Search results for: quality of life (QoL)

Authors: Ayami Umemura

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The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

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Authors: Getahun Nigusie Demise

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Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: The aim of this study is to assess the incidence and predictors of mortality among HIV positive children on antiretroviral therapy (ART) in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, treatment, Ethiopia

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Authors: Ying Shi, June Zhang, Lu Shao, Xiyan Xie, Aidi Lao, Zhangan Wang

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Background: Low levels of physical activity are associated with poorer health outcomes, and this situation is more critical in older adults living in long‐term care facilities. Objectives: To systematically identify, appraise, and synthesize current qualitative research evidence regarding the barriers and facilitators to physical activity as reported by older adults and care staff in long‐term care facilities. Design: This is a systematic review with qualitative evidence synthesis adhering to PRISMA guidelines. Methods: We conducted a systematic search on PubMed, Science Citation Index Expanded, Social Sciences Citation Index, EMBASE, CINAHL, and PsychInfo databases from inception until 30 June 2023. Thematic synthesis was undertaken to identify the barriers and facilitators relating to physical activity. Then, we mapped them onto the Capability, Opportunity, Motivation, and Behavior model and Theoretical Domains Framework. Methodological quality was assessed using the CASP Qualitative Studies Checklist, and confidence in review findings was assessed using the GRADE-CERQual approach. Results: We included 32 studies after screening 10496 citations and 177 full texts. Seven themes and 17 subthemes were identified relating to barriers and facilitators influencing physical activity in elderly residents. The main themes were mapped onto COM-B) model-Capability (physical activity knowledge gaps and individual health issues), Opportunity (social support and macro-level resources) and Motivation (health beliefs, fear of falling or injury, and personal and social incentives to physical activity). Most subthemes were graded as high (n = 9) or moderate (n = 3) confidence. Conclusions and Implications: Our comprehensive synthesis of 32 studies provides a wealth of knowledge of barriers and facilitators to physical activity from both residents and care staff’s perspectives. Intervention components were also suggested within the context of long‐term care facilities. End users such as older residents, care staff, and researchers can have confidence in our findings when formulating policies and guidance on promoting physical activity among elderly residents in long‐term care facilities.

Keywords: long‐term care, older adults, physical activity, qualitative, systematic review

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Authors: Irma Wani Othman

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The internationalization of higher education in Malaysia mainly focuses to place the implementation of the strategic, comprehensive and integrated range of stakeholders in order to highlight the visibility of Malaysia as a hub of academic excellence. While the concept of 'global citizenship' is used as a two-pronged strategy of aggressive marketing by universities which includes; (i) the involvement of the academic expatriates in stimulating international activities of higher education and (ii) an increase in international student enrollment capacity for the enculturation of science and the development of first class mentality. In this aspect, aspirations for a transnational social movement through global citizenship status to establish the identity of the university community without borders (borderless universities) - regardless of skin colour, thus rationalize and liberalize the universal principles of life and cultural traditions of a nation. The education system earlier referred by the spirit of nationalism is now progressing due to globalization, hence forming a system of higher education that is relevant and generated by the need of all time. However, debates arose when the involvement of global citizenship is said to threaten the ultimate university autonomy in determining the direction of academic affairs and governance of their human resources. Stemming from this debate, this study aims to explore the experience of 'global citizenship' that the academic expatriates and international students in shaping the university's strategic needs and interests which are in line with the transition of contemporary higher education. The objective of this study is to examine the acculturation experience of the global citizen in the form of transnational higher education system and suggest policy and policing IHE which refers directly to the experience of the global citizen. This study offers a detailed understanding of how the university communities assess their expatriation experience, thus becoming useful information for learning and transforming education. The findings also open an advanced perspective on the international mobility of human resources and the implications on the implementation of the policy of internationalization of higher education. The contribution of this study is expected to give new input, thus shift the focus of contextual literature for the internationalization of the education system. Instead of focusing on the purpose of generating income of a university, to a greater understanding of subjective experience in utilizing international human resources hence contributing to the prominent transnational character of higher education.

Keywords: internationalization, global citizens, Malaysia higher education, academic expatriate, international students

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Authors: Al-Juhaishi Mohammed, Mikael Motelica-Heino, Fabrice Muller, Audrey Guirimand-Dufour, Christian Défarge

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This study aims at improving the urban hydrological cycle of the Orléans agglomeration (France) and understanding the relationship between physical and chemical parameters of urban surface runoff and the hydrological conditions. In particular water quality parameters such as pH, conductivity, total dissolved solids, major dissolved cations and anions, and chemical and biological oxygen demands were monitored for three types of urban water discharges (wastewater treatment plant output (WWTP), storm overflow and stormwater outfall) under two hydrologic scenarii (dry and wet weather). The first results were obtained over a period of five months.Each investigated (Ormes and l’Egoutier) outfall represents an urban runoff source that receives water from runoff roads, gutters, the irrigation of gardens and other sources of flow over the Earth’s surface that drains in its catchments and carries it to the Loire River. In wet weather conditions there is rain water runoff and an additional input from the roof gutters that have entered the stormwater system during rainfall. For the comparison the results La Chilesse is a storm overflow that was selected in our study as a potential source of waste water which is located before the (WWTP).The comparison of the physical-chemical parameters (total dissolved solids, turbidity, pH, conductivity, dissolved organic carbon (DOC), concentration of major cations and anions) together with the chemical oxygen demand (COD) and biological oxygen demand (BOD) helped to characterize sources of runoff waters in the different watersheds. It also helped to highlight the infiltration of wastewater in some stormwater systems that reject directly in the Loire River. The values of the conductivity measured in the outflow of Ormes were always higher than those measured in the other two outlets. The results showed a temporal variation for the Ormes outfall of conductivity from 1465 µS cm-1 in the dry weather flow to 650 µS cm-1 in the wet weather flow and also a spatial variation in the wet weather flow from 650 µS cm-1 in the Ormes outfall to 281 μS cm-1 in L’Egouttier outfall. The ultimate BOD (BOD28) showed a significant decrease in La Corne outfall from 210 mg L-1 in the wet weather flow to 75 mg L-1 in the dry weather flow because of the nutrient load that was transported by the runoff.

Keywords: BOD, COD, the Loire River, urban hydrology, urban dry and wet weather discharges, macronutrients

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Authors: Moshiur Rahman, Tahmida Jakia

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Bangladesh, a densely populated South Asian country is home to more than 160 million people. In two decades ago, the people of this developing nation drank heavily contaminated surface water. Over the past thirty years, the country, and its development partners, has undertaken extensive efforts to provide microbiologically safe groundwater based drinking water through the use of tube-wells. About 85% of the people now drink tube-well water from about 11 million tube-wells/hand pumps. However, diarrhoeal and other water-related diseases are still reported among the major causes of morbidity and mortality among Bangladeshi children. This implies that the mode of transmission of pathogens through water and/or other modes continue. In addition, massive scale arsenic contamination has been recently reported in the ground water. Thirty five million people may be at risk of consuming arsenic contaminated water exceeding 0.05 mg/l in Bangladesh. Drinking of arsenic contaminated water has been linked with skin problems, cancer, cardiovascular diseases, neurological diseases, eye problems, cancer of the internal organs, and other diseases. In the study area, Narail district, recent investigations about existing water quality situations indicated presence of low to high levels of arsenic, salinity, iron, manganese and bacteriological contamination risks. As challenges for safe water exist; it is likely that sanitation and food hygiene practices are poor which lead threat to ensure food security.The main attempt of this study is to find out the challenges to ensure food security andprovide probable solutions to ensure food safety towards 0.7 million of people in study area. A survey has been conducted at Lohagara and Kalia sub district of Narail district with a pretested questionnaire. Primary data are collected through a questionnaire, while secondary data are collected from pertinent offices as well as academic journals. FGD has also been done to know the knowledge regarding water, sanitation as well as food preparation and consumption practice of community people in study area. The major focus of this study is to assess the state of sanitation and food hygiene condition of rural people. It is found that most of the villagers have lack of knowledge about food safety. Open defecation rate is high which lead threat to ensure food security.

