Search results for: classic literature education

Authors: Qi En Han, Si En Wai, Eugene Quek

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As one of the two Academic Medical Centres (AMCs) in Singapore, SingHealth Duke-NUS AMC strives to improve patients’ lives through excellent clinical care, research and education. These efforts are enhanced with the establishment of Academic Clinical Programmes (ACPs). Each ACP brings together specialists in a particular discipline from different institutions to maximize the power of shared knowledge and resources. Initiated by Surgery ACP, the student research mentorship programme is a programme designed to facilitate engagement between medical students and the surgical faculty. The programme offers mentors not only the opportunity to supervise research but also to nurture future clinician scientists. In turn, medical students acquire valuable research experience which may be useful in their future careers. The programme typically lasts one year, depending on the students’ commitment. Surgery ACP matches students’ research interests with the mentor's area of expertise whenever possible. Surgery ACP organizes informal tea sessions to bring students and prospective mentors together. Once a match is made, the pair is required to submit a project proposal which includes the title, proposed start and end dates, ethical and biosafety considerations and project details. The mentees either think of their own research question with guidance from the mentors or join an existing project. The mentees may participate in data collection, data analysis, manuscript writing and conference presentation. The progress of each research project is monitored through half-yearly progress report. The mentees report problems encountered or changes made to existing proposal on top of the progress made. A total of 18 mentors were successfully paired with 36 mentees since 2013. Currently, there are 23 on-going and 13 completed projects. The mentees are encouraged to present their projects at conferences and to publish in peer-reviewed journals. Six mentees have presented their completed projects at local or international conferences and one mentee has her work published. To further support student research, Surgery ACP organized a Research Day in 2015 to recognize their research efforts and to showcase their wide-range of research. Surgery ACP recognizes that early exposure of medical students to research is important in developing them into clinician scientists. As interest in research take time to develop and are usually realized during various research attachments, it is crucial that programmes such as the student research mentorship programme exist. Surgery ACP will continue to build on this programme.

Keywords: academic clinical programme, clinician scientist, medical student, mentoring

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Authors: Erin Micali, Katerina Tolstikova, Cheryl Maykel, Elizabeth Harwood

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Female ASD is seldomly studied separately from males. Further, females with ASD are disproportionately underrepresented in the research at a rate of 3:1 (male to female). As such, much of the current understanding about female rigid repetitive behaviors (RRBs) stems from research’s understanding of male RRBs. This can be detrimental to understanding female ASD because this understanding of female RRBs largely discounts female camouflaging and the possibility that females present their autistic symptoms differently. Current literature suggests that females with ASD engage in fewer RRBs than males with ASD and when females do engage in RRBs, they are likely to engage in more subtle, less overt obsessions and repetitive behaviors than males. Method: The current study utilized a mixed methods research design to identify the type and frequency of RRBs that females with ASD engaged in by using a cross-sectional design. The researcher recruited only females to be part of the present study with the criteria they be at least age six and not have co-occurring cognitive impairment. Results: The researcher collected previous testing data (Autism Diagnostic Interview-Revised (ADI-R), Child or Adolescent/Adult Sensory Profile-2, Autism/ Empathy Quotient, Yale Brown Obsessive Compulsive Checklist, Rigid Repetitive Behavior Checklist (evaluator created list), and demographic questionnaire) from 25 total participants. The participants ages ranged from six to 52. The participants were 96% Caucasion and 4% Latin American. Qualitative analysis found the current participant pool engaged in six RRB themes including repetitive behaviors, socially restrictive behaviors, repetitive speech, difficulty with transition, obsessive behaviors, and restricted interests. The current dataset engaged in socially restrictive behaviors and restrictive interests most frequently. Within the main themes 40 subthemes were isolated, defined, and analyzed. Further, preliminary quantitative analysis was run to determine if age impacted camouflaging behaviors and overall presentation of RRBs. Within this dataset this was not founded. Further qualitative data will be run to determine if this dataset engaged in more overt or subtle RRBs to confirm or rebuff previous research. The researcher intends to run SPSS analysis to determine if there was statistical difference between each RRB theme and overall presentation. Secondly, each participant will be analyzed for presentation of RRB, age, and previous diagnoses. Conclusion: The present study aimed to assist in diagnostic clarity. This was achieved by collecting data from a female only participant pool across the lifespan. Current data aided in clarity of the type of RRBs engage in. A limited sample size was a barrier in this study.

Keywords: autism spectrum disorder, camouflaging, rigid repetitive behaviors, gender disparity

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Authors: Sungeun Hyun, Sooin Lee, Gyewan Moon

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Work-Family Conflict has been an active research area for the past decades. Work-Family Conflict harms individuals and organizations, it is ultimately expected to bring the cost of losses to the company in the long run. WFC has mainly focused on effects of organizational effectiveness and job attitude such as Job Satisfaction, Organizational Commitment, and Turnover Intention variables. This study is different from consequence variable with previous research. For this purpose, we selected the positive job attitude 'Work Engagement' as a consequence of WFC. This research has its primary research purpose in identifying the negative effects of the Work-Family Conflict, and started out from the recognition of the problem that the research on the direct relationship on the influence of the WFC on Work Engagement is lacking. Based on the COR(Conservation of resource theory) and JD-R(Job Demand- Resource model), the empirical study model to examine the negative effects of WFC with Emotional Exhaustion as the link between WFC and Work Engagement was suggested and validated. Also, it was analyzed how much Positive Psychological Capital may buffer the negative effects arising from WFC within this relationship, and the Mediated Moderation model controlling the indirect effect influencing the Work Engagement by the Positive Psychological Capital mediated by the WFC and Emotional Exhaustion was verified. Data was collected by using questionnaires distributed to 500 employees engaged manufacturing, services, finance, IT industry, education services, and other sectors, of which 389 were used in the statistical analysis. The data are analyzed by statistical package, SPSS 21.0, SPSS macro and AMOS 21.0. The hierarchical regression analysis, SPSS PROCESS macro and Bootstrapping method for hypothesis testing were conducted. Results showed that all hypotheses are supported. First, WFC showed a negative effect on Work Engagement. Specifically, WIF appeared to be on more negative effects than FIW. Second, Emotional exhaustion found to mediate the relationship between WFC and Work Engagement. Third, Positive Psychological Capital showed to moderate the relationship between WFC and Emotional Exhaustion. Fourth, the effect of mediated moderation through the integration verification, Positive Psychological Capital demonstrated to buffer the relationship among WFC, Emotional Exhastion, and Work Engagement. Also, WIF showed a more negative effects than FIW through verification of all hypotheses. Finally, we discussed the theoretical and practical implications on research and management of the WFC, and proposed limitations and future research directions of research.

Keywords: emotional exhaustion, positive psychological capital, work engagement, work-family conflict

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Authors: Piotr Tylec, Alicja Dudek, Grzegorz Torbicz, Magdalena Mizera, Natalia Gajewska, Michael Su, Tanawat Vongsurbchart, Tomasz Stefura, Magdalena Pisarska, Mateusz Rubinkiewicz, Piotr Malczak, Piotr Major, Michal Pedziwiatr

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Introduction: Quality of life after bariatric surgery is an important factor when evaluating the final result of the treatment. Considering the vast surgical options, we tried to globally compare available methods in terms of quality of following the surgery. The aim of the study is to compare the quality of life a year after bariatric intervention using network meta-analysis methods. Material and Methods: We performed a systematic review according to PRISMA guidelines with Bayesian network meta-analysis. Inclusion criteria were: studies comparing at least two methods of weight loss treatment of which at least one is surgical, assessment of the quality of life one year after surgery by validated questionnaires. Primary outcomes were quality of life one year after bariatric procedure. The following aspects of quality of life were analyzed: physical, emotional, general health, vitality, role physical, social, mental, and bodily pain. All questionnaires were standardized and pooled to a single scale. Lifestyle intervention was considered as a referenced point. Results: An initial reference search yielded 5636 articles. 18 studies were evaluated. In comparison of total score of quality of life, we observed that laparoscopic sleeve gastrectomy (LSG) (median (M): 3.606, Credible Interval 97.5% (CrI): 1.039; 6.191), laparoscopic Roux en-Y gastric by-pass (LRYGB) (M: 4.973, CrI: 2.627; 7.317) and open Roux en-Y gastric by-pass (RYGB) (M: 9.735, CrI: 6.708; 12.760) had better results than other bariatric intervention in relation to lifestyle interventions. In the analysis of the physical aspects of quality of life, we notice better results in LSG (M: 3.348, CrI: 0.548; 6.147) and in LRYGB procedure (M: 5.070, CrI: 2.896; 7.208) than control intervention, and worst results in open RYGB (M: -9.212, CrI: -11.610; -6.844). Analyzing emotional aspects, we found better results than control intervention in LSG, in LRYGB, in open RYGB, and laparoscopic gastric plication. In general health better results were in LSG (M: 9.144, CrI: 4.704; 13.470), in LRYGB (M: 6.451, CrI: 10.240; 13.830) and in single-anastomosis gastric by-pass (M: 8.671, CrI: 1.986; 15.310), and worst results in open RYGB (M: -4.048, CrI: -7.984; -0.305). In social and vital aspects of quality of life, better results were observed in LSG and LRYGB than control intervention. We did not find any differences between bariatric interventions in physical role, mental and bodily aspects of quality of life. Conclusion: The network meta-analysis revealed that better quality of life in total score one year after bariatric interventions were after LSG, LRYGB, open RYGB. In physical and general health aspects worst quality of life was in open RYGB procedure. Other interventions did not significantly affect the quality of life after a year compared to dietary intervention.

