Search results for: migration of population

Authors: Hannah Evangeline Sangeetha

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Ageing is an inevitable change in the life span of an individual. India’s old age population has increased from 19 million in 1947 to 100 million in the 21st century. The United Nations World Population ageing reports that the grey population has immensely increased from 9.2% in 1990 to 11.7 % in 2013, and it’s expected to triple by the year 2050 growing from 737 million to over 2 billion persons 60 years of age and older. Ageing is a period of physical, mental and social decline which brings a host of challenges to the individual and the family. Hence it requires attention at the micro, mezzo and the macro levels of the society. The concepts of healthy and successful aging are being used to help people to change their negative attitude towards aging. This perspective is important to make people realize their potentialities to bring about a change in the minds of senior citizens as well as the society. The objective of this study was to understand the level of active ageing among the rural elderly women and its impact on the quality of life. 330 elderly women from 12 villages of Sriperumbudur associated with the Mobile medical care of Help age India were interviewed using census method. The study revealed the following findings; most respondents in this study were young old between the age group of 60 to 75 years. All the three major religious groups were represented, 85.5percent were Hindus. Majority of the respondents 73.3percent had no education. It was interesting to know that majority of the respondents were self reliant (83.94 percent) and 82.73 percent of them very independent and took care of them by themselves (activities of daily living) without any support from their families. 76.9 percent of the senior women worked based on their competencies, 75.5 percent of them were involved in plenty of activities everyday including their occupation and household chores, which enabled them to be physically active. The chi square values that there is a significant association between the overall active ageing score, religion &number of members in the family. The other demographic variables like age, occupation, income marital status, age at marriage, number of children in the family and Socio –Economic Status were not significantly associated with the overall active aging score. The p-value 0.032 showed Social network and being self-reliant are significantly associated. The study surprisingly shows that most women enjoyed freedom and Independence in their family which is a positive indicator of active ageing.

Keywords: active ageing, quality of life, independence, self reliance

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Authors: Kristen Erekson, Sarah Spendlove Caswell

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Nurse educators have the challenge of training future nurses that will provide compassionate care to an increasingly diverse population of patients in a culturally sensitive way. One approach to this challenge is an immersive public and global health experience as part of the nursing program curriculum. Undergraduate nursing students at our institution are required to participate in a Public and Global Health course. They participate in a didactic preparatory course followed by a 3-to-4-week program in one of the following locations: The Czech Republic, Ecuador, Finland/Poland, Ghana, India, Spain, Taiwan, Tonga, an Honor Flight to Washington D.C. with Veterans, or in local (Utah) communities working with marginalized populations (including incarcerated individuals, refugees, etc.). The students are required to complete 84 clinical hours and 84 culture hours (which involve exposure to local history, art, architecture, customs, etc.). As Faculty, we feel strongly that these public and global health experiences help cultivate cultural awareness in our students and prepare nurses who are better prepared to serve a diverse population of patients throughout their careers. This presentation will highlight our experiences and provide ideas for other nurse educators who have an interest in developing similar programs in their schools but do not know where to start. Suggestions about how to start building relationships that can lead to these opportunities, along with logistics for continuing the programs, will be highlighted.

Keywords: global health nursing, nursing education, clinical education, public health nursing

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Authors: Ibrahim Laro ABUBAKAR

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The study examined the Availability and Utilization of E-Learning Technologies in Teaching of Human Kinetics and Health Education courses in Nigerian Universities, specifically, Universities in Kwara State. Two purposes were formulated to guide the study from which two research questions and two hypotheses were raised. The descriptive research design was used in the research. Three Hundred respondents (100 Lecturers and 200 Students) made up the population for the study. There was no sampling, as the population of the study was not much. A structured questionnaire tagged ‘Availability and Utilization of E-Learning Technologies in Teaching and Learning Questionnaire’ (AUETTLQ) was used for data collection. The questionnaire was subjected to face and content validation, and it was equally pilot tested. The validation yielded a reliability coefficient of 0.78. The data collected from the study were statistically analyzed using frequencies and percentage count for personal data of the respondents, mean and standard deviation to answer the research questions. The null hypotheses were tested at 0.05 level of significance using the independent t-test. One among other findings of this study showed that lecturers and Student are aware of synchronous e-learning technologies in teaching and learning of Human Kinetics and Health Education but often utilize the synchronous e-learning technologies. It was recommended among others that lecturers and Students should be sensitized through seminars and workshops on the need to maximally utilize available e-learning technologies in teaching and learning of Human Kinetics and Health Education courses in Universities.

Keywords: awareness, utilization, E-Learning, technologies, human kinetics synchronous

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Authors: Hyunjung Lim, Jeonghun Nam, Hyuk Choi

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High-throughput separation is an essential technique for cancer research and diagnosis. Here, we propose a viscoelastic microfluidic device for sheathless, high-throughput isolation of circulating tumor cells (CTCs) from white blood cells. Here, we demonstrate a viscoelastic method for separation and concentration of CTCs using closed-loop microfluidics. Our device is a rectangular straight channel with a low aspect ratio. Also, to achieve high-efficiency, high-throughput processing, we used a polymer solution with low viscosity. At the inlet, CTCs and white blood cells (WBCs) were randomly injected into the microchannel. Due to the viscoelasticity-induced lateral migration to the equilibrium positions, large CTCs could be collected from the side outlet while small WBCs were removed at the center outlet. By recirculating the collected CTCs from the side outlet back to the sample reservoir, continuous separation and concentration of CTCs could be achieved with high separation efficiency (~ 99%). We believe that our device has the potential to be applied in resource-limited clinical settings.

