Search results for: evidence based app
30368 Applying Massively Parallel Sequencing to Forensic Soil Bacterial Profiling
Authors: Hui Li, Xueying Zhao, Ke Ma, Yu Cao, Fan Yang, Qingwen Xu, Wenbin Liu
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Soil can often link a person or item to a crime scene, which makes it a valuable evidence in forensic casework. Several techniques have been utilized in forensic soil discrimination in previous studies. Because soil contains a vast number of microbiomes, the analyse of soil microbiomes is expected to be a potential way to characterise soil evidence. In this study, we applied massively parallel sequencing (MPS) to soil bacterial profiling on the Ion Torrent Personal Genome Machine (PGM). Soils from different regions were collected repeatedly. V-region 3 and 4 of Bacterial 16S rRNA gene were detected by MPS. Operational taxonomic units (OTU, 97%) were used to analyse soil bacteria. Several bioinformatics methods (PCoA, NMDS, Metastats, LEfse, and Heatmap) were applied in bacterial profiles. Our results demonstrate that MPS can provide a more detailed picture of the soil microbiomes and the composition of soil bacterial components from different region was individualistic. In conclusion, the utility of soil bacterial profiling via MPS of the 16S rRNA gene has potential value in characterising soil evidences and associating them with their place of origin, which can play an important role in forensic science in the future.Keywords: bacterial profiling, forensic, massively parallel sequencing, soil evidence
Procedia PDF Downloads 56330367 The Use of Social Stories and Digital Technology as Interventions for Autistic Children; A State-Of-The-Art Review and Qualitative Data Analysis
Authors: S. Hussain, C. Grieco, M. Brosnan
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Background and Aims: Autism is a complex neurobehavioural disorder, characterised by impairments in the development of language and communication skills. The study involved a state-of-art systematic review, in addition to qualitative data analysis, to establish the evidence for social stories as an intervention strategy for autistic children. An up-to-date review of the use of digital technologies in the delivery of interventions to autistic children was also carried out; to propose the efficacy of digital technologies and the use of social stories to improve intervention outcomes for autistic children. Methods: Two student researchers reviewed a range of randomised control trials and observational studies. The aim of the review was to establish if there was adequate evidence to justify recommending social stories to autistic patients. Students devised their own search strategies to be used across a range of search engines, including Ovid-Medline, Google Scholar and PubMed. Students then critically appraised the generated literature. Additionally, qualitative data obtained from a comprehensive online questionnaire on social stories was also thematically analysed. The thematic analysis was carried out independently by each researcher, using a ‘bottom-up’ approach, meaning contributors read and analysed responses to questions and devised semantic themes from reading the responses to a given question. The researchers then placed each response into a semantic theme or sub-theme. The students then joined to discuss the merging of their theme headings. The Inter-rater reliability (IRR) was calculated before and after theme headings were merged, giving IRR for pre- and post-discussion. Lastly, the thematic analysis was assessed by a third researcher, who is a professor of psychology and the director for the ‘Centre for Applied Autism Research’ at the University of Bath. Results: A review of the literature, as well as thematic analysis of qualitative data found supporting evidence for social story use. The thematic analysis uncovered some interesting themes from the questionnaire responses, relating to the reasons why social stories were used and the factors influencing their effectiveness in each case. However, overall, the evidence for digital technologies interventions was limited, and the literature could not prove a causal link between better intervention outcomes for autistic children and the use of technologies. However, they did offer valid proposed theories for the suitability of digital technologies for autistic children. Conclusions: Overall, the review concluded that there was adequate evidence to justify advising the use of social stories with autistic children. The role of digital technologies is clearly a fast-emerging field and appears to be a promising method of intervention for autistic children; however, it should not yet be considered an evidence-based approach. The students, using this research, developed ideas on social story interventions which aim to help autistic children.Keywords: autistic children, digital technologies, intervention, social stories
Procedia PDF Downloads 12130366 Group Attachment Based Intervention® Reduces Toddlers' Fearfulness
Authors: Kristin Lewis, Howard Steele, Anne Murphy, Miriam Steele, Karen Bonuck, Paul Meissner
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The present study examines data collected during the randomized control trial (RCT) of the Group Attachment-Based Intervention (GABI©), a trauma-informed, attachment-based intervention aimed at promoting healthy parent-child relationships that support child development. Families received treatment at Treatment Center and were randomly assigned to either the GABI condition or the treatment as usual condition, a parenting class called Systematic Training for Effective Parenting (STEP). Significant improvements in the parent-child relationship have been reported for families participating in GABI, but not in the STEP control group relying on Coding Interactive Behavior (CIB) as applied to 5-minute video-films of mothers and their toddlers in a free play context. This report considers five additional attachment-relevant 'clinical codes' that were also applied to the 5-minute free play sessions. Seventy-two parent-child dyads (38 in GABI and 34 in STEP) were compared to one another at intake and end-of-treatment, on these five-point dimensions: two-parent codes—the dissociation and ignoring; two child codes—simultaneous display of contradictory behavior and fear; and one parent-child code, i.e., role reversal. Overall, scores were low for these clinical codes; thus, a binary measure was computed contrasting no evidence with some evidence of each clinical code. Crosstab analyses indicate that child fear at end-of-treatment was significantly lower among children who participated in GABI (7% or 3 children) as compared to those whose mothers participated in STEP (29% or 10 children) Chi Sq= 6.57 (1), p < .01. Discussion focuses on the potential for GABI to reduce childhood fearfulness and so enhance the child's health.Keywords: coding interactive behavior, clinical codes, group attachment based intervention, GABI, attachment, fear
Procedia PDF Downloads 11830365 The Changes of the Relationship between Audit Quality and Earnings Management after Financial Crisis
Authors: Chengxuan Geng, Yizhou E
