition of cancer cells. The future of this technology is discussed, and the potential for scaling over millions of electrodes, thus pushing further integration at sub-cellular level, is highlighted. Despite several demonstrations of electrochemical devices with LOD of 1 cell/mL, the implementation of single-cell bioelectrochemical sensor arrays has remained elusive due to their challenging implementation at a large scale. Here, the introduced nanopillar array technology combined with redox-labeled aptamers targeting epithelial cell adhesion molecule (EpCAM) is perfectly suited for such implementation. Combining nanopillar arrays with microwells determined for single cell trapping directly on the sensor surface, single target cells are successfully detected and analyzed. This first implementation of a single-cell electrochemical aptasensor array based on Brownian-fluctuating redox species opens new opportunities for large-scale implementation and statistical analysis of early cancer diagnosis and cancer therapy in clinical settings.

Keywords: bioelectrochemistry, aptasensors, single-cell, nanopillars

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Authors: Enes Caliskan, Hatice Camgoz Akdag

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There is no doubt that humanity needs to realize the sustainability problems in the world and take serious action regarding that. All members of the United Nations adopted the 2030 Agenda for Sustainable Development, the most comprehensive study on sustainability internationally, in 2015. The summary of the study is 17 sustainable development goals. It covers everything about sustainability, such as environment, society and governance. The use of Information and Communication Technology (ICT), such as the Internet, mobile phones, and satellites, is essential for tackling the main issues facing sustainable development. Hence, the contributions of 3 major ICT companies to the sustainable development goals are assessed in this study. Quality Function Deployment (QFD) is utilized as a methodology for this study. Since QFD is an excellent instrument for comparing businesses on relevant subjects, a House of Quality must be established to complete the QFD application. In order to develop a House of Quality, the demanded qualities (voice of the customer) and quality characteristics (technical requirements) must first be determined. UN SDGs are used as demanded qualities. Quality characteristics are derived from annual sustainability and corporate social responsibility reports of ICT companies. The companies' efforts, as indicated by the QFD results, are concentrated on the use of recycled raw materials and recycling, reducing GHG emissions through energy saving and improved connectivity, decarbonizing the value chain, protecting the environment and water resources by collaborating with businesses that have completed CDP water assessments and paying attention to reducing water consumption, ethical business practices, and reducing inequality. The evaluations of the three businesses are found to be very similar when they are compared. The small differences between the companies are usually about the region they serve. Efforts made by the companies mostly concentrate on responsible consumption and production, life below water, climate action, and sustainable cities and community goals. These efforts include improving connectivity in needed areas for providing access to information, education and healthcare.

Keywords: multi-criteria decision-making, sustainable supply chain risk, supply chain agility, quality function deployment, Sustainable development goals

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Authors: Georges F. Hatoum, Thomas H. Temple, Silvio Garcia, Xiaodong Wu

Abstract:

