Search results for: group decision making

Authors: Mehmet Sinan Erguven

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A number of authorities argue that radio is an outdated medium for advertising and does not have the same impact on consumers as it did in the past. This grim outlook on the future of radio has its basis in the audio-visual world that consumers now live in and the popularity of Internet-based marketing tools among advertising professionals. Nonetheless, consumers still appear to overwhelmingly prefer radio as an entertainment tool. Today, in Canada, 90% of all adults (18+) tune into the radio on a weekly basis, and they listen for 17 hours. Teens are the most challenging group for radio to capture as an audience, but still, almost 75% tune in weekly. One online radio station reaches more than 250 million registered listeners worldwide, and revenues from radio advertising in Australia are expected to grow at an annual rate of 3% for the foreseeable future. Radio is also starting to become popular again in Turkey, with a 5% increase in the listening rates compared to 2014. A major matter of concern always affecting radio advertising is creativity. As radio generally serves as a background medium for listeners, the creativity of the radio commercials is important in terms of attracting the attention of the listener and directing their focus on the advertising message. This cannot simply be done by using audio tools like sound effects and jingles. This study aims to identify the creative elements (execution formats appeals and approaches) and creativity factors of radio commercials in Turkey. As part of the study, all of the award winning radio commercials produced throughout the history of the Kristal Elma Advertising Festival were analyzed using the content analysis technique. Two judges (an advertising agency copywriter and an academic) coded the commercials. The reliability was measured according to the proportional agreement. The results showed that sound effects, jingles, testimonials, slices of life and announcements were the most common execution formats in creative Turkish radio ads. Humor and excitement were the most commonly used creative appeals while award-winning ads featured various approaches, such as surprise musical performances, audio wallpaper, product voice, and theater of the mind. Some ads, however, were found to not contain any creativity factors. In order to be accepted as creative, an ad must have at least one divergence factor, such as originality, flexibility, unusual/empathic perspective, and provocative questions. These findings, as well as others from the study, hold great value for the history of creative radio advertising in Turkey. Today, the nature of radio and its listeners is changing. As more and more people are tuning into online radio channels, brands will need to focus more on this relatively cheap advertising medium in the very near future. This new development will require that advertising agencies focus their attention on creativity in order to produce radio commercials for their customers that will differentiate them from their competitors.

Keywords: advertising, creativity, radio, Turkey

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Authors: Dorothy Ebere Adimora

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The study investigated the predictive power of home environment and peer pressure on disruptive behaviour and risky sexual behaviour of Secondary School Class Two Adolescents in Enugu State, Nigeria. The design of the study is a cross sectional survey of correlational study. The study was carried out in the six Education zones in Enugu state, Nigeria. Enugu State is divided into six education zones, namely Agbani, Awgu, Enugu, Nsukka, Obollo-Afor and Udi. The population for the study was all the 31,680 senior secondary class two adolescents in 285 secondary schools in Enugu State, Nigeria in 2014/2015 academic session. The target population was students in SSS.2 senior secondary class two. They constitute one-sixth of the entire student population in the state. The sample of the study was 528, a multi stage sampling technique was employed to draw the sample. Four research questions and four null hypotheses guided the study. The instruments for data collection were an interview session and a structured questionnaire of four clusters, they are; home environment, peer pressure, risky sexual behaviour and disruptive behaviour disorder questionnaires. The instruments were validated by 3 experts, two in psychology and one in measurement and Evaluation in Faculty of Education, University of Nigeria, Nsukka. The reliability coefficient of the instruments was ascertained by subjection to field trial. The adolescents were asked to complete the questionnaire on their home environment, peer pressure, disruptive behaviour disorder and risky sexual behaviours. The risky sexual behaviours were ascertained based on interview conducted on their actual sexual practice within the past 12 months. The research questions were analyzed using Pearson r and R-square, while the hypotheses were tested using ANOVA and multiple regression analysis at 0.05 level of significance. The results of this survey revealed that the adolescents are sexually active in very young ages. The mean age at sexual debut for the adolescents covered in this survey is a pointer to the fact that some of them started engaging in sexual activities long ago. It was also found that the adolescents engage in disruptive behaviour as a result of their poor home environment factors and association with negative peers. Based on the findings, it was recommended that the adolescents should be exposed to enhanced home environment such as parents’ responsiveness, organization of the environment, availability of appropriate learning materials, opportunities for daily stimulation and to offer a proper guidance to these adolescents to avoid negative peer influence which could result in risky sexual behaviour and disruptive behaviour disorder.

Keywords: parenting, peer group, adolescents, sexuality, conduct disorder

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Authors: Sukhdev Singh, Baljinder Singh Bal, Amandeep Singh, Kanchan Thappa

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A nation's future almost certainly rests on the future of its children, and a nation's wellbeing can be greatly improved by providing for the right upbringing of its children. Participating in physical education and sports programmes is crucial for reaching one's full potential. As we are all aware, sports have recently become incredibly popular on a global scale. Sports are continually becoming more and more popular, and this positive trend is probably going to last for some time to come. Motor abilities will provide more accurate information on the developmental process of children. Motor fitness is a component of physical fitness that includes strength, speed, flexibility, and agility, and is related to enhanced performance and the development of motor skills. In recent years, there has been increased interest in the differences in child growth between urban and rural environments. Differences in student growth, body dimensions, body composition, and fitness levels due to urban and rural environmental disparities have come into focus in recent years. The main aim of this study is to know the differentials of motor fitness components among the school children of rural and urban areas of the Jammu region. Material and Methods: In total, sixty male subjects (mean ± SD; age, 16.475 ± 1.0124 yrs.; height, 172.8 ± 2.0153 cm; Weight, 59.75 ± 3.628 kg) from the Jammu region took part in the study. A minimum sample size of 40 subjects was obtained and was derived from Rural (N1=20) and Urban (N2=20) school-going children. Statistical Applications: The Statistical Package for the Social Sciences (SPSS) version 14.0 was used for all analyses. The differences in the mean of each group for the selected variable were tested for the significance of difference by an independent samples t-test. For testing the hypotheses, the level of significance was set at 0.05. Results: Results revealed that there were significant differences of leg explosive strength (p=0.0040*), dynamic balance (p=0.0056*), and Agility (p=0.0176*) among the School Children of the rural and urban areas of the Jammu region. However, Results further revealed that there were not significant differences of cardio respiratory endurance (p=0.8612), speed (p=0.2231), Low Back/Hamstring Flexibility (p=0.6478), and Two Hand Coordination. (p= 0.0953) among the School Children of the rural and urban areas of the Jammu region. Conclusion: The results of study showed that there is significance difference between Rural and Urban School children of the Jammu region with regards to a variable," leg explosive strength, dynamic balance, Agility” and the there is no significance difference between Rural and Urban School children of the Jammu region with regards variable “cardio-respiratory endurance, speed, Low Back/Hamstring Flexibility, Two Hand Coordination”.

Keywords: motor fitness, rural areas, school children, urban areas

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Authors: A. L. Verret, N. Prince, Y. Jerome, A. Bras

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The effects of housing design on the health and well-being of populations are quite intangible. In fact, healthy housing parameters are generally difficult to establish scientifically. It is often unclear the direction of a cause-and-effect relationship between health variables and housing. However, the lack of clear and definite measurements does not entail the absence of relationship between housing, health, and well-being. Research has thus been conducted. It has mostly aimed the physical rather than the psychological or social well-being of a population, given the difficulties to establish cause-effect relationships because of the subjectivity of the psychological symptoms and of the challenge in determining the influence of other factors. That said, a strong relationship has been exposed between light and physiology. Both the nervous and endocrine systems, amongst others, are affected by different wavelengths of natural light within a building. Daylight in the workplace is indeed associated to decreased absenteeism, errors and product defects, fatigue, eyestrain, increased productivity and positive attitude. Similar associations can also be made to residential housing. Lower levels of sunlight within the home have been proven to result in impaired cognition in depressed participants of a cross-sectional case study. Moreover, minimum space (area and volume) has been linked to healthy housing and quality of life, resulting in norms and regulations for such parameters for home constructions. As a matter of fact, it is estimated that people spend the two-thirds of their lives within the home and its immediate environment. Therefore, it is possible to deduct that the health and well-being of the occupants are potentially at risk in an unhealthy housing situation. While the impact of architecture on health and well-being is acknowledged and considered somewhat crucial in various countries of the north and the south, this issue is barely raised in Haiti. In fact, little importance is given to architecture for many reasons (lack of information, lack of means, societal reflex, poverty…). However, the middle-class is known for its residential strategies and trajectories in search of better-quality homes and environments. For this reason, it would be pertinent to use this group and its strategies and trajectories to isolate the impact of housing design on the overall health and well-being. This research aims to analyze the impact of housing architecture on the health and well-being of middle-class families in the metropolitan region of Port-au-Prince. It is a case study which uses semi-structured interviews and observations as research methods. Although at an early stage, this research anticipates that homes affect their occupants both psychologically and physiologically, and consequently, public policies and the population should take into account the architectural design in the planning and construction of housing and, furthermore, cities.