Keywords: food safety, challenges, hygiene, Bangladesh

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Authors: Bharat Rawat, Shekhar Rajbhandari, Yadav Bhatta, Jay Prakash Jaiswal, Shivaji Bikram Silwal, Rajiv Shrestha, Shova Sunuwar

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Introduction: The honey produced by the bees fed on Rhobdodendron species containing grayanotoxin is known as mad honey. Grayanotoxin is found in honey obtained from the nectar of Rhododendron species growing on the mountains of the Black Sea region of Turkey and also in Japan, Nepal, Brazil, parts of North America, and Europe. Although the incidence of grayanotoxin poisoning is rare, there is concern that the number of cases per year will rise with the increasing demand for organic products. Mad honey intoxication might present with mild symptoms of cardiovascular, gastrointestinal and neurological systems or might also present with a life-threatening form with AV block and cardiovascular collapse. In this article, we describe the summary of five cases, which came to our hospital with mad honey related cardiac complications. Findings: In last one year, five cases presented in the emergency department with sudden onset of Loss of consciousness, dizziness, shortness of breath. They felt difficulty after the consumption of 1-3 teaspoonful of wild honey. The honey was brought from most of the rural parts of Nepal like khotang. Some of them also came with vomiting, dizziness, and loose stool. On examination, most of them had severe bradycardia and low blood pressure. No abnormalities were detected on systemic examinations. In one patient, ECG and cardiac enzymes showed features of the acute coronary syndrome, but his treadmill test done few days later was normal. All patients were managed with inj. Atropine, I/V normal saline, and other supportive measures and discharged in a stable condition within one or two days. Conclusions: Rhododendrons is the national flower of Nepal. The specific species of rhododendron found in Nepal which contains the toxin is not known. Bees feeding on these rhododendrons are known to transfer the grayanotoxin to the honey they produce. Most symptoms are mild and resolve themselves without medical intervention. Signs and symptoms of grayanotoxin poisoning rarely last more than 24 hours and are usually not fatal. Some signs of mad honey poisoning include Bradycardia, Cardiac arrhythmia, Hypotension, Nausea and Vomiting. They respond to close monitoring and appropriate supportive treatment. Normally, patients recover completely with no residual damage to the heart or its conduction system.

Keywords: rhobdodendron, honey, grayanotoxin, bradycardia

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Authors: Kulwinder Singh

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Punjab is one of the major labour exporting states of India. Every year more than 20,000 youths from Punjab attempt irregular migration. About 84 irregular migrants are from rural areas and 16 per cent from urban areas. Irregular migration could only be achieved if be organized through highly efficient international networks with the countries of origin, transit, and destination. A good number of Punjabis continue to immigrate into the UK for work through unauthorized means entering the country on visit visas and overstaying or getting ‘smuggled into’ the country with the help of transnational networks of agents. Although, the efforts are being made by the government to curb irregular migration through The Punjab Prevention of Human Smuggling Rules (2012, 2014) and Punjab Travel Regulation Act (2012), but yet it exists parallel to regular migration. Despite unprecedented miseries of irregular migrants and strict laws implemented by the state government to check this phenomenon, ‘why do Punjabis migrate abroad irregularly’ is the important question to answer. This study addresses this question through the comparison of irregular migration with regular one. In other words, this analysis reveals major causes, specifically economic ones, of irregular migration from rural Punjab. This study is unique by presenting economics of irregular migration, given previous studies emphasize the role of sociological and psychological factors. Addressing important question “why do Punjabis migrate abroad irregularly?”, the present study reveals that Punjabi, being far-sighted, endeavor irregular migration as it is, though, economically nonviable in short run, but offers lucrative economic gains as gets older. Despite its considerably higher cost viz-a-viz regular migration, it is the better employment option to irregular migrants with higher permanent income than local low paid jobs for which risking life has become the mindset of the rural Punjabis. Although, it carries considerably lower economic benefits as compared to regular migration, but provides the opportunity of migrating abroad to less educated, semi-skilled and language-test ineligible Punjabis who cannot migrate through regular channels. As its positive impacts on source and destination countries are evident, it might not be restricted, rather its effective management, through liberalising restrictive migration policies by destination nations, can protect the interests of all involved stakeholders.

Keywords: cost, migration, income, irregular, regular, remittances

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Authors: Danny Mwangi, Collins Oduor Ondiek

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Mass mobility is one of the most important characteristics of every industrialized civilization. Man must travel about in order to fulfill his commitment to putting food on his table. As a result, movement is an important part of human life. Man must travel from one place to another. This is a natural trait of humans, according to elementary science. Variables in human mobility have arisen as a result of technological advancements over time. Public transit is one of these modes of transportation. When it comes to reducing safety-related risks in the public transport system, awareness is crucial. So much so even when it comes to public transportation in Kenya. Having a system that can be able to keep users updated with real-time traffic updates on the route, they are on and also have the ability to rate drivers after a trip could go a long way in improving safety on Kenyan roads. What this proposed system is intended to accomplish is to reduce occurrences of reckless driving and give matatu drivers the feeling that they are accountable to someone and more so have the incentive to be better drivers who are motivated to follow the law and have passenger safety as a priority. The research was conducted, and the findings show that 95.2% of respondents were not satisfied with the current safety measures in the Kenyan public transport sector. This means that the chances for this system to be accepted in the market are high because it addresses a key issue. 98.8% of the respondents were of the opinion that the implementation of the proposed system would significantly increase safety measures in the public transport sector. During the research, it was clear that the main challenge 77.1% of the respondents face when using public transport is that there is no way to monitor driver safety performance, and 68.7% of the respondent believed the widespread use of unroadworthy public transit vehicles contributed to the lack of safety when using public transport. However, 77.1% of the respondents expect the benefit of creating a sense of accountability for the drivers, and 74.7% of the respondents expect the benefit of increased passenger safety. 63.9% believe that with the implementation of the system, there will be the benefit of monitoring driver performance. This shows that with the implementation of the proposed system, it will be possible to make a lot of progress in terms of making Kenyan roads safer when using public transit. According to the findings, it is recommended that this proposed public transportation safety awareness system be implemented as it will be able to address matatu passengers' safety concerns while also encouraging matatu drivers to drive more carefully. As a result, it's a project with a chance of becoming viable, marketable, and feasible.

