Search results for: algerian population
4559 Linking the Built Environment, Activities and Well-Being: Examining the Stories among Older Adults during Ageing-in-Place
Authors: Wenquan Gan, Peiyu Zhao, Xinyu Zhao
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Under the background of the rapid development of China’s ageing population, ageing-in-place has become a primary strategy to cope with this problem promoted by the Chinese government. However, most older adults currently living in old residential communities are insufficient to support their ageing-in-place. Therefore, exploring how to retrofit existing communities towards ageing-friendly standards to support older adults is essential for healthy ageing. To better cope with this issue, this study aims to shed light on the inter-relationship among the built environment, daily activities, and well-being of older adults in urban China. Using mixed research methods including GPS tracking, structured observation, and in-depth interview to examine: (a) what specific places or facilities are most commonly used by the elderly in the ageing-in-place process; (b) what specific built environment characteristics attract older adults in these frequently used places; (c) how has the use of these spaces impacted the well-being of older adults. Specifically, structured observation and GPS are used to record and map the older residents’ behaviour and movement in Suzhou, China, a city with a highly aged population and suitable as a research case. Subsequently, a follow-up interview is conducted to explore what impact of activities and the built environment on their well-being. Results showed that for the elderly with good functional ability, the facilities promoted by the Chinese government to support ageing-in-place, such as community nursing homes for the aged, day-care centre, and activity centres for the aged, are rarely used by older adults. Additionally, older adults have their preferred activities and built environment characteristics that contribute to their well-being. Our findings indicate that a complex interrelationship between the built environment and activities can influence the well-being of the elderly. Further investigations are needed to understand how to support healthy ageing-in-place, especially in addition to providing permanent elder-ly-care facilities, but to attend to the design interventions that can enhance these particularly built environment characteristics to facilitate a healthy lifestyle in later life.Keywords: older adults, built environment, spatial behavior, community activity, healthy ageing
Procedia PDF Downloads 1074558 Conceptualizing Psycho-Social Intervention with Juvenile Offenders as Attachment Therapy: A Practical Approach
Authors: Genziana Lay
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A wide majority of older children and adolescents who enter the juvenile court system present with an array of problematic symptoms and behaviors including anxiety, depression, aggressive acting out, detachment, and substance abuse. Attachment theory offers a framework for understanding normative and pathological functioning, which during development is influenced by emotional, social and cognitive elements. There is clear evidence that children and adolescents with the highest risk of developing adaptation problems present an insecure attachment profile. Most offending minors have experienced dysfunctional family relationships as well as social and/or economic deprivation. Their maladaptive attachment develops not only through their relationship with caregivers but with the environment at large. Activation of their faulty attachment system leads them to feel emotionally overwhelmed and engage in destructive behaviors and decision-making. A psycho-social intervention with this population conceptualized as attachment therapy is a multi-faceted, practical approach that has shown excellent results in terms of increased psychological well-being and drastically reduced rates of re-offense/ destructive behavior. Through several; components including psychotherapy, monitoring, volunteering, meditation and socialization, the program focuses on seven dimensions: self-efficacy, responsibility, empathy/reparation, autonomy/security, containment/structure, insight building, and relational health. This paper presents the program and illustrates how the framework of attachment theory practically applied to psycho-social intervention has great therapeutic and social reparation potential. Preliminary evidence drawn from the Sassari Juvenile Court is very promising; this paper will illustrate these results and propose an even more comprehensive, applicable approach to psycho-social reparative intervention that leads to greater psychological health and reduced recidivism in the child and adolescent population.Keywords: attachment, child, adolescent, crime, juvenile, psychosocial
Procedia PDF Downloads 1724557 Clothing Features of Greek Orthodox Woman Immigrants in Konya (Iconium)
Authors: Kenan Saatcioglu, Fatma Koc
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When the immigration is considered, it has been found that communities were continuously influenced by the immigrations from the date of the emergence of mankind until the day. The political, social and economic reasons seen at the various periods caused the communities go to new places from where they have lived before. Immigrations have occurred as a result of unequal opportunities among communities, social exclusion and imposition, compulsory homeland emerging politically, exile and war. Immigration is a social tool that is defined as a geographical relocation of people from a housing unit (city, village etc.) to another to spend all or part of their future lives. Immigrations have an effect on the history of humanity directly or indirectly, revealing new dimensions for communities to evaluate the concept of homeland. With these immigrations, communities carried their cultural values to their new settlements leading to a new interaction process. With this interaction process both migrant and native community cultures were reshaped and richer cultural values emerged. The clothes of these communities are amongst the most important visual evidence of this rich cultural interaction. As a result of these immigrations, communities affected each other culture’s clothing mutually and they started adding features of other cultures to the garments of its own, resulting new clothing cultures in time. The cultural and historical differences between these communities are seem to be the most influential factors of keeping the clothing cultures of the people alive. The most important and tragic of these immigrations took place after the Turkish War of Independence that was fought against Greece in 1922. The concept of forced immigration was a result of Lausanne Peace Treaty, which was signed between Turkish and Greek governments on 30th January 1923. As a result Greek Orthodoxes, who lived in Turkey (Anatolia and Thrace) and Muslim Turks, who lived in Greece were forced to immigrate. In this study, clothing features of Greek Orthodox woman immigrants who emigrated from Turkey to Greece in the period of the ‘1923 Greek-Turkish Population Exchange’ are aimed to be examined. In the study using the descriptive research method, before the ‘1923 Greek-Turkish Population Exchange’, the clothings belong to Greek Orthodox woman immigrants who lived in ‘Konya (Iconium)’ region in the Ottoman Empire, are discussed. In the study that is based on two different clothings belonging to ‘Konya (Iconium)’ region in the clothing collection archive at the ‘National Historical Museum’ in Greece, clothings of the Greek Orthodox woman immigrants are discussed with cultural norms, beliefs, values as well as in terms of form, ornamentation and dressing styles. Technical drawings are provided demonstrating formal features of the clothing parts that formed clothing integrity and their properties are described with the use of related literature in this study. This study is of importance that that it contains Greek Orthodox refugees’ clothings that are found in the clothing collection archive at the ‘National Historical Museum’ in Greece reflecting the cultural identities, providing information and documentation on the clothing features of the ‘1923 Greek-Turkish Population Exchange’.Keywords: clothing, Greece, Greek Orthodoxes, immigration, national historical museum, Turkey
Procedia PDF Downloads 2484556 Investigation p53 Codon 72 Polymorphism and miR-146a rs2910164 Polymorphism in Breast Cancer
Authors: Marjan Moradi Fard, Hossein Rassi, Masoud Houshmand
