Search results for: health information exchange (hie)
Commenced in January 2007
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Edition: International
Paper Count: 19433

Search results for: health information exchange (hie)

293 Person-Centered Thinking as a Fundamental Approach to Improve Quality of Life

Authors: Christiane H. Kellner, Sarah Reker

Abstract:

The UN-Convention on the Rights of Persons with Disabilities, which Germany also ratified, postulates the necessity of user-centred design, especially when it comes to evaluating the individual needs and wishes of all citizens. Therefore, a multidimensional approach is required. Based on this insight, the structure of the town-like centre in Schönbrunn - a large residential complex and service provider for persons with disabilities in the outskirts of Munich - will be remodelled to open up the community to all people as well as transform social space. This strategy should lead to more equal opportunities and open the way for a much more diverse community. The research project “Index for participation development and quality of life for persons with disabilities” (TeLe-Index, 2014-2016), which is anchored at the Technische Universität München in Munich and at the Franziskuswerk Schönbrunn supports this transformation process called “Vision 2030”. In this context, we have provided academic supervision and support for three projects (the construction of a new school, inclusive housing for children and teenagers with disabilities and the professionalization of employees using person-centred planning). Since we cannot present all the issues of the umbrella-project within the conference framework, we will be focusing on one sub-project more in-depth, namely “The Person-Centred Think Tank” [Arbeitskreis Personenzentriertes Denken; PZD]. In the context of person-centred thinking (PCT), persons with disabilities are encouraged to (re)gain or retain control of their lives through the development of new choice options and the validation of individual lifestyles. PCT should thus foster and support both participation and quality of life. The project aims to establish PCT as a fundamental approach for both employees and persons with disabilities in the institution through in-house training for the staff and, subsequently, training for users. Hence, for the academic support and supervision team, the questions arising from this venture can be summed up as follows: (1) has PCT already gained a foothold at the Franziskuswerk Schönbrunn? And (2) how does it affect the interaction with persons with disabilities and how does it influence the latter’s everyday life? According to the holistic approach described above, the target groups for this study are both the staff and the users of the institution. Initially, we planned to implement the group discussion method for both target-groups. However, in the course of a pretest with persons with intellectual disabilities, it became clear that this type of interview, with hardly any external structuring, provided only limited feedback. In contrast, when the discussions were moderated, there was more interaction and dialogue between the interlocutors. Therefore, for this target-group, we introduced structured group interviews. The insights we have obtained until now will enable us to present the intermediary results of our evaluation. We analysed and evaluated the group interviews and discussions with the help of qualitative content analysis according to Mayring in order to obtain information about users’ quality of life. We sorted out the statements relating to quality of life obtained during the group interviews into three dimensions: subjective wellbeing, self-determination and participation. Nevertheless, the majority of statements were related to subjective wellbeing and self-determination. Thus, especially the limited feedback on participation clearly demonstrates that the lives of most users do not take place beyond the confines of the institution. A number of statements highlighted the fact that PCT is anchored in the everyday interactions within the groups. However, the implementation and fostering of PCT on a broader level could not be detected and thus remain further aims of the project. The additional interviews we have planned should validate the results obtained until now and open up new perspectives.

Keywords: person-centered thinking, research with persons with disabilities, residential complex and service provider, participation, self-determination.

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292 Interval Functional Electrical Stimulation Cycling and Nutritional Counseling Improves Lean Mass to Fat Mass Ratio and Decreases Cardiometabolic Disease Risk in Individuals with Spinal Cord Injury

Authors: David Dolbow, Daniel Credeur, Mujtaba Rahimi, Dobrivoje Stokic, Jennifer Lemacks, Andrew Courtner

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Introduction: Obesity is at epidemic proportions in the spinal cord injury (SCI) population (66-75%), as individuals who suffer from paralysis undergo a dramatic decrease in muscle mass and a dramatic increase in adipose deposition. Obesity is a major public health concern which includes a doubling of the risk of heart disease, stroke and type II diabetes mellitus. It has been demonstrated that physical activity, and especially HIIT, can promote a healthy body composition and decrease the risk cardiometabolic disease in the able-bodied population. However, SCI typically limits voluntary exercise to the arms, but a high prevalence of shoulder pain in persons with chronic SCI (60-90%) can cause increased arm exercise to be problematic. Functional electrical stimulation (FES) cycling has proven to be a safe and effective way to exercise paralyzed leg muscles in clinical and home settings, saving the often overworked arms. Yet, HIIT-FES cycling had not been investigated prior to the current study. The purpose of this study was to investigate the body composition changes with combined HIIT-FES cycling and nutritional counseling on individuals with SCI. Design: A matched (level of injury, time since injury, body mass index) and controlled trail. Setting: University exercise performance laboratory. Subjects: Ten individuals with chronic SCI (C5-T9) ASIA impairment classification (A & B) were divided into the treatment group (n=5) for 30 minutes of HIIT-FES cycling 3 times per week for 8 weeks and nutritional counseling over the phone for 30 minutes once per week for 8 weeks and the control group (n=5) who received nutritional counseling only. Results: There was a statistically significant difference between the HIIT-FES group and the control group in mean body fat percentage change (-1.14 to +0.24) respectively, p = .030). There was also a statistically significant difference between the HIIT-FES and control groups in mean change in legs lean mass (+0.78 kg to -1.5 kg) respectively, p = 0.004. There was a nominal decrease in weight, BMI, total fat mass and a nominal increase in total lean mass for the HIIT-FES group over the control group. However, these changes were not found to be statistically significant. Additionally, there was a nominal decrease in the mean blood glucose levels for both groups 101.8 to 97.8 mg/dl for the HIIT-FES group and 94.6 to 93 mg/dl for the Nutrition only group, however, neither were found to be statistically significant. Conclusion: HIIT-FES cycling combined with nutritional counseling can provide healthful body composition changes including decreased body fat percentage in just 8 weeks. Future study recommendations include a greater number of participants, a primer electrical stimulation exercise program to better ready participants for HIIT-FES cycling and a greater volume of training above 30 minutes, 3 times per week for 8 weeks.

Keywords: body composition, functional electrical stimulation cycling, high-intensity interval training, spinal cord injury

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291 Analysis of Taxonomic Compositions, Metabolic Pathways and Antibiotic Resistance Genes in Fish Gut Microbiome by Shotgun Metagenomics

Authors: Anuj Tyagi, Balwinder Singh, Naveen Kumar B. T., Niraj K. Singh

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Characterization of diverse microbial communities in specific environment plays a crucial role in the better understanding of their functional relationship with the ecosystem. It is now well established that gut microbiome of fish is not the simple replication of microbiota of surrounding local habitat, and extensive species, dietary, physiological and metabolic variations in fishes may have a significant impact on its composition. Moreover, overuse of antibiotics in human, veterinary and aquaculture medicine has led to rapid emergence and propagation of antibiotic resistance genes (ARGs) in the aquatic environment. Microbial communities harboring specific ARGs not only get a preferential edge during selective antibiotic exposure but also possess the significant risk of ARGs transfer to other non-resistance bacteria within the confined environments. This phenomenon may lead to the emergence of habitat-specific microbial resistomes and subsequent emergence of virulent antibiotic-resistant pathogens with severe fish and consumer health consequences. In this study, gut microbiota of freshwater carp (Labeo rohita) was investigated by shotgun metagenomics to understand its taxonomic composition and functional capabilities. Metagenomic DNA, extracted from the fish gut, was subjected to sequencing on Illumina NextSeq to generate paired-end (PE) 2 x 150 bp sequencing reads. After the QC of raw sequencing data by Trimmomatic, taxonomic analysis by Kraken2 taxonomic sequence classification system revealed the presence of 36 phyla, 326 families and 985 genera in the fish gut microbiome. At phylum level, Proteobacteria accounted for more than three-fourths of total bacterial populations followed by Actinobacteria (14%) and Cyanobacteria (3%). Commonly used probiotic bacteria (Bacillus, Lactobacillus, Streptococcus, and Lactococcus) were found to be very less prevalent in fish gut. After sequencing data assembly by MEGAHIT v1.1.2 assembler and PROKKA automated analysis pipeline, pathway analysis revealed the presence of 1,608 Metacyc pathways in the fish gut microbiome. Biosynthesis pathways were found to be the most dominant (51%) followed by degradation (39%), energy-metabolism (4%) and fermentation (2%). Almost one-third (33%) of biosynthesis pathways were involved in the synthesis of secondary metabolites. Metabolic pathways for the biosynthesis of 35 antibiotic types were also present, and these accounted for 5% of overall metabolic pathways in the fish gut microbiome. Fifty-one different types of antibiotic resistance genes (ARGs) belonging to 15 antimicrobial resistance (AMR) gene families and conferring resistance against 24 antibiotic types were detected in fish gut. More than 90% ARGs in fish gut microbiome were against beta-lactams (penicillins, cephalosporins, penems, and monobactams). Resistance against tetracycline, macrolides, fluoroquinolones, and phenicols ranged from 0.7% to 1.3%. Some of the ARGs for multi-drug resistance were also found to be located on sequences of plasmid origin. The presence of pathogenic bacteria and ARGs on plasmid sequences suggested the potential risk due to horizontal gene transfer in the confined gut environment.

Keywords: antibiotic resistance, fish gut, metabolic pathways, microbial diversity

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290 The Importance and Necessity for Acquiring Pedagogical Skills by the Practice Tutors for the Training of the General Nurses

Authors: Maria Luiza Fulga, Georgeta Truca, Mihaela Alexandru, Andriescu Mariana, Crin Marcean

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The significance of nursing as a subject in the post-secondary healthcare curriculum is a major. We aimed to enable our students to assess the patient's risk, to establish prevention measures and to adapt to a specific learning context, in order to acquire the skills and abilities necessary for the nursing profession. In order to achieve these objectives, during the three years of study, teachers put an emphasis on acquiring communication skills, because in our country after the first cycle of hospital accreditation concluded in 2016, the National Authority for Quality of Health Management has introduced the criteria for the implementation and application of the nursing process according to the accreditation standards. According to these requirements, the nurse has to carry out the nursing assessment, based on communication as a distinct component, so that they can identify nursing diagnoses and implement the nursing plan. In this respect, we, the teachers, have refocused, by approaching various teaching strategies and preparing students for the real context of learning and applying what they learn. In the educational process, the tutors in the hospitals have an important role to play in acquiring professional skills. Students perform their activity in the hospital in accordance with the curriculum, in order to verify the practical applicability of the theoretical knowledge acquired in the school classes and also have the opportunity to acquire their skills in a real learning context. In clinical education, the student nurse learns in the middle of a guidance team which includes a practice tutor, who is a nurse that takes responsibility for the practical/clinical learning of the students in their field of activity. In achieving this objective, the tutor's abilities involve pedagogical knowledge, knowledge for the good of the individual and nursing theory, in order to be able to guide clinical practice in accordance with current requirements. The aim of this study is to find out the students’ confidence level in practice tutors in hospitals, the students’ degree of satisfaction in the pedagogical skills of the tutors and the practical applicability of the theoretical knowledge. In this study, we used as a method of investigation a student satisfaction questionnaire regarding the clinical practice in the hospital and the sample of the survey consisted of 100 students aged between 20 and 50 years, from the first, second and third year groups, with the General Nurse specialty (nurses responsible for general care), from 'Fundeni' Healthcare Post-Secondary School, Bucharest, Romania. Following the analysis of the data provided, we arrived the conclusion that the hospital tutor needs to improve his/her pedagogical skills, the knowledge of nursing diagnostics, and the implementation of the nursing plan, so that the applicability of the theoretical notions would be increased. Future plans include the pedagogical training of the medical staff, as well as updating the knowledge needed to implement the nursing process in order to meet current requirements.