Keywords: architectural design, health and well-being, middle-class housing, Port-au-Prince, Haiti

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Authors: Ranjita Ghoshmoulick, Aswathi Madhavan, Subhavna Juneja, Prasenjit Sen, Jaydeep Bhattacharya

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Type 2 diabetes mellitus (T2DM) is a very complex and multifactorial metabolic disease where the blood sugar level goes up. One of the major consequence of this elevated blood sugar is the formation of AGE (Advance Glycation Endproducts), from a series of chemical or biochemical reactions. AGE are detrimental because it leads to severe pathogenic complications. They are a group of structurally diverse chemical compounds formed from nonenzymatic reactions between the free amino groups (-NH2) of proteins and carbonyl groups (>C=O) of reducing sugars. The reaction is known as Maillard Reaction. It starts with the formation of reversible schiff’s base linkage which after sometime rearranges itself to form Amadori Product along with dicarbonyl compounds. Amadori products are very unstable hence rearrangement goes on until stable products are formed. During the course of the reaction a lot of chemically unknown intermediates and reactive byproducts are formed that can be termed as Early Glycation Products. And when the reaction completes, structurally stable chemical compounds are formed which is termed as Advanced Glycation Endproducts. Though all glycation products have not been characterized well, some fluorescence compounds e.g pentosidine, Malondialdehyde (MDA) or carboxymethyllysine (CML) etc as AGE and α-dicarbonyls or oxoaldehydes such as 3-deoxyglucosone (3-DG) etc as the intermediates have been identified. In this work Gold NanoParticle (GNP) was used as an optical indicator of glycation products. To achieve faster glycation kinetics and high AGE accumulation, fructose was used instead of glucose. Hemoglobin A0 (HbA0) was fructosylated by in-vitro method. AGE formation was measured fluorimetrically by recording emission at 450nm upon excitation at 350nm. Thereafter this fructosylated HbA0 was fractionated by column chromatography. Fractionation separated the proteinaceous substance from the AGEs. Presence of protein part in the fractions was confirmed by measuring the intrinsic protein fluorescence and Bradford reaction. GNPs were synthesized using the templates of chromatographically separated fractions of fructosylated HbA0. Each fractions gave rise to GNPs of varying color, indicating the presence of distinct set of glycation products differing structurally and chemically. Clear solution appeared due to settling down of particles in some vials. The reactive groups of the intermediates kept the GNP formation mechanism on and did not lead to a stable particle formation till Day 10. Whereas SPR of GNP showed monotonous colour for the fractions collected in case of non fructosylated HbA0. Our findings accentuate the use of GNPs as a simple colorimetric sensing platform for the identification of intermediates of glycation reaction which could be implicated in the prognosis of the associated health risk due to T2DM and others.

Keywords: advance glycation endproducts, glycation, gold nano particle, sensor

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Authors: Mahmoud M. S. Farrag, Alaa A. K. Elhaweet, El-Sayed Kh. A. Akel, Mohsen A. Moustafa

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The present work aimed to study the reproductive strategy of the common lessepsian puffer fish Lagocephalus sceleratus (Gmelin, 1879) from the Egyptian Mediterranean Waters. It is a famous migratory species plays an important role in the field of fisheries and ecology of aquatic ecosystem. The specimens were collected monthly from the landing centers along the Egyptian Mediterranean coast during 2012. Six maturity stages were recorded: (I) Thread like stage, (II) Immature stage (Virgin stage), (III) Maturing stage (Developing Virgin and recovering spent), (IV) Nearly ripe stage, (V) Fully ripe, (VI) Spawning stage, (VII) Spent stage. According to sex ratio, males exhibited higher number than females representing 52.44 % of the total fishes with sex ratio 1: 0.91. Fish length corresponding to 50% maturation was 38.5 cm for males and 41 cm for females. The corresponding ages (age at first maturity) are equal to 2.14 and 2.27 years for male and female respectively. The ova diameter ranged from 0.02mm to 0.85mm, the mature ova ranged from 0.16mm to 0.85mm and showed progressive increase from April towards September. Also, the presences of ova diameter in one peak of mature and ripe eggs in the ovaries were observed during spawning period. The relationship between gutted weight and absolute fecundity indicated that that fecundity increased as the fish grew in weight. The absolute fecundity ranged from 260288 to 2372931 for fish weight ranged from 698 to 3285 cm with an average of 1449522±720975. The relative fecundity ranged from 373 to 722 for fish weight ranged from 698 to 3285 cm with an average of 776±231. The spawning season of L. sceleratus was investigated from the data of gonado-somatic index and monthly distribution of maturity stages along the year as well as sequence of ova diameter for mature stages and exhibited a relatively prolong spawning season extending from April for both sexes and ends in August for male while ends in September for female. Fish releases its ripe ova in one batch during the spawning season. Histologically, the ovarian cycle of L. sceleratus was classified into six stages and the testicular cycle into five stages. Histological characters of gonads of L. sceleratus during the year of study had confirmed the previous results of distribution of maturity stages, gonado-somatic index and ova diameter, indicating this fish species has prolonged spawning season from April to September. This species is considered totally or uni spawner with synchronous group as it contained one to two developmental stages at the same gonad.

Keywords: Lagocephalus sceleratus, reproductive biology, oogenesis, histology

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Authors: Claudia Trillo

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Regional innovation eco-ecosystems are composed of a variety of interconnected urban innovation eco-systems, mutually reinforcing each other and making the whole territorial system successful. Combining principles drawn from the new economic growth theory and from the socio-constructivist approach to the economic growth, with the new geography of innovation emerging from the networked nature of innovation districts, this paper explores the spatial configuration of urban innovation districts, with the aim of unveiling replicable spatial patterns and transferable portfolios of urban policies. While some authors suggest that cities should be considered ideal natural clusters, supporting cross-fertilization and innovation thanks to the physical setting they provide to the construction of collective knowledge, still a considerable distance persists between regional development strategies and urban policies. Moreover, while public and private policies supporting entrepreneurship normally consider innovation as the cornerstone of any action aimed at uplifting the competitiveness and economic success of a certain area, a growing body of literature suggests that innovation is non-neutral, hence, it should be constantly assessed against equity and social inclusion. This paper draws from a robust qualitative empirical dataset gathered through 4-years research conducted in Boston to provide readers with an evidence-based set of recommendations drawn from the lessons learned through the investigation of the chosen innovation districts in the Boston area. The evaluative framework used for assessing the overall performance of the chosen case studies stems from the Habitat III Sustainable Development Goals rationale. The concept of inclusive growth has been considered essential to assess the social innovation domain in each of the chosen cases. The key success factors for the development of the Boston innovation ecosystem can be generalized as follows: 1) a quadruple helix model embedded in the physical structure of the two cities (Boston and Cambridge), in which anchor Higher Education (HE) institutions continuously nurture the Entrepreneurial Environment. 2) an entrepreneurial approach emerging from the local governments, eliciting risk-taking and bottom-up civic participation in tackling key issues in the city. 3) a networking structure of some intermediary actors supporting entrepreneurial collaboration, cross-fertilization and co-creation, which collaborate at multiple-scales thus enabling positive spillovers from the stronger to the weaker contexts. 4) awareness of the socio-economic value of the built environment as enabler of cognitive networks allowing activation of the collective intelligence. 5) creation of civic-led spaces enabling grassroot collaboration and cooperation. Evidence shows that there is not a single magic recipe for the successful implementation of place-based and social innovation-driven strategies. On the contrary, the variety of place-grounded combinations of micro and macro initiatives, embedded in the social and spatial fine grain of places and encompassing a diversity of actors, can create the conditions enabling places to thrive and local economic activities to grow in a sustainable way.

Keywords: innovation-driven sustainable Eco-systems , place-based sustainable urban development, sustainable innovation districts, social innovation, urban policie

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Authors: Aditi Madan, Jayant Kumar Routray

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Purpose: Over the years flood related risks have compounded due to increasing vulnerability caused by rapid urbanisation and growing population. This increase is an indication of the need for enhancing the preparedness of institutions to respond to floods. The study describes disaster management structure and its linkages with institutions involved in managing disasters. It addresses issues and challenges associated with readiness of disaster management institutions to respond to floods. It suggests policy options for enhancing the current state of readiness of institutions to respond by considering factors like institutional, manpower, financial, technical, leadership & networking, training and awareness programs, monitoring and evaluation. Methodology: The study is based on qualitative data with statements and outputs from primary and secondary sources to understand the institutional framework for disaster management in India. Primary data included field visits, interviews with officials from institutions managing disasters and the affected community to identify the challenges faced in engaging national, state, district and local level institutions in managing disasters. For focus group discussions, meetings were held with district project officers and coordinators, local officials, community based organisation, civil defence volunteers and community heads. These discussions were held to identify the challenges associated with preparedness to respond of institutions to floods. Findings: Results show that disasters are handled by district authority and the role of local institutions is limited to a reactive role during disaster. Data also indicates that although the existing institutional setup is well coordinated at the district level but needs improvement at the local level. Wide variations exist in awareness and perception among the officials engaged in managing disasters. Additionally, their roles and responsibilities need to be clearly defined with adequate budget and dedicated permanent staff for managing disasters. Institutions need to utilise the existing manpower through proper delegation of work. Originality: The study suggests that disaster risk reduction needs to focus more towards inclusivity of the local urban bodies. Wide variations exist in awareness and perception among the officials engaged in managing disasters. In order to ensure community participation, it is important to address their social and economic problems since such issues can overshadow attempts made for reducing risks. Thus, this paper suggests development of direct linkages among institutions and community for enhancing preparedness to respond to floods.

