Search results for: comprehensive emergency care and life support

Authors: Teresa Leary Handy

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As awareness of the importance of diversity has increased in society, higher education has also begun to recognize the importance of supporting faculty of color. In the university setting, faculty women of color specifically encounter barriers that impact their level of job satisfaction, retention rates, and pedagogical practices. These barriers and challenges not only undermine faculty diversity efforts but also hinder the ability of colleges and universities to provide a supportive environment that fosters students' academic success and sense of belonging. Faculty who are marginalized and on the periphery in higher education institutions need support so that they can feel confident in building a student’s sense of belonging which can impact a student’s academic success and goal of earning a college degree. This study examined and sought to understand the importance of supporting faculty of color, specifically women faculty of color, and how this type of faculty support can impact student academic success and a student’s sense of belonging. The study furthered original research on strategies to move an institution forward on the equity spectrum to support belonging and inclusions as core culture elements.

Keywords: equity, inclusion, belonging, women, faculty support

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Authors: Chirag Kothawade, Gourie Jagtap, PreetKaur Relusinghani, Vedang Chavan, Smitha S. Bhosale

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Psychological research has proven that music relieves stress, elevates mood, and is responsible for the release of “feel-good” chemicals like oxytocin, serotonin, and dopamine. It comes as no surprise that music has been a popular tool in rehabilitation centers and therapy for various disorders, thus with the interminably rising numbers of people facing mental health-related issues across the globe, addressing mental health concerns is more crucial than ever. Despite the existing music recommendation systems, there is a dearth of holistically curated algorithms that take care of the needs of users. Given that, an undeniable majority of people turn to music on a regular basis and that music has been proven to increase cognition, memory, and sleep quality while reducing anxiety, pain, and blood pressure, it is the need of the hour to fashion a product that extracts all the benefits of music in the most extensive and deployable method possible. Our project aims to ameliorate our users’ mental state by building a comprehensive mood-based music recommendation system called “Viby”.

Keywords: language, communication, speech recognition, interaction

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Authors: Florenda B. Cardinoza

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This study was conducted to determine the determinants of Grade III and grade VI pupils’ performance in the National Achievement Test in the Division of Cavite City, School Year 2011-2012. Specifically, the research aimed to: (1) describe the demographic profile of the respondents in terms of age, sex, birth order, family size, family income, and occupation of parents; (2) determine the level of attitude towards NAT; and (3) describe the degree of relationship between the following variables: school support, teachers’ support, and lastly family support for the pupils’ performance in 2012 NAT. The study used the descriptive-correlation research method to investigate the determinants of pupils’ performance in the National Achievement Test of Public Elementary Schools in the Division of Cavite City. The instrument used in data gathering was a self-structured survey. The NAT result for SY 2011-2012 provided by NETRC and DepEd Cavite City was also utilized. The statistical tools used to process and analyze the data were frequency distribution, percentage, mean, standard deviation, Kruskall Wallis, Mann-Whitney, t-test for independent samples, One-way ANOVA, and Spearman Rank Correlational Coefficient. Results revealed that there were more female students than males in the Division of Cavite City; out of 659 respondents, 345 were 11 years old and above; 390 were females; 283 were categorized as first child in the family; 371 of the respondents were from small family; 327 had Php5000 and below family income; 450 of the fathers’ respondents were non professionals; and 431 of the mothers respondents had no occupation. The attitude towards NAT, with a mean of 1.65 and SD of .485, shows that respondents considered NAT important. The school support towards NAT, with a mean of 1.89 and SD of .520, shows that respondents received school support. The pupils had a very high attitude towards teachers’ support in NAT with a mean of 1.60 and SD of .572. Family support, with t-test of 16.201 with a p-value of 0.006, shows significant at 5 percent level. Thus, the determinants of pupils’ performance in NAT in terms of family support for NAT preparation is not significant according to their family income. The grade level, with the t-test is 4.420 and a p-value of 0.000, is significant at 5 percent level. Therefore, the determinants of pupils’ performance in NAT in terms of grade level for NAT preparation vary according to their grade level. For the determinants of pupils’ performance of NAT sample test for attitude towards NAT, school support, teachers’ support, and family support were noted highly significant with a p value of 0.000.