Keywords: public safety, public transportation, accountable driving, safe transportation

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Authors: Nusrat Zabeen Islam

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Partnership between local Non-Government organizations (NGO) and International development organizations has become an important feature in the development sector of Bangladesh. It is an important challenge for International development organizations to work with local NGOs with proper HR practice. Local NGOs have a lack of quality working environment and this affects the employee’s work experiences and overall performance at individual, partnership with International development organizations and organizational level. Many local development organizations due to the size of the organization and scope do not have a human resource (HR) unit. Inadequate Human Resource Policies, skills, leadership and lack of effective strategy is now a common scenario in Non-Government organization sector of Bangladesh. So corruption, nepotism, and fraud, risk of Political Contribution in office /work space, Sexual/ gender based abuse, insecurity take place in work place of development sector. The Complaint Management Mechanism (CMM) in human resource management could be one way to improve human resource competence in these organizations. The responsibility of Complaint Management Unit (CMU) of an International development organization is to make workplace maltreating, discriminating communities free. The information of impact of CMM was collected through case study of an International organization and some of its partner national organizations in Bangladesh who are engaged in different projects/programs. In this mechanism International development organizations collect complaints from beneficiaries/ staffs by complaint management unit and investigate by segregating the type and mood of the complaint and find out solution to improve the situation within a very short period. A complaint management committee is formed jointly with HR and management personnel. Concerned focal point collect complaints and share with CM unit. By conducting investigation, review of findings, reply back to CM unit and implementation of resolution through this mechanism, a successful bridge of communication and feedback can be established within beneficiaries, staffs and upper management. The overall result of Complaint management mechanism application indicates that by applying CMM accountability and transparency of workplace and workforce in development organization can be increased significantly. Evaluations based on outcomes, and measuring indicators such as productivity, satisfaction, retention, gender equity, proper judgment will guide organizations in building a healthy workforce, and will also clearly articulate the return on investment and justify any need for further funding.

Keywords: human resource management in NGOs, challenges in human resource, workplace environment, complaint management mechanism

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Authors: L. Agneni, F. Carta, C. Micheletta, V. Tersigni

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The development of a qualitative method to profile jobseekers is needed to improve the quality of the Public Employment Services (PES) in Italy. This is why the National Agency for Active Labour Market Policies (ANPAL) decided to introduce a Qualitative Profiling Service in the context of the activities carried out by local employment offices’ operators. The qualitative profiling service provides information and data regarding the jobseeker’s personal transition status, through a semi-structured questionnaire administered to PES clients during the guidance interview. The questionnaire responses allow PES staff to identify, for each client, proper activities and policy measures to support jobseekers in their reintegration into the labour market. Data and information gathered by the qualitative profiling tool are the following: frequency, modalities and motivations for clients to apply to local employment offices; clients’ expectations and skills; difficulties that they have faced during the previous working experiences; strategies, actions undertaken and activated channels for job search. These data are used to assess jobseekers’ personal and career characteristics and to measure their employability level (qualitative profiling index), in order to develop and deliver tailor-made action programmes for each client. This paper illustrates the use of the above-mentioned qualitative profiling service on the national territory and provides an overview of the main findings of the survey: concerning the difficulties that unemployed people face in finding a job and their perception of different aspects related to the transition in the labour market. The survey involved over 10.000 jobseekers registered with the PES. Most of them are beneficiaries of the “citizens' income”, a specific active labour policy and social inclusion measure. Furthermore, data analysis allows classifying jobseekers into a specific group of clients with similar features and behaviours, on the basis of socio-demographic variables, customers' expectations, needs and required skills for the profession for which they seek employment. Finally, the survey collects PES staff opinions and comments concerning clients’ difficulties in finding a new job and also their strengths. This is a starting point for PESs’ operators to define adequate strategies to facilitate jobseekers’ access or reintegration into the labour market.

Keywords: labour market transition, public employment services, qualitative profiling, vocational guidance

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Authors: Sraman Sree Mattananda

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This present article is an analytical research on ‘Buddhism and Innovative Sustainable Development.' The main purpose of researching is to the better understanding of many social science theories both in politics and in economics. And the understanding of both Buddhism and science is complementary in order to enable any individual to live a full and meaningful human life. How people can avoid conflict, socially, economically, politically and spiritually using Buddhist teachings for a sustainable development. The aim of studying is also to comprehend every human to be aware that peoples’ happiness and sorrow depends on the choices that they had taken to do what was perceptional right and wrong. Everything that happens does have a reason. This study will be supported by the supply of environmental knowledge, philosophy, and experience. Within the domestic and international cultures, this knowledge might provide a significant basis for the contemporary and the future world. Happiness and unsatisfactoriness of mind depend on the consequences of what we had already done. This is to give deep sense to adjust the nature of all that exists and desire not to attach to them and to liberate oneself leaving the reality as it is. An implicit of references will be drawn from the primary sources, secondary sources, internet sources, and other Scholar’s diamond writings, to prove the investigation of philosophical and theoretical analysis. After the investigation of philosophical and theoretical analysis, the article will demonstrate about, what Buddha advised the follows to stop over-exploitation and how to eradicate conflicts to gain a peaceful society. This will be a lively awareness in the approach to the understanding of the Buddhist view of reality and adopt with middle path. The last part of the article will concern with the Buddhist Challenge of sustaining the society and how Buddhist contemporary scholars interpret sustainable development issues. Mahatma Gandhi’s emphasize to use Buddhist Non-Violence will be demonstrating to gain peace, freedom, and security. Twelve things that concern us when we want to explore the issues of sustainability, demonstrated by A Little Book of Hope will be cleared. How individual hearts can implicate to the contemporary globe will be demonstrated to obtain healthy and practical environment. Finally, generating new awareness and care by minimizing the negative impact on earth resources will reduce the degradation of the planet which would pose a challenge to sustain Development.

Keywords: Buddhism, economic, sustainable development, Buddhist ethics

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Authors: A. Giani

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The current pedagogical culture recognizes an educational scope within the sports practices. It is widely accepted, in the pedagogical culture, that thanks to the acquisition and development of motor skills, it is also possible to exercise abilities that concern the way of facing and managing the difficulties of everyday life. Sport is a peculiar educational environment: the children have the opportunity to discover the possibilities of their body, to correlate with their peers, and to learn how to manage the rules and the relationship with authorities, such as coaches. Educational aspects of the sport concern both non-formal and formal educational environments. Coaches play a critical role in an agonistic sphere: exactly like the competencies developed by the children, coaches have to work on their skills to properly set up the educational scene. Facing these new educational tasks - which are not new per se, but new because they are brought back to awareness - a few questions arise: does the coach have adequate preparation? Is the training of the coach in this specific area appropriate? This contribution aims to explore the issue in depth by focusing on the reality of the Football School. Starting from a possible sense of pedagogical inadequacy detected during a series of meetings with several football clubs in Piedmont (Italy), there have been highlighted some important educational needs within the professional training of sports coaches. It is indeed necessary for the coach to know the processes underlying the educational relationship in order to better understand the centrality of the assessment during the educational intervention and to be able to manage the asymmetry in the coach-athlete relationship. In order to provide a response to these pedagogical needs, a formative plan has been designed to allow both an in-depth study of educational issues and a correct self-evaluation of certain pedagogical skills’ control levels, led by the coach. This plan has been based on particular practices, the Educational Practices of Pre-test (EPP), a specific version of community practices designed for the extracurricular activities. The above-mentioned practices realized through the use of texts meant as pre-tests, promoted a reflection within the group of coaches: they set up real and plausible sports experiences - in particular football, triggering a reflection about the relationship’s object, spaces, and methods. The characteristic aspect of pre-tests is that it is impossible to anticipate the reflection as it is necessarily connected to the personal experience and sensitivity, requiring a strong interest and involvement by participants: situations must be considered by the coaches as possible settings in which they could be found on the field.

