Search results for: illicit drug policies

Authors: Emiljan Karma

Abstract:

One of the major problems of the present is young people who are not concerned with employment, education, or training (NEETs). Unfortunately, this group of people in Albania is a considerable part of working-age people, and despite the measures taken, they remain a major problem. NEETs in Albania are very heterogeneous. This is since youth unemployment and inactivity rate are at a very high level (Albania has the highest NEET rate among EU candidates/potential candidates’ countries and EU countries); the high level of NEET rate in Albania means that government agencies responsible for labour market regulation and other social actors interested in the phenomenon (representatives of employees, representatives of employers, non-governmental organizations, etc.) did not effectively materialize the policies in the field of youth employment promotion. The National Agency for Employment and Skills (NAES) delivers measures specifically designed to target unemployed youth, being the key stakeholder in the implementation of employment policies and skills development in Albania. In the context of identifying and assisting NEETs, this role becomes even stronger. The experience of different EU countries (e.g., Youth Guarantee) indicates that there are different policy-making structures and various outreach mechanisms for constraining the youth NEET phenomenon. The purpose of this research is to highlight: (1) The identification of NEETs feature in Albania; (2) The identification of tailored and efficient outreach mechanisms to assist vulnerable NEETs; (3) The fundamental importance of stakeholders’ partnership at central and regional level.

Keywords: labor market, NEETs, non-registered NEETs, unemployment

Procedia PDF Downloads 274

Authors: Bao-Fang Wen, Meng-Na Dai, Gao-Pei Zhu, Chen-Xi Zhang, Jing Sun, Xun-Bao Yin, Yu-Han Zhao, Hong-Wei Sun, Wei-Fen Zhang

Abstract:

A drug-loaded nanoparticles containing berberine hydrochloride (BH/FA-CTS-NPs) was prepared. The physicochemical characterizations of BH/FA-CTS-NPs and the inhibitory effect on the HeLa cells were investigated. Folic acid-conjugated chitosan (FA-CTS) was prepared by amino reaction of folic acid active ester and chitosan molecules; BH/FA-CTS-NPs were prepared using ionic cross-linking technique with BH as a model drug. The morphology and particle size were determined by Transmission Electron Microscope (TEM). The average diameters and polydispersity index (PDI) were evaluated by Dynamic Light Scattering (DLS). The interaction between various components and the nanocomplex were characterized by Fourier Transform Infrared Spectroscopy (FT-IR). The entrapment efficiency (EE), drug-loading (DL) and in vitro release were studied by UV spectrophotometer. The effect of cell anti-migratory and anti-invasive actions of BH/FA-CTS-NPs were investigated using MTT assays, wound healing assays, Annexin-V-FITC single staining assays, and flow cytometry, respectively. HeLa nude mice subcutaneously transplanted tumor model was established and treated with different drugs to observe the effect of BH/FA-CTS-NPs in vivo on HeLa bearing tumor. The BH/FA-CTS-NPs prepared in this experiment have a regular shape, uniform particle size, and no aggregation phenomenon. The results of DLS showed that mean particle size, PDI and Zeta potential of BH/FA-CTS NPs were (249.2 ± 3.6) nm, 0.129 ± 0.09, 33.6 ± 2.09, respectively, and the average diameter and PDI were stable in 90 days. The results of FT-IR demonstrated that the characteristic peaks of FA-CTS and BH/FA-CTS-NPs confirmed that FA-CTS cross-linked successfully and BH was encapsulated in NPs. The EE and DL amount were (79.3 ± 3.12) % and (7.24 ± 1.41) %, respectively. The results of in vitro release study indicated that the cumulative release of BH/FA-CTS NPs was (89.48±2.81) % in phosphate-buffered saline (PBS, pH 7.4) within 48h; these results by MTT assays and wund healing assays indicated that BH/FA-CTS NPs not only inhibited the proliferation of HeLa cells in a concentration and time-dependent manner but can induce apoptosis as well. The subcutaneous xenograft tumor formation rate of human cervical cancer cell line HeLa in nude mice was 98% after inoculation for 2 weeks. Compared with BH group and BH/CTS-NPs group, the xenograft tumor growth of BH/FA-CTS-NPs group was obviously slower; the result indicated that BH/FA-CTS-NPs could significantly inhibit the growth of HeLa xenograft tumor. BH/FA-CTS NPs with the sustained release effect could be prepared successfully by the ionic crosslinking method. Considering these properties, block proliferation and impairing the migration of the HeLa cell line, BH/FA-CTS NPs could be an important compound for consideration in the treatment of cervical cancer.

Keywords: folic-acid, chitosan, berberine hydrochloride, nanoparticles, cervical cancer

Procedia PDF Downloads 122

Authors: Shweta Verma

Abstract:

Background: Epilepsy is a chronic non-communicable central nervous system (CNS) disorder which affects a large population of all ages. Different classes of drugs are used for the treatment of this neurological disorder, but due to augmented drug resistance and side effects, these drugs become incompetent. Therefore, we design the synthesis of ten new derivatives of Phenytoin. The moiety of Phenytoin was hybridized with different phenols by using three step approach. The synthesized molecules were then investigated for different physicochemical parameters, such as Log P values using diverse software programs and to predict the potential to cross the blood-brain barrier. Objective: The Phenytoin derivatives were designed, synthesized, and characterized to meet the structural necessities indispensable for antiepileptic activity. Method: Firstly, the chloroacetylation of the 5,5-diphenyl hydantoin was carried out, and then various substituted phenols were added to it. The synthesized compounds were characterized and evaluated for antianxiety activity by elevated plus maze method and antiepileptic activity by using subcutaneous pentylenetetrazole (scPTZ) and maximal electroshock (MES) models and neurotoxicity. Result: The number of derivatives of 5,5-diphenyl hydantoin was developed and optimized. The number of parameters was optimized which reveal that the compound containing chloro group such as C3 and C6 showed imperative potential when compared with the standard drug Diazepam. Other compounds containing nitro and methyl group were also found to possess activity. Conclusion: It was summarized that the new compounds of 5,5-diphenyl hydantoin derivatives were synthesized. The results of the data show that the compound containing chloro group is more potent for CNS activity. The new compounds have the probability of being optimized further to engender new scaffolds to treat various CNS disorders.

