Search results for: background
2983 Characteristics of Serum Exosomes after Burn Injury and Dermal Fibroblast Regulation by Exosomes in Vitro
Authors: Jie Ding, Yingying Pan, Shammy Raj, Lindy Schaffrick, Jolene Wong, Antoinette Nguyen, Sharada Manchikanti, Larry Unsworth, Peter Kwan, Edward E. Tredget
Abstract:
Background: Exosomes (EXOs) have been considered a new target that is thought to be involved in and treat wound healing. More research is needed to fully understand the EXO characteristics and mechanisms of EXO-mediated wound healing, especially wound healing after burn injury. Methods: Total EXOs were isolated from 85 serum samples of 29 burn patients and 13 healthy individuals. We characterized the EXOs for morphology and density, serum concentration, protein level, marker expression, size distribution, and cytokine content. After confirmation of EXO uptake by dermal fibroblasts, we also explored functional regulation of primary human normal skin and hypertrophic scar fibroblast cell lines by the EXOs in vitro, including cell proliferation and apoptosis. Results: EXOs dynamically changed their morphology, density, size, and cytokine level during wound healing in burn patients, which were correlated with burn severity and the stages of wound healing. EXOs from both burn patients and healthy individuals stimulated dermal fibroblast proliferation and apoptosis. Conclusion: EXO features may be important signals that influence wound healing after burn injury; however, to understand the mechanisms by which EXOs regulated the fibroblasts in healing wounds, further studies will be required in the future.Keywords: exosome, burn, wound healing, hypertrophic scarring, cytokines
Procedia PDF Downloads 832982 Correlation between Creatinine Level with Erectile Dysfunction among Diabetics in Temerloh Health Clinic
Authors: Mohammad Zainie Bin Hassan
Abstract:
Background: Erectile dysfunction (ED) is a complication commonly seen among men with diabetes which can be assessed based upon International Index of Erectile Function (IIEF-5) questionnaire. Creatinine level is a blood test that indicates kidney functionality. Object: To evaluate the association between ED, determined by the IIEF-5scores and Creatinine level in diabetic men attending Temerloh Health Clinic, Pahang, Malaysia.Hence, to identify raising Creatinine level related with ED or not. Methods: All married diabetic patients will be investigated face to face after consented for answering the IIEF-5 questionnaire. Creatinine level will be taken by using standard method.Patients with no sexual partner, refuse to answer the questionnaire, cancer, stroke, heart disease and language barrier will be excluded.Data obtained from IIEF-5 score and Creatinine level will be analyzed by using Pearson correlation. All statistical value determined by p=0.05. ED will be categorized accordingly to IIEF-5 scores: no ED (22-25), mild (17-21), moderate (12-16), severe (8-11) and very severe (1-7). Results: A total of 450 patients were investigated with 385 patients were included (85.6% respondant rate) and 65 patients were excluded in this study with age range from 29 to 85 years old. 7% had no ED, 28% mild ED, 34% moderate ED, 16% severe ED and 15% had very severe ED. There was a significant negative correlation between Creatinine level and IIEF-5 scores (r=-0.218, p <0.001). This result implicated that poor kidney function which indicated by high Creatinine level associated significantly with erectile dysfunction. 93% had ED with a different range of severity which triggers for appropriate aggressive ED management among diabetics. Conclusion: The high level of Creatinine is associated with erectile dysfunction among diabetics in Temerloh Health Clinic.Keywords: correlation, creatinine level, erectile dysfunction, ED, diabetes
Procedia PDF Downloads 4102981 Improving Medication Understanding, Use and Self-Efficacy among Stroke Patients: A Randomised Controlled Trial; Study Protocol
Authors: Jamunarani Appalasamy, Tha Kyi Kyi, Quek Kia Fatt, Joyce Pauline Joseph, Anuar Zaini M. Zain
Abstract:
Background: The Health Belief Theory had always been associated with chronic disease management. Various health behaviour concepts and perception branching from this Health Belief Theory had involved with medication understanding, use, and self-efficacy which directly link to medication adherence. In a previous quantitative and qualitative study, stroke patients in Malaysia were found to be strongly believing information obtained by various sources such as the internet and social communication. This action leads to lower perception of their stroke preventative medication benefit which in long-term creates non-adherence. Hence, this study intends to pilot an intervention which uses audio-visual concept incorporated with mHealth service to enhance learning and self-reflection among stroke patients to manage their disease. Methods/Design: Twenty patients will be allocated to a proposed intervention whereas another twenty patients are allocated to the usual treatment. The intervention involves a series of developed audio-visual videos sent via mobile phone which later await for responses and feedback from the receiver (patient) via SMS or recorded calls. The primary outcome would be the medication understanding, use and self-efficacy measured over two months pre and post intervention. Secondary outcome is measured from changes of blood parameters and other self-reported questionnaires. Discussion: This study shall also assess uptake/attrition, feasibility, and acceptability of this intervention. Trial Registration: NMRR-15-851-24737 (IIR)Keywords: health belief, medication understanding, medication use, self-efficacy
Procedia PDF Downloads 2202980 Comparative Stem Cells Therapy for Regeneration of Liver Fibrosis
Authors: H. M. Imam, H. M. Rezk, A. F. Tohamy
Abstract:
Background: Human umbilical cord blood (HUCB) is considered as a unique source for stem cells. HUCB contain different types of progenitor cells which could differentiate into hepatocytes. Aims: To investigate the potential of rat's liver damage repair using human umbilical cord mesenchymal stem cells (hUCMSCs). We investigated the feasibility for hUCMSCs in recovery from liver damage. Moreover, investigating fibrotic liver repair and using the CCl4-induced model for liver damage in the rat. Methods: Rats were injected with 0.5 ml/kg CCl4 to induce liver damage and progressive liver fibrosis. hUCMSCs were injected into the rats through the tail vein; Stem cells were transplanted at a dose of 1×106 cells/rat after 72 hours of CCl4 injection without receiving any immunosuppressant. After (6 and 8 weeks) of transplantation, blood samples were collected to assess liver functions (ALT, AST, GGT and ALB) and level of Procollagen III as a liver fibrosis marker. In addition, hepatic tissue regeneration was assessed histopathologically and immunohistochemically using antihuman monoclonal antibodies against CD34, CK19 and albumin. Results: Biochemical and histopathological analysis showed significantly increased recovery from liver damage in the transplanted group. In addition, HUCB stem cells transdifferentiated into functional hepatocytes in rats with hepatic injury which results in improving liver structure and function. Conclusion: Our findings suggest that transplantation of hUCMSCs may be a novel therapeutic approach for treating liver fibrosis. Therefore, hUCMSCs are a potential option for treatment of liver cirrhosis.Keywords: carbon tetra chloride, liver fibrosis, mesenchymal stem cells, rat