Keywords: circulating tumor cell, closed-loop microfluidics, concentration, separation, viscoelastic fluid

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Authors: Karam Ignaim, Joao M. Fernandes, Andre L. Ferreira

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Mapping the artifacts coming from a set of similar products family developed in an ad-hoc manner to make up the resulting software product line (SPL) plays a key role to maintain the consistency between requirements and code. This paper presents a feature mapping approach that focuses on tracing the artifact coming from the migration process, the current feature model (FM), to the other artifacts of the resulting SPL, the reference architecture, and code. Thus, our approach relates each feature of the current FM to its locations in the implementation code, using the reference architecture as an intermediate artifact (as a centric point) to preserve consistency among them during an SPL evolution. The approach uses a particular artifact (i.e., traceability tree) as a solution for managing the mapping process. Tool support is provided using friendlyMapper. We have evaluated the feature mapping approach and tool support by putting the approach into practice (i.e., conducting a case study) of the automotive domain for Classical Sensor Variants Family at Bosch Car Multimedia S.A. The evaluation reveals that the mapping approach presented by this paper fits the automotive domain.

Keywords: feature location, feature models, mapping, software product lines, traceability

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Authors: S. M. P Manjula, Ishara Amarathunga, Aryan Nath Koura, Jaideepraj Rao

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Background: Laparoscopic D2 Gastrectomy for non metastatic advanced Gastric cancer (AGC) has become a controversial topic as there are confronting ideas from experts in the field. Lack of consensus are mainly due to non feasibility of the dissection and safety and efficacy. Method: Data from all D2 Gastrectomies performed (both Subtotal and Total Gastrectomies) in our unit from 2009 December to 2013 December were retrospectively analysed. Computor database was prospectively maintained. Pathological stage two A (iiA) and above considered advanced Gastric cancers, who underwent curative intent D2 Gastrectomy were included for analysis(n=46). Four patients excluded from the study as peritoneal fluid cytology came positive for cancer cells and one patient exempted as microscopic resection margin positive(R1) after curative resection. Thirty day morbidity and mortality, operative time, lymph nodes harvest and survival (disease free and overall) analyzed. Results: Complete curative resection achieved in 40 patients. Mean age of the study population was 62.2 (32-88) and male to female ratio was 23: 17. Thirty day mortality (1/40) and morbidity (6/40). Average operative time 203.7 minutes (185- 400) and average lymphnodes harvest was 40.5 (18-91). Disease free survival of the AGC in this study population was 16.75 months (1-49). Average hospital stay was 6.8 days (3-31). Conclusion: Laparoscopic dissection is effective feasible and safe in AGC.

Keywords: laparoscopy, advanced gastric cancer, safety, efficacy

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Authors: Pegah Farokhzad

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Family is a basic unit of the society and the main source of human development. The initial aim of the family is psychological and social support of its members and has special developmental stages. Researches show the families who have less cohesion, have more conflicts and maladjustments and the members of such families are not able to communicate effectively. Family is a system in which any inter communication is related to child rearing patterns and can affect it. Even the child rearing styles in childhood can determine the family communications in adulthood. Therefore, the aim of the present research was to examine the relationship between child-rearing styles including authoritative, authoritarian and permissive with dimensions of family communication patterns including the conversation and conformity. The research design was a correlational and the population consisted of the psychology students of Roudehen Islamic Azad University who were studying in academic year 2013-2014. A sample of 324 students were selected randomly from the population. The research tools were the Baumrind Child-rearing Questionnaires and Family Communication Patterns Inventory, The Revised Scale of Koerner and Fitzpatrick. The results were: (a) There was a positive and significant relationship between conversation orientation and authoritative style. (b) There was no significant relationship between conversation orientation and other child-rearing styles. (c) There was a negative significant relationship between conformity orientation and authoritative style. (d) There was a positive significant relationship between conformity orientation with authoritarian and permissive styles. (e) There was a significant relationship between 3 dimensions of child-rearing and communication patterns.

Keywords: child-rearing styles, family relationship patterns, university students, Iran

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Authors: Saranchuluun Otgon, Sugarmaa Myagmarjav, Khorolsuren Lkhagvasuren, Fabio Casati

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Background: Flourishing is a eudaimonic dimension of psychological well-being that has been associated with positive social and health-related outcomes. Determining the factors associated with health and well-being is important to the development of evidence-based intervention programs, policies, and action plans targeting the older adult population, especially in low- and middle-income countries, such as Mongolia, where evidence-based research on aging, health, and well-being is still scarce. This study makes important contributions to the study of well-being in later age and also to policy activities for the older population in Mongolia. Methods: We employed multiple regression models to predict the factors of flourishing using data from 304 older adults living in urban and rural Mongolia. Data is collected by the standardized and validated questionnaire adopted by Ed Diener. Results: The median score of the flourishing of urban and rural older adults in Mongolia was significantly different, 53 and 50, respectively. The sex (β = 2.52,p = 0.034), level of education(β = 0.94, p = 0.026), receive help for the activity of daily living (β = 2.16, p = 0.022) determine the flourishing of older adults living in a rural area, while self-reported health (β = 0.94, p = 0.026), the number of social activities, friends network determine to flourish of older adults living urban area. Conclusion: Older adults who live in urban areas have more psychological resources and strengths than those in rural areas. Determinants of flourishing are different in different settings. For instance, individual and family factors determine flourishing in rural areas, and social ties determine flourishing in urban areas.