Keywords: clinical training, nursing process, pedagogical skills, tutor

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289 Persistent Organic Pollutant Level in Challawa River Basin of Kano State, Nigeria

Authors: Abdulkadir Sarauta

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Almost every type of industrial process involves the release of trace quantity of toxic organic and inorganic compound that up in receiving water bodies, this study was aimed at assessing the Persistent Organic Pollutant Level in Challawa River Basin of Kano State, Nigeria. And the research formed the basis of identifying the presence of PCBs and PAHs in receiving water bodies in the study area, assessing the PCBs and PAHs concentration in receiving water body of Challawa system, evaluate the concentration level of PCBs and PAHs in fishes in the study area, determine the concentration level of PCBs and PAHs in crops irrigated in the study area as well as compare the concentration of PCBs and PAHs with the acceptable limit set by Nigerian, EU, U.S and WHO standard. Data were collected using reconnaissance survey, site inspection, field survey, laboratory experiment as well as secondary data source. A total of 78 samples were collected through stratified systematic random sampling (i.e., 26 samples for each of water, crops and fish) three sampling points were chosen and designated A, B and C along the stretch of the river (i.e. up, middle, and downstream) from Yan Danko Bridge to Tambirawa bridge. The result shows that the Polychlorinated biphenyls (PCBs) was not detected while, polycyclic aromatic hydrocarbons (PAHs) was detected in the whole samples analysed at the trench of Challawa River basin in order to assess the contribution of human activities to global environmental pollution. The total concentrations of ΣPAH and ΣPCB ranges between 0.001 to 0.087mg/l and 0.00 to 0.00mg/l of water samples While, crops samples ranges between 2.0ppb to 8.1ppb and fish samples ranges from 2.0 to 6.7ppb.The whole samples are polluted because most of the parameters analyzed exceed the threshold limits set by WHO, Nigerian, U.S and EU standard. The analytical results revealed that some chemicals are present in water, crops and fishes are significantly very high at Zamawa village which is very close to Challawa industrial estate and also is main effluent discharge point and drinking water around study area is not potable for consumption. Analysis of Variance was obtained by Bartlett’s test performance. There is only significant difference in water because the P < 0.05 level of significant, But there is no difference in crops concentration they have the same performance, likes wise in the fishes. It is said to be of concern to health hazard which will increase incidence of tumor related diseases such as skin, lungs, bladder, gastrointestinal cancer, this show there is high failure of pollution abatement measures in the area. In conclusion, it can be said that industrial activities and effluent has impact on Challawa River basin and its environs especially those that are living in the immediate surroundings. Arising from the findings of this research some recommendations were made the industries should treat their liquid properly by installing modern treatment plants.

Keywords: Challawa River Basin, organic, persistent, pollutant

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288 Autobiographical Memory Functions and Perceived Control in Depressive Symptoms among Young Adults

Authors: Meenu S. Babu, K. Jayasankara Reddy

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Depression is a serious mental health concern that leads to significant distress and dysfunction in an individual. Due to the high physical, psychological, social, and economic burden it causes, it is important to study various bio-psycho-social factors that influence the onset, course, duration, intensity of depressive symptoms. The study aims to explore relationship between autobiographical memory (AM) functions, perceived control over stressful events and depressive symptoms. AM functions and perceived control were both found to be protective factors for individuals against depression and were both modifiable to predict better behavioral and affective outcomes. An extensive review of literatur, with a systematic search on Google Scholar, JSTOR, Science Direct and Springer Journals database, was conducted for the purpose of this review paper. These were used for all the aforementioned databases. The time frame used for the search was 2010-2021. An additional search was conducted with no time bar to map the development of the theoretical concepts. The relevant studies with quantitative, qualitative, experimental, and quasi- experimental research designs were included for the review. Studies including a sample with a DSM- 5 or ICD-10 diagnosis of depressive disorders were excluded from the study to focus on the behavioral patterns in a non-clinical population. The synthesis of the findings that were obtained from the review indicates there is a significant relationship between cognitive variables of AM functions and perceived control and depressive symptoms. AM functions were found to be have significant effects on once sense of self, interpersonal relationships, decision making, self- continuity and were related to better emotion regulation and lower depressive symptoms. Not all the components of AM function were equally significant in their relationships with various depressive symptoms. While self and directive functions were more related to emotion regulation, anhedonia, motivation and hence mood and affect, the social function was related to perceived social support and social engagement. Perceived control was found to be another protective cognitive factor that provides individuals a sense of agency and control over one’s life outcomes which was found to be low in individuals with depression. This was also associated to the locus of control, competency beliefs, contingency beliefs and subjective well being in individuals and acted as protective factors against depressive symptoms. AM and perceived control over stressful events serve adaptive functions, hence it is imperative to study these variables more extensively. They can be imperative in planning and implementing therapeutic interventions to foster these cognitive protective factors to mitigate or alleviate depressive symptoms. Exploring AM as a determining factor in depressive symptoms along with perceived control over stress creates a bridge between biological and cognitive factors underlying depression and increases the scope of developing a more eclectic and effective treatment plan for individuals. As culture plays a crucial role in AM functions as well as certain aspects of control such as locus of control, it is necessary to study these variables keeping in mind the cultural context to tailor culture/community specific interventions for depression.

Keywords: autobiographical memories, autobiographical memory functions, perceived control, depressive symptoms, depression, young adults

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287 The Direct and Indirect Effects of Buddhism on Fertility Rates in General and in Specific Socioeconomic Circumstances of Women

Authors: Szerena Vajkovszki

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Our worldwide aging society, especially in developed countries, including members of EU, raise sophisticated sociological and economic issues and challenges to be met. As declining fertility has outstanding influence underlying this trend, numerous studies have attempted to identify, describe, measure and interpret contributing factors of the fertility rate, out of which relatively few revealed the impact of religion. Identified, examined and influential factors affecting birth rate as stated by the present scientific publications are more than a dozen out of which religious beliefs, traditions, and cultural norms were examined first with a special focus on abortion and forms of birth control. Nevertheless, connected to religion, not only these topics are crucial regarding fertility, but many others as well. Among many religious guidelines, we can separate two major categories: direct and indirect. The aim of this research was to understand what are the most crucial identified (family values, gender related behaviors, religious sentiments) and not yet identified most influential contributing religious factors. Above identifying these direct or indirect factors, it is also important to understand to what extent and how do they influence fertility, which requires a wider (inter-discipline) perspective. As proved by previous studies religion has also an influential role on health, mental state, well-being, working activity and many other components that are also related to fertility rates. All these components are inter-related. Hence direct and indirect religious effects can only be well understood if we figure out all necessary fields and their interaction. With the help of semi-structured opened interviews taking place in different countries, it was showed that indeed Buddhism has significant direct and indirect effect on fertility. Hence the initial hypothesis was proved. However, the interviews showed an overall positive effect; the results could only serve for a general understanding of how Buddhism affects fertility. Evolution of Buddhism’s direct and indirect influence may vary in different nations and circumstances according to their specific environmental attributes. According to the local patterns, with special regard to women’s position and role in the society, outstandingly indirect influences could show diversifications. So it is advisory to investigate more for a deeper and clearer understanding of how Buddhism function in different socioeconomic circumstances. For this purpose, a specific and detailed analysis was developed from recent related researches about women’s position (including family roles and economic activity) in Hungary with the intention to be able to have a complex vision of crucial socioeconomic factors influencing fertility. Further interviews and investigations are to be done in order to show a complex vision of Buddhism’s direct and indirect effect on fertility in Hungary to be able to support recommendations and policies pointing to higher fertility rates in the field of social policies. The present research could serve as a general starting point or a common basis for further specific national investigations.

Keywords: Buddhism, children, fertility, gender roles, religion, women

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286 Monsoon Controlled Mercury Transportation in Ganga Alluvial Plain, Northern India and Its Implication on Global Mercury Cycle

Authors: Anjali Singh, Ashwani Raju, Vandana Devi, Mohmad Mohsin Atique, Satyendra Singh, Munendra Singh

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India is the biggest consumer of mercury and, consequently, a major emitter too. The increasing mercury contamination in India’s water resources has gained widespread attention and, therefore, atmospheric deposition is of critical concern. However, little emphasis was placed on the role of precipitation in the aquatic mercury cycle of the Ganga Alluvial Plain which provides drinking water to nearly 7% of the world’s human population. A majority of the precipitation here occurs primarily in 10% duration of the year in the monsoon season. To evaluate the sources and transportation of mercury, water sample analysis has been conducted from two selected sites near Lucknow, which have a strong hydraulic gradient towards the river. 31 groundwater samples from Jehta village (26°55’15’’N; 80°50’21’’E; 119 m above mean sea level) and 31 river water samples from the Behta Nadi (a tributary of the Gomati River draining into the Ganga River) were collected during the monsoon season on every alternate day between 01 July to 30 August 2019. The total mercury analysis was performed by using Flow Injection Atomic Absorption Spectroscopy (AAS)-Mercury Hybride System, and daily rainfall data was collected from the India Meteorological Department, Amausi, Lucknow. The ambient groundwater and river-water concentrations were both 2-4 ng/L as there is no known geogenic source of mercury found in the area. Before the onset of the monsoon season, the groundwater and the river-water recorded mercury concentrations two orders of magnitude higher than the ambient concentrations, indicating the regional transportation of the mercury from the non-point source into the aquatic environment. Maximum mercury concentrations in groundwater and river-water were three orders of magnitude higher than the ambient concentrations after the onset of the monsoon season characterizing the considerable mobilization and redistribution of mercury by monsoonal precipitation. About 50% of both of the water samples were reported mercury below the detection limit, which can be mostly linked to the low intensity of precipitation in August and also with the dilution factor by precipitation. The highest concentration ( > 1200 ng/L) of mercury in groundwater was reported after 6-days lag from the first precipitation peak. Two high concentration peaks (>1000 ng/L) in river-water were separately correlated with the surface flow and groundwater outflow of mercury. We attribute the elevated mercury concentration in both of the water samples before the precipitation event to mercury originating from the extensive use of agrochemicals in mango farming in the plain. However, the elevated mercury concentration during the onset of monsoon appears to increase in area wetted with atmospherically deposited mercury, which migrated down from surface water to groundwater as downslope migration is a fundamental mechanism seen in rivers of the alluvial plain. The present study underscores the significance of monsoonal precipitation in the transportation of mercury to drinking water resources of the Ganga Alluvial Plain. This study also suggests that future research must be pursued for a better understand of the human health impact of mercury contamination and for quantification of the role of Ganga Alluvial Plain in the Global Mercury Cycle.