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This paper mainly examines the changes in the relationship between earnings management and audit quality before and after financial crisis in the context of American firms from 2005 to 2010. Based on a sample of 3584 firm year observations, we find that there are changes concerning the relation between accrual-based earnings management and audit quality during the pre-crisis and post-crisis periods. However, the results do not provide enough evidence with regard to the variances in the association between real activities earnings management and audit quality during these two periods.Keywords: audit quality, earnings management, financial crisis, relationship
Procedia PDF Downloads 33930364 Sociodemographic Predictors of Flourishing among Older Adults in Rural and Urban Mongolia
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
Procedia PDF Downloads 13030363 Development and Evaluation of an Internet-Based Transdiagnostic Therapy Intervention in the Arab World
Authors: Mariam Fishere
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The proposed research study aims at developing an Internet-based transdiagnostic treatment and evaluating its efficacy. Based on the Common Elements Treatment Approach (CETA), a combined low-intensity and technology supported transdiagnostic treatment protocol will be culturally adapted for usage by nonprofessional therapists in Arabic-speaking countries. This Internet-based CETA intervention will target individuals suffering from one or more of the following disorders: depression, anxiety and posttraumatic stress disorder (PTSD), which are all major contributors to the global burden of mental illness. The growing body of research in the area of transdiagnostic treatment has proven to be effective in high-income countries (HICs), but there remain questions about its efficacy, cultural appropriateness, and validity for low- to middle-income countries (LMICs). The aim of this dissertation project is to investigate the efficacy of a newly developed Internet-delivery of an evidence-based transdiagnostic treatment – CETA – for a sample of Arabic-speaking individuals suffering from at least one of the following disorders; depression, anxiety, and PTSD.Keywords: transdiagnostic, internet-based interventions, mental health, Arab world
Procedia PDF Downloads 22830362 Bridging the Gap and Widening the Divide
Authors: Lerato Dixon, Thorsten Chmura
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This paper explores whether ethnic identity in Zimbabwe leads to discriminatory behaviour and the degree to which a norm-based intervention can shift this discriminatory behaviour. Social Identity Theory suggests that group identity can lead to favouritism towards the in-group and discriminatory behaviour towards the out-group. Agents yield higher utility from maintaining positive self-esteem by confirming with group behaviour. This paper focuses on the two majority ethnic groups in Zimbabwe – the Ndebele and Shona. Racial identities are synonymous with the language spoken. Zimbabwe’s history highlights how identity formation took place. As following independence, political parties became recognised as either Ndebele or Shona-speaking. It is against this backdrop that this study investigates the degree to which norm-based nudge can alter behaviour. This paper uses experimental methods to analyse discriminatory behaviour between two naturally occurring ethnic groups in Zimbabwe. In addition, we investigate if social norm-based interventions can shift discriminatory behaviour to understand if the divide between these two identity groups can be further divided or healed. Participants are randomly assigned into three groups to receive information regarding a social norm. We compare the effect of a proscriptive social norm-based intervention, stating what shouldn't be done and prescriptive social norms as interventions, stating what should be done. Specifically, participants are either shown the socially appropriate (Heal) norm, the socially inappropriateness (Divide) norm regarding interethnic marriages or no norm-based intervention. Following the random assignment into intervention groups, participants take part in the Trust Game. We conjecture that discrimination will shift in accordance with the prevailing social norm. Instead, we find evidence of interethnic discriminatory behaviour. We also find that trust increases when interacting with Ndebele, Shona and Zimbabwean participants following the Heal intervention. However, if the participant is Shona, the Heal intervention decreases trust toward in-groups and Zimbabwean co-players. On the other hand, if the participant is Shona, the Divide treatment significantly increases trust toward Ndebele participants. In summary, we find evidence that norm-based interventions significantly change behaviour. However, the prescriptive norm-based intervention (Heal) decreases trust toward the in-group, out-group and national identity group if the participant is Shona – therefore having an adverse effect. In contrast, the proscriptive Divide treatment increases trust if the participant is Shona towards Ndebele co-players. We conclude that norm-based interventions have a ‘rebound’ effect by altering behaviour in the opposite direction.Keywords: discrimination, social identity, social norm-based intervention, zimbabwe
Procedia PDF Downloads 25030361 Analysis of DNA from Fired Cartridge Casings
Authors: S. Mawlood, L. Denanny, N. Watson, B. Pickard
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DNA analysis has been widely accepted as providing valuable evidence concerning the identity of the source of biological traces. Our work has showed that DNA samples can survive on cartridges even after firing. The study also raised the possibility of determining other information such as the age of the donor. Such information may be invaluable in certain cases where spent cartridges from automatic weapons are left behind at the scene of a crime. In spite of the nature of touch evidence and exposure to high chamber temperatures during shooting, we were still capable to retrieve enough DNA for profile typing. In order to estimate age of contributor, DNA methylation levels were analyzed using EpiTect system for retrieved DNA. However, results were not conclusive, due to low amount of input DNA.Keywords: DNA profile, DNA Methylation, fired cartridge, touch sample
Procedia PDF Downloads 45230360 Multimedia Data Fusion for Event Detection in Twitter by Using Dempster-Shafer Evidence Theory
Authors: Samar M. Alqhtani, Suhuai Luo, Brian Regan
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Data fusion technology can be the best way to extract useful information from multiple sources of data. It has been widely applied in various applications. This paper presents a data fusion approach in multimedia data for event detection in twitter by using Dempster-Shafer evidence theory. The methodology applies a mining algorithm to detect the event. There are two types of data in the fusion. The first is features extracted from text by using the bag-ofwords method which is calculated using the term frequency-inverse document frequency (TF-IDF). The second is the visual features extracted by applying scale-invariant feature transform (SIFT). The Dempster - Shafer theory of evidence is applied in order to fuse the information from these two sources. Our experiments have indicated that comparing to the approaches using individual data source, the proposed data fusion approach can increase the prediction accuracy for event detection. The experimental result showed that the proposed method achieved a high accuracy of 0.97, comparing with 0.93 with texts only, and 0.86 with images only.Keywords: data fusion, Dempster-Shafer theory, data mining, event detection