Keywords: relational needs, values, responsibility, self-evaluation

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Authors: Yena Lee, Vassilis M. Charitopoulos, Karthik Thyagarajan, Ian Morris, Jose M. Pinto, Lazaros G. Papageorgiou

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With globalisation, the need to have better coordination of production and distribution decisions has become increasingly important for industrial gas companies in order to remain competitive in the marketplace. In this work, we investigate a problem that integrates production, inventory, and routing decisions in a liquid oxygen supply chain. The oxygen supply chain consists of production facilities, external third-party suppliers, and multiple customers, including hospitals and industrial customers. The product produced by the plants or sourced from the competitors, i.e., third-party suppliers, is distributed by a fleet of heterogenous vehicles to satisfy customer demands. The objective is to minimise the total operating cost involving production, third-party, and transportation costs. The key decisions for production include production and inventory levels and product amount from third-party suppliers. In contrast, the distribution decisions involve customer allocation, delivery timing, delivery amount, and vehicle routing. The optimisation of the coordinated production, inventory, and routing decisions is a challenging problem, especially when dealing with large-size problems. Thus, we present a two-stage procedure to solve the integrated problem efficiently. First, the problem is formulated as a mixed-integer linear programming (MILP) model by simplifying the routing component. The solution from the first-stage MILP model yields the optimal customer allocation, production and inventory levels, and delivery timing and amount. Then, we fix the previous decisions and solve a detailed routing. In the second stage, we propose a column generation scheme to address the computational complexity of the resulting detailed routing problem. A case study considering a real-life oxygen supply chain in the UK is presented to illustrate the capability of the proposed models and solution method. Furthermore, a comparison of the solutions from the proposed approach with the corresponding solutions provided by existing metaheuristic techniques (e.g., guided local search and tabu search algorithms) is presented to evaluate the efficiency.

Keywords: production planning, inventory routing, column generation, mixed-integer linear programming

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Authors: Nana Katsia

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This paper explores the ways both medieval and medievalist conceptions of ugliness might be linked to the physical and spiritual transformation of the protagonists and how it is realised through specific musical rhythm, such as the dochmiac rhythm in the opera. As Eco and Henderson note, only one kind of ugliness could be represented in conformity with nature in the Middle Ages without destroying all aesthetic pleasure and, in turn, artistic beauty: namely, a form of ugliness which arouses disgust. Moreover, Eco explores the fact that the enemies of Christ who condemn, martyr, and crucify him are represented as wicked inside. In turn, the representation of inner wickedness and hostility toward God brings with it outward ugliness, coarseness, barbarity, and rage. Ultimately these result in the deformation of the figure. In all these regards, the non-beautiful is represented here as a necessary phase, which is not the case with classical (the ancient Greek) concepts of Beauty. As we can see, the understanding of disfigurement and ugliness in the Middle Ages was both varied and complex. In the Middle Ages, the disfigurement caused by leprosy (and other skin and bodily conditions) was interpreted, in a somewhat contradictory manner, as both a curse and a gift from God. Some saints’ lives even have the saint appealing to be inflicted with the disease as part of their mission toward true humility. We shall explore that this ‘different concept’ of ugliness (non-classical beauty) might be represented in Messiaen’s opera. According to Messiaen, the Leper and Saint François are the principal characters of the third scene, as both of them will be transformed, and a double miracle will take place in the process. Messiaen mirrors the idea of the true humility of Saint’s life and positions Le Baiser au Lépreux as the culmination of the first act. The Leper’s character represents his physical and spiritual disfigurement, which are healed after the miracle. So, the scene can be viewed as an encounter between beauty and ugliness, and that much of it is spent in a study of ugliness. Dochmiac rhythm is one of the most important compositional elements in the opera. It plays a crucial role in the process of creating a dramatic musical narrative and structure in the composition. As such, we shall explore how Messiaen represents the medieval idea of ugliness in the opera through particular musical elements linked to the main protagonists’ spiritual or physical ugliness; why Messiaen makes reference to dochmiac rhythm, and how they create the musical and dramatic context in the opera for the medieval aesthetic category of ugliness.

Keywords: ugliness in music, medieval time, saint françois d’assise, messiaen

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Authors: Maria Korman, Carmit Gal, Ella Gabitov, Avi Karni

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The main question addressed in this study was whether the time-of-day wherein training is afforded is a significant factor for motor skill ('how-to', procedural knowledge) acquisition and consolidation into long term memory in the healthy elderly population. Twenty-nine older adults (60-75 years) practiced an explicitly instructed 5-element key-press sequence by repeatedly generating the sequence ‘as fast and accurately as possible’. Contribution of three parameters to acquisition, 24h post-training consolidation, and 1-week retention gains in motor sequence speed was assessed: (a) time of training (morning vs. evening group) (b) sleep quality (actigraphy) and (c) chronotype. All study participants were moderately morning type, according to the Morningness-Eveningness Questionnaire score. All participants had sleep patterns typical of age, with average sleep efficiency of ~ 82%, and approximately 6 hours of sleep. Speed of motor sequence performance in both groups improved to a similar extent during training session. Nevertheless, evening group expressed small but significant overnight consolidation phase gains, while morning group showed only maintenance of performance level attained at the end of training. By 1-week retention test, both groups showed similar performance levels with no significant gains or losses with respect to 24h test. Changes in the tapping patterns at 24h and 1-week post-training were assessed based on normalized Pearson correlation coefficients using the Fisher’s z-transformation in reference to the tapping pattern attained at the end of the training. Significant differences between the groups were found: the evening group showed larger changes in tapping patterns across the consolidation and retention windows. Our results show that morning-oriented older adults effectively acquired, consolidated, and maintained a new sequence of finger movements, following both morning and evening practice sessions. However, time-of-training affected the time-course of skill evolution in terms of performance speed, as well as the re-organization of tapping patterns during the consolidation period. These results are in line with the notion that motor training preceding a sleep interval may be beneficial for the long-term memory in the elderly. Evening training should be considered an appropriate time window for motor skill learning in older adults, even in individuals with morning chronotype.