Keywords: drinking water resources, Ganga alluvial plain, india, mercury

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285 Redefining Doctors' Role in Terms of Medical Errors and Consumer Protection Act to Be in Line with Medical Ethics

Authors: Manushi Srivastava

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Introduction: Doctor’s role, and relation with respect to patient care is at the core of medical ethics. The rapid pace of medical advances along with increasing consumer awareness about their rights and hike in cost of effective health care demand a robust, transparent and patient-friendly medical care system. However, doctors’ role performance is still in the frame of activity-passivity model of Doctor-Patient Relationship (DPR) where doctors act as parent and use to instruct their patients, without their consensus that is not going to help in the 21st century. Thus the current situation is a new challenge for traditional doctor-patient relationship after the introduction of Consumer Protection Act (CPA) in medical profession and the same is evidenced by increasing cases of medical litigation. To strengthen this system of medical services, the doctor plays a vital role, and the same should be reviewed in the present context. Objective: To understand the opinion of consultants regarding medical negligence and effect of Consumer Protection Act in terms of current practices of patient care. Method: This is a cross-sectional study in which both quantitative and qualitative methods are applied. Total 69 consultants were selected from multi-specialty hospitals of densely populated Varanasi city catering a population of about 1.8 million. Two-stage sampling was used for selection of respondents. At the first stage, selection of major wards (Medicine, Surgery, Ophthalmology, Gynaecology, Orthopaedics, and Paediatrics) was carried out, which are more susceptible to medical negligence. At the second stage, selection of consultants from the respective wards was carried out. In-depth Interviews were conducted with the help of semi-structured schedule. Two case studies of medical negligence were also carried out as part of the qualitative study. Analysis: Data were analyzed with the help of SPSS software (21.0 trial version). Semi-structured research tool was used to know consultant’s opinion about the pattern of medical negligence cases, litigations and claims made by patient community and inclusion of government medical services in CPA. Statistical analysis was done to describe data, and non-parametric test was used to observe the association between the variables. Analysis of Verbatim was used in case-study. Findings and Conclusion: Majority (92.8%) of consultants felt changes in the behaviour of community (patient) after implementation of CPA, as it had increased awareness about their rights. Less than half of the consultants opined that Medical Negligence is an Unintentional act of doctors and generally occurs due to communication gap and behavioural problem between doctor and patients. Experienced consultants ( > 10 years) pointed out that unethical practice by doctors and mal-intention of patient to harass doctors were additional reasons of Medical Negligence. In-depth interview revealed that now patients’ community expects more transparency and hence they demand cafeteria approach in diagnosis and management of cases. Thus as study results, we propose ‘Agreement Model’ of DPR to re-ensure ethical practice in medical profession.

Keywords: doctors, communication, consumer protection act (CPA), medical error

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284 Epidemiological Analysis of Measles Outbreak in North-Kazakhstan Region of the Republic of Kazakhstan

Authors: Fatima Meirkhankyzy Shaizadina, Alua Oralovna Omarova, Praskovya Mikhailovna Britskaya, Nessipkul Oryntayevna Alysheva

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In recent years in the Republic of Kazakhstan there have been registered outbreaks of measles among the population. The objective of work was the analysis of outbreak of measles in 2014 among the population of North-Kazakhstan region of the Republic of Kazakhstan. For the analysis of the measles outbreak descriptive and analytical research, techniques were used and threshold levels of morbidity were calculated. The increase of incidence was noted from March to July. The peak was registered in May and made 9.0 per 100000 population. High rates were registered in April – 5.7 per 100000 population, and in June and July they made 5.7 and 3.1 respectively. Duration of the period of increase made 5 months. The analysis of monthly incidence of measles revealed spring and summer seasonality. Across the territory it was established that 69.2% of cases were registered in the city, 29.1% in rural areas and 1.7% of cases were brought in from other regions of Kazakhstan. The registered cases and threshold values of measles during the outbreak revealed that from 12 to 24 week, and also during the 40th week the cases exceeding the threshold levels are registered. Thus, for example, for the analyzed 1 week the number of the revealed patients made 4, which exceeds the calculated threshold value (3) by 33.3%. The data exceeding the threshold values confirm the emergence of a disease outbreak or the beginning of epidemic rise in morbidity. Epidemic rise in incidence of the population of North-Kazakhstan region was observed throughout 2014. The risk group includes 0-4 year-old children, who made 22.7%, 15-19 year-olds – 25.6%, 20-24 year-olds – 20.9%. The analysis of measles cases registration by gender revealed that women are registered 1.1 times more often than men. The ratio of women to men made 1:0.87. In social and professional groups often ill are unorganized children – 23.3% and students – 19.8%. Studying clinical manifestations of measles in the hospitalized patients, the typical beginning of a disease with expressed intoxication symptoms – weakness, sickliness was established. In individual cases expressed intoxication symptoms, hemorrhagic and dyspeptic syndromes, complications in the form of overlay of a secondary bacterial infection, which defined high severity of the illness, were registered both in adults and in children. The average duration of stay of patients in the hospital made 6.9 days. The average duration of time between date of getting the disease and date of delivery of health care made 3.6 days. Thus, the analysis of monthly incidence of measles revealed spring and summer seasonality, the peak of which was registered in May. Urban dwellers are ill more often (69.2%), while in rural areas people are ill more rarely (29.1%). Throughout 2014 an epidemic rise in incidence of the population of North-Kazakhstan region was observed. Risk group includes: children under 4 – 22.7%, 15-19 year-olds – 25.6%, 20-24 year-olds – 20.9%. The ratio of women and men made 1:0.87. The typical beginning of a disease in all hospitalized with the expressed intoxication symptoms – weakness, sickliness was established.

Keywords: epidemiological analysis, measles, morbidity, outbreak

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283 Impact of Wastewater Irrigation on Soil Quality and Productivity of Tuberose (Polianthes tuberosa L. cv. Prajwal)

Authors: D. S. Gurjar, R. Kaur, K. P. Singh, R. Singh

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A greater volume of wastewater generate from urban areas in India. Due to the adequate availability, less energy requirement and nutrient richness, farmers of urban and peri-urban areas are deliberately using wastewater to grow high value vegetable crops. Wastewater contains pathogens and toxic pollutants, which can enter in the food chain system while using wastewater for irrigating vegetable crops. Hence, wastewater can use for growing commercial flower crops that may avoid food chain contamination. Tuberose (Polianthes tuberosa L.) is one of the most important commercially grown, cultivated over 30, 000 ha area, flower crop in India. Its popularity is mainly due to the sweet fragrance as well as the long keeping quality of the flower spikes. The flower spikes of tuberose has high market price and usually blooms during summer and rainy seasons when there is meager supply of other flowers in the market. It has high irrigation water requirement and fresh water supply is inadequate in tuberose growing areas of India. Therefore, wastewater may fulfill the water and nutrients requirements and may enhance the productivity of tuberose. Keeping in view, the present study was carried out at WTC farm of ICAR-Indian Agricultural Research Institute, New Delhi in 2014-15. Prajwal was the variety of test crop. The seven treatments were taken as T-1. Wastewater irrigation at 0.6 ID/CPE, T-2: Wastewater irrigation at 0.8 ID/CPE, T-3: Wastewater irrigation at 1.0 ID/CPE, T-4: Wastewater irrigation at 1.2 ID/CPE, T-5: Wastewater irrigation at 1.4 ID/CPE, T-6: Conjunctive use of Groundwater and Wastewater irrigation at 1.0 ID/CPE in cyclic mode, T-7: Control (Groundwater irrigation at 1.0 ID/CPE) in randomized block design with three replication. Wastewater and groundwater samples were collected on monthly basis (April 2014 to March 2015) and analyzed for different parameters of irrigation quality (pH, EC, SAR, RSC), pollution hazard (BOD, toxic heavy metals and Faecal coliforms) and nutrients potential (N, P, K, Cu, Fe, Mn, Zn) as per standard methods. After harvest of tuberose crop, soil samples were also collected and analyzed for different parameters of soil quality as per standard methods. The vegetative growth and flower parameters were recorded at flowering stage of tuberose plants. Results indicated that wastewater samples had higher nutrient potential, pollution hazard as compared to groundwater used in experimental crop. Soil quality parameters such as pH EC, available phosphorous & potassium and heavy metals (Cu, Fe, Mn, Zn, Cd. Pb, Ni, Cr, Co, As) were not significantly changed whereas organic carbon and available nitrogen were significant higher in the treatments where wastewater irrigations were given at 1.2 and 1.4 ID/CPE as compared to groundwater irrigations. Significantly higher plant height (68.47 cm), leaves per plant (78.35), spike length (99.93 cm), rachis length (37.40 cm), numbers of florets per spike (56.53), cut spike yield (0.93 lakh/ha) and loose flower yield (8.5 t/ha) were observed in the treatment of Wastewater irrigation at 1.2 ID/CPE. Study concluded that given quality of wastewater improves the productivity of tuberose without an adverse impact on soil quality/health. However, its long term impacts need to be further evaluated.

Keywords: conjunctive use, irrigation, tuberose, wastewater

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282 Glucose Measurement in Response to Environmental and Physiological Challenges: Towards a Non-Invasive Approach to Study Stress in Fishes

Authors: Tomas Makaras, Julija Razumienė, Vidutė Gurevičienė, Gintarė Sauliutė, Milda Stankevičiūtė

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Stress responses represent animal’s natural reactions to various challenging conditions and could be used as a welfare indicator. Regardless of the wide use of glucose measurements in stress evaluation, there are some inconsistencies in its acceptance as a stress marker, especially when it comes to comparison with non-invasive cortisol measurements in the fish challenging stress. To meet the challenge and to test the reliability and applicability of glucose measurement in practice, in this study, different environmental/anthropogenic exposure scenarios were simulated to provoke chemical-induced stress in fish (14-days exposure to landfill leachate) followed by a 14-days stress recovery period and under the cumulative effect of leachate fish subsequently exposed to pathogenic oomycetes (Saprolegnia parasitica) to represent a possible infection in fish. It is endemic to all freshwater habitats worldwide and is partly responsible for the decline of natural freshwater fish populations. Brown trout (Salmo trutta fario) and sea trout (Salmo trutta trutta) juveniles were chosen because of a large amount of literature on physiological stress responses in these species was known. Glucose content in fish by applying invasive and non-invasive glucose measurement procedures in different test mediums such as fish blood, gill tissues and fish-holding water were analysed. The results indicated that the quantity of glucose released in the holding water of stressed fish increased considerably (approx. 3.5- to 8-fold) and remained substantially higher (approx. 2- to 4-fold) throughout the stress recovery period than the control level suggesting that fish did not recover from chemical-induced stress. The circulating levels of glucose in blood and gills decreased over time in fish exposed to different stressors. However, the gill glucose level in fish showed a decrease similar to the control levels measured at the same time points, which was found to be insignificant. The data analysis showed that concentrations of β-D glucose measured in gills of fish treated with S. parasitica differed significantly from the control recovery, but did not differ from the leachate recovery group showing that S. parasitica presence in water had no additive effects. In contrast, a positive correlation between blood and gills glucose were determined. Parallel trends in blood and water glucose changes suggest that water glucose measurement has much potency in predicting stress. This study demonstrated that measuring β-D-glucose in fish-holding water is not stressful as it involves no handling and manipulation of an organism and has critical technical advantages concerning current (invasive) methods, mainly using blood samples or specific tissues. The quantification of glucose could be essential for studies examining the stress physiology/aquaculture studies interested in the assessment or long-term monitoring of fish health.