Keywords: phenytoin, parameters, CNS activity, blood-brain barrier, Log P, CNS active

Procedia PDF Downloads 72

Authors: Rujeko Samanthia Chimukuche

Abstract:

Introduction: Transboundary migration at both regional and continental levels has become the defining feature of the 21st century. The recent global migration crisis due to economic strife and war brings back to the fore an old age problem, but with fresh challenges. Migration and forced displacement are issues that require long-term solutions. In South Africa, for example, whilst much attention has been placed on xenophobic attacks and other issues at the nexus of immigrant and indigenous communities, the limited focus has been placed on the integration, specifically formal labour integration of immigrant communities and the gender inequalities that are prevalent. Despite noble efforts by South Africa, hosting several immigrants, several challenges arise in integrating the migrants into society as it is often difficult to harmonize the interests of indigenous communities and those of foreign nationals. This research study has aimed to fill in the gaps by analyzing how stringent immigration and visa regulations prevent skilled migrant women spouses from employment, which often results in several societal vices, including domestic abuse, minimum or no access to important services such as healthcare, education, social welfare among others. Methods: Using a qualitative approach, the study analyzed South Africa migration and labour policies in terms of mainstreaming the gender needs of skilled migrant women. Secondly, the study highlighted the migratory experiences and constraints of skilled Zimbabwean women migrant spouses in South Africa labour integration. The experiences of these women have shown the gender inequalities of the migratory policies. Thirdly, Zimbabwean women's opportunities and/or challenges in integration into the South African formal labour market were explored. Lastly, practical interventions to support the integration of skilled migrant women spouses into South Africa’s formal labour market were suggested. Findings: Key findings show that gender dynamics are pivotal in migration patterns and the mainstreaming of gender in migration policies. This study, therefore, contributed to the fields of gender and migration by examining ways in which gender rights of skilled migrant women spouses can be incorporated in labour integration policy making.

Keywords: accompanying spouse visa, gender-migration, labour-integration, Zimbabwean women

Procedia PDF Downloads 120

Authors: Kamyar Moradi

Abstract:

Background: There is mixed evidence regarding the association between recreational cannabinoid use and memory performance. One of the major reasons for the present controversy is different cannabinoid use-related covariates that influence the cognitive status of an individual. Adjustment of these confounding variables provides accurate insight into the real effects of cannabinoid use on memory status. In this study, we sought to investigate the association between recent recreational cannabinoid use and memory performance while correcting the model for other possible covariates such as demographic characteristics and duration, and amount of cannabinoid use. Methods: Cannabinoid users were assigned to two groups based on the results of THC urine drug screen test (THC+ group: n = 110, THC- group: n = 410). THC urine drug screen test has a high sensitivity and specificity in detecting cannabinoid use in the last 3-4 weeks. The memory domain of NIH Toolbox battery and brain MRI volumetric measures were compared between the groups while adjusting for confounding variables. Results: After Benjamini-Hochberg p-value correction, the performance in all of the measured memory outcomes, including vocabulary comprehension, episodic memory, executive function/cognitive flexibility, processing speed, reading skill, working memory, and fluid cognition, were significantly weaker in THC+ group (p values less than 0.05). Also, volume of gray matter, left supramarginal, right precuneus, right inferior/middle temporal, right hippocampus, left entorhinal, and right pars orbitalis regions were significantly smaller in THC+ group. Conclusions: this study provides evidence regarding the acute effect of recreational cannabis use on memory performance. Further studies are warranted to confirm the results.

Keywords: brain MRI, cannabis, memory, recreational use, THC urine test

Procedia PDF Downloads 197

Authors: Muhammad Muzamil Khan, Asadullah Madni, Nina Filipczek, Jiayi Pan, Nayab Tahir, Hassan Shah, Vladimir Torchilin

Abstract:

Lipid-polymer hybrid nanoparticles (LPHNP) are delivery systems for controlled drug delivery at tumor sites. The superior biocompatible properties of lipid and structural advantages of polymer can be obtained via this system for controlled drug delivery. In the present study, cisplatin-loaded lipid-chitosan hybrid nanoparticles were formulated by the single step ionic gelation method based on ionic interaction of positively charged chitosan and negatively charged lipid. Formulations with various chitosan to lipid ratio were investigated to obtain the optimal particle size, encapsulation efficiency, and controlled release pattern. Transmission electron microscope and dynamic light scattering analysis demonstrated a size range of 181-245 nm and a zeta potential range of 20-30 mV. Compatibility among the components and the stability of formulation were demonstrated with FTIR analysis and thermal studies, respectively. The therapeutic efficacy and cellular interaction of cisplatin-loaded LPHNP were investigated using in vitro cell-based assays in A2780/ADR ovarian carcinoma cell line. Additionally, the cisplatin loaded LPHNP exhibited a low toxicity profile in rats. The in-vivo pharmacokinetics study also proved a controlled delivery of cisplatin with enhanced mean residual time and half-life. Our studies suggested that the cisplatin-loaded LPHNP being a promising platform for controlled delivery of cisplatin in cancer therapy.

Keywords: cisplatin, lipid-polymer hybrid nanoparticle, chitosan, in vitro cell line study

Procedia PDF Downloads 130

Authors: Pimpak Phumat, Sakornrat Khongkhunthian, Thomas Rades, Anette Müllertz, Siriporn Okonogi

Abstract:

Self-nanoemulsifying drug delivery systems (SNEDDS) containing 4-allylpyrocatechol (AP) extracted from Piper betle were developed to enhance water solubility of AP by using modeling and design (MODDE) program. The amount of AP in each SNEDDS formulation was determined by using high-performance liquid chromatography. The formulation consisted of 20% Miglyol®812N, 40 % Kolliphor®RH40, 30 % Maisine®35-1 and 10 % ethanol was found to be the best SNEDDS that provided the highest loading capacity of AP. (141.48±15.64 mg/g SNEDDS). The system also showed miscibility with water. The particle shape and size of the AP-SNEDDS after dispersing in water was investigated by using a transmission electron microscope and photon correlation spectrophotometer, respectively. The results showed that they were a spherical shape, having a particle size of 34.27 ± 1.14 nm with a narrow size distribution of 0.17 ± 0.04. The particles showed negative zeta potential with a value of -21.66 ± 2.09 mV. Antibacterial activity of AP-SNEDDS containing 1.5 mg/mL of AP was investigated against Streptococcus intermedius. The effect of this system on S. intermedius cells was observed by a scanning electron microscope (SEM). The results from SEM revealed that the bacterial cells were obviously destroyed. Killing kinetic study of AP-SNEDDS was carried out. It was found that the killing rate of AP-SNEDDS against S. intermedius was dose-dependent and the bacterial reduction was 79.86 ± 0.45 % within 30 min. In comparison with chlorhexidine (CHX), AP-SNEDDS showed similar antibacterial effects against S. intermedius. It is concluded that SNEDDS is a potential system for enhancing water solubility of AP. The antibacterial study reveals that AP-SNEDDS can be a promising system to treat bacterial infection caused by S. intermedius.

