Search results for: preventing suicide in youth

Authors: Nina Berding

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Migration and the ensuing diversity are integral parts of urban societies. However, engaging with the urban society and its diversification is rarely perceived as something trivial but rather as a difficult task and a major challenge. A central aspect of the discourse is the current migration of refugees from countries of the southern hemisphere to Europe and the resulting challenges for cities, their municipalities and the civil society as a whole. Based on exploratory field research in a German inner-city neighborhood, it is aimed to show that the discourses about migration and diversity are completely contrary to the everyday life actions of the urban society. Processes of migration that include leaving one’s hometown and moving to other places, searching for ‘safe’ environments or better opportunities are, historically speaking, not a new phenomenon. The urban dwellers have a large repertoire of strategies in managing processes of difference in everyday life situations, guided them well for centuries and also in these contemporary processes with an increased mobility and diversity. So there is obviously a considerable discrepancy between what is practically lived in everyday life, and how it is talked about. The results of the study demonstrate that the current discourse about the challenges of migration seems to legitimize interventions beyond humanist approaches where migrants serve as collective scapegoats for social problems and affected by different discrimination and criminalization processes. On the one hand, everyone takes advantage of the super-mobility and super-diversity in their daily lives and on the other hand, powerful stakeholders and designated authorities operate a sort of retro- nationalism and identity collectivism. Political players, the municipalities and other stakeholders then follow an urban public policy that takes actions (increasing police presence, concepts and activities for special groups, exclusion from active social life, preventing participation etc.) towards different ‘groups’ of residents, produced along ‘ethnic’ lines. The results also show that, despite the obstacles and adversities placed in their way, the excluded residents perpetually relocate and re-position themselves and attempt to empower themselves by redefining their identities in their neighborhood.

Keywords: coexistence, everyday life, migration and diversity regimes, urban policy

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Authors: Hamida Hamed Said Al Harthi

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Background: Illegal drug use is a rising problem that affects Omani youth. This research aimed to study a group of young Omani men who were imprisoned more than once for illegal drug use, focusing on exploring their lifestyle experiences inside and outside the prison and whether these contributed to their early relapse and re-imprisonment. This is the first study of its kind from Oman conducted in a prison setting. Methods: 19 Omani males aged 18–35 years imprisoned in Oman Central Prison were recruited using purposive sampling. Focused ethnography was conducted over 8 months to explore the drug-related experiences outside the prison and during imprisonment. Face-to-face semi-structured interviews with the participants yielded detailed transcripts and field notes. These were thematically analyzed, and the results were compared with the existing literature. Results: The participants’ voices yielded new insights into the lives of young Omani men imprisoned for illegal drug use, including their sufferings and challenges in prison. These included: entry shock, timing and boredom, drug trafficking in prison, as well as physical and psychological health issues. Overall, imprisonment was reported to have negatively impacted the participants’ health, personality, self-concept, emotions, attitudes, behavior and life expectations. The participants reported how their efforts to reintegrate into the Omani community after release from prison were rebuffed due to stigmatization and rejection from society and family. They also experienced frequent unemployment, police surveillance, accommodation problems and a lack of rehabilitation facilities. The immensity of the accumulated psychophysiological trauma contributed to their early relapse and re-imprisonment. Conclusion: This thesis concludes that imprisonment is largely ineffective in controlling drug use in Oman. Urgent action is required across multiple sectors to improve the lives and prospects of users of illegal drugs within and outside the prison to minimize factors contributing to early relapse. Key Words: illegal drugs, drug users, Oman, addiction, Omani culture, prisoners, relapse, re-imprisonment, qualitative research, ethnography.

Keywords: illigal drugs, Prison, Omani culture lifestyle, post prison life

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Authors: Katharina Kargel, Frederic Vobbe

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Sexualized violence against children and adolescents using digital media poses particular challenges for practitioners with a focus on crisis intervention (social work, psychotherapy, law enforcement). The technical delimitation of violence increases the burden on those affected and increases the complexity of interdisciplinary cooperation. Urgently needed recommendations for practical action do not yet exist in Germany. Funded by the Federal Ministry of Education and Research, these recommendations for action are being developed in the HUMAN project together with science and practice. The presentation introduces the participatory approach of the HUMAN project. We discuss the application-oriented, casuistic approach of the project and present its results using the example of concrete case-based recommendations for Action. The participants will be presented with concrete prototypical case studies from the project, which will be used to illustrate quality criteria for crisis intervention in cases of sexualized violence using digital media. On the basis of case analyses, focus group interviews and interviews with victims of violence, we present the six central challenges of sexualized violence with the use of digital media, namely: • Diffusion (Ambiguities regarding the extent and significance of violence) , • Transcendence (Space and time independence of the dynamics of violence, omnipresence), • omnipresent anxiety (considering diffusion and transcendence), • being haunted (repeated confrontation with digital memories of violence or the perpetrator), • disparity (conflicts of interpretative power between those affected and the social environment) • simultaneity (of all other factors). We point out generalizable principles with which these challenges can be dealt with professionally. Dealing professionally with sexualized violence using digital media requires a stronger networking of professional actors. A clear distinction must be made between their own mission and the mission of the network partners. Those affected by violence must be shown options for crisis intervention in the context of the aid networks. The different competencies and the professional mission of the offers of help are to be made transparent. The necessity of technical possibilities for deleting abuse images beyond criminal prosecution will be discussed. Those affected are stabilized by multimodal strategies such as a combination of rational emotive therapy, legal support and technical assistance.

Keywords: sexualized violence, intervention, digital media, children and youth

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Authors: Oleg Sokolov

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Despite the fact that the epoch of the Crusades ended more than 700 years ago, its legacy still remains relevant both in the Middle East and in the West. There was made a comparison of the positions of the most prominent Western and Arab medievalists of XX-XXI centuries, using the example of their interpretations of the success of the First Crusade. The analyzed corpus consists of 70 works. In the modern Arab Historiography, it is often pointed out that the Seljuks' struggle against the crusaders of the First Crusade was seriously hampered by the raids of the Arab Bedouin tribes of Jazira. At the same time, it is emphasized that the Arab rulers of Northern Syria were ‘pleased’ with the defeats of the Turks and made peace with the Crusaders, refusing to fight them. At the same time it is usually underlined that the Fatimid aggression against the Turks led both the first and the second to defeat from the Crusaders and became one of the main reasons for the success of the First Crusade and the Muslims' loss of Jerusalem in 1099. The position of Western historians about the reasons for the success of the First Crusade differs significantly. First of all, in the Western Historiography, it is noted that the deaths of the Fatimid and Abbasid Caliphs and the Seljuk Sultan between 1092 and 1094 years created political vacuum just before the crusaders appeared in the Middle East political arena. In 1097-1099, when the Crusaders advanced through Asia Minor, Syria and Palestine to Jerusalem, there was an active internecine struggle between the parts of the Seljuq state that had broken up by that time, and the crusaders were not perceived as a general threat of all Muslims of this region at that time. It is also pointed out that the main goals of the Crusaders - Antioch, Edessa, and Jerusalem - were at that time periphery since the main struggle for power in the Middle East was at this time in Iran. Thus, Arab historians see the lack of support from Arabs of Syria and Jazira and the aggression from Egypt as a crucial factors preventing the Seljuks from defeating the Crusaders, while their Western counterparts consider the internal power struggle between the Seljuks as a more important reason for the success of the First Crusade. The reason for this divergence in the treatment of the events of the First Crusade is probably the prevailing in much of Arab historiography, the idea of the Franks as an enemy of all peoples and religions of the Middle East. At the same time, in contemporary Western Historiography, the crusaders are described only as one of the many military and political forces that operated in this region at the end of the eleventh century.