Keywords: brown trout, landfill leachate, sea trout, pathogenic oomycetes, β-D-glucose

Procedia PDF Downloads 173
281 Assessment of Energy Efficiency and Life Cycle Greenhouse Gas Emission of Wheat Production on Conservation Agriculture to Achieve Soil Carbon Footprint in Bangladesh

Authors: MD Mashiur Rahman, Muhammad Arshadul Haque

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Emerging conservation agriculture (CA) is an option for improving soil health and maintaining environmental sustainability for intensive agriculture, especially in the tropical climate. Three years lengthy research experiment was performed in arid climate from 2018 to 2020 at research field of Bangladesh Agricultural Research Station (RARS)F, Jamalpur (soil texture belongs to Agro-Ecological Zone (AEZ)-8/9, 24˚56'11''N latitude and 89˚55'54''E longitude and an altitude of 16.46m) to evaluate the effect of CA approaches on energy use efficiency and a streamlined life cycle greenhouse gas (GHG) emission of wheat production. For this, the conservation tillage practices (strip tillage (ST) and minimum tillage (MT)) were adopted in comparison to the conventional farmers' tillage (CT), with retained a fixed level (30 cm) of residue retention. This study examined the relationship between energy consumption and life cycle greenhouse gas (GHG) emission of wheat cultivation in Jamalpur region of Bangladesh. Standard energy equivalents megajoules (MJ) were used to measure energy from different inputs and output, similarly, the global warming potential values for the 100-year timescale and a standard unit kilogram of carbon dioxide equivalent (kg CO₂eq) was used to estimate direct and indirect GHG emissions from the use of on-farm and off-farm inputs. Farm efficiency analysis tool (FEAT) was used to analyze GHG emission and its intensity. A non-parametric data envelopment (DEA) analysis was used to estimate the optimum energy requirement of wheat production. The results showed that the treatment combination having MT with optimum energy inputs is the best suit for cost-effective, sustainable CA practice in wheat cultivation without compromising with the yield during the dry season. A total of 22045.86 MJ ha⁻¹, 22158.82 MJ ha⁻¹, and 23656.63 MJ ha⁻¹ input energy for the practice of ST, MT, and CT was used in wheat production, and output energy was calculated as 158657.40 MJ ha⁻¹, 162070.55 MJ ha⁻¹, and 149501.58 MJ ha⁻¹, respectively; where energy use efficiency/net energy ratio was found to be 7.20, 7.31 and 6.32. Among these, MT is the most effective practice option taken into account in the wheat production process. The optimum energy requirement was found to be 18236.71 MJ ha⁻¹ demonstrating for the practice of MT that if recommendations are followed, 18.7% of input energy can be saved. The total greenhouse gas (GHG) emission was calculated to be 2288 kgCO₂eq ha⁻¹, 2293 kgCO₂eq ha⁻¹ and 2331 kgCO₂eq ha⁻¹, where GHG intensity is the ratio of kg CO₂eq emission per MJ of output energy produced was estimated to be 0.014 kg CO₂/MJ, 0.014 kg CO₂/MJ and 0.015 kg CO₂/MJ in wheat production. Therefore, CA approaches ST practice with 30 cm residue retention was the most effective GHG mitigation option when the net life cycle GHG emission was considered in wheat production in the silt clay loam soil of Bangladesh. In conclusion, the CA approaches being implemented for wheat production involving MT practice have the potential to mitigate global warming potential in Bangladesh to achieve soil carbon footprint, where the life cycle assessment approach needs to be applied to a more diverse range of wheat-based cropping systems.

Keywords: conservation agriculture and tillage, energy use efficiency, life cycle GHG, Bangladesh

Procedia PDF Downloads 102
280 Marketing and Business Intelligence and Their Impact on Products and Services Through Understanding Based on Experiential Knowledge of Customers in Telecommunications Companies

Authors: Ali R. Alshawawreh, Francisco Liébana-Cabanillas, Francisco J. Blanco-Encomienda

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Collaboration between marketing and business intelligence (BI) is crucial in today's ever-evolving business landscape. These two domains play pivotal roles in molding customers' experiential knowledge. Marketing insights offer valuable information regarding customer needs, preferences, and behaviors. Conversely, BI facilitates data-driven decision-making, leading to heightened operational efficiency, product quality, and customer satisfaction. Customer experiential knowledge (CEK) encompasses customers' implicit comprehension of consumption experiences influenced by diverse factors, including social and cultural influences. This study primarily focuses on telecommunications companies in Jordan, scrutinizing how experiential customer knowledge mediates the relationship between marketing intelligence and business intelligence. Drawing on theoretical frameworks such as the resource-based view (RBV) and service-dominant logic (SDL), the research aims to comprehend how organizations utilize their resources, particularly knowledge, to foster Evolution. Employing a quantitative research approach, the study collected and analyzed primary data to explore hypotheses. Structural equation modeling (SEM) facilitated by Smart PLS software evaluated the relationships between the constructs, followed by mediation analysis to assess the indirect associations in the model. The study findings offer insights into the intricate dynamics of organizational Creation, uncovering the interconnected relationships between business intelligence, customer experiential knowledge-based innovation (CEK-DI), marketing intelligence (MI), and product and service innovation (PSI), underscoring the pivotal role of advanced intelligence capabilities in developing innovative practices rooted in a profound understanding of customer experiences. Furthermore, the positive impact of BI on PSI reaffirms the significance of data-driven decision-making in shaping the innovation landscape. The significant impact of CEK-DI on PSI highlights the critical role of customer experiences in driving an organization. Companies that actively integrate customer insights into their opportunity creation processes are more likely to create offerings that match customer expectations, which drives higher levels of product and service sophistication. Additionally, the positive and significant impact of MI on CEK-DI underscores the critical role of market insights in shaping evolutionary strategies. While the relationship between MI and PSI is positive, the slightly weaker significance level indicates a subtle association, suggesting that while MI contributes to the development of ideas, In conclusion, the study emphasizes the fundamental role of intelligence capabilities, especially artificial intelligence, emphasizing the need for organizations to leverage market and customer intelligence to achieve effective and competitive innovation practices. Collaborative efforts between marketing and business intelligence serve as pivotal drivers of development, influencing customer experiential knowledge and shaping organizational strategies and practices. Future research could adopt longitudinal designs and gather data from various sectors to offer broader insights. Additionally, the study focuses on the effects of marketing intelligence, business intelligence, customer experiential knowledge, and innovation, but other unexamined variables may also influence innovation processes. Future studies could investigate additional factors, mediators, or moderators, including the role of emerging technologies like AI and machine learning in driving innovation.

Keywords: marketing intelligence, business intelligence, product, customer experiential knowledge-driven innovation

Procedia PDF Downloads 32
279 “It’s All in Your Head”: Epistemic Injustice, Prejudice, and Power in the Modern Healthcare System

Authors: David Tennison

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Epistemic injustice, an injustice done to a person specifically in their capacity as a “knower”, is a subtle form of discrimination, yet its effects can be as dehumanizing and damaging as more overt forms of discrimination. The lens of epistemic injustice has, in recent years, been fruitfully applied to the field of healthcare, examining questions of agency, power, credibility and belief in doctor-patient interactions. Contested illness patients (e.g., those with illnesses lacking scientific consensuses such as fibromyalgia (FM), Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS) and Long Covid) face higher levels of scrutiny than other patient groups and are often disbelieved or dismissed when their ailments cannot be easily imaged or tested for- often encapsulated by the expression “it’s all in your head”. Using the case study of FM, the trials of contested illness patients in healthcare can be conceptualized in terms of epistemic injustice, and what is going wrong in these doctor-patient relationships can be effectively diagnosed. This case study also helps reveal epistemic dysfunction (structural epistemic issues embedded in the healthcare system), how this relates to stigma identity-based prejudice, and how the healthcare system upholds existing societal hierarchies and disenfranchises the most vulnerable. In the modern landscape, where cases of these chronic illnesses are not only on the rise but future pandemics threaten to add to their number, this conversation is crucial for the well-being of patients and providers. This presentation will cover what epistemic injustice is and how it can be applied to the politics of the doctor-patient interaction on a micro level and the politics of the healthcare system more broadly. Contested illnesses will be explored in terms of how the “contested” label causes the patient to experience disease stigma and lowers their credibility in healthcare and across other aspects of life. This will be explored in tandem with a discussion of existing identity-based prejudice in the healthcare system and how social identities (such as those of gender, race, and socioeconomic status) intersect with the contested illness label. The effects of epistemic injustice, which include worsening patients’ symptoms of mental health and potentially disenfranchising them from the healthcare system altogether, will be presented alongside the potential ethical quandaries this poses for providers. Finally, issues with the way healthcare appointments and the modern NHS function will be explored in terms of epistemic injustice and solutions to improve doctor-patient communication and patient care will be discussed. The relationship between contested illness patients and healthcare providers is notoriously poor, and while this can mean frustration or feelings of unfulfillment in providers, the negative effects for patients are much more severe. The purpose of this research, then, is to highlight these issues and suggest ways in which to improve the healthcare experience for these patients, along with improving doctor-patient communication and mending the doctor-patient relationship in a tangible and realistic way. This research also aims to provoke important conversations about belief and hierarchy in medical settings and how these aspects intersect with identity prejudices.