Keywords: preparedness, response, disaster, flood, community, institution

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Authors: E. Nemes-Nagy, E. Fogarasi, M. Croitoru, A. Nyárádi, K. Komlódi, S. Pál, A. Kovács, O. Kopácsy, R. Tripon, Z. Fazakas, C. Uzun, Z. Simon-Szabó, V. Balogh-Sămărghițan, E. Ernő Nagy, M. Szabó, M. Tilinca

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Intense oxidative stress, increased glycated hemoglobin and mineral imbalance represent risk factors for complications in diabetic patients. Cardiovascular complications are most common in these patients, including nephropathy. This study was conducted in 2015 at the Procardia Laboratory in Tîrgu Mureș, Romania on 40 type 2 diabetic adults. Routine biochemical tests were performed on the Konleab 20XTi analyzer (serum glucose, total cholesterol, LDL and HDL cholesterol, triglyceride, creatinine, urea). We also measured serum uric acid, magnesium and calcium concentration by photometric procedures, potassium, sodium and chloride by ion selective electrode, and chromium by atomic absorption spectrometry in a group of patients. Glycated hemoglobin (HbA1c) dosage was made by reflectometry. Urine analysis was performed using the HandUReader equipment. The level of oxidative stress was measured by serum malondialdehyde dosage using the thiobarbituric acid reactive substances method. MDRD (Modification of Diet in Renal Disease) formula was applied for calculation of creatinine-derived glomerular filtration rate. GraphPad InStat software was used for statistical analysis of the data. The diabetic subject included in the study presented high MDA concentrations, showing intense oxidative stress. Calcium was deficient in 5% of the patients, chromium deficiency was present in 28%. The atherogenic cholesterol fraction was elevated in 13% of the patients. Positive correlation was found between creatinine and MDRD-creatinine values (p<0.0001), 68% of the patients presented increased creatinine values. The majority of the diabetic patients had good control of their diabetes, having optimal HbA1c values, 35% of them presented fasting serum glucose over 120 mg/dl and 18% had glucosuria. Intense oxidative stress and mineral deficiencies can increase the risk of cardiovascular complications in diabetic patients in spite of their good metabolic balance. More than two third of the patients present biochemical signs of nephropathy, cystatin C dosage and microalbuminuria could reveal better the kidney disorder, but glomerular filtration rate calculation formulas are also useful for evaluation of renal function.

Keywords: cardiovascular risk, homocysteine, malondialdehyde, metformin, minerals, type 2 diabetes, vitamin B12

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Authors: Da-Hye Jang, Woo-Jeong Cho

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Marine leisure tourism contributes greatly to the national economy in which the sea is located nearby and many countries are using marine tourism to create value added. The interest and investment of government and local governments on marine leisure tourism growing as a major trend of marine tourism is steadily increasing. But indiscriminate investment in marine leisure tourism such as duplicated business wastes limited resources. In other words, government and local governments need to select and concentrate on the goal they pursue by drawing priority on maritime leisure tourism policies. The purpose of this study is to analyze development strategies on supplier for marine leisure tourism and thus provide a comprehensive and rational framework for developing marine leisure tourism. In order to achieve the purpose, this study is to analyze priorities for each evaluation criterion of marine leisure tourism development policies using Analytic Hierarchy Process. In this study, a questionnaire was used as the survey tool and was developed based on the previous studies, government report, regional report, related thesis and literature for marine leisure tourism. The questionnaire was constructed by verifying the validity of contents from the expert group related to marine leisure tourism after conducting the first and second preliminary surveys. The AHP survey was conducted to experts (university professors, researchers, field specialists and related public officials) from April 6, 2018 to April 30, 2018 by visiting in person or e-mail. This study distributed 123 questionnaires and 68 valid questionnaires were used for data analysis. As a result, 4 factors with 12 detail strategies were analyzed using Excel. Extracted factors of development strategies of marine leisure tourism are consist of 4 factors such as infrastructure, popularization, law & system improvement and advancement. In conclusion, the results of the pairwise comparison of the four major factor on the first class were infrastructure, popularization, law & system improvement and advancement in order. Second, marine water front space maintenance had higher priority than marina facilities expansion and the establishment of marine leisure education center. Third, marine leisure safety·culture improvement had higher priority than strengthening experience·education program and the upkeep and open promotion event. Fourth, specialization·cluster of marine leisure tourism had higher priority than business support system of marine leisure tourism. Fifth, the revision of water-related leisure activities safety act had higher priority than an enactment of marine tourism promotion act and the foster of marina service industry. Finally, marine water front space maintenance was the most important development plan to boost marine leisure tourism.

Keywords: marine leisure tourism, marine leisure, marine tourism, analytic hierarchy process

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Authors: Rachana Tank, Donald. M. Lyall, Kristin Flegal, Joey Ward, Jonathan Cavanagh

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Alzheimer’s research UK estimates by 2050, 2 million individuals will be living with Late Onset Alzheimer’s disease (LOAD). However, individuals experience considerable cognitive deficits and brain pathology over decades before reaching clinically diagnosable LOAD and studies have utilised gene candidate studies such as genome wide association studies (GWAS) and polygenic risk (PGR) scores to identify high risk individuals and potential pathways. This investigation aims to determine whether high genetic risk of LOAD is associated with worse brain MRI and cognitive performance in healthy older adults within the UK Biobank cohort. Previous studies investigating associations of PGR for LOAD and measures of MRI or cognitive functioning have focused on specific aspects of hippocampal structure, in relatively small sample sizes and with poor ‘controlling’ for confounders such as smoking. Both the sample size of this study and the discovery GWAS sample are bigger than previous studies to our knowledge. Genetic interaction between loci showing largest effects in GWAS have not been extensively studied and it is known that APOE e4 poses the largest genetic risk of LOAD with potential gene-gene and gene-environment interactions of e4, for this reason we  also analyse genetic interactions of PGR with the APOE e4 genotype. High genetic loading based on a polygenic risk score of 21 SNPs for LOAD is associated with worse brain MRI and cognitive outcomes in healthy individuals within the UK Biobank cohort. Summary statistics from Kunkle et al., GWAS meta-analyses (case: n=30,344, control: n=52,427) will be used to create polygenic risk scores based on 21 SNPs and analyses will be carried out in N=37,000 participants in the UK Biobank. This will be the largest study to date investigating PGR of LOAD in relation to MRI. MRI outcome measures include WM tracts, structural volumes. Cognitive function measures include reaction time, pairs matching, trail making, digit symbol substitution and prospective memory. Interaction of the APOE e4 alleles and PGR will be analysed by including APOE status as an interaction term coded as either 0, 1 or 2 e4 alleles. Models will be adjusted partially for adjusted for age, BMI, sex, genotyping chip, smoking, depression and social deprivation. Preliminary results suggest PGR score for LOAD is associated with decreased hippocampal volumes including hippocampal body (standardised beta = -0.04, P = 0.022) and tail (standardised beta = -0.037, P = 0.030), but not with hippocampal head. There were also associations of genetic risk with decreased cognitive performance including fluid intelligence (standardised beta = -0.08, P<0.01) and reaction time (standardised beta = 2.04, P<0.01). No genetic interactions were found between APOE e4 dose and PGR score for MRI or cognitive measures. The generalisability of these results is limited by selection bias within the UK Biobank as participants are less likely to be obese, smoke, be socioeconomically deprived and have fewer self-reported health conditions when compared to the general population. Lack of a unified approach or standardised method for calculating genetic risk scores may also be a limitation of these analyses. Further discussion and results are pending.

