Search results for: competent person

Authors: Naoko Ono, Junko Kato

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According to the Ministry of Justice, 9,044,000 foreigners visited Japan in 2010. The number of foreign residents in Japan was over 2,134,000 at the end of 2010. Further, medical tourism has emerged as a new area of business. Against this background, language barriers put the health of foreigners in Japan at risk, because they have difficulty in accessing health care and communicating with medical professionals. Medical interpreting training is urgently needed in response to language problems resulting from the rapid increase in the number of foreign workers in Japan over recent decades. Especially, there is a growing need in medical settings in Japan to speak international languages for communication, with Tokyo selected as the host city of the 2020 Summer Olympics. Due to the limited number of practical activities on medical interpreting, it is difficult for learners to acquire the interpreting skills. In order to eliminate the shortcoming, a web-based English-Japanese medical interpreting training system was developed. We conducted a literature review to identify learning contents, core competencies for medical interpreters by using Pubmed, PsycINFO, Cochrane Library, and Google Scholar. Selected papers were investigated to find core competencies in medical interpreting. Eleven papers were selected through literature review indicating core competencies for medical interpreters. Core competencies in medical interpreting abstracted from the literature review, showed consistency in previous research whilst the content of the programs varied in domestic and international training programs for medical interpreters. Results of the systematic review indicated five core competencies: (a) maintaining accuracy and completeness; (b) medical terminology and understanding the human body; (c) behaving ethically and making ethical decisions; (d) nonverbal communication skills; and (e) cross-cultural communication skills. We developed an e-leaning program for training medical interpreters. A Web-based Medical Interpreter Training Program which cover these competencies was developed. The program included the following : online word list (Quizlet), allowing student to study online and on their smartphones; self-study tool (Quizlet) for help with dictation and spelling; word quiz (Quizlet); test-generating system (Quizlet); Interactive body game (BBC);Online resource for understanding code of ethics in medical interpreting; Webinar about non-verbal communication; and Webinar about incompetent vs. competent cultural care. The design of a virtual environment allows the execution of complementary experimental exercises for learners of medical interpreting and introduction to theoretical background of medical interpreting. Since this system adopts a self-learning style, it might improve the time and lack of teaching material restrictions of the classroom method. In addition, as a teaching aid, virtual medical interpreting is a powerful resource for the understanding how actual medical interpreting can be carried out. The developed e-learning system allows remote access, enabling students to perform experiments at their own place, without being physically in the actual laboratory. The web-based virtual environment empowers students by granting them access to laboratories during their free time. A practical example will be presented in order to show capabilities of the system. The developed web-based training program for medical interpreters could bridge the gap between medical professionals and patients with limited English proficiency.

Keywords: e-learning, language education, moodle, medical interpreting

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Authors: Chiou-Fang Liou

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Cancer has been one of the most life-threaten diseases worldwide for 30+ years. The influences of cancer illness include symptoms from cancer itself along with its treatments. The quality of life among patients diagnosed with cancer during cancer treatments has been conceptualized within four domains: Functional Well-Being, Social Well-Being, Physical Well-Being, and Emotional Well-Being. Patients with cancer often need to make adjustments to face all the challenges. The middle-range theory of Resourcefulness and Quality of life has been applied to explore factors contributing to cancer patients’ needs. Resourcefulness is defined as sets of skills that can be learned and consisted of Person and Social Resourcefulness. Empirical evidence also supported a possible relationship between Resourcefulness and Quality of Life. However, little is known about the extent to which the two concepts are related to each other. This study, therefore, applied a multivariate technique, Canonical Correlation Analysis, to identify the relationship between the two sets of variables with multi-dimensional measures, the Resourcefulness and Quality of Life in Cancer patients receiving treatments. After IRB approval, this multi-centered study took place at two medical centers in the Central Region of Taiwan. Sample A total of 186 patients with various cancer diagnoses and either receiving radiation therapy or chemotherapy consented to and answered questionnaires. The Import findings of the Generalized F test identified two typical sets with several linear relations and explained a total of 79.1% of the total variance. The first typical set found Personal Resourcefulness negatively related to Social Well-being, Functional being, Emotional Well-being, and Physical, in that order. The second typical set found Social Resourcefulness negatively related to Functional Well-being and Physical-being yet positively related to Social Well-being and Emotional Well-being. Discussion and Conclusion, The results of this presented study supported the statistically significant relationship between two sets of variables that are consistent with the theory. In addition, the results are considerably important in cancer patients receiving cancer treatments.

Keywords: cancer, canonical correlation analysis, quality of life, resourcefulness

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Authors: Laheeb M. Ibrahim, Ibrahim A. Salih

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Biometrics is a technology that has been widely used in many official and commercial identification applications. The increased concerns in security during recent years (especially during the last decades) have essentially resulted in more attention being given to biometric-based verification techniques. Here, a novel fusion approach of palmprint, dental traits has been suggested. These traits which are authentication techniques have been employed in a range of biometric applications that can identify any postmortem PM person and antemortem AM. Besides improving the accuracy, the fusion of biometrics has several advantages such as increasing, deterring spoofing activities and reducing enrolment failure. In this paper, a first unimodel biometric system has been made by using (palmprint and dental) traits, for each one classification applying an artificial neural network and a hybrid technique that combines swarm intelligence and neural network together, then attempt has been made to combine palmprint and dental biometrics. Principally, the fusion of palmprint and dental biometrics and their potential application has been explored as biometric identifiers. To address this issue, investigations have been carried out about the relative performance of several statistical data fusion techniques for integrating the information in both unimodal and multimodal biometrics. Also the results of the multimodal approach have been compared with each one of these two traits authentication approaches. This paper studies the features and decision fusion levels in multimodal biometrics. To determine the accuracy of GAR to parallel system decision-fusion including (AND, OR, Majority fating) has been used. The backpropagation method has been used for classification and has come out with result (92%, 99%, 97%) respectively for GAR, while the GAR) for this algorithm using hybrid technique for classification (95%, 99%, 98%) respectively. To determine the accuracy of the multibiometric system for feature level fusion has been used, while the same preceding methods have been used for classification. The results have been (98%, 99%) respectively while to determine the GAR of feature level different methods have been used and have come out with (98%).