Procedia PDF Downloads 41030359 Towards Value-Based Healthcare through a Nursing Sector Management Approach
Authors: Hadeer Hegazy, Wael Ewieda, Ranin Soliman, Samah Elway, Asmaa Tawfik, Ragaa Sayed, Sahar Mousa
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The current healthcare system is facing major challenges in terms of cost, quality of care, and access to services. In response, the concept of value-based healthcare has emerged as a new approach to healthcare delivery. This concept puts the focus on patient values rather than on the traditional medical model of care. To achieve this, healthcare organizations must be agile and able to anticipate and respond quickly to changing needs. Agile management is essential for healthcare organizations to achieve value-based care, as it allows them to rapidly adjust their strategies to changing circumstances. Additionally, it is argued that agile management can help healthcare organizations gain a better understanding of the needs of their patients and develop better care delivery models. Besides, it can help healthcare organizations develop new services, innovate, and become more efficient. The authors provide evidence to support their argument, drawing on examples from successful value-based healthcare initiatives at children’s cancer hospital Egypt-57357. The paper offers insight into how agile management can be used to facilitate the shift towards value-based healthcare and how it can be used to maximize value in the healthcare system.Keywords: value-based healthcare, agility in healthcare, nursing department, patients outcomes
Procedia PDF Downloads 76730358 A Preliminary Literature Review of Digital Transformation Case Studies
Authors: Vesna Bosilj Vukšić, Lucija Ivančić, Dalia Suša Vugec
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While struggling to succeed in today’s complex market environment and provide better customer experience and services, enterprises encompass digital transformation as a means for reaching competitiveness and foster value creation. A digital transformation process consists of information technology implementation projects, as well as organizational factors such as top management support, digital transformation strategy, and organizational changes. However, to the best of our knowledge, there is little evidence about digital transformation endeavors in organizations and how they perceive it – is it only about digital technologies adoption or a true organizational shift is needed? In order to address this issue and as the first step in our research project, a literature review is conducted. The analysis included case study papers from Scopus and Web of Science databases. The following attributes are considered for classification and analysis of papers: time component; country of case origin; case industry and; digital transformation concept comprehension, i.e. focus. Research showed that organizations – public, as well as private ones, are aware of change necessity and employ digital transformation projects. Also, the changes concerning digital transformation affect both manufacturing and service-based industries. Furthermore, we discovered that organizations understand that besides technologies implementation, organizational changes must also be adopted. However, with only 29 relevant papers identified, research positioned digital transformation as an unexplored and emerging phenomenon in information systems research. The scarcity of evidence-based papers calls for further examination of this topic on cases from practice.Keywords: digital strategy, digital technologies, digital transformation, literature review
Procedia PDF Downloads 21730357 The Impact of Equine-Assisted Therapy on Occupational Engagement for Children with Intellectual and/or Developmental Disabilities: From the Perspectives of the Children and Their Caregivers
Authors: Morgan Dempsey, Sam Lewis, Maggie Pierce, Alex Goodman
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This research investigates the impact of equine-assisted therapy programs on occupational engagement for children with intellectual and developmental disabilities. There is a general lack of evidence for equine-based services for this population, so this research aims to decrease gaps in the current literature. To gain comprehensive insight, data will be collected from both the child and their caregiver. This study takes a qualitative approach utilizing online surveys and in-person guided interviews. The participants are individuals ages 4-17 with a diagnosed intellectual or developmental disability who are currently participating in a PATH int. certified equine-assisted therapy program. Also, caregivers of individuals who meet this criterion are included. This study decreases gaps in the literature by providing comprehensive data regarding the impacts of these services on occupational engagement. The addressed domains are physical, behavioral, emotional, and social functioning, as well as overall activity engagement and impacts in everyday life. With a better understanding of how equine-assisted therapy affects relevant outcomes for children with disabilities, an increased number of occupational therapists can implement these uniquely effective services while adhering to standards of evidence-based practice. Ultimately, this research strives to contribute to generalizable data in occupational therapy by supporting the implementation of equine-assisted services for children with intellectual and/or developmental disabilities and their caregivers/families.Keywords: occupational therapy, pediatric, rehabilitation, hippotherapy
Procedia PDF Downloads 3530356 A Scoping Review of the Relationship Between Oral Health and Wellbeing: The Myth and Reality
Authors: Heba Salama, Barry Gibson, Jennifer Burr
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Introduction: It is often argued that better oral health leads to better wellbeing, and the goal of dental care is to improve wellbeing. Notwithstanding, to our best knowledge, there is a lack of evidence to support the relationship between oral health and wellbeing. Aim: The scoping review aims to examine current definitions of health and wellbeing as well as map the evidence to examine the relationship between oral health and wellbeing. Methods: The scoping review followed the Preferred Reporting Items for Systematic Reviews Extension for Scoping Review (PRISMA-ScR). A two-phase search strategy was followed because of the unmanageable number of hits returned. The first phase was to identify how well-being was conceptualised in oral health literacy, and the second phase was to search for extracted keywords. The extracted keywords were searched in four databases: PubMed, CINAHL, PsycINFO, and Web of Science. To limit the number of studies to a manageable amount, the search was limited to the open-access studies that have been published in the last five years (from 2018 to 2022). Results: Only eight studies (0.1%) of the 5455 results met the review inclusion criteria. Most of the included studies defined wellbeing based on the hedonic theory. And the Satisfaction with Life Scale is the most used. Although the research results are