Keywords: Alzheimer's dementia, cognition, polygenic risk, MRI

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Authors: Richa Jaiswal, Vidisha Sharma, Amulya Rattan, Sushma Sagar, Subodh Kumar, Amit Gupta, Biplab Mishra, Maneesh Singhal

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Background: Adequate nutritional support and daily patient monitoring have an independent therapeutic role in the successful management of high output fistulae and early recovery after abdominal trauma. Case presentation: An 18-year-old girl was brought to AIIMS emergency with alleged history of fall of a heavy weight (electric motor) over abdomen. She was evaluated as per Advanced Trauma Life Support(ATLS) protocols and diagnosed to have significant abdominal trauma. After stabilization, she was referred to Trauma center. Abdomen was guarded and focused assessment with sonography for trauma(FAST) was found positive. Complete duodenojejunal(DJ) junction transection was found at laparotomy, and end-to-end repair was done. However, patient was re-explored in view of biliary peritonitis on post-operative day3, and anastomotic leak was found with sloughing of duodenal end. Resection of non-viable segments was done followed by side-to-side anastomosis. Unfortunately, the anastomosis leaked again, this time due to a post-anastomotic kink, diagnosed on dye study. Due to hostile abdomen, the patient was planned for supportive care, with plan of build-up and delayed definitive surgery. Percutaneous transheptic biliary drainage (PTBD) and STSG were required in the course as well. Nutrition: In intensive care unit (ICU), major goals of nutritional therapy were to improve wound healing, optimize nutrition, minimize enteral feed associated complications, reduce biliary fistula output, and prepare the patient for definitive surgeries. Feeding jejunostomy (FJ) was started from day 4 at the rate of 30ml/h along with total parenteral nutrition (TPN) and intra-venous (IV) micronutrients support. Due to high bile output, bile refeed started from day 13.After 23 days of ICU stay, patient was transferred to general ward with body mass index (BMI)<11kg/m2 and serum albumin –1.5gm%. Patient was received in the ward in catabolic phase with high risk of refeeding syndrome. Patient was kept on FJ bolus feed at the rate of 30–50 ml/h. After 3–4 days, while maintaining patient diet book log it was observed that patient use to refuse feed at night and started becoming less responsive with every passing day. After few minutes of conversation with the patient for a couple of days, she complained about enteral feed discharge in urine, mild pain and sign of dumping syndrome. Dye study was done, which ruled out any enterovesical fistula and conservative management were planned. At this time, decision was taken for continuous slow rate feeding through commercial feeding pump at the rate of 2–3ml/min. Drastic improvement was observed from the second day in gastro-intestinal symptoms and general condition of the patient. Nutritional composition of feed, TPN and diet ranged between 800 and 2100 kcal and 50–95 g protein. After STSG, TPN was stopped. Periodic diet counselling was given to improve oral intake. At the time of discharge, serum albumin level was 2.1g%, weight – 38.6, BMI – 15.19 kg/m2. Patient got discharge on an oral diet. Conclusion: Successful management of post-traumatic proximal high output fistulae is a challenging task, due to impaired nutrient absorption and enteral feed associated complications. Strategic- and goal-based nutrition support can salvage such critically ill patients, as demonstrated in the present case.

Keywords: nutritional monitoring, nutritional support, duodenal fistula, abdominal trauma

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Authors: André Python

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To this day, terrorism persists as a worldwide threat, exemplified by the recent deadly attacks in January 2015 in Paris and the ongoing massacres perpetrated by ISIS in Iraq and Syria. In response to this threat, states deploy various counterterrorism measures, the cost of which could be reduced through effective preventive measures. In order to increase the efficiency of preventive measures, policy-makers may benefit from accurate predictive models that are able to capture the complex spatial dynamics of terrorism occurring at a local scale. Despite empirical research carried out at country-level that has confirmed theories explaining the diffusion processes of terrorism across space and time, scholars have failed to assess diffusion’s theories on a local scale. Moreover, since scholars have not made the most of recent statistical modelling approaches, they have been unable to build up predictive models accurate in both space and time. In an effort to address these shortcomings, this research suggests a novel approach to systematically assess the theories of terrorism’s diffusion on a local scale and provide a predictive model of the local spatial dynamics of terrorism worldwide. With a focus on the lethal terrorist events that occurred after 9/11, this paper addresses the following question: why and how does lethal terrorism diffuse in space and time? Based on geolocalised data on worldwide terrorist attacks and covariates gathered from 2002 to 2013, a binomial spatio-temporal point process is used to model the probability of terrorist attacks on a sphere (the world), the surface of which is discretised in the form of Delaunay triangles and refined in areas of specific interest. Within a Bayesian framework, the model is fitted through an integrated nested Laplace approximation - a recent fitting approach that computes fast and accurate estimates of posterior marginals. Hence, for each location in the world, the model provides a probability of encountering a lethal terrorist attack and measures of volatility, which inform on the model’s predictability. Diffusion processes are visualised through interactive maps that highlight space-time variations in the probability and volatility of encountering a lethal attack from 2002 to 2013. Based on the previous twelve years of observation, the location and lethality of terrorist events in 2014 are statistically accurately predicted. Throughout the global scope of this research, local diffusion processes such as escalation and relocation are systematically examined: the former process describes an expansion from high concentration areas of lethal terrorist events (hotspots) to neighbouring areas, while the latter is characterised by changes in the location of hotspots. By controlling for the effect of geographical, economical and demographic variables, the results of the model suggest that the diffusion processes of lethal terrorism are jointly driven by contagious and non-contagious factors that operate on a local scale – as predicted by theories of diffusion. Moreover, by providing a quantitative measure of predictability, the model prevents policy-makers from making decisions based on highly uncertain predictions. Ultimately, this research may provide important complementary tools to enhance the efficiency of policies that aim to prevent and combat terrorism.

Keywords: diffusion process, terrorism, spatial dynamics, spatio-temporal modeling

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Authors: Kamaljeet Kaur, Vinod Kumari, Jatesh Kathpalia, Bas Kaur

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A gender bias towards girl child is pervasive across the world. It is seen in all the strata of the society and manifests in various forms. However nature and extent of these inequalities are not uniform. Generally these inequalities are more prevalent in patriarchal society. Despite emerging and increasing opportunities for women, there are still inequalities between men and women in each and every sphere like education, health, economy, polity and social sphere. Patriarchal ideology as a cultural norm enforces gender construction which is oriented toward hierarchical relations between the sexes and neglect of women in Indian society. Discrimination to girls may also vary by their age and be restricted to the birth order and sex composition of her elder surviving siblings. The present study was conducted to know the gender discrimination among rural children in India. The respondents were selected from three generations as per AICRP age group viz, 18-30 years (3rd generation), 31-60 years (2nd generation) and above 60 years (1st generation). A total sample size was 600 respondents from different villages of two districts of Haryana state comprising of half males and half females. Data were collected using personal interview schedule and analysed by SPSS software. Among the total births 46.35 per cent were girl child and 53.64 % were male child. Dropout rate was more in female children as compared to male children i.e. near about one third (31.09%) female children dropped school followed by 21.17 % male children. It was quite surprising that near about two-third (61.16%) female children and more than half (59.22%) of the male children dropped school. Cooking was mainly performed by adult female with overall mean scores 2.0 and ranked first which was followed by female child (1.7 mean scores) clearly indicating that cooking was the activity performed mainly by females while activity related to purchase of fruits and vegetable, cereals and pulses was mainly done by adult male. First preference was given to male child for serving of costly and special food. Regarding professional aspiration of children of the respondents’ families, it was observed that 20.10% of the male children wanted to become engineer, whereas only 3.89 % female children wanted to become engineer. Ratio of male children was high in both generations irrespective of the districts. School dropouts were more in case of female in both the 1st and 2 nd generations. The main reasons of school dropout were lack of interest, lack of resources and early marriage in both the generations. Female enrolment was more in faculty of arts, whereas in case of male percentage it was more in faculty of non-medical and medical which showed that female children were getting traditional type of education. It is suggested to provide equal opportunities to girls and boys in home as well as outside the home for smooth functioning of society.

Keywords: gender biasness, male child, female child, education, home

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Authors: Raed Fawzi Mohammed Ameen, Haider I. Alyasari, Maryam Altaweel

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Due to rapid urbanization, developing countries faced significant urban challenges that accompanied the population growth such as the inability to provide adequate housing; sustain human and community's health and wellbeing; ensure the safety in urban areas; the prevalence corruption; lack of jobs; and a shortage of investment. The destruction, degradation, and lack of planning are acute in countries such as Iraq that have suffered for more than four decades because of war and international sanctions, resulting in severe damages to the ecology sector, social utilities, housing, infrastructure, as well as the disruption of the economic sector. Many of significant urban development, housing, and regeneration projects are currently underway in different regions in Iraq, labelled as a means to reform the environmental, social, and economic sectors. However, most often with absence of public participation. Hence, there is an urgent need for understanding public perception, especially of urban socio-economic challenges, which represents a crucial concern for many planners, designers, and policy-makers in order to develop effective policies in addition to increasing their participation. The aim of this study is to investigate stakeholder perceptions of the socio-economic challenges of urban development and their priorities in the all Iraqi provinces. A nationwide questionnaire has been conducted (N = 643) across Iraq, using 19- item structured questionnaire where the stakeholder’s perspectives were collected on a 5-point Likert-type scale. The indicators were identified through deep investigation in previous studies. Principal component analysis (PCA) and statistical tests were utilized to the collected responses in order to investigate the linkage between the perceptions of socio- economic challenges and demographic factors. A high value of internal consistency and reliability of the instrument has been achieved (Cronbach’s alpha= 0.867). Five principal components have been identified, namely: economic, cultural aspects, design context, employment, security and housing demands. The item ‘safety of public places' was ranked as the most important, followed by the items 'minimize unplanned housing', and ‘provision of affordable housing’, respectively. Promote high-rise housing from the housing demands group, was ranked the lowest component between all indicators. 'Using sustainable local materials in construction' item had the second lowest mean score. The results also illustrate a link between deficiencies in the social and economic infrastructure because of the destruction and degradation caused by political instability in Iraq in the last few decades.