Procedia PDF Downloads 3422979 Inherited Eye Diseases in Africa: A Scoping Review and Strategy for an African Longitudinal Eye Study
Authors: Bawa Yusuf Muhammad, Musa Abubakar Kana, Aminatu Abdulrahman, Kerry Goetz
Abstract:
Background: Inherited eye diseases are disorders that affect globally, 1 in 1000 people. The six main world populations have created databases containing information on eye genotypes. Aim: The aim of the scoping review was to mine and present the available information to date on the genetics of inherited eye diseases within the African continent. Method: Literature Search Strategy was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed and Google Scholar searched for articles on inherited eye diseases from inception to 20th June 2022. Both Original and review articles that report on inherited, genetic or developmental/congenital eye diseases within the African Continent were included in the research. Results: A total of 1162 citations were obtained, but only 37 articles were reviewed based on the inclusion and exclusion criteria. The highest output of publications on inherited eye diseases comes from South Africa and Tunisia (about 43%), followed by Morocco and Egypt (27%), then Sub-Saharan Africa and North Africa (13.50%), while the remaining articles (16.5%) originated from Nigeria, Ghana, Mauritania Cameroon, Zimbabwe and combined article between Zimbabwe and Cameroon. Glaucoma and inherited retinal disorders represent the most studied diseases, followed by Albinism and congenital cataracts, respectively. Conclusion: Despite the growing research from Tunisia, Morocco, Egypt and South Africa, Sub-Saharan Africa remains almost a virgin region to explore the genetics of eye diseases.Keywords: inherited eye diseases, Africa, scoping review, longitudinal eye study
Procedia PDF Downloads 572978 Research on the Efficiency and Driving Elements of Manufacturing Transformation and Upgrading in the Context of Digitization
Authors: Chen Zhang; Qiang Wang
Abstract:
With the rapid development of the new generation of digital technology, various industries have created more and more value by using digital technology, accelerating the digital transformation of various industries. The economic form of human society has evolved with the progress of technology, and in this context, the power conversion, transformation and upgrading of the manufacturing industry in terms of quality, efficiency and energy change has become a top priority. Based on the digitalization background, this paper analyzes the transformation and upgrading efficiency of the manufacturing industry and evaluates the impact of the driving factors, which have very important theoretical and practical significance. This paper utilizes qualitative research methods, entropy methods, data envelopment analysis methods and econometric models to explore the transformation and upgrading efficiency of manufacturing enterprises and driving factors. The study shows that the transformation and upgrading efficiency of the manufacturing industry shows a steady increase, and regions rich in natural resources and social resources provide certain resources for transformation and upgrading. The ability of scientific and technological innovation has been improved, but there is still much room for progress in the transformation of scientific and technological innovation achievements. Most manufacturing industries pay more attention to green manufacturing and sustainable development. In addition, based on the existing problems, this paper puts forward suggestions for improving infrastructure construction, developing the technological innovation capacity of enterprises, green production and sustainable development.Keywords: digitization, manufacturing firms, transformation and upgrading, efficiency, driving factors
Procedia PDF Downloads 662977 The Frequency of Q Fever Among Hospitalized Patients with Pyrexia
Authors: Hassan Ali Abood Nassrullah, Jabbar Fadeel Mahdi, Mohammed Salih Mahdi Alkurdi, Ali Al Mousawi, Saad Ibrahim Al-Ghabban, Abdul Amir H. Kadhum, Ahmed Al-Amiery
Abstract:
Background: Q fever is a zoonotic disease characterized by its clinical polymorphism and can present acutely as fever, pneumonia, hepatitis, and chronically as infective endocarditis, arthritis, osteomyelitis, or hepatitis. Objective: The aim of this study is To estimate the prevalence of cases of Q fever in hospitalized febrile patients in Imam Al Hussain Teaching Medical City in Karbala. Methods: One hundred patients with pyrexia were admitted to the medical ward from 1st August to 31st December 2019. Serological procedures fortified by Enzyme-linked Immunosorbent Assay test. Patients were considered to have acute Q fever when the specific antibodies (IgM and IgG) of phase II of Coxiella burnetii were positive. Results: The mean age of the patients was 35.05±12.93 years; females constituted 60% of them. Eighteen patients (18%) showed positive results for IgM, a lower proportion (13% n=13) had positive IgG levels, and 9% showed equivocal results. Statistical analysis revealed a significant association between positive IgM levels of the female gender and in patients consuming unpasteurized milk. One patient (female aged 60 years) died in the hospital, while all other patients were discharged well. Two female patients were pregnant, and one of them had an abortion. Conclusions: Q fever is more common in febrile patients. The study indicates that this disease should not be overlooked in the differential diagnosis of acute fever. Serological testing should be performed in all patients with acute febrile illness with an unsettling diagnosis.Keywords: antibodies, frequency, immunoglobulin IgM, Q fever
Procedia PDF Downloads 1232976 Exploring the Experiences of Transnational TESOL Professionals about Their Writing Assessment Practices: A Critical Ethnography in the Saudi EFL Context
Authors: Abdullah Alshakhi
Abstract:
This study aims to explore the assessment practices of transnational western teachers in Saudi EFL writing classrooms. The study adopts a critical ethnographic approach to understand the views and the experiences of four transnational TESOL professionals about how they navigate and negotiate their writing assessment practices in the Saudi EFL context. The qualitative data were collected through classroom observations and video recordings of the classroom teaching, which were followed by semi-structured interviews with the four TESOL teachers from Australia, England, USA, and Ireland. The data were analyzed from three perspectives of these transnational TESOL teachers in the Saudi EFL context: as a transnational teacher in monolingual context, as a transitional teacher abides by the prescribed curriculum and assessment instructions, and as a transnational teacher’s vision for monolingual students. The results of the study revealed that owing to the transnational teachers’ lack of understanding of the Saudi monolingual culture, bureaucratic structures, and top-down assessment policies in the institute where they work, their teaching and assessment of writing and other language skills are negatively affected and consequently had to be modified. Also, the Saudi learners’ lack of interest and their lower level of English proficiency pose serious challenges to those transnational teachers’ writing assessment practices. More often, the teachers find the prescribed writing curriculum and assessment tools ineffective in the Saudi EFL context. Because of these experiences, the transnational teachers in this study have exhibited their awareness of their monolingual/monoculture background, Saudi’s cultural and religious values, and institutional structures, which have helped them customize or supplement the writing assessment practices accordingly.Keywords: critical ethnography, Saudi EFL context, TESOL professionals, transnationalism, writing assessment