Keywords: time-of-day, elderly, motor learning, memory consolidation, chronotype

Procedia PDF Downloads 132

Authors: Xiujing Chen, Thammananya Sakcharoen, Wilailuk Niyommaneerat

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China's tourism industry is in a state of shock and recovery, although COVID-19 has brought great impact and challenges to the tourism industry. The theory of sustainable development originates from the contradiction of increasing awareness of environmental protection and the pursuit of economic interests. The sustainable development of tourism should consider social, economic, and environmental factors and develop tourism in a planned and targeted way from the overall situation. Guilin is one of the popular tourist cities in China. However, there exist several problems in Guilin tourism, such as low quality of scenic spot construction and low efficiency of tourism resource development. Due to its unwell-managed, Guilin's tourism industry is facing problems such as supply and demand crowding pressure for tourists. According to the data from 2009 to 2019, there is a change in the degree of sustainable development of Guilin tourism. This research aimed to evaluate the sustainable development state of Guilin tourism using the DPSIR (driving force/pressure/state/impact/response) framework and to provide suggestions and recommendations for sustainable development in Guilin. An improved TOPSIS (technology for order preference by similarity to an ideal solution) model based on the entropy weights relationship is applied to the quantitative analysis and to analyze the mechanisms of sustainable development of tourism in Guilin. The DPSIR framework organizes indicators into sub-five categories: of which twenty-eight indicators related to sustainable aspects of Guilin tourism are classified. The study analyzed and summarized the economic, social, and ecological effects generated by tourism development in Guilin from 2009-2019. The results show that the conversion rate of tourism development in Guilin into regional economic benefits is more efficient than that into social benefits. Thus, tourism development is an important driving force of Guilin's economic growth. In addition, the study also analyzed the static weights of 28 relevant indicators of sustainable development of tourism in Guilin and ranked them from largest to smallest. Then it was found that the economic and social factors related to tourism revenue occupy the highest weight, which means that the economic and social development of Guilin can influence the sustainable development of Guilin tourism to a greater extent. Therefore, there is a two-way causal relationship between tourism development and economic growth in Guilin. At the same time, ecological development-related indicators also have relatively large weights, so ecological and environmental resources also have a great influence on the sustainable development of Guilin tourism.

Keywords: DPSIR framework, entropy weights analysis, sustainable development of tourism, TOPSIS analysis

Procedia PDF Downloads 91

Authors: Dalia El Hadi, Alaa Bou Ghannam, Hala Mostafa, Hana Mansour, Ibrahim Hashim, Soubhi Tahhan, Tharwat El Zahran

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Introduction: Neuro-ophthalmological emergencies require prompt assessment and management to avoid vision or life-threatening sequelae. Some would require neuroimaging. Most commonly used are the CT and MRI of the Brain. They can be over-used when not indicated. Their yield remains dependent on multiple factors relating to the clinical scenario. Methods: A retrospective cross-sectional study was conducted by reviewing the electronic medical records of patients presenting to the Emergency Department (ED) with isolated neuro-ophthalmologic complaints. For each patient, data were collected on the clinical presentation, whether neuroimaging was performed (and which type), and the result of neuroimaging. Analysis of the performed neuroimaging was made, and its yield was determined. Results: A total of 211 patients were reviewed. The complaints or symptoms at presentation were: blurry vision, change in the visual field, transient vision loss, floaters, double vision, eye pain, eyelid droop, headache, dizziness and others such as nausea or vomiting. In the ED, a total of 126 neuroimaging procedures were performed. Ninety-four imagings (74.6%) were normal, while 32 (25.4%) had relevant abnormal findings. Only 2 symptoms were significant for abnormal imaging: blurry vision (p-value= 0.038) and visual field change (p-value= 0.014). While 4 physical exam findings had significant abnormal imaging: visual field defect (p-value= 0.016), abnormal pupil reactivity (p-value= 0.028), afferent pupillary defect (p-value= 0.018), and abnormal optic disc exam (p-value= 0.009). Conclusion: Risk indicators for abnormal neuroimaging in the setting of neuro-ophthalmological emergencies are blurred vision or changes in the visual field on history taking. While visual field irregularities, abnormal pupil reactivity with or without afferent pupillary defect, or abnormal optic discs, are risk factors related to physical testing. These findings, when present, should sway the ED physician towards neuroimaging but still individualizing each case is of utmost importance to prevent time-consuming, resource-draining, and sometimes unnecessary workup. In the end, it suggests a well-structured patient-centered algorithm to be followed by ED physicians.

Keywords: emergency department, neuro-ophthalmology, neuroimaging, risk indicators

Procedia PDF Downloads 177

Authors: Hacer Erdöl, Merve Aydın, Hacer Kobya Bulut, Kıymet Yeşilçiçek Çalık

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Like all occupations, nursing is significantly influenced by the society which it serves and it also affects it. Social structure affects attitudes of nurses, nursing practice, society's attitudes towards nursing and those who have chosen nursing as a profession. People who choose nursing schools take the views of the society’s they live in on nursing to nursing school. Until the 1960s, many nursing schools had not accepted men as students and women had received nursing education and profession had been carried out by women. In our country, in 2007 an amendment to article eight of Nursing Law was passed and with these changes men also began to be able to choose the nursing as a profession. In Turkish, nurse means 'sister'. Hence, in this study to determine the problems that male nursing students likely encounter at the clinic, non-clinical environment and in their private life regarding the title of nurse, among qualitative research methods phenomenological research design was used. Using purpose sampling method, a total of 18 voluntary male students-13 in third grade and 5 in fourth grade at nursing school- were taken to the study. Data were collected through interviews and by the ethical principles much attention was paid to ensure the confidentiality and to protect participants’ identity. During the interviews lasting 30-40 minutes on average, nine pre-configured standard questions were asked and when necessary free questions were also used in order to ensure the clarity of the responses. With pre- configured standard questions, the reasons why students chose the profession, the problems they had in clinical and non-clinical environment and the potential problems they might encounter in their private lives regarding the title of nurse were questioned. Content analysis was performed on data collected and three main themes were obtained. According to the findings of the evaluation of data, it was found that almost all the students preferred the profession due to possible work opportunities, there were students who did not bother nurse title as well as the ones who did bother and as the most important problem they might encounter in their private lives was to feel worried if their kids had to answer "What does your father" question as "my dad is a nurse" and being ridiculed afterwards. The results of this study show that studies should be done to change the social judgment stemmed from the recognition of nursing as a female profession and take advantage of media through creating public spotlight to accomplish this.

Keywords: choice of profession, the title of the profession, title problems, nursing

Procedia PDF Downloads 196

Authors: Soo Im Chung, Lara Marie Pangan Lo, Yao Cheng Zhang, Su Jin Nam, Xingyue Jin, Mi Young Kang