inconsistent, it has generally been shown that there is a weak or no association between oral health and wellbeing. Interpretation: The review revealed a very important point about how oral health literature uses loose definitions that have significant implications for empirical research. That results in misleading evidence-based conclusions. According to the review results, improving oral health is not a key factor in improving wellbeing. It appears that investing in oral health care to improve wellbeing is not a top priority to tell policymakers about. This does not imply that there should be no investment in oral health care to improve oral health. That could have an indirect link to wellbeing by eliminating the potential oral health-related barriers to quality of life that could represent the foundation of wellbeing. Limitation: Only the most recent five years (2018–2022), peer-reviewed English-language literature, and four electronic databases were included in the search. These restrictions were put in place to keep the volume of literature at a manageable level. This suggests that some significant studies might have been omitted. Furthermore, the study used a definition of wellbeing that is currently being evolved and might not everyone agrees with it. Conclusion: Whilst it is a ubiquitous argument that oral health is related to wellbeing, and this seems logical, there is little empirical evidence to support this claim. This question, therefore, requires much more detailed consideration. Funding: This project was funded by the Ministry of Higher Education and Scientific Research in Libya and Tripoli University.Keywords: oral health, wellbeing, satisfaction, emotion, quality of life, oral health related quality of life
Procedia PDF Downloads 11830355 Obesity and Cancer: Current Scientific Evidence and Policy Implications
Authors: Martin Wiseman, Rachel Thompson, Panagiota Mitrou, Kate Allen
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Since 1997 World Cancer Research Fund (WCRF) International and the American Institute for Cancer Research (AICR) have been at the forefront of synthesising and interpreting the accumulated scientific literature on the link between diet, nutrition, physical activity and cancer, and deriving evidence-based Cancer Prevention Recommendations. The 2007 WCRF/AICR 2nd Expert Report was a landmark in the analysis of evidence linking diet, body weight and physical activity to cancer and led to the establishment of the Continuous Update Project (CUP). In 2018, as part of the CUP, WCRF/AICR will publish a new synthesis of the current evidence and update the Cancer Prevention Recommendations. This will ensure that everyone - from policymakers and health professionals to members of the public - has access to the most up-to-date information on how to reduce the risk of developing cancer. Overweight and obesity play a significant role in cancer risk, and rates of both are increasing in many parts of the world. This session will give an overview of new evidence relating obesity to cancer since the 2007 report. For example, since the 2007 Report, the number of cancers for which obesity is judged to be a contributory cause has increased from seven to eleven. The session will also shed light on the well-established mechanisms underpinning obesity and cancer links. Additionally, the session will provide an overview of diet and physical activity related factors that promote positive energy imbalance, leading to overweight and obesity. Finally, the session will highlight how policy can be used to address overweight and obesity at a population level, using WCRF International’s NOURISHING Framework. NOURISHING formalises a comprehensive package of policies to promote healthy diets and reduce obesity and non-communicable diseases; it is a tool for policymakers to identify where action is needed and assess if an approach is sufficiently comprehensive. The framework brings together ten policy areas across three domains: food environment, food system, and behaviour change communication. The framework is accompanied by a regularly updated database providing an extensive overview of implemented government policy actions from around the world. In conclusion, the session will provide an overview of obesity and cancer, highlighting the links seen in the epidemiology and exploring the mechanisms underpinning these, as well as the influences that help determine overweight and obesity. Finally, the session will illustrate policy approaches that can be taken to reduce overweight and obesity worldwide.Keywords: overweight, obesity, nutrition, cancer, mechanisms, policy
Procedia PDF Downloads 15730354 Solution-Focused Wellness: An Evidence-Based Approach to Wellness Promotion
Authors: James Beauchemin
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Research indicates that college students are experiencing mental health challenges of greater severity, and an increased number of students are seeking help. Contributing to the compromised wellness of the college student population are the prevalence of unhealthy lifestyle habits and behaviors such as alcohol consumption, tobacco use, dietary concerns, risky sexual behaviors, and lack of physical activity. Alternative approaches are needed for this population that emphasize prevention and holistic lifestyle change that mitigate mental health and wellness challenges and alleviate strain on campus resources. This presentation will introduce a Solution-Focused Wellness (SFW) intervention model and examine wellness domains solution-focused strategies to promote personal well-being, and provide supporting research from multiple studies that illustrate intervention effectiveness with a collegiate population. Given the subjective and personal nature of wellness, a therapeutic approach that provides the opportunity for individuals to conceptualize and operationalize wellness themselves is critical to facilitating lasting wellness-based change. Solution-Focused Brief Therapy (SFBT) is a strength-based modality defined by its emphasis on constructing solutions rather than focusing on problems and the assumption that clients have the resources and capacity to change. SFBT has demonstrated effectiveness as a brief therapeutic intervention with the college population in groups and related to health and wellness. By integrating SFBT strategies with personal wellness, a brief intervention was developed to support college students in establishing lifestyles trends consistent with their conceptualizations of wellness. Research supports the effectiveness of a SFW model in improving college student wellness in both face-to-face and web-based formats. Outcomes of controlled and longitudinal studies will be presented, demonstrating significant improvements in perceptions of stress, life satisfaction, happiness, mental health, well-being, and resilience. Overall, there is compelling evidence that utilization of a Solution-Focused Brief Therapy approach with college students can help to improve personal wellness and establish healthy lifestyle trends, providing an effective prevention-focused strategy for college counseling centers and wellness centers to employ. Primary research objectives include: 1)establish an evidence-based approach to facilitating wellness pro motion among the college student population, 2) examine the effectiveness of a Solution-Focused Wellness (SFW) intervention model in decreasing stress, improving personal wellness, mental health, life satisfaction, and resiliency,3) investigate intervention impacts over time (e.g. 6-week post-intervention), and 4) demonstrate SFW intervention utility in wellness promotion and associated outcomes when compared with no-treatment control, and alternative intervention approaches.Keywords: wellness, college students, solution-focused, prevention