Keywords: SNEDDS, 4-allylpyrocathecol, solubility, antibacterial activity, Streptococcus intermedius

Procedia PDF Downloads 119

Authors: Babak Mirbaha, Mahmoud Saffarzadeh, Fatemeh Mohajeri

Abstract:

Road traffic accidents lead to a higher rate of death and injury, especially in vulnerable road users such as pedestrians. Improving the safety of facilities for pedestrians is a major concern for policymakers because of the high number of pedestrian fatalities and direct and indirect costs which are imposed to the society. This study focuses on the idea of determining the willingness to pay of pedestrians for increasing their safety while crossing the street. In this study, three different scenarios including crossing the street with zebra crossing facilities, crossing the street with zebra crossing facilities and installing a pedestrian traffic light and constructing a pedestrian bridge with escalator are presented. The research was conducted based on stated preferences method. The required data were collected from a questionnaire that consisted of three parts: pedestrian’s demographic characteristics, travel characteristics and scenarios. Four different payment amounts are presented for each scenario and a logit model has been built for each proposed payment. The results show that sex, age, education, average household income and individual salary have significant effect on choosing a scenario. Among the policies that have been mentioned through the questionnaire scenarios, the scenario of crossing the street with zebra crossing facilities and installing a traffic lights is the most frequent, with willingness to pay 10,000 Rials and the scenario of crossing the street with a zebra crossing with a willingness to pay 100,000 Rials having the least frequency. For all scenarios, as the payment is increasing, the willingness to pay decreases.

Keywords: pedestrians, willingness to pay, safety, immunization

Procedia PDF Downloads 156

Authors: Ved Vrat Verma, Rani Gupta, Manisha Goel

Abstract:

γ-glutamyltranspeptidase (GGT: EC 2.3.2.2) is an N-terminal nucleophile hydrolase conserved in all three domains of life. GGT plays a key role in glutathione metabolism where it catalyzes the breakage of the γ-glutamyl bonds and transfer of γ-glutamyl group to water (hydrolytic activity) or amino acids or short peptides (transpeptidase activity). GGTs from bacteria, archaea, and eukaryotes (human, rat and mouse) are homologous proteins sharing >50% sequence similarity and conserved four layered αββα sandwich like three dimensional structural fold. These proteins though similar in their structure to each other, are quite diverse in their enzyme activity: some GGTs are better at hydrolysis reactions but poor in transpeptidase activity, whereas many others may show opposite behaviour. GGT is known to be involved in various diseases like asthma, parkinson, arthritis, and gastric cancer. Its inhibition prior to chemotherapy treatments has been shown to sensitize tumours to the treatment. Microbial GGT is known to be a virulence factor too, important for the colonization of bacteria in host. However, all known inhibitors (mimics of its native substrate, glutamate) are highly toxic because they interfere with other enzyme pathways. However, a few successful efforts have been reported previously in designing species specific inhibitors. We aim to leverage the diversity seen in GGT family (pathogen vs. eukaryotes) for designing specific inhibitors. Thus, in the present study, we have used DIVERGE software to identify sites in GGT proteins, which are crucial for the functional and structural divergence of these proteins. Since, type II divergence sites vary in clade specific manner, so type II divergent sites were our focus of interest throughout the study. Type II divergent sites were identified for pathogen vs. eukaryotes clusters and sites were marked on clade specific representative structures HpGGT (2QM6) and HmGGT (4ZCG) of pathogen and eukaryotes clade respectively. The crucial divergent sites within 15 A radii of the binding cavity were highlighted, and in-silico mutations were performed on these sites to delineate the role of these sites on the mechanism of catalysis and protein folding. Further, the amino acid network (AAN) analysis was also performed by Cytoscape to delineate assortative mixing for cavity divergent sites which could strengthen our hypothesis. Additionally, molecular dynamics simulations were performed for wild complexes and mutant complexes close to physiological conditions (pH 7.0, 0.1 M ionic strength and 1 atm pressure) and the role of putative divergence sites and structural integrities of the homologous proteins have been analysed. The dynamics data were scrutinized in terms of RMSD, RMSF, non-native H-bonds and salt bridges. The RMSD, RMSF fluctuations of proteins complexes are compared, and the changes at protein ligand binding sites were highlighted. The outcomes of our study highlighted some crucial divergent sites which could be used for novel inhibitors designing in a species-specific manner. Since, for drug development, it is challenging to design novel drug by targeting similar protein which exists in eukaryotes, so this study could set up an initial platform to overcome this challenge and help to deduce the more effective targets for novel drug discovery.

Keywords: γ-glutamyltranspeptidase, divergence, species-specific, drug design

Procedia PDF Downloads 268

Authors: Gajanan M. Sonwane

Abstract:

The computational studies on 2-phenazinamines with their protein targets have been carried out to design compounds with potential anticancer activity. This strategy of designing compounds possessing selectivity over specific tyrosine kinase has been achieved through G-QSAR and molecular docking studies. The objective of this research has been to design newer 2-phenazinamine derivatives as Bcr-Abl tyrosine kinase inhibitors by G-QSAR, molecular docking studies followed by wet-lab studies along with evaluation of their anticancer potential. Computational chemistry was done by using VLife MDS 4.3 and Autodock 4.2 followed by wet-lab experiments for synthesizing 2-phenazinamine derivatives. The chemical structures of ligands in 2D were drawn by employing Chemdraw 2D Ultra 8.0 and were converted into 3D. These were optimized by using a semi-empirical method called MOPAC. The protein structure was retrieved from RCSC protein data bank as a PDB file. The binding interactions of protein and ligands were done by using PYMOL. The molecular properties of the designed compounds were predicted in silico by using Osiris property explorer. The parent compound 2-phenazinamine was synthesized by reduction of 2, 4-dinitro-N-phenyl-benzenamine in the presence of tin chloride followed by cyclization in the presence of nitrobenzene and magnesium sulfate. The derivatization at the amino function of 2-phenazinamine was performed by treating parent compound with various aldehydes in the presence of dicyclohexylcarbodiimide (DCC) and urea to afford 2-(2-chlorophenyl)-3-(phenazine-2-yl) thiazolidine-4-one. Synthesized 39 novel derivatives of 2-phenazinamine and performed antioxidant activity, anti antiproliferative on the bulb of onion and anticancer activity on cell line showing significant competition with marked blockbuster drug imatinib.

Keywords: computer-aided drug design, tyrosin kinases, anticancer, docking

Procedia PDF Downloads 140

Authors: Saman Ahani, Aboozar Dehghan, Roham Vali, Hamid Salehian, Amin Ebrahimi

Abstract:

Pulsed-wave (PW) doppler ultrasonography is a non-invasive, relatively accurate imaging technique that can measure blood speed. The imaging could be obtained via the common carotid artery, as one of the main vessels supplying the blood of vital organs. In horses, factors such as susceptibility to depression of the cardiovascular system and their large muscular mass have rendered them vulnerable to changes in blood speed. One of the most important factors causing blood velocity changes is the administration of anesthetic drugs, including Ketamine and Acepromazine. Thus, in this study, the Pulsed-wave doppler technique was performed to assess the highest blood velocity in the common carotid artery following administration of Ketamine and Acepromazine. Six male and six female healthy Kurdish horses weighing 351 ± 46 kg (mean ± SD) and aged 9.2 ± 1.7 years (mean ± SD) were housed under animal welfare guidelines. After fasting for six hours, the normal blood flow velocity in the common carotid artery was measured using a Pulsed-wave doppler ultrasonography machine (BK Medical, Denmark), and a high-frequency linear transducer (12 MHz) without applying any sedative drugs as a control group. The same procedure was repeated after each individual received the following medications: 1.1, 2.2 mg/kg Ketamine (Pfizer, USA), and 0.5, 1 mg/kg Acepromizine (RACEHORSE MEDS, Ukraine), with an interval of 21 days between the administration of each dose and/or drug. The ultrasonographic study was done five (T5) and fifteen (T15) minutes after injecting each dose intravenously. Lastly, the statistical analysis was performed using SPSS software version 22 for Windows and a P value less than 0.05 was considered to be statistically significant. Five minutes after administration of Ketamine (1.1, 2.2 mg/kg) in both male and female horses, the blood velocity decreased to 38.44, 34.53 cm/s in males, and 39.06, 34.10 cm/s in females in comparison to the control group (39.59 and 40.39 cm/s in males and females respectively) while administration of 0.5 mg/kg Acepromazine led to a significant rise (73.15 and 55.80 cm/s in males and females respectively) (p<0.05). It means that the most drastic change in blood velocity, regardless of gender, refers to the latter dose/drug. In both medications and both genders, the increase in doses led to a decrease in blood velocity compared to the lower dose of the same drug. In all experiments in this study, the blood velocity approached its normal value at T15. In another study comparing the blood velocity changes affected by Ketamine and Acepromazine through femoral arteries, the most drastic changes were attributed to Ketamine; however, in this experiment, the maximum blood velocity was observed following administration of Acepromazine via the common carotid artery. Therefore, further experiments using the same medications are suggested using Pulsed-wave doppler measuring the blood velocity changes in both femoral and common carotid arteries simultaneously.

Keywords: Acepromazine, common carotid artery, horse, ketamine, pulsed-wave doppler ultrasonography

Procedia PDF Downloads 128

Authors: Sreeparna Majee, G. C. Shit

Abstract:

A study on targeted drug delivery is carried out in an unsteady flow of blood infused with magnetic NPs (nanoparticles) with an aim to understand the flow pattern and nanoparticle aggregation in a diseased arterial segment having stenosis. The magnetic NPs are supervised by the magnetic field which is significant for therapeutic treatment of arterial diseases, tumor and cancer cells and removing blood clots. Coupled thermal energy have also been analyzed by considering dissipation of energy because of the application of the magnetic field and the viscosity of blood. Simulation technique used to solve the mathematical model is vorticity-stream function formulations in the diseased artery. An elevation in SLP (Specific loss power) is noted in the aortic bloodstream when the agglomeration of nanoparticles is higher. This phenomenon has potential application in the treatment of hyperthermia. The study focuses on the lowering of WSS (Wall Shear Stress) with increasing particle concentration at the downstream of the stenosis which depicts the vigorous flow circulation zone. These low shear stress regions prolong the residing time of the nanoparticles carrying drugs which soaks up the LDL (Low Density Lipoprotein) deposition. Moreover, an increase in NP concentration enhances the Nusselt number which marks the increase of heat transfer from the arterial wall to the surrounding tissues to destroy tumor and cancer cells without affecting the healthy cells. The results have a significant influence in the study of medicine, to treat arterial diseases such as atherosclerosis without the need for surgery which can minimize the expenditures on cardiovascular treatments.

Keywords: magnetic nanoparticles, blood flow, atherosclerosis, hyperthermia

Procedia PDF Downloads 141

Authors: Bilge Ozel

Abstract:

Cities are high-complex living organisms and are subjects to continuous transformations produced by the stress that derives from changing conditions. Today the metropolises are seen like “development engines” of the countries and accordingly they become the centre of better living conditions that encourages demographic growth which constitutes the main reason of the changes. Indeed, the potential for economic advancement of the cities directly represents the economic status of their countries. The term of “resilience”, which sees the changes as natural processes and represents the flexibility and adaptability of the systems in the face of changing conditions, becomes a key concept for the development of urban transformation policies. The term of “resilience” derives from the Latin word ‘resilire’, which means ‘bounce’, ‘jump back’, refers to the ability of a system to withstand shocks and still maintain the basic characteristics. A resilient system does not only survive the potential risks and threats but also takes advantage of the positive outcomes of the perturbations and ensures adaptation to the new external conditions. When this understanding is taken into the urban context - or rather “urban resilience” - it delineates the capacity of cities to anticipate upcoming shocks and changes without undergoing major alterations in its functional, physical, socio-economic systems. Undoubtedly, the issue of coordinating the urban systems in a “resilient” form is a multidisciplinary and complex process as the cities are multi-layered and dynamic structures. The concept of “urban transformation” is first launched in Europe just after World War II. It has been applied through different methods such as renovation, revitalization, improvement and gentrification. These methods have been in continuous advancement by acquiring new meanings and trends over years. With the effects of neoliberal policies in the 1980s, the concept of urban transformation has been associated with economic objectives. Subsequently this understanding has been improved over time and had new orientations such as providing more social justice and environmental sustainability. The aim of this research is to identify the most applied urban transformation methods in Turkey and its main reasons of being selected. Moreover, investigating the lacking and limiting points of the urban transformation policies in the context of “urban resilience” in a comparative way with European interventions. The emblematic examples, which symbolize the breaking points of the recent evolution of urban transformation concepts in Europe and Turkey, are chosen and reviewed in a critical way.

Keywords: resilience, urban dynamics, urban resilience, urban transformation

Procedia PDF Downloads 265

Authors: Apostolos Lagarias, Anastasia Stratigea

Abstract:

Coastal urbanization is heavily affecting the Mediterranean, taking the form of linear urban sprawl along the coastal zone. This process is posing extreme pressure on ecosystems, leading to an unsustainable model of growth. The aim of this research is to analyze coastal urbanization patterns in the Mediterranean using High-resolution multi-temporal data provided by the Global Human Settlement Layer (GHSL) database. Methodology involves the estimation of a set of spatial metrics characterizing the density, aggregation/clustering and dispersion of built-up areas. As case study areas, the Spanish Coast and the Adriatic Italian Coast are examined. Coastalization profiles are examined and selected sub-areas massively affected by tourism development and suburbanization trends (Costa Blanca/Murcia, Costa del Sol, Puglia, Emilia-Romagna Coast) are analyzed and compared. Results show that there are considerable differences between the Spanish and the Italian typologies of spatial development, related to the land use structure and planning policies applied in each case. Monitoring and analyzing spatial patterns could inform integrated Mediterranean strategies for coastal areas and redirect spatial/environmental policies towards a more sustainable model of growth

Keywords: coastalization, Mediterranean, multi-temporal, urban sprawl, spatial metrics

Procedia PDF Downloads 138

Authors: Dereje Regasa

Abstract:

The global food system is at a crossroads, which requires prompt action to minimize the effects of the crises. Agroecology is gaining prominence due to its contributions to sustainable food systems. To support efforts in mitigating the crises, the Food and Agriculture Organization (FAO) established alternative approaches for sustainable agri-food systems. Agroecological elements and principles were developed to guide and support measures that countries need to achieve the Sustainable Development Goals (SDGs). The SDGs require the systemic integration of practices for a smart intensification or adaptation of traditional or industrial agriculture. As one of the countries working towards SDGs, the agricultural practices in Ethiopia need to be guided by these agroecological elements and principles. Aiming at the identification of challenging aspects of a sustainable agri-food system and the characterization of an enabling environment for agroecology, as well as exploring to what extent the existing policies and strategies support the agroecological transition process, five policy and strategy documents were reviewed. These documents are the Rural Development Policy and Strategy, the Environment Policy, the Biodiversity Policy, and the Soil Strategy of the Ministry of Agriculture (MoA). Using the Agroecology Criteria Tool (ACT), the contents were reviewed, focusing on agroecological requirements and the inclusion of sustainable practices. ACT is designed to support a self-assessment of elements supporting agroecology. For each element, binary values were assigned based on the inclusion of the minimum requirements index and then validated through discussion with the document owners. The results showed that the documents were well below the requirements for an agroecological transition of the agri-food system. The Rural Development Policy and Strategy only suffice to 83% in Human and Social Value. It does not support the transition concerning the other elements. The Biodiversity Policy and Soil Strategy suffice regarding the inclusion of Co-creation and Sharing of knowledge (100%), while the remaining elements were not considered sufficiently. In contrast, the Environment Policy supports the transition with three elements accounting for 100%. These are Resilience, Recycling, and Human and Social Care. However, when the four documents were combined, elements such as Synergies, Diversity, Efficiency, Human and Social value, Responsible governance, and Co-creation and Sharing of knowledge were identified as fully supportive (100%). This showed that the policies and strategies complemented one another to a certain extent. However, the evaluation results call for improvements concerning elements like Culture and food traditions, Circular and solidarity economy, Resilience, Recycling, and Regulation and balance since the majority of the elements were not sufficiently observed. Consequently, guidance for the smart intensification of local practices is needed, as well as traditional knowledge enriched with advanced technologies. Ethiopian agricultural and environmental policies and strategies should provide sufficient support and guidance for the intensification of sustainable practices and should provide a framework for an agroecological transition towards a sustainable agri-food system.

Keywords: agroecology, diversity, recycling, sustainable food system, transition

Procedia PDF Downloads 87

Authors: Somsakhool Neelasmith, Darunee Jongudomkarn, Rutja Phuphaibul

Abstract:

Adolescent pregnancy is a major global concern including Thailand, which has long adopted policies and solutions to prevent such problem. Family is one of the key strategies to drive policy achievement whereas the various families and regional differences will be challenges. This article reports a preliminary study finding using qualitative case study methods, aiming to explore the situation of families living with adolescent mother in the North Eastern of Thailand or ISAN. Data were collected by in-depth interview with six key informants; five adolescent mothers age 14- 19 years and one mother in law of adolescent mother during November to December of 2017. The preliminary suggests that firstly, the adolescent pregnancy was found to be one of the significant issues among most of the families and that adolescent mothers and their family perceived other families were also faced with this problem with despite different conditions. Secondly, the parents assumed simultaneous roles as both parents and grandparents when one of their adolescent girls became an adolescent mother. Lastly, when perceiving that their adolescent daughter became pregnant, families addressed this issue by compromise with the related parties to maintain family and social relationship. This situation can be a potential intractable problem to adolescents and their families. Families may suffer from adolescent pregnancy with respect to health, economy and other family burdens. Moreover, the national development may be affected or delayed since this group of people is considered promising human resource. It is therefore required to further conduct in-depth research to cope with this issue particularly about the policies related to adolescent pregnancy.

Keywords: adolescent mother, adolescent pregnancy, consequential effect, family living with adolescent mother

Procedia PDF Downloads 278

Authors: V. Bezverbny

Abstract:

The actuality of the project deals with stable growing of deviant behavior’ statistics among Moscow citizens. During the recent years the socioeconomic health, wealth and life expectation of Moscow residents is regularly growing up, but the limits of crime and drug addiction have grown up seriously. Another serious Moscow problem has been economical stratification of population. The cost of identical residential areas differs at 2.5 times. The project is aimed at complex research and the development of methodology for main factors and reasons evaluation of deviant behavior growing in Moscow. The main project objective is finding out the links between the urban environment quality and dynamics of citizens’ deviant behavior in regional and municipal aspect using the statistical research methods and GIS modeling. The conducted research allowed: 1) to evaluate the dynamics of deviant behavior in Moscow different administrative districts; 2) to describe the reasons of crime increasing, drugs addiction, alcoholism, suicides tendencies among the city population; 3) to develop the city districts classification based on the level of the crime rate; 4) to create the statistical database containing the main indicators of Moscow population deviant behavior in 2010-2015 including information regarding crime level, alcoholism, drug addiction, suicides; 5) to present statistical indicators that characterize the dynamics of Moscow population deviant behavior in condition of expanding the city territory; 6) to analyze the main sociological theories and factors of deviant behavior for concretization the deviation types; 7) to consider the main theoretical statements of the city sociology devoted to the reasons for deviant behavior in megalopolis conditions. To explore the level of deviant behavior’ factors differentiation, the questionnaire was worked out, and sociological survey involved more than 1000 people from different districts of the city was conducted. Sociological survey allowed to study the socio-economical and psychological factors of deviant behavior. It also included the Moscow residents’ open-ended answers regarding the most actual problems in their districts and reasons of wish to leave their place. The results of sociological survey lead to the conclusion that the main factors of deviant behavior in Moscow are high level of social inequality, large number of illegal migrants and bums, nearness of large transport hubs and stations on the territory, ineffective work of police, alcohol availability and drug accessibility, low level of psychological comfort for Moscow citizens, large number of building projects.

Keywords: deviant behavior, megapolis, Moscow, urban environment, social stratification

Procedia PDF Downloads 193

Authors: Lutfurrahman Aftab

Abstract:

The Taliban’s relationships with the neighboring countries are a complex political issue that local people interpret one way, and politicians have different perceptions; therefore, it is a current issue that needs to be analyzed broadly and impartially. In this article, the writer investigates the Taliban’s current relationships with the neighboring countries, as well as looking at the effects these relationships have on the current peace negotiations in Doha, which began on September 12, 2020. The issue of Taliban and the current peace process has turned to be the center-of-attention for most of the neighboring countries, and every country has opened new pages in their foreign policies because after the Taliban-US peace agreement, the neighboring countries are meticulously and closely observing the situation and they believe that the Taliban are on the verge to tighten their grips on the future political power of Afghanistan. Every neighboring country of Afghanistan has political, economic, and social interests in this land-locked country. The Taliban’s current role within the peace talks and anticipated future position within the Afghan government will have great political, economic, and social implications on countries in the region as they assess their foreign policies. As these countries move to form closer ties with the Taliban, the government of Afghanistan is worried that this may hinder the peace process. Afghanistan has long blamed Pakistan for sheltering the Taliban and providing safe havens for the terrorist groups, including Al Qaeda, and the recent visits of Taliban’s delegations to Islamabad, Pakistan, have raised concern among government officials in Afghanistan who believe that the Taliban are not independent in their decisions, and for every step they take, are consulting with Pakistan’s political leadership.