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Rice (Oryza sativa L.) is one of the most widely consumed grains. Due to the growing number of demand as a potential functional food and nutraceutical source and the increasing awareness of people towards healthy diet and good quality of living, more researches dwell upon the development of new rice cultivars for population consumption. However, studies on the antioxidant capacities of newly developed rice were limited as well as the effects of germination in these rice cultivars. Therefore, this study aimed to focus on analysis of the antioxidant potential of pre-germinated and germinated pigmented rice cultivars in South Korea such as purple cultivar Superjami (SJ) and red cultivar Super hongmi (SH) in comparison with the non-pigmented Normal Brown (NB) Rice. The powdered rice grain samples were extracted with 80% methanol and their antioxidant activities were determined. The Results showed that pre-germinated pigmented rice cultivars have higher Fe2+ Chelating Ability (Fe2+), Reducing Power (RP), 2,2´-azinobis[3-ethylbenzthiazoline]-6-sulfonic acid (ABTS) radical scavenging and Superoxide Dismutase activity than the control NB rice. Moreover, it is revealed that germination process induced a significant increased in the antioxidant activities of all the rice samples regardless of their strains. Purple rice SJ showed greater Fe2+ (88.82 + 0.53%), RP (0.82 + 0.01) , ABTS (143.63 + 2.38 mg VCEAC/100 g) and SOD (59.31 + 0.48%) activities than the red grain SH and the control NB having the lowest antioxidant potential among the three (3) rice samples examined. The Effective concentration at 50% (EC50) of 1, 1-Diphenyl-2-picrylhydrazyl (DPPH) and Hydroxyradical (-OH) Scavenging activity for the rice samples were also obtained. SJ showed lower EC50 in terms of its DPPH (3.81 + 0.15 mg/mL) and –OH (5.19 + 0.08 mg/mL) radical scavenging activities than the red grain SH and control NB rice indicating that at lower concentrations, it can readily exhibit antioxidant effects against reactive oxygen species (ROS). These results clearly suggest the higher antioxidant potential of pigmented rice varieties as compared with the widely consumed NB rice. Also, it is revealed in the study that even at lower concentrations, pigmented rice varieties can exhibit their antioxidant activities. Germination process further enhanced the antioxidant capacities of the rice samples regardless of their types. With these results at hand, these new rice varieties can be further developed as a good source of bio functional elements that can help alleviate the growing number of cases of metabolic disorders.

Keywords: antioxidant capacity, germinated rice, pigmented rice, super hongmi, superjami

Procedia PDF Downloads 437

Authors: Calister Wingang Makebe, Wilson Agwanande Ambindei, Zangue Steve Carly Desobgo, Abraham Billu, Emmanuel Jong Nso, P. Nisha

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Traditional liquid-state fermentation processes of Annona muricata L. juice can result in fluctuating product quality and quantity due to difficulties in control and scale up. This work describes a laboratory-scale batch fermentation process to produce a probiotic Annona muricata L. enzymatically extracted juice, which was modeled using the Doehlert design with independent extraction factors being incubation time, temperature, and enzyme concentration. It aimed at a better understanding of the traditional process as an initial step for future optimization. Annona muricata L. juice was fermented with L. acidophilus (NCDC 291) (LA), L. casei (NCDC 17) (LC), and a blend of LA and LC (LCA) for 72 h at 37 °C. Experimental data were fitted into mathematical models (Monod, Logistic and Luedeking and Piret models) using MATLAB software, to describe biomass growth, sugar utilization, and organic acid production. The optimal fermentation time was obtained based on cell viability, which was 24 h for LC and 36 h for LA and LCA. The model was particularly effective in estimating biomass growth, reducing sugar consumption, and lactic acid production. The values of the determination coefficient, R2, were 0.9946, 0.9913 and 0.9946, while the residual sum of square error, SSE, was 0.2876, 0.1738 and 0.1589 for LC, LA and LCA, respectively. The growth kinetic parameters included the maximum specific growth rate, µm, which was 0.2876 h-1, 0.1738 h-1 and 0.1589 h-1, as well as the substrate saturation, Ks, with 9.0680 g/L, 9.9337 g/L and 9.0709 g/L respectively for LC, LA and LCA. For the stoichiometric parameters, the yield of biomass based on utilized substrate (YXS) was 50.7932, 3.3940 and 61.0202, and the yield of product based on utilized substrate (YPS) was 2.4524, 0.2307 and 0.7415 for LC, LA, and LCA, respectively. In addition, the maintenance energy parameter (ms) was 0.0128, 0.0001 and 0.0004 with respect to LC, LA and LCA. With the kinetic model proposed by Luedeking and Piret for lactic acid production rate, the growth associated and non-growth associated coefficients were determined as 1.0028 and 0.0109, respectively. The model was demonstrated for batch growth of LA, LC, and LCA in Annona muricata L. juice. The present investigation validates the potential of Annona muricata L. based medium for heightened economical production of a probiotic medium.

Keywords: L. acidophilus, L. casei, fermentation, modelling, kinetics

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Authors: Lindsay Foreman

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Introduction: Goals have become synonymous with the quest for the good life and the pursuit of happiness, with coaching and positive psychology gaining popularity as an approach in recent decades. And yet mental health is on the rise and the leading cause of disability, wellbeing is on the decline, stress is leading to 50-60% of workday absences and the need for action is indisputable and urgent. Purpose: The purpose of this study is to better understand two things we cannot see, but that play the most significant role in these outcomes - what we think and how we feel. With many working on the assumption that positive thinking and an optimistic outlook are necessary or valuable components of goal pursuit, this study uncovers the reality of the ‘inner-game’ from the coachees perspective. Method: With a mixed methods design using a Q Method study of subjectivity to ‘make the unseen seen’. First, a wide-ranging universe of subjective thoughts and feelings experienced during goal pursuit are explored.. These are generated from literature and a Qualtrics survey to create a Q-Set of 40 statements. Then 19 participants in professional and organisational settings offer their perspectives on these 40 Q-Set statements. Each rank them in a semi-forced distribution from ‘most like me’ to ‘least like me’ using Q-Sort software. From these individual perspectives, clusters of perspectives are identified using factor analysis and four distinct viewpoints, have emerged. Findings: These Goal Pursuit Viewpoints offer insight into the states and self-talk experienced by coachees and may not reflect the assumption of positive thinking associated with achieving goals. The four Viewpoints are 1) the Positive View, 2) the Realistic View 3) The Dreamer View and 4) The Conflicted View. With only a quarter of the Dreamer View, and a third of the Positive view going on to achieve their goals, these assumptions need review. And with all the Realistic View going on to achieve their goals, the role of self-doubt, overwhelm and anxiousness in goal achievement cannot be overlooked. Contribution: This study offers greater insight and understanding of people's inner experiences as they pursue goals and highlights the necessary and normal negative states associated with goal achievement. It also offers a practical tool of 40 ‘Clarity Card’ Q-set statements to help coaches and coachees explore the current state and help navigate the journey towards goal achievement. It calls into question whether goals should always be part of coaching, and if values, identity, and purpose may play a greater role than goals

Keywords: self-talk, mental health, inner critic, inner coach

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Authors: Jia-Jin He, Tzu-Yuan Stessa Chao

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It is generally accepted that community residents with abundant open space have better health status on average, and thus more and more cities around the world began their pursuit of the greatest possible amount of green space within urban areas through urban planning approach. Nevertheless, only a few studies managed to provide empirical evidence regarding the actual relationship between 'providing' green space and 'improving' human health at city level. There is also lack of evidence of direct positive improvement of health by increasing the amount of green space. For urban planning professional, it is important to understand citizens’ usage behaviour towards green space as a critical evidence for future planning and design strategies. There is a research need to further investigate the amount of green space, user behaviour of green spaces and the health outcome of urban dwellers. To this end, we would like to find out other important factors for urban dwellers’ usage behaviours of green spaces. 'Average green spaces per person' is one of the National well-being Indicators in Taiwan as in many other countries. Through our preliminary research, we collected and analyzed the official data of planned open space coverages, average life expectancy, exercise frequency and obesity ratio in all cities of Taiwan. The study result indicates an interesting finding that Kaohsiung city, the second largest city in Taiwan, tells a completely different story. Citizens in Kaosiung city have more open spaces than any other city through urban planning, yet have relatively unhealthy condition in contrary. Whether it pointed out that the amount of the open spaces per person has would not direct to the health outcome. Therefore, the pre-established view which states that open spaces must have positive effects on human health should be examined more prudently. Hence, this paper intends to explore the relationship between user behaviour of open spaces and citizens’ health conditions by critically analyzing past related literature and collecting selective data from government health database in 2015. We also take Kaohsiung city, as a case study area to conduct statistical analysis first followed by questionnaire survey to gain a better understanding. Finally, we aim to feedback our findings to the current planning system in Taiwan for better health promotion urbanized areas.