Procedia PDF Downloads 7230353 Effectiveness of N-Acetylcysteine in the Treatment of Adults with Trichotillomania: An Evidenced Based Review
Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras
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Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine
Procedia PDF Downloads 10230352 Social Impact Bonds in the US Context
Authors: Paula M. Lantz
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In the United States, significant socioeconomic and racial inequalities exist in many population-based indicators of health and social welfare. Although a number of effective prevention programs and interventions are available, local and state governments often do not pursue prevention in the face of budgetary constraints and more acute problems. There is growing interest in and excitement about Pay for Success” (PFS) strategies, also referred to as social impact bonds, as an approach to financing and implementing promising prevention programs and services that help the public sector either save money or achieve greater value for an investment. The PFS finance model implements evidence-based interventions using capital from investors who only receive a return on their investment from the government if agreed-upon, measurable outcomes are achieved. This paper discusses the current landscape regarding social impact bonds in the U.S., and their potential and challenges in addressing serious health and social problems. The paper presents an analysis of a number of social science issues that are fundamental to the potential for social impact bonds to successfully address social inequalities in health and social welfare. This includes: a) the economics of the intervention and a potential public payout; b) organizational and management issues in intervention implementation; c) evaluation research design and methods; d) legal/regulatory issues in public payouts to investors; e) ethical issues in the design of social impact bond deals and their evaluation; and f) political issues. Despite significant challenges in the U.S. context, there is great potential for social impact bonds as a type of social impact investing to encourage private investments in evidence-based interventions that address important public health and social problems in underserved populations and provide a return on investment.Keywords: pay for success, public/private partnerships, social impact bonds, social impact investing
Procedia PDF Downloads 30030351 Development and Evaluation of a Cognitive Behavioural Therapy Based Smartphone App for Low Moods and Anxiety
Authors: David Bakker, Nikki Rickard
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Smartphone apps hold immense potential as mental health and wellbeing tools. Support can be made easily accessible and can be used in real-time while users are experiencing distress. Furthermore, data can be collected to enable machine learning and automated tailoring of support to users. While many apps have been developed for mental health purposes, few have adhered to evidence-based recommendations and even fewer have pursued experimental validation. This paper details the development and experimental evaluation of an app, MoodMission, that aims to provide support for low moods and anxiety, help prevent clinical depression and anxiety disorders, and serve as an adjunct to professional clinical supports. MoodMission was designed to deliver cognitive behavioural therapy for specifically reported problems in real-time, momentary interactions. Users report their low moods or anxious feelings to the app along with a subjective units of distress scale (SUDS) rating. MoodMission then provides a choice of 5-10 short, evidence-based mental health strategies called Missions. Users choose a Mission, complete it, and report their distress again. Automated tailoring, gamification, and in-built data collection for analysis of effectiveness was also included in the app’s design. The development process involved construction of an evidence-based behavioural plan, designing of the app, building and testing procedures, feedback-informed changes, and a public launch. A randomized controlled trial (RCT) was conducted comparing MoodMission to two other apps and a waitlist control condition. Participants completed measures of anxiety, depression, well-being, emotional self-awareness, coping self-efficacy and mental health literacy at the start of their app use and 30 days later. At the time of submission (November 2016) over 300 participants have participated in the RCT. Data analysis will begin in January 2017. At the time of this submission, MoodMission has over 4000 users. A repeated-measures ANOVA of 1390 completed Missions reveals that SUDS (0-10) ratings were significantly reduced between pre-Mission ratings (M=6.20, SD=2.39) and post-Mission ratings (M=4.93, SD=2.25), F(1,1389)=585.86, p < .001, np2=.30. This effect was consistent across both low moods and anxiety. Preliminary analyses of the data from the outcome measures surveys reveal improvements across mental health and wellbeing measures as a result of using the app over 30 days. This includes a significant increase in coping self-efficacy, F(1,22)=5.91, p=.024, np2=.21. Complete results from the RCT in which MoodMission was evaluated will be presented. Results will also be presented from the continuous outcome data being recorded by MoodMission. MoodMission was successfully developed and launched, and preliminary analysis suggest that it is an effective mental health and wellbeing tool. In addition to the clinical applications of MoodMission, the app holds promise as a research tool to conduct component analysis of psychological therapies and overcome restraints of laboratory based studies. The support provided by the app is discrete, tailored, evidence-based, and transcends barriers of stigma, geographic isolation, financial limitations, and low health literacy.Keywords: anxiety, app, CBT, cognitive behavioural therapy, depression, eHealth, mission, mobile, mood, MoodMission
Procedia PDF Downloads 27130350 Analysis of Indoor Air Quality and Sick Building Syndrome in Control Room Oil Gas Refinery
Authors: Dessy Laksyana Utami
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The sick building syndrome comprises of various nonspecific symptoms that occur in the occupants of a building. It is commonly increases sickness absenteeism and causes a decrease in productivity of the workers. Evidence suggests that what is called the Sick Building Syndrome are at least three separate entities, which has at least one cause. The following are some of the factors that might be primarily responsible for Sick Building Syndrome such as: Chemical contaminants, Biological contaminants, Inadequate ventilation and Electromagnetic radiation. In many cases it is due to insufficient maintenance of the HVAC (heating, ventilation, air conditioning) system in the building. As this syndrome is increasingly becoming a major occupational hazard. It was used the analytic cross-sectional design. Based on data obtained 80% of respondents reported significant ongoing health problems in the eyes, head, and the nose. 60% had bad symptoms in the throat, the stomach and cough, 50% had gastrointestinal disorders, 40% fatigue and 25% occurred all symptoms sick building syndrome. The 40 respondents were recruited to the study, with a mean age of 35 years (range 20-55). To support the evidence of Sick Building Syndrome, further checks are needed for some of the factors in next research, i.e. measurement of Chemical contaminants, Biological contaminants, inadequate ventilation & Electromagnetic radiation.Keywords: indoor air pollution, sick building syndrome, indoor air quality, oil gas polution
