Search results for: nursing home

Authors: Farah Amalina Mohamed Affandi, Redhwan Ahmad Al-Naggar, Seok Mui Wang, Thanikasalam Kathiresan

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Gestational choriocarcinoma is a condition in which there is an abnormal growth or a tumor inside the women’s uterus after conception. It is a type of gestational trophoblastic disease which is relatively rare and malignant. The current epidemiological data of this disease are inadequate. The purposes of this study are to examine the epidemiology of choriocarcinoma and their risk factors based on all available population-based and hospital-based data of the disease. In this study, we searched The MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases using the keywords ‘choriocarcinoma’, ‘gestational’, ‘gestational choriocarcinoma’ and ‘epidemiology’. We included only human studies published in English between 1995 and 2015 to ensure up to date evidence. Case studies, case reports, animal studies, letters to the editor, news, and review articles were excluded. Retrieved articles were screened in three phases. In the first phase, any articles that did not match the inclusion criteria based solely on titles were excluded. In the second phase, the abstracts of remaining articles were screened thoroughly; any articles that did not meet our inclusion criteria were excluded. In the final phase, full texts of the remaining articles were read and assessed to exclude articles that did not meet the inclusion criteria or any articles that fulfilled the exclusion criteria. Duplicates articles were also removed. Systematic reviews and meta-analysis were excluded. Extracted data were summarized in table and figures descriptively. The reference lists of included studies were thoroughly reviewed in search for other relevant studies. A total of ten studies met all the selection criteria. Nine were retrospective studies and one was cohort study. Total numbers of 4563 cases of choriocarcinoma were reviewed from several countries which are Korea, Japan, South Africa, USA, New Mexico, Finland, Turkey, China, Brazil and The Netherlands. Different studies included different range of age with their mean age of 28.5 to 30.0 years. All studies investigated on the disease’s incidence rate, only two studies examined on the risk factors or associations of the disease. Approximately 20% of the studies showed a reduction in the incidence of choriocarcinoma while the other 80% showed inconsistencies in rate. Associations of age, fertility age, occupations and socio-demographic with the status remains unclear. There is limited information on the epidemiological aspects of gestational choriocarcinoma. The observed results indicated there was a decrease in the incidence rate of gestational choriocarcinoma globally. These could be due to the reduction in the incidence of molar pregnancy and the efficacy of the treatment, mainly by chemotherapy.

Keywords: epidemiology, gestational choriocarcinoma, incidence, prevalence, risk factor

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Authors: Henry Okechukwu Onyeiwu, Arfah Ab. Majid

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To fully understand the critical role of marriage in society, it is important to view it as a social institution that provides some basic social needs for society. A ‘social institution’ is the network of shared meanings, norms, definitions, expectations, and understandings held by the members of society. It is what guides and governs how the members of the society are expected to act and interact, what is socially desirable and legitimate, what they should be striving for, and so on. One of the major social institutions is marriage. Marriage is and has often focused on children and what is best for them because the rising generation literally is the future of every society. However, according to the aforementioned definition, which notes that marriage may also be a union between two persons of the same sex with legal support, this study stands with the definitions that are based on marriage being a union between a man and woman that is the most appropriate in Igbo land and not the other way round. The issue to be evaluated concerns marriage as it associates with Igbo Catholic Christians in Nigeria. Pasts of Igbo culture should be better organized into the Christian faith. Igbo Christians actually convey a significant number of their customary thoughts, customs, and social qualities, particularly regarding marriage, in the aftermath of switching to Christianity. The analyst agrees that marriage among Igbo Christians warrants adequate evolution. This study, therefore, concentrates on the Igbo community’s interpretation of the concept of culture and religion and the religious implications of traditional marriage and Christian marriage ceremonies in Igbo. The research design of this study is a qualitative design that provides in-depth information on the dual religious identity of the Igbo people on the rite of marriage in Imo state. The study population was composed of both male and female members from each selected local government area in Imo State. Thematic analysis was used to elaborate on the result from the respondents. This survey found that reputation is a major concern for Ibo people. Parental discomfort can lead to the use of coping strategies such as displacement, in which parents pass on their own vulnerable sentiments to their children. Those who participate in marriage negotiations feel the pain of their parents because they are unable to communicate their own feelings. As a result, participants experience increased stress and a range of negative emotions related to their marriage, including worry, dissatisfaction, and ambivalence. It was concluded that when it comes to Igbo culture, marriage is seen as a need for the continuation of the family’s lineage of descent, according to the outcome. The Task at hand was to discover how the locals preparing to get married define the impending transition. Imo State is home to the practice of Igba-nkwu, where the woman is either inherited or taken in the place of another.

Keywords: Igbo, culture, Christianity, traditional marriage, Christian wedding

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Authors: M. H. Arslan, U. K. Sahin, H. Acikgoz-Tufan, I. Gocek, I. Erdem

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Various exterior factors have perpetual effects on textile materials during wear, use and laundering in everyday life. In accordance with their frequency of use, textile materials are required to be laundered at certain intervals. The medium in which the laundering process takes place have inevitable detrimental physical and chemical effects on textile materials caused by the unique parameters of the process inherently existing. Connatural structures of various textile materials result in many different physical, chemical and mechanical characteristics. Because of their specific structures, these materials have different behaviors against several exterior factors. By modeling the behavior of commercial and test textiles as group-wise against laundering process, it is possible to disclose the relation in between these two groups of materials, which will lead to better understanding of their behaviors in terms of similarities and differences against the washing parameters of the laundering. Thus, the goal of the current research is to examine the behavior of two groups of textile materials as commercial textiles and as test textiles towards the main washing machine parameters during laundering process such as temperature, load quantity, mechanical action and level of water amount by concentrating on shrinkage, pilling, sewing defects, collar abrasion, the other defects other than sewing, whitening and overall properties of textiles. In this study, cotton fabrics were preferred as commercial textiles due to the fact that garments made of cotton are the most demanded products in the market by the textile consumers in daily life. Full factorial experimental set-up was used to design the experimental procedure. All profiles always including all of the commercial and the test textiles were laundered for 20 cycles by commercial home laundering machine to investigate the effects of the chosen parameters. For the laundering process, a modified version of ‘‘IEC 60456 Test Method’’ was utilized. The amount of detergent was altered as 0.5% gram per liter depending on varying load quantity levels. Datacolor 650®, EMPA Photographic Standards for Pilling Test and visual examination were utilized to test and characterize the textiles. Furthermore, in the current study the relation in between commercial and test textiles in terms of their performance was deeply investigated by the help of statistical analysis performed by MINITAB® package program modeling their behavior against the parameters of the laundering process. In the experimental work, the behaviors of both groups of textiles towards washing machine parameters were visually and quantitatively assessed in dry state.

Keywords: behavior against washing machine parameters, performance evaluation of textiles, statistical analysis, commercial and test textiles

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Authors: Yun-Hsiang Lee

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Cancer is the main cause of death worldwide. With advances in medical technology, immunotherapy, which is a newly developed advanced treatment, is currently a crucial cancer treatment option. For better quality cancer care, the ability to communicate and critical thinking plays a central role in clinical oncology settings. However, few studies have explored the impact of communication skills on immunotherapy-related issues and their related factors. This study was to (i) explore the current status of communication skill ability for immunotherapy-related issues, self-efficacy for immunotherapy-related care, and critical thinking ability; and (ii) identify factors related to communication skill ability. This is a cross-sectional study. Oncology nurses were recruited from the Taiwan Oncology Nursing Society, in which nurses came from different hospitals distributed across four major geographic regions (North, Center, South, East) of Taiwan. A total of 123 oncology nurses participated in this study. A set of questionnaires were used for collecting data. Communication skill ability for immunotherapy issues, self-efficacy for immunotherapy-related care, critical thinking ability, and background information were assessed in this survey. Independent T-test and one-way ANOVA were used to examine different levels of communication skill ability based on nurses having done oncology courses (yes vs. no) and education years (< 1 year, 1-3 years, and > 3 years), respectively. Spearman correlation was conducted to understand the relationships between communication skill ability and other variables. Among the 123 oncology nurses in the current study, the majority of them were female (98.4%), and most of them were employed at a hospital in the North (46.8%) of Taiwan. Most of them possessed a university degree (78.9%) and had at least 3 years of prior work experience (71.7%). Forty-three of the oncology nurses indicated in the survey that they had not received oncology nurses-related training. Those oncology nurses reported moderate to high levels of communication skill ability for immunotherapy issues (mean=4.24, SD=0.7, range 1-5). Nurses reported moderate levels of self-efficacy for immunotherapy-related care (mean=5.20, SD=1.98, range 0-10) and also had high levels of critical thinking ability (mean=4.76, SD=0.60, range 1-6). Oncology nurses who had received oncology training courses had significantly better communication skill ability than those who had not received oncology training. Oncology nurses who had higher work experience (1-3 years, or > 3 years) had significantly higher levels of communication skill ability for immunotherapy-related issues than those with lower work experience (<1 year). When those nurses reported better communication skill ability, they also had significantly better self-efficacy (r=.42, p<.01) and better critical thinking ability (r=.47, p<.01). Taken altogether, courses designed to improve communication skill ability for immunotherapy-related issues can make a significant impact in clinical settings. Communication skill ability for oncology nurses is the major factor associated with self-efficacy and critical thinking, especially for those with lower work experience (< 1 year).