Keywords: Arabs, Crusades, historiography, Turks

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Authors: Marina Petrova

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Language policy issues related to the preservation and development of the native languages of the Russian peoples and the state languages of the national republics are increasingly becoming the focus of recent attention of educators and parents, public and national figures. Is it legal to teach the national language or the mother tongue as the state language? Due to that dispute language phobia moods easily evolve into xenophobia among the population. However, a civilized, intelligent multicultural personality can only be formed if the country develops bilingualism and multilingualism, and languages as a political tool help to find ‘keys’ to sufficiently closed national communities both within a poly-ethnic state and in internal relations of multilingual countries. The purpose of this study is to design and theoretically substantiate an efficient model of language education in the innovatively developing Republic of Sakha. 800 participants from different educational institutions of Yakutia worked at developing a multilingual model of education. This investigation is of considerable practical importance because researchers could build a methodical system designed to create conditions for the formation of a cultural language personality and the development of the multilingual communicative competence of Yakut youth, necessary for communication in native, Russian and foreign languages. The selected methodology of humane-personal and competence approaches is reliable and valid. Researchers used a variety of sources of information, including access to related scientific fields (philosophy of education, sociology, humane and social pedagogy, psychology, effective psychotherapy, methods of teaching Russian, psycholinguistics, socio-cultural education, ethnoculturology, ethnopsychology). Of special note is the application of theoretical and empirical research methods, a combination of academic analysis of the problem and experienced training, positive results of experimental work, representative series, correct processing and statistical reliability of the obtained data. It ensures the validity of the investigation’s findings as well as their broad introduction into practice of life-long language education.

Keywords: intercultural communication, language policy, multilingual and multicultural education, the Sakha Republic of Yakutia

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Authors: Petre Voicu, Mircea Oaida, Radu Vasiu, Catalin Gheorghiu, Aurel Dumitru

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The present work deals with the way in which food and tobacco waste can be used in agriculture. As a result of the lack of efficient technologies for their recycling, we are currently faced with the appearance of appreciable quantities of residual organic residues that find their use only very rarely and only after long storage in landfills. The main disadvantages of long storage of organic waste are the unpleasant smell, the high content of pathogenic agents, and the high content in the water. The release of these enormous amounts imperatively demands the finding of solutions to ensure the avoidance of environmental pollution. The measure practiced by us consists of the processing of this waste in special installations, testing in pilot experimental perimeters, and later administration on agricultural lands without harming the quality of the soil, agricultural crops, and the environment. The current crisis of raw materials and energy also raises special problems in the field of organic waste valorization, an activity that takes place with low energy consumption. At the same time, their composition recommends them as useful secondary sources in agriculture. The transformation of food scraps and other residues concentrated organics thus acquires a new orientation, in which these materials are seen as important secondary resources. The utilization of food and tobacco waste in agriculture is also stimulated by the increasing lack of chemical fertilizers and the continuous increase in their price, under the conditions that the soil requires increased amounts of fertilizers in order to obtain high, stable, and profitable production. The need to maintain and increase the humus content of the soil is also taken into account, as an essential factor of its fertility, as a source and reserve of nutrients and microelements, as an important factor in increasing the buffering capacity of the soil, and the more reserved use of chemical fertilizers, improving the structure and permeability for water with positive effects on the quality of agricultural works and preventing the excess and/or deficit of moisture in the soil.

Keywords: ecology, soil, organic waste, fertility

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Authors: Anuruddhi Edirisinghe, Anusha Edirisinghe, Maithree Wicramasinghe, Sagarika Kannangara, Annista Wijayanayake

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SGBV which refer to acts of inflicting physical, mental or sexual harm or sufferings that deprive a person’s liberty based on one’s gender or sexuality is known to occur in various forms. Ragging in educational institutions can often be one such form of SGBV. Ragging related SGBV is a growing problem despite various legal, policy and programme initiatives introduced over the years. While the punishment of perpetrators through the criminal justice system is expected to bring a deterrent effect, other strategies such as awareness-raising, attitudinal changes, and the empowerment of students to say no to ragging and SGBV will lead to enlightened attitudes about the practice in universities. Thus, effective regular prevention programmes are the need of the hour. The objectives of the paper are to engage with the case of a female fresher subjected to verbal abuse, physical assault and sexual harassment due to events which started as a result of wearing a trouser to the university during the ragging season. The case came to the limelight since a complaint was made to the police and 10 students were arrested under the anti-ragging act. This led to dividend opinions among the student population and a backlash from the student union. Simultaneously, this resulted in the society demanding the stricter implementation of laws and the punishment of perpetrators. The university authority appointed a task force comprising of academics, non-academics, parents, community leaders, stakeholders and students to draw up an action plan to respond to the immediate situation as well as future prevention. The paper will also discuss the implementation of task force plan. The paper is based on interviews with those involved with the issue and the experiences of the task force members and is expected to provide an in-depth understanding of the intricacies and complications associated with dealing with a contentious problem such as ragging. Given the political and ethical issues involved with insider research as well as the sensationalism of the topic, maximum care will be taken to safeguard the interests of those concerned.

Keywords: fresher, sexual and gender based violence (SGBV), sexual harassment, ragging

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Authors: Farahnaz Sadat Golestan Hashemi, Mohd Razi Ismail, Mohd Y. Rafii

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A huge revolution has emerged in genome engineering by the discovery of CRISPR (clustered regularly interspaced palindromic repeats) and CRISPR-associated system genes (Cas) in bacteria. The function of type II Streptococcus pyogenes (Sp) CRISPR/Cas9 system has been confirmed in various species. Other S. thermophilus (St) CRISPR-Cas systems, CRISPR1-Cas and CRISPR3-Cas, have been also reported for preventing phage infection. The CRISPR1-Cas system interferes by cleaving foreign dsDNA entering the cell in a length-specific and orientation-dependant manner. The S. thermophilus CRISPR3-Cas system also acts by cleaving phage dsDNA genomes at the same specific position inside the targeted protospacer as observed in the CRISPR1-Cas system. It is worth mentioning, for the effective DNA cleavage activity, RNA-guided Cas9 orthologs require their own specific PAM (protospacer adjacent motif) sequences. Activity levels are based on the sequence of the protospacer and specific combinations of favorable PAM bases. Therefore, based on the specific length and sequence of PAM followed by a constant length of target site for the three orthogonals of Cas9 protein, a well-organized procedure will be required for high-throughput and accurate mining of possible target sites in a large genomic dataset. Consequently, we created a reliable procedure to explore potential gRNA sequences for type I (Streptococcus thermophiles), II (Streptococcus pyogenes), and III (Streptococcus thermophiles) CRISPR/Cas systems. To mine CRISPR target sites, four different searching modes of sgRNA binding to target DNA strand were applied. These searching modes are as follows: i) coding strand searching, ii) anti-coding strand searching, iii) both strand searching, and iv) paired-gRNA searching. The output of such procedure highlights the power of comparative genome mining for different CRISPR/Cas systems. This could yield a repertoire of Cas9 variants with expanded capabilities of gRNA design, and will pave the way for further advance genome and epigenome engineering.