Procedia PDF Downloads 13630349 Evaluation of Merger Premium and Firm Performance in Europe
Authors: Matthias Nnadi
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This paper investigates the relationship between premiums and returns in the short and long terms in European merger and acquisition (M&A) deals. The study employs Calendar Time Portfolio (CTP) model and find strong evidence that in the long run, premiums have a positive impact on performance, and we also establish evidence of a significant difference between the abnormal returns of the high premium paying portfolio and the low premium paying ones. Even in cases where all sub-portfolios show negative abnormal returns, the high premium category still outperforms the low premium category. Our findings have implications for companies engaging in acquisitions.Keywords: mergers, premium, performance, returns, acquisitions
Procedia PDF Downloads 27830348 Customer Satisfaction and Effective HRM Policies: Customer and Employee Satisfaction
Authors: S. Anastasiou, C. Nathanailides
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The purpose of this study is to examine the possible link between employee and customer satisfaction. The service provided by employees, help to build a good relationship with customers and can help at increasing their loyalty. Published data for job satisfaction and indicators of customer services were gathered from relevant published works which included data from five different countries. The reviewed data indicate a significant correlation between indicators of customer and employee satisfaction in the Banking sector. There was a significant correlation between the two parameters (Pearson correlation R2=0.52 P<0.05) The reviewed data provide evidence that there is some practical evidence which links these two parameters.Keywords: job satisfaction, job performance, customer’ service, banks, human resources management
Procedia PDF Downloads 32130347 The Role of NAD+ and Nicotinamide (Vitamin B3) in Glaucoma: A Literature Review
Authors: James Pietris
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Glaucoma is a collection of irreversible optic neuropathies which, if left untreated, lead to severe visual field loss. These diseases are a leading cause of blindness across the globe and are estimated to affect approximately 80 million people, particularly women and people of Asian descent.1This represents a major burden on healthcare systems worldwide. Recently, there has been increasing interest in the potential of nicotinamide (vitamin B3) as a novel option in the management of glaucoma. This review aims to analyse the currently available literature to determine whether there is evidence of an association between nicotinamide adenine dinucleotide (NAD+) and glaucomatous optic neuropathy and whether nicotinamide has the potential to prevent or reverse these effects. The literature showed a strong connection between reduced NAD+ levels and retinal ganglion cell dysfunction through multiple different studies. There is also evidence of the positive effect of nicotinamide supplementation on retinal ganglion cell function in models of mouse glaucoma and in a study involving humans. Based on the literature findings, a recommendation has been made that more research into the efficacy, appropriate dosing, and potential side effects of nicotinamide supplementation is needed before it can be definitively determined whether it is appropriate for widespread prophylactic and therapeutic use against glaucoma in humans.Keywords: glaucoma, nicotinamide, vitamin B3, optic neuropathy
Procedia PDF Downloads 10630346 Admissibility as a Property of Evidence in Modern Conditions
Authors: Iryna Teslenko
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According to the provisions of the current criminal procedural legislation of Ukraine, the issue of admissibility of evidence is closely related to both the right to a fair trial and the presumption of innocence. The general rule is that evidence obtained improperly or illegally cannot be taken into account in a court case. Therefore, the evidence base of the prosecution, collected at the stage of the pre-trial investigation, compliance with the requirements of the law during the collection of evidence, is of crucial importance for the criminal process, the violation of which entails the recognition of the relevant evidence as inadmissible, which can nullify all the efforts of the pre-trial investigation body and the prosecution. Therefore, the issue of admissibility of evidence in criminal proceedings is fundamentally important and decisive for the entire process. Research on this issue began in December 2021. At that time, there was still no clear understanding of what needed to be conveyed to the scientific community. In February 2022, the lives of all citizens of Ukraine have totally changed. A war broke out in the country. At a time when the entire world community is on the path of humanizing society, respecting the rights and freedoms of man and citizen, a military conflict has arisen in the middle of Europe - one country attacked another, war crimes are being committed. The world still cannot believe it, but it is happening here and now, people are dying, infrastructure is being destroyed, war crimes are being committed, contrary to the signed and ratified international conventions, and contrary to all the acquisitions and development of world law. At this time, the life of the world has divided into before and after February 24, 2022, the world cannot be the same as it was before, and the approach to solving legal issues in the criminal process, in particular, issues of proving the commission of crimes and the involvement of certain persons in their commission. An international criminal has appeared in the humane European world, who disregards all norms of law and morality, and does not adhere to any principles. Until now, the practice of the European Court of Human Rights and domestic courts of Ukraine treated with certain formalism, such a property of evidence in criminal proceedings as the admissibility of evidence. Currently, we have information that the Office of the Prosecutor of the International Criminal Court in The Hague has started an investigation into war crimes in Ukraine and is documenting them. In our opinion, the world cannot allow formalism in bringing a war criminal to justice. There is a war going on in Ukraine, the cities are under round-the-clock missile fire from the aggressor country, which makes it impossible to carry out certain investigative actions. If due to formal deficiencies, the collected evidence is declared