Keywords: communication skills, critical thinking, immunotherapy, oncology nurses, self-efficacy

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Authors: Shagufta Riaz, Ayesha Younus, Munir Ashraf, Tanveer Hussain

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Aesthetic and performance are two most important considerations along with quality, durability, comfort and cost that affect the garment credibility. Fabric drape is perhaps the most important clothing characteristics that distinguishes fabric from the sheet, paper, steel or other film materials. It enables the fabric to mold itself under its own weight into desired and required shape when only part of it is directly sustained. The fabric has the ability to be crumpled charmingly in bent folds of single or double curvature due to its drapeability to produce a smooth flowing i.e. ‘the sinusoidal-type folds of a curtain or skirt’. Drape and seam strength are two parameters that are considered for aesthetic and performance of fabric for both apparel and home textiles. Until recently, no such study have been conducted in which effect of weave designs on drape and seam strength of fabric and garment is inspected. Therefore, the aim of this study was to measure seam strength and drape of fabric and garment objectively by changing weave designs and quality of the fabric. Also, the comparison of 2-D drape and 3-D drape was done to find whether a fabric behaves in same manner or differently when sewn and worn on the body. Four different cotton weave designs were developed and pr-treatment was done. 2-D Drape of the fabric was measured by drapemeter attached with digital camera and a supporting disc to hang the specimen on it. Drape coefficient value (DC %) has negative relation with drape. It is the ratio of draped sample’s projected shadow area to the area of undraped (flat) sample expressed as percentage. Similarly, 3-D drape was measured by hanging the A-line skirts for developed weave designs. BS 3356 standard test method was followed for bending length examination. It is related to the angle that the fabric makes with its horizontal axis. Seam strength was determined by following ASTM test standard. For sewn fabric, stitch density of seam was found by magnifying glass according to standard ASTM test method. In this research study, from the experimentation and evaluation it was investigated that drape and seam strength were significantly affected by change of weave design and quality of fabric (PPI & yarn count). Drapeability increased as the number of interlacement or contact point deceased between warp and weft yarns. As the weight of fabric, bending length, and density of fabric had indirect relationship with drapeability. We had concluded that 2-D drape was higher than 3-D drape even though the garment was made of the same fabric construction. Seam breakage strength decreased with decrease in picks density and yarn count.

Keywords: drape coefficient, fabric, seam strength, weave

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Authors: Douglas N. Simoes, Michele Pittol, Vanda F. Ribeiro, Daiane Tomacheski, Ruth M. C. Santana

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Thermoplastic elastomers (TPE) compounds are used in a wide range of applications, like home appliances, automotive components, medical devices, footwear, and others. These materials are susceptible to microbial attack, causing a crack in polymer chains compounds based on SEBS copolymers, poly (styrene-b-(ethylene-co-butylene)-b-styrene, are a class of TPE, largely used in domestic appliances like refrigerator seals (gaskets), bath mats and sink squeegee. Moisture present in some areas (such as shower area and sink) in addition to organic matter provides favorable conditions for microbial survival and proliferation, contributing to the spread of diseases besides the reduction of product life cycle due the biodegradation process. Zinc oxide (ZnO) has been studied as an alternative antibacterial additive due its biocidal effect. It is important to know the influence of these additives in the properties of the compounds, both at the beginning and during the life cycle. In that sense, the aim of this study was to evaluate the effect of accelerated aging in oven on antibacterial and mechanical properties of ZnO loaded SEBS based TPE compounds. Two different comercial zinc oxide, named as WR and Pe were used in proportion of 1%. A compound with no antimicrobial additive (standard) was also tested. The compounds were prepared using a co-rotating double screw extruder (L/D ratio of 40/1 and 16 mm screw diameter). The extrusion parameters were kept constant for all materials, screw rotation rate was set at 226 rpm, with a temperature profile from 150 to 190 ºC. Test specimens were prepared using the injection molding machine at 190 ºC. The Standard Test Method for Rubber Property—Effect of Liquids was applied in order to simulate the exposition of TPE samples to detergent ingredients during service. For this purpose, ZnO loaded TPE samples were immersed in a 3.0% w/v detergent (neutral) and accelerated aging in oven at 70°C for 7 days. Compounds were characterized by changes in mechanical (hardness and tension properties) and mass. The Japan Industrial Standard (JIS) Z 2801:2010 was applied to evaluate antibacterial properties against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). The microbiological tests showed a reduction up to 42% in E. coli and up to 49% in S. aureus population in non-aged samples. There were observed variations in elongation and hardness values with the addition of zinc The changes in tensile at rupture and mass were not significant between non-aged and aged samples.

Keywords: antimicrobial, domestic appliance, sebs, zinc oxide

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Authors: Zakia Hammouni

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Healthcare professionals’ well-being is becoming a priority during this Covid-19 pandemic due to stress, fatigue, and workload. Well before this pandemic, contemporary hospitals are endowed with environmental attributes that contribute to achieving well-being within their environment with the emphasis on the patient. The patient-centered care approach has been followed by the patient-centered design approach. Studies that have focused on the physical environment in hospitals have dealt with the patient's recovery process and his well-being. Prior scientific literature has placed less emphasis on the healthcare professionals’ interactions within the physical environment and to guide hospital designers to make evidence-based design choices to meet the needs and expectations of hospital users by considering, in addition to patients, healthcare professionals. This paper examines these issues related to the daily stress of professionals who provide care in a hospital environment. In this exploratory study, the interest was to grasp the issues related to this environment and explores the current realities of newly built hospitals based on design approaches and what attributes of the physical setting support healthcare professional’s well-being. Within a constructivist approach, this study was conducted in two care units in a new hospital in a big city in Canada before the Covid-19 pandemic (august 2nd to November 2nd 2018). A spatial evaluation of these care units allowed us to understand the interaction of health professionals in their work environment, to understand the spatial behavior of these professionals, and the narratives from 44 interviews of various healthcare professionals. The mental images validated the salient components of the hospital environment as perceived by these healthcare professionals. Thematic analysis and triangulation of the data set were conducted. Among the key attributes promoting the healthcare professionals’ well-being as revealed by the healthcare professionals are the overall light-color atmosphere in the hospital and care unit, particularly in the corridors and public areas of the hospital, the maintenance and cleanliness. The presence of the art elements also brings well-being to the health professionals as well as panoramic views from the staff lounge and corridors of the care units or elevator lobbies. Despite the overall positive assessment of this environment, some attributes need to be improved to ensure the well-being of healthcare professionals and to provide them with a restructuring environment. These are the supply of natural light, softer colors, sufficient furniture, comfortable seating in the restroom, and views, which are important in allowing these healthcare professionals to recover from their work stress. Noise is another attribute that needs to be further improved in the hospital work environment, especially in the nursing workstations and consultant's room. In conclusion, this study highlights the importance of providing healthcare professionals with work and rest areas that allow them to resist the stress they face, particularly during periods of extreme stress and fatigue such as a Covid-19 pandemic.