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Aim: Breast cancer is one of the most common cancers affecting the morbidity and mortality of Iranian women. This disease is a result of collective alterations of oncogenes and tumor suppressor genes. Studies have produced conflicting results concerning the role of p53 codon 72 polymorphism (G>C) and miR-146a rs2910164 polymorphism (G>C) on the risk of several cancers; therefore, a research was performed to estimate the association between the p53 codon 72 polymorphism and miR-146a rs2910164 polymorphism in breast cancer. Methods and Materials: A total of 45 archival breast cancer samples from khatam hospital and 40 healthy samples were collected. Verification of each cancer reported in a relative was sought through the pathology reports of the hospital records. Then, DNA extracted from all samples by standard methods and p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes were analyzed using multiplex PCR. The tubules, mitotic activity, necrosis, polymorphism and grade of breast cancer were staged by Nottingham histological grading and immunohistochemical staining of the sections from the paraffin wax embedded tissues for the expression of ER, PR and p53 was carried out using a standard method. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Successful DNA extraction was assessed by PCR amplification of b-actin gene (99 bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of breast cancer in the study population. In this study, we established that tumors of p53 GG genotype and miR-146a rs2910164 CC genotype exhibited higher mitotic activity, higher polymorphism, lower necrosis, lower tubules, higher ER- and PR-negatives and lower TP53-positives than the other genotypes. Conclusion: The present study provided preliminary evidence that a p53 GG genotype may effect breast cancer risk in the study population, interacting synergistically with miR-146a rs2910164 CC genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with clinical parameters can serve as major risk factors in the early identification of breast cancers.Keywords: breast cancer, p53 codon 72 polymorphism, miR-146a rs2910164 polymorphism, genotypes
Procedia PDF Downloads 3364555 Therapeutic Drug Monitoring by Dried Blood Spot and LC-MS/MS: Novel Application to Carbamazepine and Its Metabolite in Paediatric Population
Authors: Giancarlo La Marca, Engy Shokry, Fabio Villanelli
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Epilepsy is one of the most common neurological disorders, with an estimated prevalence of 50 million people worldwide. Twenty five percent of the epilepsy population is represented in children under the age of 15 years. For antiepileptic drugs (AED), there is a poor correlation between plasma concentration and dose especially in children. This was attributed to greater pharmacokinetic variability than adults. Hence, therapeutic drug monitoring (TDM) is recommended in controlling toxicity while drug exposure is maintained. Carbamazepine (CBZ) is a first-line AED and the drug of first choice in trigeminal neuralgia. CBZ is metabolised in the liver into carbamazepine-10,11-epoxide (CBZE), its major metabolite which is equipotent. This develops the need for an assay able to monitor the levels of both CBZ and CBZE. The aim of the present study was to develop and validate a LC-MS/MS method for simultaneous quantification of CBZ and CBZE in dried blood spots (DBS). DBS technique overcomes many logistical problems, ethical issues and technical challenges faced by classical plasma sampling. LC-MS/MS has been regarded as superior technique over immunoassays and HPLC/UV methods owing to its better specificity and sensitivity, lack of interference or matrix effects. Our method combines advantages of DBS technique and LC-MS/MS in clinical practice. The extraction process was done using methanol-water-formic acid (80:20:0.1, v/v/v). The chromatographic elution was achieved by using a linear gradient with a mobile phase consisting of acetonitrile-water-0.1% formic acid at a flow rate of 0.50 mL/min. The method was linear over the range 1-40 mg/L and 0.25-20 mg/L for CBZ and CBZE respectively. The limit of quantification was 1.00 mg/L and 0.25 mg/L for CBZ and CBZE, respectively. Intra-day and inter-day assay precisions were found to be less than 6.5% and 11.8%. An evaluation of DBS technique was performed, including effect of extraction solvent, spot homogeneity and stability in DBS. Results from a comparison with the plasma assay are also presented. The novelty of the present work lies in being the first to quantify CBZ and its metabolite from only one 3.2 mm DBS disc finger-prick sample (3.3-3.4 µl blood) by LC-MS/MS in a 10 min. chromatographic run.Keywords: carbamazepine, carbamazepine-10, 11-epoxide, dried blood spots, LC-MS/MS, therapeutic drug monitoring
Procedia PDF Downloads 4174554 Physical Fitness Normative Reference Values among Lithuanian Primary School Students: Population-Based Cross-Sectional Study
Authors: Brigita Mieziene, Arunas Emeljanovas, Vida Cesnaitiene, Ingunn Fjortoft, Lise Kjonniksen
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Background. Health-related physical fitness refers to the favorable health status, i.e. ability to perform daily activities with vigor, as well as capacities that are associated with a low risk for development of chronic diseases and premature death. However, in school-aged children it is constantly declining, while some aspects of fitness declined as much as 50 percent during the last two decades, which prognosticates increasingly earlier onset of health problems, decreasing the quality of life of the population and financial burden for the society. Therefore, the goal of the current study was to indicate nationally representative age- and gender-specific reference values of anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness in Lithuanian primary school children from 6 to 10 years. Methods. The study included 3556 students in total, from 73 randomly selected schools. Ethics approval for research by the Kaunas Regional Ethics Committee (No. BE-2-42) was obtained. Physical fitness was measured by the 9-item test battery, developed by Fjørtoft and colleagues. Height and weight were measured and body mass index calculated. Smoothed centile charts were derived using the LMS method. Results. The numerical age- and gender-specific percentile values (3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile) for anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness were provided. The equivalent smoothed LMS curves were performed. The study indicated 12.5 percent of overweight and 5 percent of obese children in accordance with international gender and age specific norms of body mass index. This data could be used in clinical and educational settings in order to identify the level of individual physical fitness within its different components.Keywords: fitness, overweight, primary school children, reference values, smoothed percentile curves
Procedia PDF Downloads 1624553 Prevalence of Diabetes Mellitus in the Western North Part of Libya
Authors: Mustafa Ali Abugila
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A total of 13807 diabetic patients [(males 5893(42.68%), females 7914 (57.32%)] were on the registered in diabetic clinics in the western north of Libya at the end of 2012. Of the total clinic population, 865 patients had Type 1 IDDM (6.26%) and the rest cases had Type 2 NIDDM (93.74%). Diabetes mellitus was higher in females than in males (57.32% , 42.68%), the male to female ratio was (0.74 : 1).Keywords: Diabetes Mellitus (DM), gestational diabetes mellitus, North Western of Libya,
Procedia PDF Downloads 5034552 The Correlation between Clostridium Difficile Infection and Bronchial Lung Cancer Occurrence
Authors: Molnar Catalina, Lexi Frankel, Amalia Ardeljan, Enoch Kim, Marissa Dallara, Omar Rashid
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Introduction: Clostridium difficile (C. diff) is a toxin-producing bacteria that can cause diarrhea and colitis. U.S. Center for Disease Control and Prevention revealed that C. difficile infection (CDI) has increased from 31 cases per 100,000 persons per year in 1996 to 61 per 100,000 in 2003. Approximately 500,000 cases per year occur in the United States. After exposure, the bacteria colonize the colon, where it adheres to the intestinal epithelium where it produces two toxins: TcdA and TcdB. TcdA affects the intestinal epithelium, causing fluid secretion, inflammation, and tissue necrosis, while TcdB acts as a cytotoxin purpose of this study was to evaluate the association between C diff infection and bronchial lung cancer development. Methods: Using ICD- 9 and ICD-10 codes, the data was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to assess the patients infected with C diff as opposed to the non-infected patients. The Holy Cross Health, Fort Lauderdale, granted access to the database for the purpose of academic research. Patients were matched for age and Charlson Comorbidity Index (CCI). Standard statistical methods were used. Results: Bronchial lung cancer occurrence in the population not infected with C diff infection was 4741, as opposed to the population infected with C. diff, where 2039 cases of lung cancer were observed. The difference was statistically significant (p-value < 2.2x10^e-16), which reveals that C diff might be protective against bronchial lung cancer. The data was then matched by treatment to create to minimize the effect of treatment bias. Bronchial cancer incidence was 422 and 861 in infected vs. non-infected (p-value of < 2.2x10^e-16), which once more indicates that C diff infection could be beneficial in diminishing bronchial cancer development. Conclusion: This retrospective study conveys a statistical correlation between C diff infection and decreased incidence of lung bronchial cancer. Further studies are needed to comprehend the protective mechanisms of C. Diff infection on lung cancer.Keywords: C. diff, lung cancer, protective, microbiology