Keywords: peace process, USA, Afghanistan, Taliban

Procedia PDF Downloads 116

Authors: Mauro Cristeche

Abstract:

This paper approaches the intervention of the American State in the social arena and the modeling of the rights system from the Argentinian experience, by observing the characteristics of its federal budgetary system, the evolution of social public spending and welfare programs in recent years, labor and poverty statistics, and the changes on the labor market structure. The analysis seeks to combine different methodologies and sources: in-depth interviews with specialists, analysis of theoretical and mass-media material, and statistical sources. Among the results, it could be mentioned that the tendency to state interventionism (what has been called ‘nationalization of social life’) is quite evident in the United States, and manifests itself in multiple forms. The bibliography consulted, and the experts interviewed pointed out this increase of the state presence in historical terms (beyond short-term setbacks) in terms of increase of public spending, fiscal pressure, public employment, protective and control mechanisms, the extension of welfare policies to the poor sectors, etc. In fact, despite the significant differences between both countries, the United States and Argentina have common patterns of behavior in terms of the aforementioned phenomena. On the other hand, dissimilarities are also important. Some of them are determined by each country's own political history. The influence of political parties on the economic model seems more decisive in the United States than in Argentina, where the tendency to state interventionism is more stable. The centrality of health spending is evident in America, while in Argentina that discussion is more concentrated in the social security system and public education. The biggest problem of the labor market in the United States is the disqualification as a consequence of the technological development while in Argentina it is a result of its weakness. Another big difference is the huge American public spending on Defense. Then, the more federal character of the American State is also a factor of differential analysis against a centralized Argentine state. American public employment (around 10%) is comparatively quite lower than the Argentinian (around 18%). The social statistics show differences, but inequality and poverty have been growing as a trend in the last decades in both countries. According to public rates, poverty represents 14% in The United States and 33% in Argentina. American public spending is important (welfare spending and total public spending represent around 12% and 34% of GDP, respectively), but a bit lower than Latin-American or European average). In both cases, the tendency to underemployment and disqualification unemployment does not assume a serious gravity. Probably one of the most important aspects of the analysis is that private initiative and public intervention are much more intertwined in the United States, which makes state intervention more ‘fuzzy’, while in Argentina the difference is clearer. Finally, the power of its accumulation of capital and, more specifically, of the industrial and services sectors in the United States, which continues to be the engine of the economy, express great differences with Argentina, supported by its agro-industrial power and its public sector.

Keywords: state intervention, welfare policies, labor market, system of rights, United States of America

Procedia PDF Downloads 131

Authors: Masoud Rabbani, Majede Smizadeh, Hamed Farrokhi-Asl

Abstract:

We study jointly determining prices and production in a multiple period horizon under a general non-stationary stochastic demand with continuous prices. In some periods we need to increase capacity of production to satisfy demand. This paper presents a model to aid multi-period production capacity planning by quantifying the trade-off between product quality and production cost. The product quality is estimated as the statistical variation from the target performances obtained from the output tolerances of the production machines that manufacture the components. We consider different tolerance for different machines that use to increase capacity. The production cost is estimated as the total cost of owning and operating a production facility during the planning horizon.so capacity planning has cost that impact on price. Pricing products often turns out to be difficult to measure them because customers have a reservation price to pay that impact on price and demand. We decide to determine prices and production for periods after enhance capacity and consider reservation price to determine price. First we use an algorithm base on fuzzy set of the optimal objective function values to determine capacity planning by determine maximize interval from upper bound in minimum objectives and define weight for objectives. Then we try to determine inventory and pricing policies. We can use a lemma to solve a problem in MATLAB and find exact answer.

Keywords: price policy, inventory policy, capacity planning, product quality, epsilon -constraint

Procedia PDF Downloads 569

Authors: Anisa Suraya Ab Razak, Izza Hayat

Abstract:

Introduction: The diagnosis and management of severe hyponatremia in neuropsychiatric patients present a significant challenge to physicians. Several factors contribute, including diagnostic shadowing and attributing abnormal behavior to intellectual disability or psychiatric conditions. Hyponatraemia is the commonest electrolyte abnormality in the inpatient population, ranging from mild/asymptomatic, moderate to severe levels with life-threatening symptoms such as seizures, coma and death. There are several documented fatal case reports in the literature of severe hyponatremia secondary to psychogenic polydipsia, often diagnosed only in autopsy. This paper presents a case study of acute severe hyponatremia in a neuropsychiatric patient with early diagnosis and admission to intensive care. Case study: A 21-year old Caucasian male with known epilepsy and learning disability was admitted from residential living with generalized tonic-clonic self-terminating seizures after refusing medications for several weeks. Evidence of superficial head injury was detected on physical examination. His laboratory data demonstrated mild hyponatremia (125 mmol/L). Computed tomography imaging of his brain demonstrated no acute bleed or space-occupying lesion. He exhibited abnormal behavior - restlessness, drinking water from bathroom taps, inability to engage, paranoia, and hypersexuality. No collateral history was available to establish his baseline behavior. He was loaded with intravenous sodium valproate and leveritircaetam. Three hours later, he developed vomiting and a generalized tonic-clonic seizure lasting forty seconds. He remained drowsy for several hours and regained minimal recovery of consciousness. A repeat set of blood tests demonstrated profound hyponatremia (117 mmol/L). Outcomes: He was referred to intensive care for peripheral intravenous infusion of 2.7% sodium chloride solution with two-hourly laboratory monitoring of sodium concentration. Laboratory monitoring identified dangerously rapid correction of serum sodium concentration, and hypertonic saline was switched to a 5% dextrose solution to reduce the risk of acute large-volume fluid shifts from the cerebral intracellular compartment to the extracellular compartment. He underwent urethral catheterization and produced 8 liters of urine over 24 hours. Serum sodium concentration remained stable after 24 hours of correction fluids. His GCS recovered to baseline after 48 hours with improvement in behavior -he engaged with healthcare professionals, understood the importance of taking medications, admitted to illicit drug use and drinking massive amounts of water. He was transferred from high-dependency care to ward level and was initiated on multiple trials of anti-epileptics before achieving seizure-free days two weeks after resolution of acute hyponatremia. Conclusion: Psychogenic polydipsia is often found in young patients with intellectual disability or psychiatric disorders. Patients drink large volumes of water daily ranging from ten to forty liters, resulting in acute severe hyponatremia with mortality rates as high as 20%. Poor outcomes are due to challenges faced by physicians in making an early diagnosis and treating acute hyponatremia safely. A low index of suspicion of water intoxication is required in this population, including patients with known epilepsy. Monitoring urine output proved to be clinically effective in aiding diagnosis. Early referral and admission to intensive care should be considered for safe correction of sodium concentration while minimizing risk of fatal complications e.g. central pontine myelinolysis.