Keywords: public participation in development, socio-economic challenges, urban development, urban sustainability

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Authors: Chris Neale, Jenny Roe, Peter Aspinall, Sara Tilley, Steve Cinderby, Panos Mavros, Richard Coyne, Neil Thin, Catharine Ward Thompson

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This research directly assesses older people’s neural activation in response to walking through a changing urban environment, as measured by electroencephalography (EEG). As the global urban population is predicted to grow, there is a need to understand the role that the urban environment may play on the health of its older inhabitants. There is a large body of evidence suggesting green space has a beneficial restorative effect, but this effect remains largely understudied in both older people and by using a neuroimaging assessment. For this study, participants aged 65 years and over were required to walk between a busy urban built environment and a green urban environment, in a counterbalanced design, wearing an Emotiv EEG headset to record real-time neural responses to place. Here we report on the outputs for these responses derived from both the proprietary Affectiv Suite software, which creates emotional parameters with a real time value assigned to them, as well as the raw EEG output focusing on alpha and beta changes, associated with changes in relaxation and attention respectively. Each walk lasted around fifteen minutes and was undertaken at the natural walking pace of the participant. The two walking environments were compared using a form of high dimensional correlated component regression (CCR) on difference data between the urban busy and urban green spaces. For the Emotiv parameters, results showed that levels of ‘engagement’ increased in the urban green space (with a subsequent decrease in the urban busy built space) whereas levels of ‘excitement’ increased in the urban busy environment (with a subsequent decrease in the urban green space). In the raw data, low beta (13 – 19 Hz) increased in the urban busy space with a subsequent decrease shown in the green space, similar to the pattern shown with the ‘excitement’ result. Alpha activity (9 – 13 Hz) shows a correlation with low beta, but not with dependent change in the regression model. This suggests that alpha is acting as a suppressor variable. These results suggest that there are neural signatures associated with the experience of urban spaces which may reflect the age of the cohort or the spatiality of the settings themselves. These are shown both in the outputs of the proprietary software as well as the raw EEG output. Built busy urban spaces appear to induce neural activity associated with vigilance and low level stress, while this effect is ameliorated in the urban green space, potentially suggesting a beneficial effect on attentional capacity in urban green space in this participant group. The interaction between low beta and alpha requires further investigation, in particular the role of alpha in this relationship.

Keywords: ageing, EEG, green space, urban space

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Authors: Sandra Biewers Grimm

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International studies such as Pisa have shown an increasing social inequality in the education system, which is determined in particular by social origin and migration status. This is especially the case in the Luxembourg school system, which creates challenges for many young people due to the multilingualism in the country. While the international and also the national debate on education in the immediate aftermath of the publications of the Pisa results mainly focused on the further development of school-based learning venues and formal educational processes, it initially remained largely unclear what role exactly out-of-school learning venues and non-formal and informal learning processes could play in this further development. This has changed in the meantime. Both in the political discourses and in the scientific disciplines, those voices have become louder that draw attention to the important educational function and the enormous educational potential of out-of-school learning places as a response to the crisis of the formal education system and more than this. Youth work as an actor and approach of non-formal education is particularly in demand here. Due to its principles of self-education, participation and openness, it is considered to have a special potential in supporting the acquisition of important key competencies. In this context, the study "Educational experiences in non-formal settings" at CCY takes a differentiated look behind the scenes of education-oriented youth work and describes on the basis of empirical data what and how young people learn in youth centers and which significance they attach to these educational experiences for their subjective life situation. In this sense, the aim of the study is to reconstruct the subjective educational experiences of young people in Open Youth Work as well as to explore the value that these experiences have for young people. In doing so, it enables scientifically founded conclusions about the educational potential of youth work from the user's perspective. Initially, the study focuses on defining the concept of education in the context of non-formal education and thus sets a theoretical framework for the empirical analysis. This socio-educational term of education differs from the relevant conception of education in curricular, formal education as the acquisition of knowledge. It also differs from the operationalization of education as competence, or the differentiation into cultural, social and personal or into factual, social or methodological competence, which is often used in the European context and which has long been interpreted as a "social science reading of the question of education" (XX). Now the aim is to define a "broader" concept of education that goes beyond the normative and educational policy dimensions of a "non-formal education" and includes the classical socio-educational dimensions. Furthermore, the study works with different methods of empirical social research: In addition to ethnographic observation and an online survey, group discussions were conducted with the young people. The presentation gives an insight into the context, the methodology and the results of this study.

Keywords: non-formal education, youth research, qualitative research, educational theory

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Authors: Jannis Kountouras, Nikolaos Kapetanakis, Stergios A. Polyzos, Apostolis Papaeftymiou, Panagiotis Katsinelos, Ioannis Venizelos, Christina Nikolaidou, Christos Zavos, Iordanis Romiopoulos, Elena Tsiaousi, Evangelos Kazakos, Michael Doulberis

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Background & Aims: Helicobacter pylori infection (Hp-I) has been recognized as a substantial risk agent involved in gastrointestinal (GI) tract oncogenesis by stimulating cancer stem cells (CSCs), oncogenes, immune surveillance processes, and triggering GI microbiota dysbiosis. We aimed to investigate the possible involvement of active Hp-I in the sequence: chronic inflammation–adenoma–colorectal cancer (CRC) development. Methods: Four pillars were investigated: (i) endoscopic and conventional histological examinations of patients with CRC, colorectal adenomas (CRA) versus controls to detect the presence of active Hp-I; (ii) immunohistochemical determination of the presence of Hp; expression of CD44, an indicator of CSCs and/or bone marrow-derived stem cells (BMDSCs); expressions of oncogene Ki67 and anti-apoptotic Bcl-2 protein; (iii) expression of CD45, indicator of immune surveillance locally (assessing mainly T and B lymphocytes locally); and (iv) correlation of the studied parameters with the presence or absence of Hp-I. Results: Among 50 patients with CRC, 25 with CRA, and 10 controls, a significantly higher presence of Hp-I in the CRA (68%) and CRC group (84%) were found compared with controls (30%). The presence of Hp-I with accompanying immunohistochemical expression of CD44 in biopsy specimens was revealed in a high proportion of patients with CRA associated with moderate/severe dysplasia (88%) and CRC patients with moderate/severe degree of malignancy (91%). Comparable results were also obtained for Ki67, Bcl-2, and CD45 immunohistochemical expressions. Concluding Remarks: Hp-I seems to be involved in the sequence: CRA – dysplasia – CRC, similarly to the upper GI tract oncogenesis, by several pathways such as the following: Beyond Hp-I associated insulin resistance, the major underlying mechanism responsible for the metabolic syndrome (MetS) that increase the risk of colorectal neoplasms, as implied by other Hp-I related MetS pathologies, such as non-alcoholic fatty liver disease and upper GI cancer, the disturbance of the normal GI microbiota (i.e., dysbiosis) and the formation of an irritative biofilm could contribute to a perpetual inflammatory upper GIT and colon mucosal damage, stimulating CSCs or recruiting BMDSCs and affecting oncogenes and immune surveillance processes. Further large-scale relative studies with a pathophysiological perspective are necessary to demonstrate in-depth this relationship.

Keywords: Helicobacter pylori, colorectal cancer, colorectal adenomas, gastrointestinal oncogenesis

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Authors: Fiona Whittington-Walsh

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Including All Citizens Pathway (IACP) is addressing the systems wide discrimination that students with disabilities experience throughout the education system. IACP offers a wide, institutional support structure so that all students, including students with intellectual/developmental disabilities, are included and can succeed. The entire process from admissions, course selection, course instruction, graduation is designed to address systemic discrimination while supporting learners and faculty. The inclusive and accessible pedagogical model that is the foundation of IACP opens the doors of post-secondary education by making existing academic courses environments where all students can participate and succeed. IACP is about transforming teaching, not modifying, or adapting the curriculum or essential knowledge and skill sets that are required learning outcomes. Universal Design for Learning (UDL) principles are applied to instructional teaching strategies such as lectures, presentations, and assessment tools. Created in 2016 as a research pilot, IACP is one of the first fully inclusive for credit post-secondary options available. The pilot received numerous external and internal grants to support its initiative to investigate and assess the teaching strategies and techniques that support student learning of essential knowledge and skill sets. IACP pilot goals included: (1) provide a successful pilot as a model of inclusive and accessible pedagogy; (2) create a teacher’s guide to assist other instructors in transforming their teaching to reach a wide range of learners; (3) identify policy barriers located within the educational system; and (4) provide leadership and encouraging innovative and inclusive pedagogical practices. The pilot was a success and in 2020 the first cohort of students graduated with an exit credential that pre-exists IACP and consists of ten academic courses. The University has committed to continue IACP and has developed a sustainable model. Each new academic year a new cohort of IACP students starts their post-secondary educational journey, while two additional instructors are mentored with the pedagogy. The pedagogical foundation of IACP has far-reaching potential including, but not limited to, programs that offer services for international students whose first language is not English as well as influencing pedagogical reform in secondary and post-secondary education. IACP also supports universities in satisfying educational standards that are or will be included in accessibility/disability legislation. This session will present information about IACP, share examples of systems transformation, hear from students and instructors, and provide participatory experiential activities that demonstrate the transformative techniques. We will be drawing from the experiences of a recent course that explored research documenting the lived experiences of students with disabilities in post-secondary institutes in B.C (Whittington-Walsh). Students created theatrical scenes out of the data and presented it using Forum Theatre method. Forum Theatre was used to create conversations, challenge stereotypes, and build connections between ableism, disability justice, Indigeneity, and social policy.