Keywords: CRISPR/Cas systems, gRNA mining, Streptococcus pyogenes, Streptococcus thermophiles

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Authors: Mohamad Bolandmartabe, Nafiseh Hassani, Saeed Abdi Darake, Maryam Asghari

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Dogs are highly susceptible to diseases, nutritional problems, toxins, and parasites, with parasitic infections being common and causing hardship in their lives. Some important internal parasites include worms (such as roundworms and tapeworms) and protozoa, which can lead to anemia in dogs. Important bloodborne parasites in dogs include microfilariae and adult forms of Dirofilaria immitis, Dipetalonema reconditum, Babesia, Trypanosoma, Hepatozoon, Leishmania, Ehrlichia, and Hemobartonella. Babesia and Hemobartonella are parasites that reside inside red blood cells and cause regenerative anemia by directly destroying the red blood cells. Hepatozoon, Leishmania, and Ehrlichia are also parasites that reside within white blood cells and can infiltrate other tissues, such as the liver and lymph nodes. Since intermediate hosts are more commonly found in the open environment, the prevalence of parasites in stray and free-roaming dogs is higher compared to pet dogs. Furthermore, pet dogs are less exposed to internal and external parasites due to better care, hygiene, and being predominantly indoors. Therefore, they are less likely to be affected by them. Among the parasites, Leishmania carries significant importance as it is shared between dogs and humans, causing a dangerous disease known as visceral Leishmaniasis or kala-azar and cutaneous Leishmaniasis. Furthermore, dogs can act as reservoirs and spread the disease agent within human communities. Therefore, timely and accurate diagnosis of these diseases in dogs can be highly beneficial in preventing their occurrence in humans. In this article, we employed the Giemsa staining technique under a light microscope for the identification of bloodborne parasites in dogs. However, considering the negative impact of these parasites on the natural life of dogs, the development of chronic diseases, and the gradual loss of the animal's well-being, rapid and timely diagnosis is essential. Serological methods and PCR are available for the diagnosis of certain parasites, which have high sensitivity and desirable characteristics. Therefore, this research aims to investigate the molecular aspects of bloodborne parasites in dogs referred to veterinary hospitals in Tehran city.

Keywords: leishmaniasis, babesiosis, ehrlichiosis, dirofilariasis, hepatozoonosis

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Authors: Andres Manuel Garcia Lamparte, Rocio Losada Iglesias, Marcos BoullóN Magan, David Miranda Barros

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The biodiversity strategy of the European Union for 2030, mentions climate change as one of the key factors for biodiversity loss and considers green infrastructure as one of the solutions to this problem. In this line, the European Commission has developed a green infrastructure strategy which commits members states to consider green infrastructure in their territorial planning. This green infrastructure is aimed at granting the provision of a wide number of ecosystem services to support biodiversity and human well-being by countering the effects of climate change. Yet, there are not too many tools available to delimit green infrastructure. The available ones consider the potential of the territory to provide ecosystem services. However, these methods usually aggregate several maps of ecosystem services potential without considering possible trade-offs. This can lead to excluding areas with a high potential for providing ecosystem services which have many trade-offs with other ecosystem services. In order to tackle this problem, a methodology is proposed to consider ecosystem services trade-offs in the objective function of a simulated annealing algorithm aimed at delimiting green infrastructure multifunctional buffer areas. To this end, the provision potential maps of the regulating ecosystem services considered to delimit the multifunctional buffer areas are clustered in groups, so that ecosystem services that create trade-offs are excluded in each group. The normalized provision potential maps of the ecosystem services in each group are added to obtain a potential map per group which is normalized again. Then the potential maps for each group are combined in a raster map that shows the highest provision potential value in each cell. The combined map is then used in the objective function of the simulated annealing algorithm. The algorithm is run both using the proposed methodology and considering the ecosystem services individually. The results are analyzed with spatial statistics and landscape metrics to check the number of ecosystem services that the delimited areas produce, as well as their regularity and compactness. It has been observed that the proposed methodology increases the number of ecosystem services produced by delimited areas, improving their multifunctionality and increasing their effectiveness in preventing climate change impacts.

Keywords: ecosystem services trade-offs, green infrastructure delineation, multifunctional buffer areas, climate change

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Authors: B. Arzhanov, A. Correia, P. Delgado, J. Meireles

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Quad Flat No-Lead (QFN) packages have become very popular for turners, converters and audio amplifiers, among others applications, needing efficient power dissipation in small footprints. Since semiconductor junction temperature (TJ) is a critical parameter in the product quality. And to ensure that die temperature does not exceed the maximum allowable TJ, a thermal analysis conducted in an earlier development phase is essential to avoid repeated re-designs process with huge losses in cost and time. A simulation tool capable to estimate die temperature of components with QFN package was developed. Allow establish a non-empirical way to define an acceptance criterion for amount of voids in solder interface between its exposed pad and Printed Circuit Board (PCB) to be applied during industrialization process, and evaluate the impact of PCB designs parameters. Targeting PCB layout designer as an end user for the application, a user-friendly interface (GUI) was implemented allowing user to introduce design parameters in a convenient and secure way and hiding all the complexity of finite element simulation process. This cost effective tool turns transparent a simulating process and provides useful outputs after acceptable time, which can be adopted by PCB designers, preventing potential risks during the design stage and make product economically efficient by not oversizing it. This article gathers relevant information related to the design and implementation of the developed tool, presenting a parametric study conducted with it. The simulation tool was experimentally validated using a Thermal-Test-Chip (TTC) in a QFN open-cavity, in order to measure junction temperature (TJ) directly on the die under controlled and knowing conditions. Providing a short overview about standard thermal solutions and impacts in exposed pad packages (i.e. QFN), accurately describe the methods and techniques that the system designer should use to achieve optimum thermal performance, and demonstrate the effect of system-level constraints on the thermal performance of the design.

Keywords: QFN packages, exposed pads, junction temperature, thermal management and measurements

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Authors: Meital Amzalag, Sharon Hardof-Jaffe

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In the last few decades, children and youth have been immersed in digital technologies. Indeed, recent studies explored the implication of technology use in their leisure and learning activities. Educators face an essential need to utilize technology and implement them into the curriculum. To do that, educators need to understand how young people use digital technology. This study aims to explore K12 students' digital lives from their point of view, to reveal their digital activities, age and gender differences with respect to digital activities, and to present the students' attitudes towards technologies in learning. The study approach is quantitative and includes354 students ages 6-16 from three schools in Israel. The online questionnaire was based on self-reports and consists of four parts: Digital activities: leisure time activities (such as social networks, gaming types), search activities (information types and platforms), and digital application use (e.g., calendar, notes); Digital skills (requisite digital platform skills such as evaluation and creativity); Social and emotional aspects of digital use (conducting digital activities alone and with friends, feelings, and emotions during digital use such as happiness, bullying); Digital attitudes towards digital integration in learning. An academic ethics board approved the study. The main findings reveal the most popular K12digital activities: Navigating social network sites, watching TV, playing mobile games, seeking information on the internet, and playing computer games. In addition, the findings reveal age differences in digital activities, such as significant differences in the use of social network sites. Moreover, the finding raises gender differences as girls use more social network sites and boys use more digital games, which are characterized by high complexity and challenges. Additionally, we found positive attitudes towards technology integration in school. Students perceive technology as enhancing creativity, promoting active learning, encouraging self-learning, and helping students with learning difficulties. The presentation will provide an up-to-date, accurate picture of the use of various digital technologies by k12 students. In addition, it will discuss the learning potentials of such use and how to implement digital technologies in the curriculum. Acknowledgments: This study is a part of a broader study about K-12 digital life in Israel and is supported by Mofet-the Israel Institute for Teachers'Development.