Keywords: epilepsy, psychogenic polydipsia, seizure, severe hyponatremia

Procedia PDF Downloads 122

Authors: Saiyeed Jakaria Baksh Imran

Abstract:

The earth is being endangered by many of the climate related issues today. The most serious issue for the world today is the global warming. Increase in Greenhouse gas (GHG) emissions post-industrial revolution period is the prime reason for global warming. Shipping is the fifth largest GHG emitting sector worldwide. The key reason for this is because, over 90% of the world trade is conducted through ocean as the ocean alone covers 70% of the earth surface. While the countries continue to develop, trade and commerce continue to increase between them simultaneously. However, there is no sign of reduction in GHG emission from shipping because of many concerned issues. Firstly, there is technological barrier for which ships cannot just become environment friendly immediately. Secondly, there is no alternative fuel available as well. Thirdly, there is no proper mechanism to measure how much ships emit as emission from ships vary according to the size, engine type and loading capacity of ships. The International Maritime Organization (IMO) being the governing body of the international shipping has implemented MARPOL Annex VI. However, the policy alone is not enough unless there is a proper data available regarding ship emissions, which the IMO is yet to figure out. This paper will present a critical analysis of existing IMO policies such as the Energy Efficiency Design Index (EEDI), Ship Energy Efficiency Management Plan (SEEMP), Data Collection System (SEEMP) and the IMO’s Initial Strategy on Reduction of Greenhouse Gas emissions from shipping. Also, the challenges exist in implementing such policies have been presented in the paper.

Keywords: GHG, IMO, EEDI, SEEMP, DCS, greenhouse gas, decarbonization, shipping

Procedia PDF Downloads 76

Authors: Elham Rajabian

Abstract:

The ascent of cybersecurity incidents is a rising threat to most organisations in general, while the impact of the incidents is unique to each of the organizations. It is a need for behavioural sciences to concentrate on employees’ behaviour in order to prepare key security mitigation opinions versus cybersecurity incidents. There are noticeable differences among users of a computer system in terms of complying with security behaviours. We can discuss the people's differences under several subjects such as delaying tactics on something that must be done, the tendency to act without thinking, future thinking about unexpected implications of present-day issues, and risk-taking behaviours in security policies compliance. In this article, we introduce high-profile cyber-attacks and their impacts on weakening cyber resiliency in organizations. We also give attention to human errors that influence network security. Human errors are discussed as a part of psychological matters to enhance compliance with the security policies. The organizational challenges are studied in order to shape a sustainable cyber risks management approach in the related work section. Insiders’ behaviours are viewed as a cyber security gap to draw proper cyber resiliency in section 3. We carry out the best cybersecurity practices by discussing four CIS challenges in section 4. In this regard, we provide a guideline and metrics to measure cyber resilience in organizations in section 5. In the end, we give some recommendations in order to build a cybersecurity culture based on individual behaviours.

Keywords: cyber resilience, human factors, cybersecurity behavior, attitude, usability, security culture

Procedia PDF Downloads 97

Authors: Mohsen Shati, Seyede Salehe Mortazavi, Seyed Kazem Malakouti, Hamidreza Khanke Fazlollah Ahmadi

Abstract:

Taking unnecessary or excessive medication or using drugs with no indication (polypharmacy) by people of all ages, especially the elderly, is associated with increased adverse drug reactions (ADR), medical errors, hospitalization and escalating the costs. It may be facilitated or impeded by the healthcare system. In this study, we are going to describe the role of the health system in the practice of polypharmacy in Iranian elderly. In this Inductive qualitative content analysis using Graneheim and Lundman methods, purposeful sample selection until saturation has been made. Participants have been selected from doctors, pharmacists, policy-makers and the elderly. A total of 25 persons (9 men and 16 women) have participated in this study. Data analysis after incorporating codes with similar characteristics revealed 14 subcategories and six main categories of the referral system, physicians’ accessibility, health data management, drug market, laws enforcement, and social protection. Some of the conditions of the healthcare system have given rise to polypharmacy in the elderly. In the absence of a comprehensive specialty and subspecialty referral system, patients may go to any physician office so may well be confused about numerous doctors' prescriptions. Electronic records not being prepared for the patients, failure to comply with laws, lack of robust enforcement for the existing laws and close surveillance are among the contributing factors. Inadequate insurance and supportive services are also evident. Age-specific care providing has not yet been institutionalized, while, inadequate specialist workforce playing a major role. So, one may not ignore the health system as contributing factor in designing effective interventions to fix the problem.

Keywords: elderly, polypharmacy, health system, qualitative study

Procedia PDF Downloads 151

Authors: Omoruyi Gold Idemudia, Alexander P. Sadimenko

Abstract:

The synthesis of N-heterocycles with novel properties, having broad spectrum biological activities that may become alternative medicinal drugs, have been attracting a lot of research attention due to the emergence of medicinal drug’s limitations such as disease resistance and their toxicity effects among others. Acylpyrazolones have been employed as pharmaceuticals as well as analytical reagent and their application as coordination complexes with transition metal ions have been well established. By way of a condensation reaction with amines acylpyrazolone ketones form a more chelating and superior group of compounds known as azomethines. 4-propyl-3-methyl-1-phenyl-2-pyrazolin-5-one was reacted with phenylhydrazine to get a new phenylhydrazone which was further reacted with aqueous solutions of palladium and platinum salts, in an effort towards the discovery of transition metal based synthetic drugs. The compounds were characterized by means of analytical, spectroscopic, thermogravimetric analysis TGA, as well as x-ray crystallography. 4-propyl-3-methyl-1-phenyl-2-pyrazolin-5-one phenylhydrazone crystallizes in a triclinic crystal system with a P-1 (No. 2) space group based on x-ray crystallography. The bidentate ON ligand formed a square planar geometry on coordinating with metal ions based on FTIR, electronic and NMR spectra as well as magnetic moments. Reported compounds showed antibacterial activities against the nominated bacterial isolates using the disc diffusion technique at 20 mg/ml in triplicates. The metal complexes exhibited a better antibacterial activity with platinum complex having an MIC value of 0.63 mg/ml. Similarly, ligand and complexes also showed antioxidant scavenging properties against 2, 2-diphenyl-1-picrylhydrazyl DPPH radical at 0.5mg/ml relative to ascorbic acid (standard drug).

Keywords: acylpyrazolone, antibacterial studies, metal complexes, phenylhydrazone, spectroscopy

Procedia PDF Downloads 254

Authors: Natasha Lalla

Abstract:

The impact of free trade on growth has been highly debated and studies have generated varying results. Since the 1970s the Caribbean has engaged in asymmetrical trade with some European states characterized by the Lomé Conventions (1975-1999). These agreements allowed for Caribbean products such as sugar and banana to enter some European countries duty-free and above market prices. With the onset of the World Trade Organization by the mid-1990s, the EU’s banana trade regime was considered illegitimate. Lomé was replaced by the Cotonou agreement (2000-2007), in order to phase out preferences and ensure that the Caribbean trade arrangements were consistent with the international economic environment of trade liberalization. This agreement facilitated signing of the Economic Partnership Agreement in 2008 by both trade blocs whereby Caribbean states must implement freer trade by 2033. The current study is an exploration of how the Organization of the Eastern Caribbean States, the smallest, economically and ecologically vulnerable states of the Caribbean have restructured their trade policies towards the end of preferences and what has been the economic developmental impact of this. This is done by analyzing key reports to understand how these states restructured policies towards freer trade. Secondly, to determine the impact of this, data collected for specific economic indicators were analyzed in a fixed effects panel data framework for the period 1979-2016 on six states of the Organization of the Eastern Caribbean States. The study, therefore, found that freer trade has resulted in negative growth in these states.