Procedia PDF Downloads 2354551 A Study on the Interest of Muslims towards Syariah Bank in Yogyakarta, Indonesia
Authors: Muhammad Hikmah
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Based on the population census in 2015, Indonesia consists of 254.9 millions of people, and 80% of them are Muslims (Data of Central Bureau of Statistic). Indonesia becomes the highest number of Muslims civilization in the world. The question would be, is the number of population proportional to the growth of Syariah transaction in Indonesia? It is going to be discussed in this research. The problem limitation of this research is in Syariah Banking. Therefore, Syariah transaction in this study is described as transaction only in Syariah Banking. The researcher focused on the study in Yogyakarta, a city in Indonesia. The development of Syariah Bank assets until January 2016, based on statistic data launched by Financial Services Authority (FSA), has increased Rp 287.44 trillion, however, a total amount of bank achieves Rp 6.198,15 trillions. It means that the assets of Syariah Bank are only 4.64% from the total amount of banking assets in Indonesia, though, Syariah Banking was first established in 1991, known as Bank Muamalat. As we can see that in these 25 years, Syariah Banking could only reach that number. Based on the press conference of FSA and Syariah Banking Exhibition iB Vaganza in 2015, the number of Syariah Bank’s customers are under 10 millions. With 80% of Muslims, Syariah Bank is not able to be a market leader in Indonesia. This will be answered in this research, how much the interest if Muslims in Yogyakarta towards Syariah Bank compared to conventional bank. This study will be conducted in Yogyakarta. The sampling will represent to the muslims having good knowledge of Islam, such as dawn prayer worshipers in some mosques in Yogyakarta. There are some reasons why Indonesian muslims are not interested in Syariah Bank, such as the people do not put trust in Syariah Bank; there are some obligation where they work to have conventional bank; business matters services which is not covered by Syariah Bank where most of them are limited to the laws authorities; and there is no sufficient knowledge about the importance of syariah transaction from religion point of view. Each of them is going to be discussed in this research. The suggestions of this study are we should share our knowledge about Islamic transaction anywhere and we need to support Syariah Bank to have Syariah principles. For those who have the authority should be active as well to announce the rules of the constitution supporting the development of syariah transaction in order to be apply perfectly. We hope that trust from the people will increase, and we should provide Syariah Banking products which fulfill business needs. Finally, syariah transaction will be the solution for all people in the world in bussiness transaction.Keywords: shariah, Islamic, banking, Indonesia
Procedia PDF Downloads 3544550 Cross Site Scripting (XSS) Attack and Automatic Detection Technology Research
Authors: Tao Feng, Wei-Wei Zhang, Chang-Ming Ding
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Cross-site scripting (XSS) is one of the most popular WEB Attacking methods at present, and also one of the most risky web attacks. Because of the population of JavaScript, the scene of the cross site scripting attack is also gradually expanded. However, since the web application developers tend to only focus on functional testing and lack the awareness of the XSS, which has made the on-line web projects exist many XSS vulnerabilities. In this paper, different various techniques of XSS attack are analyzed, and a method automatically to detect it is proposed. It is easy to check the results of vulnerability detection when running it as a plug-in.Keywords: XSS, no target attack platform, automatic detection,XSS detection
Procedia PDF Downloads 4034549 Constructing Digital Memory for Chinese Ancient Village: A Case on Village of Gaoqian
Authors: Linqing Ma, Huiling Feng, Jihong Liang, Yi Qian
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In China, some villages have survived in the long history of changes and remain until today with their unique styles and featured culture developed in the past. Those ancient villages, usually aged for hundreds or thousands of years, are the mirror for traditional Chinese culture, especially the farming-studying culture represented by the Confucianism. Gaoqian, an ancient village with a population of 3,000 in Zhejiang province, is such a case. With a history dating back to Yuan Dynasty, Gaoqian Village has 13 well-preserved traditional Chinese houses with a courtyard, which were built in the Ming and Qing Dynasty. It is a fine specimen to study traditional rural China. In China, some villages have survived in the long history of changes and remain until today with their unique styles and featured culture developed in the past. Those ancient villages, usually aged for hundreds or thousands of years, are the mirror for traditional Chinese culture, especially the farming-studying culture represented by the Confucianism. Gaoqian, an ancient village with a population of 3,000 in Zhejiang province, is such a case. With a history dating back to Yuan Dynasty, Gaoqian Village has 13 well-preserved traditional Chinese houses with a courtyard, which were built in the Ming and Qing Dynasty. It is a fine specimen to study traditional rural China. Then a repository for the memory of the Village will be completed by doing arrangement and description for those multimedia resources such as texts, photos, videos and so on. Production of Creative products with digital technologies is also possible based a thorough understanding of the culture feature of Gaoqian Village using research tools for literature and history studies and a method of comparative study. Finally, the project will construct an exhibition platform for the Village and its culture by telling its stories with completed structures and treads.Keywords: ancient villages, digital exhibition, multimedia, traditional culture
Procedia PDF Downloads 5874548 Importance of Detecting Malingering Patients in Clinical Setting
Authors: Sakshi Chopra, Harsimarpreet Kaur, Ashima Nehra
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Objectives: Malingering is fabricating or exaggerating the symptoms of mental or physical disorders for a variety of secondary gains or motives, which may include financial compensation; avoiding work; getting lighter criminal sentences; or simply to attract attention or sympathy. Malingering is different from somatization disorder and factitious disorder. The prevalence of malingering is unknown and difficult to determine. In an estimated study in forensic population, it can reach up to 17% cases. But the accuracy of such estimates is questionable as successful malingerers are not detected and thus, not included. Methods: The case study of a 58 years old, right handed, graduate, pre-morbidly working in a national company with reported history of stroke leading to head injury; cerebral infarction/facial palsy and dementia. He was referred for disability certification so that his job position can be transferred to his son as he could not work anymore. A series of Neuropsychological tests were administered. Results: With a mental age of < 2.5 years; social adaptive functioning was overall < 20 showing profound Mental Retardation, less than 1 year social age in abilities of self-help, eating, dressing, locomotion, occupation, communication, self-direction, and socialization; severely impaired verbal and performance ability, 96% impairment in Activities of Daily Living, with an indication of very severe depression. With inconsistent and fluctuating medical findings and problem descriptions to different health professionals forming the board for his disability, it was concluded that this patient was malingering. Conclusions: Even though it can be easily defined, malingering can be very challenging to diagnosis. Cases of malingering impose a substantial economic burden on the health care system and false attribution of malingering imposes a substantial burden of suffering on a significant proportion of the patient population. Timely, tactful diagnosis and management can help ease this patient burden on the healthcare system. Malingering can be detected by only trained mental health professionals in the clinical setting.Keywords: disability, India, malingering, neuropsychological assessment