Keywords: epistemic injustice, fibromyalgia, contested illnesses, chronic illnesses, doctor-patient relationships, philosophy of medicine

Procedia PDF Downloads 60
278 Physical Activity Based on Daily Step-Count in Inpatient Setting in Stroke and Traumatic Brain Injury Patients in Subacute Stage Follow Up: A Cross-Sectional Observational Study

Authors: Brigitte Mischler, Marget Hund, Hilfiker Roger, Clare Maguire

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Background: Brain injury is one of the main causes of permanent physical disability, and improving walking ability is one of the most important goals for patients. After inpatient rehabilitation, most do not receive long-term rehabilitation services. Physical activity is important for the health prevention of the musculoskeletal system, circulatory system and the psyche. Objective: This follow-up study measured physical activity in subacute patients after traumatic brain injury and stroke. The difference in the number of steps in the inpatient setting was compared to the number of steps 1 year after the event in the outpatient setting. Methods: This follow-up study is a cross-sectional observational study with 29 participants. The measurement of daily step count over a seven-day period one year after the event was evaluated with the StepWatch™ ankle sensor. The number of steps taken one year after the event in the outpatient setting was compared with the number of steps taken during the inpatient stay and evaluated if they reached the recommended target value. Correlations between steps-count and exit domain, FAC level, walking speed, light touch, joint position sense, cognition, and fear of falling were calculated. Results: The median (IQR) daily step count of all patients was 2512 (568.5, 4070.5). During follow-up, the number of steps improved to 3656(1710,5900). The average difference was 1159(-2825, 6840) steps per day. Participants who were unable to walk independently (FAC 1) improved from 336(5-705) to 1808(92, 5354) steps per day. Participants able to walk with assistance (FAC 2-3) walked 700(31-3080) and at follow-up 3528(243,6871). Independent walkers (FAC 4-5) walked 4093(2327-5868) and achieved 3878(777,7418) daily steps at follow-up. This value is significantly below the recommended guideline. Step-count at follow-up showed moderate to high and statistically significant correlations: positive for FAC score, positive for FIM total score, positive for walking speed, and negative for fear of falling. Conclusions: Only 17% of all participants achieved the recommended daily step count one year after the event. We need better inpatient and outpatient strategies to improve physical activity. In everyday clinical practice, pedometers and diaries with objectives should be used. A concrete weekly schedule should be drawn up together with the patient, relatives, or nursing staff after discharge. This should include daily self-training, which was instructed during the inpatient stay. A good connection to social life (professional connection or a daily task/activity) can be an important part of improving daily activity. Further research should evaluate strategies to increase daily step counts in inpatient settings as well as in outpatient settings.

Keywords: neurorehabilitation, stroke, traumatic brain injury, steps, stepcount

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277 Premature Departure of Active Women from the Working World: One Year Retrospective Study in the Tunisian Center

Authors: Lamia Bouzgarrou, Amira Omrane, Malika Azzouzi, Asma Kheder, Amira Saadallah, Ilhem Boussarsar, Kamel Rejeb

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Introduction: Increasing the women’s labor force participation is a political issue in countries with developed economies and those with low growth prospects. However, in the labor market, women continue to face several obstacles, either for the integration or for the maintenance at work. This study aims to assess the prevalence of premature withdrawal from working life -due to invalidity or medical justified early retirement- among active women in the Tunisian center and to identify its determinants. Material and methods: We conducted a cross-sectional study, over one year, focusing on the agreement for invalidity or early retirement for premature usury of the body- delivered by the medical commission of the National Health Insurance Fund (CNAM) in the central Tunisian district. We exhaustively selected women's files. Data related to Socio-demographic characteristics, professional and medical ones, were collected from the CNAM's administrative and medical files. Results: During the period of one year, 222 women have had an agreement for premature departure of their professional activity. Indeed, 149 women (67.11%) benefit of from invalidity agreement and 20,27% of them from favorable decision for early retirement. The average age was 50 ± 6 years with extremes of 23 and 62 years, and 18.9% of women were under 45 years. Married women accounted for 69.4% and 59.9% of them had at least one dependent child in charge. The average professional seniority in the sector was 23 ± 8 years. The textile-clothing sector was the most affected, with 70.7% of premature departure. Medical reasons for withdrawal from working life were mainly related to neuro-degenerative diseases in 46.8% of cases, rheumatic ones in 35.6% of cases and cardiovascular diseases in 22.1% of them. Psychiatric and endocrine disorders motivated respectively 17.1% and 13.5% of these departures. The evaluation of the sequels induced by these pathologies concluded to an average permanent partial disability equal to 61.4 ± 17.3%. The analytical study concluded that the agreement of disability or early retirement was correlated with the insured ‘age (p = 10-3), the professional seniority (p = 0.003) and the permanent partial incapacity (PPI) rate assessed by the expert physician (p = 0.04). No other social or professional factors were correlated with this decision. Conclusion: Despite many advances in labour law and Tunisian legal text on employability, women still exposed to several social and professional inequalities (payment inequality, precarious work ...). Indeed, women are often pushed to accept working in adverse conditions, thus they are more vulnerable to develop premature wear on the body and being forced to premature departures from the world of work. These premature withdrawals from active life are not only harmful to the concerned women themselves, but also associated with considerable costs for the insurance organism and the society. In order to ensure maintenance at work for women, a political commitment is imperative in the implementation of global prevention strategies and the improvement of working conditions, particularly in our socio-cultural context.

Keywords: Active Women , Early Retirement , Invalidity , Maintenance at Work

Procedia PDF Downloads 152
276 Association between Physical Inactivity and Sedentary Behaviours with Risk of Hypertension among Sedentary Occupation Workers: A Cross-Sectional Study

Authors: Hanan Badr, Fahad Manee, Rao Shashidhar, Omar Bayoumy

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Introduction: Hypertension is the major risk factor for cardiovascular diseases and stroke and a universe leading cause of disability-adjusted life years and mortality. Adopting an unhealthy lifestyle is thought to be associated with developing hypertension regardless of predisposing genetic factors. This study aimed to examine the association between recreational physical activity (RPA), and sedentary behaviors with a risk of hypertension among ministry employees, where there is no role for occupational physical activity (PA), and to scrutinize participants’ time spent in RPA and sedentary behaviors on the working and weekend days. Methods: A cross-sectional study was conducted among randomly selected 2562 employees working at ten randomly selected ministries in Kuwait. To have a representative sample, the proportional allocation technique was used to define the number of participants in each ministry. A self-administered questionnaire was used to collect data about participants' socio-demographic characteristics, health status, and their 24 hours’ time use during a regular working day and a weekend day. The time use covered a list of 20 different activities practiced by a person daily. The New Zealand Physical Activity Questionnaire-Short Form (NZPAQ-SF) was used to assess the level of RPA. The scale generates three categories according to the number of hours spent in RPA/week: relatively inactive, relatively active, and highly active. Gender-matched trained nurses performed anthropometric measurements (weight and height) and measuring blood pressure (two readings) using an automatic blood pressure monitor (95% accuracy level compared to a calibrated mercury sphygmomanometer). Results: Participants’ mean age was 35.3±8.4 years, with almost equal gender distribution. About 13% of the participants were smokers, and 75% were overweight. Almost 10% reported doctor-diagnosed hypertension. Among those who did not, the mean systolic blood pressure was 119.9±14.2 and the mean diastolic blood pressure was 80.9±7.3. Moreover, 73.9% of participants were relatively physically inactive and 18% were highly active. Mean systolic and diastolic blood pressure showed a significant inverse association with the level of RPA (means of blood pressure measures were: 123.3/82.8 among relatively inactive, 119.7/80.4 among relatively active, and 116.6/79.6 among highly active). Furthermore, RPA occupied 1.6% and 1.8% of working and weekend days, respectively, while sedentary behaviors (watching TV, using electronics for social media or entertaining, etc.) occupied 11.2% and 13.1%, respectively. Sedentary behaviors were significantly associated with high levels of systolic and diastolic blood pressure. Binary logistic regression revealed that physical inactivity (OR=3.13, 95% CI: 2.25-4.35) and sedentary behaviors (OR=2.25, CI: 1.45-3.17) were independent risk factors for high systolic and diastolic blood pressure after adjustment for other covariates. Conclusions: Physical inactivity and sedentary lifestyle were associated with a high risk of hypertension. Further research to examine the independent role of RPA in improving blood pressure levels and cultural and occupational barriers for practicing RPA are recommended. Policies should be enacted in promoting PA in the workplace that might help in decreasing the risk of hypertension among sedentary occupation workers.

Keywords: physical activity, sedentary behaviors, hypertension, workplace

Procedia PDF Downloads 178
275 Internet of Assets: A Blockchain-Inspired Academic Program

Authors: Benjamin Arazi

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Blockchain is the technology behind cryptocurrencies like Bitcoin. It revolutionizes the meaning of trust in the sense of offering total reliability without relying on any central entity that controls or supervises the system. The Wall Street Journal states: “Blockchain Marks the Next Step in the Internet’s Evolution”. Blockchain was listed as #1 in Linkedin – The Learning Blog “most in-demand hard skills needed in 2020”. As stated there: “Blockchain’s novel way to store, validate, authorize, and move data across the internet has evolved to securely store and send any digital asset”. GSMA, a leading Telco organization of mobile communications operators, declared that “Blockchain has the potential to be for value what the Internet has been for information”. Motivated by these seminal observations, this paper presents the foundations of a Blockchain-based “Internet of Assets” academic program that joins under one roof leading application areas that are characterized by the transfer of assets over communication lines. Two such areas, which are pillars of our economy, are Fintech – Financial Technology and mobile communications services. The next application in line is Healthcare. These challenges are met based on available extensive professional literature. Blockchain-based assets communication is based on extending the principle of Bitcoin, starting with the basic question: If digital money that travels across the universe can ‘prove its own validity’, can this principle be applied to digital content. A groundbreaking positive answer here led to the concept of “smart contract” and consequently to DLT - Distributed Ledger Technology, where the word ‘distributed’ relates to the non-existence of reliable central entities or trusted third parties. The terms Blockchain and DLT are frequently used interchangeably in various application areas. The World Bank Group compiled comprehensive reports, analyzing the contribution of DLT/Blockchain to Fintech. The European Central Bank and Bank of Japan are engaged in Project Stella, “Balancing confidentiality and auditability in a distributed ledger environment”. 130 DLT/Blockchain focused Fintech startups are now operating in Switzerland. Blockchain impact on mobile communications services is treated in detail by leading organizations. The TM Forum is a global industry association in the telecom industry, with over 850 member companies, mainly mobile operators, that generate US$2 trillion in revenue and serve five billion customers across 180 countries. From their perspective: “Blockchain is considered one of the digital economy’s most disruptive technologies”. Samples of Blockchain contributions to Fintech (taken from a World Bank document): Decentralization and disintermediation; Greater transparency and easier auditability; Automation & programmability; Immutability & verifiability; Gains in speed and efficiency; Cost reductions; Enhanced cyber security resilience. Samples of Blockchain contributions to the Telco industry. Establishing identity verification; Record of transactions for easy cost settlement; Automatic triggering of roaming contract which enables near-instantaneous charging and reduction in roaming fraud; Decentralized roaming agreements; Settling accounts per costs incurred in accordance with agreement tariffs. This clearly demonstrates an academic education structure where fundamental technologies are studied in classes together with these two application areas. Advanced courses, treating specific implementations then follow separately. All are under the roof of “Internet of Assets”.