Keywords: bariatric surgery, network meta-analysis, quality of life, one year follow-up

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Authors: Kai-Cheng Yang, Yen-Ling Chen, Er-Chieh Cho, Kuen-Chan Lee

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Titanium dioxide nanomaterials offer superior protection for human skin against the full spectrum of ultraviolet light. However, some literature reviews indicated that it might be associated with adverse effects such as cytotoxicity or reactive oxygen species (ROS) due to their nanoscale. The surface of fullerene is covered with π electrons constituting aromatic structures, which can effectively scavenge large amount of radicals. Unfortunately, fullerenes are poor solubility in water, severe aggregation, and toxicity in biological applications when dispersed in solvent have imposed the limitations to the use of fullerenes. Carboxyfullerene acts as the scavenger of radicals for several years. Some reports indicate that carboxyfullerene not only decrease the concentration of free radicals in ambience but also prevent cells from reducing the number or apoptosis under UV irradiation. The aim of this study is to decorate fullerene –C70-carboxylic acid (C70-COOH) on the surface of titanium dioxide nanoparticles (P25) for the purpose of scavenging ROS during the irradiation. The modified material is prepared through the esterification of C70-COOH with P25 (P25/C70-COOH). The binding edge and structure are studied by using Transmission electron microscope (TEM) and Fourier transform infrared (FTIR). The diameter of P25 is about 30 nm and C70-COOH is found to be conjugated on the edge of P25 in aggregation morphology with the size of ca. 100 nm. In the next step, the FTIR was used to confirm the binding structure between P25 and C70-COOH. There are two new peaks are shown at 1427 and 1720 cm-1 for P25/C70-COOH, resulting from the C–C stretch and C=O stretch formed during esterification with dilute sulfuric acid. The IR results further confirm the chemically bonded interaction between C70-COOH and P25. In order to provide the evidence of scavenging radical ability of P25/C70-COOH, we chose pyridoxine (Vit.B6) and terephthalic acid (TA) to react with singlet oxygen and hydroxyl radicals. We utilized these chemicals to observe the radicals scavenging statement via detecting the intensity of ultraviolet adsorption or fluorescence emission. The UV spectra are measured by using different concentration of C70-COOH modified P25 with 1mM pyridoxine under UV irradiation for various duration times. The results revealed that the concentration of pyridoxine was increased when cooperating with P25/C70-COOH after three hours as compared with control (only P25). It indicates fewer radicals could be reacted with pyridoxine because of the absorption via P25/C70-COOH. The fluorescence spectra are observed by measuring P25/C70-COOH with 1mM terephthalic acid under UV irradiation for various duration times. The fluorescence intensity of TAOH was decreased in ten minutes when cooperating with P25/C70-COOH. Here, it was found that the fluorescence intensity was increased after thirty minutes, which could be attributed to the saturation of C70-COOH in the absorption of radicals. However, the results showed that the modified P25/C70-COOH could reduce the radicals in the environment. Therefore, we expect that P25/C70-COOH is a potential materials in using for antioxidant.

Keywords: titanium dioxide, fullerene, radical scavenging activity, antioxidant

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Authors: Amy L. Smith

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This study investigates the impact of student authenticity while engaging in academic exploration of students' sense of belonging, autonomy, and persistence. Research questions include: How does incorporating authenticity in first-year academic exploration courses impact; 1) first-year students’ sense of belonging, autonomy, and persistence? 2) first-year students’ sense of belonging, autonomy, and persistence during the first and last halves of the fall semester? 3) first-year students’ sense of belonging, autonomy, and persistence among various student demographics? First-year students completed a Likert-like survey at the conclusion of eight weeks (first and last eight weeks/fall semester) academic exploration courses. Course redesign included grounding the curriculum and instruction with student authenticity and creating opportunities for students to explore, define, and reflect upon their authenticity during academic exploration. Surveys were administered at the conclusion of these eight week courses (first and last eight weeks/fall semester). Data analysis included an entropy balancing matching method and t-tests. Research findings indicate integrating authenticity into academic exploration courses for first-year students has a positive impact on students' autonomy and persistence. There is a significant difference between authenticity and first-year students' autonomy (p = 0.00) and persistence (p = 0.01). Academic exploration courses with the underpinnings of authenticity are more effective in the second half of the fall semester. There is a significant difference between an academic exploration course grounding the curriculum and instruction in authenticity offered M8A (first half, fall semester) and M8B (second half, fall semester) (p = 0); M8B courses illustrate an increase of students' sense of belonging, autonomy, and persistence. Integrating authenticity into academic exploration courses for first-year students has a positive impact on varying student demographics (p = 0.00). There is a significant difference between authenticity and low-income (p = 0.04), first-generation (p = 0.00), Caucasian (p = 0.02), and American Indian/Alaskan Native (p = 0.05) first-year students' sense of belonging, autonomy, and persistence. Academic exploration courses embedded in authenticity helps develop first-year students’ sense of belonging, autonomy, and persistence, which are effective traits of college students. As first-year students engage in content courses, professors can empower students to have greater engagement in their learning process by relating content to students' authenticity and helping students think critically about how content is authentic to them — how students' authenticity relates to the content, how students can take their content expertise into the future in ways that, to the student, authentically contribute to the greater good. A broader conversation within higher education needs to include 1) designing courses that allow students to develop and reflect upon their authenticity/to formulate answers to the questions: who am I, who am I becoming, and how will I move my authentic self forward; and 2) a discussion of how to shift from the university shaping students to the university facilitating the process of students shaping themselves.

Keywords: authenticity, first-year experience, sense of belonging, autonomy, persistence

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Authors: Marian Emmanuel Okon

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Introduction: The Niger Delta region of Nigeria has a vast reserve of oil and gas, which has globally positioned the nation as the sixth largest exporter of crude oil. Production rapidly rose following oil discovery. In most oil producing nations of the world, the wealth generated from oil production and export has propelled economic advancement, enabling the development of industries and other relevant infrastructures. Therefore, it can be assumed that majority of the oil resource such as Nigeria’s, has the potential to improve the health of the population via job creation and derived revenues. However, the health benefits of this economic development might be offset by the environmental consequences of oil exploitation and production. Objective: This research aims to evaluate the balance between the health benefits of oil-led economic development and harmful environmental consequences of crude oil exploitation in Nigeria. Study Design: A pathway has been designed to guide data search and this study. The model created will assess the relationship between oil-led economic development and population health development via job creation, improvement of education, development of infrastructure and other forms of development as well as through harmful environmental consequences from oil activities. Data/Emerging Findings: Diverse potentially suitable datasets which are at different geographical scales have been identified, obtained or applied for and the dataset from the World Bank has been the most thoroughly explored. This large dataset contains information that would enable the longitudinal assessment of both the health benefits and harms from oil exploitation in Nigeria as well as identify the disparities that exist between the communities, states and regions. However, these data do not extend far back enough in time to capture the start of crude oil production. Thus, it is possible that the maximum economic benefits and health harms could be missed. To deal with this shortcoming, the potential for a comparative study with countries like United Kingdom, Morocco and Cote D’ivoire has also been taken into consideration, so as to evaluate the differences between these countries as well as identify the areas of improvement in Nigeria’s environmental and health policies. Notwithstanding, these data have shown some differences in each country’s economic, environmental and health state over time as well as a corresponding summary statistics. Conclusion: In theory, the beneficial effects of oil exploitation to the health of the population may be substantial as large swaths of the ‘wider determinants’ of population heath are influenced by the wealth of a nation. However, if uncontrolled, the consequences from environmental pollution and degradation may outweigh these benefits. Thus, there is a need to address this, in order to improve environmental and population health in Nigeria.