Procedia PDF Downloads 4194547 Human Pressure Threaten Swayne’s Hartebeest to Point of Local Extinction from the Savannah Plains of Nech Sar National Park, South Rift Valley, Ethiopia
Authors: Simon Shibru, Karen Vancampenhout, Jozef Deckers, Herwig Leirs
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We investigated the population size of the endemic and endangered Swayne’s Hartebeest (Alcelaphus buselaphus swaynei) in Nech Sar National Park from 2012 to 2014 and document the major threats why the species is on the verge of local extinction. The park was once known for its abundant density of Swayne’s Hartebeest. We used direct total count methods for a census. We administered semi-structured interviews and open-ended questionnaires with senior scouts who are the member of the local communities. Historical records were obtained to evaluate the population trends of the animals since 1974. The density of the animal decreased from 65 in 1974 to 1 individual per 100 km2 in 2014 with a decline of 98.5% in the past 40 years. The respondents agreed that the conservation status of the park was in its worst condition ever now with only 2 Swayne’s Hartebeest left, with a rapid decline from 4 individuals in 2012 and 12 individuals in 2009. Mainly hunting and habitat loss, but also the unsuitable season of reproduction and shortage of forage as minor factors were identified as threats for a local extinction of the Swayne’s Hartebeests. On the other hand, predation, fire, disease, and ticks were not considered a cause for the declining trend. Hunting happens mostly out of some kind of revenge since the local community thought that they were pushed out from the land because of the presence of Swayne's Hartebeest in the area. Respondents agreed that the revenge action of the local communities was in response to their unwillingness to be displaced from the park in 1982/3. This conflict situation is resulting from the exclusionary wildlife management policy of the country. We conclude that the human interventions in general and illegal hunting, in particular, pushed the Swayne’s Hartebeest to a point of local extinction. Therefore, we recommend inclusive wildlife management approach for continuing existence of the park together with its natural resources so that sustainable use of the resources is in place.Keywords: hunting, habitat destruction, local extinction, Nech Sar National Park, Swayne’s Hartebeest
Procedia PDF Downloads 4744546 A Meta-Analysis of the Academic Achievement of Students With Emotional/Behavioral Disorders in Traditional Public Schools in the United States
Authors: Dana Page, Erica McClure, Kate Snider, Jenni Pollard, Tim Landrum, Jeff Valentine
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Extensive research has been conducted on students with emotional and behavioral disorders (EBD) and their rates of challenging behavior. In the past, however, less attention has been given to their academic achievement and outcomes. Recent research examining outcomes for students with EBD has indicated that these students receive lower grades, are less likely to pass classes, and experience higher rates of school dropout than students without disabilities and students with other high incidence disabilities. Given that between 2% and 20% of the school-age population is likely to have EBD (though many may not be identified as such), this is no small problem. Despite the need for increased examination of this population’s academic achievement, research on the actual performance of students with EBD has been minimal. This study reports the results of a meta-analysis of the limited research examining academic achievement of students with EBD, including effect sizes of assessment scores and discussion of moderators potentially impacting academic outcomes. Researchers conducted a thorough literature search to identify potentially relevant documents before screening studies for inclusion in the systematic review. Screening identified 35 studies that reported results of academic assessment scores for students with EBD. These studies were then coded to extract descriptive data across multiple domains, including placement of students, participant demographics, and academic assessment scores. Results indicated possible collinearity between EBD disability status and lower academic assessment scores, despite a lack of association between EBD eligibility and lower cognitive ability. Quantitative analysis of assessment results yielded effect sizes for academic achievement of student participants, indicating lower performance levels and potential moderators (e.g., race, socioeconomic status, and gender) impacting student academic performance. In addition to discussing results of the meta-analysis, implications and areas for future research, policy, and practice are discussed.Keywords: students with emotional behavioral disorders, academic achievement, systematic review, meta-analysis
Procedia PDF Downloads 694545 Inferring Influenza Epidemics in the Presence of Stratified Immunity
Authors: Hsiang-Yu Yuan, Marc Baguelin, Kin O. Kwok, Nimalan Arinaminpathy, Edwin Leeuwen, Steven Riley
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Traditional syndromic surveillance for influenza has substantial public health value in characterizing epidemics. Because the relationship between syndromic incidence and the true infection events can vary from one population to another and from one year to another, recent studies rely on combining serological test results with syndromic data from traditional surveillance into epidemic models to make inference on epidemiological processes of influenza. However, despite the widespread availability of serological data, epidemic models have thus far not explicitly represented antibody titre levels and their correspondence with immunity. Most studies use dichotomized data with a threshold (Typically, a titre of 1:40 was used) to define individuals as likely recently infected and likely immune and further estimate the cumulative incidence. Underestimation of Influenza attack rate could be resulted from the dichotomized data. In order to improve the use of serosurveillance data, here, a refinement of the concept of the stratified immunity within an epidemic model for influenza transmission was proposed, such that all individual antibody titre levels were enumerated explicitly and mapped onto a variable scale of susceptibility in different age groups. Haemagglutination inhibition titres from 523 individuals and 465 individuals during pre- and post-pandemic phase of the 2009 pandemic in Hong Kong were collected. The model was fitted to serological data in age-structured population using Bayesian framework and was able to reproduce key features of the epidemics. The effects of age-specific antibody boosting and protection were explored in greater detail. RB was defined to be the effective reproductive number in the presence of stratified immunity and its temporal dynamics was compared to the traditional epidemic model using use dichotomized seropositivity data. Deviance Information Criterion (DIC) was used to measure the fitness of the model to serological data with different mechanisms of the serological response. The results demonstrated that the differential antibody response with age was present (ΔDIC = -7.0). The age-specific mixing patterns with children specific transmissibility, rather than pre-existing immunity, was most likely to explain the high serological attack rates in children and low serological attack rates in elderly (ΔDIC = -38.5). Our results suggested that the disease dynamics and herd immunity of a population could be described more accurately for influenza when the distribution of immunity was explicitly represented, rather than relying only on the dichotomous states 'susceptible' and 'immune' defined by the threshold titre (1:40) (ΔDIC = -11.5). During the outbreak, RB declined slowly from 1.22[1.16-1.28] in the first four months after 1st May. RB dropped rapidly below to 1 during September and October, which was consistent to the observed epidemic peak time in the late September. One of the most important challenges for infectious disease control is to monitor disease transmissibility in real time with statistics such as the effective reproduction number. Once early estimates of antibody boosting and protection are obtained, disease dynamics can be reconstructed, which are valuable for infectious disease prevention and control.Keywords: effective reproductive number, epidemic model, influenza epidemic dynamics, stratified immunity