Keywords: open spaces, urban planning systems, healthy cities, health outcomes

Procedia PDF Downloads 164

Authors: Noor Taleb Ismael, Areej Abd Al Kareem Al Titi, Ala'a Fayez Jaber

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Objectives: To investigate self-perceived functional performance among adults with IDD who are Jordanian residential care and rehabilitation centers residents. Also, to investigate their functional abilities (i.e., motor, and cognitive). In addition, to determine the motor and cognitive predictors of their functional performance. Methods: The study utilized a cross-sectional descriptive design; the sample included 180 individuals with IDD (90 males and 90 females) aged 18 to 75 years. The inclusion criteria encompassed: 1) Adults with a confirmed IDD by their physician’s professional and 2) residents in Jordanian Residential Care and Rehabilitation Centers affiliated with the Jordanian Ministry of Social Development. The exclusion criteria were: 1) bedridden or totally dependent on their care providers; 2) who had an accident or acquired neurological conditions. Researchers conducted semi-structured interviews to complete the outcome measures that include the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure (FIM), the Montreal Cognitive Assessment (MoCA), the Mini-Mental Status Examination (MMSE), and the sociodemographic questionnaire. Data analyses consisted of descriptive statistics, analysis of frequencies, correlation, and regression analyses. Result: Individuals with IDD showed low functional performance in all daily life areas, including self-care, productivity, and leisure; there was severe cognitive impairment and poor independence and functional performance. (COPM Performance M= 1.433, SD±.57021, COPM Satisfaction M= 1.31, SD±.54, FIM M= 3.673, SD± 1.7918). Two predictive models were validated for the COPM performance and FIM total scores. First, significant predictors of high self-perceived functional performance on COPM were high scores on FIM Motor sub scores, FIM cognitive sub scores, young age, and having a high school educational level (R2=0.603, p=0.012). Second, significant predictors of high functional capacity on FIM were a high score on the COPM performance subscale, a high MMSE score, and having a cerebral palsy (CP) diagnosis (R2=0.671, p<0.001). Conclusions: Evaluating functional performance and associated factors is important in rehabilitation to provide better services and improve health and QoL for individuals with IDD. This study suggested conducting future studies targeting integrated individuals with IDD who live with their families in the communities.

Keywords: functional performance, intellectual and developmental disabilty, cognitive abilities, motor abilities

Procedia PDF Downloads 45

Authors: Scott Cavinder

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Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.

Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery

Procedia PDF Downloads 77

Authors: Ivana Scidà, Francesco Alotto, Anna Osello

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Due to the importance given today to innovation, the education sector is evolving thanks digital technologies. Virtual Reality (VR) can be a potential teaching tool offering many advantages in the field of training and education, as it allows to acquire theoretical knowledge and practical skills using an immersive experience in less time than the traditional educational process. These assumptions allow to lay the foundations for a new educational environment, involving and stimulating for students. Starting from the objective of strengthening the innovative teaching offer and the learning processes, the case study of the research concerns the digitalization of MastrLAB, High Quality Laboratory (HQL) belonging to the Department of Structural, Building and Geotechnical Engineering (DISEG) of the Polytechnic of Turin, a center specialized in experimental mechanical tests on traditional and innovative building materials and on the structures made with them. The MastrLAB-VR has been developed, a revolutionary innovative training tool designed with the aim of educating the class in total safety on the techniques of use of machinery, thus reducing the dangers arising from the performance of potentially dangerous activities. The virtual laboratory, dedicated to the students of the Building and Civil Engineering Courses of the Polytechnic of Turin, has been projected to simulate in an absolutely realistic way the experimental approach to the structural tests foreseen in their courses of study: from the tensile tests to the relaxation tests, from the steel qualification tests to the resilience tests on elements at environmental conditions or at characterizing temperatures. The research work proposes a methodology for the virtualization of technical laboratories through the application of Building Information Modelling (BIM), starting from the creation of a digital model. The process includes the creation of an independent application, which with Oculus Rift technology will allow the user to explore the environment and interact with objects through the use of joypads. The application has been tested in prototype way on volunteers, obtaining results related to the acquisition of the educational notions exposed in the experience through a virtual quiz with multiple answers, achieving an overall evaluation report. The results have shown that MastrLAB-VR is suitable for both beginners and experts and will be adopted experimentally for other laboratories of the University departments.

Keywords: building information modelling, digital learning, education, virtual laboratory, virtual reality

Procedia PDF Downloads 127

Authors: Blessing C. Nwachukwu, Michael O. Taiwo, Wasiu A. Abibu, Isaac O. Ayodeji

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Milk is an important source of micro and macronutrients for humans. Soft Cheese (Wara) is an example of a by-product of milk. In addition, water is considered as one of the most vital resources in cattle farms. Due to the high consumption rate of milk and soft cheese and the traditional techniques involved in their production in Nigeria, there was a need for a microbiological assessment which will be of utmost public health importance. The study thus investigated microbial risk assessments associated with consumption of milk and soft cheese (Wara). It also investigated common pathogens present in dairy water in farms and antibiotic sensitivity profiling for implicated pathogens were conducted. Samples were collected from three different Fulani dairy herds in Ido local government, Ibadan, Oyo State, Nigeria and subjected to microbiological evaluation and antimicrobial susceptibility testing. Aspergillus flavus was the only isolated fungal isolate from Wara while Staphylococcus aureus, Vibro cholera, Hafnia alvei, Proteus mirabilis, Escherishia coli, Psuedomonas aeuroginosa, Citrobacter freundii, and Klebsiella pneumonia were the bacteria genera isolated from Wara, dairy milk and dairy drinking water. Bacterial counts from Wara from the three selected farms A, B and C were 3.5×105 CFU/ml, 4.0×105 CFU/ml and 5.3×105 CFU/ml respectively while the fungal count was 3CFU/100µl. The total bacteria count from dairy milk from the three selected farms A, B and C were Farms 2.0 ×105 CFU/ml, 3.5 × 105 CFU/ml and 6.5 × 105 CFU/ml respectively. 1.4×105 CFU/ml, 1.9×105 CFU/ml and 4.9×105 CFU/ml were the recorded bacterial counts from dairy water from farms A, B and C respectively. The highest antimicrobial resistance of 100% was recorded in Wara with Enrofloxacin, Gentamycin, Cefatriaxone and Colistin. The highest antimicrobial susceptibility of 100% was recorded in Raw milk with Enrofloxacin and Gentamicin. Highest antimicrobial intermediate response of 100% was recorded in Raw milk with Streptomycin. The study revealed that most of the cheeses sold at Ido local Government are contaminated with pathogens. Further research is needed on standardizing the production method to prevent pathogens from gaining access. The presence of bacteria in raw milk indicated contamination due to poor handling and unhygienic practices. Thus, drinking unpasteurized milk is hazardous as it increases the risk of zoonoses. Also, the Provision of quality drinking water is crucial for optimum productivity of dairy. Health education programs aiming at increasing awareness of the importance of clean water for animal health will be helpful.