Keywords: technology and learning, K-12, digital life, gender differences

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Authors: Hyojung Shin, Munhee Kweon

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Non-suicide Self Injuri (NSSI) can be defined as the act of an individual who does not intend to die directly and intentionally damaging his or her body tissues. According to a study conducted by the Korean Ministry of Education in 2018, the NSSI is widely spreading among teenagers, with 7.9 percent of all middle school students and 6.4 percent of high school students reporting experience in NSSI. As such, it is understood that the first time of the NSSI is in adolescence. However, the NSSI may not start and stop at a certain time, but may last longer. However, despite the widespread prevalence of NSSI among teenagers, little is known about the process and maintenance of NSSI college students on a continuous development basis. Korea's NSSI research trends are mainly focused on individual internal vulnerabilities (high levels of painful emotions/awareness, lack of pain tolerance) and interpersonal vulnerabilities (poor communication skills and social problem solving), and little studies have been done on individuals' unique characteristics and environmental factors such as substrate or environmental vulnerability factors. In particular, environmental factors are associated with the occurrence of NSSI by acting as a vulnerability factor that can interfere with the emotional control of individuals, whereas individual factors play a more direct role by contributing to the maintenance of NSSI, so it is more important to consider this for personal environmental involvement in NSSI. This study focused on the Fight-Flight-Freeze System as a factor in the defensive avoidance system of Reward Sensitivity in individual factors. Also, Environmental factors include the level of expressed emotion in family. Wedig and Nock (2007) said that if parents with a self-critical cognitive style take the form of criticizing their children, the experience of NSSI increases. The high level of parental criticism is related to the increasing frequency of NSSI acts as well as to serious levels of NSSI. If the normal coping mechanism fails to control emotions, people want to overcome emotional difficulties even through NSSI, and emotional disturbances experienced by individuals within an unsupported social relationship increase vulnerability to NSSI. Based on these theories, this study is to find ways to prevent NSSI and intervene in counseling effectively by verifying the differences between the characteristics experienced NSSI persons and non-experienced NSSI persons. Therefore, the purpose of this research was to examine the relationship of Fight-Flight-Freeze System (FFFS), level of expressed emotion in family and emotion regulation difficulties, comparing those who experienced Non-Suicidal Self-Injury (NSSI) with those who did not experienced Non-Suicidal Self-Injury (NSSI). The data were collected from university students in Seoul Korea and Gyeonggi-do province. 99 subjects were experienced student of NSSI, while 375 were non- experienced student of NSSI. The results of this study are as follows. First, the result of t-test indicated that NSSI attempters showed a significant difference in fight-flight-freeze system, level of expressed emotion and emotion regulation difficulties, compared with non-attempters. Second, fight-flight-freeze system, level of expressed emotion in family and emotion regulation difficulties of NSSI attempters showed a significant difference in correlation. The correlation was significant only freeze system of fight-flight-freeze system, Level of expressed emotion in family and emotion regulation difficulties. Third, freeze system and level of expressed emotion in family predicted emotion regulation difficulties of NSSI attempters. Fight-freeze system and level of expressed emotion in family predicted emotion regulation difficulties of non-NSSI attempters. Lastly, Practical implications for counselors and limitations of this study are discussed.

Keywords: fight-flight-freeze system, level of expressed emotion in family, emotion regulation difficulty, non-suicidal self injury

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Authors: Victor Counted

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Staying true to self is complicated. In most cases, we might not fully come to terms with this realities. Just like any journey, a self-discovery experience with the ‘self’, is like a rollercoaster ride. The researcher attempts to engage the reader in an empirical study on authenticity tendencies of African Christian Millennials. Hence, attempting the all-important question: What does it actually mean to be true to self for the African youth? A comprehensive, yet an unfinished business that applies the authenticity theory in its exploratory navigations to uncover the “lived world” of the participants who were part of this study. Using a mixed methods approach, the researcher will exhaustively give account to the authenticity tendencies and experiences of the respondents in the study by providing the reader with a unique narrative for understanding what it means to be true to oneself in Africa. At the quantitative study, the participants recorded higher scores on the Authenticity Scale (AS) authentic living, while showing a significant correlation within the subscales. Hypotheses were tested at the quantitative phase, which statistically supported gender and church affiliation as possible predictors for the authenticity orientations of the participants, while being a Christian native and race/ethnicity were not impact factors statistically. The results helped the researcher to develop the objectives behind the qualitative study, where only fifteen AS-authentic living participants were interviewed to understand why they scored high on authentic living, in order to understand what it means to be authentic. The hallmark of the qualitative case study exploration was the common coping mechanism of splitting adopted by the respondents to deal with their self-crisis as they tried to remain authentic to self, whilst self-regulating and self-investing the self to discover ‘self’. Specifically, the researcher observed the concurrent utilization of some kind of the religious-self by the respondents to regulate their self crisis, as they relate with self fragmenting through different splitting stages in hope for some kind of redemption. It was an explanation that led to the conclusion that being authentic is the new pieces. Authenticity is in fragments. This proposition led the researcher to introduce a hermeneutical support-system that will enable future researchers engage more critically and responsibly with their “living human documents” in order to inspire timely solutions that resolve the concerns of authenticity and wellbeing among Millennials in Africa.

Keywords: authenticity, self, identity, self-fragmentation, weak self integration, postmodern self, splitting

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Authors: Nicholas P. Fenlon, Aisling Lavelle, David Mclean, Margaret O'riordan

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Background: The case for continuing professional development has been well made, and was formalized in Ireland in recent years through the enactment of the Medical Practitioner’s Act, which requires registered medical practitioners to complete a minimum of 50 hours CPD each year. The ICGP, who have been providing CPD opportunities to its members for many years, have responded to this need by developing a series of evidence-based, high-quality, multimedia modules across a range of clinical and non-clinical areas. (More traditional education opportunities are still being provided by the college also). Overview of Programme: The first module was released in September 2011, since when the eLearning program has grown steadily, and there are currently almost 20 modules available, with a further 5 in production. Each module contains three to six 10-minute video lessons, which use a combination of graphics, images, text, voice-over and clinical clips. These are supported by supplementary videos of expert pieces-to-camera, Q&As with content experts, clinical scenarios, external links and relevant documentation and other resources. Successful completion of MCQs will result in a Certificate of Completion, which can be printed or stored in Professional Competence portfolio. The Medical Practitioner’s Act requires doctors to gather CPD credits across 8 domains of practice, and various eLearning modules have been developed to address each. For instance, modules with a strong clinical content would include Management of Hypertension, Management of COPD, and Management of Asthma. Other modules focus on health promotion such as Promoting Smoking Cessation, Promoting Physical Activity, and Addressing Childhood Obesity. Modules where communication skills are keys include modules on Suicide Prevention and Management of Depression. Other modules, currently in development include non-clinical topics around risk management, including Confidentiality, Consent etc. Each module is developed by a core group, which includes where possible, a GP with a special interest in the area, and a content expert(s). The college works closely with a medical education consultant and a production company in developing and producing the modules. Modules can be accessed (with password) through the ICGP website and are available free to all ICGP members. Summary of Evaluation: There are over 1700 registered users to date (over 55% of College membership). The program was evaluated using an online survey in 2013 (N = 144/950 – 12%) and results were very positive overall but provided material for the further improvement of the program also. Future Plans: While knowledge can be imparted well through eLearning, skills and attitudes are more difficult to influence through an online environment. The college is now developing a series of linked workshops, which will lead to ICGP Professional Competence Awards. The first pilot workshop is scheduled for February 2015 and is Cardiology-themed. Participants will be required to complete the following 4 modules in advance of attending – Management of Hypertension, Management of Heart Failure, Promoting Smoking Cessation, and Promoting Physical Activity. The workshop will be case-based and interactive, addressing ECG Interpretation in General Practice. Conclusions: The ICGP have responded to members needs for high-quality evidence-based education delivered in a way that suits GPs.