Keywords: healthcare facilities, healthcare professionals, physical environment, well-being

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Authors: Dina Dahood Dabash

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Refugee camps are habitually defined as receptive sites, transient spaces of exile and nondescript depoliticized places of exception. However, such arguments form partial sides of reality, especially in countries that are geopolitically challenged and rely immensely on international aid. In Jordan, the dynamics brought with the floating population of refugees (Palestinian amongst others) have resulted in spatial after-effects that cannot be easily overlooked. For instance, Palestine refugee camps have turned by time into socioeconomic centers of gravity and cores of spatial evolution. Yet, such a position is not instantaneous. Amongst various reasons, it can be related, according to this paper, to a distinctive institutional climate that has been co-produced by the refugees, host community and the state. This paper aims to investigate the evolution of urban and spatial regulations in Jordan between 1948 and 1995, more specifically, state regulations, community regulations and refugee-self-regulation that all dynamically interacted that period. The paper aims to unpack the relations between refugee camps and their environs to further explore the agency of such floating populations in establishing rooted networks that extended the time and place boundaries. The paper’s argument stems from the fact that the spatial configuration of urban systems is not only an outcome of a historical evolutionary process but is also a result of interactions between the actors. The research operationalizes Marka camp in Jordan as a case study. Marka Camp is one of the six "emergency" camps erected in 1968 to shelter 15,000 Palestine refugees and displaced persons who left the West Bank and Gaza Strip. Nowadays, camp shelters more than 50,000 refugees in the same area of land. The camp is located in Russeifa, a city in Zarqa Governorate in Jordan. Together with Amman and Zarqa, Russeifa is part of a larger metropolitan area that acts as a home to more than half of Jordan’s businesses. The paper aspires to further understand the post-conflict strategies which were historically applied in Jordan and can be employed to handle more recent geopolitical challenges such as the Syrian refugee crisis. Methodological framework: The paper traces the evolution of the refugee-camp regulating norms in Jordan, parallel with the horizontal and vertical evolution of the Marka camp and its surroundings. Consequently, the main methods employed are historical and mental tracing, Interviews, in addition to using available Aerial and archival photos of the Marka camp and its surrounding.

Keywords: forced migration, Palestine refugee camps, spatial agency, urban regulations

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Authors: Tjipta Lesmana

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Terrorist attacks quickly penetrated Indonesia following the downfall of Soeharto regime in May 1998. Reform era was officially proclaimed. Indonesia turned to 'heaven state' from 'authoritarian state'. For the first time since 1966, the country experienced a full-scale freedom of expression, including freedom of the press, and heavy acknowledgement of human rights practice. Some religious extremists previously run away to neighbor countries to escape from security apparatus secretly backed home. Quickly they consolidated the power to continue their long aspiration and dream to establish 'Shariah Indonesia', Indonesia based on Khilafah ideology. Bali bombings I which shocked world community occurred on 12 October 2002 in the famous tourist district of Kuta on the Indonesian island of Bali, killing 202 people (including 88 Australians, 38 Indonesians, and people from more than 20 other nationalities). In the capital, Jakarta, successive bombings were blasted in Marriott hotel, Australian Embassy, residence of the Philippine Ambassador and stock exchange office. A 'drunken Indonesia' is far from ready to combat nationwide sudden and massive terrorist attacks. Police Detachment 88 (Densus 88) Indonesian counter-terrorism squad, was quickly formed following 2002 Bali Bombing. Anti-terrorism Provisional Act was immediately erected, as well, due to urgent need to fight terrorism. Some Bali bombings criminals were deadly executed after sentenced by the court. But a series of terrorist suicide attacks and another Bali bombings (the second one) in Bali, again, shocked world community. Terrorism network is undoubtedly spreading nationwide. Suspicion is high that they had close connection with Al Qaeda’s groups. Even 'Afghanistan alumni' and 'Syria alumni' returned to Indonesia to back up the local mujahidins in their fights to topple Indonesia constitutional government and set up Islamic state (Khilafah). Supported by massive aids from friendly nations, especially Australia and United States, Indonesia launched large scale operations to crush terrorism consisted of various radical groups such as JAD, JAS, and JAADI. Huge energy, money, and souls were dedicated. Terrorism is, however, persistently entrenched. High ranking officials from Detachment 88 squad and military intelligence believe that terrorism is still one the most deadly enemy of Indonesia.

Keywords: counter-radicalization, de-radicalization, Khalifah, Union State, Al Qaedah, ISIS

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Authors: I. Ling Tsai, Shu Fen Wu, Chen-Fuh Lam, Chia Yu Chen, Shu Jiuan Chen, Yen Lin Liu

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Purpose: Following the conduction of the National Health Insurance (NHI) system in Taiwan since 1995, the demand for anesthesia services continues to increase in the operating rooms and other medical units. It has been well recognized that increased work stress not only affects the clinical performance of the medical staff, long-term work load may also result in occupational burnout. Our study aimed to determine the influence of working environment, work stress and job satisfaction on the occupational burnout in nurse anesthetists. The ultimate goal of this research project is to develop a strategy in establishing a friendly, less stressful workplace for the nurse anesthetists to enhance their job satisfaction, thereby reducing occupational burnout and increasing the career life for nurse anesthetists. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator 2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the nurse anesthetists. The relationships between two numeric datasets were analyzed by the Pearson correlation test (SPSS 20.0). Results: A total of 66 completed questionnaires were collected from 75 nurses (response rate 88%). The average scores for the working environment, job satisfaction, and work stress were 69.6%, 61.5%, and 63.9%, respectively. The three perspectives used to assess the occupational burnout, namely emotional exhaustion, depersonalization and sense of personal accomplishment were 26.3, 13.0 and 24.5, suggesting the presence of moderate to high degrees of burnout in our nurse anesthetists. The presence of occupational burnout was closely correlated with the unsatisfactory working environment (r=-0.385, P=0.001) and reduced job satisfaction (r=-0.430, P=0.000). Junior nurse anesthetists (<1-year clinical experience) reported having higher satisfaction in working environment than the seniors (5 to 10-year clinical experience) (P=0.02). Although the average scores for work stress, job satisfaction, and occupational burnout were lower in junior nurses, the differences were not statistically different. The linear regression model, the working environment was the independent factor that predicted occupational burnout in nurse anesthetists up to 19.8%. Conclusions: High occupational burnout is more likely to develop in senior nurse anesthetists who experienced the dissatisfied working environment, work stress and lower job satisfaction. In addition to the regulation of clinical duties, the increased workload in the supervision of the junior nurse anesthetists may result in emotional stress and burnout in senior nurse anesthetists. Therefore, appropriate adjustment of clinical and teaching loading in the senior nurse anesthetists could be helpful to improve the occupational burnout and enhance the retention rate.

Keywords: nurse anesthetists, working environment, work stress, job satisfaction, occupational burnout

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Authors: Eun-Jeong Jang

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Inequality has been considered as a core issue in public policy. Korea is categorized into one of the countries in the high level of inequality, which matters to not only current but also future generations. The relationship between individuals' origin and destination has an implication of intergenerational inequality. The previous work on this was mostly conducted at macro level using panel data to our knowledge. However, in this level, there is no room to track down what happened during the time between origin and destination. Individuals' origin is represented by their parents' socio-economic status, and in the same way, destination is translated into their own socio-economic status. The first research question is that how origin is related to the destination. Certainly, destination is highly affected by origin. In this view, people's destination is already set to be more or less than a reproduction of previous generations. However, educational achievement is widely believed as an independent factor from the origin. From this point of view, there is a possibility to change the path given by parents by educational attainment. Hence, the second research question would be that how education is related to destination and also, which factor is more influential to destination between origin and education. Also, the focus lies in the mediation of education between origin and destination, which would be the third research question. Socio-economic status in this study is referring to class as a sociological term, as well as wealth including labor and capital income, as an economic term. The combination of class and wealth would be expected to give more accurate picture about the hierarchy in a society. In some cases of non-manual and professional occupations, even though they are categorized into relatively high class, their income is much lower than those who in the same class. Moreover, it is one way to overcome the limitation of the retrospective view during survey. Education is measured as an absolute term, the years of schooling, and also as a relative term, the rank of school. Moreover, all respondents were asked the effort scaled by time intensity, self-motivation, before and during the course of their college based on a standard questionnaire academic achieved model provides. This research is based on a survey at an individual level. The target for sampling is an individual who has a job, regardless of gender, including income-earners and self-employed people and aged between thirties and forties because this age group is considered to reach the stage of job stability. In most cases, the researcher met respondents person to person visiting their work place or home and had a chance to interview some of them. One hundred forty individual data collected from May to August in 2017. It will be analyzed by multiple regression (Q1, Q2) and structural equation modeling (Q3).