Procedia PDF Downloads 2604544 Safety Profile of Anti-Retroviral Medicine in South Africa Based on Reported Adverse Drug Reactions
Authors: Sarah Gounden, Mukesh Dheda, Boikhutso Tlou, Elizabeth Ojewole, Frasia Oosthuizen
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Background: Antiretroviral therapy (ART) has been effective in the reduction of mortality and resulted in an improvement in the prognosis of HIV-infected patients. However, treatment with antiretrovirals (ARVs) has led to the development of many adverse drug reactions (ADRs). It is, therefore, necessary to determine the safety profile of these medicines in a South African population in order to ensure safe and optimal medicine use. Objectives: The aim of this study was to quantify ADRs experienced with the different ARVs currently used in South Africa, to determine the safety profile of ARV medicine in South Africa based on reported ADRs, and to determine the ARVs with the lowest risk profile based on specific patient populations. Methodology: This was a quantitative study. Individual case safety reports for the period January 2010 – December 2013 were obtained from the National Pharmacovigilance Center; these reports contained information on ADRs, ARV medicine, and patient demographics. Data was analysed to find associations that may exist between ADRs experienced, ARV medicines used and patient demographics. Results: A total of 1916 patient reports were received of which 1534 met the inclusion criteria for the study. The ARV with the lowest risk of ADRs were found to be lamivudine (0.51%, n=12), followed by lopinavir/ritonavir combination (0.8%, n=19) and abacavir (0.64%, n=15). A higher incidence of ADRs was observed in females compared to males. The age group 31–50 years and the weight group 61–80 kg had the highest incidence of ADRs reported. Conclusion: This study found that the safest ARVs to be used in a South African population are lamivudine, abacavir, and the lopinavir/ritonavir combination. Gender differences play a significant role in the occurrence of ADRs and both anatomical and physiological differences account for this. An increased BMI (body mass index) in both men and women showed an increase in the incidence of ADRs associated with ARV therapy.Keywords: adverse drug reaction, antiretrovirals, HIV/AIDS, pharmacovigilance, South Africa
Procedia PDF Downloads 3514543 The Cost of Healthcare among Malaysian Community-Dwelling Elderly with Dementia
Authors: Roshanim Koris, Norashidah Mohamed Nor, Sharifah Azizah Haron, Normaz Wana Ismail, Syed Mohamed Aljunid Syed Junid, Amrizal Muhammad Nur, Asrul Akmal Shafie, Suraya Yusuff, Namaitijiang Maimaiti
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An ageing population has huge implications for virtually every aspect of Malaysian societies. The elderly consume a greater volume of healthcare facilities not because they are older, but because of they are sick. The chronic comorbidities and deterioration of cognitive ability would lead the elderly’s health to become worst. This study aims to provide a comprehensive estimate of the direct and indirect costs of health care used in a nationally representative sample of community-dwelling elderly with dementia and as well as the determinants of healthcare cost. A survey using multi-stage random sampling techniques recruited a final sample of 2274 elderly people (60 years and above) in the state of Johor, Perak, Selangor and Kelantan. Mini Mental State Examination (MMSE) score was used to measure the cognitive capability among the elderly. Only the elderly with a score less than 19 marks were selected for further analysis and were classified as dementia. By using a two-part model findings also indicate household income and education level are variables that strongly significantly influence the healthcare cost among elderly with dementia. A number of visits and admission are also significantly affect healthcare expenditure. The comorbidity that highly influences healthcare cost is cancer and seeking the treatment in private facilities is also significantly affected the healthcare cost among the demented elderly. The level of dementia severity is not significant in determining the cost. This study is expected to attract the government's attention and act as a wake-up call for them to be more concerned about the elderly who are at high risk of having chronic comorbidities and cognitive problems by providing more appropriate health and social care facilities. The comorbidities are one of the factor that could cause dementia among elderly. It is hoped that this study will promote the issues of dementia as a priority in public health and social care in Malaysia.Keywords: ageing population, dementia, elderly, healthcare cost, healthcare utiliztion
Procedia PDF Downloads 2054542 Similar Correlation of Meat and Sugar to Global Obesity Prevalence
Authors: Wenpeng You, Maciej Henneberg
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Background: Sugar consumption has been overwhelmingly advocated as a major dietary offender to obesity prevalence. Meat intake has been hypothesized as an obesity contributor in previous publications, but a moderate amount of meat to be included in our daily diet still has been suggested in many dietary guidelines. Comparable sugar and meat exposure data were obtained to assess the difference in relationships between the two major food groups and obesity prevalence at population level. Methods: Population level estimates of obesity and overweight rates, per capita per day exposure of major food groups (meat, sugar, starch crops, fibers, fats and fruits) and total calories, per capita per year GDP, urbanization and physical inactivity prevalence rate were extracted and matched for statistical analysis. Correlation coefficient (Pearson and partial) comparisons with Fisher’s r-to-z transformation and β range (β ± 2 SE) and overlapping in multiple linear regression (Enter and Stepwise) were used to examine potential differences in the relationships between obesity prevalence and sugar exposure and meat exposure respectively. Results: Pearson and partial correlations (controlled for total calories, physical inactivity prevalence, GDP and urbanization) analyses revealed that sugar and meat exposures correlated to obesity and overweight prevalence significantly. Fisher's r-to-z transformation did not show statistically significant difference in Pearson correlation coefficients (z=-0.53, p=0.5961) or partial correlation coefficients (z=-0.04, p=0.9681) between obesity prevalence and both sugar exposure and meat exposure. Both Enter and Stepwise models in multiple linear regression analysis showed that sugar and meat exposure were most significant predictors of obesity prevalence. Great β range overlapping in the Enter (0.289-0.573) and Stepwise (0.294-0.582) models indicated statistically sugar and meat exposure correlated to obesity without significant difference. Conclusion: Worldwide sugar and meat exposure correlated to obesity prevalence at the same extent. Like sugar, minimal meat exposure should also be suggested in the dietary guidelines.Keywords: meat, sugar, obesity, energy surplus, meat protein, fats, insulin resistance
Procedia PDF Downloads 3064541 Hindrances to Effective Delivery of Infrastructural Development Projects in Nigeria’s Built Environment
Authors: Salisu Gidado Dalibi, Sadiq Gumi Abubakar, JingChun Feng
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Nigeria’s population is about 190 million and is on the increase annually making it the seventh most populated nation in the world and first in Africa. This population growth comes with its prospects, needs, and challenges especially on the existing and future infrastructure. Infrastructure refers to structures, systems, and facilities serving the economy of a country, city, town, businesses, industries, etc. These include roads, railways lines, bridges, tunnels, ports, stadiums, dams and water projects, power generation plants and distribution grids, information, and communication technology (ICT), etc. The Nigerian government embarked on several infrastructural development projects (IDPs) to address the deficit as the present infrastructure cannot cater to the needs nor sustain the country. However, delivering such IDPs have not been smooth; comes with challenges from within and outside the project; frequent delays and abandonment. Thus, affecting all the stakeholders involved. Hence, the aim of this paper is to identify and assess the factors that are hindering the effective delivery of IDPs in Nigeria’s built environment with the view to offer more insight into such factors, and ways to address them. The methodology adopted in this study involves the use of secondary sources of data from several materials (official publications, journals, newspapers, internet, etc.) were reviewed within the IDPs field by laying more emphasis on Nigeria’s cases. The hindrance factors in this regard were identified which forms the backbone of the questionnaire. A pilot survey was used to test its suitability; after which it was randomly administered to various project professionals in Nigeria’s construction industry using a 5-point Likert scale format to ascertain the impact of these hindrances. Cronbach’s Alpha reliability test, mean item score computations, relative importance indices, T-test, Chi-Square statistics were used for data analyses. The results outline the impact of various internal, external and project related factors that are hindering IDPs within Nigeria’s built environment.Keywords: built environment, development, factors, hindrances, infrastructure, Nigeria, project