Keywords: CPD opportunities, evidence-based, high quality, multimedia modules across a range of clinical and non-clinical areas, medical practitioner’s act

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Authors: Larry O. Awo, George N. Duru

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There are growing public and mental health concerns over the availability of gambling platforms and shops in Nigeria and the high level of youth involvement in gambling. Early theorizing maintained that gambling involvement was driven by a quest for resource gains. However, evidence shows that the economic model of gambling tends to explain the involvement of the gambling business owners (sport lottery operators: SLOs) as most gamblers lose more than they win. This loss, according to the law of effect, ought to discourage decisions to gamble. However, the quest to recover losses has often initiated prolonged gambling sessions. Therefore, the need to investigate mental contemplations (such as counterfactual reasoning (upward versus downward) of what “would, should, or could” have been, and feeling of the illusion of control; IOC) over gambling outcomes as risk or protective factors in gambling decisions became pertinent. The present study sought to understand the differential contributions and conditional effects of upward versus downward counterfactual reasoning as pathways through which the association between IOC and gambling decisions of Nigerian youths (N = 120, mean age = 18.05, SD = 3.81) could be explained. The study adopted a randomized group design, and data were obtained by means of stimulus material (the Gambling Episode; GE) and self-report measures of IOC and Gambling Decision. One-way analysis of variance (ANOVA) result showed that participants in the upward counterfactual reasoning group (M = 22.08) differed from their colleagues in the downward counterfactual reasoning group (M = 17.33) on the decision to gamble, and this difference was significant [F(1,112) = 23, P < .01]. HAYES PROCESS macro moderation analysis results showed that 1) IOC and upward counterfactual reasoning were positively associated with the decision to gamble (B = 14.21, t = 6.10, p < .01 and B = 7.22, t = 2.07, p <.05, respectively), 2) downward counterfactual reasoning was negatively associated with the decision to gamble more to recover losses (B = 10.03, t = 3.21, p < .01), 3) upward counterfactual reasoning did not moderate the association between IOC and gambling decision (p > .05), and 4) downward counterfactual reasoning negatively moderated the association between IOC and gambling decision (B = 07, t = 2.18, p < .05) such that the association was strong at the low level of downward counterfactual, but wane at high levels of downward counterfactual reasoning. The implication of these findings is that IOC and upward counterfactual reasoning were risk factors and promoted gambling behavior, while downward counterfactual reasoning protects individuals from gambling activities. Thus, it is concluded that downward counterfactual reasoning strategies should be included in gambling therapy and treatment packages as it could diminish feelings of both IOC and negative feelings of missed positive outcomes and the urge to gamble.

Keywords: counterfactual reasoning, gambling cognition, gambling decision, Nigeria, youths

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Authors: Miguel Angel Calvo Salve

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Building enclosures and façades not only have an aesthetic component they must also ensure thermal comfort and improve the acoustics and air quality in buildings. The role of facades design, its assemblies, and construction are key in developing a greener future in architecture. This research and study focus on the design of a multi-leaves building envelope, with a self-supporting wall of granite slabs. The study will demonstrate the advantages of its use in compare with the hanging stone veneer in a vented cladding system. Using the Design of the School of Music and Theatre of the Atlantic Area in Spain as a case study where the multi-leaves enclosure system consists in a self-supported outer leaf of large granite slabs of 15cm. of thickness, a vent cavity with thermal isolation, a brick wall, and a series of internal layers. The methodology used were simulations and data collected in building. The advantages of the self-supporting wall of granite slabs in the outer leaf (15cm). compared with a hanging stone veneer in a vented cladding system can summarize the goals as follows: Using the stone in more natural way, by compression. The weight of the stone slabs goes directly to a strip-footing and don't overload the reinforced concrete structure of the building. The weight of the stone slabs provides an external aerial soundproofing, preventing the sound transmission to the structure. The thickness of the stone slabs is enough to provide the external waterproofing of the building envelope. The self-supporting system with minimum anchorages allows having a continuous and external thermal isolation without thermal bridges. The thickness of ashlars masonry provides a thermal inertia that balances the temperatures between day and night in the external thermal insulation layer. The absence of open joints gives the quality of a continuous envelope transmitting the sensations of the stone, the heaviness in the facade, the rhythm of the music and the sequence of the theatre. The main cost of stone due his bigger thickness is more than compensated with the reduction in assembly costs. Don´t need any substructure systems for hanging stone veneers.

Keywords: self-supporting wall, stone cladding systems, hanging veneer cladding systems, sustainability of facade systems

Procedia PDF Downloads 58

Authors: Bhawna Shivan

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Indian monuments have been spoken of as for variety, extent, completeness and beauty unsurpassed perhaps unequaled in world. India’s monumental heritage is a part and parcel of India today. The underlying issue with the monumental heritage in contemporary times is that these monuments suffered many times with various degrees of threats/ pressures which hampered their beauty. In the current situation, the urbanization policies for sustainable development and tourism management pay no attention to the basic point of conservation and protection of these cultural heritages rather they focus more on profit earned from these sites. Many times rich heritage is found balancing between conflicting pressures of conservation of heritage elements with sustainability and local economic development. There is a need of a new attitude to India’s independent and democratic ideology. The paper will enquire about the historical perspective by analyzing and understanding the importance of Mughal Architecture while focusing on Humayun Tomb while assessing the value and sentiment people attach to these monuments. It will also put the focus on the future of these monuments in the era of globalization and urbanization. The role of public and private authorities for conservation and sustainable development of these monuments. As well as assessing other facilities like toilets, parking, eatery joint, Museum with Display of structural representation and display of books, and a mobile shop. The research will be helpful in assessing the importance of heritage buildings whether they are a tool of enhancing ‘Tourism Industry’ for Central and State Government or really there is still some future of these monuments. Can we still consider these heritage sites as the integral part of our society in this urbanized world? The study will also analyze the attitude of the central and state government towards a building when it declared as a ‘World Heritage Site’. The study will also examine how the Youth and other aged generations append their sentimental values towards them, say (what is their purpose of coming to a heritage site, what makes them coming here, how they view this particular monument) Apart from this, probing the factors such as rapid growth of cities and its population, increasing value of urban land and effect of globalization on urban growth pattern that are capable of producing a variety of threats and pressures on any monument for instance Humayun Tomb.