Keywords: achievement, determinants, national, performance, public, pupils', test

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Authors: Birgit Reime, Sonja Gscheidle, Toni Hübener, Lara Hübener

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Suicide in individuals under 30 years is a global public health concern. The objective of this study was to identify strategies for the prevention of suicide and suicidal behavior preferred by adolescents and young adults who are vulnerable to suicidal behavior and by relevant experts. Using semi-structured interviews with n= 17 adolescents and young adults (18-25 years of age) and with n= 11 experts from relevant fields, we have applied an inductive approach and applied thematic content analysis. Six strategies for suicide prevention in young individuals were reported. These were digital solutions with appealing designs, anonymous support, trained peer support, spiritual support, improving existing structures, and raising suicide literacy. Accessibility of anonymous digital support may contribute to suicide prevention in young people.

Keywords: suicide prevention, adolescents, E-health, Germany

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Authors: Chuang-Chun Chiou

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In this study, a systematic framework of graceful ageing has been used to explore the possible human resource utilization models for graceful ageing purpose. This framework is based on the Chinese culture. We call ‘Nine-old’ target. They are ageing gracefully with feeding, accomplishment, usefulness, learning, entertainment, care, protection, dignity, and termination. This study is focused on two areas: accomplishment and usefulness. We exam the current practices of initiatives and laws of promoting labor participation. That is to focus on how to increase Labor Force Participation Rate of the middle aged as well as the elderly and try to promote the elderly to achieve graceful ageing. Then we present the possible models that support graceful ageing.

Keywords: human resource utilization model, labor participation, graceful ageing, employment

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Authors: Joana PaScoa Pinheiro, David Goncalves Ferreira, Filipe Ramos, Joaquim Soares Do Brito, Samuel Martins, Marco Sarmento

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Introduction: The SARS-CoV-2 (COVID-19) pandemic was identified in January 2020 in China, in the city of Wuhan. The increase in the number of cases over the following months was responsible for the restructuring of hospitals and departments in order to accommodate admissions related to COVID-19. Essential services, such as trauma, had to readapt to maintain their functionality and thus guarantee quick and safe access in case of an emergency. Objectives: This study describes the impact of COVID-19 on a Level III Trauma Center and particularly on the clinical management of hospitalized patients with spine injuries. Study Design & Methods: This is a retrospective cohort study whose results were obtained through the medical records of patients with spine injuries who underwent surgical intervention in the years 2019 and 2020 (period from March 1st to December 31st). A comparison between the two groups was made. In the study patients with injuries in the context of trauma were included who underwent surgery in the periods previously described. Patients hospitalized with a spine injury in a non-traumatic context and/or were not surgically treated were excluded. Results: In total, 137 patients underwent trauma spine surgery of which 71 in 2019 (51.8%) were without significant differences in intergroup comparisons. The most frequent injury mechanism in 2019 was motor vehicle crash (47.9%) compared to 2020 which was of a person falling from a height between 2-4 meters (37.9%). Cervical trauma was reported to be the most frequent spine injury in both years. There was a significant decrease in the need for intensive care in 2020, 51.4% vs 30.3%, p = .015 and the number of complications was also lower in 2020 (1.35% vs 0.98%), including the number of deaths, being the difference marginally significant. There were no significant differences regarding time for presentation to surgery or in the total days of hospitalization. Conclusions: The restructuring made in the trauma unit at a Level III Trauma Center in the context of the current COVID-19 pandemic was effective, with no significant differences between the years of 2019 vs 2020 when compared with the time for presentation to surgery or the number of days of hospitalization. It was also found that lockdown rules in 2020 were probably responsible for the decrease in the number of road traffic accidents, which justifies a significant decrease in the need for intensive care as well as in the number of complications in patients hospitalized in the context of spine trauma.