Keywords: back propagation neural network BP ANN, multibiometric system, parallel system decision-fusion, practical swarm intelligent PSO

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Authors: Jasbir Arora, Indu Talwar, Daisy Sahni, Vidya Rattan

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Introduction: Age estimation is a crucial step to build the identity of a person, both in case of deceased and alive. In adults, age can be estimated on the basis of six regressive (Attrition, Secondary dentine, Dentine transparency, Root resorption, Cementum apposition and Periodontal Disease) changes in teeth qualitatively using scoring system and quantitatively by micrometric method. The present research was designed to establish the reliability of qualitative (method 1) and quantitative (method 2) of age estimation among North Indians and to compare the efficacy of these two methods. Method: 250 single-rooted extracted teeth (18-75 yrs.) were collected from Department of Oral Health Sciences, PGIMER, Chandigarh. Before extraction, periodontal score of each tooth was noted. Labiolingual sections were prepared and examined under light microscope for regressive changes. Each parameter was scored using Gustafson’s 0-3 point score system (qualitative), and total score was calculated. For quantitative method, each regressive change was measured quantitatively in form of 18 micrometric parameters under microscope with the help of measuring eyepiece. Age was estimated using linear and multiple regression analysis in Gustafson’s method and Kedici’s method respectively. Estimated age was compared with actual age on the basis of absolute mean error. Results: In pooled data, by Gustafson’s method, significant correlation (r= 0.8) was observed between total score and actual age. Total score generated an absolute mean error of ±7.8 years. Whereas, for Kedici’s method, a value of correlation coefficient of r=0.5 (p<0.01) was observed between all the eighteen micrometric parameters and known age. Using multiple regression equation, age was estimated, and an absolute mean error of age was found to be ±12.18 years. Conclusion: Gustafson’s (qualitative) method was found to be a better predictor for age estimation among North Indians.

Keywords: forensic odontology, age estimation, North India, teeth

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Authors: Ana L. Martins, Rita S. Saraiva, João C. Ferreira

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Much effort has been placed on the assessment of perceived service quality. Several models can be found in literature, but these are mainly focused on business-to-consumer (B2C) relationships. Literature on how to assess perceived quality in business-to-business (B2B) contexts is scarce both conceptually and in terms of its application. This research aims at filling this gap in literature by applying INDSERV to a case study situation. Under this scope, this research aims at analyzing the adequacy of the proposed assessment tool to other context besides the one where it was developed and by doing so analyzing the perceive quality of the advertisement service provided by a specific television network to its B2B customers. The INDSERV scale was adopted and applied to a sample of 33 clients, via questionnaires adapted to interviews. Data was collected in person or phone. Both quantitative and qualitative data collection was performed. Qualitative data analysis followed content analysis protocol. Quantitative analysis used hypotheses testing. Findings allowed to conclude that the perceived quality of the television service provided by television network is very positive, being the Soft Process Quality the parameter that reveals the highest perceived quality of the service as opposed to Potential Quality. To this end, some comments and suggestions were made by the clients regarding each one of these service quality parameters. Based on the hypotheses testing, it was noticed that only advertisement clients that maintain a connection to the television network from 5 to 10 years do show a significant different perception of the TV advertisement service provided by the company in what the Hard Process Quality parameter is concerned. Through the collected data content analysis, it was possible to obtain the percentage of clients which share the same opinions and suggestions for improvement. Finally, based on one of the four service quality parameter in a B2B context, managerial suggestions were developed aiming at improving the television network advertisement perceived quality service.

Keywords: B2B, case study, INDSERV, perceived service quality

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Authors: Mohammad S. Razai, Jan Williams, Rachel Nestel, Dermot Dalton

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Purpose: This descriptive qualitative study aimed to obtain parents recommendations for improving the notification process and communication of positive newborn screening result for cystic fibrosis (CF). Methods: Thematic analysis of semi-structured open-ended interviews with 11 parents of 7 children with confirmed diagnosis of CF between 2 months — 2 years of age. Results: Parents preferred face to face disclosure of positive NBS results by a pediatrician with CF professional qualification. They trusted a pediatrician more than any other professional in providing accurate, credible and comprehensive information about the diagnosis and its implications. Parents recommended that health professionals be knowledgeable and provide clear, succinct and understandable information. Providers should also explore parents concerns and acknowledge feelings and emotions. Most parents reported that they preferred to be notified immediately as soon as the results were available. Several parents preferred to be told once the diagnosis was certain. Most parents regarded open access to CF team as the most significant part of care coordination. In addition to health professionals, most parents used internet as an important source of information, interaction and exchange of experiences. Most parents also used social networking sites such as Facebook groups and smart phone apps. Conclusion: This study provides significant new evidence from parental perspective in emphasizing the pivotal role of good communication skills deployed by a knowledgeable CF specialist in person. Parents use of social media and internet has replaced some traditional methods of information exchange and may reduce the need for professional input for newly diagnosed CF patients.

Keywords: care coordination, cystic fibrosis, newborn screening, notification process, parental preferences, professional-paren communication

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Authors: Rieski Prihastuti, Meliana Depo, Trisno A. Wibowo, Misinem

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On October 19, 2017, Yogyakarta Islamic Hospital reported 38 garment employees with nausea, vomiting, headache, abdominal pain, and diarrhea after they had lunch on October 18, 2017, to Sleman District Health Office. Objectives of this study were to ensure the outbreak and identify source and route of transmission. Case-control study was conducted to analyze food items that caused the outbreak. A case was defined as a person who got symptoms such as abdominal pain, diarrhea, nausea with/without vomiting, fever, and headache after they had lunch on October 18, 2017. Samples included leftover lunch box, vomit, tap water and drinking water had been sent to the laboratory. Data were analyzed descriptively as frequency table and analyzed by using chi-square in bivariate analysis. All of 196 garment employee was included in this study. The common symptoms of this outbreak were abdominal pain (84.4%), diarrhea (72.8%), nausea (61.6%), headache (52.8%), vomiting (12.8%), and fever (6.4%) with median incubation period 13 hours (range 1-34 hours). Highest attack rate and odds ratio was found in grilled chicken (Attack Rate 58,49%) with Odds Ratio 11,023 (Confidence Interval 95% 1.383 - 87.859; p value 0,005). Almost all samples showed mold, except drinking water. Based on its sign and symptoms, also incubation period, diarrheal Bacillus cereus and Clostridium perfringens were suspected to be the causative agent of the outbreak. Limitation of this study was improper sample handling and no sample of food handler and stools in the food caterer. Outbreak investigation training needed to be given to the hospital worker, and monitoring should be done to the food caterer to prevent another outbreak.

Keywords: disease outbreak, foodborne disease, food poisoning, outbreak

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Authors: S. A. N. Rashani, S. Pigera, P. N. J. Fernando, S. Jayawickema, M. A. Niriella, A. P. De Silva

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Dietary supplement (DS) consumption is drastically trending among the young athlete generation in developing countries. Many athletes try to fulfill their nutrition requirements using dietary supplements without knowing their effects on health and performance. This study aimed to assess the DS usage patterns of university athletes in Sri Lanka. A self-administered questionnaire was employed to collect data from state university students representing a university team, and a sample of 200 respondents was selected based on a stratified random sampling technique. Incomplete questionnaires were omitted from the analysis. The data were analyzed using IBM SPSS statistics for Windows version 25. The level of significance was set at p<0.05 in the data analysis. The prevalence of DS was 48.2% (n= 94), with no significant association between gender and DS intake. Protein (15.9%), vitamin (14.9%), sports drinks (12.8%), and creatine (8.2%) were the most consumed DS by students. Weightlifting (85.0%), football (62.5%), rugby (57.7%), and wrestling (40.9%) players showed higher DS usage among other sports. Coaches were reported as the most frequent person who was advised to use DS (43.0%). Students who won interuniversity games showed significantly low DS intake (p = 0.002) compared to others. Interestingly, DS use was significantly affected by the season of use (p = 0.000), pointing out that during competition and training seasons (62.4%) was the most frequent use. The pharmacy (27.0%) was the commonest place to buy DS. Students who used nutrient-dense meal plans during the training and competition period still showed a 61.0% tendency to consume DS. Most claimed reason to use DS was to increase energy and strength (29.0%). A majority reported that they used DS for less than one month (35.5%), while the second-highest duration was over three years (17.2%). Considering body mass index (BMI), healthy weight students showed 71.0% DS prevalence. DS prevalence was moderate among Sri Lankan university students, highlighting that the highest DS use was during competition and training seasons. Moreover, it emphasizes the need for nutrition and anti-doping counseling in the Sri Lankan university system.