Keywords: free trade, growth, OECS, small island developing states

Procedia PDF Downloads 195

Authors: Yuchao Yao

Abstract:

As two of the main characteristics of Chinese demographic trends, increasing divorce rates and decreasing fertility rates both shaped the population structure in the recent decade. Figuring out to what extent can be having a child make a difference in the divorce rate of a couple will not only draw a picture of Chinese families but also bring about a new perspective to evaluate the Chinese child-breeding policies. Based on China Family Panel Studies (CFPS) Data 2010-2018, this paper provides a systematic evaluation of how children influence a couple’s marital stability through a series of empirical models. Using survival analysis and propensity score matching (PSM) model, this paper finds that the number and age of children that a couple has mattered in consolidating marital relationship, and these effects vary little over time; during the last decade, newly having children can in fact decrease the possibility of divorce for Chinese couples; the such decreasing effect is largely due to the birth of a second child. As this is an inclusive attempt to study and compare not only the effects but also the causality of children on divorce risk in the last decade, the results of this research will do a good summary of the status quo of divorce in China. Furthermore, this paper provides implications for further reforming the current marriage and child-breeding policies.

Keywords: divorce risk, fertility, China, survival analysis, propensity score matching

Procedia PDF Downloads 73

Authors: Thanduxolo Nomngcoyiya, Simon M. Kang’ethe

Abstract:

The paper aimed to critically analyse gaps pertaining to the cultural policy environments governing traditional male circumcision in the Eastern Cape as exemplified by an empirical case study. The original study which this paper is derived from utilized qualitative paradigm; and encompassed 28 participants. It used in-depth one-on-one interviews complemented by focus group discussions and key informants as a method of data collection. It also adopted interview guide as a data collection instrument. The original study was cross-sectional in nature, and the data was audio recorded and transcribed later during the data analysis and coding process. The study data analysis was content thematic analysis and identified the following key major findings on the culture of male circumcision policy: Lack of clarity on culture of male circumcision policy operations; Myths surrounding procedures on culture of male circumcision; Divergent views on cultural policies between government and male circumcision custodians; Unclear cultural policies on selection criteria of practitioners; and Lack of policy enforcement and implementation on transgressors of culture of male circumcision. It recommended: a stringent selection criteria of practitioners; a need to carry out death-free male circumcision; a need for male circumcision stakeholders to work with other culture and tradition-friendly stakeholders.

Keywords: human rights, policy enforcement, traditional male circumcision, traditional surgeons and nurses

Procedia PDF Downloads 297

Authors: Nisa Mohan

Abstract:

Adverse drug event (ADE) related hospital admissions are common among older people. The first step in prevention is accurately estimating the prevalence of ADE admissions. Clinical coding is an efficient method to estimate the prevalence of ADE admissions. The objective of the study is to estimate the rate of under-coding of ADE admissions in older people in New Zealand and to explore how clinical coders decide whether or not to code an admission as an ADE. There has not been any research in New Zealand to explore these areas. This study is done using a mixed-methods approach. Two common and serious ADEs in older people, namely bleeding and hypoglycaemia were selected for the study. In study 1, eight hundred medical records of people aged 65 years and above who are admitted to hospital due to bleeding and hypoglycemia during the years 2015 – 2016 were selected for quantitative retrospective medical records review. This selection was made to estimate the proportion of ADE-related bleeding and hypoglycemia admissions that are not coded as ADEs. These files were reviewed and recorded as to whether the admission was caused by an ADE. The hospital discharge data were reviewed to check whether all the ADE admissions identified in the records review were coded as ADEs, and the proportion of under-coding of ADE admissions was estimated. In study 2, thirteen clinical coders were selected to conduct qualitative semi-structured interviews using a general inductive approach. Participants were selected purposively based on their experience in clinical coding. Interview questions were designed in a way to investigate the reasons for the under-coding of ADE admissions. The records review study showed that 35% (Cl 28% - 44%) of the ADE-related bleeding admissions and 22% of the ADE-related hypoglycemia admissions were not coded as ADEs. Although the quality of clinical coding is high across New Zealand, a substantial proportion of ADE admissions were under-coded. This shows that clinical coding might under-estimate the actual prevalence of ADE related hospital admissions in New Zealand. The interviews with the clinical coders added that lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing might be the potential reasons for the under-coding of the ADE admissions. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. These results highlight that further work is needed on interventions to improve the clinical coding of ADE admissions, such as providing education to coders about the importance of ADEs, education to clinicians about the importance of clear and confirmed medical records entries, availing pharmacist service to improve the detection and clear documentation of ADE admissions and including a mandatory field in the discharge summary about external causes of diseases.

Keywords: adverse drug events, bleeding, clinical coders, clinical coding, hypoglycemia

Procedia PDF Downloads 130

Authors: Haykal. Kay-Anne

Abstract:

The health and well-being of students is a priority for the Faculty of Medicine at the University of Ottawa. The demands of medical studies are extreme, and many studies confirm that the prevalence of psychological distress is very high among medical students and that it is higher than that of the general population of the same age. The main goal is to identify risk factors for mental health among medical students at the University of Ottawa. The secondary objectives are to determine the variation of these risk factors according to demographic variables, as well as to determine if there is a change in the mental health of students during the 1st and 3rd years of their study. Medical students have a mandatory first and third-year wellness check meeting. This assessment includes a questionnaire on demographic information, mental health, and risk factors such as physical health, sleep, social support, financial stress, education and career, stress and drug use and/or alcohol. Student responses were converted to numerical values and analyzed statistically. The results show that 61% of the variation in the mean of the mental health score is explained by the following risk factors (R2 = 0.61, F (9.396) = 67.197, p < 0.01): lack of sleep and fatigue (β = 0.281, p < 0.001), lack of social support (β = 0.217, p <0.001), poor study or career development (β = 0.195, p < 0.001) and an increase stress and drug and alcohol use (β = -0.239, p < 0.001). No demographic variable has a significant effect on the presence of risk factors. In addition, fixed-effects regression demonstrated significantly lower mental health (p < 0.1) among first-year students (M = 0.587, SD = 0.072) than among third-year students (M = 0.719, SD = 0.071). This preliminary study indicates the need to continue data collection and analysis to increase the significance of the study results. As risk factors are present at the beginning of medical studies, it is important to offer resources to students very early in their medical studies and to have close monitoring and supervision.

Keywords: assessment of mental health, medical students, risk factors for mental health, wellness assessment

Procedia PDF Downloads 123