Keywords: trauma, spine, impact, covid-19

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Authors: Stacie Nelson Colling, Adele Cummings

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The United States Supreme Court recently announced that it is unconstitutional to sentence a child to life without parole for non-homicide offenses, and that each child so situated must be afforded a meaningful opportunity for release from prison in his lifetime. The Court also declared that it is unconstitutional to impose a mandatory sentence of life without parole on a child for homicide offenses. Across the United States, attorneys and advocates continue to litigate issues surrounding the implementation of these legal principles. Some states have held that any sentence to a finite term of years, no matter how long, is not the same as ‘life’ and therefore does not violate the constitution. Other states have held that a sentence to a term of years that is less than the expected life of that particular child is not unconstitutional. In Colorado, the courts have routinely looked to life expectancy estimates from governmental organizations to determine how long a particular child is expected to live. They then compare that the date that the child is expected to be eligible for parole, and if the child is expected to still be living when he is eligible for parole, the sentence is deemed constitutional. This paper argues that it is inappropriate, reckless, unconstitutional and not scientifically sound to use such estimates in determining whether a child will have a meaningful opportunity for release from prison and life outside of prison before he dies. This paper argues that the opportunity for release must mean more than a probability that a child will be released before his death, and that it must include an opportunity for a meaningful life outside of prison (not just the opportunity to be released and then die on the outside). The paper further argues that life expectancy estimates cannot guide a court or a legislature in determining whether a sentence is or is not constitutional.

Keywords: life without parole, life expectancy, juvenile sentencing, meaningful opportunity for release from prison

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Authors: Chien-Lin Wang, Cha-Ling Ko, Tainsong Chen

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Pulse Blood pressure (BP) is one of the vital signs, and is an index that helps determining the stability of life. In this respect, some spinal cord injury patients need to take the tilt table test. While doing the test, the posture changes abruptly, and may cause a patient’s BP to change abnormally. This may cause patients to feel discomfort, and even feel as though their life is threatened. Therefore, if a continuous non-invasive BP assessment system were built, it could help to alert health care professionals in the process of rehabilitation when the BP value is out of range. In our research, BP assessed by the pulse transit time technique was developed. In the system, we use a self-made photoplethysmograph (PPG) sensor and filter circuit to detect two PPG signals and to calculate the time difference. The BP can immediately be assessed by the trend line. According to the results of this study, the relationship between the systolic BP and PTT has a highly negative linear correlation (R2=0.8). Further, we used the trend line to assess the value of the BP and compared it to a commercial sphygmomanometer (Omron MX3); the error rate of the system was found to be in the range of ±10%, which is within the permissible error range of a commercial sphygmomanometer. The continue blood pressure measurement from pulse transit time technique may have potential to become a convenience method for clinical rehabilitation.

Keywords: continous blood pressure measurement, PPG, time transit time, transit velocity

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Authors: Shannon Hearney, Jeffrey Hoch

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While all cancers are costly to treat, pancreatic cancer is a notoriously costly and deadly form of cancer. Across the world there are a variety of treatment centers ranging from small clinics to large, high-volume hospitals as well as differing structures of payment and access. It has been noted that centers that treat a high volume of pancreatic cancer patients have higher quality of care, it is unclear if that care is cost-effective. In the US there is no clear consensus on the cost-effectiveness of high-volume centers for the surgical care of pancreatic cancer. Other European countries, like Finland and Italy have shown that high-volume centers have lower mortality rates and can have lower costs, there however, is still a gap in knowledge about these centers cost-effectiveness globally. This paper seeks to review the current literature in Europe and the US to gain a better understanding of the state of high-volume pancreatic surgical centers cost-effectiveness while considering the contextual differences in health system structure. A review of major reference databases such as Medline, Embase and PubMed will be conducted for cost-effectiveness studies on the surgical treatment of pancreatic cancer at high-volume centers. Possible MeSH terms to be included, but not limited to, are: “pancreatic cancer”, “cost analysis”, “cost-effectiveness”, “economic evaluation”, “pancreatic neoplasms”, “surgical”, “Europe” “socialized medicine”, “privatized medicine”, “for-profit”, and “high-volume”. Studies must also have been available in the English language. This review will encompass European scientific literature, as well as those in the US. Based on our preliminary findings, we anticipate high-volume hospitals to provide better care at greater costs. We anticipate that high-volume hospitals may be cost-effective in different contexts depending on the national structure of a healthcare system. Countries with more centralized and socialized healthcare may yield results that are more cost-effective. High-volume centers may differ in their cost-effectiveness of the surgical care of pancreatic cancer internationally especially when comparing those in the United States to others throughout Europe.