Keywords: environmental pollution, health benefits, oil-led economic development, petroleum exploitation

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Authors: Atefeh Abdollahi, Maryam Bahreini, Babak Choobi Anzali, Fatemeh Rasooli

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Introduction: Triage becomes the main part of organization of care in Emergency department (ED)s. It is used to describe the sorting of patients for treatment priority in ED. The accurate triage of injured patients has reduced fatalities and improved resource usage. Besides, the nurses’ knowledge and skill are important factors in triage decision-making. The ability to define an appropriate triage level and their need for intervention is crucial to guide to a safe and effective emergency care. Methods: This is a prospective cross-sectional study designed for emergency nurses working in four public university hospitals. Five triage workshops have been conducted every three months for emergency nurses based on a standard triage Emergency Severity Index (ESI) IV slide set - approved by Iranian Ministry of Health. Most influential items on triage performance were discussed through brainstorming in workshops which then, were peer reviewed by five emergency physicians and two head registered nurses expert panel. These factors that might distract nurse’ attention from proper decisions included patients’ past medical diseases, the natural tricks of triage and system failure. After permission had been taken, emergency nurses participated in the study and were given the structured questionnaire. Data were analysed by SPSS 21.0. Results: 92 emergency nurses enrolled in the study. 30 % of nurses reported the past history of chronic disease as the most influential confounding factor to ascertain triage level, other important factors were the history of prior admission, past history of myocardial infarction and heart failure to be 20, 17 and 11 %, respectively. Regarding the concept of difficulties in triage practice, 54.3 % reported that the discussion with patients and family members was difficult and 8.7 % declared that it is hard to stay in a single triage room whole day. Among the participants, 45.7 and 26.1 % evaluated the triage workshops as moderately and highly effective, respectively. 56.5 % reported overcrowding as the most important system-based difficulty. Nurses were mainly doubtful to differentiate between the triage levels 2 and 3 according to the ESI VI system. No significant correlation was found between the work record of nurses in triage and the uncertainty in determining the triage level and difficulties. Conclusion: The work record of nurses hardly seemed to be effective on the triage problems and issues. To correct the deficits, training workshops should be carried out, followed by continuous refresher training and supportive supervision.

Keywords: assessment, education, nurse, triage

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Authors: Danilo F. Rodrigues, Hérida Regina N. Salgado

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Introduction: The emergence of resistant microorganisms to a large number of clinically approved antimicrobials has been increasing, which restrict the options for the treatment of bacterial infections. As a strategy, drugs with high antimicrobial activities are in evidence. Stands out a class of antimicrobial, the cephalosporins, having as fourth generation cefepime (CEF) a semi-synthetic product which has activity against various Gram-positive bacteria (e.g. oxacillin resistant Staphylococcus aureus) and Gram-negative (e.g. Pseudomonas aeruginosa) aerobic. There are few studies in the literature regarding the development of microbiological methodologies for the analysis of this antimicrobial, so researches in this area are highly relevant to optimize the analysis of this drug in the industry and ensure the quality of the marketed product. The development of microbiological methods for the analysis of antimicrobials has gained strength in recent years and has been highlighted in relation to physicochemical methods, especially because they make possible to determine the bioactivity of the drug against a microorganism. In this context, the aim of this work was the development and validation of a microbiological method for quantitative analysis of CEF in powder lyophilized for injectable solution by turbidimetric assay. Method: For performing the method, Staphylococcus aureus ATCC 6538 IAL 2082 was used as the test microorganism and the culture medium chosen was the Casoy broth. The test was performed using temperature control (35.0 °C ± 2.0 °C) and incubated for 4 hours in shaker. The readings of the results were made at a wavelength of 530 nm through a spectrophotometer. The turbidimetric microbiological method was validated by determining the following parameters: linearity, precision (repeatability and intermediate precision), accuracy and robustness, according to ICH guidelines. Results and discussion: Among the parameters evaluated for method validation, the linearity showed results suitable for both statistical analyses as the correlation coefficients (r) that went 0.9990 for CEF reference standard and 0.9997 for CEF sample. The precision presented the following values 1.86% (intraday), 0.84% (interday) and 0.71% (between analyst). The accuracy of the method has been proven through the recovery test where the mean value obtained was 99.92%. The robustness was verified by the parameters changing volume of culture medium, brand of culture medium, incubation time in shaker and wavelength. The potency of CEF present in the samples of lyophilized powder for injectable solution was 102.46%. Conclusion: The turbidimetric microbiological method proposed for quantification of CEF in lyophilized powder for solution for injectable showed being fast, linear, precise, accurate and robust, being in accordance with all the requirements, which can be used in routine analysis of quality control in the pharmaceutical industry as an option for microbiological analysis.

Keywords: cefepime hydrochloride, quality control, turbidimetric assay, validation

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Authors: María de los Ángeles Cerda González, Itzel Arriaga Hurtado, Pascacio José Martínez Pichardo

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In México, the recognition of refugee condition is a fundamental right which, as host State, has the obligation of respect, protect, and fulfill to the foreigners – where we can find the figure of immigrants in irregular situation-, that cannot return to their country of origin for humanitarian reasons. The recognition of the refugee condition as a fundamental right in the Mexican law system proceeds under these situations: 1. The immigrant applies for the refugee condition, even without the necessary proving elements to accredit the humanitarian character of his departure from his country of origin. 2. The immigrant does not apply for the recognition of refugee because he does not know he has the right to, even if he has the profile to apply for. 3. The immigrant who applies fulfills the requirements of the administrative procedure and has access to the refugee recognition. Of the three situations above, only the last one is contemplated for the national indexes of the status refugee; and the first two prove the inefficiency of the governmental system viewed from its lack of sensibility consequence of the no education in human rights matter and which results in the legal vulnerability of the immigrants in irregular situation because they do not have access to the procuration and administration of justice. In the aim of determining the causes and consequences of the no recognition of the refugee status, this investigation was structured from a systemic analysis which objective is to show the advances in Central American humanitarian emergency investigation, the Mexican States actions to protect, respect and fulfil the fundamental right of refugee of immigrants in irregular situation and the social and legal vulnerabilities suffered by Central Americans in Mexico. Therefore, to achieve the deduction of the legal nature of the humanitarian emergency from the Human Rights as a branch of the International Public Law, a conceptual framework is structured using the inductive deductive method. The problem statement is made from a legal framework to approach a theoretical scheme under the theory of social systems, from the analysis of the lack of communication of the governmental and normative subsystems of the Mexican legal system relative to the process undertaken by the Central American immigrants to achieve the recognition of the refugee status as a human right. Accordingly, is determined that fulfilling the obligations of the State referent to grant the right of the recognition of the refugee condition, would mean a guideline for a new stage in Mexican Law, because it would enlarge the constitutional benefits to everyone whose right to the recognition of refugee has been denied an as consequence, a great advance in human rights matter would be achieved.

Keywords: central American immigrants in irregular situation, humanitarian emergency, human rights, refugee

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Authors: Raheel Shakoor Siddiqui, Shahbaz Malik, Manikandar Srinivas Cheruvu, Sanjay Narayana Murthy, Livio DiMascio

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Background: elderly traumatic hip fracture patients frequently present to trauma services globally. Rising low energy falls amongst an osteoporotic aging population is the commonest cause for injury. Hip fractures in this population are a major cause for severe pain, morbidity and mortality. The term hip fracture is interchangeable with neck of femur fracture, fractured neck of femur or proximal femur fracture. Hip fracture pain management protocols and guidelines suggest conventional analgesia, nerve block and opioid based treatment as rescue analgesia. There is a current global opioid crisis with overuse, abuse and dependence. Adverse opioid related complications in vulnerable elderly patients further adds to morbidity and mortality. Systematic reviews in literature have evidenced superiority of multimodal analgesia in osteoarthritic primary joint replacements compared to opioids however, this has not yet been conducted for elderly traumatic hip fracture patients. Aims: The primary aim of this systematic review is to provide standardised evidence following Cochrane and PRISMA guidance in determining advantages of perioperative multimodal analgesia over conventional opioid based treatments in elderly traumatic hip fractures. Methods: 5 databases were searched from January 2000-2023 which identified 8 randomised controlled trials and 446 total participants. These trials met defined PICOS eligibility criteria of patient mean age ≥ 65 years presenting with a unilateral traumatic fractured neck of femur for operative intervention. Analgesic intervention with perioperative multimodal analgesia has been compared to conventional opioid based analgesia. Outcomes of interest include, primarily, the change in postoperative opioid consumption within a 0-30 postoperative period and secondarily, the change in postoperative adverse events and complications. A qualitative synthesis has been performed due to clinical heterogenicity and variance amongst trials. Results: GRADE evidence of moderate quality supports perioperative multimodal analgesia leads to a reduction in postoperative opioid consumption however, low quality evidence supports a reduction of adverse effects and complications. Conclusion: Perioperative multimodal analgesia whether used preoperative, intraoperative and/or postoperative leads to a reduction in postoperative opioid consumption for elderly traumatic hip fracture patients. This review recommends the use of perioperative multimodal analgesia as part of hip fracture pain protocols however, caution and clinical judgement should be used as the risk of adverse effects may not be lower.