Procedia PDF Downloads 1122975 English Test Success among Syrian Refugee Girls Attending Language Courses in Lebanon
Authors: Nina Leila Mussa
Abstract:
Background: The devastating effects of the war on Syria’s educational infrastructure has been widely reported, with millions of children denied access. However, among those who resettled in Lebanon, the impact of receiving educational assistance on their abilities to pass the English entrance exam is not well described. The aim of this study was to identify predictors of success among Syrian refugees receiving English language courses in a Lebanese university. Methods: The database of Syrian refugee girls matriculated in English courses at the American University of Beirut (AUB) was reviewed. The study period was 7/2018-09/2020. Variables compared included: family size and income, welfare status, parents’ education, English proficiency, access to the internet, and need for external help with homework. Results: For the study period, there were 28 girls enrolled. The average family size was 6 (range 4-9), with eight having completed primary, 14 secondary education, and 6 graduated high school. Eighteen were single-income families. After 12 weeks of English courses, 16 passed the Test of English as Foreign Language (TOEFL) from the first attempt, and 12 failed. Out of the 12, 8 received external help, and 6 passed on the second attempt, which brings the total number of successful passing to 22. Conclusion: Despite the tragedy of war, girls receiving assistance in learning English in Lebanon are able to pass the basic language test. Investment in enhancing those educational experiences will be determinantal in achieving widespread progress among those at-risk children.Keywords: refugee girls, TOEFL, education, success
Procedia PDF Downloads 1232974 Learning Participation and Baby Care Ability in Mothers of Preterm Infant
Authors: Yi-Chuan Cheng, Li-Chi Huang, Yu-Shan Chang
Abstract:
Introduction: The main purpose of this study was to explore the relationship between the learning number, care knowledge, care skills and maternal confidence in preterm infant care in Taiwan. Background: Preterm infants care has been stressful for mother caring at home. Many programs have been applied for improving the infant care maternal confident. But less to know the learning behavior in mothers of preterm infant. Methods: The sample consisted of 55 mothers with preterm infants were recruited in a neonatal intermediate unit at a medical center in central Taiwan. The self-reported questionnaires including knowledge and skills of preterm infant care scales and maternal confidence scale were used to evaluation, which were conducted during hospitalization, before hospital discharge, and one month after discharge. We performed by using Pearson correlation of the collected data using SPSS 18. Results: The study showed that the learning number and knowledge in preterm infant care was a significant positive correlation (r = .40), and the skills and confidence preterm infant care was positively correlated (r = .89). Conclusions: Study results showed the mother had more learning number in preterm infant care will be stronger knowledge, and the skills and confidence in preterm infant care were also positively correlated. Thus, we found the learning behavior change significant care knowledge. And the maternal confidence change significant with skill on preterm infant’s care. But bondage still needs further study and develop the participation in hospital-based instructional programs, which could lead to greater long-term retention of learning.Keywords: learning behavior, care knowledge, care skills, maternal confidence
Procedia PDF Downloads 2602973 Development of Star Image Simulator for Star Tracker Algorithm Validation
Authors: Zoubida Mahi
Abstract:
A successful satellite mission in space requires a reliable attitude and orbit control system to command, control and position the satellite in appropriate orbits. Several sensors are used for attitude control, such as magnetic sensors, earth sensors, horizon sensors, gyroscopes, and solar sensors. The star tracker is the most accurate sensor compared to other sensors, and it is able to offer high-accuracy attitude control without the need for prior attitude information. There are mainly three approaches in star sensor research: digital simulation, hardware in the loop simulation, and field test of star observation. In the digital simulation approach, all of the processes are done in software, including star image simulation. Hence, it is necessary to develop star image simulation software that could simulate real space environments and various star sensor configurations. In this paper, we present a new stellar image simulation tool that is used to test and validate the stellar sensor algorithms; the developed tool allows to simulate of stellar images with several types of noise, such as background noise, gaussian noise, Poisson noise, multiplicative noise, and several scenarios that exist in space such as the presence of the moon, the presence of optical system problem, illumination and false objects. On the other hand, we present in this paper a new star extraction algorithm based on a new centroid calculation method. We compared our algorithm with other star extraction algorithms from the literature, and the results obtained show the star extraction capability of the proposed algorithm.Keywords: star tracker, star simulation, star detection, centroid, noise, scenario
Procedia PDF Downloads 962972 The Influence of Human Factors Education on the Irish Registered Pre-Hospital Practitioner within the National Ambulance Service
Authors: Desmond Wade, Alfredo Ormazabal
Abstract:
Background: Ever since it commenced its registration process of pre-hospital practitioners in the year 2000 through the Irish Government Statute Instrument (SI 109 of 2000) process, the approach to education of its professionals has changed drastically. The progression from the traditional behaviouristic to the current constructivist approach has been based on experiences from other sectors and industries, nationally and internationally. Today, the delivery of a safe and efficient ambulance service heavily depends on its practitioners’ range of technical skills, academic knowledge, and overall competences. As these increase, so does the level of complexity of paramedics’ everyday practice. This has made it inevitable to consider the 'Human Factor' as a source of potential risk and made formative institutions like the National Ambulance Service College to include it in their curriculum. Methods: This paper used a mixed-method approach, where both, an online questionnaire and a set of semi-structured interviews were the source of primary data. An analysis of this data was carried out using qualitative and quantitative data analysis. Conclusions: The evidence presented leads to the conclusion that in the National Ambulance Service there is a considerable lack of education of Human Factors and the levels in understanding of how to manage Human Factors in practice vary across its spectrum. Paramedic Practitioners in Ireland seem to understand that the responsibility of patient care lies on the team, rather than on the most hierarchically senior practitioner present in the scene.Keywords: human factors, ergonomics, stress, decision making, pre-hospital care, paramedic, education
