Search results for: poverty severity

Authors: A. Bentley, A. Prost, N. Daruwalla, D. Osrin

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Background: This study aims to investigate the relationship between experiences of violence against women in the family, and levels of self-esteem in women residing in informal settlement (slum) areas of Mumbai, India. The authors hypothesise that violence against women in Indian households extends beyond that of intimate partner violence (IPV), to include other members of the family and that experiences of violence are associated with lower levels of self-esteem. Methods: Experiences of violence were assessed through a cross-sectional survey of 598 women, including questions about specific acts of emotional, economic, physical and sexual violence across different time points, and the main perpetrator of each. Self-esteem was assessed using the Rosenberg self-esteem questionnaire. A global score for self-esteem was calculated and the relationship between violence in the past year and Rosenberg self-esteem score was assessed using multivariable linear regression models, adjusted for years of education completed, and clustering using robust standard errors. Results: 482 (81%) women consented to interview. On average, they were 28.5 years old, had completed 6 years of education and had been married 9.5 years. 88% were Muslim and 46% lived in joint families. 44% of women had experienced at least one act of violence in their lifetime (33% emotional, 22% economic, 24% physical, 12% sexual). Of the women who experienced violence after marriage, 70% cited a perpetrator other than the husband for at least one of the acts. 5% had low self-esteem (Rosenberg score < 15). For women who experienced emotional violence in the past year, the Rosenberg score was 2.6 points lower (p < 0.001). It was 1.2 points lower (p = 0.03) for women who experienced economic violence. For physical or sexual violence in the past year, no statistically significant relationship with Rosenberg score was seen. However, for a one-unit increase in the number of different acts of each type of violence experienced in the past year, a decrease in Rosenberg score was seen (-0.62 for emotional, -0.76 for economic, -0.53 for physical and -0.47 for sexual; p < 0.05 for all). Discussion: The high prevalence of violence experiences across the lifetime was likely due to the detailed assessment of violence and the inclusion of perpetrators within the family other than the husband. Experiences of emotional or economic violence in the past year were associated with lower Rosenberg scores and therefore lower self-esteem, but no relationship was seen between experiences of physical or sexual violence and Rosenberg score overall. For all types of violence in the past year, a greater number of different acts were associated with a decrease in Rosenberg score. Emotional violence showed the strongest relationship with self-esteem, but for all types of violence the more complex the pattern of perpetration with different methods used, the lower the levels of self-esteem. Due to the cross-sectional nature of the study causal directionality cannot be attributed. Further work to investigate the relationship between severity of violence and self-esteem and whether self-esteem mediates relationships between violence and poorer mental health would be beneficial.

Keywords: family violence, India, informal settlements, Rosenberg self-esteem scale, self-esteem, violence against women

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Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras

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Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.

Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine

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Authors: Okanlawon Simon Ayorinde, Odunjo Oluronke Omolola, Fadamiro Joseph Akinlabi, Adedibu Afolabi Adebgite

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A road is a path established over land, especially prepared way between places for the use of pedestrian, riders, and vehicles: a hard surface built for vehicles to travel on. The social, economic and health importance of roads in any community and nation cannot be underestimated. Roads provide access to properties and they also provide mobility which is ability to transport goods and services from one place to another. In the residential zones of many indigenous cities in Nigeria, roads are usually blocked for social ceremonies. Road blocked for ceremonies as used in this study are a temporary barrier across a road, used to stop or hinder traffic from passing through to the other side. Social ceremonies that could warrant road blockage include marriage, child naming, funeral, celebration of life’s achievement, birthday anniversary etc. These activities are likely to generate environmental hazards and their attendant risks. The assessment of these hazards and risks in residential zones of indigenous cities in Nigeria becomes imperative. The study is focused on Ogbomoso, Oyo State, Nigeria. The town has two local government councils namely Ogbomoso North and Ogbomoso South. Urban tracts that are easy to identify are political wards in the absence of land use segregation, houses numbering and street naming. The wards that had residential having a minimum of 60% of their land use components were surveyed and fifteen out of twenty wards identified in the town were surveyed. The study utilized primary data collected through questionnaire administration The three major road categories (Trunk A-Federal; Trunk B- State; Trunk C-Local) were identified and trunk C-Local roads were purposively selected being the concern of this study because they are the ones often blocked for social activities. The major stakeholders interviewed and the respective sampling methods are residents (random and systematic), social ceremony organizers (purposive), government officials (purposive) and road users namely commercial motorists and commercial motor cyclists (random and incidental). Data analysis was mainly descriptive. Two indices to measure respondents’ perception were developed. These are ‘Hazard Severity Index’ (HSI) and ‘Relative Awareness Index’ (RAI).Thereafter, policy implications and recommendations were provided.

Keywords: road, residential zones, indigenous cities, blocked, social ceremonies

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Authors: Kajal Attri

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Introduction: Transgender people are considered third gender in India, although they still face identification issues and alienated from society. Furthermore, they face several challenges, including discrimination in employment, resources, education, and property as a result, most transgender people make a living through begging at traffic lights, trains, and buses; attending auspicious occasions such as childbirth and weddings; and engaging in sex work, which includes both home-based and street-based sex work. During COVID-19, maintaining social distance exacerbates transgender people's circumstances and prevents them from accessing health care services, sexual reassignment surgery, identity-based resources, government security, and financial stability. Nonetheless, the pandemic raised unfavorable attitudes about transgender persons, such as unsupportive family members and trouble forming emotional relationships. This study focuses on how we missed transgender people during COVID-19 to provide better facilities to cope with this situation when they are already the most vulnerable segment of the society. Methodology: The research was conducted using secondary data from published publications and grey literature obtained from four databases: Pubmed, Psychinfo, Science direct, and Google scholar. The literature included total 25 articles that met the inclusion criteria for a review. Result and Discussion: Transgender people, who are considered the most vulnerable sector of society, have already faced several obstacles as a result of the outbreak. The analysis underscores the difficulties that transgender persons faced during COVID-19, such as, They had trouble accessing the government's social security programmes during the lockdown, which provide rations and pensions since they lack the necessary identifying cards. The impact of COVID-19 leaves transgender people at heightened risk of poverty and ill health because they exist on the margins of society, those livelihood base on sex work, begging, and participation on auspicious occasions. They had a significant risk of contracting SARS-CoV2 because they lived in congested areas or did not have permanent shelter, and they were predominantly infected with HIV, cancer, and other non-communicable illnesses. The pandemic raised unfavorable attitudes about transgender persons, such as unsupportive family members and trouble forming emotional relationships. Conclusion: The study comes forward with useful suggestions based on content analysis and information to reduce the existing woes of transgenders during any pandemic like COVID-19.

Keywords: COVID-19, transgender, lockdown, transwomen, stigmatization

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Authors: Marta Kaprzyk

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The cinema of Alejandro González Iñárritu hasn’t been subjected to a lot of detailed analysis yet, what makes it an exceptionally interesting research material. The purpose of this presentation is to discuss the significance of urban space in three films of this Mexican director, that forms Death Trilogy: ‘Amores Perros’ (2000), ‘21 Grams’ (2003) and ‘Babel’ (2006). The fact that in the aforementioned movies the urban space itself becomes an additional protagonist with its own identity, psychology and the ability to transform and affect other characters, in itself warrants for independent research and analysis. Independently, such mode of presenting urban space has another function; it enables the director to complement the rest of characters. The basis for methodology of this description of cinematographic space is to treat its visual layer as a point of departure for a detailed analysis. At the same time, the analysis itself will be supported by recognised academic theories concerning special issues, which are transformed here into essential tools necessary to describe the world (mise-en-scène) created by González Iñárritu. In ‘Amores perros’ the Mexico City serves as a scenery – a place full of contradictions- in the movie depicted as a modern conglomerate and an urban jungle, as well as a labyrinth of poverty and violence. In this work stylistic tropes can be found in an intertextual dialogue of the director with photographies of Nan Goldin and Mary Ellen Mark. The story recounted in ‘21 Grams’, the most tragic piece in the trilogy, is characterised by almost hyperrealistic sadism. It takes place in Memphis, which on the screen turns into an impersonal formation full of heterotopias described by Michel Foucault and non-places, as defined by Marc Augé in his essay. By contrast, the main urban space in ‘Babel’ is Tokio, which seems to perfectly correspond with the image of places discussed by Juhani Pallasmaa in his works concerning the reception of the architecture by ‘pathological senses’ in the modern (or, even more adequately, postmodern) world. It’s portrayed as a city full of buildings that look so surreal, that they seem to be completely unsuitable for the humans to move between them. Ultimately, the aim of this paper is to demonstrate the coherence of the manner in which González Iñárritu designs urban spaces in his Death Trilogy. In particular, the author attempts to examine the imperative role of the cities that form three specific microcosms in which the protagonists of the Mexican director live their overwhelming tragedies.