Keywords: disability justice, inclusive education, pedagogical transformation, systems transformation

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Authors: Kadhim Alabady

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Background: Autism poses a particularly large public health challenge and an inspiring lifelong challenge for many families; it is a lifelong challenge of a different kind. Purpose: Therefore, it is important to understand what the key challenges are and how to improve the lives of children who are affected with autism in Dubai. Method: In order to carry out this research we have used a qualitative methodology. We performed structured in–depth interviews and focus groups with mental health professionals working at: Al Jalila hospital (AJH), Dubai Autism Centre (DAC), Dubai Rehabilitation Centre for Disabilities, Latifa hospital, Private Sector Healthcare (PSH). In addition to that, we conducted quantitative approach to estimate ASD prevalence or incidence data due to lack of registry. ASD estimates are based on research from national and international documents. This approach was applied to increase the validity of the findings by using a variety of data collection techniques in order to explore issues that might not be highlighted through one method alone. Key findings: Autism is the most common of the Pervasive Developmental Disorders. Dubai Autism Center estimates it affects 1 in 146 births (0.68%). If we apply these estimates to the total number of births in Dubai for 2014, it is predicted there would be approximately 199 children (of which 58 were Nationals and 141 were Non–Nationals) suffering from autism at some stage. 16.4% of children (through their families) seek help for ASD assessment between the age group 6–18+. It is critical to understand and address factors for seeking late–stage diagnosis, as ASD can be diagnosed much earlier and how many of these later presenters are actually diagnosed with ASD. Autism spectrum disorder (ASD) is a public health concern in Dubai. Families do not consult GPs for early diagnosis for a variety of reasons including cultural reasons. Recommendations: Effective school health strategies is needed and implemented by nurses who are qualified and experienced in identifying children with ASD. There is a need for the DAC to identify and develop a closer link with neurologists specializing in Autism, to work alongside and for referrals. Autism can be attributed to many factors, some of those are neurological. Currently, when families need their child to see a neurologist they have to go independently and search through the many that are available in Dubai and who are not necessarily specialists in Autism. Training of GP’s to aid early diagnosis of Autism and increase awareness. Since not all GP’s are trained to make such assessments increasing awareness about where to send families for a complete assessment and the necessary support. There is an urgent need for an adult autism center for when the children leave the safe environment of the school at 18 years. These individuals require a day center or suitable job training/placements where appropriate. There is a need for further studies to cover the needs of people with an Autism Spectrum Disorder (ASD).

Keywords: autism spectrum disorder, autism, pervasive developmental disorders, incidence

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Authors: Emily Moore, Dora Amos, Tracy Ellimah, Natasha Parrott

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Postoperative haematoma is a well-recognised complication of thyroid surgery with an incidence of 1-5%. Haematoma formation causes progressive airway obstruction, necessitating emergency bedside haematoma evacuation in up to ¼ of patients. ENT UK, BAETS and DAS have developed consensus guidelines to improve perioperative care, recommending that all healthcare staff interacting with patients undergoing thyroid surgery should be trained in managing post-thyroidectomy haematoma. The aim was to assess the effectiveness of a hybrid simulation model in improving clinician’s confidence in dealing with this surgical emergency. A hybrid simulation was designed, consisting of a standardised patient wearing a part-task trainer to mimic a post-thyroidectomy haematoma in a real patient. The part-task trainer was an adapted C-spine collar with layers of silicone representing the skin and strap muscles and thickened jelly representing the haematoma. Both the skin and strap muscle layers had to be opened in order to evacuate the haematoma. Boxes have been implemented into the appropriate post operative areas (recovery and surgical wards), which contain a printed algorithm designed to assist in remembering a sequence of steps for haematoma evacuation using the ‘SCOOP’ method (skin exposure, cut sutures, open skin, open muscles, pack wound) along with all the necessary equipment to open the front of the neck. Small-group teaching sessions were delivered by ENT and anaesthetic trainees to members of the multidisciplinary team normally involved in perioperative patient care, which included ENT surgeons, anaesthetists, recovery nurses, HCAs and ODPs. The DESATS acronym of signs and symptoms to recognise (difficulty swallowing, EWS score, swelling, anxiety, tachycardia, stridor) was highlighted. Then participants took part in the hybrid simulation in order to practice this ‘SCOOP’ method of haematoma evacuation. Participants were surveyed using a Likert scale to assess their level of confidence pre- and post teaching session. 30 clinicians took part. Confidence (agreed/strongly agreed) in recognition of post thyroidectomy haematoma improved from 58.6% to 96.5%. Confidence in management improved from 27.5% to 89.7%. All participants successfully decompressed the haematoma. All participants agreed/strongly agreed, that the sessions were useful for their learning. Multidisciplinary team simulation teaching is effective at significantly improving confidence in both the recognition and management of postoperative haematoma. Hybrid simulation sessions are useful and should be incorporated into training for clinicians.

Keywords: thyroid surgery, haematoma, teaching, hybrid simulation

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Authors: Laura Butabayeva, Svetlana Ismagulova, Gulbarshin Nogaibayeva, Maiya Temirbayeva, Aidana Zhussip

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Over the years of independence, Kazakhstan has not only ratified international documents regulating the rights of children to Inclusive education, but also developed its own inclusive educational policy. Along with this, the state pays particular attention to high school students' preparedness for professional self-determination. However, a number of problematic issues in this field have been revealed, such as the lack of systemic mechanisms coordinating stakeholders’ actions in preparing schoolchildren for a conscious choice of in-demand profession, meeting their individual capabilities and special educational needs (SEN). The analysis of the state’s current situation indicates school graduates’ adaptation to the labor market does not meet existing demands of the society. According to the Ministry of Labor and Social Protection of the Population of the Republic of Kazakhstan, about 70 % of Kazakhstani school graduates find themselves difficult to choose a profession, 87 % of schoolchildren make their career choice under the influence of parents and school teachers, 90 % of schoolchildren and their parents have no idea about the most popular professions on the market. The results of the study conducted by KorlanSyzdykova in 2016 indicated the urgent need of Kazakhstani school graduates in obtaining extensive information about in- demand professions and receiving professional assistance in choosing a profession in accordance with their individual skills, abilities, and preferences. The results of the survey, conducted by Information and Analytical Center among heads of colleges in 2020, showed that despite significant steps in creating conditions for students with SEN, they face challenges in studying because of poor career guidance provided to them in schools. The results of the study, conducted by the Center for Inclusive Education of the National Academy of Education named after Y. Altynsarin in the state’s general education schools in 2021, demonstrated the lack of career guidance, pedagogical and psychological support for children with SEN. To investigate these issues, the further study was conducted to examine the state of students’ career guidance and socialization, taking into account their SEN. The hypothesis of this study proposed that to prepare school graduates for a conscious career choice, school teachers and specialists need to develop their competencies in early identification of students' interests, inclinations, SEN and ensure necessary support for them. The state’s 5 regions were involved in the study according to the geographical location. The triangulation approach was utilized to ensure the credibility and validity of research findings, including both theoretical (analysis of existing statistical data, legal documents, results of previous research) and empirical (school survey for students, interviews with parents, teachers, representatives of school administration) methods. The data were analyzed independently and compared to each other. The survey included questions related to provision of pedagogical support for school students in making their career choice. Ethical principles were observed in the process of developing the methodology, collecting, analyzing the data and distributing the results. Based on the results, methodological recommendations on students’ career guidance for school teachers and specialists were developed, taking into account the former’s individual capabilities and SEN.

Keywords: career guidance, children with special educational needs, inclusive education, Kazakhstan

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Authors: Angela T. H. Kwan, Wenjun Liang, Jack Wellington, Mohammad Mofatteh, Thanh N. Nguyen, Pingzhong Fu, Juanmei Chen, Zile Yan, Weijuan Wu, Yongting Zhou, Shuiquan Yang, Sijie Zhou, Yimin Chen

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Background: Endovascular Therapy (EVT)—in the form of mechanical thrombectomy—following intravenous thrombolysis is the standard gold treatment for patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). It is well established that an ASPECTS ≥ 7 is associated with an increased likelihood of positive post-EVT outcomes, as compared to an ASPECTS < 7. There is also prognostic utility in coupling posterior circulation ASPECTS (pc-ASPECTS) with magnetic resonance imaging for evaluating the post-EVT functional outcome. However, the value of pc-ASPECTS applied to CT must be explored further to determine its usefulness in predicting functional outcomes following EVT. Objective: In this study, we aimed to determine whether pc-ASPECTS on CT can predict post-EVT functional outcomes among patients with AIS due to LVO. Methods: A total of 247 consecutive patients aged 18 and over receiving EVT for LVO-related AIS were recruited into a prospective database. The data were retrospectively analyzed between March 2019 to February 2022 from two comprehensive tertiary care stroke centers: Foshan Sanshui District People’s Hospital and First People's Hospital of Foshan in China. Patient parameters included EVT within 24hrs of symptom onset, premorbid modified Rankin Scale (mRS) ≤ 2, presence of distal and terminal cerebral blood vessel occlusion, and subsequent 24–72-hour post-stroke onset CT scan. Univariate comparisons were performed using the Fisher exact test or χ2 test for categorical variables and the Mann–Whitney U test for continuous variables. A p-value of ≤ 0.05 was statistically significant. Results: A total of 247 patients met the inclusion criteria; however, 3 were excluded due to the absence of post-CTs and 8 for pre-EVT ASPECTS < 7. Overall, 236 individuals were examined: 196 anterior circulation ischemic strokes and 40 posterior strokes of basilar artery occlusion. We found that both baseline post- and pc-ASPECTS ≥ 7 serve as strong positive markers of favorable outcomes at 90 days post-EVT. Moreover, lower rates of inpatient mortality/hospice discharge, 90-day mortality, and 90-day poor outcome were observed. Moreover, patients in the post-ASPECTS ≥ 7 anterior circulation group had shorter door-to-recanalization time (DRT), puncture-to-recanalization time (PRT), and last known normal-to-puncture-time (LKNPT). Conclusion: Patients of anterior and posterior circulation ischemic strokes with baseline post- and pc-ASPECTS ≥ 7 may benefit from EVT.