Keywords: trauma, orthopaedics, hip, fracture, neck of femur fracture, analgesia, multimodal analgesia, opioid

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Authors: Y. Z. Gad

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Disorders of Sex Development (DSD) are defined as congenital conditions in which development of chromosomal, gonadal or anatomical sex is atypical. The DSD are relatively prevalent in Egypt. In spite of that, the relative rarity of the individual disease types or their molecular pathologies frequently resulted in reporting on single or few cases. This augmented the challenging nature of phenotype-genotype correlation in this disease group and its utilization in the management of such medical emergency. Through critical assessment of the published DSD reports, the current review aims at analyzing the clinical characteristics of the various DSD forms in relation to the underlying molecular pathologies. A systematic literature search was done in Pubmed, using relevant keywords (Egypt versus DSD, genital ambiguity or ambiguous genitalia, the old terms of 'intersex, hermaphroditism and pseudohermaphroditism', and a list of the DSD entities and their related genes). The search yielded 24 reports of molecular data in Egyptian patients presenting with ambiguous genitalia. However, only 21 publications fulfilled the criteria of inclusion of detailed clinical descriptions and definitive molecular diagnoses of individual patients. Curation of the data yielded a total of 53 cases that were ascertained from 40 families. Fifty-one patients present with ambiguous genitalia only while 2 had multiple congenital anomalies. Parental consanguinity was noted in 60% of cases. Sex of rearing at initial presentation was female in 75% and 60% in 46,XY and 46,XX DSD cases, respectively. The external genital phenotype in 2/3 of the 46,XY DSD cases showed moderate undermasculinization [Quigley scores 3 & 4] and 1/3 had severe presentations [scores 5 & 6]. For 46,XX subjects, 1 had severe virilization of the external genitalia while 8 had moderate phenotype. Hormonal data were inconclusive or contradictory to final diagnosis in a forth of cases. Collectively, 31 families [31/40, 77.5%] with 46,XY DSD had molecular defects in the genes, 5 alpha reductase 2 (SRD5A2) [12/31], 17 beta-hydroxysteroid dehydrogenase 3 [8/31], androgen receptor [7/31], Steroidogenic factor 1 [2/31], luteinizing hormone receptor [1/31], and fibroblast growth factor receptor 1 [1/31]. In a multiethnic study, 9 families afflicted with 46,XX DSD due to 11 beta hydroxylase (CYP11B1) deficiency were documented. Two recurrent mutations, G34R and N160D, in SRD5A2 were present, respectively, in 42 and 17% of cases. Similarly, 4 recurrent mutations resulted in 89% of the CYP11B1 presentations. In conclusion, this analysis highlights the importance of autosomal recessive inheritance and inbreeding among DSD presentations, the importance of founder effect in at least 2 disorders, the difficulties in relating the genotype with the indeterminate genital phenotype, the under-reporting of some DSD subtypes, and the notion that the reported mutational profiles among Egyptian DSD cases are relatively different from those reported in other ethnic groups.

Keywords: disorders of sex development, genital ambiguity, mutation, molecular diagnosis, Egypt

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Authors: P. Naderi, M. N. Ouarzazi, S. C. Hirata, H. Ben Hamed, H. Beji

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The stability of mixed convection in a Newtonian fluid medium heated from below and cooled from above, also known as the Poiseuille-Rayleigh-Bénard problem, has been extensively investigated in the past decades. To our knowledge, mixed convection in porous media has received much less attention in the published literature. The present paper extends the mixed convection problem in porous media for the case of a viscoelastic fluid flow owing to its numerous environmental and industrial applications such as the extrusion of polymer fluids, solidification of liquid crystals, suspension solutions and petroleum activities. Without a superimposed through-flow, the natural convection problem of a viscoelastic fluid in a saturated porous medium has already been treated. The effects of the viscoelastic properties of the fluid on the linear and nonlinear dynamics of the thermoconvective instabilities have also been treated in this work. Consequently, the elasticity of the fluid can lead either to a Hopf bifurcation, giving rise to oscillatory structures in the strongly elastic regime, or to a stationary bifurcation in the weakly elastic regime. The objective of this work is to examine the influence of the main horizontal flow on the linear and characteristics of these two types of instabilities. Under the Boussinesq approximation and Darcy's law extended to a viscoelastic fluid, a temporal stability approach shows that the conditions for the appearance of longitudinal rolls are identical to those found in the absence of through-flow. For the general three-dimensional (3D) perturbations, a Squire transformation allows the deduction of the complex frequencies associated with the 3D problem using those obtained by solving the two-dimensional one. The numerical resolution of the eigenvalue problem concludes that the through-flow has a destabilizing effect and selects a convective configuration organized in purely transversal rolls which oscillate in time and propagate in the direction of the main flow. In addition, by using the mathematical formalism of absolute and convective instabilities, we study the nature of unstable three-dimensional disturbances. It is shown that for a non-vanishing through-flow, general three-dimensional instabilities are convectively unstable which means that in the absence of a continuous noise source these instabilities are drifted outside the porous medium, and no long-term pattern is observed. In contrast, purely transversal rolls may exhibit a transition to absolute instability regime and therefore affect the porous medium everywhere including in the absence of a noise source. The absolute instability threshold, the frequency and the wave number associated with purely transversal rolls are determined as a function of the Péclet number and the viscoelastic parameters. Results are discussed and compared to those obtained from laboratory experiments in the case of Newtonian fluids.

Keywords: instability, mixed convection, porous media, and viscoelastic fluid

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Authors: Michael McCann

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Managerial theories propose that, in joint stock companies, executives may be tempted to waste excess free cash on unprofitable projects to keep control of resources. In order to conceal their projects' poor performance, they may seek to engage in earnings management. On the one hand, managers may manipulate earnings upwards in order to post ‘good’ performances and safeguard their position. On the other, since managers pursuit of unrewarding investments are likely to lead to low long-term profitability, managers will use negative accruals to reduce current year’s earnings, smoothing earnings over time in order to conceal the negative effects. Agency models argue that boards of directors are delegated by shareholders to ensure that companies are governed properly. Part of that responsibility is ensuring the reliability of financial information. Analyses of the impact of board characteristics, particularly board independence on the misuse of free cash flow and earnings management finds conflicting evidence. However, existing characterizations of board independence do not account for such directors gaining firm-specific knowledge over time, influencing their monitoring ability. Further, there is little analysis of the influence of the relative experience of independent directors and executives on decisions surrounding the use of free cash. This paper contributes to this literature regarding the heterogeneous characteristics of boards by investigating the influence of independent director tenure on earnings management and the relative tenures of independent directors and Chief Executives. A balanced panel dataset comprising 51 companies across 11 annual periods from 2005 to 2015 is used for the analysis. In each annual period, firms were classified as conducting earnings management if they had discretionary accruals in the bottom quartile (downwards) and top quartile (upwards) of the distributed values for the sample. Logistical regressions were conducted to determine the marginal impact of independent board tenure and a number of control variables on the probability of conducting earnings management. The findings indicate that both absolute and relative measures of board independence and experience do not have a significant impact on the likelihood of earnings management. It is the level of free cash flow which is the major influence on the probability of earnings management. Higher free cash flow increases the probability of earnings management significantly. The research also investigates whether board monitoring of earnings management is contingent on the level of free cash flow. However, the results suggest that board monitoring is not amplified when free cash flow is higher. This suggests that the extent of earnings management in companies is determined by a range of company, industry and situation-specific factors.