Keywords: cinematographic space, Death Trilogy, film Studies, González Iñárritu Alejandro, urban space

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Authors: A. T. Muruviwa

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To-date, the discourse on corporate social responsibility (CSR) has primarily centred on the actions and inactions of corporations; hence, the dominant focus on CSR has been on impacts and outcomes. The obscuring effect of this approach has, arguably, resulted in the emergence of what may be termed a ‘Northern’ agenda on CSR theory and practice, in contrast to an emergency ‘Southern’ discourse, which appears to highlight the crucial issues of poverty reduction, infrastructure development and the broader questions of social provisioning and community empowerment. Some scholars have explicitly called for a CSR research agenda that focuses on the 'reciprocal duties' of the stakeholders in the CSR process rather than fixate on the actions and inactions of business. It is against the backdrop of these contestations that this study assesses the reciprocal relationships amongst CSR stakeholders in a Zimbabwean platinum mining town, with a view to demonstrating how such relationships – and the expectations and obligations embedded in them – impact on the success or failure of CSR initiatives. The existence of mutual relations between the corporation and its stakeholders signifies the successes of CSR processes and hence the outcomes. The company is Zimplats Mining Company; the community is Mhondoro-Ngezi, and the stakeholders are clearly identified in the study. The study utilised a triangulated design, with data collected using a mini survey, focus groups, in-depth interview and observation. The key findings are that the CSR process in the study community is dominated by the mining company. Despite the existence of a CSR framework that recognises government, local leaders and community members as legitimate stakeholders, there is little evidence of concrete contributions made by these stakeholders towards the realisation of CSR objectives. As a result, the community development process – in so far as CSR is concerned – fails to address the developmental concerns of the various stakeholders. On the basis of these findings, the study concludes that there is a crisis of reciprocity in the CSR process in Mhondoro-Ngezi, and that a situation where the conceptualisation of local development needs and the deployment of specific development tools seems to be driven by one stakeholder almost to the exclusion of all others, can only present contradictory development outcomes. The significance of this study is that it allows for the development of a more nuanced and robust CSR discourse. Rather than focusing on the corporate and stakeholder perspectives and outcomes of CSR initiatives, this study examines the CSR- development nexus by interrogating the idea of reciprocal responsibility as a sin qua non to CSR success. This analytical strategy and focus allow the researcher to gain a clear understanding of how stakeholder relationships and duties influence CSR processes and also the overall outcome. At a more practical level, the findings of the study should help to shape the policy on corporate community relationships with a view to enhancing the role of mining in development.

Keywords: community development, processes, reciprocity, stakeholders

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Authors: Marina Charalambous, Phivos Phylactou, Thekla Elriz, Loukia Psychogios, Jean-Marie Annoni

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Background: Evidence-based practices for the evaluation and treatment of people with aphasia (PWA) in Greek are mainly impairment-based. Functional and multimodal communication is usually under assessed and neglected by clinicians. This study explores the adaptation and psychometric testing of the Greek (GR) version of The Scenario Test. The Scenario Test assesses the everyday functional communication of PWA in an interactive multimodal communication setting with the support of an active communication facilitator. Aims: To define the reliability and validity of The Scenario Test GR and discuss its clinical value. Methods & Procedures: The Scenario Test-GR was administered to 54 people with chronic stroke (6+ months post-stroke): 32 PWA and 22 people with stroke without aphasia. Participants were recruited from Greece and Cyprus. All measures were performed in an interview format. Standard psychometric criteria were applied to evaluate reliability (internal consistency, test-retest, and interrater reliability) and validity (construct and known – groups validity) of the Scenario Test GR. Video analysis was performed for the qualitative examination of the communication modes used. Outcomes & Results: The Scenario Test-GR shows high levels of reliability and validity. High scores of internal consistency (Cronbach’s α = .95), test-retest reliability (ICC = .99), and interrater reliability (ICC = .99) were found. Interrater agreement in scores on individual items fell between good and excellent levels of agreement. Correlations with a tool measuring language function in aphasia (the Aphasia Severity Rating Scale of the Boston Diagnostic Aphasia Examination), a measure of functional communication (the Communicative Effectiveness Index), and two instruments examining the psychosocial impact of aphasia (the Stroke and Aphasia Quality of Life questionnaire and the Aphasia Impact Questionnaire) revealed good convergent validity (all ps< .05). Results showed good known – groups validity (Mann-Whitney U = 96.5, p < .001), with significantly higher scores for participants without aphasia compared to those with aphasia. Conclusions: The psychometric qualities of The Scenario Test-GR support the reliability and validity of the tool for the assessment of functional communication for Greek-speaking PWA. The Scenario Test-GR can be used to assess multimodal functional communication, orient aphasia rehabilitation goal setting towards the activity and participation level, and be used as an outcome measure of everyday communication. Future studies will focus on the measurement of sensitivity to change in PWA with severe non-fluent aphasia.

Keywords: the scenario test GR, functional communication assessment, people with aphasia (PWA), tool validation

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Authors: Noor Hasmini Abd Ghani

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Brand resonance is among of new focused strategy that getting more attention in nowadays by larger companies for their long-term market survival. The brand resonance emphasizing of two main characteristics that are intensity and activity able to generate psychology bond and enduring relationship between a brand and consumer. This strong attachment relationship has represented brand resonance with the concept of consumer brand relationship (CBR) that exhibit competitive advantage for long-term market survival. The main consideration toward this brand resonance approach is not only in the context of larger companies but also can be adapted in Small and Medium Enterprises (SMEs) as well. The SMEs have been recognized as vital pillar to the world economy in both developed and emergence countries are undeniable due to their economic growth contributions, such as opportunity for employment, wealth creation, and poverty reduction. In particular, the facts that SMEs in Malaysia are pivotal to the well-being of the Malaysian economy and society are clearly justified, where the SMEs competent in provided jobs to 66% of the workforce and contributed 40% to the GDP. As regards to it several sectors, the SMEs service category that covers the Food & Beverage (F&B) sector is one of the high-potential industries in Malaysia. For that reasons, SMEs strong brand or brand equity is vital to be developed for their long-term market survival. However, there’s still less appropriate strategies in develop their brand equity. The difficulties have never been so evident until Covid-19 swept across the globe from 2020. Since the pandemic began, more than 150,000 SMEs in Malaysia have shut down, leaving more than 1.2 million people jobless. Otherwise, as the SMEs are the pillar of any economy for the countries in the world, and with negative effect of COVID-19 toward their economic growth, thus, their protection has become important more than ever. Therefore, focusing on strategy that able to develop SMEs strong brand is compulsory. Hence, this is where the strategy of brand resonance is introduced in this study. Mainly, this study aims to investigate the impact of CBR as a predictor and mediator in the context of social media marketing (SMM) activities toward SMEs e-brand equity (or strong brand) building. The study employed the quantitative research design concerning on electronic survey method with the valid response rate of 300 respondents. Interestingly, the result revealed the importance role of CBR either as predictor or mediator in the context of SMEs SMM as well as brand equity development. Further, the study provided several theoretical and practical implications that can benefit the SMEs in enhancing their strategic marketing decision.