Keywords: athlete, dietary, supplements, university

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Authors: Azar Sharafianpor, Hossein Rassi, Fahimeh Nemati Mansur

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Cardiovascular diseases (CVD) are the most important cause of death in industrialized and developing countries such as Iran. The most important risk factors for the CVD, genetic factors and chronic infectious agents, such as Helicobacter pylori, can be mentioned. The TNFα gene is one of the most important anti-inflammatory cytokines that can affect the sensitivity, efficacy, and ability of the immune response to chronic infections. Some TNF-α gene polymorphisms, including the replacement of the G nucleotide G with A at position 308 in the promoter region of TNF-α, increase the transcription of cytokines in the target cells and thus predispose a person to chronic infections. This study examines the TNF-α 308 polymorphism and its association with Helicobacter pylori infection in this disease. This study was a case-control study in which 154 patients were examined as cases or patients with symptoms of myocardial infarction or angina and 160 as controls or healthy subjects. All of the subjects at different ages were given venous blood and age, BMI, cholesterol, LDL, and HDL were determined. DNA was extracted from the specimens, and the cagA gene from H. pylori and the TNF-α-308 polymorphism were determined by PCR in patients and healthy subjects. Statistical analysis was performed with Epi Info software. The results showed that the frequency of H. pylori infection in the patients and healthy group were 53.23% (82 out of 154) and 47.5% (76 out of 160). There was no significant difference in H. pylori outbreak between the two groups. The frequencies of TNF-α-308 genotype for GG, GA, and AA in patients were 0.17, 0.49, and 0.34, respectively, whereas for controls 0.47, 0.35, and 0.18 for GG, GA, and AA, respectively. The frequency of genotype analysis of TNF-α-308 polymorphisms in both patients and healthy groups showed that there was a significant difference in the frequency of genotypes and the AA genotype was higher in the affected individuals. Also, there was a significant relationship between the genotype and the contamination with H. pylori and changes in cholesterol, LDL, and HDL levels were observed. The results of the study indicate that H. pylori detection in individuals with AA genotype in people under 50 years of age can play an important role in early diagnosis and treatment of cardiovascular disease.

Keywords: Helicobacter pylori, TNFα gene, cardiovascular diseases, TNFα-308 polymorphism

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Authors: Shahla Bukhtair

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A paradigm presents a consensus view of a particular or collective community, accepted into by the members of that community, either consciously pronounced or, more likely, simply assumed and not intentionally acknowledged but is articulated. Paradigm shift is based on the behavioral attitude of the community. Change is inexorable. The world is suffering with the innovative creation of globalization. Media boosted this paradigm shift all over the world. Globalization is a vigorous process which impacts differentially on various cultures around the world. The outcome of the globalization is permeates cultural boundaries and in the process results in the spread of Western ideologies and values across the world. The term flourished in 20th century. Globalization is regarded as having substantial impact on such crises through its encouragement of conflicts rather than conciliation; through opportunities of expression, various groups get benefit with it. Identity crisis refers to inflexible mechanism i.e. cultural and political conflicts among polarized groups, which struggle with each other over the definition of a national identity. Violence is not only a kind of physical but it also psychological as well. Due to identity crisis, a person is having an issue of fear, anxiety, and lack of security. Everything has negative and positive aspects. Newspaper columns, magazine articles, films, made-for-TV movies, television special reports, and talk shows are all public arenas where images of political agenda of their own interest are constructed, debated, and reproduced. From these resources, individuals construct their own conceptions of what is normal and acceptable. This bias affects images in the media, and in turn has a negative effect on public development in a society. This paper investigates the relationship between globalization and cultural war, identity crisis and the role of violence. Objectives: - To determine which type of media plays an important role in shaping perceptions and attitudes of public negatively; - To analyze the impact of globalization on identity crisis, violence and global culture (positive and negative).

Keywords: paradigm shift, globalization, identity crisis, cultural war

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Authors: Vinay Suhalka

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In India, the official nomenclature used by the State for persons with disability is divyang (literally, the one with a divine limb), a word coming from the Sanskrit language. Disability thus gets portrayed as divine, at least in the welfare sector from where it flows down even to the popular imagination where it gets equated to divinity. This paper looks at reference to persons with disabilities as divyangs and goes on to discusses what such usage for an already marginalized group achieves and misses out. The issue of nomenclature and language has always been a contested one when it comes to disability. At the same time, there is also an issue of who determines these labels for the persons with disability. Nomenclature and language used for disability can have real consequences for the population of persons with disability as it may empower or disempower them. Thus, this paper looks at the issue of what it means for persons with disabilities as ‘exceptionally gifted’ and hence divyang. Language can be a powerful tool to communicate meanings and messages associated with a term. When the persons with disabilities as a group are described as ‘exceptionally gifted, talented and the source of inspiration’, it essentially stereotypes and marginalizes them by putting a burden of performance that all of them ought to be achievers, and it is only then that they would be assimilated in the larger society. This paper also argues that such a situation creates a ‘double bind’ where the person is always trying to match up to the labels (the disabled as ‘achiever, overcomer, inspirational’) created by somebody else and looks at self through the eyes of others. This conceptual paper also presents an overview of disability labels while simultaneously looking at projecting disability as divinity which has the potential to wrongly portray the lives of persons with disability in India due to the official usage of the term. It also explores the question of visibility of disability since the idea of divyang implicitly assumes that all disabilities are visible. In reality, however, it may not be the case simply because all forms of disabilities are not visible, people may choose not to visibilize their disabilities if they can and pass as able-bodied, fearing the stigma that surrounds disability. Finally, it argues for an increased focus on understanding the everyday lived realities of those with disability in order to regard it as an important form of difference which could be a potential resource for the society.