Procedia PDF Downloads 1502971 Liquid Biopsy and Screening Biomarkers in Glioma Grading
Authors: Abdullah Abdu Qaseem Shamsan
Abstract:
Background: Gliomas represent the most frequent, heterogeneous group of tumors arising from glial cells, characterized by difficult monitoring, poor prognosis, and fatality. Tissue biopsy is an established procedure for tumor cell sampling that aids diagnosis, tumor grading, and prediction of prognosis. We studied and compared the levels of liquid biopsy markers in patients with different grades of glioma. Also, it tried to establish the potential association between glioma and specific blood groups antigen. Result: 78 patients were identified, among whom maximum percentage with glioblastoma possessed blood group O+ (53.8%). The second highest frequency had blood group A+ (20.4%), followed by B+ (9.0%) and A- (5.1%), and least with O-. Liquid biopsy biomarkers comprised of ALT, LDH, lymphocytes, Urea, Alkaline phosphatase, AST Neutrophils, and CRP. The levels of all the components increased significantly with the severity of glioma, with maximum levels seen in glioblastoma (grade IV), followed by grade III and grade II respectively. Conclusion: Gliomas possess significant clinical challenges due to their progression with heterogeneous nature and aggressive behavior. Liquid biopsy is a non-invasive approach which aids to establish the status of the patient and determine the tumor grade, therefore may show diagnostic and prognostic utility. Additionally, our study provides evidence to demonstrate the role of ABO blood group antigens in the development of glioma. However, future clinical research on liquid biopsy will improve the sensitivity and specificity of these tests and validate their clinical usefulness to guide treatment approaches.Keywords: GBM: glioblastoma multiforme, CT: computed tomography, MRI: magnetic resonance imaging, ctRNA: circulating tumor RNA
Procedia PDF Downloads 512970 Equipment Donation: A Perspective from a Teaching Tertiary Care Hospital in North India
Authors: Jitender Sodhi, Shweta Talati, A. K. Gupta, Pankaj Arora
Abstract:
Background:Equipment donation to hospitals in resource-limited settings can significantly benefit services in these settings albeit requires important ethical, practical and financial issues to be considered before accepting donations. Objective: To understand the decision making process leading to acceptance/ rejection/ deferment of equipment donation from the perspective of a public sector teaching tertiary care hospital. Design: Retrospective, record based study. Setting: 2000-bedded public sector teaching tertiary care hospital in North India. Methods: A total of 30 cases of equipment donation from March 2010-October 2013, were analysed for their decision process leading to acceptance/rejection/deferment.Each case was studied retrospectively and data pertaining to the agenda and decision taken was collected. Results: A total of 30 cases of equipment donation received from March 2010- October 2013 were screened, out of which 17 (56.6%) were for diagnostic purpose and 13 (43.3%) for therapeutic purpose. Out of 30 cases, 16 (53.3%) were accepted and 8 (26.6%) were rejected. The remaining 6 cases included 3 (10%) which required further clarification and other 3 (10%) which were out of the domain of committee. Conclusion: This study highlights the importance of equipment donation in resource limited settings and considerations involved while making decisions for acceptance/rejections/defermentof such donations.Keywords: equipment donation, teaching hospital, decision-making, North India
Procedia PDF Downloads 2952969 Molecular Comparison of HEV Isolates from Sewage & Humans at Western India
Authors: Nidhi S. Chandra, Veena Agrawal, Debprasad Chattopadhyay
Abstract:
Background: Hepatitis E virus (HEV) is a major cause of acute viral hepatitis in developing countries. It spreads feco orally mainly due to contamination of drinking water by sewage. There is limited data on the genotypic comparison of HEV isolates from sewage water and humans. The aim of this study was to identify genotype and conduct phylogenetic analysis of HEV isolates from sewage water and humans. Materials and Methods: 14 sewage water and 60 serum samples from acute sporadic hepatitis E cases (negative for hepatitis A, B, C) were tested for HEV-RNA by nested polymerase chain reaction (RTnPCR) using primers designed with in RdRp (RNA dependent RNA polymerase) region of open reading frame-1 (ORF-1). Sequencing was done by ABI prism 310. The sequences (343 nucleotides) were compared with each other and were aligned with previously reported HEV sequences obtained from GeneBank, using Clustal W software. A Phylogenetic tree was constructed by using PHYLIP version 3.67 software. Results: HEV-RNA was detected in 49/ 60 (81.67%) serum and 5/14 (35.71%) sewage samples. The sequences obtained from 17 serums and 2 sewage specimens belonged to genotype I with 85% similarity and clustering with previously reported human HEV sequences from India. HEV isolates from human and sewage in North West India are genetically closely related to each other. Conclusion: These finding suggest that sewage acts as reservoir of HEV. Therefore it is important that measures are taken for proper waste disposal and treatment of drinking water to prevent outbreaks and epidemics due to HEV.Keywords: hepatitis E virus, nested polymerase chain reaction, open reading frame-1, nucleotidies
Procedia PDF Downloads 3772968 Bilingualism Contributes to Cognitive Reserve in Parkinson's Disease
Authors: Arrate Barrenechea Garro
Abstract:
Background: Bilingualism has been shown to enhance cognitive reserve and potentially delay the onset of dementia symptoms. This study investigates the impact of bilingualism on cognitive reserve and the age of diagnosis in Parkinson's Disease (PD). Methodology: The study involves 16 non-demented monolingual PD patients and 12 non-demented bilingual PD patients, matched for age, sex, and years of education. All participants are native Spanish speakers, with Spanish as their first language (L1). Cognitive performance is assessed through a neuropsychological examination covering all cognitive domains. Cognitive reserve is measured using the Cognitive Reserve Index Questionnaire (CRIq), while language proficiency is evaluated using the Bilingual Language Profile (BLP). The age at diagnosis is recorded for both monolingual and bilingual patients. Results: Bilingual PD patients demonstrate higher scores on the CRIq compared to monolingual PD patients, with significant differences between the groups. Furthermore, there is a positive correlation between cognitive reserve (CRIq) and the utilization of the second language (L2) as indicated by the BLP. Bilingual PD patients are diagnosed, on average, three years later than monolingual PD patients. Conclusion: Bilingual PD patients exhibit higher levels of cognitive reserve compared to monolingual PD patients, as indicated by the CRIq scores. The utilization of the second language (L2) is positively correlated with cognitive reserve. Bilingual PD patients are diagnosed with PD, on average, three years later than monolingual PD patients. These findings suggest that bilingualism may contribute to cognitive reserve and potentially delay the onset of clinical symptoms associated with PD. This study adds to the existing literature supporting the relationship between bilingualism and cognitive reserve. Further research in this area could provide valuable insights into the potential protective effects of bilingualism in neurodegenerative disorders.Keywords: bilingualis, cogntiive reserve, diagnosis, parkinson's disease
Procedia PDF Downloads 1002967 An Audit of Local Guidance Compliance For Stereotactic Core Biopsy For DCIS In The Breast Screening Programme
Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester
Abstract:
Background: The breast unit local guideline recommends that 12 cores should be used in a stereotactic-guided biopsy to diagnose DCIS. Twelve cores are regarded to provide good diagnostic value without removing more breast tissue than necessary. This study aimed to determine compliance with guidelines and investigated how the number of cores impacted upon the re-excision rate and size discrepancies. Methods: This single-centre retrospective cohort study of 72 consecutive breast screened patients with <15mm DCIS on radiological report underwent stereotactic-guided core biopsy and subsequent surgical excision. Clinical, radiological, and histological data were collected over 5 years, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Results: Forty-six (63.9%) patients had <12 cores taken, and 26 (36.1%) patients had ≥12 cores taken. Only six (8.3%) patients had 12 cores taken in their stereotactic biopsy. Incomplete surgical excision was seen in 17 patients overall (23.6%), and of these patients, twelve (70.6%) had fewer than 12 cores taken (p=0.55 for the difference between groups). Mammogram and biopsy underestimated the size of the DCIS in this subgroup by a median of 15mm (range: 6-135mm). Re-excision was required in 9 patients (12.5%), and five patients (6.9%) were found to have invasive ductal carcinoma on excision (80% had <12 cores, p=0.43). Discussion: There is poor compliance with the breast unit local guidelines and higher rates of re-excision in patients who did not have ≥12 cores taken. Taking ≥12 cores resulted in fewer missed invasive cancers lower incomplete excision and re-excision rates.Keywords: stereotactic core biopsy, DCIS, breast screening, Re-excision rates, core biopsy
Procedia PDF Downloads 1282966 The Association between Masculinity and Anxiety in Canadian Men
Authors: Nikk Leavitt, Peter Kellett, Cheryl Currie, Richard Larouche
Abstract:
Background: Masculinity has been associated with poor mental health outcomes in adult men and is colloquially referred to as toxic. Masculinity is traditionally measured using the Male Role Norms Inventory, which examines behaviors that may be common in men but that are themselves associated with poor mental health regardless of gender (e.g., aggressiveness). The purpose of this study was to examine if masculinity is associated with generalized anxiety among men using this inventory vs. a man’s personal definition of it. Method: An online survey collected data from 1,200 men aged 18-65 across Canada in July 2022. Masculinity was measured using: 1) the Male Role Norms Inventory Short Form and 2) by asking men to self-define what being masculine means. Men were then asked to rate the extent they perceived themselves to be masculine on a scale of 1 to 10 based on their definition of the construct. Generalized anxiety disorder was measured using the GAD-7. Multiple linear regression was used to examine associations between each masculinity score and anxiety score, adjusting for confounders. Results: The masculinity score measured using the inventory was positively associated with increased anxiety scores among men (β = 0.02, p < 0.01). Masculinity subscales most strongly correlated with higher anxiety were restrictive emotionality (β = 0.29, p < 0.01) and dominance (β = 0.30, p < 0.01). When traditional masculinity was replaced by a man’s self-rated masculinity score in the model, the reverse association was found, with increasing masculinity resulting in a significantly reduced anxiety score (β = -0.13, p = 0.04). Discussion: These findings highlight the need to revisit the ways in which masculinity is defined and operationalized in research to better understand its impacts on men’s mental health. The findings also highlight the importance of allowing participants to self-define gender-based constructs, given they are fluid and socially constructed.Keywords: masculinity, generalized anxiety disorder, race, intersectionality
Procedia PDF Downloads 712965 Controlling Fear: Jordanian Women’s Perceptions of the Diagnosis and Surgical Treatment of Early Stage Breast Cancer
Authors: Rana F. Obeidat, Suzanne S. Dickerson, Gregory G. Homish, Nesreen M. Alqaissi, Robin M. Lally
Abstract:
Background: Despite the fact that breast cancer is the most prevalent cancer among Jordanian women, practically nothing is known about their perceptions of early stage breast cancer and surgical treatment. Objective: To gain understanding of the diagnosis and surgical treatment experience of Jordanian women diagnosed with early stage breast cancer. Methods: An interpretive phenomenological approach was used for this study. A purposive sample of 28 Jordanian women who were surgically treated for early stage breast cancer within 6 months of the interview was recruited. Data were collected using individual interviews and analyzed using Heideggerian hermeneutical methodology. Results: Fear had a profound effect on Jordanian women’s stories of diagnosis and surgical treatment of early stage breast cancer. Women’s experience with breast cancer and its treatment was shaped by their pre-existing fear of breast cancer, the disparity in the quality of care at various health care institutions, and sociodemographic factors (e.g., education, age). Conclusions: Early after the diagnosis, fear was very strong and women lost perspective of the fact that this disease was treatable and potentially curable. To control their fears, women unconditionally trusted God, the health care system, surgeons, family, friends, and/or neighbors, and often accepted treatment offered by their surgeons without questioning. Implications for practice: Jordanian healthcare providers have a responsibility to listen to their patients, explore meanings they ascribe to their illness, and provide women with proper education and support necessary to help them cope with their illness.Keywords: breast cancer, early stage, Jordanian, experience, phenomenology
Procedia PDF Downloads 3252964 Presuppositions and Implicatures in Four Selected Speeches of Osama Bin Laden's Legitimisation of 'Jihad'