Keywords: dairy, raw milk, soft cheese, Wara

Procedia PDF Downloads 177

Authors: Asena Demirci, Gozen Guner Aktaş, Nur Ayalp

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Nature provides a living space for humans, also in contrast it is destroyed by humans for their personal needs and ambitions. For decreasing these damages against nature, solutions are started to generate and to develop. Moreover, precautions are implemented. After 1960s, especially when the ozone layer got harmed and got thinner by toxic substances coming from man made structures, environmental problems which effected human’s activities of daily living. Thus, this subject about environmental solutions and precautions is becoming a priority issue for scientists. Most of the environmental problems are caused by buildings and factories which are built without any concerns about protecting nature. This situation creates awareness about environmental issues and also the terms like sustainability, Renewable energy show up in building, Construction and architecture sectors to provide environmental protection. In this perspective, the design disciplines also should be respectful to nature and the sustainability. Designs which involve the features like sustainability, renewability and being ecologic have specialties to be less detrimental to the environment rather than the designs which do not involve. Furthermore, these designs produce their own energy for consuming, So they do not use the natural resources. They do not contain harmful substances and they are made of recyclable materials. Thus, they are becoming environmentally friendly structures. There is a common concern among designers about the issue of sustainable design. They believe that the idea of sustainability inhibits the creativity. All works of design resemble each other from the point of aesthetics and technological matters. In addition, there is a concern about design ethics which aesthetic designs cannot be accepted as a priority. For these reasons, there are few designs included the features of being eco-friendly and well-designed and also had design concerns around the world. Despite the other design disciplines, The concept of sustainability is getting more important each day in interior architecture and interior design. As it is known that human being spends 90 % of his life in interior spaces, The importance of that concept in interior spaces is obvious. Aesthetic is another vital concern in interior space design also. Most of the time sustainable materials and sustainable interior design applications conflicts with personal aesthetic parameters. This study aims to discuss the great paradox between the design aesthetic and the sustainable design. Does the sustainable approach in interior design disturbs the design aesthetic? This is one of the most popular questions that have been discussed for a while. With this paper this question will be evaluated with a case study which analyzes the aesthetic perceptions and preferences of the users and designers in sustainable interior spaces.

Keywords: aesthetics, interior design, sustainable design, sustainability

Procedia PDF Downloads 284

Authors: Sweta Pandey, Samridhi Dhyani, Susmita Chaudhuri

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Klebsiella pneumoniae bacteria is a global threat to human health due to an increase in multi-drug resistance among strains. The hypervirulent strains of Klebsiella pneumoniae is a major trouble due to their association with life-threatening infections in a healthy population. One of the major virulence factors of hyper virulent strains of Klebsiella pneumoniae is the T6SS (Type six secretary system) which is majorly involved in microbial antagonism and causes interaction with the host eukaryotic cells during infections. T6SS mediates some of the crucial factors for establishing infection by the bacteria, such as cell adherence, invasion, and subsequent in vivo colonisation. The antibacterial activity and the cell invasion property of the T6SS system is a major requirement for the establishment of K. pneumoniae infections within the gut. The T6SS can be an appropriate target for developing therapeutics. The T6SS consists of an inner tube comprising hexamers of Hcp (Haemolysin -regulated protein) protein, and at the top of this tube sits VgrG (Valine glycine repeat protein G); the tip of the machinery consists of PAAR domain containing proteins which act as a delivery system for bacterial effectors. For this study, immune response to recombinant VgrG protein was generated to establish this protein as a potential immunogen for the development of therapeutic leads. The immunogenicity of the selected protein was determined by predicting the B cell epitopes by the BCEP analysis tool. The gene sequence for multiple domains of VgrG protein (phage_base_V, T6SS_Vgr, DUF2345) was selected and cloned in pMAL vector in E. coli. The construct was subcloned and expressed as a fusion protein of 203 residue protein with mannose binding protein tag (MBP) to enhance solubility and purification of this protein. The purified recombinant VgrG fusion protein was used for mice immunisation. The antiserum showed reactivity with the recombinant VgrG in ELISA and western blot. The immunised mice were challenged with K. pneumoniae bacteria and showed bacterial clearance in immunised mice. The recombinant VgrG protein can further be used for studying downstream signalling of VgrG protein in mice during infection and for therapeutic MAb development to eradicate K. pneumoniae infections.

Keywords: immune response, Klebsiella pneumoniae, multi-drug resistance, recombinant protein expression, T6SS, VgrG

Procedia PDF Downloads 98

Authors: Carly Copolov, Rema Nazha, Sahba C. Delshad, George Bisas

Abstract:

In New South Wales (NSW), Australia, we speak more than 275 languages and dialects. Interpreters play an indispensable role in our multicultural society by ensuring the people of NSW all enjoy the same opportunities. The NSW Government offers scholarships to enable people who speak in-demand and high priority languages to become eligible to be practicing interpreters. The NSW Interpreter Scholarship Program was launched in January 2019, targeting priority languages from new and emerging, as well as existing language communities. The program offers fully-funded scholarships to study at Technical and Further Education (TAFE), receive National Accreditation Authority for Translators and Interpreters (NAATI) certification, and be mentored and gain employment with the interpreter panel of Multicultural NSW. A Participatory Action Research approach was engaged to challenge the current system for people to become practicing interpreters in NSW. There were over 800 metro Sydney applications and close to 200 regional applications. Three courses were run through TAFE NSW (2 in metro Sydney and 1 in regional NSW). Thirty-nine students graduated from the program in 2019. The first metro Sydney location had 18 graduates complete the course in Assyrian, Burmese, Chaldean, Kurdish-Kurmanji, Nepali, and Tibetan. The second metro Sydney location had 9 graduates complete the course in Tongan, Kirundi, Mongolian and Italian. The regional location had 12 graduates who complete the course from new emerging language communities such as Kurdish-Kurmanji, Burmese, Zomi Chin, Hakha Chin, and Tigrinya. The findings showed that students were very positive about the program as the large majority said they were satisfied with the course content, they felt prepared for the NAATI test at the conclusion of the course, and they would definitely recommend the program to their friends. Also, 18 students from the 2019 cohort signed up to receive further mentoring by experienced interpreters. In 2020 it is anticipated that 3 courses will be run through TAFE NSW (2 in regional NSW and 1 in metro Sydney) to reflect the needs of new emerging language communities settling in regional areas. In conclusion, it has been demonstrated that the NSW Interpreter Scholarship Program improves the supply, quality, and use of language services in NSW, Australia, so that people who speak in-demand and high priority languages are ensured better access to crucial government services

Keywords: interpreting, emerging communities, scholarship program, Sydney

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