Keywords: persons with disability, labels, language use, divinity

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Authors: Omotoyosi Bilikies Ilori, Adekunle Saheed Ajisebiyawo

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After the Second World War, there was an emergence of a new stage of capitalist globalization with its Neo-liberal ideology. There were global economic and political restructurings that affected third-world countries like Nigeria. Neo-liberalism is the driving force of globalization, which is the latest manifestation of imperialism that engenders endemic poverty in Nigeria. Poverty is severe and widespread in Nigeria. Poverty entails a situation where a person lives on less than one dollar per day and has no access to basic necessities of life. Poverty is inhuman and a breach of human rights. The Nigerian government initiated some strategies in the past to help in poverty reduction. Neo-liberalism manifested in the Third World, such as Nigeria, through the privatization of public enterprises, trade liberalization, and the rollback of the state investments in providing important social services. These main ideas of Neo-liberalism produced poverty in Nigeria and also encouraged the abandonment of the social contract between the government and the people. There is thus a gap in the provision of social services and subsidies for the masses, all of which Neo-liberal ideological positions contradict. This paper is a qualitative study which draws data from secondary sources. The theoretical framework is anchored on the market theory of capitalist globalization and public choice theory. The objectives of this study are to (i) examine the impacts of Neo-liberalism on poverty in Nigeria as a typical example of a Third World country and (ii) find out the effects of Neo-liberalism on the provision of social services and subsidies and employment. The findings from this study revealed that (i) the adoption of the Neo-liberal ideology by the Nigerian government has led to increased poverty and poor provision of social services and employment in Nigeria; and (ii) there is an increase in foreign debts which compounds poverty situation in Nigeria. This study makes the following recommendations: (i) Government should adopt strategies that are pro-poor to eradicate poverty; (ii) The Trade Unions and the masses should develop strategies to challenge Neo-liberalism and reject Neo-liberal ideology.

Keywords: neo-liberalism, poverty, employment, poverty reduction, structural adjustment programme

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Authors: Abdela Zeinu Yasin

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The current research aimed to assess the status of IMC in providing treatment for malnourished children and programs in water, sanitation, and hygiene (WASH), food and livelihood security, and comprehensive healthcare through Mobile health and nutrition programs during the last 5 years period. We have conducted 60 in-depth interviews with women during the period from conception to a child’s birthday, health facility staff, and female community health volunteers (FCHVs), as well as 12 focus group discussions with health facility staff and other household decision-makers. We employed thematic analysis using framework matrices and analytical memorandums. The study revealed that 78% of the respondents, of whom 97% were women, have benefited from the selected vulnerable areas. The use of the clear water and sanitization program has reached the 81% of selected households. The use of a modern baby delivery system among the respondent has been 68% of the women and health facilities among the decision-makers/focal person. More than 8 in 10 participants (84%) could read and understand the health facility instructions, and the majority (82%) of women, health facility staff, and male decision-makers can also read and write bulletins and instructions. We found that decision-maker women preferred participative education, whereas health facilities and the IMC desired educational and motivational bulletins. A Mobile Health and Nutrition program intervention by the IMC is acceptable in the conditions of the Ethiopian community and has the potential to improve community health and nutrition service utilization, particularly by providing clean water and sanitization; women’s birth control, and health improvement in the vulnerable regions of the country. The current research findings shall contribute to text IMC Mobile Health and Nutritional intervention design in under-resourced settings.

Keywords: clean water, health and nutrition services, hygiene, IMC, mobile health, sanitation

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Authors: Jotham Mazhura

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Floriculture production is an ideal project for sustainable horticultural production in Masvingo city.Gender links in collaboration with the embasy of Sweedenare supporting the floriculture project with the aim of improving residents livelihoods in the city.World trade in floriculture such as cut flowers,live ornamental plants and foliage continue to increase and there are recognised markets opportunities across the globe.Some specific opportunitiesin an interview discussion by the consultant appointed by gender links and embasy of Sweeden highlightedsome constraints and opportunities in the project of floriculture in Masvingo city.Based on the outcome of the scoping studies this research project developed and evaluated strategies for enhancing floriculture production in Masvingo city. A survey was therefore carried out by the researcher among the existing florists farmers in the city to determine strategies to be employed to improve floriculture production.The survey was conducted to twenty florists in the city.The sample was taken by using purposive sampling which is a sampling technique based on the certain considerations, hence there were some basic creteria in selecting samples. A questionnaire in this aspect was administered to the 20 florists to determine the essential strategies to be employed to enhance floriculture production.Each respondent was given data for the business strategies and asked to rank those strategies from the most to the least important.From the research findings the following were revealed out by the respondents that is capturing marketshare,establishment of of ownership of the project,the project manager to be innovative,the business should gain competitive strategic through generic strategies market development strategy and product development strategy. Based on the observation and structured interview with respondents the average of floriculture owners had similar strategies implemented on their business.The research proved that floriculture farmers use various strategies to keep their businesses running and succeding in achieving set goals.Therefore the ressearche who happens to be the project focal person became certain that it is edeal to emply a variety of of strategies to improve floriculture oproduction

Keywords: florist, floriculture, strategy, livelihoods

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Authors: Cliff Shunsheng Han

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Identifying the direct allergy cause that can be easily mitigated is the foundation to stop the allergy epidemic that has been started in the seventies. It has confirmed that the personal and social hygiene practices are associated with the allergy prevalence. But direct causes have been found, and proposed translational measures have not been effective. This study, assisted by a particular case of allergies, has seen the direct cause of allergies, developed a valid test resulted in lasting relief for allergies, and constructed theory describing general relationship between microbiota and host immune system. Saliva samples were collected from a subject for three years during which time the person experienced yearlong allergy, seasonal allergy, and remission of allergy symptoms. Bacterial DNA was extracted and 16S rRNA genes were profiled with Illumina sequencing technology. The analyzing results indicate that the possible direct cause of allergy is the lacking probiotic bacteria in the oral cavity, such as genera Streptococcus and Veilonella, that can produce metabolites to pacify immune system. Targeted promotion of those bacteria with a compound designed for them, has led to lasting remissions of allergic rhinitis. During the development of the translational measure, the subject's oral biofilm was completely destructed by a moderate fever due to an unrelated respiratory infection. The incident not only facilitated the development of the heat based microbiota reseeding procedure but also indicated a possible natural switch that subsequently increases the efficacy of the immune system previously restrained by metabolites from microbiota. These results lead to the proposal of a Theory of Negative Trigger (TNT) to describe the relationship between oral probiotics and immune system, in which probiotics are the negative trigger that will release the power of immune system when removed by fever or modern lifestyles. This study could open doors leading to further understanding of how the immune system functions under the influence of microbiota as well as validate simple traditional practices for healthy living.