Keywords: flourishing, predictors, older adults, Mongolia, psychological well-being

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Authors: Mercia I. Van Der Walt, Suzan Sayegh, Izzeldin E. L. J. Ibrahim, Mohamed G. Al-Kuwari, Manaf Kamil

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Background: Increased physical activity is associated with improvements in health conditions. Walking is recognized as an easy form of physical activity and a strategy used in health promotion. Step into Health (SIH), a national community program, was established in Qatar to support physical activity promotion through the monitoring of step counts. This study aims to assess the physical activity levels of the adult population in Qatar through a pedometer-based community program over a three-year-period. Methodology: This cross-sectional longitudinal study was conducted between from January 2013 and December 2015 based on daily step counts. A total of 15,947 adults (8,551 males and 7,396 females), from different nationalities enrolled in the program and aged 18 to 64, are included. The program involves free distribution of pedometers to members who voluntarily choose to register. It is also supported by a self-monitoring online account and linked to a web-database. All members are informed about the 10,000 steps/day target and automated emails as well as text messages are sent as reminders to upload data. Daily step counts were measured through the Omron HJ-324U pedometer (Omron Healthcare Co., Ltd., Japan). Analyses are done on the data extracted from the web-database. Results: Daily average step count for the overall community increased from 4,830 steps/day (2013) to 6,124 steps /day (2015). This increase was also observed within the three age categories (18–30), (31-45) and (>45) years. Average steps per day were found to be more among males compared with females in each of the aforementioned age groups. Moreover, males and females in the age group (>45 years) show the highest average step count with 7,010 steps/day and 5,564 steps/day respectively. The 21% increase in overall step count throughout the study period is associated with well-resourced program and ongoing impact in smaller communities such as workplaces and universities, a step in the right direction. However, the average step count of 6,124 steps/day in the third year is still classified as the low active category. Although the program showed an increase step count we found, 33% of the study population are low active, 35 % are sedentary with only 32% being active. Conclusion: This study indicates that the pedometer-based intervention was effective in increasing the daily physical activity of participants. However, alternative approaches need to be incorporated within the program to educate and encourage the community to meet the physical activity recommendations in relation to step count.

Keywords: pedometer, physical activity, Qatar, step count

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Authors: Mary Ostaszewski

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For many years China was riddled by poverty among many other issues and was far from a world power. However, today China has one of the largest GDPs of any country in the world and is a global powerhouse. Since China has accomplished so much, many would presume that this means China is moving away from being a “developing country” alongside countries such as India, Brazil, Israel, etc. into the category “developed country” with countries such as the U.S. Yet, this is not the case as, despite their economic strides, China still has ways to come, especially when it comes to human rights. China faces extreme criticism regarding how the Chinese Communist Party (CCP) handles human rights. China has an Orwellian-based society where technology is highly monitored, critics are quickly silenced, and freedoms are heavily restricted. One of their most recent human rights violations is attempting to repress Uyghur populations by placing them into “re-education camps,” where an already vulnerable population is being deprived of their freedoms through severe oppression. These violations create concerns as other developing countries with authoritarian governments follow the example of China. This is mainly because China has seen great success economically while simultaneously being able to maintain its authoritarian regime, thus, inspiring other countries to continue their human rights violations in hopes of gaining success similar to China’s. This idolization of China by other authoritarian regimes creates a concern especially regarding their “re-education” camps. This paper will argue that Chinese “re-education” camps are not only dangerous because they severely oppress and harm the Uyghur population. Yet they are also dangerous because other countries already impressed by China’s success may adopt similar camps in their countries to ensure their oppressive governments retain their tight grasp on power.

Keywords: China, re-education camps, developing countries, Africa, West

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Authors: Gareth Baxter

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We use a mathematical model of language change to examine two recently observed patterns of language change: one in which most speakers change gradually, following the mean of the community change, and one in which most individuals use predominantly one variant or another, and change rapidly if they change at all. The model is based on Croft’s Utterance Selection account of language change, which views language change as an evolutionary process, in which different variants (different ‘ways of saying the same thing’) compete for usage in a population of speakers. Language change occurs when a new variant replaces an older one as the convention within a given population. The present model extends a previous simpler model to include effects related to speaker aging and interspeaker variation in behaviour. The two patterns of individual change (one more centralized and the other more polarized) were recently observed in historical language changes, and it was further observed that slower changes were more associated with the centralized pattern, while quicker changes were more polarized. Our model suggests that the two patterns of change can be explained by different balances between the preference of speakers to use one variant over another and the degree of accommodation to (propensity to adapt towards) other speakers. The correlation with the rate of change appears naturally in our model, and results from the fact that both differential weighting of variants and the degree of accommodation affect the time for change to occur, while also determining the patterns of change. This work represents part of an ongoing effort to examine phenomena in language change through the use of mathematical models. This offers another way to evaluate qualitative explanations that cannot be practically tested (or cannot be tested at all) in a real-world, large-scale speech community.

Keywords: agent based modeling, cultural evolution, language change, social behavior modeling, social influence

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Authors: Christina Jery, R. K. Anjana, D. N. Arnepalli, R. Sobha

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Modern landfills employ a composite liner consisting of a geomembrane overlying a compacted clay liner (CCL) or a geosynthetic clay liner (GCL) as a barrier system. The primary function of a barrier system is to control the contaminant transport from the leachate (dissolved phase) and landfill gas (vapour phase) out of the landfill thereby minimizing the environmental impact. This study is undertaken to investigate the diffusive migration of VOCs through composite liners. VOCs are known hazardous air pollutants were often existing in both the vapour phase and dissolved phase. These compounds are known to diffuse readily through the polymeric geomembranes. The objective of the research is to develop a comprehensive data set of diffusive parameters involved in the diffusion of VOCs in the composite liner (1.5 mm HDPE geomembrane overlying a 30mm compacted clay layer). For this purpose, the study aims to develop a new experimental setup for determining the diffusion characteristics. The key parameters of diffusion (partitioning, diffusion and permeation coefficients) are examined. The diffusion tests are carried out both in aqueous and vapor phase. Finally, an attempt is also made to study the effect of low temperature on the diffusion characteristics.