Keywords: endovascular therapy, thrombectomy, large vessel occlusion, cerebral ischemic stroke, ASPECTS

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Authors: Archil Undilashvili, Ketevan Stvilia, Dustin Gilbreath, Giorgi Dzneladze, Gordon Charchward

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Introduction: In recent years, diverse types of wheelchairs, both local production and imported, have been made available on the Georgian market for wheelchair users. Some types of wheelchairs are sold together with a service package, while the others, including the State Program, Supported locally-produced ones, don’t provide adjustment and maintenance service packages to users. Within the USAID Physical Rehabilitation Project in Georgia, a study was conducted to assess the impact of the wheelchair service provision in line with the WHO guidelines on the health and overall satisfaction of wheelchair users in Georgia. Methodology: A cross-sectional survey was conducted in May 2021. A structured questionnaire was used for telephone interviews that, along with socio-demographic characteristics, included questions for assessment of accessibility, availability, timeliness, cost and quality of wheelchair services received. Out of 1060 individuals listed in the census of wheelchair users, 752 were available for interview, with an actual response rate of 73.4%. 552 wheelchair users (31%) or their caregivers (69%) agreed to participate in the survey. In addition to using descriptive statistics, the study used multivariate matching of wheelchair users who received wheelchair services and who did not (control group). In addition, to evaluate satisfaction with service provision, respondents were asked to assess services. Findings: The majority (67%) of wheelchair users included in the survey were male. The average age of participants was 43. The three most frequently named reasons for using a wheelchair were cerebral palsy (29%), followed by stroke (18%), and amputation (12%). Users have had their current chair for four years on average. Overall, 60% of respondents reported that they were assessed before providing a wheelchair, but only half of them reported that their preferences and needs were considered. Only 13% of respondents had services in line with WHO guidelines and only 22% of wheelchair users had training when they received their current chair. 16% of participants said they had follow-up services, and 41% received adjustment services after receiving the chair. A slight majority (56%) of participants were satisfied with the quality of service provision and the service provision overall. Similarly, 55% were satisfied with the accessibility of service provision. A slightly larger majority (61%) were satisfied with the timeliness of service provision. The matching analysis suggests that users that received services in line with WHO guidelines were more satisfied with their chairs (the difference 17 point/0-100 scale) and they were four percentage points less likely to have health problems attributed to the chair. The regression analysis provides a similar finding of a 21 point increase in satisfaction attributable to services. Conclusion: The provision of wheelchair services in line with WHO guidelines and with follow-up services is likely to have a positive impact on the daily lives of wheelchair users in Georgia. Wheelchair services should be institutionalized as a standard component of wheelchair provision in Georgia.

Keywords: physical rehabilitation, wheelchair users, persons with disabilities, wheelchair production

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Authors: Dembel Bonta Gebeyehu

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In the study area, the impacts of deforestation for environmental degradation and livelihood of farmers manifest in different faces. They are more vulnerable as they depend on rain-fed agriculture and immediate natural forests. On the other hand, after planting seedling, waste disposal and management system of the plastic cover is poorly practiced and administered in the country in general and in the study area in particular. If this situation continues, the plastic waste would also accentuate land degradation. Besides, there is the absence of empirical studies conducted comprehensively on the research under study the case. The results of the study could suffice to inform any intervention schemes or to contribute to the existing knowledge on these issues. The study employed a qualitative approach based on intensive fieldwork data collected via various tools namely open-ended interviews, focus group discussion, key-informant interview and non-participant observation. The collected data was duly transcribed and latter categorized into different labels based on pre-determined themes to make further analysis. The major causes of deforestation were the expansion of agricultural land, poor administration, population growth, and the absence of conservation methods. The farmers are vulnerable to soil erosion and soil infertility culminating in low agricultural production; loss of grazing land and decline of livestock production; climate change; and deterioration of social capital. Their adaptation and coping strategies include natural conservation measures, diversification of income sources, safety-net program, and migration. Due to participatory natural resource conservation measures, soil erosion has been decreased and protected, indigenous woodlands started to regenerate. These brought farmers’ attitudinal change. The existing forestation program has many flaws. Especially, after planting seedlings, there is no mechanism for the plastic waste disposal and management. It was also found out organizational challenges among the mandated offices In the studied area, deforestation is aggravated by a number of factors, which made the farmers vulnerable. The current forestation programs are not well-planned, implemented, and coordinated. Sustainable and efficient seedling plastic cover collection and reuse methods should be devised. This is possible through creating awareness, organizing micro and small enterprises to reuse, and generate income from the collected plastic etc.

Keywords: land-cover and land-dynamics, vulnerability, adaptation strategy, mitigation strategies, sustainable plastic waste management

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Authors: Abiola O. Temitayo-Oboh, Olugbenga L. Abodunrin, Wasiu O. Adebimpe, Micheal C. Asuzu

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Introduction: Many women who are sexually active would prefer to avoid becoming pregnant but are not using any method of contraception. These women are considered to have an unmet need for contraception. In an ideal situation, all women who want to space or limit their births and are exposed to the risk of conception would use some kind of conception; in practice, however, some women fail to use contraception which put them at risk of having mistimed or unwanted births, induced abortion, or maternal death. This study, therefore, aimed to assess the determinants of unmet need for contraception among currently married women in rural and urban communities of Osun State, South-West Nigeria. Methods: This was an analytical cross-sectional comparative study, which was carried out among currently married women. Three hundred and twenty respondents each were selected for the rural and urban groups from four Local Government Areas using multi-stage sampling technique. Data were collected using a pre-tested semi-structured interviewer-administered questionnaire and focus group discussion (FGD) guide; data analysis was done with Statistical Package for Social Sciences (SPSS) version 17.0 and detailed content analysis method respectively. Statistical analysis of the difference between proportions was done by the use of the Chi-square test and T-test was used to compare the means of the continuous variables. The study also utilized descriptive, bivariate and multivariate analytical techniques to examine the effect of some variables on unmet need. Level of statistical significance was set at p-value < 0.05 for all values. Results: Two hundred and ninety-six (92.5%) of the rural and 306 (95.6%) of the urban study population had heard of contraception, 365 (57.0 %) of the total respondents had good knowledge [162 (50.6 %) for rural respondents and 203 (63.4 %) for urban respondents]. This difference was statistically significant (p < 0.001). Five hundred and twenty-one (81.4%) respondents had a positive attitude towards contraception [243 (75.9%) in the rural and 278 (86.9%) in the urban area], and the difference was also statistically significant (p < 0.001). Only 47 (14.7%) and 59 (18.4%) of rural and urban women were current contraceptive users respectively. The total unmet need for contraception among rural women was 138 (43.1%) of which 82 (25.6%) was for spacing and 56 (17.5%), for limiting. While the total unmet need for contraception among urban women was 145 (45.3%) of which 96 (30.0%) was for spacing and 49 (15.3%) for limiting. Number of living children, knowledge of contraceptive methods, discussion with health workers about family planning, couples discussion about family planning and availability of family planning services were found to be predictors of women’s unmet need for contraception (p < 0.05). Conclusion: It is, therefore, recommended that there is need to intensify reproductive health education in bridging the knowledge gap, improving attitude and modifying practices regarding use of contraception in Nigeria. Hence, this will help to enhance the utilization of family planning services among Nigerian women.