Keywords: oral microbiome, allergy, immune system, infection

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Authors: Sarah M. Schoellhammer, Stephen Gibb

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Bureaucracy, in particular, its core element, a formal and stable hierarchy of authority, is proving less and less appropriate under the conditions of today’s knowledge economy. Centralization and formalization were consistently found to hinder innovation, undermining cross-functional collaboration, personal responsibility, and flexibility. With its focus on systematical planning, controlling and monitoring the development of new or improved solutions for customers, even innovation management as a discipline is to a significant extent based on a mechanistic understanding of organizations. The most important drivers of innovation, human creativity, and initiative, however, can be more hindered than supported by central elements of classic innovation management, such as predefined innovation strategies, rigid stage gate processes, and decisions made in management gate meetings. Heterarchy, as an alternative network form of organization, is essentially characterized by its dynamic influence structures, whereby the biggest influence is allocated by the collective to the persons perceived the most competent in a certain issue. Theoretical arguments that the non-hierarchical concept better supports innovation than bureaucracy have been supported by empirical research. These prior studies either focus on the structure and general functioning of non-hierarchical organizations or on their innovativeness, that means innovation as an outcome. Complementing classic innovation management approaches, this work aims to shed light on how innovations are initiated and realized in heterarchies in order to identify alternative solutions practiced under conditions of the post-bureaucratic organization. Through an initial individual case study, which is part of a multiple-case project, the innovation practices of an innovative and highly heterarchical medium-sized company in the German fire engineering industry are investigated. In a pragmatic mixed methods approach media resonance, company documents, and workspace architecture are analyzed, in addition to qualitative interviews with the CEO and employees of the case company, as well as a quantitative survey aiming to characterize the company along five scaled dimensions of a heterarchy spectrum. The analysis reveals some similarities and striking differences to approaches suggested by classic innovation management. The studied heterarchy has no predefined innovation strategy guiding new product and service development. Instead, strategic direction is provided by the CEO, described as visionary and creative. Procedures for innovation are hardly formalized, with new product ideas being evaluated on the basis of gut feeling and flexible, rather general criteria. Employees still being hesitant to take responsibility and make decisions, hierarchical influence is still prominent. Described as open-minded and collaborative, culture and leadership were found largely congruent with definitions of innovation culture. Overall, innovation efforts at the case company tend to be coordinated more through cultural than through formal organizational mechanisms. To better enable innovation in mainstream organizations, responsible practitioners are recommended not to limit changes to reducing the central elements of the bureaucratic organization, formalization, and centralization. The freedoms this entails need to be sustained through cultural coordination mechanisms, with personal initiative and responsibility by employees as well as common innovation-supportive norms and values. These allow to integrate diverse competencies, opinions, and activities and, thus, to guide innovation efforts.

Keywords: bureaucracy, heterarchy, innovation management, values

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Authors: Sara Cumming, Julianne DiSanto, Leah Burton

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Homelessness in Canada is a persistent problem. It has been widely argued that the best tactic for eradicating homelessness is to approach social issues from a Housing First perspective—an approach that centers on quickly moving people into permanent and independent housing and then providing them additional support and services as needed. It is recognized that life skills training is both necessary and an effective way to reduce cyclical homelessness; however, there is a scarcity of research on effective ways to teach life skills; this problem was exacerbated in a pandemic context, where in-person delivery was severely restricted or no longer possible. Very little attention has been paid to the diverse cultural needs of clients in a multicultural context and the need to foster cultural knowledge/awareness in individuals to successfully contribute to the cultural safety of communities. This research attempts to fill these gaps in the literature and in practice by employing a community-engaged research (CER) approach. Academic, government, funders, front-line staff, and clients at 15 not-for-profits from across the Greater Toronto Area in Ontario, Canada, collaborated to co-create a virtual, client-centric, equity, diversity, and inclusion (EDI) informed life skill learning management system. We employed a triangulation methodology for this research. An environmental scan was conducted for best practices. Two separate Creative Problem Solving Sessions were held with over 100 front-line workers, managers, and executive directors who work with homeless populations. Quantitative and open-ended surveys were completed by over 200 individuals with experience with homelessness. All sections of this research aimed to discover the areas of skills that individuals need to maintain housing and to ascertain what a more client-driven EDI approach to life skills training should include. This research will showcase which life skills are deemed essential for homeless and precariously housed individuals.

Keywords: homelessness, Housing First, life skills, community engaged research

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Authors: M. Manohari, S. Priyadharshini, K. Bajeer Sulthan, R. Santhanam, S. Chandrasekaran, B. Venkatraman

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In-vivo monitoring facility at Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam, caters to the monitoring of internal exposure of occupational radiation workers from various radioactive facilities of IGCAR. Internal exposure measurement is done using Na(Tl) based Scintillation detectors. Two types of whole-body counters, namely Shielded Chair Counter (SC) and Standing Whole-Body Monitor (SWBM), are being used. The shielded Chair is based on a NaI detector of 20.3 cm diameter and 10.15 cm thick. The chair of the system is shielded using lead shots of 10 cm lead equivalent and the detector with 8 cm lead bricks. Counting geometry is sitting geometry. Calibration is done using 95 percentile BOMAB phantom. The minimum Detectable Activity (MDA) for 137Cs for the 60s is 1150 Bq. Standing Wholebody monitor (SWBM) has two NaI(Tl) detectors of size 10.16 x 10.16 x 40.64 cm3 positioned serially, one over the other. It has a shielding thickness of 5cm lead equivalent. Counting is done in standup geometry. Calibration is done with the help of Ortec Phantom, having a uniform distribution of mixed radionuclides for the thyroid, thorax and pelvis. The efficiency of SWBM is 2.4 to 3.5 times higher than that of the shielded chair in the energy range of 279 to 1332 keV. MDA of 250 Bq for 137Cs can be achieved with a counting time of 60s. MDA for 131I in the thyroid was estimated as 100 Bq from the MDA of whole-body for one-day post intake. Standing whole body monitor is better in terms of efficiency, MDA and ease of positioning. In case of emergency situations, the optimal MDAs for in-vivo monitoring service are 1000 Bq for 137Cs and 100 Bq for 131I. Hence, SWBM is more suitable for the rapid screening of workers as well as the public in the case of an emergency. While a person reports for counting, there is a potential for external contamination. In SWBM, there is a feasibility to discriminate them as the subject can be counted in anterior or posterior geometry which is not possible in SC.

Keywords: minimum detectable activity, shielded chair, shielding thickness, standing whole body monitor

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Authors: Rose A. Yemson, Ping Jiang, Oyedeji L. Inumoh

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The deployment of wireless sensor network has rapidly increased, however with the increased capacity and diversity of sensors, and applications ranging from biological, environmental, military etc. generates tremendous volume of data’s where more attention is placed on the distributed sensing and little on how to manage, analyze, retrieve and understand the data generated. This makes it more quite difficult to process live sensor data, run concurrent control and update because sensor data are either heavyweight, complex, and slow. This work will focus on developing a web service platform for automatic detection of sensors, acquisition of sensor data, storage of sensor data into a database, processing of sensor data using reconfigurable software components. This work will also create a web service based sensor data management system to monitor physical movement of an individual wearing wireless network sensor technology (SunSPOT). The sensor will detect movement of that individual by sensing the acceleration in the direction of X, Y and Z axes accordingly and then send the sensed reading to a database that will be interfaced with an internet platform. The collected sensed data will determine the posture of the person such as standing, sitting and lying down. The system is designed using the Unified Modeling Language (UML) and implemented using Java, JavaScript, html and MySQL. This system allows real time monitoring an individual closely and obtain their physical activity details without been physically presence for in-situ measurement which enables you to work remotely instead of the time consuming check of an individual. These details can help in evaluating an individual’s physical activity and generate feedback on medication. It can also help in keeping track of any mandatory physical activities required to be done by the individuals. These evaluations and feedback can help in maintaining a better health status of the individual and providing improved health care.