Keywords: diffusion, sorption, organic compounds, composite liners, geomembrane

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Authors: Elizabeth Grier, Meg Gemmill, Mary Martin, Leora Reiter, Herman Tang, Alexandra Donaldson, Isis Lunsky, Mia Wu

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Background: Individuals with Cerebral Palsy (CP) and/or IDD face numerous physical and mental health challenges, including difficulty accessing effective palliative care. The aim of this study is to assess the knowledge and comfort of healthcare providers in providing community-based palliative care for patients with Cerebral Palsy (CP) and severe to profound Intellectual and Developmental Disabilities (IDD). Methods: This study includes a mixed methods approach obtaining both quantitative and qualitative data. Quantitative data from palliative care practitioners was obtained through an online survey assessing comfort in symptom management, grief assessment, and goals of care discussion. This survey was distributed to physicians and allied health practitioners across Canada through the College of Family Physicians of Canada Member Interest Groups for Palliative Care and for IDD. Survey results guided the development of a semi-structured interview template, which was used to conduct a focus group on the same topic. Participants were four palliative care providers (3 physicians and one spiritual care practitioner). The focus group transcript is currently undergoing thematic analysis using NVivo 12 software. Results: 57 palliative care practitioners completed the survey. 87% of participants indicated they have provided palliative care services for persons with CP and/or IDD. Findings suggest practitioners are somewhat confident in identifying specific physical symptoms (dyspnea, pressure ulcers) but less confident in identifying physical/emotional pain, addressing grief, and prognosticating life expectancy in this population. 54% of responses indicated they had little/no training on palliating those with CP or IDD, and 45% somewhat or strongly disagree members of their profession can manage symptoms for this population. Focus group analysis is underway, and results will be available at the time of the poster presentation. Conclusion: Persons with CP and IDD are more likely to experience severe health inequities when accessing palliative care. Results of this study suggest further education is needed for palliative care professionals to address the barriers and challenges in providing palliative care to this patient population.

Keywords: palliative care, symptom management, health equity, community healthcare, intellectual and developmental disabilities

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Authors: Nahela Nowshin, Rafia Sultana, Farzana Misha, Sabina F. Rashid

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Sexual and reproductive health and rights (SRHR) are currently an area of neglect for males (aged 15-24 years) in Bangladesh. The lack of focus on the male youth population has consequences not only for their own health and wellbeing, but the patriarchal structure of Bangladeshi society and socio-cultural norms mean that the male population’s SRH behavior can severely impact the lives of their female counterparts. A majority of sexual and reproductive health and rights-related research and interventions in the country are female-centric. Although the Government of Bangladesh has taken many initiatives to improve the SRHR of the general population, the male youth segment has not been prioritized in most of these interventions. There is an urgent need for male-youth-focused SRHR interventions in Bangladesh, but due to a lack of evidence-based research on this issue, there exist data gaps on how such interventions could be better designed and implemented. Therefore, to ascertain strategies for better program design and smoother implementation of male-youth-focused sexual and reproductive health and rights interventions, we carried out 25 key informant interviews with experts as well as focal persons involved in more than 20 ongoing and recently-ended SRHR-related interventions of national and international non-government organizations in which male youth were targeted or engaged. The results show that program implementers face several challenges at the field, organizational and policy levels. Some of the most common field challenges include high sensitivity to SRHR topics due to cultural reasons, difficulties in acquiring access to boys and young men due to their high mobility and engagement in labor for commercial purposes, as well as accessing them in hard-to-reach areas due to transportation and communication issues. Common organizational-level challenges include a lack of skilled manpower. Policy-level challenges include the prohibition of SRH service provision to unmarried adolescents and youth and lack of readiness of local governments to implement existing action plans. Some ways in which male-youth-focused SRHR interventions can be made more effective are through sensitization of service providers, awareness-raising at the community level to engage parents, advocacy to increase donor interest, and generating data on SRHR of male youth.

Keywords: Bangladesh, intervention, male, SRHR

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Authors: Ebru Dalgakiran

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Border and bordering studies have come to the forefront in recent years especially with parallel to increase in international migratory movements. Although conceptualizations of the border and bordering are quite contested within academia, the general point of view is that borders are politically and socially constructed. It means that borders have always their own ‘us vs. them’, and bordering process produce separate identities as well. In that case, Turkey and Greece are notable examples since these two nation-states constructed their borders upon each other’s for years although the Turkish-Greek border was drawn with the Lausanne Treaty of 1923. Nevertheless, on the other hand, The European Union (EU) has been externalized of border management policies to build a stronger area of freedom, security, and justice within the borders. Thus, Turkish-Greek border has become one of the significant external borders of the EU. In this context, this study aims to understand whether the EU’s bordering process through externalizing border management policies can affect Turkey’s and Greece’s bordering processes. By examining official documents of the EU and conducting in-depth interviews with local actors of the border management policies of the EU in Edirne, where is the border city of Turkey with Greece, this study’s main finding is that the EU’s bordering process to control migration at the external borders affects Turkey’s and Greece’s bordering processes. It seems that Turkey and Greece construct their borders upon a common Other, ‘irregular migrants’ now.

Keywords: border, bordering, the European Union, externalization

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Authors: T. Asefi, J. Faiz, M. A. Khan

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This paper introduces dual rotor axial flux machines with surface mounted and spoke type ferrite permanent magnets with concentrated windings; they are introduced as alternatives to a generator with surface mounted Nd-Fe-B magnets. The output power, voltage, speed and air gap clearance for all the generators are identical. The machine designs are optimized for minimum mass using a population-based algorithm, assuming the same efficiency as the Nd-Fe-B machine. A finite element analysis (FEA) is applied to predict the performance, emf, developed torque, cogging torque, no load losses, leakage flux and efficiency of both ferrite generators and that of the Nd-Fe-B generator. To minimize cogging torque, different rotor pole topologies and different pole arc to pole pitch ratios are investigated by means of 3D FEA. It was found that the surface mounted ferrite generator topology is unable to develop the nominal electromagnetic torque, and has higher torque ripple and is heavier than the spoke type machine. Furthermore, it was shown that the spoke type ferrite permanent magnet generator has favorable performance and could be an alternative to rare-earth permanent magnet generators, particularly in wind energy applications. Finally, the analytical and numerical results are verified using experimental results.