Keywords: class, destination, educational achievement, effort, income, origin, socio-economic status, South Korea

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Authors: Tanya Kaur Bedi, Shankha Pratim Bhattacharya

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The US Environmental Protection Agency defines indoor air pollution as “The air quality within and around buildings, especially as it relates to the health and comfort of building occupants”. According to the 2021 report by the Energy Policy Institute at Chicago, Indian residents, a country which is home to the highest levels of air pollution in the world, lose about 5.9 years from life expectancy due to poor air quality and yet has numerous dwellings dependent on natural ventilation. Currently the urban population spends 90% of the time indoors, this scenario raises a concern for occupant health and well-being. This study attempts to demonstrate the causal relationship between the indoor air pollution and its determining aspects. Detailed indoor air pollution audits were conducted in residential buildings located in Kolkata, India in the months of December and January 2021. According to the air pollution knowledge assessment city program in India, Kolkata is also the second most polluted mega-city after Delhi. Although the air pollution levels are alarming year-long, the winter months are most crucial due to the unfavourable environmental conditions. While emissions remain typically constant throughout the year, cold air is denser and moves slower than warm air, trapping the pollution in place for much longer and consequently is breathed in at a higher rate than the summers. The air pollution monitoring period was selected considering environmental factors and major pollution contributors like traffic and road dust. This study focuses on the relationship between the built environment and the spatial-temporal distribution of air pollutants in and around it. The measured parameters include, temperature, relative humidity, air velocity, particulate matter, volatile organic compounds, formaldehyde, and benzene. A total of 56 rooms were audited, selectively targeting the most dominant middle-income group in the urban area of the metropolitan. The data-collection was conducted using a set of instruments positioned in the human breathing-zone. The study assesses the relationship between indoor air pollution levels and factors determining natural ventilation and air pollution dispersion such as surrounding environment, dominant wind, openable window to floor area ratio, windward or leeward side openings, and natural ventilation type in the room: single side or cross-ventilation, floor height, residents cleaning habits, etc.

Keywords: indoor air quality, occupant health, air pollution, architecture, urban environment

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Authors: Girija Madhavanprabhakaran, Frincy Franacis, Sheeba Elizabeth John

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Introduction: A wide range of prenatal genetic screening is introduced with increasing incidences of congenital anomalies even in low-risk pregnancies and is an emerging standard of care. Being frontline caretakers, the role and responsibilities of nurses and midwives are critical as they are working along with couples to provide evidence-based supportive educative care. The increasing genetic disorders and advances in prenatal genetic screening with limited genetic counselling facilities urge nurses and midwifery nurses with essential competencies to help couples to take informed decision. Objective: This integrative literature review aimed to explore nurse midwives’ knowledge and role in prenatal screening and genetic counselling competency and the challenges faced by them to cater to all pregnant women to empower their autonomy in decision making and ensuring psychological comfort. Method: An electronic search using keywords prenatal screening, genetic counselling, prenatal counselling, nurse midwife, nursing education, genetics, and genomics were done in the PUBMED, SCOPUS and Medline, Google Scholar. Finally, based on inclusion criteria, 8 relevant articles were included. Results: The main review results suggest that nurses and midwives lack essential support, knowledge, or confidence to be able to provide genetic counselling and help the couples ethically to ensure client autonomy and decision making. The majority of nurses and midwives reported inadequate levels of knowledge on genetic screening and their roles in obtaining family history, pedigrees, and providing genetic information for an affected client or high-risk families. The deficiency of well-recognized and influential clinical academic midwives in midwifery practice is also reported. Evidence recommended to update and provide sound educational training to improve nurse-midwife competence and confidence. Conclusion: Overcoming the challenges to achieving informed choices about fetal anomaly screening globally is a major concern. Lack of adequate knowledge and counselling competency, communication insufficiency, need for education and policy are major areas to address. Prenatal nurses' and midwives’ knowledge on prenatal genetic screening and essential counselling competencies can ensure services to the majority of pregnant women around the globe to be better-informed decision-makers and enhances their autonomy, and reduces ethical dilemmas.

Keywords: challenges, genetic counselling, prenatal screening, prenatal counselling

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Authors: Arun Perumbilavil Anand

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For the past few years, the state of Kerala has been witnessing a large inflow of migrant workers from other states of the country, which emerged as a result of demographic transition and Gulf emigration. The in-migration patterns in Kerala have changed over the time with the migrants having a higher residence history bringing their families to the state, thereby making the process more complicated and divergent in its approach. These developments have led to an increase in the young migrant population at least in some parts of the state, which has opened up doubts and questions related to their future in the host society. At this juncture, the study ponders into the factors that are associated with the assimilation and wellbeing of migrant children in the society of Kerala. As one of the objectives, the study also analyzed the influence and role played by the educational institutions (both public and private) in meeting the needs and aspirations of both the children and their parents. The study gains significance as it tries to identify various impediments that hinder the cognitive skill formation and behaviour patterns of the migrant children in the host society. Data and Methodology: The study is based on the primary data collected through a series of interviews and interactions held with parents, children, and teachers of different educational institutions, including both public and private. The primary survey also made use of research techniques like observation, in-depth interviews, and case study method. The study was conducted in schools in the Kanjikode area of the Palakkad district in Kerala. The findings of the study are on the basis of a survey conducted in four schools and 40 migrant children. Findings: The study found that majority of the children have wholly integrated and assimilated into the host society. The influence of the peer group was quite visible in giving stimulus to the assimilation process. Most of the children do not have any emotional or cultural sentiments attached to their state of origin, and they consider Kerala as their ‘home state’ and the local language (Malayalam) as their ‘mother tongue'. The study could also find that the existing education system in the host society fails to meet the needs and aspirations of migrants as well as that of their children. On a comparative scale, to some extent, private schools have succeeded in fulfiling the special requirements of the migrant children. An interesting point that the study could pinpoint at is that the children of the migrants show better health conditions and wellbeing than compared to the natives, which is usually addressed as an epidemiologic paradox. As a concluding remark, the study recommends the inclusion concept of inclusive education into the education system of the state with giving due emphasis on those who are at higher risk of being excluded or marginalized, along with fostering increased interaction between diverse groups.

Keywords: assimilation, Kerala, migrant children, well-being

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Authors: Angelika Kris D. Dalangin, Cesar B. Quicoy

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Rice farming is a major source of livelihood and employment in the Philippines, but it requires a substantial amount of capital. Capital may come from income (farm, non-farm, and off-farm), savings and credit. However, rice farmers suffer from lack of capital due to high costs of inputs and low productivity. Capital insufficiency, coupled with low productivity, hindered them to meet their basic household and production needs. Hence, they resorted to borrowing money, mostly from informal lenders who charge very high interest rates. As another source of capital, savings can help rice farmers meet their basic needs for both the household and the farm. However, information is inadequate whether the farmers save or not, as well as, why they do not depend on savings to augment their lack of capital. Thus, it is worth analyzing how rice farmers saved. The study revealed, using the actual savings which is the difference between the household income and expenditure, that about three-fourths (72%) of the total number of farmers interviewed are savers. However, when they were asked whether they are savers or not, more than half of them considered themselves as non-savers. This gap shows that there are many farmers who think that they do not have savings at all; hence they continue to borrow money and do not depend on savings to augment their lack of capital. The study also identified the forms of savings, saving motives, and savings utilization among rice farmers. Results revealed that, for the past 12 months, most of the farmers saved cash at home for liquidity purposes while others deposited cash in banks and/or saved their money in the form of livestock. Among the most important reasons of farmers for saving are for daily household expenses, for building a house, for emergency purposes, for retirement, and for their next production. Furthermore, the study assessed the factors affecting the rice farmers’ savings behaviour using logistic regression. Results showed that the factors found to be significant were presence of non-farm income, per capita net farm income, and per capita household expense. The presence of non-farm income and per capita net farm income positively affects the farmers’ savings behaviour. On the other hand, per capita household expenses have negative effect. The effect, however, of per capita net farm income and household expenses is very negligible because of the very small chance that the farmer is a saver. Generally, income and expenditure were proved to be significant factors that affect the savings behaviour of the rice farmers. However, most farmers could not save regularly due to low farm income and high household and farm expenditures. Thus, it is highly recommended that government should develop programs or implement policies that will create more jobs for the farmers and their family members. In addition, programs and policies should be implemented to increase farm productivity and income.