Keywords: SME brand equity, SME social media marketing, SME consumer brand relationship, SME brand resonance

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Authors: Corinna Zeli, Silvia Calati, Marco Simeoni, Chiara Comastri

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Developmental stuttering affects about 10% of preschool children; although the high percentage of natural recovery, a quarter of them will become an adult who stutters. An effective early intervention should help those children with high persistence risk for the future. The Psicodizione method for early stuttering is an Italian behavior indirect treatment for preschool children who stutter in which method parents act as good guides for communication, modeling their own fluency. In this study, we give a preliminary measure to evaluate the long-term effectiveness of Psicodizione method on stuttering preschool children with a high persistence risk. Among all Italian children treated with the Psicodizione method between 2018 and 2019, we selected 8 kids with at least 3 high risk persistence factors from the Illinois Prediction Criteria proposed by Yairi and Seery. The factors chosen for the selection were: one parent who stutters (1pt mother; 1.5pt father), male gender, ≥ 4 years old at onset; ≥ 12 months from onset of symptoms before treatment. For this study, the families were contacted after an average period of time of 14,7 months (range 3 - 26 months). Parental reports were gathered with a standard online questionnaire in order to obtain data reflecting fluency from a wide range of the children’s life situations. The minimum worthwhile outcome was set at "mild evidence" in a 5 point Likert scale (1 mild evidence- 5 high severity evidence). A second group of 6 children, among those treated with the Piscodizione method, was selected as high potential for spontaneous remission (low persistence risk). The children in this group had to fulfill all the following criteria: female gender, symptoms for less than 12 months (before treatment), age of onset <4 years old, none of the parents with persistent stuttering. At the time of this follow-up, the children were aged 6–9 years, with a mean of 15 months post-treatment. Among the children in the high persistence risk group, 2 (25%) hadn’t had stutter anymore, and 3 (37,5%) had mild stutter based on parental reports. In the low persistency risk group, the children were aged 4–6 years, with a mean of 14 months post-treatment, and 5 (84%) hadn’t had stutter anymore (for the past 16 months on average).62,5% of children at high risk of persistence after Psicodizione treatment showed mild evidence of stutter at most. 75% of parents confirmed a better fluency than before the treatment. The low persistence risk group seemed to be representative of spontaneous recovery. This study’s design could help to better evaluate the success of the proposed interventions for stuttering preschool children and provides a preliminary measure of the effectiveness of the Psicodizione method on high persistence risk children.

Keywords: early treatment, fluency, preschool children, stuttering

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Authors: Lorenza Sganzetta, Nunzia Borrelli

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The research intends to reflect on the current mapping of the Food Strategies, on the reasons why in the planning objectives panorama, such sustainability priorities are located in those geographic areas and on the evolutions of these priorities of the Mediterranean planning dispositions. The whirling population growth that is affecting global cities is causing an enormous challenge to conventional resource-intensive food production and supply and the urgent need to face food safety, food security and sustainability concerns. Urban or Territorial Food Strategies can provide an interesting path for the development of this new agenda within the imperative principle of sustainability. In the specific, it is relevant to explore what ‘sustainability’ means within these policies. Most of these plans include actions related to four main components and interpretations of sustainability that are food security and safety, food equity, environmental sustainability itself and cultural identity and, at the designing phase, they differ slightly from each other according to the degree of approximation to one of these dimensions. Moving from these assumptions, the article would analyze some practices and policies representatives of different Food Strategies of the world and focus on the Mediterranean ones, on the problems and negative externalities from which they start, on the first interventions that are implementing and on their main objectives. We will mainly use qualitative data from primary and secondary collections. So far, an essential observation could have been made about the relationship between these sustainability dimensions and geography. In statistical terms, the US and Canadian policies tended to devote a large research space to health issues and access to food; those northern European showed a special attention to the environmental issues and the shortening of the chain; and finally the policies that, even in limited numbers, were being developed in the Mediterranean basin, were characterized by a strong territorial and cultural imprint and their major aim was to preserve local production and the contact between the productive land and the end consumer. Recently, though, Mediterranean food planning strategies are focusing more on health related and food accessibility issues and analyzing our diets not just as a matter of culture and territorial branding but as tools for reducing public health costs and accessibility to fresh food for everyone. The article would reflect then on how Food Safety, Food Security and Health are entering the new agenda of the Mediterranean Food Strategies. The research hypothesis suggests that the economic crisis that in the last years invested both producers and consumers had a significant impact on the nutrition habits and on the redefinition of food poverty, even in the fatherland of the healthy Mediterranean diet. This trend and other variables influenced the orientation and the objectives of the food strategies.

Keywords: food security, food strategy, health, sustainability

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Authors: Vojtěch Svěrák

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Climate change ethics have recently shifted away from individualistic paradigms towards concepts of shared or collective responsibility. Despite this evolving trend, a noticeable gap remains: a lack of research exclusively addressing the moral responsibility of specific unorganized social groups. The primary objective of the article is to fill this gap. The article employs the structuralist methodological approach proposed by some feminist philosophers, utilizing structural analysis to explain the existence of social groups. The argument is made for the integration of this framework with the so-called forward-looking Social Connection Model (SCM) of responsibility, which ascribes responsibilities to individuals based on their participation in social structures. The article offers an extension of this model to justify the responsibility of unorganized social groups. The major finding of the study is that although members of unorganized groups are loosely connected, collectively they instantiate specific external social structures, share social positioning, and the notion of responsibility could be based on that. Specifically, if the structure produces harm or perpetuates injustices, and the group both benefits from and possesses the capacity to significantly influence the structure, a greater degree of responsibility should be attributed to the group as a whole. This thesis is applied and justified within the context of climate change, based on the asymmetrical positioning of different social groups. Climate change creates a triple inequality: in contribution, vulnerability, and mitigation. The study posits that different degrees of group responsibility could be drawn from these inequalities. Two social groups serve as a case study for the article: first, the Pakistan lower class, consisting of people living below the national poverty line, with a low greenhouse gas emissions rate, severe climate change-related vulnerability due to the lack of adaptation measures, and with very limited options to participate in the mitigation of climate change. Second, the so-called polluter elite, defined by members' investments in polluting companies and high-carbon lifestyles, thus with an interest in the continuation of structures leading to climate change. The first identified group cannot be held responsible for climate change, but their group interest lies in structural change and should be collectively maintained. On the other hand, the responsibility of the second identified group is significant and can be fulfilled by a justified demand for some political changes. The proposed approach of group responsibility is suggested to help navigate climate justice discourse and environmental policies, thus helping with the sustainability transition.

Keywords: collective responsibility, climate justice, climate change ethics, group responsibility, social ontology, structural analysis

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Authors: A. Zare Javid, H. Babaee, E. Ashrafzadeh, H. Yousefimanesh, M. Zakerkish, K. Ahmadi Angali, M. Ravanbakhsh

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Introduction: Type 2 diabetes mellitus and periodontal disease hold a physiologically relationship. Periodontal disease, a common widespread chronic disease, is considered as an important complication in diabetes mellitus. The prevalence and severity of periodontal disease are increased among diabetic patients. A balanced nutrition may improve either diabetes or periodontal disease by controlling one of them. The aim of this study was to evaluate the effects of cranberry juice enriched with n-3 PUFA and their individual consumption on glycemic control and antioxidant status in diabetic patients with periodontal disease. Methods: In this randomized clinical trial 41 diabetic patients (35 – 65 y) with chronic adult periodontal disease were recruited from Endocrinology Clinic of Golestan Hospital in Ahvaz city, Iran. Subjects were randomly assigned to four groups as follow: one control group (n=12) and three intervention groups as receiving 1 g n-3 PUFA capsule (n=10), 400 ml cranberry juice (n=9), 400 ml cranberry juice enriched with 1g n-3 PUFA (n=10) for 8 weeks. Non-surgical periodontal therapy was provided for all patients during study. Fasting blood glucose, glycated hemoglobin, plasma and saliva TAOC and MDA, pocket depth and bleeding on probing were measured at baseline and post intervention. Results: There was a significant reduction in glycated hemoglobin observed in intervention groups of receiving n-3 PUFA and cranberry enriched with n-3 PUFA (11 %, P = 0.01 and 7 %, P = 0.01, respectively). The intervention group receiving n-3 PUFA had significantly lower glycated hemoglobin compared with control group. There was no significant difference found in FBS between and within groups. Furthermore, there was a significant increase in plasma TAOC only in cranberry enriched with n-3 PUFA group. Moreover, plasma MDA significantly decreased in intervention groups of receiving cranberry and cranberry enriched with n-3 PUFA. A significant increase was observed in TAOC of salvia in cranberry enriched with n-3 PUFA group compared to control group .The intervention group receiving cranberry enriched with n-3 PUFA had significantly lower MDA of salvia compared with control group. Pocket depth were significantly decreased in all groups, however, bleeding on probing didn’t significantly changed in patients post intervention. Conclusion: It is suggested that consumption of cranberry juice enriched with n-3 PUFA as a nutritional approach in adjunct with non-surgical periodontal therapy may help to improve glycosylated hemogolobin and TAOC in salvia and plasma in diabetic patients with periodontal disease.