inadmissible, it may lead to the fact that the guilty people will not be punished. And this, in turn, sends a message to other terrorists in the world about the impunity of their actions, the system of deterring criminals from committing criminal offenses (crimes) will collapse due to the understanding of the inevitability of punishment, and this will affect the entire world security and European security in particular. Therefore, we believe that the world cannot allow chaos in the issue of general security, there should be a transformation of the approach in general to such a property of evidence in the criminal process as admissibility in order to ensure the inevitability of the punishment of criminals. We believe that the scientific and legal community should not allow criminals to avoid responsibility. The evil that is destroying Ukraine should be punished. We must all together prove that legal norms are not just words written on paper but rules of behavior of all members of society, their non-observance leads to mandatory responsibility. Everybody who commits crimes will be punished, which is inevitable, and this principle is the guarantor of world security in the future.Keywords: admissibility of evidence, criminal process, war, Ukraine
Procedia PDF Downloads 8730345 Intergenerational Class Mobility in Greece: A Cross-Cohort Analysis with Evidence from European Union-Statistics on Income and Living Conditions
Authors: G. Stamatopoulou, M. Symeonaki, C. Michalopoulou
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In this work, we study the intergenerational social mobility in Greece, in order to provide up-to-date evidence on the changes in the mobility patterns throughout the years. An analysis for both men and women aged between 25-64 years old is carried out. Three main research objectives are addressed. First, we aim to examine the relationship between the socio-economic status of parents and their children. Secondly, we investigate the evolution of the mobility patterns between different birth cohorts. Finally, the role of education is explored in shaping the mobility patterns. For the analysis, we draw data on both parental and individuals' social outcomes from different national databases. The social class of origins and destination is measured according to the European Socio-Economic Classification (ESeC), while the respondents' educational attainment is coded into categories based on the International Standard Classification of Education (ISCED). Applying the Markov transition probability theory, and a range of measures and models, this work focuses on the magnitude and the direction of the movements that take place in the Greek labour market, as well as the level of social fluidity. Three-way mobility tables are presented, where the transition probabilities between the classes of destination and origins are calculated for different cohorts. Additionally, a range of absolute and relative mobility rates, as well as distance measures, are presented. The study covers a large time span beginning in 1940 until 1995, shedding light on the effects of the national institutional processes on the social movements of individuals. Given the evidence on the mobility patterns of the most recent birth cohorts, we also investigate the possible effects of the 2008 economic crisis.Keywords: cohort analysis, education, Greece, intergenerational mobility, social class
Procedia PDF Downloads 12930344 How Polarization and Ideological Divisiveness Increase the Likelihood of Executive Action: Evidence from the Italian Case
Authors: Umberto Platini
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This paper analyses the role of government fragmentation as predictor of the use of emergency decrees in parliamentary democracies. In particular, it focuses on the relationship between ideological divisiveness within cabinets and the choice by executives to issue emergency decrees rather initiating ordinary legislative procedures. A Bayesian multilevel analysis conducted on the population of government-initiated legislation in Italy between 1996 and 2018 finds significant evidence that those legislative proposals which are further away from the ideological centre of gravity of the executive are around three times more likely to be issued as emergency decrees. Likewise, legislative projects regulating more contentious policy areas are significantly more likely to be issued by decree. However, for more contentious issues the importance of ideological distance as a predictor diminishes. This evidence suggests that cabinets prefer decrees to ordinary legislative procedures when they expect that the bargaining environment in Parliament is more hostile. These results persist regardless of the fluctuations of the political-economic cycle. Their robustness is also tested against a battery of controls and against fixed effects both at the government level and at the legislature level.Keywords: Bayesian multilevel logit models, executive action, executive decrees, ideology, legislative studies, polarization
Procedia PDF Downloads 10430343 Title: Real World Evidence a Tool to Overcome the Lack of a Comparative Arm in Drug Evaluation in the Context of Rare Diseases
Authors: Mohamed Wahba
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Objective: To build a comparative arm for product (X) in specific gene mutated advanced gastrointestinal cancer using real world evidence to fulfill HTA requirements in drug evaluation. Methods: Data for product (X) were collected from phase II clinical trial while real world data for (Y) and (Z) were collected from US database. Real-world (RW) cohorts were matched to clinical trial base line characteristics using weighting by odds method. Outcomes included progression-free survival (PFS) and overall survival (OS) rates. Study location and participants: Internationally (product X, n=80) and from USA (Product Y and Z, n=73) Results: Two comparisons were made: trial cohort 1 (X) versus real-world cohort 1 (Z), trial cohort 2 (X) versus real-world cohort 2 (Y). For first line, the median OS was 9.7 months (95% CI 8.6- 11.5) and the median PFS was 5.2 months (95% CI 4.7- not reached) for real-world cohort 1. For second line, the median OS was 10.6 months (95% CI 4.7- 27.3) for real-world cohort 2 and the median PFS was 5.0 months (95% CI 2.1- 29.3). For OS analysis, results were statistically significant but not for PFS analysis. Conclusion: This study provided the clinical comparative outcomes needed for HTA evaluation.Keywords: real world evidence, pharmacoeconomics, HTA agencies, oncology
Procedia PDF Downloads 9030342 Experimental Assessment of the Effectiveness of Judicial Instructions and of Expert Testimony in Improving Jurors’ Evaluation of Eyewitness Evidence
Authors: Alena Skalon, Jennifer L. Beaudry