Keywords: axial flux, permanent magnet generator, dual rotor, ferrite permanent magnet generator, finite element analysis, wind turbines, cogging torque, population-based algorithms

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Authors: Chengbin Wang, Li Lu, Luodan Suo, Qinghai Wang, Fan Yang, Xu Wang, Mona Marin

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Background: Two-dose varicella vaccination has been recommended in Beijing since November 2012. We investigated a varicella outbreak in a highly vaccinated elementary school population to examine transmission patterns and risk factors for vaccine failure. Methods: A varicella case was defined as an acute generalized maculopapulovesicular rash without other apparent cause in a student attending the school from March 28 to May 17, 2015. Breakthrough varicella was defined as varicella >42 days after last vaccine dose. Vaccination information was collected from immunization records. Information on prior disease and clinical presentation was collected via survey of students’ parents. Results: Of the 1056 school students, 1028 (97.3%) reported no varicella history, of whom 364 (35.4%) had received 1-dose and 650 (63.2%) had received 2-dose varicella vaccine, for 98.6% school-wide vaccination coverage with ≥ 1 dose before the outbreak. A total of 20 cases were identified for an overall attack rate of 1.9%. The index case was in a 2-dose vaccinated student who was not isolated. The majority of cases were breakthrough (19/20, 95%) with attack rates of 7.1% (1/14), 1.6% (6/364) and 2.0% (13/650) among unvaccinated, 1-dose, and 2-dose students, respectively. Most cases had < 50 lesions (18/20, 90%). No difference was found between 1-dose and 2-dose breakthrough cases in disease severity or sociodemographic factors. Conclusion: Moderate 2-dose varicella vaccine coverage was insufficient to prevent a varicella outbreak. Two-dose breakthrough varicella is still contagious. High 2-dose varicella vaccine coverage and timely isolation of ill persons might be needed for varicella outbreak control in the 2-dose era.

Keywords: varicella, outbreak, breakthrough varicella, vaccination

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Authors: Elena Parmentier, Henrik Endeman

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Introduction: Large mediastinal masses often present with diagnostic and clinical challenges due to compression of the respiratory and hemodynamic system. We present a case of a mediastinal mass with symptomatic mechanical compression of the trachea, resulting in challenging airway management. Methods: We present a case of 66-year-old male, complaining of progressive dysphagia. Initial esophagogastroscopy revealed a stenosis secondary to external compression, biopsies were inconclusive. Additional CT scan showed a large mediastinal mass of unknown origin, situated between the vertebrae and esophagus. Symptoms progressed and patient developed dyspnea and stridor. A new CT showed quick growth of the mass with compression of the trachea, subglottic to just above the carina. A tracheal covered stent was successfully placed. Endobronchial ultrasound revealed a large irregular mass without tracheal invasion, biopsies were taken. 4 days after stent placement, the patients’ condition deteriorated with worsening of stridor, dyspnea and desaturation. Migration of the tracheal stent into the right main bronchus was seen on chest X ray, with obstruction of the left main bronchus and secondary atelectasis. Different methods have been described in the literature for tracheobronchial stent removal (surgical, endoscopic, fluoroscopyguided), our first choice in this case was flexible bronchoscopy. However, this revealed tracheal compression above the migrated stent and passage of the scope occurred impossible. Patient was admitted to the ICU, high-flow nasal oxygen therapy was started and the situation stabilized, giving time for extensive assessment and preparation of the airway management approach. Close cooperation between the intensivist, pulmonologist, anesthesiologist and otorhinolaryngologist was essential. Results: In case of sudden deterioration, a protocol for emergency situations was made. Given the increased risk of additional tracheal compression after administration of neuromuscular blocking agents, an approach with awake fiberoptic intubation maintaining spontaneous ventilation was proposed. However, intubation without retrieval of the tracheal stent was found undesirable due to expected massive shunting over the left atelectatic lung. As rescue option, assistance of extracorporeal circulation was considered and perfusionist was kept on standby. The patient stayed stable and was transferred to the operating theatre. High frequency jet ventilation under general anesthesia resulted in desaturations up to 50%, making rigid bronchoscopy impossible. Subsequently an endotracheal tube size 8 could be placed successfully and the stent could be retrieved via bronchoscopy over (and with) the tube, after which the patient was reintubated. Finally, a tracheostomy (Shiley™ Tracheostomy Tube With Cuff, size 8) was placed, fiberoptic control showed a patent airway. Patient was readmitted to the ICU and could be quickly weaned of the ventilator. Pathology was positive for rhabdomyosarcoma, without indication for systemic therapy. Extensive surgery (laryngectomy, esophagectomy) was suggested, but patient refused and palliative care was started. Conclusion: Due to meticulous planning in an interdisciplinary team, we showed a successful airway management approach in this complicated case of critical airway compression secondary to a rare rhabdomyosarcoma, complicated by tracheal stent migration. Besides presenting our thoughts and considerations, we support exploring other possible approaches of this specific clinical problem.

Keywords: airway management, rhabdomyosarcoma, stent displacement, tracheal stenosis

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Authors: Katia C. Bortoletto, Maria Isabel C. de Freitas, Rodrigo B. N. de Oliveira

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The environmental vulnerability studies are essential for priority actions to the reduction of disasters risk. The aim of this study is to analyze the socio-environmental vulnerability obtained through a Census survey, followed by both a statistical analysis (PCA/SPSS/IBM) and a spatial analysis by GIS (ArcGis/ESRI), taking as a case study the Municipality of Caraguatatuba-SP, Brazil. In the municipal development plan analysis the emphasis was given to the Special Zone of Social Interest (ZEIS), the Urban Expansion Zone (ZEU) and the Environmental Protection Zone (ZPA). For the mapping of the social and environmental vulnerabilities of the study area the exposure of people (criticality) and of the place (support capacity) facing disaster risk were obtained from the 2010 Census from the Brazilian Institute of Geography and Statistics (IBGE). Considering the criticality, the variables of greater influence were related to literate persons responsible for the household and literate persons with 5 or more years of age; persons with 60 years or more of age and income of the person responsible for the household. In the Support Capacity analysis, the predominant influence was on the good household infrastructure in districts with low population density and also the presence of neighborhoods with little urban infrastructure and inadequate housing. The results of the comparative analysis show that the areas with high and very high vulnerability classes cover the classes of the ZEIS and the ZPA, whose zoning includes: Areas occupied by low-income population, presence of children and young people, irregular occupations and land suitable to urbanization but underutilized. The presence of zones of urban sprawl (ZEU) in areas of high to very high socio-environmental vulnerability reflects the inadequate use of the urban land in relation to the spatial distribution of the population and the territorial infrastructure, which favors the increase of disaster risk. It can be concluded that the study allowed observing the convergence between the vulnerability analysis and the classified areas in urban zoning. The occupation of areas unsuitable for housing due to its characteristics of risk was confirmed, thus concluding that the methodologies applied are agile instruments to subsidize actions to the reduction disasters risk.