Keywords: antioxidant, cranberry, oxidant status, periodontal disease, type 2 diabetes mellitus

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Authors: Kongmeng Ly

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The management of transboundary river basins across developing countries, such as the Lower Mekong River Basin (LMB), is frequently challenging given the development and conservation divergences of the basin countries. Driven by needs to sustain economic performance and reduce poverty, the LMB countries (Cambodia, Lao PDR, Thailand, Viet Nam) are embarking on significant land use changes in the form hydropower dam, to fulfill their energy requirements. This pathway could lead to irreversible changes to the ecosystem of the Mekong River, if not properly managed. Given the uncertain trade-offs of hydropower development and operation, the Lower Mekong River Basin Countries through the technical support of the Mekong River Commission (MRC) Secretariat embarked on decade long the development of Technical Guidelines for Transboundary Environmental Impact Assessment. Through a series of workshops, seminars, national and regional consultations, and pilot studies and further development following the recommendations generated through legal and institutional reviews undertaken over two decades period, the LMB Countries jointly adopted the MRC Technical Guidelines for Transboundary Environmental Impact Assessment (TbEIA Guidelines). These guidelines were developed with particular regard to the experience gained from MRC supported consultations and technical reviews of the Xayaburi Dam Project, Don Sahong Hydropower Project, Pak Beng Hydropower Project, and lessons learned from the Srepok River and Se San River case studies commissioned by the MRC under the generous supports of development partners around the globe. As adopted, the TbEIA Guidelines have been designed as a supporting mechanism to the national EIA legislation, processes and systems in each Member Country. In recognition of the already agreed mechanisms, the TbEIA Guidelines build on and supplement the agreements stipulated in the 1995 Agreement on the Cooperation for the Sustainable Development of the Mekong River Basin and its Procedural Rules, in addressing potential transboundary environmental impacts of development projects and ensuring mutual benefits from the Mekong River and its resources. Since its adoption in 2022, the TbEIA Guidelines have already been voluntary implemented by Lao PDR on its underdevelopment Sekong A Downstream Hydropower Project, located on the Sekong River – a major tributary of the Mekong River. While this implementation is ongoing with results expected in early 2024, the implementation thus far has strengthened cooperation among concerned Member Countries with multiple successful open dialogues organized at national and regional levels. It is hope that lessons learnt from this application would lead to a wider application of the TbEIA Guidelines for future water resources development projects in the LMB.

Keywords: transboundary, EIA, lower mekong river basin, mekong river

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Authors: P. Kavuma, J. Mukasa, M. Lusunku

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Background and Problem: The widespread poverty in Africa- together with the negative impacts of climate change-are two great global challenges that call for everyone’s involvement including Architects. This in particular places serious challenges on architects to have additional skills in both Entrepreneurship and Environmental Design (SEED). Regrettably, while Architectural Training in most African Universities including those from Uganda lack comprehensive implementation of SEED in their curricula, regulatory bodies have not contributed towards the effective integration of SEED in their professional practice. In response to these challenges, Nkumba University (NU) under Architect Kavuma Paul supported by the Uganda Chambers of Architects– initiated the SEED integration in the undergraduate Architectural curricula to cultivate SEED know-how and examples of best practices. Main activities: Initiated in 2007, going beyond the traditional Architectural degree curriculum, the NU Architect department offers SEED courses including provoking passions for creating desirable positive changes in communities. Learning outcomes are assessed theoretically and practically through field projects. The first set of SEED graduates came out in 2012. As part of the NU post-graduation and alumni survey, in October 2014, the pioneer SEED graduates were contacted through automated reminder emails followed by individual, repeated personal follow-ups via email and phone. Out of the 36 graduates who responded to the survey, 24 have formed four (4) private consortium agencies of 5-7 graduates all of whom have pioneered Ugandan-own-cultivated Architectural social projects that include: fishing farming in shipping containers; solar powered mobile homes in shipping containers, solar powered retail kiosks in rural and fishing communities, and floating homes in the flood-prone areas. Primary outcomes: include being business self –reliant in creating the social change the architects desired in the communities. Examples of the SEED project returns to communities reported by the graduates include; employment creation via fabrication, retail business, marketing, improved diets, safety of life and property, decent shelter in the remote mining and oil exploration areas. Negative outcomes-though not yet evaluated include the disposal of used-up materials. Conclusion: The integration of SEED in Architectural Training has established a baseline benchmark and a replicable model based on best practice projects.

Keywords: architectural training, entrepreneurship, environment, integration

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Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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Background and significance: Patients with eating disorders have traditionally been an underserviced population within the publicly-funded Canadian healthcare system. This situation was worsened by the COVID-19 pandemic and accompanying public health measures, such as “lockdowns” which led to increased isolation, changes in routine, and other disruptions. Illness severity and prevalence rose significantly with corresponding increases in patient suffering and poor outcomes. In Ontario, Canada, the provincial government responded by increasing funding for the treatment of eating disorders, including the launch of a new day program at an intermediate, regional health centre that already housed an outpatient treatment service. The funding was received in March 2022. The care team sought to optimize this opportunity by designing a program that would fit well within the resource-constrained context in Ontario. Methods: This case study will detail how the team consulted the literature and sought patient and family input to design a program that optimizes patient outcomes and supports for patients and families while they await treatment. Early steps include a review of the literature, expert consultation and patient and family focus groups. Interprofessional consensus was sought at each step with the team adopting a shared leadership and patient-centered approach. Methods will include interviews, observations and document reviews to detail a rich description of the process undertaken to design the program, including evaluation measures adopted. Interim findings pertaining to the early stages of the program-building process will be detailed as well as early lessons and ongoing evolution of the program and design process. Program implementation and outcome evaluation will continue throughout 2022 and early 2023 with further publication and presentation of study results expected in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to the design and implementation of eating disorder treatment services that combine outpatient and day treatment services in a resource-constrained context.

Keywords: eating disorders, day program, interprofessional, outpatient, adolescents, transitional aged youth

Procedia PDF Downloads 84

Authors: Aparecida De Fatima Dutra, Freddie Avant, Wilma Cordova

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People living with HIV/AIDS (PLWHA) have benefited from advances in treatment. Medical costs are a challenge for some, but the real challenge is the stigma and discrimination PLWHA continue to face, even though the disease has festered for the last four decades. Few studies regarding stigma and discrimination give voice to those affected by these practices. This study provides a voice to PLWHA in Brazil and in the US as to how they perceive stigma and discrimination, as well as services they access. The methodology of this study was designed based on phenomenological research, which is a research that aims to identify what individuals facing the same situation have to share about their experiences. Qualitative research using in- depth interviews was used in order to gather participants’ perceptions about services they access, and stigma and discrimination they experience as PLWHA (hypothesis). The target population was a minority group of 13 Afro-descendant men, mean age of 48.3, residents in East Texas, United States and Salvador, Brazil. Our findings indicate that in both countries, overall, participants have reasonable access to medication and qualified services, except for some specialties, such as dentistry. With regard to stigma and discrimination the majority of participants have not disclosed their diagnosis. They state they prefer not to disclose for fear of being ostracized and rejected. Participants who did reveal their status indicate that stigma and discrimination is a daily occurrence. These experiences tend to occur within their own families, neighborhoods, and in public health agencies where HIV/AIDS is not the focus. Participants who did offer suggestions for social change indicated they would have to reveal their status even if it means being stigmatized and discriminated against. Other factors contributing to this discrimination include skin color and poverty. This study concludes that even after decades since the spread of this epidemic, nothing has changed regarding stigma and discrimination towards PLWHA. Lack of awareness, empathy and education continue to be a major challenge, not only at a local level but across the globe. In conclusion, as documented in previous studies while stigma and discrimination towards this population prevail, negative attitudes will continue to jeopardize all individuals from receiving equal access to prevention, treatment and care. It is crucial to face stigma and discrimination not only as individual experiences, but as social practices that violate and restrict human rights and that as a result, reinforce inequality and social exclusion. Policies should be at the forefront to eliminate the stigma and discrimination PLWHA experience. Health professionals and societies must take a stand in order to promote mindfulness about the negative effect of oppression towards individuals living with HIV/AIDS and the potential global impact of these practices.