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Eyewitness misidentifications can sometimes lead to wrongful convictions of innocent people. This occurs in part because jurors tend to believe confident eyewitnesses even when the identification took place under suggestive conditions. Empirical research demonstrated that jurors are often unaware of the factors that can influence the reliability of eyewitness identification. Most common legal safeguards that are designed to educate jurors about eyewitness evidence are judicial instructions and expert testimony. To date, very few studies assessed the effectiveness of judicial instructions and most of them found that judicial instructions make jurors more skeptical of eyewitness evidence or do not have any effect on jurors’ judgments. Similar results were obtained for expert testimony. However, none of the previous studies focused on the ability of legal safeguards to improve jurors’ assessment of evidence obtained from suggestive identification procedures—this is one of the gaps addressed by this paper. Furthermore, only three studies investigated whether legal safeguards improve the ultimate accuracy of jurors’ judgments—that is, whether after listening to judicial instructions or expert testimony jurors can differentiate between accurate and inaccurate eyewitnesses. This presentation includes two studies. Both studies used genuine eyewitnesses (i.e., eyewitnesses who watched the crime) and manipulated the suggestiveness of identification procedures. The first study manipulated the presence of judicial instructions; the second study manipulated the presence of one of two types of expert testimony: a traditional, verbal expert testimony or expert testimony accompanied by visual aids. All participant watched a video-recording of an identification procedure and of an eyewitness testimony. The results indicated that neither judicial instructions nor expert testimony affected jurors’ judgments. However, consistent with the previous findings, when the identification procedure was non-suggestive, jurors believed accurate eyewitnesses more often than inaccurate eyewitnesses. When the procedure was suggestive, jurors believed accurate and inaccurate eyewitnesses at the same rate. The paper will discuss the implications of these studies and directions for future research.Keywords: expert testimony, eyewitness evidence, judicial instructions, jurors’ decision making, legal safeguards
Procedia PDF Downloads 17730341 Customers' Perception towards the Service Marketing Mix and Frequency of Use of Mercedes Benz Automobile Service, Thailand
Authors: Pranee Tridhoskul
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This research paper is aimed to examine a relationship between the service marketing mix and customers’ frequency of use of service at Mercedes Benz Auto Repair Centres under Thonburi Group, Thailand. Based on 2,267 customers who used the service of Thonburi Group’s Auto Repair Centres as the population, the sampling of this research was a total of 340 samples, by use of Probability Sampling Technique. Systematic Random Sampling was applied by use of questionnaire in collecting the data at Thonburi Group’s Auto Repair Centres. Mean and Pearson’s basic statistical correlations were utilized in analyzing the data. The study discovered a medium level of customers’ perception towards product and service of Thonburi Group’s Auto Repair Centres, price, place or distribution channel and promotion. People who provided service were perceived also at a medium level, whereas the physical evidence and service process were perceived at a high level. Furthermore, there appeared a correlation between the physical evidence and service process, and customers’ frequency of use of automobile service per year.Keywords: service marketing mix, behavior, Mercedes Auto Service Centre, frequency of use
Procedia PDF Downloads 32630340 The Association between Acupuncture Treatment and a Decreased Risk of Irritable Bowel Syndrome in Patients with Depression
Authors: Greg Zimmerman
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Background: Major depression is a common illness that affects millions of people globally. It is the leading cause of disability and is projected to become the number one cause of the global burden of disease by 2030. Many of those who suffer from depression also suffer from Irritable Bowel Syndrome (IBS). Acupuncture has been shown to help depression. The aim of this study was to investigate the effectiveness of acupuncture in reducing the risk of IBS in patients with depression. Methods: We enrolled patients diagnosed with depression through the Taiwanese National Health Insurance Research Database (NHIRD). Propensity score matching was used to match equal numbers (n=32971) of the acupuncture cohort and no-acupuncture cohort based on characteristics including sex, age, baseline comorbidity, and medication. The Cox regression model was used to compare the hazard ratios (HRs) of IBS in the two cohorts. Results: The basic characteristics of the two groups were similar. The cumulative incidence of IBS was significantly lower in the acupuncture cohort than in the no-acupuncture cohort (Log-rank test, p<0.001). Conclusion: The results provided real-world evidence that acupuncture may have a beneficial effect on IBS risk reduction in patients with depression.Keywords: acupuncture, depression, irritable bowel syndrome, national health insurance research database, real-world evidence
Procedia PDF Downloads 10630339 Communities as a Source of Evidence: A Case of Advocating for Improved Human Resources for Health in Uganda
Authors: Asinguza P. Allan
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The Advocacy for Better Health aims to equip citizens with enabling environment and systems to effectively advocate for strong action plans to improve health services. This is because the 2020 Government target for Uganda to transform into a middle income country will be achieved if investment is made in keeping the population healthy and productive. Citizen participation as an important foundation for change has been emphasized to gather data through participatory rural appraisal and inform evidence-based advocacy for recruitment and motivation of human resources. Citizens conduct problem ranking during advocacy forums on staffing levels and health worker absenteeism. Citizens prioritised inadequate number of midwives and absenteeism. On triangulation, health worker to population ratio in Uganda remains at 0.25/1,000 which is far below the World Health Organization (WHO) threshold of 2.3/1,000. Working with IntraHealth, the project advocated for recruitment of critical skilled staff (doctors and midwives) and scale up health workers motivation strategy to reduce Uganda’s Neonatal Mortality Rate of 22/1,000 and Maternal Mortality Ratio of 320/100,000. Government has committed to increase staffing to 80% by 2018 (10 districts have passed ordinances and revived use of duty rosters to address health worker absenteeism. On the other hand, the better health advocacy debate has been elevated with need to increase health sector budget allocations from 8% to 10%. The project has learnt that building a body of evidence from citizens enhances the advocacy agenda. Communities will further monitor government commitments to reduce Neonatal Mortality Rate and Maternal Mortality Ratio. The project has learnt that interface meeting between duty bearers and the community allows for immediate feedback and the process is a strong instrument for empowerment. It facilitates monitoring and performance evaluation of services, projects and government administrative units (like district assemblies) by the community members themselves. This, in turn, makes the human resources in health to be accountable, transparent and responsive to communities where they work. This, in turn, promotes human resource performance.Keywords: advocacy, empowerment, evidence, human resources
Procedia PDF Downloads 216