Authors: Sawsan Al-Saaidi, Ghayth K. Shaker Al-Shaibani
Abstract:
This paper investigates certain linguistics properties of four selected speeches by Al-Qaeda’s former leader Osama bin Laden who legitimated the use of jihad by Muslims in various countries when he was alive. The researchers adopt van Dijk’s (2009; 1998) Socio-Cognitive approach and Ideological Square theory respectively. Socio-Cognitive approach revolves around various cognitive, socio-political, and discursive aspects that can be found in political discourse as in Osama bin Laden’s one. The political discourse can be defined in terms of textual properties and contextual models. Pertaining to the ideological square, it refers to positive self-presentation and negative other-presentation which help to enhance the textual and contextual analyses. Therefore, among the most significant properties in Osama bin Laden’s discourse are the use of presuppositions and implicatures which are based on background knowledge and contextual models as well. Thus, the paper concludes that Osama bin Laden used a number of manipulative strategies which augmented and embellished the use of ‘jihad’ in order to develop a more effective discourse for his audience. In addition, the findings have revealed that bin Laden used different implicit and embedded interpretations of different topics which have been accepted as taken-for-granted truths for him to legitimate Jihad against his enemies. There are many presuppositions in the speeches analysed that result in particular common-sense assumptions and a world-view about the selected speeches. More importantly, the assumptions in the analysed speeches help consolidate the ideological analysis in terms of in-group and out-group members.Keywords: Al-Qaeda, cognition, critical discourse analysis, Osama Bin Laden, jihad, implicature, legitimisation, presupposition, political discourse
Procedia PDF Downloads 2392963 Contemporary Challenges in Public Relations in the Context of Globalization
Authors: Marine Kobalava, Eter Narimanishvili, Nino Grigolaia
Abstract:
The paper analyzes the contemporary problems of public relations in Georgia. The approaches to public attitudes towards the relationship with the population of the country are studied on a global scale, the importance of forming the concept of public relations in Georgia in terms of globalization is justified. The basic components of public relations are characterized by the RACE system, namely analyzing research, action, communication, evaluation. The main challenges of public relations are identified in the research process; taking into consideration the scope of globalization, the influence of social, economic, and political changes in Georgia on PR development are identified. The article discusses the public relations as the strategic management function that facilitates communication with the society, recognition of public interests, and their prediction. In addition, the feminization of the sector is considered to be the most important achievement of public relations in the modern world. The conclusion is that the feminization indicator of the field is an unconditional increase in the employment rates of women. In the paper, the problems of globalization and public relations in the industrial countries are studied, the directions of improvement of public relations with the background of peculiarities of different countries and globalization process are proposed. Public relations under globalization are assessed in accordance with the theory of benefits and requirements, and the requirements are classified according to informational, self-identification, integration, social interaction, and other types of signs. In the article, conclusions on the current challenges of public relations in Georgia are made, and the recommendations for their solution, taking into consideration globalization processes in the world, are proposed.Keywords: public relations, globalization, RACE system, public relationship concept, feminization
Procedia PDF Downloads 1722962 In vitro Inhibitory Action of an Aqueous Extract of Carob on the Release of Myeloperoxidase by Human Neutrophils
Authors: Kais Rtibi, Slimen Selmi, Jamel El-Benna, Lamjed Marzouki, Hichem Sebai
Abstract:
Background: Myeloperoxidase (MPO) is a hemic enzyme found in high concentrations in the primary neutrophils granules. In addition to its peroxidase activity, it has a chlorination activity, using hydrogen peroxide and chloride ions to form hypochlorous acid, a strong oxidant, capable of chlorinating molecules. Bioactive compounds contained in medicinal plants could limit the action of this enzyme to reduce the reactive oxygen species production and its chlorination activity. The purpose of this study is to evaluate the effect of the carob aqueous extract (CAE) on the release of MPO by human neutrophils in vitro and its activity following stimulation of these cells by PMA. Methods: Neutrophils were isolated by simple sedimentation using the Dextran/Ficoll method. After stimulation with phorbol 12-myristate 13-acetate (PMA), neutrophils release the MPO by degranulation. The effect of CAE on the release of MPO was analyzed by the Western blot technique, while, its activity was determined by biochemical method using the method of 3,3', 5,5'- Tetramethylbenzidine (TMB) and hydrogen peroxide. The data were expressed as mean ± SEM. Results: The carob aqueous extract causes a decrease in MPO quantity and activity in a concentration-dependent manner which leads to a reduction of the production of the ROS (reactive oxygen species) and the protection of the molecules against oxidation and chlorination mechanisms. Conclusion: Thanks to its richness in bioactive compounds, the aqueous extract of carob could limit the development of damages related to the uncontrolled activity of MPO.Keywords: carob, MPO, myeloperoxidase, neutrophils, PMA, phorbol 12-myristate 13-acetate
Procedia PDF Downloads 1572961 High Efficacy of Combined Therapy with Microbicide BASANT and Triple Combination of Selected Probiotics for Treatment of Vaginosis and Restoration of Vaginal Health
Authors: Nishu Atrey, Priyanka Singh, G. P. Talwar, Jagdish Gupta, Alka Kriplani, Rohini Sehgal, Indrani Ganguli, Soni Sinha
Abstract:
Background: Vaginosis is a widely prevalent syndrome in India and elsewhere. Recurrence is frequent in women treated with antibiotics, whose vagina pH remains above 5.0 indicative of the loss of resident lactobacilli. The objective of the present trial was to determine whether a Polyherbal microbicide BASANT can regress Vaginosis. Another objective was to determine whether the three selected strains of Probiotics endowed with making high amounts of lactic acid can colonise and restore the pH of the vagina to the acidic healthy range. Materials and Procedure: BASANT, was employed in powder form in veg (cellulose) capsules. TRF#36 strain of Lactobacillus fermentum, TRF#8 strain of L.gasseri, and TRF#30 strain of L.salivarius (combination termed as Pro-vag-Health) were employed at 3x109 bacilli lyophilized, packaged in capsules. The trials were conducted in women suffering from vaginosis with vaginal pH above 5.0. Women were given intravaginally either BASANT, Pro-vag-Health or a combination of the two intravaginally for seven days and thereafter once weekly as a maintenance dose. Results: BASANT cleared vaginosis in 14/20 women and Pro-vag-Health in 13/20 women. Interestingly, the combination of BASANT plus Pro-vag-Health was effective in 19/20 women, in contrast to Placebo capsules effective only in 1/20 women. Interpretation and Conclusion: The combination of BASANT and Pro-veg-Health Probiotics taken together intravaginally for seven days relieves 19 out of 20 women from vaginosis to restore acidic pH and healthy vagina. Extension of trial with this combination in larger number is indicated.Keywords: microbicide, probiotics, vaginal pH, vaginosis