Keywords: discrimination, HIV/AIDS, human rights, stigma

Procedia PDF Downloads 310

Authors: Charles Mazhazhate

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This study interrogates and analyses the intricate kin- and- kith network patterns of corruption and mismanagement of resources prevalent in public sector supply chains bedeviling the developing economies of Sub-Saharan Africa with particular reference to Zimbabwe. This is forcing governments to resort to harsh fiscal policies that see their citizens paying high taxes against a backdrop of incomes below the poverty datum line, and this negatively affects their quality of life. The corporate world is also affected by the various tax-regime instituted. Mismanagement of resources and corrupt practices are rampant in state-owned enterprises to the extent that institutional policies, procedures, and practices are often flouted for the benefit of a clique of individuals. This interwoven in kith and kin blood human relations in organizations where appointments to critical positions are based on ascribed status. People no longer place value in their systems to make them work thereby violating corporate governance principles. Greediness and ‘unholy friendship connections’ are instrumental in fueling the employment of people who know each other from their discrete backgrounds. Such employments or socio-metric unions are meant to protect those at the top by giving them intelligent information through spying on what other subordinates are doing inside and outside the organization. This practice has led to the underperforming of organizations as those employees with connections and their upper echelons favorites connive to abuse resources for their own benefit. Even if culprits are known, no draconian measures are employed as a deterrence measure. Public value along public sector supply chains is lost. The study used a descriptive case study research design on fifty organizations in Zimbabwe mainly state-owned enterprises. Both qualitative and quantitative instrumentations were used. Both Snowball and random sampling techniques were used. The study found out that in all the fifty SOEs, there were employees in key positions related to top management, with tentacles feeding into the law enforcement agents, judiciary, security systems, and the executive. Such employees in public seem not to know each other with but would be involved in dirty scams and then share the proceeds with top people behind the scenes. The study also established that the same employees do not have the necessary competencies, qualifications, abilities, and capabilities to be in those positions. This culture is now strong that it is difficult to bust. The study recommends recruitment of all employees through an independent employment bureau to ensure strategic fit.

Keywords: corruption, state owned enterprises, strategic fit, public sector supply chains, efficiency

Procedia PDF Downloads 139

Authors: Weeradej Cheewapattananuwong, Keeree Srivichian, Godchamon Somchai, Wasin Phusanong, Nontawat Yoddamnern

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Natural rubber used for traffic devices in Thailand has been developed and researched for several years. When compared with Dry Rubber Content (DRC), the quality of Rib Smoked Sheet (RSS) is better. However, the cost of admixtures, especially CaCO₃ and sulphur, is higher than the cost of RSS itself. In this research, Flexible Guideposts and Rubber Fender Barriers (RFB) are taken into consideration. In case of flexible guideposts, the materials used are both RSS and DRC60%, but for RFB, only RSS is used due to the controlled performance tests. The objective of flexible guideposts and RFB is to decrease a number of accidents, fatal rates, and serious injuries. Functions of both devices are to save road users and vehicles as well as to absorb impact forces from vehicles so as to decrease of serious road accidents. This leads to the mitigation methods to remedy the injury of motorists, form severity to moderate one. The solution is to find the best practice of traffic devices using natural rubber under the engineering concepts. In addition, the performances of materials, such as tensile strength and durability, are calculated for the modulus of elasticity and properties. In the laboratory, the simulation of crashes, finite element of materials, LRFD, and concrete technology methods are taken into account. After calculation, the trials' compositions of materials are mixed and tested in the laboratory. The tensile test, compressive test, and weathering or durability test are followed and based on ASTM. Furthermore, the Cycle-Repetition Test of Flexible Guideposts will be taken into consideration. The final decision is to fabricate all materials and have a real test section in the field. In RFB test, there will be 13 crash tests, 7 Pickup Truck tests, and 6 Motorcycle Tests. The test of vehicular crashes happens for the first time in Thailand, applying the trial and error methods; for example, the road crash test under the standard of NCHRP-TL3 (100 kph) is changed to the MASH 2016. This is owing to the fact that MASH 2016 is better than NCHRP in terms of speed, types, and weight of vehicles and the angle of crash. In the processes of MASH, Test Level 6 (TL-6), which is composed of 2,270 kg Pickup Truck, 100 kph, and 25 degree of crash-angle is selected. The final test for real crash will be done, and the whole system will be evaluated again in Korea. The researchers hope that the number of road accidents will decrease, and Thailand will be no more in the top tenth ranking of road accidents in the world.

Keywords: LRFD, load and resistance factor design, ASTM, american society for testing and materials, NCHRP, national cooperation highway research program, MASH, manual for assessing safety hardware

Procedia PDF Downloads 100

Authors: Cecile Garry, Katia Rovira, Julie Brisson

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Autism Spectrum Disorder (ASD) is defined by a qualitative and quantitative impairment of social interaction. Indeed early intervention programs, such as the Early Start Denver Model (ESDM), aimed at encouraging the development of social skills. In classroom, the children need to be socially engaged to learn. Early intervention programs can thus be implemented in kindergarten schools. In these schools, ASD children have more opportunities to interact with their peers or adults than in elementary schools. However, the preschool children with ASD are less socially engaged than their typically developing peers in the classroom. They initiate, respond and maintain less the social interactions. In addition, they produce more responses than initiations. When they interact, the non verbal communication is more used than verbal or symbolic communication forms and they are more engaged with adults than with peers. Nevertheless, communicative patterns may vary according to the clinical profiles of ASD children. Indeed, the ASD children with better cognitive skills interact more with their peers and use more symbolic communication than the ASD children with a low cognitive level. ASD children with the less severe symptoms use more the verbal communication than ASD children with the more severe symptoms. Small groups and structured activities encourage coordinated joint engagement episodes in ASD children. Our goal is to evaluate ASD children’s social engagement development in class, with their peers or adults, during dyadic or group activities. Participants were 19 preschool children with ASD aged from 3 to 6 years old that benefited of an early intervention in special kindergarten schools. Severity of ASD symptoms was measured with the CARS at the beginning of the follow-up. Classroom situations of interaction were recorded during 10 minutes (5 minutes of dyadic interaction and 5 minutes of a group activity), every 2 months, during 10 months. Social engagement behaviors of children, including initiations, responses and imitation, directed to a peer or an adult, were then coded. The Observer software (Noldus) that allows to annotate behaviors was the coding system used. A double coding was conducted and revealed a good inter judges fidelity. Results show that ASD children were more often and longer socially engaged in dyadic than in groups situations. They were also more engaged with adults than with peers. Children with the less severe symptoms of ASD were more socially engaged in groups situations than children with the more severe symptoms of ASD. Then, ASD children with the less severe symptoms of ASD were more engaged with their peers than ASD children with the more severe symptoms of ASD. However, the engagement frequency increased during the 10 month of follow-up but only for ASD children with the more severe symptoms at the beginning. To conclude, these results highlighted the necessity of individualizing early intervention programs according to the clinical profile of the child.