Keywords: blockchain, education, financial technology, mobile telecommunications services

Procedia PDF Downloads 180
274 Legume Grain as Alternative to Soya Bean Meal in Small Ruminant Diets

Authors: Abidi Sourour, Ben Salem Hichem, Zoghlemi Aziza, Mezni Mejid, Nasri Saida

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In Tunisia, there is an urgent need to maintain food security by reversing soil degradation and improving crop and livestock productivity. Conservation Agriculture (CA) can be helpful in enhancing crop productivity and soil health. However, the demand for crop residues as animal feed are among the major constraints for the adoption of CA. Thus, the objective of this trial is to test the nutritional value of new forage mixture hays as alternative to cereal residues. Two tri-specific cereal-legume mixture were studied and compared to the classic Vetch-Oat one. They were implemented at farm level in four regions characterized by sub-humi climatic: V70-A15-T15 (Vetch70% - Oat15% -Triticale15%) installed in two sites (Zhir and safasaf), V60-A7-T33 (Vetch60% - Oat7% -Triticale33%) and V70-A30 (Vetch70%-Oat30%). Results revealed a significant variation between mixtures V70-A15-T15 installed at Safsafa, recorded the highest forage yield with 12t DM ha-1 than V60A7T33 and V70A30 installed, respectively in ksar cheikh and Fernana with 11.6 and 11.2.tMSha-1. The same mixture installed in Safsafa gave 22% less yields than the one installed in Safsafa. In fact, the month of March was dry in Z'hir. Moreover, these yields in DM can be comparable to those observed by Yucel and Avci (2009). The CP contents of the samples studied vary significantly between the mixtures (P<0.0003). V70-A15-T15 installed in Safsaf and V70A30 present higher contents of CP (respectively 14.4 and 13.7% DM) compared to the other mixtures. These contents are explained by the high proportion of vetch in the fourth mixture and by the low proportion of weeds in the second. In all cases, the hay produced from these mixtures is significantly richer in protein than that of oats in pure culture (Abdelraheem et al., 2019). The positive correlation between the CP content and the proportion of vetch explains this superior quality. The NDF and ADF contents were similar for all mixtures. These values were similar to those reported in the literature (Abidi and Benyoussef, 2019; Haj-Ayed and al., 2000). In general, the Land Equivalent Ratio (LER) was significantly greater than 1 for the vetch-oat-triticale mixture at Zhiir and Safsafa and also for the vetch-oat a at Fernana, proving that they are more productive in intercropping than in pure culture. For the Ksar Cheikh site, the LER value of the vetch-oat-triticale mixture is maintained at around 1. Proving the absence of the advantage of mixture culture compared to pure culture. This proves the massive presence of weeds interferes with the two partners of the mixture increases. The LER for the vetch-oat mixture reached its maximum in March 13 and decreases in April but remained above 1. This proves that the tutoring power of oats showed itself in a constant way until an advanced stage since the variety used is characterized by very thick stems, protecting it from the risk of lodging. These forages mixture present a promising option, a high nutritional quality that could reduce the use of concentrate and, therefore, the cost of feed. With such feed value, these mixtures allow good animal performance.

Keywords: soybean, lupine, vetch, lamb-ADG, meat

Procedia PDF Downloads 89
273 Targeting Apoptosis by Novel Adamantane Analogs as an Emerging Therapy for the Treatment of Hepatocellular Carcinoma Through EGFR, Bcl-2/BAX Cascade

Authors: Hanan M. Hassan, Laila Abouzeid, Lamya H. Al-Wahaibi, George S. G. Shehatou, Ali A. El-Emam

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Cancer is a major public health problem and the second leading cause of death worldwide. In 2020, cancer diagnosis and treatment have been negatively affected by the coronavirus 2019 (COVID-19) pandemic. During the quarantine, because of the limited access to healthcare and avoiding exposure to COVID-19 as a contagious disease; patients of cancer suffered deferments in follow-up and treatment regimens leading to substantial worsening of disease, death, and increased healthcare costs. Thus, this study is designed to investigate the molecular mechanisms by which adamantne derivatives attenuate hepatocllular carcinoma experimentally and theoretically. There is a close association between increased resistance to anticancer drugs and defective apoptosis that considered a causative factor for oncogenesis. Cancer cells use different molecular pathways to inhibit apoptosis, BAX and Bcl-2 proteins have essential roles in the progression or inhibition of intrinsic apoptotic pathways triggered by mitochondrial dysfunction. Therefore, their balance ratio can promote the cellular apoptotic fate. In this study, the in vitro cytotoxic effects of seven synthetic adamantyl isothiorea derivatives were evaluated against five human tumor cell lines by MTT assay. Compounds 5 and 6 showed the best results, mostly against hepatocellular carcinoma (HCC). Hence, in vivo studies were performed in male Sprague-Dawley (SD) rats in which experimental hepatocellular carcinoma was induced with thioacetamide (TAA) (200 mg/kg, i.p., twice weekly) for 16 weeks. The most promising compounds, 5 and 6, were administered to treat liver cancer rats at a dose of 10 mg/kg/day for an additional two weeks, and the effects were compared with doxorubicin (DR), the anticancer drug. Hepatocellular carcinoma was evidenced by a dramatic increase in liver indices, oxidative stress markers, and immunohistochemical studies that were accompanied by a plethora of inflammatory mediators and alterations in the apoptotic cascade. Our results showed that treatment with adamantane derivatives 5 and 6 significantly suppressed fibrosis, inflammation, and other histopathological insults resulting in the diminished formation of hepatocyte tumorigenesis. Moreover, administration of the tested compounds resulted in amelioration of EGFR protein expression, upregulation of BAX, and lessening down of Bcl-2 levels that prove their role as apoptosis inducers. Also, the docking simulations performed for adamantane showed good fit and binding to the EGFR protein through hydrogen bond formation with conservative amino acids, which gives a shred of strong evidence for its hepatoprotective effect. In most analyses, the effects of compound 6 were more comparable to DR than compound 5. Our findings suggest that adamantane derivatives 5 and 6 are shown to have cytotoxic activity against HCC in vitro and in vivo, by more than one mechanism, possibly by inhibiting the TLR4-MyD88-NF-κB pathway and targeting EGFR signaling.

Keywords: adamantane, EGFR, HCC, apoptosis

Procedia PDF Downloads 146
272 Translation, Cross-Cultural Adaption, and Validation of the Vividness of Movement Imagery Questionnaire 2 (VMIQ-2) to Classical Arabic Language

Authors: Majid Alenezi, Abdelbare Algamode, Amy Hayes, Gavin Lawrence, Nichola Callow

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The purpose of this study was to translate and culturally adapt the Vividness of Movement Imagery Questionnaire-2 (VMIQ-2) from English to produce a new Arabic version (VMIQ-2A), and to evaluate the reliability and validity of the translated questionnaire. The questionnaire assesses how vividly and clearly individuals are able to imagine themselves performing everyday actions. Its purpose is to measure individuals’ ability to conduct movement imagery, which can be defined as “the cognitive rehearsal of a task in the absence of overt physical movement.” Movement imagery has been introduced in physiotherapy as a promising intervention technique, especially when physical exercise is not possible (e.g. pain, immobilisation.) Considerable evidence indicates movement imagery interventions improve physical function, but to maximize efficacy it is important to know the imagery abilities of the individuals being treated. Given the increase in the global sharing of knowledge it is desirable to use standard measures of imagery ability across language and cultures, thus motivating this project. The translation procedure followed guidelines from the Translation and Cultural Adaptation group of the International Society for Pharmacoeconomics and Outcomes Research and involved the following phases: Preparation; the original VMIQ-2 was adapted slightly to provide additional information and simplified grammar. Forward translation; three native speakers resident in Saudi Arabia translated the original VMIQ-2 from English to Arabic, following instruction to preserve meaning (not literal translation), and cultural relevance. Reconciliation; the project manager (first author), the primary translator and a physiotherapist reviewed the three independent translations to produce a reconciled first Arabic draft of VMIQ-2A. Backward translation; a fourth translator (native Arabic speaker fluent in English) translated literally the reconciled first Arabic draft to English. The project manager and two study authors compared the English back translation to the original VMIQ-2 and produced the second Arabic draft. Cognitive debriefing; to assess participants’ understanding of the second Arabic draft, 7 native Arabic speakers resident in the UK completed the questionnaire, and rated the clearness of the questions, specified difficult words or passages, and wrote in their own words their understanding of key terms. Following review of this feedback, a final Arabic version was created. 142 native Arabic speakers completed the questionnaire in community meeting places or at home; a subset of 44 participants completed the questionnaire a second time 1 week later. Results showed the translated questionnaire to be valid and reliable. Correlation coefficients indicated good test-retest reliability. Cronbach’s a indicated high internal consistency. Construct validity was tested in two ways. Imagery ability scores have been found to be invariant across gender; this result was replicated within the current study, assessed by independent-samples t-test. Additionally, experienced sports participants have higher imagery ability than those less experienced; this result was also replicated within the current study, assessed by analysis of variance, supporting construct validity. Results provide preliminary evidence that the VMIQ-2A is reliable and valid to be used with a general population who are native Arabic speakers. Future research will include validation of the VMIQ-2A in a larger sample, and testing validity in specific patient populations.

Keywords: motor imagery, physiotherapy, translation and validation, imagery ability

Procedia PDF Downloads 334
271 Optimization Of Biogas Production Using Co-digestion Feedstocks Via Anaerobic Technologhy

Authors: E Tolufase

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The demand, high costs and health implications of using energy derived from hydrocarbon compound have necessitated the continuous search for alternative source of energy. The World energy market is facing some challenges viz: depletion of fossil fuel reserves, population explosion, lack of energy security, economic and urbanization growth and also, in Nigeria some rural areas still depend largely on wood, charcoal, kerosene, petrol among others, as the sources of their energy. To overcome these short falls in energy supply and demand, as well as taking into consideration the risks from global climate change due to effect of greenhouse gas emissions and other pollutants from fossil fuels’ combustion, brought a lot of attention on efficiently harnessing the renewable energy sources. A very promising among the renewable energy resources for a clean energy technology for power production, vehicle and domestic usage is biogas. Therefore, optimization of biogas yield and quality is imperative. Hence, this study investigated yield and quality of biogas using low cost bio-digester and combination of various feed stocks referred to as co-digestion. Batch/Discontinuous Bio-digester type was used because it was cheap, easy, plausible and appropriate for different substrates used to get the desired results. Three substrates were used; cow dung, chicken droppings and lemon grass digested in five separate 21 litre digesters, A, B, C, D, and E and the gas collection system was designed using locally available materials. For single digestion we had; cow dung, chicken droppings, lemon grass, in Bio-digesters A, B, and C respectively, the co-digested three substrates in different mixed ratio 7:1:2 in digester D and E in ratio 5:3:2. The respective feed-stocks materials were collected locally, digested and analyzed in accordance with standard procedures. They were pre-fermented for a period of 10 days before being introduced into the digesters. They were digested for a retention period of 28 days, the physiochemical parameters namely; pressure, temperature, pH, volume of the gas collector system and volume of biogas produced were all closely monitored and recorded daily. The values of pH and temperature ranged 6.0 - 8.0, and 220C- 350C respectively. For the single substrate, bio-digester A(Cow dung only) produced biogas of total volume 0.1607m3(average volume of 0.0054m3 daily),while B (Chicken droppings ) produced 0.1722m3 (average of 0.0057m3 daily) and C (lemon grass) produced 0.1035m3 (average of 0.0035m3 daily). For the co-digested substrates in bio-digester D the total biogas produced was 0.2007m³ (average volume of 0.0067m³ daily) and bio-digester E produced 0.1991m³ (average volume of 0.0066m³ daily) It’s obvious from the results, that combining different substrates gave higher yields than when a singular feed stock was used and also mixing ratio played some roles in the yield improvement. Bio-digesters D and E contained the same substrates but mixed with different ratios, but higher yield was noticed in D with mixing ratio of 7:1:2 than in E with ratio 5:3:2.Therefore, co-digestion of substrates and mixing proportions are important factors for biogas production optimization.