Keywords: agricultural economics, agricultural finance, binary logistic regression, logit, Philippines, Quezon, rice farmers, savings, savings behaviour

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Authors: D. Hilton

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The importance and significance of this research is based upon the fundamental knowledge reported in the scientific literature that physical activity is inversely associated with obesity. In addition, it is recognized there is a global epidemic of sedentariness while at the same time it is known that morbidity and mortality are associated with physical inactivity and as a result of overweight or obesity. Hence this small study in school students is an important area of research in our community. An application submitted in 2005 for the inaugural Public Health Education Research Trust [PHERT] Post Graduate Research Scholarship scheme organized by the Public Health Association of Australia [PHAA] was awarded 3rd place within Australia. The author and title was: D. Hilton, Methods to increase physical activity in school aged children [literature review, a trial using pedometers and a policy paper]. Third place is a good result, however this did not secure funding for the project, as only first place received $5000 funding. Some years later within Australia, a program commenced called the Global Children's Challenge [GCC]. Given details of the 2005 award above were included an application submission prepared for Parkhill Primary School [PPS] which is located in Victoria, Australia was successful. As a result, an excited combined grade 3/ 4 class at the school [27 students] in 2012 became recipients of these free pedometers. Ambassadors for the program were Mrs Catherine Freeman [OAM], Olympic Gold Medalist – Sydney 2000 [400 meters], while another ambassador was Mr Colin Jackson [CBE] who is a Welsh former sprint and hurdling athlete. In terms of PPS and other schools involved in 2012, website details show that the event started on 19th Sep 2012 and students were to wear the pedometer every day for 50 days [at home and at school] aiming for the recommended 15,000 steps/day recording steps taken in a booklet provided. After the finish, an analysis of the average step count for this school showed that the average steps taken / day was 14, 003 [however only a small percentage of students returned the booklets and units] as unfortunately the dates for the program coincided with school holidays so some students either forgot or misplaced the units / booklets. Unfortunately funding for this program ceased in 2013, however the lasting impact of the trial on student’s knowledge and awareness remains and in fact becomes a good grounding for students in how to monitor basic daily physical activity using a method that is easy, fun, low cost and readily accessible.

Keywords: walking, physical activity, exercise, Australian school

Procedia PDF Downloads 309

Authors: Kadidiatou Toure

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Mali has started experimentation of teaching the national languages at school through the convergent pedagogy in 1987. Then, it is in 1994 that it will become widespread with eleven of the thirteen former national languages used at primary school. The aim was to improve the Malian educational system because the use of French as the only medium of instruction was considered a contributing factor to the significant number of student dropouts and the high rate of repetition. The Convergent pedagogy highlights the knowledge acquired by children at home, their vision of the world and especially the knowledge they have of their mother tongue. That pedagogy requires the use of a specific medium only during classroom practices and teachers have been trained in this sense. The specific medium depends on the learning content, which sometimes is French, other times, it is the national language. Research has shown that bilingual learners do not only use the required medium in their learning activities, but they code switch. It is part of their learning processes. Currently, many scholars agree on the importance of CS in bilingual classes, and teachers have been told about the necessity of integrating it into their classroom practices. One of the challenges of the Malian bilingual education curriculum is the question of ‘effective languages management’. Theoretically, depending on the classrooms, an average have been established for each of the involved language. Following that, teachers make use of CS differently, sometimes, it favors the learners, other times, it contributes to the development of some linguistic weaknesses. The present research tries to fill that gap through a tentative model of didactization of CS, which simply means the practical management of the languages involved in the bilingual classrooms. It is to know how to use CS for effective learning. Moreover, the didactization of CS tends to sensitize the teachers about the functional role of CS so that they may overcome their own weaknesses. The overall goal of this research is to make code switching a real tool for bilingual education. The specific objectives are: to identify the types of CS used during classroom activities to present the functional role of CS for the teachers as well as the pupils. to develop a tentative model of code-switching, which will help the teachers in transitional classes of bilingual schools to recognize the appropriate moment for making use of code switching in their classrooms. The methodology adopted is a qualitative one. The study is based on recorded videos of teachers of 3rd year of primary school during their classroom activities and interviews with the teachers in order to confirm the functional role of CS in bilingual classes. The theoretical framework adopted is the typology of CS proposed by Poplack (1980) to identify the types of CS used. The study reveals that teachers need to be trained on the types of CS and the different functions they assume and on the consequences of inappropriate use of language alternation.

Keywords: bilingual curriculum, code switching, didactization, national languages

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

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

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

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Authors: Denisa Mackova, Andrea Pokorna

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The management of postoperative pain is a meaningful part of quality care. The experience and knowledge of registered nurses in postoperative pain management can be influenced by local know-how. Therefore, the research helps to understand the cultural differences between two countries with the aim of evaluating the management of postoperative pain management among the nurses from the Czech Republic and the Kingdom of Saudi Arabia. Both countries have different procedures on managing postoperative pain and the research will provide an understanding of both the advantages and disadvantages of the procedures and also highlight the knowledge and experience of registered nurses in both countries. Between the Czech Republic and the Kingdom of Saudi Arabia, the expectation is for differing results in the usage of opioid analgesia for the patients postoperatively and in the experience of registered nurses with Patient Controlled Analgesia. The aim is to evaluate the knowledge and awareness of registered nurses and to merge the data with the postoperative pain management in the early postoperative period in the Czech Republic and the Kingdom of Saudi Arabia. Also, the aim is to assess the knowledge and experience of registered nurses by using Patient Controlled Analgesia and epidural analgesia treatment in the early postoperative period. The criteria for those providing input into the study, are registered nurses, working in surgical settings (standard departments, post-anesthesia care unit, day care surgery or ICU’s) caring for patients in the postoperative period. Method: Research is being conducted by questionnaires. It is a quantitative research, a comparative study of registered nurses in the Czech Republic and the Kingdom of Saudi Arabia. Questionnaire surveys were distributed through an electronic Bristol online survey. Results: The collection of the data in the Kingdom of Saudi Arabia has been completed successfully, with 550 respondents, 77 were excluded and 473 respondents were included for statistical data analysis. The outcome of the research is expected to highlight the differences in treatment through Patient Controlled Analgesia, with more frequent use in the Kingdom of Saudi Arabia. A similar assumption is expected for treatment conducted by analgesia. We predict that opioids will be used more regularly in the Kingdom of Saudi Arabia, whilst therapy through NSAID’s being the most common approach in the Czech Republic. Discussion/Conclusion: The majority of respondents from the Kingdom of Saudi Arabia were female registered nurses from a multitude of nations. We are expecting a similar split in gender between the Czech Republic respondents; however, there will be a smaller number of nationalities. Relevance for research and practice: Output from the research will assess the knowledge, experience and practice of patient controlled analgesia and epidural analgesia treatment. Acknowledgement: This research was accepted and affiliated to the project: Postoperative pain management, knowledge and experience registered nurses (Czech Republic and Kingdom of Saudi Arabia) – SGS05/2019-2020.