Keywords: autism spectrum disorder, preschool children, developmental psychology, early interventions, social interactions

Procedia PDF Downloads 134

Authors: Vardan Melkonyan, Arman Azizyan, Astghik Boyajyan

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Virtual reality (VR) exposure therapy is a form of cognitive-behavioral therapy that uses immersive virtual environments to expose individuals to the feared stimuli or situations that trigger their phobia. VR exposure therapy has become an increasingly popular treatment for phobias, including fear of heights, public speaking, and flying, due to its ability to provide a controlled and safe environment for individuals to confront their fears while also allowing therapists to tailor the virtual exposure to the specific needs and goals of each individual. It is also a cost-effective and accessible treatment option, as it can be delivered remotely and does not require the use of drugs. Overall, VR exposure therapy has the potential to be a valuable tool for therapists in the treatment of phobias. But current methods may be improved by incorporating advanced technology such as photorealistic VR environments, tactile feedback suits, and responsive systems. The aim of this study was to identify the most effective approach for enhancing VR exposure therapy for the treatment of phobias. Photorealistic VR environments and stimuli can greatly enhance the effectiveness of VR exposure therapy for the treatment of phobias. By creating immersive, realistic virtual environments that closely mimic the real-life situations that trigger phobia responses, patients are able to more fully engage in the therapeutic process and confront their fears in a controlled and safe manner. This can help to reduce the severity of phobia symptoms and increase treatment outcomes. The use of tactile feedback suits and responsive systems can further enhance the VR exposure therapy experience by adding a physical element to the virtual environment. These suits, which can mimic the sensations of touch, pressure, and movement, allow patients to fully immerse themselves in the virtual world and feel as if they are physically present in the situation. This can help to increase the realism of the virtual environment and make it more effective in reducing phobia symptoms. Additionally, responsive systems can be used to trigger specific events or responses within the virtual environment based on the patient's actions, providing a more interactive and personalized treatment experience. A comprehensive literature review was conducted, including studies on VR exposure therapy for phobias and the use of advanced technology to enhance the therapy. Results indicate that incorporating these enhancements may significantly increase the effectiveness of VR exposure therapy for phobias. Further research is needed to fully understand the potential of these enhancements and to determine the optimal combination and implementation.

Keywords: virtual reality, mental health, phobias, fears, treatment, photorealistic, immersive, phobia

Procedia PDF Downloads 60

Authors: Mareen Brosterhaus, Antje Hammer, Steffen Kalina, Stefan Grau, Anjali A. Roeth, Hany Ashmawy, Thomas Gross, Marcel Binnebosel, Wolfram T. Knoefel, Tanja Manser

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Background: The identification of critical incidents in hospitals is an essential component of improving patient safety. To date, various methods have been used to measure and characterize such critical incidents. These methods are often viewed by physicians and nurses as external quality assurance, and this creates obstacles to the reporting events and the implementation of recommendations in practice. One way to overcome this problem is to use tools that directly involve staff in measuring indicators of quality and safety of care in the department. One such instrument is the global trigger tool (GTT), which helps physicians and nurses identify adverse events by systematically reviewing randomly selected patient records. Based on so-called ‘triggers’ (warning signals), indications of adverse events can be given. While the tool is already used internationally, its implementation in German hospitals has been very limited. Objectives: This study aimed to assess the feasibility and potential of the global trigger tool for identifying adverse events in German hospitals. Methods: A total of 120 patient records were randomly selected from two surgical, and one neurosurgery, departments of three university hospitals in Germany over a period of two months per department between January and July, 2017. The records were reviewed using an adaptation of the German version of the Institute for Healthcare Improvement Global Trigger Tool to identify triggers and adverse event rates per 1000 patient days and per 100 admissions. The severity of adverse events was classified using the National Coordinating Council for Medication Error Reporting and Prevention. Results: A total of 53 adverse events were detected in the three departments. This corresponded to adverse event rates of 25.5-72.1 per 1000 patient-days and from 25.0 to 60.0 per 100 admissions across the three departments. 98.1% of identified adverse events were associated with non-permanent harm without (Category E–71.7%) or with (Category F–26.4%) the need for prolonged hospitalization. One adverse event (1.9%) was associated with potentially permanent harm to the patient. We also identified practical challenges in the implementation of the tool, such as the need for adaptation of the global trigger tool to the respective department. Conclusions: The global trigger tool is feasible and an effective instrument for quality measurement when adapted to the departmental specifics. Based on our experience, we recommend a continuous use of the tool thereby directly involving clinicians in quality improvement.

Keywords: adverse events, global trigger tool, patient safety, record review

Procedia PDF Downloads 223

Authors: Ledi Neçaj

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Objectives: The target of this paper is (1) to explain objectively physical activity model throughout three chronic cardiopulmonary conditions, and (2) to study the connection among physical activity dimensions with disease severity, self-reported physical and emotional functioning, and exercise performance. Material and Methods: This is a cross-sectional study of patients in their domestic environment. Patients with cardiopulmonary diseases were: chronic obstructive pulmonary disease (COPD), (n-63), coronary heart failure (n=60), and patients with implantable cardioverter defibrillator (n=60). Main results measures: Seven ambulatory physical activity dimensions (total steps, percentage time active, percentage time ambulating at low, medium, and hard intensity, maximum cadence for 30 non-stop minutes, and peak performance) have been measured with an accelerometer. Results: Subjects with COPD had the lowest amount of ambulatory physical activity compared with topics with coronary heart failure and cardiac dysrhythmias (all 7 interest dimensions, P<.05); total step counts have been: 5319 as opposed to 7464 as opposed to 9570, respectively. Six-minute walk distance becomes correlated (r=.44-.65, P<.01) with all physical activity dimensions inside the COPD pattern, the most powerful correlations being with total steps and peak performance. In topics with cardiac impairment, maximal oxygen intake had the most effective small to slight correlations with five of the physical activity dimensions (r=.22-.40, P<.05). In contrast, correlations among 6-minute walk test distance and physical activity have been higher (r=.48-.61, P<.01) albeit in a smaller pattern of most effective patients with coronary heart failure. For all three samples, self-reported physical and mental health functioning, age, frame mass index, airflow obstruction, and ejection fraction had both exceptionally small and no significant correlations with physical activity. Conclusions: Findings from this study present a profitable benchmark of physical activity patterns in individuals with cardiopulmonary diseases for comparison with future studies. All seven dimensions of ambulatory physical activity have disfavor between subjects with COPD, heart failure, and cardiac dysrhythmias. Depending on the research or clinical goal, the use of one dimension, such as total steps, may be sufficient. Although physical activity had high correlations with performance on a six-minute walk test relative to other variables, accelerometers-based physical activity monitoring provides unique, important information about real-world behavior in patients with cardiopulmonary not already captured with existing measures.

Keywords: ambulatory physical activity, walking, monitoring, COPD, heart failure, implantable defibrillator, exercise performance

Procedia PDF Downloads 67

Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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In Canada, as prevalence rates and severity of illness have increased among patients suffering from eating disorders, wait times have grown substantially. Patients in Canada often face wait times in excess of 12 months. It is known that delaying treatment for eating disorders contributes to poor patient outcomes and higher rates of symptom relapse. Improving interim services for adult patients awaiting outpatient treatment is a priority for an outpatient eating disorders clinic in Ontario, Canada. The clinical setting currently provides care for adults diagnosed with anorexia nervosa, bulimia nervosa and binge eating disorder. At present, the only support provided while patients are on the waitlist consists of communication with primary care providers regarding parameters for medical monitoring. The significance of this study will be to test the feasibility, acceptability and efficacy of an intervention to support adult patients awaiting outpatient eating disorder treatment for anorexia nervosa, bulimia nervosa and binge eating disorder. Methods: An intervention including psychoeducation, supportive resources, self-monitoring, and auxiliary referral will be pilot-tested with a group of patients in the summer of 2022 and detailed using a prospective cohort case study research design. The team will host patient focus groups in May 2022 to gather input informing the content of the intervention. The intervention will be pilot tested with newly-referred patients in June and July 2022. Patients who participate in the intervention will be asked to complete a survey evaluating the utility of the intervention and for suggestions, they may have for improvement. Preliminary findings describing the existing literature pertaining to waitlist interventions for patients with eating disorders, data gathered from the focus groups and early pilot testing results will be presented. Data analysis will continue throughout 2022 and early 2023 for follow-up publication and presentation in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to providing interim support to those patients waiting for treatment for eating disorders and, by extension, to improve outcomes for this population.