Procedia PDF Downloads 1774540 Regulation of Apoptosis in Human Lung Cancer NCI-H226 Cells through Caspase – Dependent Mechanism by Benjakul Extract
Authors: Pintusorn Hansakul, Ruchilak Rattarom, Arunporn Itharat
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Background: Benjakul, a Thai traditional herbal formulation, comprises of five plants: Piper chaba, Piper sarmentosum, Piper interruptum, Plumbago indica, and Zingiber officinale. It has been widely used to treat cancer patients in the context of folk medicine in Thailand. This study aimed to investigate the cytotoxic effect of the ethanol extract of Benjakul against three non-small cell lung cancer (NSCLC) cell lines (NCI-H226, A549, COR-L23), small cell lung cancer (SCLC) cell line NCI-H1688 and normal lung fibroblast cell line MRC-5. The study further examined the molecular mechanisms underlying its cytotoxicity via induction of apoptosis in NCI-H226 cells. Methods: The cytotoxic effect of Benjakul was determined by SRB assay. The effect of Benjakul on cell cycle distribution was assessed by flow cytometric analysis. The apoptotic effects of Benjakul were determined by sub-G1 quantitation and Annexin V-FITC/PI flow cytometric analyses as well as by changes in caspase-3 activity. Results: Benjakul exerted potent cytotoxicity on NCI-H226 and A549 cells but lower cytotoxicity on COR-L23 and NCI-H1688 cells without any cytotoxic effect on normal cells. Molecular studies showed that Benjakul extract induced G2/M phase arrest in human NCI-H226 cells in a dose-dependent manner. The highest concentration of Benjakul (150 μg/ml) led to the highest increase in the G2/M population at 12 h, followed by the highest increase in the sub-G1 population (apoptotic cells) at 60 h. Benjakul extract also induced early apoptosis (AnnexinV +/PI−) in NCI-H226 cells in a dose- and time- dependent manner. Moreover, treatment with 150 μg/ml Benjakul extract for 36 h markedly increased caspase-3 activity by 3.5-fold, and pretreatment with the general caspase inhibitor z-VAD-fmk completely abolished such activity. Conclusions: This study reveals for the first time the regulation of apoptosis in human lung cancer NCI-H226 cells through caspase-dependent mechanism by Benjakul extract.Keywords: apoptosis, Benjakul, caspase activation, cytotoxicity
Procedia PDF Downloads 4434539 A Comparative Psychological Interventional Study of Nicotine Dependence in Schizophrenic Patients
Authors: S. Madhusudhan, G. V. Vaniprabha
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Worldwide statistics have shown that smoking contributes significantly to mortality, with nicotine, being more addictive. Smoking causes more than 7,00,000 deaths/year in India. Compared to the general population, the prevalence of smoking is found to be much higher among people with psychotic disorders and, more so in schizophrenia. Schizophrenic patients who smoke tend to have higher frequency of heavy smoking, with rates ranging from 60% to as high as 80%. Hence, smokers with psychiatric disorders suffer higher rates of morbidity and mortality secondary to smoking related illnesses.Keywords: brief intervention, nicotine dependence, schizophrenia
Procedia PDF Downloads 3854538 Prevalence of Seropositivity for Cytomegalovirus in Patients with Hereditary Bleeding Diseases in West Azerbaijan of Iran
Authors: Zakieh Rostamzadeh, Zahra Shirmohammadi
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Human cytomegalovirus is a species of the cytomegalovirus family of viruses, which in turn is a member of the viral family known as herpesviridae or herpesviruses. Although they may be found throughout the body, HCMV infections are frequently associated with the salivary glands. HCMV infection is typically unnoticed in healthy people, but can be life-threatening for the immunocompromised such as HIV-infected persons, organ transplant recipients, or newborn infants. After infection, HCMV has an ability to remain latent within the body over long periods. Cytomegalovirus (CMV) causes infection in immunocompromised, hemophilia patients and those who received blood transfusion frequently. This study aimed at determining the prevalence of cytomegalovirus (CMV) antibodies in hemophilia patients. Materials and Methods: A retrospective observational study was carried out in Urmia, North West of Iran. The study population comprised a sample of 50 hemophilic patients born after 1985 and have received blood factors in West Azerbaijan. The exclusion criteria include: drug abusing, high risk sexual contacts, vertical transmission of mother to fetus and suspicious needling. All samples were evaluated with the method of ELISA, with a certain kind of kit and by a certain laboratory. Results: Fifty hemophiliacs from 250 patients registered with Urmia Hemophilia Society were enrolled in the study including 43 (86%) male, and 7 (14%) female. The mean age of patients was 10.3 years, range 3 to 25 years. None of patients had risk factors mentioned above. Among our studied population, 34(68%) had hemophilia A, 1 (2%) hemophilia B, 8 (16%) VWF, 3(6%) factor VII deficiency, 1 (2%) factor V deficiency, 1 (2%) factor X deficiency, 1 (2%). Sera of 50 Hemodialysis patients were investigated for CMV-specific immunoglobulin G (IgG) and IgM. % 91.89 patients were anti-CMV IgG positive and %40.54 was seropositive for anti-CMV IgM. 37.8% patient had serological evidence of reactivation and 2.7% of patients had the primary infection. Discussion: There was no relationship between the antibody titer and: drug abusing, high risk sexual contacts, vertical transmission of mother to fetus and suspicious needling.Keywords: bioinformatics, biomedicine, cytomegalovirus, immunocompromise
Procedia PDF Downloads 3574537 The Relationship between Amplitude and Stability of Circadian Rhythm with Sleep Quality and Sleepiness: A Population Study, Kerman 2018
Authors: Akram Sadat Jafari Roodbandi, Farzaneh Akbari, Vafa Feyzi, Zahra Zare, Zohreh Foroozanfar
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Introduction: Circadian rhythm or sleep-awake cycle in 24 hours is one of the important factors affecting the physiological and psychological characteristics in humans that contribute to biochemical, physiological and behavioral processes and helps people to set up brain and body for sleep or active awakening during certain hours. The purpose of this study was to investigate the relationship between the characteristics of circadian rhythms on the sleep quality and sleepiness according to their demographic characteristics such as age. Methods: This cross-sectional descriptive-analytic study was carried out among the general population of Kerman, aged 15-84 years. After dividing the age groups into 10-year demographic characteristics questionnaire, the type of circadian questionnaire, Pittsburgh sleep quality questionnaire and Euporth sleepiness questionnaire were completed in equal numbers between men and women of that age group. Using cluster sampling with effect design equal 2, 1300 questionnaires were distributed during the various hours of 24 hours in public places in Kerman city. Data analysis was done using SPSS software and univariate tests and linear regressions at a significance level of 0.05. Results: In this study, 1147 subjects were included in the study, 584 (50.9%) were male and the rest were women. The mean age was 39.50 ± 15.38. 133 (11.60%) subjects from the study participants had sleepiness and 308 (26.90%) subjects had undesirable sleep quality. Using linear regression test, sleep quality was the significant correlation with sex, hours needed for sleep at 24 hours, chronic illness, sleepiness, and circadian rhythm amplitude. Sleepiness was the meaningful relationship with marital status, sleep-wake schedule of other family members and the stability of circadian rhythm. Both women and men, with age, decrease the quality of sleep and increase the rate of sleepiness. Conclusion: Age, sex, and type of circadian people, the need for sleep at 24 hours, marital status, sleep-wake schedule of other family members are significant factors related to the sleep quality and sleepiness and their adaptation to night shift work.Keywords: circadian type, sleep quality, sleepiness, age, shift work