Keywords: socio-environmental vulnerability, urban zoning, reduction disasters risk, methodologies

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Authors: William Cheng, Yuni Astria, Rini Sekartini

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Background: Prevalence of anemia among school-aged children is relatively high (25.4%). This condition can affect children’s life, including cognitive function. One of the most common factors that is associated with anemia in children is nutritional status. This simple indicator will be very helpful in identifying more population at risk. The aim of this study is to correlate the clinical implication of nutritional status to the prevalence of anemia in children, with intention to determine a more effective nutritional status indicator in detecting anemia. Method: Anthropometric and haemoglobin status were gathered from children between 5 to 7-years-old in one of the urban areas in Jakarta in 2012. We identified children with haemoglobin level under 11.5 as anemia and correlated them to their WHO z-score from each of these indicators: Body Weight for Age (normal weight and underweight), Height for Age (not stunted and stunted), and Body Mass Index for Age (not wasted and wasted). Results: A total of 195 children were included in this research and 57 of them (29,2%) were diagnosed as anemia. The majority of the children had good nutritional status, however, 30 (15,4%) of them were found to be underweight, 33 (16,9%) were stunted, and 1 children (0,5%) was wasted. There were no overweight result found in this population. From the three nutritional status indicators, none proved to be statistically significant in relation to the incidence of anemia (p>0.05). Out of 33 children who were diagnosed as stunted, 36.36 % were found to have anemia, in comparison to 27,7% of children who were not stunted. Meanwhile, among 30 children who were diagnosed as underweight, 33,3 % of them were anemic whereas only 28,4% of the normal weight group were anemic. Conclusion: In this study, there is no significant correlation between anemia with any nutritional status indicator. However, more than a third of the stunted children are proven to have low haemoglobin status. The finding of stunting in children should be given more attention to further investigate for anemia.

Keywords: school-aged children, nutritional status, anemia, pediatrics

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Authors: Lateefat Amao, Misagh Faezipour

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Implementing electronic health records (EHR) in healthcare is a pivotal transition aimed at digitizing and optimizing patient health information management. The expectations associated with this transition are high, even towards other health information systems (HIS) and health technology. This multifaceted process involves careful planning and execution to improve the quality and efficiency of patient care, especially as healthcare technology is a sensitive niche. Key considerations include a thorough needs assessment, judicious vendor selection, robust infrastructure development, and training and adaptation of healthcare professionals. Comprehensive training programs, data migration from legacy systems and models, interoperability, as well as security and regulatory compliance are imperative for healthcare staff to navigate EHR systems adeptly. The purpose of this work is to offer a comprehensive review of the literature on EHR implementation. It explores the impact of this health technology on health practices, highlights challenges and barriers to its successful utility, and offers practical strategies that can impact its success in healthcare. This paper provides a thorough review of studies on the adoption of EHRs, emphasizing the wide range of experiences and results connected to EHR use in the medical field, especially across different types of healthcare organizations.

Keywords: healthcare, electronic health records, EHR implementation, patient care, interoperability

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Authors: A. Lianah, B. Peter Sopade, C. Krisantini

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Walikadep/Tetrastigma glabratum (Blume) Planch is a traditional herb that has been used by people of Blumah village; it is believed to have a stimulant effect and ailments for many illnesses. Our survey demonstrated that the people of Blumah village has exploited walikadep from Protected Forest of Mount Prau. More than 10% of 448 households at Blumah village have used walikadep as traditional herb or jamu. Part of the walikadep plants used is the liquid extract of the stem. The population of walikadep is getting scarce and it is rarely found now. The objectives of this study are to examine the stimulant effect of walikadep, to measure growth and exploitation rate of walikadep, and to find ways to effectively propagate the plants, as well as identifying the impact on the environment through field experiments and explorative survey. Stimulant effect was tested using open-field and hole-board test. Data were collected through field observation and experiment, and data were analysed using lab test and Anova. Rate of exploitation and plant growth was measured using Regression analysis; comparison of plant growth in-situ and ex-situ used descriptive analysis. The environmental impact was measured by population structure vegetation analysis method by Shannon Weinner. The study revealed that the walikadep exudates did not have a stimulant effect. Exploitation of walikadep and the long time required to reach harvestable size resulted in the scarcity of the plant in the natural habitat. Plant growth was faster in-situ than ex-situ; and fast growth was obtained from middle part cuttings treated with vermicompost. Biodiversity index after exploitation was higher than before exploitation, possibly due to the toxic and allellopathic effect (phenolics) of the plant. Based on these findings, further research is needed to examine the toxic effects of the leave and stem extract of walikadep and their allelopathic effects. We recommend that people of Blumah village to stop using walikadep as the stimulant. The local people, village government in the regional and central levels, and perhutani should do an integrated efforts to conserve walikadep through Pengamanan Terpadu Konservasi Walikadep Lestari (PTKWL) program, so this population of this plant in the natural habitat can be maintained.