Keywords: globalization, monuments, tourism, urban heritage

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Authors: Jyh-Ping Chen, Chia-Lin Sheu

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In this study, we propose to use electrospinning to fabricate porous nanofibrous membranes as postsurgical anti-adhesion barriers and to improve the properties of current post-surgical anti-adhesion products. We propose to combine FDA-approved biomaterials with anti-adhesion properties, polycaprolactone (PCL), polyethylene glycol (PEG), hyaluronic acid (HA) with silver nanoparticles (Ag) and ibuprofen (IBU), to produce anti-adhesion barrier nanofibrous membranes. For this purpose, PEG/PCL/Ag/HA/IBU core-shell nanofibers were prepared. The shell layer contains PEG + PCL to provide mechanical supports and Ag was added to the outer PEG-PCL shell layer during electrospinning to endow the nanofibrous membrane with anti-bacterial properties. The core contains HA to exert anti-adhesion and IBU to exert anti-inflammation effects, respectively. The nanofibrous structure of the membranes can reduce cell penetration while allowing nutrient and waste transports to prevent postsurgical adhesion. Nanofibers with different core/shell thickness ratio were prepared. The nanofibrous membranes were first characterized for their physico-chemical properties in detail, followed by in vitro cell culture studies for cell attachment and proliferation. The HA released from the core region showed extended release up to 21 days for prolonged anti-adhesion effects. The attachment of adhesion-forming fibroblasts is reduced using the nanofibrous membrane from DNA assays and confocal microscopic observation of adhesion protein vinculin expression. The Ag released from the shell showed burst release to prevent E Coli and S. aureus infection immediately and prevent bacterial resistance to Ag. Minimum cytotoxicity was observed from Ag and IBU when fibroblasts were culture with the extraction medium of the nanofibrous membranes. The peritendinous anti-adhesion model in rabbits and the peritoneal anti-adhesion model in rats were used to test the efficacy of the anti-adhesion barriers as determined by gross observation, histology, and biomechanical tests. Within all membranes, the PEG/PCL/Ag/HA/IBU core-shell nanofibers showed the best reduction in cell attachment and proliferation when tested with fibroblasts in vitro. The PEG/PCL/Ag/HA/IBU nanofibrous membranes also showed significant improvement in preventing both peritendinous and peritoneal adhesions when compared with other groups and a commercial adhesion barrier film.

Keywords: anti-adhesion, electrospinning, hyaluronic acid, ibuprofen, nanofibers

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Authors: Natalia M. Acevedo, Luis M. Jimenez, Erick Lambis

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Imperfections in the capital market are used to argue the relevance of the corporate risk management function. With corporate hedge, the value of the company is increased by reducing the volatility of the expected cash flow and making it possible to face a lower bankruptcy costs and financial difficulties, without sacrificing tax advantages for debt financing. With the propose to avoid exchange rate troubles over cash flows of Colombian exporting firms, this dissertation uses financial options, over exchange rate between Peso and Dollar, for realizing a financial hedge. In this study, a strategy of hedge is designed for an exporting company in Colombia with the objective of preventing fluctuations because, if the exchange rate down, the number of Colombian pesos that obtains the company by exports, is less than agreed. The exchange rate of Colombia is measured by the TRM (Representative Market Rate), representing the number of Colombian pesos for an American dollar. First, the TMR is modelled through the Geometric Brownian Motion, with this, the project price is simulated using Montecarlo simulations and finding the mean of TRM for three, six and twelve months. For financial hedging, currency options were used. The 6-month projection was covered with financial options on European-type currency with a strike price of $ 2,780.47 for each month; this value corresponds to the last value of the historical TRM. In the compensation of the options in each month, the price paid for the premium, calculated with the Black-Scholes method for currency options, was considered. Finally, with the modeling of prices and the Monte Carlo simulation, the effect of the exchange hedging with options on the exporting company was determined, this by means of the unit price estimate to which the dollars in the scenario without coverage were changed and scenario with coverage. After using the scenarios: is determinate that the TRM will have a bull trend and the exporting firm will be affected positively because they will get more pesos for each dollar. The results show that the financial options manage to reduce the exchange risk. The expected value with coverage is approximate to the expected value without coverage, but the 5% percentile with coverage is greater than without coverage. The foregoing indicates that in the worst scenarios the exporting companies will obtain better prices for the sale of the currencies if they cover.

Keywords: currency hedging, futures, geometric Brownian motion, options

Procedia PDF Downloads 126

Authors: Daniela Pisu

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The paper deals with the issue of territorial inequalities focused on the gap of the marginalization of inland areas with respect to the centrality of urban centers as they are subjected to an almost unstoppable demographic hemorrhage in a context marked by the tendency to depopulation such as the Sardinian territory, to which are added further and intense phenomena of de-anthropization. The research question is aimed at exploring the functionality of the interventions envisaged by the Piano Nazionale Ripresa Resilienza for the reduction of territorial imbalances in these areas to the extent that it is possible to identify policy strategies aimed at increasing the relational expertise of citizenship, functional to the consolidation of results in a long-term perspective. In order to answer this question, the qualitative case study on the Municipality of Ulàssai (province of Nuoro) is highlighted as the only winner on the island, with the Pilot Project ‘Where nature meets art’, intended for the cultural and social regeneration of small towns. The main findings, which emerged from the analysis of institutional sources and secondary data, highlight the socio-demographic fragility of the territory in the face of the active institutional commitment to make Ulàssai a smart community, starting from the enhancement of natural resources and the artistic heritage of fellow citizen Maria Lai. The findings drawn from the inspections and focus groups with the youth population present the aforementioned project as a generative opportunity for both the economic and social fabric, leveraging the public debates of the living labs, where the process of public communication becomes the main vector for the exercise of the rights of participatory democracy. The qualitative lunge leads to the conclusion that the repercussions envisaged by the PNRR in internal areas will be able to show their self-sustainable effect through colloquial administrations such as that of Ulàssai, capable of seeing in the interactive paradigm of public communication that natural process with which to reduce that historical sense of extraneousness attributed to the institution-citizenship relationship.

Keywords: social labs, smart community, depopulation, Sardinia, Piano Nazionale di Ripresa e Resilienza

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Authors: Ochuko K. Overen, Edson L. Meyer

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Uncontrolled heat transfer between the inner and outer space of low-cost housings through the thermal envelope result in indoor thermal discomfort. As a result, an excessive amount of energy is consumed for space heating and cooling. Thermo-optical properties are the ability of paints to reduce the rate of heat transfer through the thermal envelope. The aim of this study is to analyze the thermal performance of a low-cost house with its walls inner surface coated with transparent infrared reflective paint. The thermo-optical properties of the paint were analyzed using Scanning Electron Microscopy/ Energy Dispersive X-ray spectroscopy (SEM/EDX), Fourier Transform Infra-Red (FTIR) and thermal photographic technique. Meteorological indoor and ambient parameters such as; air temperature, relative humidity, solar radiation, wind speed and direction of a low-cost house in Golf-course settlement, South Africa were monitored. The monitoring period covers both winter and summer period before and after coating. The thermal performance of the coated walls was evaluated using time lag and decrement factor. The SEM image shows that the coat is transparent to light. The presence of Al as Al2O and other elements were revealed by the EDX spectrum. Before coating, the average decrement factor of the walls in summer was found to be 0.773 with a corresponding time lag of 1.3 hours. In winter, the average decrement factor and corresponding time lag were 0.467 and 1.6 hours, respectively. After coating, the average decrement factor and corresponding time lag were 0.533 and 2.3 hour, respectively in summer. In winter, an average decrement factor of 1.120 and corresponding time lag of 3 hours was observed. The findings show that the performance of the coats is influenced by the seasons. With a 74% reduction in decrement factor and 1.4 time lag increase in winter, it implies that the coatings have more ability to retain heat within the inner space of the house than preventing heat flow into the house. In conclusion, the results have shown that transparent infrared reflective paint has the ability to reduce the propagation of heat flux through building walls. Hence, it can serve as a remedy to the poor thermal performance of low-cost housings in South Africa.