Keywords: HTML, java, javascript, MySQL, sunspot, UML, web-based, wireless network sensor

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Authors: Payman Tajalli, Steven Segal

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Applied ethics is an area of ethics which is looked upon most favorably as the most appropriate and useful for educational purposes; after all if ethics finds no application would any investment of time, effort and finance by the educational institutions be warranted? The current approaches to ethics in business and management often entail appealing to various types of moral theories and to this end almost every major philosophical approach has been enlisted. In this paper, we look at ethics through the philosophy of Emmanuel Levinas to argue that since ethics is ‘first philosophy’ it can neither be rule-based nor rule-governed, not something that can be worked out first and then applied to a given situation, hence the overwhelming emphasis on ‘applied ethics’ as a field of study in business and management education is unjustified. True ethics is not applied ethics. This assertion does not mean that teaching ethical theories and philosophies need to be abandoned rather it is the acceptance of the fact that an increase in cognitive awareness of such theories and ethical models and frameworks, or the mastering of techniques and procedures for ethical decision making, will not affect the desired ethical transformation in our students. Levinas himself argued for an ethics without a foundation, not one that required us to go ‘beyond good and evil’ as Nietzsche contended, rather an ethics which necessitates going ‘before good and evil'. Such an ethics does not provide us with a set of methods or techniques or a decision tree that enable us determine the rightness of an action and what we ought to do, rather it is about a way of being, an ethical posture or approach one takes in the inter-subjective relationship with the other that holds the promise of ethical conduct. Ethics in this Levinasian sense then is one of infinite and unconditional responsibility for the other person in relationship, an ethics which is not subject to negotiation, calculation or reciprocity, and as such it could neither be applied nor taught through conventional pedagogy with its focus on knowledge transfer from the teacher to student, and to this end Levinas offers a non-maieutic, non-conventional approach to pedagogy. The paper concludes that from a Levinasian perspective on ethics and education, we may need to guide our students to move away from the clear and objective professionalism of the management and applied ethics towards the murky individual spiritualism. For Levinas, this is ‘the Copernican revolution’ in ethics.

Keywords: business ethics, ethics education, Levinas, maieutic teaching, ethics without foundation

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Authors: Babar Rasheed, Saad Ghafoor

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Introduction: Idea campaigns are commonly held across organizations for generating employee engagement. The contribution is specifically designed to identify and solve prevalent issues. It is argued that numerous organizations fail to achieve their desired goals despite arranging for such campaigns and investing heavily in them. There are however practices that organizations use to achieve higher degree of effectiveness, and these practices may be up for exploration by research to make them usable for the other organizations. Purpose: The aim of this research is to surface the idea management practices of a leading electric company with global operations. The study involves a large sized, multi site organization that is attributed to have added challenges in terms of managing ideas from employees, in comparison to smaller organizations. The study aims to highlight the factors that are looked at as the idea management team strategies for the campaign, sets terms and rewards for it, makes follow up with the employees and lastly, evaluate and award ideas. Methodology: The study is conducted in a leading electric appliance corporation that has a large number of employees and is based in numerous regions of the world. A total of 7 interviews are carried out involving the chief innovation officer, innovation manager and members of idea management and evaluation teams. The interviews are carried out either on Skype or in-person based on the availability of the interviewee. Findings: While this being a working paper and while the study is under way, it is anticipated that valuable information is being achieved about specific details on how idea management systems are governed and how idea campaigns are carried out. The findings may be particularly useful for innovation consultants as resources they can use to promote idea campaigning. The usefulness of the best practices highlighted as a result is, in any case, the most valuable output of this study.

Keywords: employee engagement, motivation, idea campaigns, large organizations, best practices, employees input, organizational output

Procedia PDF Downloads 159

Authors: Maiya Smith, Tyler Thorne

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Background: The Pacific faces multiple healthcare crises, including high rates of noncommunicable diseases, infectious disease outbreaks, and susceptibility to natural disasters. These issues are expected to worsen in the coming decades, increasing the burden on an already understaffed healthcare system. Telehealth is not new to the Pacific, but improvements in technology and accessibility have increased its utility and have already proven to reduce costs and increase access to care in remote areas. Telehealth includes distance learning; a form of education that can help alleviate many healthcare issues by providing continuing education to healthcare professionals and upskilling staff, while decreasing costs. This study examined distance learning programs at the Ministry of Health in the Pacific nation of Palau and identified key elements to their successful distance learning programs. Methods: Staff at the Belau National Hospital in Koror, Palau as well as private practitioners were interviewed to assess distance learning programs utilized. This included physicians, IT personnel, public health members, and department managers of allied health. In total, 36 people were interviewed. Standardized questions and surveys were conducted in person throughout the month of July 2019. Results: Two examples of successful distance learning programs were identified. Looking at the factors that made these programs successful, as well as consulting with staff who undertook other distance learning programs, four factors for success were determined: having a cohort, having a facilitator, dedicated study time off from work, and motivation. Discussion: In countries as geographically isolated as the Pacific, with poor access to specialists and resources, telehealth has the potential to radically change how healthcare is delivered. Palau shares similar resources and issues as other countries in the Pacific and the lessons learned from their successful programs can be adapted to help other Pacific nations develop their own distance learning programs.

Keywords: distance learning, Pacific, Palau, telehealth

Procedia PDF Downloads 125

Authors: Xharavina V., Gallopeni F., Ahmeti K.

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Stuttered speech is filled with intermittent sound prolongations and/or rapid part word repetitions. Oftentimes, these aberrant acoustic behaviors are associated with intermittent physical tension and struggle behaviors such as head jerks, arm jerks, finger tapping, excessive eye-blinks, etc. Additionally, the jarring nature of acoustic and physical manifestations that often accompanies moderate-severe stuttering may induce negative emotional responses in listeners, which alters communication between the person who stutters and their listeners. However, researches for the influence of negative emotions in the communication and for physical reaction are limited. Therefore, to compare psycho-physiological responses of fluent adults, while listening the speech of adults who speak fluency and adults who stutter, are necessary. This study comprises the experimental method, with total of 104 participants (average age-20 years old, SD=2.1), divided into 3 groups. All participants self-reported no impairments in speech, language, or hearing. Exploring the responses of the participants, there were used two records speeches; a voice who speaks fluently and the voice who stutters. Heartbeats and the pulse were measured by the digital blood pressure monitor called 'Tensoval', as a physiological response to the fluent and stuttering sample. Meanwhile, the emotional responses of participants were measured by the self-reporting questionnaire (Steenbarger, 2001). Results showed an increase in heartbeats during the stuttering speech compared with the fluent sample (p < 0.5). The listeners also self-reported themselves as more alive, unhappy, nervous, repulsive, sad, tense, distracted and upset when listening the stuttering words versus the words of the fluent adult (where it was reported to experience positive emotions). These data support the notions that speech with stuttering can bring a psycho-physical reaction to the listeners. Speech pathologists should be aware that listeners show intolerable physiological reactions to stuttering that remain visible over time.