Keywords: corporate governance, boards of directors, agency theory, earnings management

Procedia PDF Downloads 231

Authors: N. Szczepanska, B. Kudlak, G. Yotova, S. Tsakovski, J. Namiesnik

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In the scientific literature related to the widely understood issue of packaging materials designed to have contact with food (food contact materials), there is much information on raw materials used for their production, as well as their physiochemical properties, types, and parameters. However, not much attention is given to the issues concerning migration of toxic substances from packaging and its actual influence on the health of the final consumer, even though health protection and food safety are the priority tasks. The goal of this study was to estimate the impact of particular foodstuff packaging type, food production, and storage conditions on the degree of leaching of potentially toxic compounds and endocrine disruptors to foodstuffs using the acute toxicity test Microtox and XenoScreen YES YAS assay. The selected foodstuff packaging materials were metal cans used for fish storage and tetrapak. Five stimulants respectful to specific kinds of food were chosen in order to assess global migration: distilled water for aqueous foods with a pH above 4.5; acetic acid at 3% in distilled water for acidic aqueous food with pH below 4.5; ethanol at 5% for any food that may contain alcohol; dimethyl sulfoxide (DMSO) and artificial saliva were used in regard to the possibility of using it as an simulation medium. For each packaging three independent variables (temperature and contact time) factorial design simulant was performed. Xenobiotics migration from epoxy resins was studied at three different temperatures (25°C, 65°C, and 121°C) and extraction time of 12h, 48h and 2 weeks. Such experimental design leads to 9 experiments for each food simulant as conditions for each experiment are obtained by combination of temperature and contact time levels. Each experiment was run in triplicate for acute toxicity and in duplicate for estrogen disruption potential determination. Multi-factor analysis of variation (MANOVA) was used to evaluate the effects of the three main factors solvent, temperature (temperature regime for cup), contact time and their interactions on the respected dependent variable (acute toxicity or estrogen disruption potential). From all stimulants studied the most toxic were can and tetrapak lining acetic acid extracts that are indication for significant migration of toxic compounds. This migration increased with increase of contact time and temperature and justified the hypothesis that food products with low pH values cause significant damage internal resin filling. Can lining extracts of all simulation medias excluding distilled water and artificial saliva proved to contain androgen agonists even at 25°C and extraction time of 12h. For tetrapak extracts significant endocrine potential for acetic acid, DMSO and saliva were detected.

Keywords: food packaging, extraction, migration, toxicity, biotest

Procedia PDF Downloads 178

Authors: Adamantini Loukodimou, David Weston, Shiladitya Paul

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Offshore structures are subjected to harsh environments. It is documented that carbon steel needs protection from corrosion. The combined effect of UV radiation, seawater splash, and fluctuating temperatures diminish the integrity of these structures. In addition, the possibility of damage caused by floating ice, seaborne debris, and maintenance boats make them even more vulnerable. Their inspection and maintenance when far out in the sea are difficult, risky, and expensive. The most known method of mitigating corrosion of offshore structures is the use of cathodic protection. There are several zones in an offshore wind turbine. In the atmospheric zone, due to the lack of a continuous electrolyte (seawater) layer between the structure and the anode at all times, this method proves inefficient. Thus, the use of protective coatings becomes indispensable. This research focuses on the atmospheric zone. The conversion of commercially available and conventional paint (epoxy) system to an autonomous self-healing paint system via the addition of suitable encapsulated healing agents and catalyst is investigated in this work. These coating systems, which can self-heal when damaged, can provide a cost-effective engineering solution to corrosion and related problems. When the damage of the paint coating occurs, the microcapsules are designed to rupture and release the self-healing liquid (monomer), which then will react in the presence of the catalyst and solidify (polymerization), resulting in healing. The catalyst should be compatible with the system because otherwise, the self-healing process will not occur. The carbon steel substrate will be exposed to a corrosive environment, so the use of a sacrificial layer of Zn is also investigated. More specifically, the first layer of this new coating system will be TSZA (Thermally Sprayed Zn85/Al15) and will be applied on carbon steel samples with dimensions 100 x 150 mm after being blasted with alumina (size F24) as part of the surface preparation. Based on the literature, it corrodes readily, so one additional paint layer enriched with microcapsules will be added. Also, the reaction and the curing time are of high importance in order for this bilayer system of coating to work successfully. For the first experiments, polystyrene microcapsules loaded with 3-octanoyltio-1-propyltriethoxysilane were conducted. Electrochemical experiments such as Electrochemical Impedance Spectroscopy (EIS) confirmed the corrosion inhibiting properties of the silane. The diameter of the microcapsules was about 150-200 microns. Further experiments were conducted with different reagents and methods in order to obtain diameters of about 50 microns, and their self-healing properties were tested in synthetic seawater using electrochemical techniques. The use of combined paint/electrodeposited coatings allows for further novel development of composite coating systems. The potential for the application of these coatings in offshore structures will be discussed.

Keywords: corrosion mitigation, microcapsules, offshore wind turbines, self-healing

Procedia PDF Downloads 111

Authors: Alice D. Dioquino, Olivia N. Buzon, Emilio F. Aguinaldo, Ruel Avila, Erwin R. Callo, Cristy Ocampo, Malvin R. Tabajen, Marla C. Papango, Marilou M. Ubina, Josephine Tondo, Cromwell L. Valeriano

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The main purpose of this study was to develop, evaluate and validate courseware on Selected Topics in Mathematics, Science, and the English Language. Specifically, it aimed to: 1. Identify the appropriate Instructional Systems Design (ISD) model in the development of the courseware material; 2. Assess the courseware material according to its: a. Content Characteristics; b. Instructional Characteristics; and c. Technical Characteristics 3. Find out if there is a significant difference in the performance of students before and after using the tutorial CAI. This research is developmental as well as a one group pretest-posttest design. The study had two phases. Phase I includes the needs analysis, writing of lessons and storyboard by the respective experts in each field. Phase II includes the digitization or the actual development of the courseware by the faculty of the ICT department. In this phase it adapted an instructional systems design (ISD) model which is the ADDIE model. ADDIE stands for Analysis, Design, Development, Implementation and Evaluation. Formative evaluation was conducted simultaneously with the different phases to detect and remedy any bugs in the courseware along the areas of content, instructional and technical characteristics. The expected output are the digitized lessons in Algebra, Biology, Chemistry, Physics and Communication Arts in English. Students and some IT experts validated the CAI material using the Evaluation Form by Wong & Wong. They validated the CAI materials as Highly Acceptable with an overall mean rating of 4.527and standard deviation of 0 which means that they were one in the ratings they have given the CAI materials. A mean gain was recorded and computing the t-test for dependent samples it showed that there were significant differences in the mean achievement of the students before and after the treatment (using CAI). The identified ISD model used in the development of the tutorial courseware was the ADDIE model. The quantitative analyses of data based on ratings given by the respondents’ shows that the tutorial courseware possess the characteristics and or qualities of a very good computer-based courseware. The ratings given by the different evaluators with regard to content, instructional, and technical aspects of the Tutorial Courseware are in conformity towards being excellent. Students performed better in mathematics, biology chemistry, physics and the English Communication Arts after they were exposed to the tutorial courseware.

Keywords: CAI, tutorial courseware, Instructional Systems Design (ISD) Model, education

Procedia PDF Downloads 341

Authors: Éva Pintér, Péter Bagó, Nikolett Deutsch, Miklós Hetényi

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The process of digital transformation has a profound influence on all sectors of the worldwide economy and the business environment. The influence of blockchain technology can be observed in the digital economy and e-government, rendering it an essential element of a nation's growth strategy. The banking industry is experiencing significant expansion and development of financial technology firms. Utilizing developing technologies such as artificial intelligence (AI), machine learning (ML), and big data (BD), these entrants are offering more streamlined financial solutions, promptly addressing client demands, and presenting a challenge to incumbent institutions. The advantages of digital transformation are evident in the corporate realm, and firms that resist its adoption put their survival at risk. The advent of digital technologies has revolutionized the business environment, streamlining processes and creating opportunities for enhanced communication and collaboration. Thanks to the aid of digital technologies, businesses can now swiftly and effortlessly retrieve vast quantities of information, all the while accelerating the process of creating new and improved products and services. Big data analytics is generally recognized as a transformative force in business, considered the fourth paradigm of science, and seen as the next frontier for innovation, competition, and productivity. Big data, an emerging technology that is shaping the future of the banking sector, offers numerous advantages to banks. It enables them to effectively track consumer behavior and make informed decisions, thereby enhancing their operational efficiency. Banks may embrace big data technologies to promptly and efficiently identify fraud, as well as gain insights into client preferences, which can then be leveraged to create better-tailored products and services. Moreover, the utilization of big data technology empowers banks to develop more intelligent and streamlined models for accurately recognizing and focusing on the suitable clientele with pertinent offers. There is a scarcity of research on big data analytics in the banking industry, with the majority of existing studies only examining the advantages and prospects associated with big data. Although big data technologies are crucial, there is a dearth of empirical evidence about the role of big data analytics (BDA) capabilities in bank performance. This research addresses a gap in the existing literature by introducing a model that combines the resource-based view (RBV), the technical organization environment framework (TOE), and dynamic capability theory (DC). This study investigates the influence of Big Data Analytics (BDA) utilization on the performance of market and risk management. This is supported by a comparative examination of Hungarian mobile banking services.