Keywords: anaerobic, batch, biogas, biodigester, digestion, fermentation, optimization

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270 Psychosocial Challenges of Multi-Drug Resistant Tuberculosis (MDR-TB) Patients at St. Peter TB Specialized Hospital in Addis Ababa

Authors: Tamrat Girma Biru

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Multidrug-resistant tuberculosis (MDR-TB) is defined as resistant to at least Refampicin and Isoniazed: the most two power full TB drugs. It is a leading cause of high rates of morbidity and mortality, and increasing psychosocial challenges to patients, especially when co-infected with Human Immunodeficiency Virus (HIV). Ethiopia faces the highest rates of MDR-TB infection in the world. Objectives: The main objective of this study was to identify the psychosocial challenges of MDR-TB patients, to investigate the extent of the psychosocial challenges on (self-esteem, depression, and stigma) that MDR-TB patients encounter, to examine whether there is a sex difference in experiencing psychosocial challenges and assess the counseling needs of MDR-TB patients. Methodology: A cross-sectional study was conducted at St. Peter TB Specialized Hospital, Addis Ababa on 40 patients (25 males and 15 females) who are hospitalized for treatment. The patients were identified by using purposive sampling and made fill a questionnaire measuring their level of self-esteem, depression and stigma. Besides, data were collected from 16 participants, 28 care providers and 8 guardians, using semi-structured interview. The obtained data were analyzed using SPSS statistical program, descriptive statistics, independent t-test, and qualitative description. Results and Discussion: The results of the study showed that the majority (80%) of the respondents had suffered psychological challenges and social discriminations. Thus, the significance of MDR-TB and its association with HIV/AIDS problems is considered. Besides the psychosocial challenges, various aggravating factors such as length of treatment, drug burden and insecurity in economy together highly challenges the life of patients. In addition, 60% of participants showed low level of self-esteem. The patients also reported that they experienced high self-stigma and stigma by other members of the society. The majority of the participants (75%) showed moderate and severe level of depression. In terms of sex there is no difference between the mean scores of males and females in the level of depression and stigmatization by others and by themselves. But females showed lower level of self-esteem than males. The analysis of the t-test also shows that there were no statistically significant sex difference on the level of depression and stigma. Based on the qualitative data MDR-TB patients face various challenges in their life sphere such as: Psychological (depression, low self value, lowliness, anxiety), social (stigma, isolation from social relations, self-stigmatization,) and medical (drug side effect, drug toxicity, drug burden, treatment length, hospital stays). Recommendations: Based on the findings of this study possible recommendations were forwarded: develop and extend MDR-TB disease awareness creation through by media (printing and electronic), school net TB clubs, and door to door community education. Strengthen psychological wellbeing and social relationship of MDR-TB patients using proper and consistent psychosocial support and counseling. Responsible bodies like Ministry of Health (MOH) and its stakeholders and Non Governmental Organizations (NGOs) need to assess the challenges of patients and take measures on this pressing issue.

Keywords: psychosocial challenges, counseling, multi-drug resistant tuberculosis (MDR-TB), tuberculosis therapy

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269 Defense Priming from Egg to Larvae in Litopenaeus vannamei with Non-Pathogenic and Pathogenic Bacteria Strains

Authors: Angelica Alvarez-Lee, Sergio Martinez-Diaz, Jose Luis Garcia-Corona, Humberto Lanz-Mendoza

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World aquaculture is always looking for improvements to achieve productions with high yields avoiding the infection by pathogenic agents. The best way to achieve this is to know the biological model to create alternative treatments that could be applied in the hatcheries, which results in greater economic gains and improvements in human public health. In the last decade, immunomodulation in shrimp culture with probiotics, organic acids and different carbon sources has gained great interest, mainly in larval and juvenile stages. Immune priming is associated with a strong protective effect against a later pathogen challenge. This work provides another perspective about immunostimulation from spawning until hatching. The stimulation happens during development embryos and generates resistance to infection by pathogenic bacteria. Massive spawnings of white shrimp L. vannamei were obtained and placed in experimental units with 700 mL of sterile seawater at 30 °C, salinity of 28 ppm and continuous aeration at a density of 8 embryos.mL⁻¹. The immunostimulating effect of three death strains of non-pathogenic bacterial (Escherichia coli, Staphylococcus aureus and Bacillus subtilis) and a pathogenic strain for white shrimp (Vibrio parahaemolyticus) was evaluated. The strains killed by heat were adjusted to O.D. 0.5, at A 600 nm, and directly added to the seawater of each unit at a ratio of 1/100 (v/v). A control group of embryos without inoculum of dead bacteria was kept under the same physicochemical conditions as the rest of the treatments throughout the experiment and used as reference. The duration of the stimulus was 12 hours, then, the larvae that hatched were collected, counted and transferred to a new experimental unit (same physicochemical conditions but at a salinity of 28 ppm) to carry out a challenge of infection against the pathogen V. parahaemolyticus, adding directly to seawater an amount 1/100 (v/v) of the live strain adjusted to an OD 0.5; at A 600 nm. Subsequently, 24 hrs after infection, nauplii survival was evaluated. The results of this work shows that, after 24 hrs, the hatching rates of immunostimulated shrimp embryos with the dead strains of B. subtillis and V. parahaemolyticus are significantly higher compared to the rest of the treatments and the control. Furthermore, survival of L. vanammei after a challenge of infection of 24 hrs against the live strain of V. parahaemolyticus is greater (P < 0.05) in the larvae immunostimulated during the embryonic development with the dead strains B. subtillis and V. parahaemolyticus, followed by those that were treated with E. coli. In summary superficial antigens can stimulate the development cells to promote hatching and can have normal development in agreeing with the optical observations, plus exist a differential response effect between each treatment post-infection. This research provides evidence of the immunostimulant effect of death pathogenic and non-pathogenic bacterial strains in the rate of hatching and oversight of shrimp L. vannamei during embryonic and larval development. This research continues evaluating the effect of these death strains on the expression of genes related to the defense priming in larvae of L. vannamei that come from massive spawning in hatcheries before and after the infection challenge against V. parahaemolyticus.

Keywords: immunostimulation, L. vannamei, hatching, survival

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268 In situ Growth of ZIF-8 on TEMPO-Oxidized Cellulose Nanofibril Film and Coated with Pectin for pH and Enzyme Dual-Responsive Controlled Release Active Packaging

Authors: Tiantian Min, Chuanxiang Cheng, Jin Yue

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The growth and reproduction of microorganisms in food packaging can cause food decay and foodborne diseases, which pose a serious threat to the health of consumers and even cause serious economic losses. Active food packaging containing antibacterial bioactive compounds is a promising strategy for extending the shelf life of products and maintaining the food quality, as well as reducing the food waste. However, most active packaging can only act as slow-release effect for antimicrobials, which causes the release rate of antimicrobials not match the growth rate of microorganisms. Stimuli-responsive active packaging materials based on biopolymeric substrates and bioactive substances that respond to some biological and non-biological trigger factors provide more opportunities for fresh food preservation. The biological stimuli factors such as relative humidity, pH and enzyme existed in the exudate secreted by microorganisms have been expected to design food packaging materials. These stimuli-responsive materials achieved accurate release or delivery of bioactive substances at specific time and appropriate dose. Recently, metal-organic-frameworks (MOFs) nanoparticles become attractive carriers to enhance the efficiency of bioactive compounds or drugs. Cellulose nanofibrils have been widely applied for film substrates due to their biodegradability and biocompatibility. The abundant hydroxyl groups in cellulose can be oxidized to carboxyl groups by TEMPO, making it easier to anchoring MOFs and to be further modification. In this study, a pH and enzyme dual-responsive CAR@ZIF-8/TOCNF/PE film was fabricated by in-situ growth of ZIF-8 nanoparticles onto TEMPO-oxidized cellulose (TOCNF) film and further coated with pectin (PE) for stabilization and controlled release of carvacrol (CAR). The enzyme triggered release of CAR was achieved owing to the degradation of pectin by pectinase secreted by microorganisms. Similarly, the pH-responsive release of CAR was attributed to the unique skeleton degradation of ZIF-8, further accelerating the release of CAR from the topological structure of ZIF-8. The composite film performed excellent crystallinity and adsorb ability confirmed by X-ray diffraction and BET analysis, and the inhibition efficiency against Escherichia coli, Staphylococcus aureus and Aspergillus niger reached more than 99%. The composite film was capable of releasing CAR when exposure to dose-dependent enzyme (0.1, 0.2, and 0.3 mg/mL) and acidic condition (pH = 5). When inoculated 10 μL of Aspergillus niger spore suspension on the equatorial position of mango and raspberries, this composite film acted as packaging pads effectively inhibited the mycelial growth and prolonged the shelf life of mango and raspberries to 7 days. Such MOF-TOCNF based film provided a targeted, controlled and sustained release of bioactive compounds for long-term antibacterial activity and preservation effect, which can also avoid the cross-contamination of fruits.