Keywords: emotional, physiological, stuttering, fluent speech

Procedia PDF Downloads 126

Authors: Brittany L. Kang

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One familiar theory of the origin of multiple personalities focuses on how symptoms of trauma or abuse are central causes, as seen in paradigmatic examples of the condition. The theory states that multiple personalities constitute a congenital condition, as babies all exhibit multiplicity, and that generally alters only remain separated due to trauma. In more typical cases, the alters converge and become a single identity; only in cases of trauma, according to this account, do the alters remain separated. This theory is misleading in many aspects, the most prominent being that not all multiple personality patients are victims of child abuse or trauma, nor are all cases of multiple personality observed in early childhood. The use of this criterion also causes clinical problems, including an inability to identify multiple personalities through the variety of symptoms and traits seen across observed cases. These issues present a need for revision in the currently applied criterion in order to separate the notion of child abuse and to be able to better understand the origins of multiple personalities itself. Identifying multiplicity through the application of identity theories will improve the current criterion, offering a bridge between identifying existing cases and understanding their origins. We begin by applying arguments from Wiggins, who held that each personality within a multiple was not a whole individual, but rather characters who switch off. Wiggins’ theory is supported by observational evidence of how such characters are differentiated. Alters of older ages are seen to require different prescription lens, in addition to having different handwriting. The alters may also display drastically varying styles of clothing, preferences in food, their gender, sexuality, religious beliefs and more. The definitions of terms such as 'personality' or 'persons' also become more distinguished, leading to greater understanding of who is exactly able to be classified as a patient of multiple personalities. While a more common meaning of personality is a designation of specific characteristics which account for the entirety of a person, this paper argues from Wiggins’ theory that each 'personality' is in fact only partial. Clarification of the concept in question will allow for more successful future clinical applications.

Keywords: identification, multiple personalities, origin, Wiggins' theory

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Authors: Stellina Jolly

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July 18th to August 19th 2013 has gone down in the history of India for undertaking the country’s first environment referendum. The Supreme Court had ruled that the Vedanta Group's bauxite mining project in the Niyamgiri Hills of Orissa will have to get clearance from the gram sabha, which will consider the cultural and religious rights of the tribals and forest dwellers living in Rayagada and Kalahandi districts. In the Niyamgiri hills, people of small tribal hamlets were asked to voice their opinion on bauxite mining in their habitat. The ministry has reiterated its stand that mining cannot be allowed on the Niyamgiri hills because it will affect the rights of the Dongria Kondhs. The tribal person who occupies the Niyamgiri Hills in Eastern India accomplished their first success in 2010 in their struggle to protect and preserve their existence, culture and land against Vedanta a London-based mining giant. In August, 2010 Government of India revoked permission for Vedanta Resources to mine bauxite from hills in Orissa State where the Dongria Kondh live as forest dwellers. This came after various protests and reports including amnesty report wherein it highlighted that an alumina refinery in eastern India operated by a subsidiary of mining company. Vedanta was accused of causing air and water pollution that threatens the health of local people and their access to water. The abuse of human rights by corporate is not a new issue it has occurred in Africa, Asia and other parts of the world. Paper focuses on the instances and extent of human right especially in terms of environment violations by corporations. Further Paper details on corporations and sustainable development. Paper finally comes up with certain recommendation including call for a declaration by United Nations on Corporate environment Human Rights Liability.

Keywords: environment, corporate, human rights, sustainable development

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Authors: Seong-Jin Cho, Jin Ho Kim

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Energy harvesting is the technology which gathers and converts external energies such as light, vibration and heat which are disposed into reusable electrical energy and uses such electrical energy. The vibration energy harvesting is very interesting technology because it produces very high density of energy and unaffected by the climate. Vibration energy can be harvested by the electrostatic, electromagnetic and piezoelectric systems. The electrostatic system has low energy conversion efficiency, and the piezoelectric system is expensive and needs the frequent maintenance because it is made of piezoelectric ceramic. On the other hand, the electromagnetic system has a long life time and high harvesting efficiency, and it is relatively cheap. The electromagnetic harvesting system includes the linear generator and the rotary-type generator. The rotary-type generators require the additional mechanical conversion device if it uses linear motion of vibration. But, the linear generator uses directly linear motion of vibration without a mechanical conversion device, and it has uncomplicated structure and light weight compared with the rotary-type generator. Therefore, the linear electromagnetic generator can be useful in using vibration energy harvesting. The pole transformer systems need electricity sensor system for sending voltage and power information to administrator. Therefore, the battery is essential, and its regular maintenance of replacement is required. In case of the transformer of high location in mountainous areas, the person can’t easily access it resulting in high maintenance cost. To overcome these problems, we designed and developed the linear electromagnetic generator which can replace battery in electricity sensor system for sending voltage and power information of the pole transformer. And, it uses vibration energy of frequency more than 50 Hz by the pole transformer. In order to analyze the electromagnetic characteristics of small linear electric generator, a commercial electromagnetic finite element analysis program "MAXWELL" was used. Then, through the actual production and experiment of linear generator, we confirmed output power of linear generator.

Keywords: energy harvesting, frequency, linear generator, experiment

Procedia PDF Downloads 248

Authors: Érica Lima

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In the digital era, in which we have an avalanche of information, it is not new that the Internet has brought new modes of communication and knowledge access. Characterized by the multiplicity of discourses, opinions, beliefs and cultures, the web is a space of political-ideological dimensions where people (who often do not know each other) interact and create representations, deconstruct stereotypes, and redefine identities. Currently, the translator needs to be able to deal with digital spaces ranging from specific software to social media, which inevitably impact on his professional life. One of the most impactful ways of being seen in cyberspace is the participation in social networking groups. In addition to its ability to disseminate information among participants, social networking groups allow a significant personal and social exposure. Such exposure is due to the visibility of each participant achieved not only on its personal profile page, but also in each comment or post the person makes in the groups. The objective of this paper is to study the representations of translators and translation process on the Internet, more specifically in publications in two Brazilian groups of great influence on the Facebook: "Translators/Interpreters" and "Translators, Interpreters and Curious". These chosen groups represent the changes the network has brought to the profession, including the way translators are seen and see themselves. The analyzed posts allowed a reading of what common sense seems to think about the translator as opposed to what the translators seem to think about themselves as a professional class. The results of the analysis lead to the conclusion that these two positions are antagonistic and sometimes represent conflict of interests: on the one hand, the society in general consider the translator’s work something easy, therefore it is not necessary to be well remunerated; on the other hand, the translators who know how complex a translation process is and how much it takes to be a good professional. The results also reveal that social networking sites such as Facebook provide more visibility, but it takes a more active role from the translator to achieve a greater appreciation of the profession and more recognition of the role of the translator, especially in face of increasingly development of automatic translation programs.