Keywords: utilization, medical plants, traditional, Tetastigma glabratum

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Authors: Karolin Bauer, Anna Brinkmann

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Vulnerabilities in critical infrastructure can cause significant difficulties for the affected population during crises. Securing the food supply as part of the critical infrastructure in crisis situations is an essential part of public services and a ground stone for a successful concept of civil protection. In most industrialized countries, there are currently no comparative studies regarding the food supply of the population during crisis and disaster events. In order to mitigate the potential impact in case of major disasters in Germany, it is absolutely necessary to investigate how the food supply can be secured. The research project aims to provide in-depth research on the experiences gathered during past large-scale disasters in the 34 OECD member countries in order to discover alternatives for an updated civil protection system in Germany. The basic research question is: "Which international approaches and structures of civil protection have been proven and would be useful to modernize the German civil protection with regards to the critical infrastructure and food supply?" Research findings should be extracted from an extensive literature review covering the entire research period as well as from personal and online-based interviews with experts and responsible persons from involved institutions. The capability of the research project insists on the deliberate choice to investigate previous large-scale disasters to formulate important and practical approaches to modernize civil protection in Germany.

Keywords: food supply, vulnerabilty, critical infratstructure, large-scale disaster

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Authors: Fatima Achouri, Zakaria Smahi

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Bir El Djir is an important coastal township in Oran department, located at 450 Km far away from Algiers on northwest of Algeria. In this coastal area, the urban sprawl is one of the main problems that reduce the limited highly fertile land. So, using the remote sensing and GIS technologies have shown their great capabilities to solve many earth resources issues. The aim of this study is to produce land use and cover map for the studied area at varied periods to monitor possible changes that may occurred, particularly in the urban areas and subsequently predict likely changes. For this, two spatial images SPOT and Landsat satellites from 1987 and 2014 respectively were used to assess the changes of urban expansion and encroachment during this period with photo-interpretation and GIS approach. The results revealed that the town of Bir El Djir has shown a highest growth rate in the period 1987-2014 which is 521.1 hectares in terms of area. These expansions largely concern the new real estate constructions falling within the social and promotional housing programs launched by the government. Indeed, during the last census period (1998 -2008), the population of this town has almost doubled from 73 029 to 152 151 inhabitants with an average annual growth of 5.2%. This also significant population growth is causing an accelerated urban expansion of the periphery which causing its conurbation with the towns of Oran in the West side. The most urban expansion is characterized by the new construction in the form of spontaneous or peripheral precarious habitat, but also unstructured slums settled especially in the southeastern part of town.

Keywords: urban expansion, remote sensing, photo-interpretation, spatial dynamics

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Authors: Mohammed Alateeq, Abdulaziz Alrshoud

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Objectives: To examine the attitude and practice of family physicians in giving smoking cessation advice at King Abdul-Aziz Medical City for National Guard, Riyadh. Methods: Cross sectional study using validated self-reported questionnaire that distributed to all family physicians and primary health care doctors at the four main family medicine and primary health care centers, KAMC, Riyadh. Results: 73 physicians are contributed in this study. 28 (38.4%) physicians were from (KASHM ALAN) clinic, 26 (35.6%) physicians were from (UM ALHAMAM) Clinic. 13 (17.8%) physicians were from (ISKAN) clinic. 6 (8.2%) physicians were from the Employee Health Clinic. 73 (100%) of the target population agreed that giving brief smoking cessation advice is part of their duties. 67 (91.7%) agreed that Presence of hospital guidelines and special clinics for smoking cessation will encourage them to provide advice. Only 5 (6.84%) received training courses (1-4 weeks) in smoking cessation interventions. Conclusion: Most of the target population agreed that brief smoking cessation advice is part of their duties. Also, they agreed that Presence of hospital guidelines and special clinics for smoking cessation will encourage them to provide advice although most of them did not received a formal training in smoking cessation advice.

Keywords: advice, attitude, cessation, family physicians, smoking

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Authors: Asim Abbasi, Muhammad Sufyan

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The present experiment was carried out to examine the effects of silicon dioxide on tritrophic interaction of cotton, whitefly, and the predator Chrysoperla carnea. Population of whitefly was maintained on silicon treated and non-treated cotton for two generations in greenhouse net cages exposed to outside temperature and luminosity. The cotton was treated with silicon dioxide twice after 15 days intervals with 200 ppm concentration. A stock rearing of the natural predator was developed in the laboratory conditions. In the bioassay eggs of the predator all at the same age were individualized in glass petri plates that will be pierced with a pin to allow aeration and maintained in an incubator at 28 ± 2°C, 70 ± 10% relative humidity and 12h photo phase. Population of whitefly stayed on silicon treated, and non-treated cotton were offered to newly hatched chrysopid larvae until the end of the larval stage, assuring a permanent supply. Feeding preference of C. carnea along with longevity, survival of each instar larvae, pupation, adult emergence, and fecundity was checked. The results revealed that there was no significant difference in the feeding preference of C. carnea among both treatments. Durations of 1st and 2nd larval instar were also at par in both treatments. However overall longevity and adult emergence were a bit lower in silicon treated whitefly treatment. This may be due to the fact that silicon reduces the nutritional quality of host because of reduced whitefly feeding on silicon treated cotton. No significant difference in 1st and 2nd larval instars and then increased larval duration in later instars suggested that the effect of silicon treated host should be checked on more than 1 generation of C. carnea to get better findings.

Keywords: Chrysoperla carnea, silicon, tritrophic, whitefly

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Authors: Sheng-Hui Lan, Shan-Ying Wu, Shu-Ching Lin, Wei-Chen Wang, Hsiao-Sheng Liu

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Autophagy is an essential mechanism to maintain cellular homeostasis through its degradation function, and the autophagy deficiency is related various diseases including tumorigenesis in several cancers. MicroRNAs (miRNAs) are small none coding RNAs, which regulate gene expression through degradation of mRNA or inhibition of translation. However, the relationship between autophagy deficiency and dysregulated miRNAs is still unclear. We revealed a mechanism that autophagy up-regulates miR-449a expression at the transcriptional level through activation of forkhead transcription factor family member FoxO1 and then suppresses tumorigenesis in CRC. Our data showed that the autophagic activity and miR-449a expression were lower in colorectal cancer (CRC) and has a positive correlation. We further reveal that autophagy degrades p300 expression and then suppresses acetylation of FoxO1. Under autophagic induction conditions, FoxO1 is transported from the cytoplasm to the nucleus and binds to the miR-449a promoter and then promotes miR-449a expression. In addition, either miR-449a overexpression or amiodarone-induced autophagy inhibits cell cycle progression, proliferation, colony formation migration, invasion, and tumor formation of SW480 cells. Our findings indicate that autophagy inducers may have the potential to be used for prevention and treatment of CRC through upregulation of miR-449a expression.