Procedia PDF Downloads 3082960 Knowledge and Perceptions of Final-year Students towards Pharmacovigilance and Adverse Drug Reaction Reporting at the Faculty of Medical Sciences, Al-Razi University - Sana`a - Yemen
Authors: Nabil A. Albaser
Abstract:
Background: There is a serious problem with adverse drug reactions (ADRs) everywhere, including Yemen. Since it helps with the detection, assessment, reporting and prevention of ADRs, pharmacovigilance (PV) is an essential part of the healthcare system. The unbiased reporting of ADRs remains the foundation of PV. Students majoring in healthcare should acquire the knowledge and skills necessary to conduct PV in a range of clinical settings. The primary objective of this study was to evaluate the understanding and attitudes of final-year Pharmacy, Nursing, and Midwifery students at Al-Razi University in Sana'a, Yemen, regarding PV and ADRs reporting. Methods: The study followed descriptive cross-sectional approach. A validated, self-administered questionnaire with three parts—demographic information, knowledge, and perceptions of Pharmacovigilance was online distributed to final-year Pharmacy, Nursing, and Midwifery students. The questionnaire was given to 175 students; 122 of them responded with a percentage (69.7%). Results: The majority of respondents were male (79.5%). More than the tow-third of the students, 68.9%, were beyond the age of 23. Although the majority of students, 80%, heard about the terms of ADRs and PV, but only 50% and 57.4% of the respondents, respectively, could define the both terms correctly. However, only 11.48 % of them, nevertheless, took a PV course. More than a half of them (56.6%) had a positive perceptions towards pharmacovigilance and ADR reporting and had a moderate degree of knowledge (68.9%). Conclusion: The study demonstrated that the participants lacked sufficient knowledge of pharmacovigilance and ADR reporting. They showed a moderate level of understanding of reporting ADRs as well as a favorable opinion of dealing with and reporting ADRs. Yemen's health care curriculum should include lessons on pharmacovigilance.Keywords: adverse drug reaction reporting, pharmacovigilance, yemen, knowlegde
Procedia PDF Downloads 1182959 Pattern of Bacterial Isolates and Antimicrobial Resistance at Ayder Comprehensive Specialized Referral Hospital in Northern Ethiopia: A Retrospective Study
Authors: Solomon Gebremariam, Mulugeta Naizigi, Aregawi Haileselassie
Abstract:
Background: Knowledge of the pattern of bacterial isolates and their antimicrobial susceptibility is crucial for guiding empirical treatment and infection prevention and control measures. Objective: The aim of this study was to analyze the pattern of bacterial isolates and their susceptibility patterns from various specimens. Methods: Retrospectively, a total of 1067 microbiological culture results that were isolated, characterized, and identified by standard microbiological methods and whose antibiotic susceptibility was determined using CLSI guidelines between 2017 and 2019 were retrieved and analyzed. Data were entered and analyzed using the Stata release 10.1 statistical package. Result: The positivity rate of culture was 26.04% (419/1609). The most common bacteria isolated were S. aureus 23.8% (94), E. coli 15.1% (60), Klebsiella pneumonia 14.1% (56), Pseudomonas aeruginosa 8.5% (34), and CONS 7.3% (29). S. aureus and CONS showed a high (58.1% - 96.2%) rate of resistance to most antibiotics tested. They were less resistant to Vancomycin which is 18.6% (13/70) and 11.8% (2/17), respectively. Similarly, the resistance of E. coli, Klebsella pneumonia, and Pseudomonas aeruginosa was high (69.4% - 100%) to most antibiotics. They were less resistant to Ciprofloxacilin, which is 41.1% (23/56), 19.2% (10/52), and 16.1% (5/31), respectively. Conclusion: This study has shown that there is a high rate of antibiotic resistance among bacterial isolates in this hospital. A combination of Vancomycin and Ciprofloxacin should be considered in the choice of antibiotics for empirical treatment of suspected infections due to S. aureus, CONS, E. coli, Klebsiella pneumonia, Pseudomonas such as in infections within hospital setup.Keywords: antimicrobial, resistance, bacteria, hospital
Procedia PDF Downloads 742958 Developing a Culturally Acceptable End of Life Survey (the VOICES-ESRD/Thai Questionnaire) for Evaluation Health Services Provision of Older Persons with End-Stage Renal Disease (ESRD) in Thailand
Authors: W. Pungchompoo, A. Richardson, L. Brindle
Abstract:
Background: The developing of a culturally acceptable end of life survey (the VOICES-ESRD/Thai questionnaire) is an essential instrument for evaluation health services provision of older persons with ESRD in Thailand. The focus of the questionnaire was on symptoms, symptom control and the health care needs of older people with ESRD who are managed without dialysis. Objective: The objective of this study was to develop and adapt VOICES to make it suitable for use in a population survey in Thailand. Methods: The mixed methods exploratory sequential design was focussed on modifying an instrument. Data collection: A cognitive interviewing technique was implemented, using two cycles of data collection with a sample of 10 bereaved carers and a prototype of the Thai VOICES questionnaire. Qualitative study was used to modify the developing a culturally acceptable end of life survey (the VOICES-ESRD/Thai questionnaire). Data analysis: The data were analysed by using content analysis. Results: The revisions to the prototype questionnaire were made. The results were used to adapt the VOICES questionnaire for use in a population-based survey with older ESRD patients in Thailand. Conclusions: A culturally specific questionnaire was generated during this second phase and issues with questionnaire design were rectified.Keywords: VOICES-ESRD/Thai questionnaire, cognitive interviewing, end of life survey, health services provision, older persons with ESRD
Procedia PDF Downloads 2862957 Influence of Food Microbes on Horizontal Transfer of β-Lactam Resistance Genes between Salmonella Strains in the Mouse Gut
Authors: M. Ottenbrite, G. Yilmaz, J. Devenish, M. Kang, H. Dan, M. Lin, C. Lau, C. Carrillo, K. Bessonov, J. Nash, E. Topp, J. Guan
Abstract:
Consumption of food contaminated by antibiotic-resistant (AR) bacteria may lead to the transmission of AR genes in the gut microbiota and cause AR bacterial infection, a significant public health concern. However, information is limited on if and how background microbes from the food matrix (food microbes) may influence resistance transmission. Thus, we assessed the colonization of a β-lactam resistant Salmonella Heidelberg strain (donor) and a β-lactam susceptible S. Typhimurium strain (recipient) and the transfer of the resistance genes in the mouse gut in the presence or absence of food microbes that were derived from washing freshly-harvested carrots. Mice were pre-treated with streptomycin and then inoculated with both donor and recipient bacteria or recipient only. Fecal shedding of the donor, recipient, and transconjugant bacteria was enumerated using selective culture techniques. Transfer of AR genes was confirmed by whole genome sequencing. Gut microbial composition was determined by 16s rRNA amplicon sequencing. Significantly lower numbers of donors and recipients were shed from mice that were inoculated with food microbes compared to those without food microbe inoculation. S. Typhimurium transconjugants were only recovered from mice without inoculation of food microbes. A significantly higher survival rate was in mice with vs. without inoculation of food microbes. The results suggest that the food microbes may compete with both the donor and recipient Salmonella, limit their growth and reduce transmission of the β-lactam resistance gene in the mouse gut.Keywords: antibiotic resistance, gene transfer, gut microbiota, Salmonella infection
Procedia PDF Downloads 742956 The Importance of Clinicopathological Features for Differentiation Between Crohn's Disease and Ulcerative Colitis
Authors: Ghada E. Esheba, Ghadeer F. Alharthi, Duaa A. Alhejaili, Rawan E. Hudairy, Wafaa A. Altaezi, Raghad M. Alhejaili
Abstract:
Background: Inflammatory bowel disease (IBD) consists of two specific gastrointestinal disorders: ulcerative colitis (UC) and Crohn's disease (CD). Despite their distinct natures, these two diseases share many similar etiologic, clinical and pathological features, as a result, their accurate differential diagnosis may sometimes be difficult. Correct diagnosis is important because surgical treatment and long-term prognosis differ from UC and CD. Aim: This study aims to study the characteristic clinicopathological features which help in the differential diagnosis between UC and CD, and assess the disease activity in ulcerative colitis. Materials and methods: This study was carried out on 50 selected cases. The cases included 27 cases of UC and 23 cases of CD. All the cases were examined using H& E and immunohistochemically for bcl-2 expression. Results: Characteristic features of UC include: decrease in mucous content, irregular or villous surface, crypt distortion, and cryptitis, whereas the main cardinal histopathological features seen in CD were: epitheloid granuloma, transmural chronic inflammation, absence of mucin depletion, irregular surface, or crypt distortion. 3 cases of UC were found to be associated with dysplasia. UC mucosa contains fewer Bcl-2+ cells compared with CD mucosa. Conclusion: This study using multiple parameters such clinicopathological features and Bcl-2 expression as studied by immunohistochemical stain, helped to gain an accurate differentiation between UC and CD. Furthermore, this work spotted the light on the activity and different grades of UC which could be important for the prediction of relapse.Keywords: Crohn's disease, dysplasia, inflammatory bowel disease, ulcerative colitis
Procedia PDF Downloads 1912955 HIV and STIs among Female Sex Workers in Ba Ria – Vung Tau, Vietnam
Authors: Tri Nguyen
Abstract:
Background: Female sex workers (FSWs) are at heightened risk of sexually transmitted infections (STIs) and HIV. The purpose of the research is to study FSWs socio-demographic and behavioral characteristics and their HIV/STIs prevalence in Ba Ria – Vung Tau, Vietnam. Methods: A cross-sectional survey of 420 direct and indirect FSWs between January and May, 2014 from 2 cities and 6 districts in Ba Ria – Vung Tau were collected using sampling methods. FSWs were interviewed using the structured questionnaire and biological samples were tested for syphilis, gonorrhoea, chlamydia and HIV in the study. A database was constructed and entered using Epidata 3.1 software and analyzed using the SPSS 20.0 statistical package. Results: A total of 420 FSWs participated in the survey, with a median age of 27 years within a range of 18 – 43 years. Education levels were low with 33.1% only completing all seven major indicators. The median age of first sexual intercourse of the FSWs was 18 years. Most (88.8%) of the FSWs had oral sex. A high proportion (82.4 %) of the FSWs had consumed alcohol. Among them, 51.2% of the FSWs have had sex after drunk. Of the 177 FSWs have reported that they have had sex after drunk, almost half of direct FSWs have had unprotected sex. Among the 420 FSWs who participated in the survey, 2.6 % (11/420) were found to be HIV positive. There was a difference in HIV prevalence among direct and indirect FSWs (4.8 % and 1.2%, p= 0,022). Nearly 7 percent of the FSWs were infected with Syphilis. Similarly, the percentage (7.9 %) of the FSWs was found with Gonorrhoea and a doubly higher percentage (16.4%) of them was suffering from Chlamydia. On the aggregate, the percentage of FSWs with any one of the STIs (Gonorrhoea or Chlamydia) was highest 21.4 %. Conclusions: FSWs in Ba Ria – Vung Tau, Vietnam are highly vulnerable to STIs and need to enhance the existing STIs treatment and intervention programs in order to reduce the risk of HIV infections. HIV/STIs health education and a 100% condom use program should be implemented, and sex industry should be regulated by law.Keywords: sex workers, female sex workers, HIV, STIs
Procedia PDF Downloads 2562954 Heritage Management Planning, Stakeholders and Legal Problematic: The Case of the Archeological Site of Jarash in Jordan
Authors: Abdelkader Ababneh
Abstract:
Heritage management planning is increasingly important throughout the international context, particularly in the developing countries. Jordan has important and unique heritage resources due to its natural topography and climate, but also to its history and old sites. A high number of these archaeological sites are in very good state of preservation. Most natural sites and resources are privately managed while archaeological heritage sites are publicly managed within national legal texts and with some referencing to international legal documents. This study examines the development of cultural heritage management in Jarash, and questions if this heritage has been managed in an appropriate manner. The purpose of this paper is to define and review the stakeholders in charge of the management of the archaeological site of Jarash, the legal texts, laws and documents adopted to apply the site management. Relations and coordination between stakeholders and the challenge of the planning process is also the focus of this paper. A review of pertinent academic, technical studies, reports and projects literature pertaining to the heritage management planning in general and related to the site of Jarash in particular coupled with field study of the site served as the background of the information base for the study. Current context of actors, legislative framework, planning policies and initiatives for the site of Jarash reveal important and continuous challenge for managing the site. Recommendations suggest reviewing and restructuring the entity responsible of the sites management. It is also recommended to review their applied policies and a redevelopment of the legislative frame work.Keywords: heritage management, stakeholders, legal protection, Jarash
Procedia PDF Downloads 379