Procedia PDF Downloads 1534536 Presenting of 'Local Wishes Map' as a Tool for Promoting Dialogue and Developing Healthy Cities
Authors: Ana Maria G. Sperandio, Murilo U. Malek-Zadeh, João Luiz de S. Areas, Jussara C. Guarnieri
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Intersectoral governance is a requirement for developing healthy cities. However, this achievement is difficult to be succeeded, especially in regions at low resources condition. Therefore, it was developed a cheap investigative procedure to diagnose sectoral wishes related to urban planning and health promotion. This procedure is composed of two phases, which can be applied to different groups in order to compare the results. The first phase is a conversation guided by a list of questions. Some of those questions aim to gather information about how individuals understand concepts such as healthy city or a health promotion and what they believe that constitutes the relation between urban planning and urban health. Other questions investigate local issues, and how citizens would like to promote dialogue between sectors. At second phase individuals stand around the investigated city (or city region) map and are asked to represent their wishes on it. They can represent it by writing text notations or inserting icons on it, with the latter representing a city element, for example, some trees, a square, a playground, a hospital, a cycle track. After groups had represented their wishes, the map can be photographed, and then the results from distinct groups can be compared. This procedure was conducted at a small city in Brazil (Holambra), in 2017 which is the first out of four years of the mayor’s term. The prefecture asked for this tool in order to make Holambra become a city of Potential Healthy Municipalities Network in Brazil. Two sectors were investigated: the government and the urban population. By the end of our investigation, the intersection from the group (i.e., population and government) maps was accounted for creating a map of common wishes. Therefore, the material produced can be used as a guide for promoting dialogue between sectors and as a tool of monitoring politics progress. The report of this procedure was directed to public managers, so they could see the common wishes between themselves and local populations, and use this tool as a guide for creating urban politics which intends to enhance health promotion and to develop a healthy city, even at low resources condition.Keywords: governance, health promotion, intersectorality, urban planning
Procedia PDF Downloads 1394535 Navigating Life Transitions for Young People with Vision Impairment: A Community-Based Participatory Research Approach to Accessibility and Diversity
Authors: Aikaterini Tavoulari, Michael Proulx, Karin Petrini
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Objective: This study aims to explore the unique challenges faced by young individuals with vision impairment (VI) during key life transitions, utilizing a community-based participatory research (CBPR) approach to identify limitations and positive aspects of existing support systems, with a focus on accessibility and diversity. Design: The study employs a qualitative CBPR design, engaging young participants with VI through online and in-person working groups over six months, prioritizing their active involvement and diverse perspectives. Methods: Twenty-one young individuals with VI from across the UK and with different VI conditions were recruited to participate in the study via a climbing and virtual reality event and stakeholders’ support. Data collection methods included open discussions, forum exchanges, and qualitative questionnaires. The data were analyzed with NVivo using inductive thematic analysis to identify key themes and patterns related to the challenges and experiences of life transitions for this diverse population. Results: The analysis revealed barriers to accessibility, such as assumptions about what a person with VI can do, inaccessibility to material, noisy environments, and insufficient training with assistive technologies. Enablers included guidance from diverse professionals and peers, multisensory approaches (beyond tactile), and peer collaborations. This study underscores the need for developing accessible and tailored strategies together with these young people to address the specific needs of this diverse population during critical life transitions (e.g., to independent living, employment and higher education). Conclusion: Engaging and co-designing effective approaches and tools with young people with VI is key to tackling the specific accessibility barriers they encounter. These approaches should be targeted at different transitional periods of their life journey, promoting diversity and inclusion.Keywords: vision impairement, life transitions, qualitative research, community-based participatory design, accessibility
Procedia PDF Downloads 494534 Acquisition and Preservation of Traditional Medicinal Knowledge in Rural Areas of KwaZulu Natal, South Africa
Authors: N. Khanyile, P. Dlamini, M. Masenya
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Background: Most of the population in Africa is still dependent on indigenous medicinal knowledge for treating and managing ailments. Indigenous traditional knowledge owners/practitioners who own this knowledge are consulted by communities, but their knowledge is not known how they get it. The question of how knowledge is acquired and preserved remains one of the biggest challenges in traditional healing and treatment with herbal medicines. It is regrettable that despite the importance and recognition of indigenous medicinal knowledge globally, the details of acquirement, storing and transmission, and preservation techniques are not known. Hence this study intends to unveil the process of acquirement and transmission, and preservation techniques of indigenous medical knowledge by its owners. Objectives: This study aims to assess the process of acquiring and preservation of traditional medicinal knowledge by traditional medicinal knowledge owners/practitioners in uMhlathuze Municipality, in the province of KwaZulu-Natal, South Africa. The study was guided by four research objectives which were to: identify the types of traditional medicinal knowledge owners who possess this knowledge, establish the approach used by indigenous medicinal knowledge owners/healers for acquiring medicinal knowledge, identify the process of preservation of medicinal knowledge by indigenous medicinal knowledge owners/healers, and determine the challenges encountered in transferring the knowledge. Method: The study adopted a qualitative research approach, and a snowball sampling technique was used to identify the study population. Data was collected through semi-structured interviews with indigenous medicinal knowledge owners. Results: The findings suggested that uMhlathuze municipality had different types of indigenous medicinal knowledge owners who possess valuable knowledge. These are diviners (Izangoma), faith healers (Abathandazi), and herbalists (Izinyanga). The study demonstrated that indigenous medicinal knowledge is acquired in many different ways, including visions, dreams, and vigorous training. The study also revealed the acquired knowledge is preserved or shared with specially chosen children and trainees. Conclusion: The study concluded that this knowledge is gotten through vigorous training, which requires the learner to be attentive and eager to learn. It was recommended that a study of this nature be conducted but at a broader level to enhance an informed conclusion and recommendations.Keywords: preserving, indigenous medicinal knowledge, indigenous knowledge, indigenous medicinal knowledge owners/practitioners, acquiring
Procedia PDF Downloads 874533 Enhancing Oral Pre-Exposure Prophylaxis Uptake and Continuation among Adolescent Girls and Young Women in Busia District East Central Uganda
Authors: Jameson Mirimu, Edward Mawejje, Ibra Twinomujuni