Keywords: autophagy, MiR-449a, FoxO1, colorectal cancer

Procedia PDF Downloads 315

Authors: Jacqueline Kunzelman, Val Anderson, Robert Johnson, Nicholas Anderson, Rebecca Bates

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In an effort to protect honeybees from colony collapse disorder, beekeepers are filing for government permits to use natural lands as summer pasture for honeybees under the multiple-use management regime in the United States. Utilizing natural landscapes in high mountain ranges may help strengthen honeybee colonies, as this natural setting is generally void of chemical pollutants and pesticides that are found in agricultural and urban settings. However, the introduction of a competitive species could greatly impact the native species occupying these natural landscapes. While honeybees and butterflies have different life histories, behavior, and foraging strategies, they compete for the same nectar resources. Few, if any, studies have focused on the potential population effects of commercial honeybees on native butterfly abundance and diversity. This study attempts to observe this impact using a paired before-after control-impact (BACI) design. Over the course of two years, malaise trap samples were collected every week during the months of the flowering season in two similar areas separated by 11 kilometers. Each area contained nine malaise trap sites for replication. In the first year, samples were taken to analyze and establish trends within the pollinating communities. In the second year, honeybees were introduced to only one of the two areas, and a change in trends between the two areas was assessed. Contrary to the original hypothesis, the resulting observation was an overall significant increase in the mean butterfly abundance in the impact areas after honeybees were introduced, while control areas remained relatively stable. This overall increase in abundance over the season can be attributed to an increase in butterflies during the first and second periods of the data collection when populations were near their peak. Several potential theories are 1) Honeybees are deterring a natural predator/competitor of butterflies that previously limited population growth. 2) Honeybees are consuming resources regularly used by butterflies, which may extend the foraging time and consequent capture rates of butterflies. 3) Environmental factors such as number of rainy days were inconsistent between control and impact areas, biasing capture rates. This ongoing research will help determine the suitability of high mountain ranges for the summer pasturing of honeybees and the population impacts on many different pollinators.

Keywords: butterfly, competition, honeybee, pollinator

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Authors: Zane Bulderberga

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Spatial dimension in development planning is becoming more topical in 21st century as a result of changes in population structure. Sustainable spatial development focuses on identifying and using territorial advantages to foster the harmonized development of the entire country, reducing negative effects of population concentration, increasing availability and mobility. EU and national development planning documents state polycentrism as main tool for balance spatial development, including investment concentration in growth centres. If mutual cooperation of growth centres as well as urban-rural cooperation is not fostered, then territorial differences can deepen and create unbalanced development. The aim of research: to evaluate the urban-rural interaction, elaborating spatial development scenarios in framework of Latvian regional policy. To perform the research monographic, comparison, abstract-logical method, synthesis and analysis will be used when studying the theoretical aspects of research aiming at collecting the ideas of scientists from different countries, concepts, regulations as well as to create meaningful scientific discussion. Hierarchy analysis process (AHP) will be used to state further scenarios of spatial development in Latvia. Experts from various institutions recognized urban-rural interaction and co-operation as an essential tool for the development. The most important factors for balanced spatial development in Latvia are availability of public transportation and improvement of service availability. Evaluating the three alternative scenarios, it was concluded that the urban-rural partnership will ensure a balanced development in Latvian regions.

Keywords: rural-urban interaction, rural-urban cooperation, spatial development, AHP

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Authors: Ahmed Abdulfatah Yusuf, Collins Oduor Ondiek

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The automation of farming activities can have a transformational impact on the agricultural sector, especially from the emerging new technologies such as the Internet of Things (IoT). The system uses water level sensors and soil moisture sensors that measure the content of water in the soil as the values generated from the sensors enable the system to use an appropriate quantity of water, which avoids over or under irrigation. Due to the increase in the world’s population, there is a need to increase food production. With this demand in place, it is difficult to increase crop yield using the traditional manual approaches that lead to the wastage of water, thus affecting crop production. Food insecurity has become a scourge greatly affecting the developing countries and agriculture is an essential part of human life and tends to be the mainstay of the economy in most developing nations. Thus, without the provision of adequate food supplies, the population of those living in poverty is likely to multiply. The project’s main objective is to design and develop an IoT (Internet of Things) microcontroller-based Smart Irrigation System. In addition, the specific research objectives are to find out the challenges with traditional irrigation approaches and to determine the benefits of IoT-based smart irrigation systems. Furthermore, the system includes Arduino, a website and a database that works simultaneously in collecting and storing the data. The system is designed to pave the way in attaining the Sustainable Development Goal (SDG 1), which aims to end extreme poverty in all forms by 2030. The research design aimed at this project is a descriptive research design. Data was gathered through online questionnaires that used both quantitative and qualitative in order to triangulate the data. Out of the 32 questionnaires sent, there were 32 responses leading to a 100% response rate. In terms of sampling, the target group of this project is urban farmers, which account for about 25% of the population of Nairobi. From the findings of the research carried out, it is evident that there is a need to move away from manual irrigation approaches due to the high wastage of water to the use of smart irrigation systems that propose a better way of conserving water while maintaining the quality and moisture of the soil. The research also found out that urban farmers are willing to adopt this system to better their farming practices. However, this system can be improved in the future by incorporating it with other features and deploying it to a larger geographical area.

Keywords: crop production, food security, smart irrigation system, sustainable development goal

Procedia PDF Downloads 150