Keywords: eating disorders, waitlist management, intervention study, pilot test

Procedia PDF Downloads 76

Authors: Kitty Kioskli, Theofanis Fotis, Nineta Polemi

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The European Union (EU) directive Artificial Intelligence (AI) Act in Article 9 requires that risk management of AI systems includes both technical and human oversight, while according to NIST_AI_RFM (Appendix C) and ENISA AI Framework recommendations, claim that further research is needed to understand the current limitations of social threats and human-AI interaction. AI threats within social contexts significantly affect the security and trustworthiness of the AI systems; they are interrelated and trigger technical threats as well. For example, lack of explainability (e.g. the complexity of models can be challenging for stakeholders to grasp) leads to misunderstandings, biases, and erroneous decisions. Which in turn impact the privacy, security, accountability of the AI systems. Based on the NIST four fundamental criteria for explainability it can also classify the explainability threats into four (4) sub-categories: a) Lack of supporting evidence: AI systems must provide supporting evidence or reasons for all their outputs. b) Lack of Understandability: Explanations offered by systems should be comprehensible to individual users. c) Lack of Accuracy: The provided explanation should accurately represent the system's process of generating outputs. d) Out of scope: The system should only function within its designated conditions or when it possesses sufficient confidence in its outputs. Biases may also stem from historical data reflecting undesired behaviors. When present in the data, biases can permeate the models trained on them, thereby influencing the security and trustworthiness of the of AI systems. Social related AI threats are recognized by various initiatives (e.g., EU Ethics Guidelines for Trustworthy AI), standards (e.g. ISO/IEC TR 24368:2022 on AI ethical concerns, ISO/IEC AWI 42105 on guidance for human oversight of AI systems) and EU legislation (e.g. the General Data Protection Regulation 2016/679, the NIS 2 Directive 2022/2555, the Directive on the Resilience of Critical Entities 2022/2557, the EU AI Act, the Cyber Resilience Act). Measuring social threats, estimating the risks to AI systems associated to these threats and mitigating them is a research challenge. In this paper it will present the efforts of two European Commission Projects (FAITH and THEMIS) from the HorizonEurope programme that analyse the social threats by building cyber-social exercises in order to study human behaviour, traits, cognitive ability, personality, attitudes, interests, and other socio-technical profile characteristics. The research in these projects also include the development of measurements and scales (psychometrics) for human-related vulnerabilities that can be used in estimating more realistically the vulnerability severity, enhancing the CVSS4.0 measurement.

Keywords: social threats, artificial Intelligence, mitigation, social experiment

Procedia PDF Downloads 40

Authors: Varsha Tol, Laila Garda, Neelam Bhardwaj, Malata Usar

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In India, differently- abled girls suffer from a “dual stigma” of being female and physically challenged. The general consensus is that they are incapable of standing on their own two feet. It was observed that these girls do not have access to educational programs as most hostels do not keep them after the tenth grade. They are forced to return to a life of poverty and are often considered a liability by their families. Higher education is completely ignored. Parents focus on finding a husband and passing on their ‘burden’ to someone else. An innovative, intervention for differently-abled adolescent girls with the express purpose of mainstreaming them into society was started by Helplife. The objective was to enrich the lives of these differently abled adolescent girls through precise research, focused intervention and professionalism. This programme addresses physical, mental and social rehabilitation of the girls who come from impoverished backgrounds. These adolescents are reached by word of mouth, snowball technique and through the network of the NGO. Applications are invited from potential candidates which are scrutinized by a panel of experts. Selection criteria include her disability, socio-economic status, and desire and drive to make a difference in her own life. The six main areas of intervention are accommodation, education, health, professional courses, counseling and recreational activities. Each girl on an average resides in Helplife for a period of 2-3 years. Analysis of qualitative data collected at various time points indicates holistic development of character. A quality of life questionnaire showed a significant improvement in scores at three different time points in 75% of the current population under intervention i.e. 19 girls. Till date, 25 girls have successfully passed out from the intervention program completing their graduation/post-graduation. Currently, we have 19 differently abled girls housed in three flats in Pune district of Maharashtra. Out of which 14 girls are pursuing their graduation or post-graduation. Six of the girls are working in jobs in various sectors. In conclusion it may be noted with adequate support and guidance the sky is the limit. This journey of 12 years has been a learning for us with ups and downs modifying the intervention at every step. Helplife has a belief of impacting positively, individual lives of differently abled girls in order to empower them in a holistic manner. The intervention has a positive impact on differently abled girls. They serve as role models to other differently abled girls indicating that this is a road map to success by getting empowered to live with full potential and get integrated in the society in a dignified way.

Keywords: differently-abled, dual-stigma, empowerment, youth

Procedia PDF Downloads 138

Authors: Gyaltsen Dakpa, K. J. Senthil Kumar, Nai-Wen Tsao, Sheng-Yang Wang

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Context: Coronavirus disease 2019 (COVID-19) is a severe respiratory illness caused by the SARS-CoV-2 virus. One of the hallmarks of COVID-19 is a change in metabolism, which can lead to increased severity and mortality. The mechanism of SARS-CoV-2-mediated perturbations of metabolic pathways has yet to be fully understood. Research Aim: This study aimed to investigate the metabolic alteration caused by SARS-CoV-2 spike protein in Phorbol 12-myristate 13-acetate (PMA)-induced human monocytes (THP-1) and to examine the regulatory effect of natural compounds like Antcins A on SARS-CoV-2 spike protein-induced metabolic alteration. Methodology: The study used a combination of proton nuclear magnetic resonance (1H-NMR) and MetaboAnalyst 5.0 software. THP-1 cells were treated with SARS-CoV-2 spike protein or control, and the metabolomic profiles of the cells were compared. Antcin A was also added to the cells to assess its regulatory effect on SARS-CoV-2 spike protein-induced metabolic alteration. Findings: The study results showed that treatment with SARS-CoV-2 spike protein significantly altered the metabolomic profiles of THP-1 cells. Eight metabolites, including glycerol-phosphocholine, glycine, canadine, sarcosine, phosphoenolpyruvic acid, glutamine, glutamate, and N, N-dimethylglycine, were significantly different between control and spike-protein treatment groups. Antcin A significantly reversed the changes in these metabolites. In addition, treatment with antacid A significantly inhibited SARS-CoV-2 spike protein-mediated up-regulation of TLR-4 and ACE2 receptors. Theoretical Importance The findings of this study suggest that SARS-CoV-2 spike protein can cause significant metabolic alterations in THP-1 cells. Antcin A, a natural compound, has the potential to reverse these metabolic alterations and may be a potential candidate for developing preventive or therapeutic agents for COVID-19. Data Collection: The data for this study was collected from THP-1 cells that were treated with SARS-CoV-2 spike protein or a control. The metabolomic profiles of the cells were then compared using 1H-NMR and MetaboAnalyst 5.0 software. Analysis Procedures: The metabolomic profiles of the THP-1 cells were analyzed using 1H-NMR and MetaboAnalyst 5.0 software. The software was used to identify and quantify the cells' metabolites and compare the control and spike-protein treatment groups. Questions Addressed: The question addressed by this study was whether SARS-CoV-2 spike protein could cause metabolic alterations in THP-1 cells and whether Antcin A can reverse these alterations. Conclusion: The findings of this study suggest that SARS-CoV-2 spike protein can cause significant metabolic alterations in THP-1 cells. Antcin A, a natural compound, has the potential to reverse these metabolic alterations and may be a potential candidate for developing preventive or therapeutic agents for COVID-19.