Keywords: energy efficiency, decrement factor, low-cost housing, paints, rural development, thermal comfort, time lag

Procedia PDF Downloads 281

Authors: Hyun-Ju Oh, Soon-Rim Suh, Mihan Kim

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The steady and rapid increase of the older population is a global phenomenon. Chronic diseases and disabilities are increased due to aging. In general, exercise has been known to be most effective in preventing and managing chronic back pain. However, it is hard for the older women to initiate and maintain the exercise. Transtheoretical model (TTM) is one of the theories explain behavioral changes such as exercise. The application of the program considering the stage of behavior change is effective for the elderly woman to start and maintain the exercise. The purpose of this study was to develop TTM based exercise program and to examine its effect for elderly women with chronic back-pain. For the program evaluation, the non-equivalent control pre-posttest design was applied. The independent variable of this study is exercise intervention program. The contents of the program were constructed considering the characteristics of the elderly women with chronic low back pain, focusing on the process of change, the stage of change by the previous studies. The developed exercise program was applied to the elderly women with chronic low back pain in the planning stage and the preparation stage. The subjects were 50 older women over 65 years of age with chronic back-pain who did not practice regular exercise. The experimental group (n=25) received the 8weeks TTM based exercise program. The control group received the book which named low back pain management. Data were collected at three times: before the exercise intervention, right after the intervention, and 4weeks after the intervention. The dependent variables were the processes of change, decisional balance, exercise self-efficacy, back-pain, depression and muscle strength. The results of this study were as follows. Processes of change (<.001), pros of decisional balance (<.001), exercise self-efficacy (<.001), back pain (<.001), depression (<.001), muscle strength (<.001) were higher in the experimental group than in the control group right after the program and 4weeks after the programs. The results of this study show that applying the TTM based exercise program increases the use of the change process, increases the exercise self-efficacy, increases the stage of changing the exercise behavior and strengthens the muscular strength by lowering the degree of pain and depression Respectively. The significance of the study was to confirm the effect of continuous exercise by maintaining regular exercise habits by applying exercise program of the transtheoretical model to the chronic low back pain elderly with exercise intention.

Keywords: chronic back pain, elderly, exercise, women

Procedia PDF Downloads 251

Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

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Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

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Authors: Chang Yu Chuan

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Background and Aim: Pressure sore is not only the consequence of any gradual damage of the skin leading to tissue defects but also an important indicator of clinical care. If hospitalized patients develop pressure sores without proper care, it would result in delayed healing, wound infection, increase patient physical pain, prolonged hospital stay and even death, which would have a negative impact on the quality of care and also increase nursing manpower and medical costs. This project is aimed at decreasing the incidence of pressure sore in one ward of internal medicine. Our data showed 53 cases (0.61%) of pressure sore in 2015, which exceeded the average (0.5%) of Taiwan Clinical Performance Indicator (TCPI) for medical centers. The purpose of this project is to reduce the incidence rate of pressure sore in the ward. After data collection and analysis from January to December 2016, the reasons of developing pressure sore were found: 1. Lack of knowledge to prevent pressure among nursing staffs; 2. No relevant courses about preventing pressure ulcers and pressure wound care being held in this unit; 3. Low complete rate of pressure sore care education that family members should receive from nursing staffs; 4. Decompression equipment is not enough; 5. Lack of standard procedures for body-turning and positioning care. After team members brainstorming, several strategies were proposed, including holding in-service education, pressure sore care seed training, purchasing decompression mattress and memory pillows, designing more elements of health education tools, such as health education pamphlet, posters and multimedia films of body-turning and positioning demonstration, formulation and promotion of standard operating procedures. In this way, nursing staffs can understand the body-turning and positioning guidelines for pressure sore prevention and enhance the quality of care. After the implementation of this project, the pressure sore density significantly decreased from 0.61%(53 cases) to 0.45%(28 cases) in this ward. The project shows good results and good example for nurses working at the ward and helps to enhance quality of care.

Keywords: body-turning and positioning, incidence density, nursing, pressure sore

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Authors: Mastewal Endeshaw Getnet

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Imunization is one of the most cost-effective and extensively adopted public health strategies for preventing child disability and mortality. Expanded Program on Immunization (EPI) was launched in 1974 with the goal of providing life-saving vaccines to all children in all and building on the success of the global smallpox eradication program. According to World Health Organization report, by 2020, all countries should have achieved 90% vaccination coverage. Many developing countries still have not achieved the goal. Ethiopia is one of Africa's developing countries. The Ethiopian Ministry of health (MoH) launched the EPI program in 1980, with the goal of achieving 90% coverage among children under the age of 1 year by 1990. Among children aged 12-23 months, complete immunization coverage was 47% based on the Ethiopian Demographic and Health Survey (EDAS) 2019 report. The coverage varies depending on the administrative region, ranging from 21% in Afar region to 89% in Amhara region, Ethiopia. Therefore, identifying risk factors for incomplete immunization among children is a key challenge, particularly in Ethiopia, which has a large geographical diversity and a predicted with 119.96 million projected population size in the year 2022. Despite its critical and challenging issue, this issue is still open and has not yet been fully investigated. Recently, a few previous studies have been conducted on the assessment of incomplete children immunization determinants. However, the majority of the studies were cross-sectional surveys that assessed only EPI coverage. Motivated by the above investigation, this study focuses on investigating determinants associated with incomplete immunization among Ethiopian children to facilitate the rate of full immunization coverage. Moreover, we consider both individual immunization and service performance-related factors to investigate incomplete children's determinants. Consequently, we adopted an ecological model in this study. Individual and environmental factors are combined in the Ecological model, which provides multilevel framework for exploring different determinants related with health behaviors. The Ethiopian Demographic and Health Survey will be used as a source of data from 2021 to achieve the objective of this study. The findings of this study will be useful to the Ethiopian government and other public health institutes to improve the coverage score of childhood immunization based on the identified risk determinants.

Keywords: incomplete immunization, children, ethiopia, ecological model

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Authors: Mohd Taufiq bin Azmy, Yahaya Hassan, Shubashini Gnanasan, Loganathan Fahrni

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Inappropriate prescribing in older patients has been associated with resource utilization and adverse drug events (ADE) such as hospitalization, morbidity and mortality. Globally, there is a lack of published data on ADE induced by inappropriate prescribing. Our study is specific to an older population and is aimed at identifying risk factors for ADE and to develop a model that will link ADE to inappropriate prescribing. The design of the study was prospective whereby computerized medical records of 302 hospitalized elderly aged 65 years and above in 3 public hospitals in Malaysia (Hospital Serdang, Hospital Selayang and Hospital Sungai Buloh) were studied over a 7 month period from September 2013 until March 2014. Potentially inappropriate medications and potential prescribing omissions were determined using the published and validated START-STOPP criteria. Patients who had at least one inappropriate medication were included in Phase II of the study where ADE were identified by local expert consensus panel based on the published and validated Naranjo ADR probability scale. The panel also assessed whether ADE were causal or contributory to current hospitalization. The association between inappropriate prescribing and ADE (hospitalization, mortality and adverse drug reactions) was determined by identifying whether or not the former was causal or contributory to the latter. Rate of ADE avoidability was also determined. Our findings revealed that the prevalence of potential inappropriate prescribing was 58.6%. A total of ADEs were detected in 31 of 105 patients (29.5%) when STOPP criteria were used to identify potentially inappropriate medication; All of the 31 ADE (100%) were considered causal or contributory to admission. Of the 31 ADEs, 28 (90.3%) were considered avoidable or potentially avoidable. After adjusting for age, sex, comorbidity, dementia, baseline activities of daily living function, and number of medications, the likelihood of a serious avoidable ADE increased significantly when a potentially inappropriate medication was prescribed (odds ratio, 11.18; 95% confidence interval [CI], 5.014 - 24.93; p < .001). The medications identified by STOPP criteria, are significantly associated with avoidable ADE in older people that cause or contribute to urgent hospitalization but contributed less towards morbidity and mortality. Findings of the study underscore the importance of preventing inappropriate prescribing.