Keywords: acute postoperative pain, epidural analgesia, nursing care, patient controlled analgesia

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Authors: Zhe Li, Tao Ju, Liguo Zhang, Zehong Zhang, Baoshun Zhang

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In-grow stacking-faults (IGSFs) in 4H-SiC epilayers can cause increased leakage current and reduce the blocking voltage of 4H-SiC power devices. Double Shockley stacking fault (2SSF) is a common type of IGSF with double slips on the basal planes. In this study, a 2SSF in the 4H-SiC epilayer grown by chemical vaper deposition (CVD) is characterized. The nucleation site of the 2SSF is discussed, and a model for the 2SSF nucleation is proposed. Homo-epitaxial 4H-SiC is grown on a commercial 4 degrees off-cut substrate by a home-built hot-wall CVD. Defect-selected-etching (DSE) is conducted with melted KOH at 500 degrees Celsius for 1-2 min. Room temperature cathodoluminescence (CL) is conducted at a 20 kV acceleration voltage. Low-temperature photoluminescence (LTPL) is conducted at 3.6 K with the 325 nm He-Cd laser line. In the CL image, a triangular area with bright contrast is observed. Two partial dislocations (PDs) with a 20-degree angle in between show linear dark contrast on the edges of the IGSF. CL and LTPL spectrums are conducted to verify the IGSF’s type. The CL spectrum shows the maximum photoemission at 2.431 eV and negligible bandgap emission. In the LTPL spectrum, four phonon replicas are found at 2.468 eV, 2.438 eV, 2.420 eV and 2.410 eV, respectively. The Egx is estimated to be 2.512 eV. A shoulder with a red-shift to the main peak in CL, and a slight protrude at the same wavelength in LTPL are verified as the so called Egx- lines. Based on the CL and LTPL results, the IGSF is identified as a 2SSF. Back etching by neutral loop discharge and DSE are conducted to track the origin of the 2SSF, and the nucleation site is found to be a threading screw dislocation (TSD) in this sample. A nucleation mechanism model is proposed for the formation of the 2SSF. Steps introduced by the off-cut and the TSD on the surface are both suggested to be two C-Si bilayers height. The intersections of such two types of steps are along [11-20] direction from the TSD, while a four-bilayer step at each intersection. The nucleation of the 2SSF in the growth is proposed as follows. Firstly, the upper two bilayers of the four-bilayer step grow down and block the lower two at one intersection, and an IGSF is generated. Secondly, the step-flow grows over the IGSF successively, and forms an AC/ABCABC/BA/BC stacking sequence. Then a 2SSF is formed and extends by the step-flow growth. In conclusion, a triangular IGSF is characterized by CL approach. Base on the CL and LTPL spectrums, the estimated Egx is 2.512 eV and the IGSF is identified to be a 2SSF. By back etching, the 2SSF nucleation site is found to be a TSD. A model for the 2SSF nucleation from an intersection of off-cut- and TSD- introduced steps is proposed.

Keywords: cathodoluminescence, defect-selected-etching, double Shockley stacking fault, low-temperature photoluminescence, nucleation model, silicon carbide

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Authors: Hanee Ryu

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The supporting policies for renewable energy have been designed to deploy renewable energy technology targeting domestic market. The government encourages market creation through obligations such as FIT or RPS on an energy supplier. With these policy measures, the securing vast market needs to induce technology development. Furthermore, it is crucial that ensuring developing market can make the environment nurture the renewable energy industry. Overseas expansion to countries being in demand is essential under immature domestic market. Extending its business abroad can make the domestic company get the knowledge through learning-by-doing. Besides, operation in the countries to be rich in renewable resources such as weather conditions helps to develop proven track record required for verifying technologies. This paper figures out the factor to hamper the global market entry and build up the strategies to overcome difficulties. Survey conducted renewable energy company having overseas experiences at least once. Based on the survey we check the obstacle against exporting home goods and services. As a result, securing funds is salient fact to proceed to business. It is difficult that only private bank or investment agencies participate in the project under uncertainty which renewable energy development project bears inherently. These uncertainties need public fund such as ODA to encourage private sectors to start a business. Furthermore, international organizations such as IRENA or multilateral development banks as WBG play a role to guarantee the investment including risk insurance against uncertainty. It can also manage excavation business cooperating with developing countries and supplement inadequate government funding involved. With survey results strategies to obtain the order, the international organization places are categorized according to the type of getting a contract. This paper suggests 3 types approaching to the international organization project (going through international competitive bidding, using ODA and project financing) and specifies the role of government to support the domestic firms with running out of funds. Under renewable energy industry environment where hard to being created as a spontaneous market, government policy approach needs to motivate the actors to get into the business. It is one of the good strategies that countries with the low demand of renewable energies participate in the project international agencies order in the developing countries having abundant resources. This provides crucial guidance for the formulation of renewable energy development policy and planning with consideration of business opportunities and funding.

Keywords: exporting strategies, multilateral development banks, promoting in developing countries, renewable energy technologies

Procedia PDF Downloads 518

Authors: Xavier Louis, Madhava Soma Sundaram

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The Palk Bay, a narrow strip of water, separates the state of Tamil Nadu in India from north Sri Lanka. The bay, which is 137 km in length and varies from 64 to 137 kilometers in width and is home to more than 580 fish species and chunks of shrimp’s resources, is divided by the International Maritime Boundary Line (IMBL). The bay, bordering it are five Tamil Nadu districts of India and three Sri Lankan districts and assumes importance as it is one of the areas presenting permanent and serious challenges to both India and Sri Lanka with respect to the fishing rights in the Bay. Fishermen from both sides were enjoying fishing with hormones for centuries. Katchchadeevu is a tiny Island located in the Bay, which was a part of India. After the Katchchadeevu agreement 1974 it became a part of Sri Lanka and a fishing conflict arose between the two countries' fishermen. Fuelling the dispute over Katchatheevu is the overfishing of Indian mechanized trawlers in Palk Bay and the damaging environmental and economic effects of trawling. Since 2008, more than 300 Indian fishermen have been killed by firing by Sri Lankan Navy, nearly 100 fishermen have gone missing and more than 3000 fishermen were arrested and later released after the trials for trespassing into Sri Lankan waters. Currently, more than 120 fishing boats and 29 fishermen are in Sri Lankan custody. This paper attempts to find out the causes of fishing conflict and who has the fishing rights in the mentioned waters, how the international treaties are complied with at the time of arrest and trials, how the arrested fishermen are treated by them and how they suffer from fishermen families without a breadwinner. A Semi-structured interview schedule tool was prepared by the researcher, which is suitable for measuring quantitative and qualitative aspects of the above-mentioned theme. One hundred arrested fishermen were interviewed and recorded their prison experiences in Sri Lanka. The research found that the majority of the fishermen believe that they have the right to fish in the historical water and that the Sri Lankan Naval personnel have brutally attacked the Indian fishermen at the time of the arrest. The majority of the fishermen accepted that they had limited fishing grounds. As a result, they entered Sri Lankan waters for their livelihood. The majority of the fishermen expected that they would also get their belongings back at the time of release, primarily the boats. Most of the arrested fishermen's families face financial crises in the absence of their breadwinners and this situation has created conditions for child labor among the affected families and some fishers migrate to different places for different occupations. The majority of the fishers have trauma about their victimization and face uncertainty in the future of their occupation. We can discuss more the causes and nature of the fishing conflict and the financial and psychological victimization of Indian fishermen in relation to the conflict.

Keywords: palk bay, historical water, fishing conflict, arrested fishermen, victimization

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Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

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Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

Procedia PDF Downloads 315

Authors: İlknur Gökşin, Sultan Ayaz Alkaya

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Objective: Progressive muscle relaxation (PMR) include the deliberate stretching and relaxation of the major muscle groups of the human body. This study was conducted to evaluate the effect of PMR applied in women on the postpartum depression and general comfort level. Methods: The study population of this quasi-experimental study with pre-test, post-test and control group consisted of primipara women who had vaginal delivery in the obstetric service of a university hospital. The experimental and control groups consisted of 35 women each. The data were collected by questionnaire, the Edinburgh Postnatal Depression Scale (EPDS) and the General Comfort Questionnaire (GCQ). The women were matched according to their age and education level and divided into the experimental and control groups by simple random selection. Postpartum depression risk and general comfort was evaluated at the 2nd and 5th days, 10th and 15th days, fourth week and eighth week after birth. The experimental group was visited at home and PMR was applied. After the first visit, women were asked to apply PMR regularly three times a week for eight weeks. During the application, the researcher called the participants twice a week to follow up the continuity of the application. No intervention was performed in the control group. For data analysis, descriptive statistics such as number, percentage, mean, standard deviation, significance test of difference between two means and ANOVA were used. Approval of the ethics committee and permission of the institution were obtained for the study. Results: There were no significant differences between the women in the experimental and control groups in terms of age, education status and employment status (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of EPDS pre-test, 1st, 2nd and 3rd follow-up mean scores (p>0.05). There was a statistically significant difference between EPDS pre-test and 3rd follow-up scores of the experimental group (p<0.05), whereas there was no such difference in the control group (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of mean GCQ pre-test scores (p>0.05), whereas in the 1st, 2nd and 3rd follow-ups there was a statistically significant difference between the mean GCQ scores (p<0.05). It was found that there was a significant increase in the GCQ physical, psychospiritual and sociocultural comfort sub-scales, relief and relaxation levels of the experimental group between the pre-test and 3rd follow-ups scores (p<0.05). And, a significant decrease was found between pre-test and 3rd follow-up GCQ psychospiritual, environmental and sociocultural comfort sub-scale, relief, relaxation and superiority levels (p<0.05). Conclusion: Progressive muscle relaxation was effective on reducing the postpartum depression risk and increasing general comfort. It is recommended to provide progressive muscle relaxation training to women in the postpartum period as well as ensuring the continuity of this practice.