Keywords: SARS-CoV-2-spike, ¹H-NMR, metabolomics, antcin-A, taiwanofungus camphoratus

Procedia PDF Downloads 46

Authors: Yu-Jia Jian, Emily Chia-Yu Su, Hui-Ling Hsu, Jian-Jhih Chen

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Coronary artery is the major supplier of myocardial blood flow. When fat and cholesterol are deposit in the coronary arterial wall, narrowing and stenosis of the artery occurs, which may lead to myocardial ischemia and eventually infarction. According to the World Health Organization (WHO), estimated 740 million people have died of coronary heart disease in 2015. According to Statistics from Ministry of Health and Welfare in Taiwan, heart disease (except for hypertensive diseases) ranked the second among the top 10 causes of death from 2013 to 2016, and it still shows a growing trend. According to American Heart Association (AHA), the risk factors for coronary heart disease including: age (> 65 years), sex (men to women with 2:1 ratio), obesity, diabetes, hypertension, hyperlipidemia, smoking, family history, lack of exercise and more. We have collected a dataset of 421 patients from a hospital located in northern Taiwan who received coronary computed tomography (CT) angiography. There were 300 males (71.26%) and 121 females (28.74%), with age ranging from 24 to 92 years, and a mean age of 56.3 years. Prior to coronary CT angiography, basic data of the patients, including age, gender, obesity index (BMI), diastolic blood pressure, systolic blood pressure, diabetes, hypertension, hyperlipidemia, smoking, family history of coronary heart disease and exercise habits, were collected and used as input variables. The output variable of the prediction module is the degree of coronary artery stenosis. The output variable of the prediction module is the narrow constriction of the coronary artery. In this study, the dataset was randomly divided into 80% as training set and 20% as test set. Four machine learning algorithms, including logistic regression, stepwise regression, neural network and decision tree, were incorporated to generate prediction results. We used area under curve (AUC) / accuracy (Acc.) to compare the four models, the best model is neural network, followed by stepwise logistic regression, decision tree, and logistic regression, with 0.68 / 79 %, 0.68 / 74%, 0.65 / 78%, and 0.65 / 74%, respectively. Sensitivity of neural network was 27.3%, specificity was 90.8%, stepwise Logistic regression sensitivity was 18.2%, specificity was 92.3%, decision tree sensitivity was 13.6%, specificity was 100%, logistic regression sensitivity was 27.3%, specificity 89.2%. From the result of this study, we hope to improve the accuracy by improving the module parameters or other methods in the future and we hope to solve the problem of low sensitivity by adjusting the imbalanced proportion of positive and negative data.

Keywords: decision support, computed tomography, coronary artery, machine learning

Procedia PDF Downloads 208

Authors: Zenebu Adere Tola

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Informal settlements behave dynamically over space and time and the number of people living in such housing areas is growing worldwide. In the cities of developing countries especially in sub-Saharan Africa, poverty, unemployment rate, poor living condition, lack transparency and accountability, lack of good governance are the major factors to contribute for the people to hold land informally and built houses for residential or other purposes. In most of Ethiopian cities informal settlement is highly seen in peripheral areas this is because people can easily to hold land for housing from local farmers, brokers, speculators without permission from concerning bodies. In Adama informal settlement has created risky living conditions and led to environmental problems in natural areas the main reason for this was the lack of sufficient knowledge about informal settlement development. On the other side there is a strong need to transform informal into formal settlements and to gain more control about the actual spatial development of informal settlements. In another hand to tackle the issue it is at least very important to understand the scale of the problem. To understand the scale of the problem it is important to use up-to-date technology. For this specific problem, it is good to use high-resolution imagery to detect informal settlement in Adama city. The main objective of this study is to assess the spatiotemporal dynamics and environmental impacts of informal settlement using OBIA. Specifically, the objective of this study is to; identify informal settlement in the study area, determine the change in the extent and pattern of informal settlement and to assess the environmental and social impacts of informal settlement in the study area. The methods to be used to detect the informal settlement is object-oriented image analysis. Consequently, reliable procedures for detecting the spatial behavior of informal settlements are required in order to react at an early stage to changing housing situations. Thus, obtaining spatial information about informal settlement areas which is up to date is vital for any actions of enhancement in terms of urban or regional planning. Using data for this study aerial photography for growth and change of informal settlements in Adama city. Software ECognition software for classy to built-up and non-built areas. Thus, obtaining spatial information about informal settlement areas which is up to date is vital for any actions of enhancement in terms of urban or regional planning.

Keywords: informal settlement, change detection, environmental impact, object based analysis

Procedia PDF Downloads 43

Authors: Kristine Demilou Santiago

Abstract:

In a context of a developing nation, how important is the role of Corporate Social Responsibility health programs? Is there a possibility that this will render a large impact in a society where health benefits are insufficient? The Philippine government has been in an unceasing battle to provide its citizens competitive health benefits through launching various health programs. As the efforts are being claimed by the government, the numbers just show that all the health benefits being offered such as PhilHealth health cards, medical missions and other subsidized government health benefits are not effective and sufficient at the minimum level. This is a major characteristic of a developing nation which the Philippine government is focusing on addressing as it becomes a national concern under the effects of poverty. Industrial companies, through Corporate Social Responsibility, are playing an important role in the aspiration to resolve this problem on health programs as supposed to be basic services to citizens of the Philippine government. The rise of commitment by these industrial companies to render health programs to communities as part of their corporate citizenship has covered a large portion of the basic health services that the Filipino citizens are supposed to be receiving. This is the most salient subject that a developing nation should focus on determining the important contribution of industrial companies present in their country as part of the citizens’ access to basic health services. The use of survey forms containing quantitative and qualitative questions which aim to give numerical figures and support answers as to the role of CSR Health programs in helping the communities receive the basic health services they need was the methodological procedure followed in this research. A sample population in a community where the largest industrial company in a province of the Philippines was taken through simple random sampling. The assumption is that this sample population which represents the whole of the community has the highest opportunities to access both the government health services and the CSR health program services of the industrial company located in their community. Results of the research have shown a significant level of participation by industrial companies through their CSR health programs in the attainment of basic health services that should be rendered by the Philippine government to its citizens as part of the state’s health benefits. In a context of a developing nation such as the Philippines, the role of Corporate Social Responsibility is beyond the expectation of initiating to resolve environmental and social issues. It is moving deeper in the concept of the corporate industries being a pillar of the government in catering the support needed by the individuals in the community for its development. As such, the concept of the presence of an industrial company in a community is said to be a parallel progress: by which when an industrial company expands because it is becoming more profitable, so is the community gaining the same step of progress in terms of socioeconomic development.

Keywords: basic health services, CSR health program, health services in a developing nation, Philippines health benefits

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Authors: Lin-Han Chiang Hsieh, Hsiao-Yi Lin

Abstract:

This study aims to determine the impact of the disclosure of flood potential map on housing prices. The disclosure is supposed to mitigate the market failure by reducing information asymmetry. On the other hand, opponents argue that the official disclosure of simulated results will only create unnecessary disturbances on the housing market. This study identifies the impact of the disclosure of the flood potential map by comparing the hedonic price of flood potential before and after the disclosure. The flood potential map used in this study is published by Taipei municipal government in 2015, which is a result of a comprehensive simulation based on geographical, hydrological, and meteorological factors. The residential property sales data of 2013 to 2016 is used in this study, which is collected from the actual sales price registration system by the Department of Land Administration (DLA). The result shows that the impact of flood potential on residential real estate market is statistically significant both before and after the disclosure. But the trend is clearer after the disclosure, suggesting that the disclosure does have an impact on the market. Also, the result shows that the impact of flood potential differs by the severity and frequency of precipitation. The negative impact for a relatively mild, high frequency flood potential is stronger than that for a heavy, low possibility flood potential. The result indicates that home buyers are of more concern to the frequency, than the intensity of flood. Another contribution of this study is in the methodological perspective. The classic hedonic price analysis with OLS regression suffers from two spatial problems: the endogeneity problem caused by omitted spatial-related variables, and the heterogeneity concern to the presumption that regression coefficients are spatially constant. These two problems are seldom considered in a single model. This study tries to deal with the endogeneity and heterogeneity problem together by combining the spatial fixed-effect model and geographically weighted regression (GWR). A series of literature indicates that the hedonic price of certain environmental assets varies spatially by applying GWR. Since the endogeneity problem is usually not considered in typical GWR models, it is arguable that the omitted spatial-related variables might bias the result of GWR models. By combing the spatial fixed-effect model and GWR, this study concludes that the effect of flood potential map is highly sensitive by location, even after controlling for the spatial autocorrelation at the same time. The main policy application of this result is that it is improper to determine the potential benefit of flood prevention policy by simply multiplying the hedonic price of flood risk by the number of houses. The effect of flood prevention might vary dramatically by location.

Keywords: flood potential, hedonic price analysis, endogeneity, heterogeneity, geographically-weighted regression

Procedia PDF Downloads 269