Keywords: big data, digital transformation, dynamic capabilities, mobile banking

Procedia PDF Downloads 57

Authors: H.C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

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Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological wellbeing, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes. Hopefully it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

Procedia PDF Downloads 299

Authors: Mariana Branco, Nahida Sobrino, Cristina Neves, Márcia Santos, Afonso Granja, João Rosa Oliveira, Joana Costa, Luísa Castro Leite

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This case reports a COVID-19 infection in an unvaccinated adult man with no history of COVID-19 and no relevant clinical history besides anabolic steroid use, undergoing weaning with tamoxifen after a bodybuilding competition. The patient presented a 4cm cervical mass 3 weeks after COVID-19 infection in his cohabitants. He was otherwise asymptomatic and tested negative to multiple RT-PCR tests. Nevertheless, the IgG COVID-19 antibody was positive, suggesting the previous infection. This report raises a potential link between anabolic steroid use and atypical COVID-19 onset. Objectives: The goals of this paper are to raise a potential link between anabolic steroid use and atypical COVID-19 onset but also to report an uncommon case of COVID-19 infection with consecutive negative gold standard tests. Methodology: The authors used CARE guidelines for case report writing. Introduction: This case reports a COVID-19 infection case in an unvaccinated adult man, with multiple serial negative reverse transcription polymerase chain reaction (RT-PCR) test results, presenting with single cervical lymphadenopathy. Although the association between COVID-19 and lymphadenopathy is well established, there are no cases with this presentation, and consistently negative RT-PCR tests have been reported. Methodologies: The authors used CARE guidelines for case report writing. Case presentation: This case reports a 28-year-old Caucasian man with no previous history of COVID-19 infection or vaccination and no relevant clinical history besides anabolic steroid use undergoing weaning with tamoxifendue to participation in a bodybuilding competition. He visits his primary care physician because of a large (4 cm) cervical lump, present for 3 days prior to the consultation. There was a positive family history for COVID-19 infection 3 weeks prior to the visit, during which the patient cohabited with the infected family members. The patient never had any previous clinical manifestation of COVID-19 infection and, despite multiple consecutive RT-PCR testing, never tested positive. The patient was treated with an NSAID and a broad-spectrum antibiotic, with little to no effect. Imagiological testing was performed via a cervical ultrasound, followed by a needle biopsy for histologic analysis. Serologic testing for COVID-19 immunity was conducted, revealing a positive Anti-SARS-CoV-2 IgG (Spike S1) antibody, suggesting the previous infection, given the unvaccinated status of our patient Conclusion: In patients with a positive epidemiologic context and cervical lymphadenopathy, physicians should still consider COVID-19 infection as a differential diagnosis, despite negative PCR testing. This case also raises a potential link between anabolic steroid use and atypical COVID-19 onset, never before reported in scientific literature.

Keywords: COVID-19, cervical lymphadenopathy, anabolic steroids, primary care

Procedia PDF Downloads 113

Authors: Emre Kara, Şura Karakuzu, Ahmet Fatih Geylan, Metehan Demir, Kadir Koç, Halil Aykul

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The material selection in the design of the sandwich structures is very crucial aspect because of the positive or negative influences of the base materials to the mechanical properties of the entire panel. In the literature, it was presented that the selection of the skin and core materials plays very important role on the behavior of the sandwich. Beside this, the use of the correct adhesive can make the whole structure to show better mechanical results and behavior. By this way, the sandwich structures realized in the study were obtained with the combination of aluminum foam core and three different glass fiber reinforced polymer (GFRP) skins using two different commercial adhesives which are based on flexible polyurethane and toughened epoxy. The static and dynamic tests were already applied on the sandwiches with different types of adhesives. In the present work, the static three-point bending tests were performed on the sandwiches having an aluminum foam core with the thickness of 15 mm, the skins with three different types of fabrics ([0°/90°] cross ply E-Glass Biaxial stitched, [0°/90°] cross ply E-Glass Woven and [0°/90°] cross ply S-Glass Woven which have same thickness value of 1.75 mm) and two different commercial adhesives (flexible polyurethane and toughened epoxy based) at different values of support span distances (L= 55, 70, 80, 125 mm) by aiming the analyses of their flexural performance. The skins used in the study were produced via Vacuum Assisted Resin Transfer Molding (VARTM) technique and were easily bonded onto the aluminum foam core with flexible and toughened adhesives under a very low pressure using press machine with the alignment tabs having the total thickness of the whole panel. The main results of the flexural loading are: force-displacement curves obtained after the bending tests, peak force values, absorbed energy, collapse mechanisms, adhesion quality and the effect of the support span length and adhesive type. The experimental results presented that the sandwiches with epoxy based toughened adhesive and the skins made of S-Glass Woven fabrics indicated the best adhesion quality and mechanical properties. The sandwiches with toughened adhesive exhibited higher peak force and energy absorption values compared to the sandwiches with flexible adhesive. The core shear mode occurred in the sandwiches with flexible polyurethane based adhesive through the thickness of the core while the same mode took place in the sandwiches with toughened epoxy based adhesive along the length of the core. The use of these sandwich structures can lead to a weight reduction of the transport vehicles, providing an adequate structural strength under operating conditions.

Keywords: adhesive and adhesion, aluminum foam, bending, collapse mechanisms

Procedia PDF Downloads 325

Authors: Lo Kai Chung

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Fathers in the family of disabled children play a crucial role in fostering child development. Previous studies addressing emotions of father involvement in rearing children with special needs have been rare. With reference to the cultural orientation and masculine idea of Chinese fathers, shame and guilt are probable causal emotions that affect fathers’ psycho-behavioral reactions and, thus, father involvement. Based on the findings of our earlier qualitative studies, the current study aims to develop and validate a multi-item scale of guilt or shame and explore their relations with and fatherhood in families with children with special needs. A model is proposed to understand the roles that shame and guilt play in affecting fathers’ involvement in their family system. The severity and type of the child’s special needs are regarded as independent variables affecting the father’s emotional responses – shame and guilt. It is hypothesized that shame and guilt, under the influence of masculinity, lead to avoidance and compensation, respectively, which subsequently decrease and increase father involvement with children with special needs. A cross-sectional online questionnaire survey of fathers with children with special needs recruited by convenience sampling was conducted. Potential participants were reached by bulk emails, related groups on the Internet and education/social services providers. Totally 537 valid sets of online questionnaires were collected from fathers of children with special needs. EFA on the items pool of shame and guilt was performed, resulting in an x-item single-factor solution and y-item single-factor solution, respectively. Further path model analysis revealed that shame and guilt, under the influence of masculinity, showed differential avoidance and compensation responses and resulted in a decrease and increase in father involvement with special needs children. Demographic and key confounding variables were controlled in the analysis. The shame and guilt scales developed show good psychometric properties. Furthermore, they showed significant differential impacts, under the influence of masculinity, on avoidance and compensation behaviours, consequently resulting in a decrease/increase in father involvement in the expected directions. The findings have important theoretical and practical implications. At the community and policy level, the findings inform the design of strategies for strengthening the role of men in families with special needs children.

Keywords: emotions, father involvement, guilt, shame, special needs

Procedia PDF Downloads 64

Authors: Tamas Dani

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The author’s research explores the geo-economical role and importance of some small and medium sized states, reviews their adaption strategies in foreign trade and also in foreign affairs in the course of changing into a multipolar world, uses international background. With these, the paper analyses the recent years and the future of ‘Opening towards Eastern foreign economic policies’ from East-Central Europe and parallel with that the ‘Western foreign economy policies’ from Asia, as the Chinese One Belt One Road new silk route plans (so far its huge part is an infrastructural development plan to reach international trade and investment aims). It can be today’s question whether these ideas will reshape the global trade or not. How does the new silk road initiatives and the Eurasian Union reflect the effect of globalization? It is worth to analyse that how did Central and Eastern European countries open to Asia; why does China have the focus of the opening policies in many countries and why could China be seen as the ‘winner’ of the world economic crisis after 2008. The research is based on the following methodologies: national and international literature, policy documents and related design documents, complemented by processing of international databases, statistics and live interviews with leaders from East-Central European countries’ companies and public administration, diplomats and international traders. The results also illustrated by mapping and graphs. The research will find out as major findings whether the state decision-makers have enough margin for manoeuvres to strengthen foreign economic relations. This work has a hypothesis that countries in East-Central Europe have real chance to diversify their relations in foreign trade, focus beyond their traditional partners. This essay focuses on the opportunities of East-Central-European countries in diversification of foreign trade relations towards China and Russia in terms of ‘Eastern Openings’. The effects of the new silk road initiatives and the Eurasian Union to Hungary’s economy with a comparing outlook on East-Central European countries and exploring common regional cooperation opportunities in this area. The essay concentrate on the changing trade relations between East-Central-Europe and China as well as Russia, try to analyse the effects of the new silk road initiatives and the Eurasian Union also. In the conclusion part, it shows how the cooperation is necessary for the East-Central European countries if they want to have a non-asymmetric trade with Russia, China or some Chinese regions (Pearl River Delta, Hainan, …). The form of the cooperation for the East-Central European nations can be Visegrad 4 Cooperation (V4), Central and Eastern European Countries (CEEC16), 3 SEAS Cooperation (or BABS – Baltic, Adriatic, Black Seas Initiative).