Keywords: general comfort, postpartum depression, postpartum period, progressive muscle relaxation

Procedia PDF Downloads 256

Authors: Alok Saini, Rajkumar Ghosh

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Water is nature's important resource for survival of all living things, but freshwater scarcity exists in some parts of world. This study has predicted that Gomti Nagar area (49.2 sq. km.) will harvest about 91110 ML of rainwater till 2051 (assuming constant and present annual rainfall). But 17.71 ML of rainwater was harvested from only 53 buildings in Gomti Nagar area in the year 2021. Water level will be increased (rise) by 13 cm in Gomti Nagar from such groundwater recharge. The total annual groundwater abstraction from Gomti Nagar area was 35332 ML (in 2021). Due to hydrogeological constraints and lower annual rainfall, groundwater recharge is less than groundwater abstraction. The recent scenario is only 0.07% of rainwater recharges by RTRWHs in Gomti Nagar. But if RTRWHs would be installed in all buildings then 12.39% of rainwater could recharge groundwater table in Gomti Nagar area. But if RTRWHs would be installed in all buildings then 12.39% of rainwater could recharge groundwater table in Gomti Nagar area. Gomti Nagar is situated in 'Zone–A' (water distribution area) and groundwater is the primary source of freshwater supply. Current scenario indicates only 0.07% of rainwater recharges by RTRWHs in Gomti Nagar. In Gomti Nagar, the difference between groundwater abstraction and recharge will be 735570 ML in 30 yrs. Statistically, all buildings at Gomti Nagar (new and renovated) could harvest 3037 ML of rainwater through RTRWHs annually. The most recent monsoonal recharge in Gomti Nagar was 10813 ML/yr. Harvested rainwater collected from RTRWHs can be used for rooftop irrigation, and residential kitchen and gardens (home grown fruit and vegetables). According to bylaws, RTRWH installations are required in both newly constructed and existing buildings plot areas of 300 sq. m or above. Harvested rainwater is of higher quality than contaminated groundwater. Harvested rainwater from RTRWHs can be considered water self-sufficient. Rooftop Rainwater Harvesting Systems (RTRWHs) are least expensive, eco-friendly, most sustainable, and alternative water resource for artificial recharge. This study also predicts about 3.9 m of water level rise in Gomti Nagar area till 2051, only when all buildings will install RTRWHs and harvest for groundwater recharging. As a result, this current study responds to an impact assessment study of RTRWHs implementation for the water scarcity problem in the Gomti Nagar area (1.36 sq.km.). This study suggests that common storage tanks (recharge wells) should be built for a group of at least ten (10) households and optimal amount of harvested rainwater will be stored annually. Artificial recharge from alternative water sources will be required to improve the declining water level trend and balance the groundwater table in this area. This over-exploitation of groundwater may lead to land subsidence, and development of vertical cracks.

Keywords: aquifer, aquitard, artificial recharge, bylaws, groundwater, monsoon, rainfall, rooftop rainwater harvesting system, RTRWHs water table, water level

Procedia PDF Downloads 97

Authors: Janice Keener, Christine Houlihan

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Over the last several years, there has been an increase in children identified as having Autism Spectrum Disorder (ASD). Specialists across several disciplines: mental health and medical professionals have been tasked with ensuring accurate and timely evaluations for children with suspected ASD. Due to the nature of the ASD symptom presentation, an interdisciplinary assessment and treatment approach best addresses the needs of the whole child. During the unprecedented COVID-19 Pandemic, clinicians were faced with how to continue with interdisciplinary assessments in a telehealth arena. Instruments that were previously used to assess ASD in-person were no longer appropriate measures to use due to the safety restrictions. For example, The Autism Diagnostic Observation Schedule requires examiners and children to be in very close proximity of each other and if masks or face shields are worn, they render the evaluation invalid. Similar issues arose with the various cognitive measures that are used to assess children such as the Weschler Tests of Intelligence and the Differential Ability Scale. Thus the need arose to identify measures that are able to be safely and accurately administered using safety guidelines. The incidence of ASD continues to rise over time. Currently, the Center for Disease Control estimates that 1 in 59 children meet the criteria for a diagnosis of ASD. The reasons for this increase are likely multifold, including changes in diagnostic criteria, public awareness of the condition, and other environmental and genetic factors. The rise in the incidence of ASD has led to a greater need for diagnostic and treatment services across the United States. The uncertainty of the diagnostic process can lead to an increased level of stress for families of children with suspected ASD. Along with this increase, there is a need for diagnostic clarity to avoid both under and over-identification of this condition. Interdisciplinary assessment is ideal for children with suspected ASD, as it allows for an assessment of the whole child over the course of time and across multiple settings. Clinicians such as Psychologists and Developmental Pediatricians play important roles in the initial evaluation of autism spectrum disorder. An ASD assessment may consist of several types of measures such as standardized checklists, structured interviews, and direct assessments such as the ADOS-2 are just a few examples. With the advent of telehealth clinicians were asked to continue to provide meaningful interdisciplinary assessments via an electronic platform and, in a sense, going to the family home and evaluating the clinical symptom presentation remotely and confidently making an accurate diagnosis. This poster presentation will review the benefits, limitations, and interpretation of these various instruments. The role of other medical professionals will also be addressed, including medical providers, speech pathology, and occupational therapy.

Keywords: Autism Spectrum Disorder Assessments, Interdisciplinary Evaluations , Tele-Assessment with Autism Spectrum Disorder, Diagnosis of Autism Spectrum Disorder

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Authors: Najlaa Yousef Qusti, Steven J. Brookes, Paul A. Brunton

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Background: Tooth discoloration can be an aesthetic problem, and tooth whitening using carbamide peroxide bleaching agents are a popular treatment option. However, there are concerns about possible adverse effects such as demineralisation of the bleached enamel; however, the cause of this demineralisation is unclear. Introduction: Teeth can become stained or discoloured over time. Tooth whitening is an aesthetic solution for tooth discoloration. Bleaching solutions of 10% carbamide peroxide (CP) have become the standard agent used in dentist-prescribed and home-applied ’vital bleaching techniques’. These materials release hydrogen peroxide (H₂O₂), the active whitening agent. However, there is controversy in the literature regarding the effect of bleaching agents on enamel integrity and enamel mineral content. The purpose of this study was to establish if carbamide peroxide bleaching agents affect the acid solubility of enamel (i.e., make teeth more prone to demineralisation). Materials and Methods: Twelve human premolar teeth were sectioned longitudinally along the midline and varnished to leave the natural enamel surface exposed. The baseline behavior of each tooth half in relation to its demineralisation in acid was established by sequential exposure to 4 vials containing 1ml of 10mM acetic acid (1 minute/vial). This was followed by exposure to 10% CP for 8 hours. After washing in distilled water, the tooth half was sequentially exposed to 4 further vials containing acid to test if the acid susceptibility of the enamel had been affected. The corresponding tooth half acted as a control and was exposed to distilled water instead of CP. The mineral loss was determined by measuring [Ca²⁺] and [PO₄³⁻] released in each vial using a calcium ion-selective electrode and the phosphomolybdenum blue method, respectively. The effect of bleaching on the tooth surfaces was also examined using SEM. Results: Exposure to carbamide peroxide did not significantly alter the susceptibility of enamel to acid attack, and SEM of the enamel surface revealed a slight alteration in surface appearance. SEM images of the control enamel surface showed a flat enamel surface with some shallow pits, whereas the bleached enamel appeared with an increase in surface porosity and some areas of mild erosion. Conclusions: Exposure to H₂O₂ equivalent to 10% CP does not significantly increase subsequent acid susceptibility of enamel as determined by Ca²⁺ release from the enamel surface. The effects of bleaching on mineral loss were indistinguishable from distilled water in the experimental system used. However, some surface differences were observed by SEM. The phosphomolybdenum blue method for phosphate is compromised by peroxide bleaching agents due to their oxidising properties. However, the Ca²⁺ electrode is unaffected by oxidising agents and can be used to determine the mineral loss in the presence of peroxides.