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Introduction: Adolescent girls and young women (AGYW) are a vulnerable category whose risk of acquiring HIV is 20 times compared to the general population accounting for 25% of the new infections. Despite proven scientific evidence of preventing HIV acquisition, Oral Pre-Exposure Prophylaxis (PreP) is less used as one of the biomedical interventions among the AGYW. By 2020, only 31000-32000 of the targeted 90,000 persons in Uganda enrolled on Oral PreP LPHS-EC project employed a combination of Expanded Peer Outreach Approach (EPOA) and Effective client follow-up to increase PreP initiation (PrEP_NEW) and continuation for more than three months (PrEP_CT). Method: Quantitatively, data from National Key population Combination tracker retrospectively analyzed by M&E, focused group discussion with AGYWs and Health care workers to identify barriers. Barriers found; hesitancy of AGYW, misconceptions about Oral PrEP, inadequate knowledge and skills in handling adolescent and Data quality issues. To address the mentioned barriers, youth friendly corners initiated in study sites, identified PrEP Champions among the AGYW, oral PrEP dialogues, group Antenatal counselling, CQI Projects initiated, weekly perfomance meetings to track performance. Results: Routine program data review PrEP_NEW and PrEP_CT increased from 5% (4/80) and 4% (2/54), respectively, in July 2022 to 90% (72/80) and 79% (43/54) respectively for PrEP_NEW and PrEP_CT at the end of March 2023. Lessons Learnt: Demystifying misconception about oral Prep through provision of adequate information by involving health care workers through skills enhancement, CQI projects are critical intervention. Conclusion: With improved safe spaces, skills enhancement of health workers, stakeholders’ engagement through Oral Prep dialogues is critical in improving PreP uptake and continuity among the AGYWS.Keywords: prep, uptake, continuation, AGYW
Procedia PDF Downloads 714532 TP53 Mutations in Molecular Subtypes of Breast Cancer in Young Pakistani Patients
Authors: Nadia Naseem, Farwa Batool, Nasir Mehmood, AbdulHannan Nagi
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Background: The incidence and mortality of breast cancer vary significantly in geographically distinct populations. In Pakistan, breast cancer has shown an increase in incidence in young females and is characterized by more aggressive behavior. The tumor suppressor TP53 gene is a crucial genetic factor that plays a significant role in breast carcinogenesis. This study investigated the TP53 mutations in molecular subtypes of both nodes negative and positive breast cancer in young Pakistani patients. Material and Methods: p53, Estrogen Receptor (ER), Progesterone Receptor (PR), Her-2 neu and Ki 67 expressions were analyzed immunohistochemically in a series of 75 node negative (A) and 75 node positive (B) young (aged: 19-40 years) breast cancer patients diagnosed between 2014 to 2017 at two leading hospitals of Punjab, Pakistan. Tumor tissue specimens and peripheral blood samples were examined for TP53 mutations by direct sequencing of the gene (exons 4-9). The relation of TP53 mutations to these markers and clinicopathological data was investigated. Results: Mean age of the patients was 32.4 + 9.1 SD. Invasive breast carcinoma was the most frequent histological variant (A=92%, B=94.6%). Grade 3 carcinoma was the commonest grade (A=72%, B=81.3%). Triple negative cases (ER-, PR-, Her-2) formed most of the molecular subtypes (A=44%, B=50.6%). A total of 17.2% (A: 6.6%, B: 10.6%) patients showed TP53 mutations. Mutations were significantly more frequent in triple negative cases (A: 74.8%, B: 62.2%) compared to HER2-positive patients (P < 0.0001). In the multivariate analysis of the whole patient group, the independent prognosticator were triple negative cases (P=0.021), TP53 overexpression by IHC (P=0.001) and advanced-stage disease (P=0.007). No statistically significant correlation between TP53 mutations and clinicopathological parameters was found (P < 0.05). Conclusions: It is concluded that TP53 mutations are infrequently present in breast carcinoma of young Pakistani population and there was no significant correlation between p53 mutation and early onset disease. Immunohistochemically detected TP53 expression in our resource-constrained to set up can be beneficial in predicting mutations at the younger age in our population.Keywords: immunohistochemistry (IHC), invasive breast carcinoma (IBC), Pakistan, TP53
Procedia PDF Downloads 1584531 Study of Relation between P53 and Mir-146a Rs2910164 Polymorphism in Cervical Lesion
Authors: Hossein Rassi, Marjan Moradi Fard, Masoud Houshmand
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Background: Cervical cancer is multistep disease that is thought to result from an interaction between genetic background and environmental factors. Human papillomavirus (HPV) infection is the leading risk factor for cervical intraepithelial neoplasia(CIN)and cervical cancer. In other hand, some of p53 and miRNA polymorphism may plays an important role in carcinogenesis. This study attempts to clarify the relation of p53 genotypes and miR-146a rs2910164 polymorphism in cervical lesions. Method: Forty two archival samples with cervical lesion retired from Khatam hospital and 40 sample from healthy persons used as control group. A simple and rapid method was used to detect the simultaneous amplification of the HPV consensus L1 region and HPV-16,-18, -11, -31, 33 and -35 along with the b-globin gene as an internal control. We use Multiplex PCR for detection of P53 and miR-146a rs2910164 genotypes in our lab. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Cervix lesions were collected from 42 patients with Squamous metaplasia, cervical intraepithelial neoplasia, and cervical carcinoma. Successful DNA extraction was assessed by PCR amplification of b-actin gene (99bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of cervical lesions in the study population. In this study, we detected 13 HPV 18 from 42 cervical cancer. Conclusion: The connection between several SNP polymorphism and human virus papilloma in rare researches were seen. The reason of these differences in researches' findings can result in different kinds of races and geographic situations and also differences in life grooves in every region. The present study provided preliminary evidence that a p53 GG genotype and miR-146a rs2910164 CC genotype may effect cervical cancer risk in the study population, interacting synergistically with HPV 18 genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with HPV18 can serve as major risk factors in the early identification of cervical cancers. Furthermore, the results indicate the possibility of primary prevention of cervical cancer by vaccination against HPV18 in Iran.Keywords: cervical cancer, p53, miR-146a, rs2910164, polymorphism
Procedia PDF Downloads 4684530 Role of P53 Codon 72 Polymorphism and miR-146a Rs2910164 Polymorphism in Breast Cancer
Authors: Marjan Moradi fard, Hossein Rassi, Masoud Houshmand
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Aim: Breast cancer is one of the most common cancers affecting the morbidity and mortality of Iranian women. This disease is a result of collective alterations of oncogenes and tumor suppressor genes. Studies have produced conflicting results concerning the role of p53 codon 72 polymorphism (G>C) and miR-146a rs2910164 polymorphism (G>C) on the risk of several cancers; therefore, a research was performed to estimate the association between the p53 codon 72 polymorphism and miR-146a rs2910164 polymorphism in breast cancer. Methods and Materials: A total of 45 archival breast cancer samples from Khatam hospital and 40 healthy samples were collected. Verification of each cancer reported in a relative was sought through the pathology reports of the hospital records. Then, DNA extracted from all samples by standard methods and p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes were analyzed using multiplex PCR. The tubules, mitotic activity, necrosis, polymorphism and grade of breast cancer were staged by Nottingham histological grading and immunohistochemical staining of the sections from the paraffin wax embedded tissues for the expression of ER, PR and p53 was carried out using a standard method. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Successful DNA extraction was assessed by PCR amplification of b-actin gene (99 bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of breast cancer in the study population. In this study, we established that tumors of p53 GG genotype and miR-146a rs2910164 CC genotype exhibited higher mitotic activity, higher polymorphism, lower necrosis, lower tubules, higher ER- and PR-negatives and lower TP53-positives than the other genotypes. Conclusion: The present study provided preliminary evidence that a p53 GG genotype may effect breast cancer risk in the study population, interacting synergistically with miR-146a rs2910164 CC genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with clinical parameters can serve as major risk factors in the early identification of breast cancers.Keywords: breast cancer, miR-146a rs2910164 polymorphism, p53 codon 72 polymorphism, tumors, pathology reports
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