Keywords: China, East-Central Europe, foreign trade relations, geoeconomics, geopolitics, Russia

Procedia PDF Downloads 178

Authors: Yaron Covo, Tamar Kofman, Shira Palti

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Over the recent decades, debates about the engagement of fans in football governance have focused on the club level and national level, emphasizing the significance of fans’ involvement in increasing the connection of clubs with the community, and in safeguarding the transparency, accountability, and clubs’ financial stability. This paper will offer a different conceptual justification for providing fans with access to decision-making processes in football. First, it will suggest that the participation of fans is necessary for addressing discriminatory practices against women in football stadiums. Second, it will argue that fans’ involvement in football governance is important not only at the club and national level but also at the global level, relying on the principles of Global Administrative Law. In contemporary men’s football, female fans face different forms of discrimination. Iranian women are still prohibited from attending football games at the domestic level; In Saudi Arabia, female fans are only permitted to enter designated family areas; Qatar – the host of the 2022 FIFA world cup – requires women to attend matches wearing modest clothing. Similarly, in Turkey, Lebanon, UAE, and Algeria, women face cultural barriers when attending men’s football games. In other countries, female fans suffer from subtle discrimination, including micro-aggressions, misogyny, sexism, and noninstitutionalized exclusion. Despite the vital role of fans in world football and the importance of football for many women’s lives, little has been done to address this problem. While FIFA recognizes that these discriminatory practices contradict its statutes, this recognition fails to materialize into meaningful change. This paper will argue that FIFA’s omission stems from two interrelated characteristics of world football: (1) the ultra-masculine nature of the game; (2) the insufficient recognition of fans’ significance. While fans have been given a voice in various football bodies on the domestic level, FIFA has yet to allow the representation of fans as stakeholders in world football governance. Since fans are a more heterogeneous group than players, the voices of those fans who do not fit the ultra-masculine model are not heard. Thus, by focusing mainly on male players, FIFA reproduces the hegemonic masculinity that feeds back into fan dynamics and marginalizes female fans. To rectify this problem, we will call on FIFA to provide fans and female fans in particular, with voice mechanisms and access to decision-making processes. In addition to its impact on the formation of fans’ identities, such a move will allow fans to demand better enforcement of existing anti-discrimination norms and new regulations to address their needs. The literature has yet to address the relationship between fans’ gender discrimination and global football governance. Building on Global Administrative Law scholarship and feminist theories, this paper will aim to fill this gap.

Keywords: fans, FIFA, football governance, gender discrimination, global administrative law, human rights

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Authors: Rosemary E. Huntriss, Lucy Jones

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Obesity and excess weight continue to be significant health problems in England. Traditional weight management programmes offer face-to-face support or group education. Remote care is recognised as a viable means of support; however, its effectiveness has not previously been evaluated in a tier 3 weight management setting. This service evaluation explored the effectiveness of online coaching, telephone support, and face-to-face support as optional management strategies within a tier 3 weight management programme. Outcome data were collected for adults with a BMI ≥ 45 or ≥ 40 with complex comorbidity who were referred to a Tier 3 weight management programme from January 2018 and had been discharged before October 2018. Following an initial 45-minute consultation with a specialist weight management dietitian, patients were offered a choice of follow-up support in the form of online coaching supported by an app (8 x 15 minutes coaching), face-to-face or telephone appointments (4 x 30 minutes). All patients were invited to a final 30-minute face-to-face assessment. The planned intervention time was between 12 and 24 weeks. Patients were offered access to adjunct face-to-face or telephone psychological support. One hundred and thirty-nine patients were referred into the programme from January 2018 and discharged before October 2018. One hundred and twenty-four patients (89%) attended their initial assessment. Out of those who attended their initial assessment, 110 patients (88.0%) completed more than half of the programme and 77 patients (61.6%) completed all sessions. The average length of the completed programme (all sessions) was 17.2 (SD 4.2) weeks. Eighty-five (68.5%) patients were coached online, 28 (22.6%) patients were supported face-to-face support, and 11 (8.9%) chose telephone support. Two patients changed from online coaching to face-to-face support due to personal preference and were included in the face-to-face group for analysis. For those with data available (n=106), average weight loss across the programme was 4.85 (SD 3.49)%; average weight loss was 4.70 (SD 3.19)% for online coaching, 4.83 (SD 4.13)% for face-to-face support, and 6.28 (SD 4.15)% for telephone support. There was no significant difference between weight loss achieved with face-to-face vs. online coaching (4.83 (SD 4.13)% vs 4.70 (SD 3.19) (p=0.87) or face-to-face vs. remote support (online coaching and telephone support combined) (4.83 (SD 4.13)% vs 4.85 (SD 3.30)%) (p=0.98). Remote support has been shown to be as effective as face-to-face support provided by a dietitian in the short-term within a tier 3 weight management setting. The completion rates were high compared with another tier 3 weight management services suggesting that offering remote support as an option may improve completion rates within a weight management service.

Keywords: dietitian, digital health, obesity, weight management

Procedia PDF Downloads 138

Authors: Vivian Caroline Koerbel Dombrowski

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Armed conflicts have always meant the ultimate expression of power and at the same time, lack of understanding among nations. Cities were destroyed, people were killed, assets were devastated. But these are not only the loss of a war: the environmental damage comes to be considered immeasurable losses in the short, medium and long term. And this is because no nation wants to bear that cost. They invest in military equipment, training, technical equipment but the environmental account yet finds gaps in international law. Considering such a generalization in rights protection, many nations are at imminent danger in a conflict if the water will be used as a mass weapon, especially if we consider important rivers such as Jordan, Euphrates and Nile. The top three international documents were analyzed on the subject: the Stockholm Convention (1972), Additional Protocol I to the Geneva Convention (1977) and the Rome Statute (1998). Indeed, some references are researched in doctrine, especially scientific articles, to substantiate with consistent data about the extent of the damage, historical factors and decisions which have been successful. However, due to the lack of literature about this subject, the research tends to be exhaustive. From the study of the indicated material, it was noted that international law - humanitarian and environmental - calls in some of its instruments the environmental protection in war conflicts, but they are generic and vague rules that do not define exactly what is the environmental damage , nor sets standards for measure them. Taking into account the mains conflicts of the century XX: World War II, the Vietnam War and the Gulf War, one must realize that the environmental consequences were of great rides - never deactivated landmines, buried nuclear weapons, armaments and munitions destroyed in the soil, chemical weapons, not to mention the effects of some weapons when used (uranium, agent Orange, etc). Extending the search for more recent conflicts such as Afghanistan, it is proven that the effects on health of the civilian population were catastrophic: cancer, birth defects, and deformities in newborns. There are few reports of nations that, somehow, repaired the damage caused to the environment as a result of the conflict. In the pitch of contemporary conflicts, many nations fear that water resources are used as weapons of mass destruction, because once contaminated - directly or indirectly - can become a means of disguised genocide side effect of military objective. In conclusion, it appears that the main international treaties governing the subject mention the concern for environmental protection, however leave the normative specifications vacancies necessary to effectively there is a prevention of environmental damage in armed conflict and, should they occur, the repair of the same. Still, it appears that there is no protection mechanism to safeguard natural resources and avoid them to become a mass destruction weapon.