Keywords: active food packaging, controlled release, fruit preservation, in-situ growth, stimuli-responsive

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267 Promoting Compassionate Communication in a Multidisciplinary Fellowship: Results from a Pilot Evaluation

Authors: Evonne Kaplan-Liss, Val Lantz-Gefroh

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Arts and humanities are often incorporated into medical education to help deepen understanding of the human condition and the ability to communicate from a place of compassion. However, a gap remains in our knowledge of compassionate communication training for postgraduate medical professionals (as opposed to students and residents); how training opportunities include and impact the artists themselves, and how train-the-trainer models can support learners to become teachers. In this report, the authors present results from a pilot evaluation of the UC San Diego Health: Sanford Compassionate Communication Fellowship, a 60-hour experiential program that uses theater, narrative reflection, poetry, literature, and journalism techniques to train a multidisciplinary cohort of medical professionals and artists in compassionate communication. In the culminating project, fellows design and implement their own projects as teachers of compassionate communication in their respective workplaces. Qualitative methods, including field notes and 30-minute Zoom interviews with each fellow, were used to evaluate the impact of the fellowship. The cohort included both artists (n=2) and physicians representing a range of specialties (n=7), such as occupational medicine, palliative care, and pediatrics. The authors coded the data using thematic analysis for evidence of how the multidisciplinary nature of the fellowship impacted the fellows’ experiences. The findings show that the multidisciplinary cohort contributed to a greater appreciation of compassionate communication in general. Fellows expressed that the ability to witness how those in different fields approached compassionate communication enhanced their learning and helped them see how compassion can be expressed in various contexts, which was both “exhilarating” and “humbling.” One physician expressed that the fellowship has been “really helpful to broaden my perspective on the value of good communication.” Fellows shared how what they learned in the fellowship translated to increased compassionate communication, not only in their professional roles but in their personal lives as well. A second finding was the development of a supportive community. Because each fellow brought their own experiences and expertise, there was a sense of genuine ability to contribute as well as a desire to learn from others. A “brave space” was created by the fellowship facilitators and the inclusion of arts-based activities: a space that invited vulnerability and welcomed fellows to make their own meaning without prescribing any one answer or right way to approach compassionate communication. This brave space contributed to a strong connection among the fellows and reports of increased well-being, as well as multiple collaborations post-fellowship to carry forward compassionate communication training at their places of work. Results show initial evidence of the value of a multidisciplinary fellowship for promoting compassionate communication for both artists and physicians. The next steps include maintaining the supportive fellowship community and collaborations with a post-fellowship affiliate faculty program; scaling up the fellowship with non-physicians (e.g., nurses and physician assistants); and collecting data from family members, colleagues, and patients to understand how the fellowship may be creating a ripple effect outside of the fellowship through fellows’ compassionate communication.

Keywords: compassionate communication, communication in healthcare, multidisciplinary learning, arts in medicine

Procedia PDF Downloads 69
266 Symptomatic Strategies: Artistic Approaches Resembling Psychiatric Symptoms

Authors: B. Körner

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This paper compares deviant behaviour in two different readings: 1) as symptomatic for so-called ‘mental illness’ and 2) as part of artistic creation. It analyses works of performance art in the respective frames of psychiatric evaluation and performance studies. This speculative comparison offers an alternative interpretation of mad behaviour beyond pathologisation. It questions the distinction of psychiatric diagnosis, which can contribute to reducing the stigmatisation of mad people. The stigma associated with madness entails exclusion, prejudice, and systemic oppression. Symptoms of psychiatric diagnoses can be considered as behaviour exceptional to the psychological norm. This deviant behaviour constitutes an outsider role which is also defining for the societal role of ‘the artist’, whose transgressions of the norm are expected and celebrated. The research proposes the term ‘artistic exceptionalism’ for this phenomenon. In this study, a set of performance artworks are analysed within the frame of an art-theoretical interpretation and as if they were the basis of a psychiatric assessment. This critical comparison combines the perspective on ‘mental illness’ of mad studies with methods of interpretation used in performance studies. The research employs auto theory and artistic research; interweaving lived experience with scientific theory building through the double role of the author as both performance artist and survivor researcher. It is a distinctly personal and mad thought experiment. The research proposes three major categories of artistic strategies approaching madness: (a) confronting madness (processing and publicly addressing one's own experiences with mental distress through artistic creation), (b) creating critical conditions (conscious or unconscious, voluntary or involuntary creation of crisis situations in order to create an intense experience for a work of art), and (c) symptomatic strategies. This paper focuses on the last of the three categories: symptomatic strategies. These can be described as artistic methods with parallels to forms of coping with and/or symptoms of ‘mental disorders.’ These include, for example feverish activity, a bleak worldview, additional perceptions, an urge for order, and the intensification of emotional experience. The proposed categories are to be understood as a spectrum of approaches that are not mutually exclusive. This research does not aim to diagnose or pathologise artists or their strategies; disease value is neither sought nor assumed. Neither does it intend to belittle psychological suffering, implying that it cannot be so bad if it is productive for artists. It excludes certain approaches that romanticise and/or exoticise mental distress, for example, artistic portrayal of people in mental crisis (e.g., documentary-observational or exoticising depictions) or the deliberate and exaggerated imitation of their forms of expression and behaviour as ‘authentic’ (e.g., Art Brut). These are based on the othering of the Mad and thus perpetuate the social stigma to which they are subjected. By noting that the same deviant behaviour can be interpreted as the opposite in different contexts, this research offers an alternative approach to madness beyond the confines of psychiatry. It challenges the distinction of psychiatric diagnosis and exposes its social constructedness. Hereby, it aims to empower survivors and reduce the stigmatisation of madness.

Keywords: artistic research, mad studies, mental health, performance art, psychiatric stigma

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265 Antifungal Activity of Processed Sulfur Solution as Potential Eco-Friendly Disinfectant against Saprolegnia parasitica and Its Safety in Freshwater-Farmed Fish

Authors: Hye-Hyun Lee, Hyo-Kon Chun, Kyung-Hee Kim Kim, Mi-Hee Kim, Saet-Byul Chu, Sang-Jong Lee, Seung-Hyeop Lee, Seung-Won Yi

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Some chemicals such as malachite green, methylene blue, and copper sulfate had been used frequently as disinfectants controlling fungal infection in aquaculture. However, their carcinogenicity, mutagenicity and teratogenicity were reported in mammals. After their accumulation in food fish and its consumers was confirmed, concerns about public health has resulted in enhanced monitoring and increased demand for eco-friendly treatments. Therefore, this study aimed to evaluate safety to fish and efficacy of sulfur solution processed by effective microorganisms (EM-PSS) against Saprolegnia parasitica, for use of a potential aquatic fungicidal disinfectant. The natural sulfur purchased from Kawah Ijen volcano, East Java, Indonesia was processed by the liquid mixture consisting of following twelve effective microorganisms (Rapha-el®; Lbiotech, Jeonnam, Korea), Lactobacillus parafarraginis, L. paracasei, L. harbinensis, L. buchneri, L. perolens, L. rhamnosus, L. vaccinostercus, Acetobacter lovaniensis, A. peroxydans, Pichia fermentans, Candida ethanolica, Saccharomycopsis schoenii isolated from fermentation process of oriental medicinal herbs including green tea, privet, and puer tea. The material was applied to in vitro antifungal activity test for Saprolegnia parasitica using agar dilution method. In addition, an acute toxicity test was performed on carp (Cyprinus carpio), eel (Anguilla japonica), and mud fish (Misgurnus mizolepis) for 96 hours. After three species of fish (n=15) were accustomed to experimental water environment for three days, the EM-PSS was added to each tank as final concentrations to be 0 to 500 ppm. The fish were taken into necropsy, and the histological sections of the gill, liver, and spleen were counter-stained with hematoxylin and eosin (H-E). And hence, no observed effect concentration (NOEC) of the solution was used for taking a medicinal bath for mudfish infected by Saprolegnia parasitica in practice. The result of in vitro antifungal activity test showed the growth inhibition of the fungus at 100 ppm, which and the lower concentrations occurred no fatal case in any fish species tested until the end of the examination. The 125 ppm of the solution, however, resulted in 13.3 %, 13.3 %, and 6.3 % of mortality in carp, eel, and mudfish, respectively. But both 250 and 500 ppm of the solution leaded lethality to all population of each fish species within 24 hours. Besides, H-E staining also showed no specific evidence for toxicity in fish at lesser than 100 ppm of EM-PSS. On the other hand, as a result of field application of the solution, no growth of fungal mycelium was found in fish bodies from gross observation 5 days post treatment. In conclusion, 100ppm of EM-PSS resulted in inhibition and treatment of Saprolegnia parasitica infection. In addition, the use of EM-PSS lower than 100 ppm is safe for fish. Therefore, EM-PSS could be used as aquatic fungicide, and also may be possible to be a potential eco-friendly disinfectant in aquaculture.

Keywords: antifungal activity, effective microorganism, toxicity, saprolegnia, processed sulfur solution

Procedia PDF Downloads 255
264 Wood Dust and Nanoparticle Exposure among Workers during a New Building Construction

Authors: Atin Adhikari, Aniruddha Mitra, Abbas Rashidi, Imaobong Ekpo, Jefferson Doehling, Alexis Pawlak, Shane Lewis, Jacob Schwartz

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Building constructions in the US involve numerous wooden structures. Woods are routinely used in walls, framing floors, framing stairs, and making of landings in building constructions. Cross-laminated timbers are currently being used as construction materials for tall buildings. Numerous workers are involved in these timber based constructions, and wood dust is one of the most common occupational exposures for them. Wood dust is a complex substance composed of cellulose, polyoses and other substances. According to US OSHA, exposure to wood dust is associated with a variety of adverse health effects among workers, including dermatitis, allergic respiratory effects, mucosal and nonallergic respiratory effects, and cancers. The amount and size of particles released as wood dust differ according to the operations performed on woods. For example, shattering of wood during sanding operations produces finer particles than does chipping in sawing and milling industries. To our knowledge, how shattering, cutting and sanding of woods and wood slabs during new building construction release fine particles and nanoparticles are largely unknown. General belief is that the dust generated during timber cutting and sanding tasks are mostly large particles. Consequently, little attention has been given to the generated submicron ultrafine and nanoparticles and their exposure levels. These data are, however, critically important because recent laboratory studies have demonstrated cytotoxicity of nanoparticles on lung epithelial cells. The above-described knowledge gaps were addressed in this study by a novel newly developed nanoparticle monitor and conventional particle counters. This study was conducted in a large new building construction site in southern Georgia primarily during the framing of wooden side walls, inner partition walls, and landings. Exposure levels of nanoparticles (n = 10) were measured by a newly developed nanoparticle counter (TSI NanoScan SMPS Model 3910) at four different distances (5, 10, 15, and 30 m) from the work location. Other airborne particles (number of particles/m3) including PM2.5 and PM10 were monitored using a 6-channel (0.3, 0.5, 1.0, 2.5, 5.0 and 10 µm) particle counter at 15 m, 30 m, and 75 m distances at both upwind and downwind directions. Mass concentration of PM2.5 and PM10 (µg/m³) were measured by using a DustTrak Aerosol Monitor. Temperature and relative humidity levels were recorded. Wind velocity was measured by a hot wire anemometer. Concentration ranges of nanoparticles of 13 particle sizes were: 11.5 nm: 221 – 816/cm³; 15.4 nm: 696 – 1735/cm³; 20.5 nm: 879 – 1957/cm³; 27.4 nm: 1164 – 2903/cm³; 36.5 nm: 1138 – 2640/cm³; 48.7 nm: 938 – 1650/cm³; 64.9 nm: 759 – 1284/cm³; 86.6 nm: 705 – 1019/cm³; 115.5 nm: 494 – 1031/cm³; 154 nm: 417 – 806/cm³; 205.4 nm: 240 – 471/cm³; 273.8 nm: 45 – 92/cm³; and 365.2 nm: Keywords: wood dust, industrial hygiene, aerosol, occupational exposure

Procedia PDF Downloads 189