Keywords: adverse drug events, appropriate prescribing, health services research

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Authors: Qianli Ma, Xuemin Zhao, Lingai Yao, Zhencheng Xu, Li Wang

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Heavy metal pollution accidents, frequently happened in this decade in China, severely threaten aquatic ecosystem and economy. In January 2012, a basin-scale accidental Cd pollution happened in Longjiang River in southwest China. Although water quality was recovered in short period by emergency treatment with flocculants, a large amount of contaminated cage-cultivated fish were left with the task of preventing or mitigating Cd contamination of fish. In this study, unpolluted Ctenopharyngodon idellus were fed by Cd-contaminated macrophytes for assessing the effect of Cd accumulation through food exposure, and the contaminated C. idellus were fed with Cd-free macrophytes for assessing the ability of Cd depuration. The on-site cultivation experiments were done in two sites of Lalang (S1, accidental Cd pollution originated) and Sancha (S2, a large amount of flocculants were added to accelerate Cd precipitation) in Longjiang river. Results showed that Cd content in fish muscle presented an increasing trend in the accumulation experiment. In S1, Cd content of fish muscle rose sharply from day 8 to day 18 with higher average Cd content in macrophytes and sediment, and kept in the range of 0.208-0.308 mg/kg afterward. In S2, Cd content of fish muscle rose gradually throughout the experiment and reached the maximum level of 0.285 mg/kg on day 76. The results of the depuration experiment showed that Cd content in fish muscle decreased and significant changes were observed in the first half time of the experiment. Meanwhile, fish with lower initial Cd content presented higher elimination constant. In S1, Cd content of fish significantly decreased from 0.713 to 0.304 mg/kg in 18 days and kept decreasing to 0.110 mg/kg in the end, and 84.6% of Cd content was eliminated. While in S2, there was a sharp decrease of Cd content of fish in 0-8 days from 0.355 mg/kg to 0.069 mg/kg. The total elimination percentage was 93.8% and 80.6% of which appeared in day 0-8. The elimination constant of fish in S2 was 0.03 which was higher than 0.02 in S1. Collectively, our results showed Cd could be absorbed through food exposure and accumulate in fish muscle, and the accumulated Cd in fish muscle can be excreted after isolated from the polluted food sources. This knowledge allows managers to assess health risk of Cd contaminated fish and minimize aquaculture loss when considering fish cultivation after accidental pollution.

Keywords: accidental pollution, cadmium accumulation and depuration, cage-cultivated fish, environmental management, river

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Authors: Sara Zelman, Courtney Meyer, Hiren Patel, Lisa Philpotts, Sue Lahey, Thomas Burke

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Background: As the global burden of disease shifts from infectious diseases to noncommunicable diseases, there is growing urgency to provide treatment for time-sensitive illnesses, such as ST-Elevation Myocardial Infarctions (STEMIs). The standard of care for STEMIs in developed countries is Percutaneous Coronary Intervention (PCI). However, this is inaccessible in resource-limited settings. Before the discovery of PCI, Streptokinase (STK) and other thrombolytic drugs were first-line treatments for STEMIs. STK has been recognized as a cost-effective and safe treatment for STEMIs; however, in settings which lack access to PCI, it has not become the established second-line therapy. A systematic literature review was conducted to geographically map the use of STK for STEMIs in resource-limited settings. Methods: Our literature review group searched the databases Cinhal, Embase, Ovid, Pubmed, Web of Science, and WHO’s Index Medicus. The search terms included ‘thrombolytics’ AND ‘myocardial infarction’ AND ‘resource-limited’ and were restricted to human studies and papers written in English. A considerable number of studies came from Latin America; however, these studies were not written in English and were excluded. The initial search yielded 3,487 articles, which was reduced to 3,196 papers after titles were screened. Three medical professionals then screened abstracts, from which 291 articles were selected for full-text review and 94 papers were chosen for final inclusion. These articles were then analyzed and mapped geographically. Results: This systematic literature review revealed that STK has been used for the treatment of STEMIs in 33 resource-limited countries, with 18 of 94 studies taking place in India. Furthermore, 13 studies occurred in Pakistan, followed by Iran (6), Sri Lanka (5), Brazil (4), China (4), and South Africa (4). Conclusion: Our systematic review revealed that STK has been used for the treatment of STEMIs in 33 resource-limited countries, with the highest utilization occurring in India. This demonstrates that even though STK has high utility for STEMI treatment in resource-limited settings, it still has not become the standard of care. Future research should investigate the barriers preventing the establishment of STK use as second-line treatment after PCI.

Keywords: cardiovascular disease, global health, resource-limited setting, ST-Elevation Myocardial Infarction, Streptokinase

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Authors: Semyachkina-Glushkovskaya Oxana, Fedosov Ivan, Blokhina Inna, Terskov Andrey, Evsukova Arina, Elovenko Daria, Adushkina Viktoria, Dubrovsky Alexander, Jürgen Kurths

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In modern neurobiology, sleep is considered a novel biomarker and a promising therapeutic target for brain diseases. This is due to recent discoveries of the nighttime activation of the brain lymphatic system (BLS), playing an important role in the removal of wastes and toxins from the brain and contributes neuroprotection of the central nervous system (CNS). In our review, we discuss that night stimulation of BLS might be a breakthrough strategy in a new treatment of Alzheimer’s and Parkinson’s disease, stroke, brain trauma, and oncology. Although this research is in its infancy, however, there are pioneering and promising results suggesting that night transcranial photostimulation (tPBM) stimulates more effectively lymphatic removal of amyloid-beta from mouse brain than daily tPBM that is associated with a greater improvement of the neurological status and recognition memory of animals. In our previous study, we discovered that tPBM modulates the tone and permeability of the lymphatic endothelium by stimulating NO formation, promoting lymphatic clearance of wastes and toxins from the brain tissues. We also demonstrate that tPBM can also lead to angio- and lymphangiogenesis, which is another mechanism underlying tPBM-mediated stimulation of BLS. Thus, photo-augmentation of BLS might be a promising therapeutic target for preventing or delaying brain diseases associated with BLS dysfunction. Here we present pioneering technology for simultaneous tPBM in humans and sleep monitoring for stimulation of BLS to remove toxins from CNS and modulation of brain immunity. The wireless-controlled gadget includes a flexible organic light-emitting diode (LED) source that is controlled directly by a sleep-tracking device via a mobile application. The designed autonomous LED source is capable of providing the required therapeutic dose of light radiation at a certain region of the patient’s head without disturbing of sleeping patient. To minimize patients' discomfort, advanced materials like flexible organic LEDs were used. Acknowledgment: This study was supported by RSF project No. 23-75-30001.

Keywords: brain diseases, brain lymphatic system, phototherapy, sleep

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