Keywords: armed conflicts, criminal liability, environmental damages, humanitarian law, mass weapon

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Authors: Mahmut Sozmen, Alparslan Kadir Devrim, Yonca Betil Kabak, Tuba Devrim

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Acute myocardial infarction is the leading cause of deaths in the worldwide. Mature cardiomyocytes do not have the ability to regenerate instead fibrous tissue proliferate and granulation tissue to fill out. Periostin is an extracellular matrix protein from fasciclin family and it plays an important role in the cell adhesion, migration, and growth of the organism. Periostin prevents apoptosis while stimulating cardiomyocytes. The main objective of this project is to investigate the effects of the recombinant murine periostin peptide administration for the cardiomyocyte regeneration in a rat model of acute myocardial infarction. The experiment was performed on 84 male rats (6 months old) in 4 group each contains 21 rats. Saline applied subcutaneously (1 ml/kg) two times with 24 hours intervals to the rats in control group (Group 1). Recombinant periostin peptide (1 μg/kg) dissolved in saline applied intraperitoneally in group 2 on 1, 3, 7, 14 and 21. days on same dates in group 4. Isoproterenol dissolved in saline applied intraperitoneally (85mg/kg/day) two times with 24 hours intervals to the groups 3 and 4. Rats in group 4 further received recombinant periostin peptide (1 μg/kg) dissolved in saline intraperitoneally starting one day after the final isoproterenol administration on days 1, 3, 7, 14 and 21. Following the final application of periostin rats continued to feed routinely with pelleted chow and water ad libitum for further seven days. At the end of 7th day rats sacrificed, blood and heart tissue samples collected for the immunohistochemical and biochemical analysis. Angiogenesis in response to tissue damage, is a highly dynamic process regulated by signals from the surrounding extracellular matrix and blood serum. In this project, VEGF, ANGPT, bFGF, TGFβ are the key factors that contribute to cardiomyocyte regeneration were investigated. Additionally, the relationship between mitosis and apoptosis (Bcl-2, Bax, PCNA, Ki-67, Phopho-Histone H3), cell cycle activators and inhibitors (Cyclin D1, D2, A2, Cdc2), the origin of regenerating cells (cKit and CD45) were examined. Present results revealed that periostin stimulated cardiomyocye cell-cycle re-entry in both normal and MCA damaged cardiomyocytes and increased angiogenesis. Thus, periostin contributes to cardiomyocyte regeneration during the healing period following myocardial infarction which provides a better understanding of its role of this mechanism, improving recovery rates and it is expected to contribute the lack of literature on this subject. Acknowledgement: This project was financially supported by Turkish Scientific Research Council- Agriculture, Forestry and Veterinary Research Support Group (TUBİTAK-TOVAG; Project No: 114O734), Ankara, TURKEY.

Keywords: cardiotoxicity, immunohistochemistry, isoproterenol, periostin

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Authors: Afsaneh Ghanbari Panah, Elyaz Bornak, Shiva Ghadiri Karizi, Amna Ahmad, Burcu Yildirim

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This study explores domestic violence (DV) and coping strategies among married women in Iran, Pakistan, and Turkey. DV is a universal issue characterized by physical, psychological, or economic abuse by male family members towards female partners. The study aims to examine the prevalence of DV and the coping mechanisms employed by women in these three countries. The research highlights the significant impact of DV globally, transcending cultural, social, and economic boundaries. Despite the lack of comprehensive state-sponsored reports on Violence Against Women (VAW) in South Asia, fragmented reports by non-governmental agencies indicate high rates of self-reported intimate partner violence (IPV), including sexual violence, across these regions. The study emphasizes the urgent need for effective measures to address VAW, as existing laws often exclude unregistered and unmarried intimate partners. Coping mechanisms play a crucial role in responding to and managing the consequences of DV. The study defines coping as cognitive and behavioral responses to environmental stressors. Common coping strategies identified in the literature include spirituality, temporary or permanent separation, silence, submission, minimizing violence, denial, and seeking external support. Understanding these coping mechanisms is crucial for developing effective prevention and management strategies. The study presents findings from Iran, Pakistan, and Turkey, indicating varying prevalence rates of different forms of violence. Turkish respondents reported higher rates of emotional, physical, economic, and sexual violence, while Iranian respondents reported high levels of psychological, physical, and sexual violence. In Karachi, Pakistan, physical, sexual, and psychological violence were prevalent among women. The study highlights the importance of cross-cultural research and the need to consider individual and collective coping mechanisms in different societal contexts. Factors such as personal ideologies, political agendas, and economic stability influence societal support and cultural acceptance of IPV. To develop sustainable strategies, an in-depth exploration of coping mechanisms is necessary. In conclusion, this comparative study provides insights into DV and coping strategies among married women in Iran, Pakistan, and Turkey. The findings underscore the urgent need for comprehensive measures to address VAW, considering cultural, social, and economic factors. By understanding the prevalence and coping mechanisms employed by women, policymakers can develop effective interventions to support DV survivors and prevent further violence.

Keywords: domestic violence, coping styles, cultural study, violence against women

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Authors: Anar Koli

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After the Paris agreement in 2015, a comprehensive initiative both from the developed and developing countries towards the adaptation to climate change is emerging. The Global Environmental Facility (GEF), which is financing a global portfolio of adaptation projects and programs in over 124 countries is playing a significant role to a new financing framework that included the concept of “climate-resilient development”. However, both the adaptation and sustainable development paradigms remain continuously contested, especially the role of the multilateral institutions with their technical and financial assistance to the developing world. Focusing on the adaptation initiatives of the GEF, this study aims to understand to what extent the global multilateral institutions, particularly the GEF is contributing to the climate-resilient development. From the political ecology perspective, the argument of this study is that the global financial framework is highly politicized, and understanding the contribution of the global institutions of the global climate change needs to be related both from the response and causal perspectives. A holistic perspective, which includes the contribution of the GEF as a response to the climate change and as well the cause of global climate change, are needed to understand the broader environment- political economic relation. The study intends to make a critical analysis of the way in which the political economy structure and the environment are related along with the social and ecological implications. It does not provide a narrow description of institutional responses to climate change, rather it looks at how the global institutions are influencing the relationship of the global ecologies and economies. This study thus developed a framework combining the global governance and the political economy perspective. This framework includes environment-society relation, environment-political economy linkage, global institutions as the orchestra, and division between the North and the South. Through the analysis of the GEF as the orchestra of the global governance, this study helps to understand how GEF is coordinating the interactions between the North and the South and responding the global climate resilient development. Through the other components of the framework, the study explains how the role of the global institutions is related to the cause of the human induced global climate change. The study employs a case study based on both the quantitative and qualitative data. Along with the GEF reports and data sets, this study draws from an eclectic range of literature from a range of disciplines to explain the broader relation of the environment and political economy. Based on a case study on GEF, the study found that the GEF has positive contributions in bringing developing countries’ capacity in terms of sustainable development goal, local institutional development. However, through a critical holistic analysis, this study found that this contribution to the resilient development helps the developing countries to conform the fossil fuel based capitalist political economy. The global governance institution is contributing both to the pro market based environment society relation and, to the consequences of this relation.

Keywords: climate change adaptation, global environmental facility (GEF), political economy, the north -south relation

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Authors: Aboubakr Mashali

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Context: The paper focuses on the relationship between architecture and nature, emphasizing the importance of incorporating natural elements in design to reconnect individuals with the natural environment. It highlights the positive impact of a harmonious architecture on people's well-being and the environment, as well as the concept of sustainable architecture. Research aim: The aim of this research is to showcase how nature can be integrated into architectural designs, ultimately reestablishing a connection between humans and the natural world. Methodology: The research employs an in-depth approach, delving into the subject matter through extensive research and the analysis of case studies. These case studies provide practical examples and insights into successful architectural designs that have effectively incorporated nature. Findings: The findings suggest that when architecture and nature coexist harmoniously, it creates a positive atmosphere and enhances people's wellbeing. The use of materials obtained from nature in their raw or minimally refined form, such as wood, clay, stone, and bamboo, contributes to a natural atmosphere within the built environment. Additionally, a color palette inspired by nature, consisting of earthy tones, green, brown, and rusty shades, further enhances the harmonious relationship between individuals and their surroundings. The paper also discusses the concept of sustainable architecture, where materials used are renewable, and energy consumption is minimal. It acknowledges the efforts of organizations such as the US Green Building Council in promoting sustainable design practices. Theoretical importance: This research contributes to the understanding of the relationship between architecture and nature and highlights the importance of incorporating natural elements into design. It emphasizes the potential of naturefriendly architecture to create greener, resilient, and sustainable cities. Data collection and analysis procedures: The researcher gathered data through comprehensive research, examining existing literature, and studying relevant case studies. The analysis involved studying the successful implementation of nature in architectural design and its impact on individuals and the environment. Question addressed: The research addresses the question of how nature can be incorporated into architectural designs to reconnect humans with the nature. Conclusion: In conclusion, this research highlights the significance of architecture being in harmony with its surrounding, which in turn should be in harmony with nature. By incorporating nature in architectural designs, individuals can rediscover their connection with nature and experience its positive impact on their well-being. The use of natural materials and a color palette inspired by nature further enhances this relationship. Additionally, embracing sustainable design practices contributes to the creation of greener and more resilient cities. This research underscores the importance of integrating nature-friendly architecture to foster a healthier and more sustainable future.

Keywords: nature, architecture, reconnecting, greencities, sustainable, openspaces, landscape

Procedia PDF Downloads 69