Keywords: contraception, married women, Nigeria, rural, urban, unmet need

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Authors: Honey Bryant, Elvina Chu

Abstract:

Stroke is the leading cause of disability in adults in Canada and directly related to depression, anxiety, and sleep disorders; with an estimated annual cost of $50 billion in health care. Strokes not only impact the individual but society as a whole. Current stroke rehabilitation does not include Music Therapy, although it has success in clinical research in the use of stroke rehabilitation. This study examines the use of neurologic music therapy (NMT) in conjunction with stroke rehabilitation to improve sleep quality, reduce stress levels, and promote neurogenesis. Existing research on NMT in stroke is limited, which means any conclusive information gathered during this study will be significant. My novel hypotheses are a.) stroke patients will become less depressed and less anxious with improved sleep following NMT. b.) NMT will reduce stress levels and promote neurogenesis in stroke patients admitted for rehabilitation. c.) Beneficial effects of NMT will be sustained at least short-term following treatment. Participants were recruited from the in-patient stroke rehabilitation program at Providence Care Hospital in Kingston, Ontario, Canada. All participants-maintained stroke rehabilitation treatment as normal. The study was spilt into two groups, the first being Passive Music Listening (PML) and the second Neurologic Music Therapy (NMT). Each group underwent 10 sessions of intensive music therapy lasting 45 minutes for 10 consecutive days, excluding weekends. Psychiatric Assessments, Epworth Sleepiness Scale (ESS), Hospital Anxiety & Depression Rating Scale (HADS), and Music Engagement Questionnaire (MusEQ), were completed, followed by a general feedback interview. Physiological markers of stress were measured through blood pressure measurements and heart rate variability. Serum collections reviewed neurogenesis via Brain-derived neurotrophic factor (BDNF) and stress markers of cortisol levels. As this study is still on-going, a formal analysis of data has not been fully completed, although trends are following our hypotheses. A decrease in sleepiness and anxiety is seen upon the first cohort of PML. Feedback interviews have indicated most participants subjectively felt more relaxed and thought PML was useful in their recovery. If the hypothesis is supported, larger external funding which will allow for greater investigation of the use of NMT in stroke rehabilitation. As we know, NMT is not covered under Ontario Health Insurance Plan (OHIP), so there is limited scientific data surrounding its uses as a clinical tool. This research will provide detailed findings of the treatment of neuropsychiatric aspects of stroke. Concurrently, a passive music listening study is being designed to further review the use of PML in rehabilitation as well.

Keywords: music therapy, psychotherapy, neurologic music therapy, passive music listening, neuropsychiatry, counselling, behavioural, stroke, stroke rehabilitation, rehabilitation, neuroscience

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Authors: Maria E. V. Amarante, Carolina L. Cerdeira, Julia V. Cortes, Fiorita G. L. Mundim

Abstract:

Basal cell carcinoma (BCC) is the most prevalent type of skin cancer in humans. It arises from the basal cells of the epidermis and cutaneous appendages. The role of sunlight exposure as a risk factor for BCC is very well defined due to its power to influence genetic mutations, in addition to having a suppressor effect on the skin immune system. Despite showing low metastasis and mortality rates, the tumor is locally infiltrative, aggressive, and destructive. Considering the high prevalence rate of this carcinoma and the importance of early detection, a retrospective study was carried out in order to correlate the clinical data available on BBC, characterize it epidemiologically, and thus enable effective prevention measures for the population. Data on the period from January 2015 to December 2019 were collected from the medical records of patients registered at one pathology service located in the southeast region of Brazil, known as SVO, which delivers skin biopsy results. The study was aimed at correlating the variables, sex, age, and subtypes found. Data analysis was performed using the chi-square test at a nominal significance level of 5% in order to verify the independence between the variables of interest. Fisher's exact test was applied in cases where the absolute frequency in the cells of the contingency table was less than or equal to five. The statistical analysis was performed using the R® software. Ninety-three basal cell carcinoma were analyzed, and its frequency in the 31-to 45-year-old age group was 5.8 times higher in men than in women, whereas, from 46 to 59 years, the frequency was found 2.4 times higher in women than in men. Between the ages of 46 to 59 years, it should be noted that the sclerodermiform subtype appears more than the solid one, with a difference of 7.26 percentage points. Reversely, the solid form appears more frequently in individuals aged 60 years or more, with a difference of 8.57 percentage points. Among women, the frequency of the solid subtype was 9.93 percentage points higher than the sclerodermiform frequency. In males, the same percentage difference is observed, but sclerodermiform is the most prevalent subtype. It is concluded in this study that, in general, there is a predominance of basal cell carcinoma in females and in individuals aged 60 years and over, which demonstrates the tendency of this tumor. However, when rarely found in younger individuals, the male gender prevailed. The most prevalent subtype was the solid one. It is worth mentioning that the sclerodermiform subtype, which is more aggressive, was seen more frequently in males and in the 46-to 59-year-old range.

Keywords: basal cell carcinoma, epidemiology, sclerodermiform basal cell carcinoma, skin cancer, solar radiation, solid basal cell carcinoma

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Authors: Kevin Potoczny, Katsuichiro Goda

Abstract:

The St. Lawrence lowlands extend from Ottawa to Quebec City and are known for large deposits of sensitive Leda clay. Leda clay deposits are responsible for many large landslides, such as the 1993 Lemieux and 2010 St. Jude (4 fatalities) landslides. Due to the large extent and sensitivity of Leda clay, regional hazard analysis for landslides is an important tool in risk management. A 2018 regional study by Farzam et al. on the susceptibility of Leda clay slopes to landslide hazard uses 1 arc second topographical data. A qualitative method known as Hazus is used to estimate susceptibility by checking for various criteria in a location and determine a susceptibility rating on a scale of 0 (no susceptibility) to 10 (very high susceptibility). These criteria are slope angle, geological group, soil wetness, and distance from waterbodies. Given the flat nature of St. Lawrence lowlands, the current assessment fails to capture local slopes, such as the St. Jude site. Additionally, the data did not allow one to analyze failure planes accurately. This study majorly improves the analysis performed by Farzam et al. in two aspects. First, regional assessment with high resolution data allows for identification of local locations that may have been previously identified as low susceptibility. This then provides the opportunity to conduct a more refined analysis on the failure plane of the slope. Slopes derived from 1 arc second data are relatively gentle (0-10 degrees) across the region; however, the 1- and 2-meter resolution 2022 HRDEM provided by NRCAN shows that short, steep slopes are present. At a regional level, 1 arc second data can underestimate the susceptibility of short, steep slopes, which can be dangerous as Leda clay landslides behave retrogressively and travel upwards into flatter terrain. At the location of the St. Jude landslide, slope differences are significant. 1 arc second data shows a maximum slope of 12.80 degrees and a mean slope of 4.72 degrees, while the HRDEM data shows a maximum slope of 56.67 degrees and a mean slope of 10.72 degrees. This equates to a difference of three susceptibility levels when the soil is dry and one susceptibility level when wet. The use of GIS software is used to create a regional susceptibility map across the St. Lawrence lowlands at 1- and 2-meter resolutions. Failure planes are necessary to differentiate between small and large landslides, which have so far been ignored in regional analysis. Leda clay failures can only retrogress as far as their failure planes, so the regional analysis must be able to transition smoothly into a more robust local analysis. It is expected that slopes within the region, once previously assessed at low susceptibility scores, contain local areas of high susceptibility. The goal is to create opportunities for local failure plane analysis to be undertaken, which has not been possible before. Due to the low resolution of previous regional analyses, any slope near a waterbody could be considered hazardous. However, high-resolution regional analysis would allow for more precise determination of hazard sites.

Keywords: hazus, high-resolution DEM, leda clay, regional analysis, susceptibility

Procedia PDF Downloads 78

Authors: Jacqueline P. Davies

Abstract:

Introduction: Student nurses must develop skills in observation, communication and reflection as well as public health knowledge from their first year of training. This paper will explain a method developed for students to collect their own findings about public health in urban areas. These areas are both rich in the history of old public health that informs the content of many traditional public health walks, but are also locations where new public health concerns about chronic disease are concentrated. The learning method explained in this paper enables students to collect their own data and write original work as first year students. Examples of their findings will be given. Methodology: In small groups, health care students are instructed to walk in neighbourhoods near to the hospitals they will soon attend as apprentice nurses. On their walks, they wander slowly, engage in conversations, and enter places open to the public. As they drift, they observe with all five senses in the real three dimensional world to collect data for their reflective accounts of old and new public health. They are encouraged to stop for refreshments and taste, as well as look, hear, smell, and touch while on their walk. They reflect as a group and later develop an individual reflective account in which they write up their deep reflections about what they observed on their walk. In preparation for their walk, they are encouraged to look at studies of quality of Life and other neighbourhood statistics as well as undertaking a risk assessment for their walk. Findings: Reflecting on their walks, students apply theoretical concepts around social determinants of health and health inequalities to develop their understanding of communities in the neighbourhoods visited. They write about the treasured historical architecture made of stone, bronze and marble which have outlived those who built them; but also how the streets are used now. The students develop their observations into thematic analyses such as: what we drink as illustrated by the empty coke can tossed into a now disused drinking fountain; the shift in home-life balance illustrated by streets where families once lived over the shop which are now walked by commuters weaving around each other as they talk on their mobile phones; and security on the street, with CCTV cameras placed at regular intervals, signs warning trespasses and barbed wire; but little evidence of local people watching the street. Conclusion: In evaluations of their first year, students have reported the health walk as one of their best experiences. The innovative approach was commended by the UK governing body of nurse education and it received a quality award from the nurse education funding body. This approach to education allows students to develop skills in the real world and write original work.

Keywords: education, innovation, nursing, urban

Procedia PDF Downloads 288