Keywords: bleaching, carbamide peroxide, demineralisation, teeth whitening

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Authors: Ivan Orozco

Abstract:

Introduction: Forced contraception constitutes part of an effort to control the life and reproductive capacity of women through public health institutions. This phenomenon has affected many Mexican women historically and still persists nowadays. The notion of reproductive governmentality refers to the mechanisms through which different historical configurations of social actors (state institutions, churches, donor agents, NGOs, etc.) use legislative controls, economic incentives, moral mandates, direct coercion, and ethical incitements, to produce, monitor and control reproductive behaviors and practices. This research focuses on the use of these mechanisms by the Mexican State to control women's contraceptive practices in a public hospital. Method: An Institutional Ethnography was carried out, with the objective of knowing women's experiences from their own perspective, as they occur in their daily lives, but at the same time, discovering the structural elements that shape the discourses that promote women's contraception, even against their will. The fieldwork consisted in an observation of the dynamics between different participants within a public hospital and the conduction of interviews with the medical and nursing staff in charge of family planning services, as well as women attending the family planning office. Results: Public health institutions in Mexico are state tools to control and regulate reproduction. There are several strategies that are used for this purpose, for example, health personnel provide insufficient or misleading information to ensure that women agree to use contraceptives; health institutions provide economic incentives to the members of the health staff who reach certain goals in terms of contraceptive placement; young women are forced to go to the family planning service, regardless of the reason they went to the clinic; health campaigns are carried out, consisting of the application of contraceptives outside the health facilities, directly in the communities of people who visit the hospital less frequently. All these mechanisms seek for women to use contraceptives, from the women’s perspective; however, the reception of these discourses is ambiguous. While, for some women, the strategies become coercive mechanisms to use contraceptives against their will, for others, they represent an opportunity to take control over their reproductive lives. Conclusion: Since 1974, the Mexican government has implemented campaigns for the promotion of family planning methods as a means to control population growth. Although it is established in several legislations that the counselling must be carried out with a gender and human rights perspective, always respecting the autonomy of people, these research testify that health personnel uses different strategies to force some women to use contraceptive methods, thereby violating their reproductive rights.

Keywords: feminist research, forced contraception, institutional ethnography, reproductive. governmentality

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Authors: A. T. Muruviwa

Abstract:

Empirical studies of the current CSR agenda have been dominated by literature from the North at the expense of the nations from the South where most TNCs are located. Therefore, owing to the limitations of the current discourse that is dominated by Western ideas such as voluntarism, philanthropy, business case and economic gains, scholars have been calling for a new CSR agenda that is South-centred and addresses the needs of developing nations. The development theme has dominated in the recent literature as scholars concerned with the relationship between business and society have tried to understand its relationship with CSR. Despite a plethora of literature on the roles of corporations in local communities and the impact of CSR initiatives, there is lack of adequate empirical evidence to help us understand the nexus between CSR and development. For all the claims made about the positive and negative consequences of CSR, there is surprisingly little information about the outcomes it delivers. This study is a response to these claims made about the developmental aspect of CSR in developing countries. It offers some empirical bases for assessing the major CSR projects that have been fulfilled by a major mining company, Zimplats in Mhondoro-Ngezi Zimbabwe. The neo-liberal idea of capitalism and market dominations has empowered TNCs to stamp their authority in the developing countries. TNCs have made their mark in developing nations as they stamp their global private authority, rivalling or implicitly challenging the state in many functions. This dominance of corporate power raises great concerns over their tendencies of abuses in terms of environmental, social and human rights concerns as well as how to make them increasingly accountable. The hegemonic power of TNCs in the developing countries has had a tremendous impact on the overall CSR practices. While TNCs are key drivers of globalization they may be acting responsibly in their Global Northern home countries where there is a combination of legal mechanisms and the fear of civil society activism associated with corporate scandals. Using a triangulated approach in which both qualitative and quantitative methods were used the study found out that most CSR projects in Zimbabwe are dominated and directed by Zimplats because of the power it possesses. Most of the major CSR projects are beneficial to the mining company as they serve the business plans of the mining company. What was deduced from the study is that the infrastructural development initiatives by Zimplats confirm that CSR is a tool to advance business obligations. This shows that although proponents of CSR might claim that business has a mandate for social obligations to society, we need not to forget the dominant idea that the primary function of CSR is to enhance the firm’s profitability.

Keywords: hegemonic power, projects, reciprocity, stakeholders

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Authors: I. Nanako, Mariko Era, Hiroshi Morita

Abstract:

Objectives: Japanese uses TATAMI rather than flooring at home. Igusa ( Juncus effuses var. decipiens ), which is commonly known in the forms of TATAMI. Juncus spp. grow at a relatively high humidity area (Japan, China and Southeast Asia ). Yatsushiro region in the southern part of Kumamoto prefecture is major produing area of Igusa. Igusa found to have honeycomb structure and was also shown to have the ability to control humidity. And Igusa has been used as a medicinal herb for diuretic and antiphlogistic agent. In previous study, we investigated antimicrobial effects of Igusa, and showed high antimicrobial activity against food poisoning bacteria. Therefore, the food trays blended Igusa can be kept clean by antimicrobial activity of Igusa. We focus on ‘Igusa foam materials’. In this study, we investigated the antibacterial and antifungal activity of Igusa, and new application to foam materials for food industry. Materials and method: We used Igusa foam materials (3 × 3 × 3 cm) as a sample. We set about fifteen types of samples combined with a commercial antibacterial agent A, a commercial antibacterial agent B, potassium laurate (C12K) and a commercial antifungal agent C, a commercial antifungal agent D and a commercial antifungal agent E. We selected four bacteria strains (Escherichia coli NBRC 3972, Staphylococus aureus NBRC 12732, Salmonella typhimurium NBRC 13245, Bacillus subtilis NBRC 3335 ) and three fungus strains (Penicillium pinophilum NBRC 6345, Cladosporium cladosporioides NBRC 30314, Aspergillus oryzae NBRC 5238 ). The fungus was cultured at 30 °C on Igusa foam materials after inoculation of the fungus for fourteen days. The bacteria was cultured at 30 °C on Igusa foam materials after inoculation of the bacteria for three days. And the Igusa foam materials were washed with 10 mL normal saline after three days. The normal saline washed Igusa foam materials plated the NA medium. After, It was cultured at 30 °C and used colony counting method. Result and Conclusion: The fifteen types of sample of Igusa foam materials had antifungal activity against C. cladosporioides, A. oryzae and P. pinophilum for fourteen days. The four types of sample contained potassium laurate and antibacterial agent A, sample contained antibacterial agent B and antifungal agent D, sample contained A and antifungal agent E, sample contained B and E had antibacterial activity against B. subtilis. The three types of sample contained potassium laurate and A, sample contained B and D, sample contained A and E had antibacterial activity against S. typhimurium. The five types of sample contained potassium laurate and A, sample contained B and D, sample contained A and E, sample contained B and E, sample contained B and antifungal agent C had antibacterial activity against E. coli and S. aureus. These results indicate that Igusa of Igusa foam materials had high antifungal activity. In addition, Igusa foam materials combined with a commercial antibacterial agent had antibacterial activity. In the future, we consider that use of Igusa foam materials may be spread from food industry.

Keywords: antibacterial, antifungal, foam materials, Igusa

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