Keywords: Facebook, social representation, translation, translator

Procedia PDF Downloads 137

Authors: Hamide Azimi Lolaty, Fateme Alsadat Ghanipoor, Azar Ramzani, Reza Ali Mohammadpoor, Alireza Babaei

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Background and Objective: Despite the merits behind orthognathic surgery, self-care training in such patients seems logical. The current research was performed pursuing the goal of outlining the effect of training mindfulness-based self-care on Self-Esteem (SE) and Body Image Concern (BIC) of orthognathic surgery candidate patients. Material and Methods: The present study was performed using a semi-experimental method with pre-and post-design in the control and intervention groups. The eligible patients to enter the Babol-based Shahid Beheshti Orthognathic Surgery Clinic were conveniently divided into two 25-person groups. The variables of Self-Esteem and Body Image Concern were measured before and after executing the eight 90-minute training sessions and in the follow-up period done three months after executing the intervention using Cooper Smith’s Self-Esteem Inventory (CSEI) and Body Image Concern Inventory (BICI). The data were analyzed using ANOVA and the independent t-test and using SPSS-26, the data were analyzed at a 0.05 level. Results: As a result of the intervention, the intervention group’s SE score critically changed on average from 25.4±7.31 in the pre-intervention to 31.16±7.05 in the post-intervention and to 40.45±3.51 in the follow-up period (P=0.01), the intervention group’s BIC score changed on average from 60.28±16.47 in the pre-intervention to 47.15±80.47 in the post-intervention and to 32.20 ± 10.73 in the follow-up period. This difference was meaningful (P=0.001). But due to time and the intervention interaction, the control group underwent this significant reduction with a delay. The study revealed the scores of the SE as 32± 6.84 and that of the BIC as 43.32±10.64 in the control group didn’t result in any meaningful statistical difference (P<0.05). Conclusion: Training mindfulness-based self-care exerts an effect on the SE and BIC of the patients undergoing orthognathic surgery. Therefore, it’s recommended to train mindfulness-based self-care for orthognathic surgery candidate patients.

Keywords: self-care, mindfulness, self-esteem, body image concern, orthognathic surgery

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Authors: Michelle Maurer, Antonia Last, Mark S. Gresnigt, Bernhard Hube, Alexander S. Mosig

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The intestinal epithelium forms an essential barrier to prevent translocation of microorganisms, toxins or other potentially harmful molecules into the bloodstream. In particular, dendritic cells of the intestinal epithelium orchestrate an adapted response of immune tolerance to commensals and immune defense against invading pathogens. Systemic inflammation is typically associated with a dysregulation of this adapted immune response and is accompanied by a disruption of the epithelial and endothelial gut barrier which enables dissemination of pathogens within the human body. To understand the pathophysiological mechanisms underlying the inflammation-associated gut barrier breakdown, it is crucial to elucidate the complex interplay of the host and the intestinal microbiome. A microfluidically perfused three-dimensional intestine-on-chip model was established to emulate these processes in the presence of immune cells, commensal bacteria, and facultative pathogens. Multi-organ tissue flow (MOTiF) biochips made from polystyrene were used for microfluidic perfusion of the intestinal tissue model. The biochips are composed of two chambers separated by a microporous membrane. Each chamber is connected to inlet and outlet channels allowing independent perfusion of the individual channels and application of microfluidic shear stress. Human umbilical vein endothelial cells (HUVECs), monocyte-derived macrophages and intestinal epithelial cells (Caco-2) were assembled on the biochip membrane. Following 7 – 14 days of growth in the presence of physiological flow conditions, the epithelium was colonized with the commensal bacterium Lactobacillus rhamnosus, while the endothelium was perfused with peripheral blood mononuclear cells (PBMCs). Additionally, L. rhamnosus was co-cultivated with the opportunistic fungal pathogen Candida albicans. Within one week of perfusion, the epithelial cells formed self-organized and well-polarized villus- and crypt-like structures that resemble essential morphological characteristics of the human intestine. Dendritic cells were differentiated in the epithelial tissue that specifically responds to bacterial lipopolysaccharide (LPS) challenge. LPS is well-tolerated at the luminal epithelial side of the intestinal model without signs of tissue damage or induction of an inflammatory response, even in the presence of circulating PBMC at the endothelial lining. In contrast, LPS stimulation at the endothelial side of the intestinal model triggered the release of pro-inflammatory cytokines such as TNF, IL-1β, IL-6, and IL-8 via activation of macrophages residing in the endothelium. Perfusion of the endothelium with PBMCs led to an enhanced cytokine release. L. rhamnosus colonization of the model was tolerated in the immune competent tissue model and was demonstrated to reduce damage induced by C. albicans infection. A microfluidic intestine-on-chip model was developed to mimic a systemic infection with a dysregulated immune response under physiological conditions. The model facilitates the colonization of commensal bacteria and co-cultivation with facultative pathogenic microorganisms. Both, commensal bacteria alone and facultative pathogens controlled by commensals, are tolerated by the host and contribute to cell signaling. The human intestine-on-chip model represents a promising tool to mimic microphysiological conditions of the human intestine and paves the way for more detailed in vitro studies of host-microbiota interactions under physiologically relevant conditions.

Keywords: host-microbiota interaction, immune tolerance, microfluidics, organ-on-chip

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Authors: S. M. C. Kelly, A. Hargreaves, S. Hargreaves

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Introduction: The Can’t intubate, Can’t ventilate emergency scenario is one which has been shown to be managed badly in the past. Reasons identified included gaps in knowledge of the procedure and the emergency equipment used. We aimed to show an increase in confidence amongst anesthetists and operating department practitioners in the technique following a short tea trolley style teaching intervention. Methods: We carried out the teaching on a one-to-one basis. Two Anaesthetists visited each operating theatre during normal working days. One carried out the teaching session and one took over the intra‐operative care of the patient, releasing the listed anaesthetist for a short teaching session. The teaching was delivered to mixture of students and healthcare professionals, both anaesthetists and anaesthetic practitioners. The equipment includes a trolley, an airway manikin, size 10 scalpel, bougie and size 6.0 tracheal tube. The educator discussed the equipment, performed a demonstration and observed the participants performing the procedure. We asked each person to fill out a pre and post teaching questionnaire, stating their confidence with the procedure. Results: The teaching was delivered to 63 participants in total, which included 21 consultant anaesthetists, 23 trainee doctors and 19 anaesthetic practitioners. The teaching sessions lasted on average 9 minutes (range 5– 15 minutes). All participants reported an increase in confidence in both the equipment and technique in front of neck access. Anaesthetic practitioners reported the greatest increase in confidence (53%), with trainee anaesthetists reporting 27% increase and consultant anaesthetists 22%. Overall, confidence in the performance of emergency front of neck access increased by 31% after the teaching session. Discussion: Short ‘Trolley style’ teaching improves confidence in the equipment and technique used for the emergency front of neck access. This is true for students and for consultant anaesthetists. This teaching style is quick with minimal running costs and is relevant for all anesthetic departments.

Keywords: airway teaching, can't intubate can't ventilate, cricothyroidotomy, front-of-neck

Procedia PDF Downloads 130