Soft Tissue Sarcomas (STS) represent a diverse group of malignancies with heterogeneous clinical and pathological features. The treatment of extremity STS aims to achieve optimal local tumor control, improved survival, and preservation of limb function. The National Comprehensive Cancer Network guidelines, based on the cumulated clinical data, recommend radiation therapy (RT) in conjunction with limb-sparing surgery for large, high-grade STS measuring greater than 5 cm in size. Such treatment strategy can offer a cure for patients. However, when recurrence occurs (in nearly half of patients), the prognosis is poor, with a median survival of 12 to 15 months and with only palliative treatment options available. The spatially-fractionated-radiotherapy (SFRT), with a long history of treating bulky tumors as a non-mainstream technique, has gained new attention in recent years due to its unconventional therapeutic effects, such as bystander/abscopal effects. Combining single fraction of GRID, the original form of SFRT, with conventional RT was shown to have marginally increased the rate of pathological necrosis, which has been recognized to have a positive correlation to overall survival. In an effort to consistently increase the pathological necrosis rate over 90%, multiple fractions of Lattice RT (LRT), a newer form of 3D SFRT, interdigitated with the standard RT as neoadjuvant therapy was conducted in a preliminary clinical setting. With favorable results of over 95% of necrosis rate in a small cohort of patients, a Phase I/II clinical study was proposed to exam the safety and feasibility of this new strategy. Herein the design of the clinical study is presented. In this single-arm, two-stage phase I/II clinical trial, the primary objectives are >80% of the patients achieving >90% tumor necrosis and to evaluation the toxicity; the secondary objectives are to evaluate the local control, disease free survival and overall survival (OS), as well as the correlation between clinical response and the relevant biomarkers. The study plans to accrue patients over a span of two years. All patient will be treated with the new neoadjuvant RT regimen, in which one of every five fractions of conventional RT is replaced by a LRT fraction with vertices receiving dose ≥10Gy while keeping the tumor periphery at or close to 2 Gy per fraction. Surgical removal of the tumor is planned to occur 6 to 8 weeks following the completion of radiation therapy. The study will employ a Pocock-style early stopping boundary to ensure patient safety. The patients will be followed and monitored for a period of five years. Despite much effort, the rarity of the disease has resulted in limited novel therapeutic breakthroughs. Although a higher rate of treatment-induced tumor necrosis has been associated with improved OS, with the current techniques, only 20% of patients with large, high-grade tumors achieve a tumor necrosis rate exceeding 50%. If this new neoadjuvant strategy is proven effective, an appreciable improvement in clinical outcome without added toxicity can be anticipated. Due to the rarity of the disease, it is hoped that such study could be orchestrated in a multi-institutional setting.

Keywords: lattice RT, necrosis, SFRT, soft tissue sarcoma

Procedia PDF Downloads 45

Authors: Medan Isaeva, Anna Degtyareva

Abstract:

Context: Biliary atresia is a common reason for liver transplants in children, and the Kasai procedure can potentially be successful in avoiding the need for transplantation. However, it is important to identify factors that influence surgical outcomes in order to optimize treatment and improve patient outcomes. Research aim: The aim of this study was to develop prognostic models to assess the outcomes of the Kasai procedure in children with biliary atresia. Methodology: This retrospective study analyzed data from 166 children with biliary atresia who underwent the Kasai procedure between 2002 and 2021. The effectiveness of the operation was assessed based on specific criteria, including post-operative stool color, jaundice reduction, and bilirubin levels. The study involved a comparative analysis of various parameters, such as gestational age, birth weight, age at operation, physical development, liver and spleen sizes, and laboratory values including bilirubin, ALT, AST, and others, measured pre- and post-operation. Ultrasonographic evaluations were also conducted pre-operation, assessing the hepatobiliary system and related quantitative parameters. The study was carried out by two experienced specialists in pediatric hepatology. Comparative analysis and multifactorial logistic regression were used as the primary statistical methods. Findings: The study identified several statistically significant predictors of a successful Kasai procedure, including the presence of the gallbladder and levels of cholesterol and direct bilirubin post-operation. A detectable gallbladder was associated with a higher probability of surgical success, while elevated post-operative cholesterol and direct bilirubin levels were indicative of a reduced chance of positive outcomes. Theoretical importance: The findings of this study contribute to the optimization of treatment strategies for children with biliary atresia undergoing the Kasai procedure. By identifying early predictive signs of success, clinicians can modify treatment plans and manage patient care more effectively and proactively. Data collection and analysis procedures: Data for this analysis were obtained from the health records of patients who received the Kasai procedure. Comparative analysis and multifactorial logistic regression were employed to analyze the data and identify significant predictors. Question addressed: The study addressed the question of identifying predictive factors for the success of the Kasai procedure in children with biliary atresia. Conclusion: The developed prognostic models serve as valuable tools for early detection of patients who are less likely to benefit from the Kasai procedure. This enables clinicians to modify treatment plans and manage patient care more effectively and proactively. Potential limitations of the study: The study has several limitations. Its retrospective nature may introduce biases and inconsistencies in data collection. Being single centered, the results might not be generalizable to wider populations due to variations in surgical and postoperative practices. Also, other potential influencing factors beyond the clinical, laboratory, and ultrasonographic parameters considered in this study were not explored, which could affect the outcomes of the Kasai operation. Future studies could benefit from including a broader range of factors.

Keywords: biliary atresia, kasai operation, prognostic model, native liver survival

Procedia PDF Downloads 35