Keywords: cost-effectiveness analysis, economic evaluation, pancreatic cancer, scientific literature review

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Authors: Harmeet Pal Singh Dhooria, Deepinder Chinna, UPS Sidhu, Alok Jain

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Serious infections caused by gram-negative bacteria are a significant cause of mortality and morbidity in the hospital setting. In acute care facilities like in intensive care units (ICUs), the intensity of antimicrobial use together with a population highly susceptible to infection, creates an environment, which facilitates both emergence and transmission of Extended Spectrum -lactamase (ESBL) producing Enterobacteriaceae species. The study was conducted in the Medical Intensive Care Unit (MICU) and the Pulmonary Critical Care Unit (PCCU) of the Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. Out of a total of 1108 samples of urine, blood and respiratory tract secretions received for culture and sensitivity analysis from Medical Intensive Care Unit and Pulmonary Critical Care Unit, a total of 170 isolates of Enterobacteriaceae species were obtained which were then included in our study. Out of these 170 isolates, confirmed ESBL production was seen in 116 (68.24%) cases. E.coli was the most common species isolated (56.47%) followed by Klebsiella (32.94%), Enterobacter (5.88%), Citrobacter (3.53%), Enterobacter (0.59%) and Morganella (0.59%) among the total isolates. The rate of ESBL production was more in Klebsiella (78.57%) as compared to E.coli (60.42%). ESBL producers were found to be significantly more common in patients with prior history of hospitalization, antibiotic use, and prolonged ICU stay. Also significantly increased the prevalence of ESBL related infections was observed in patients with a history of catheterization or central line insertion but not in patients with the history of intubation. Patients who had an underlying malignancy had significantly higher prevalence of ESBL related infections as compared to other co-morbid illnesses. A slightly significant difference in the rate of mortality/LAMA was observed in the ESBL producer versus the non-ESBL producer group. The rate of mortality/LAMA was significantly higher in the ESBL related UTI but not in the ESBL related respiratory tract and bloodstream infections. ESBL producing isolates had significantly higher rates of resistance to Cefepime and Piperacillin/Tazobactum, and to non β-lactum antibiotics like Amikacin and Ciprofloxacin. The level of resistance to Imipenem was lower as compared to other antibiotics. However, it was noted that ESBL producing isolates had higher levels of resistance to Imipenem as compared to non-ESBL producing isolates. Conclusion- The prevalence of ESBL producing organisms was found to be very high (68.24%) among Enterobacteriaceae isolates in our ICU setting as among other ICU care settings around the world.

Keywords: enterobacteriaceae, extended spectrum B-lactamase (ESBL), ICU, antibiotic resistance

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Authors: R. Pääkkönen, L. Korpinen, T. Kava, I. Salmi

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This study evaluates obstructive sleep apnea treatment through a case study involving a 67-year-old male driver who had a successful continuous positive airway pressure (CPAP) treatment at home but experienced difficulties with traveling and dental care. There are many cheap sleep apnea and snoring devices available, but there is little professional advice on what kind of devices can help. Professional drivers receive yearly specialized medical care follow-up.

Keywords: sleep, apnea patient, CPAP, professional driver

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Authors: Sera Ratu, Jane Chivers, Jessica Botfield

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Objectives: The Reproductive and Family Health Association of Fiji (RFHAF) and Family Planning Australia are working together to introduce quality comprehensive sexuality education into Special Schools - which are schools for students with disability. Sexual and reproductive health information is needed by students with disability attending Special Schools. Children with special needs go through the same changes as able-bodied children. The Fiji Disability Inclusion project is a three-year project that started in 2015. One of its objectives is to increase exposure to comprehensive sexuality education for primary and secondary school students with disability. Method: A baseline survey was undertaken with 72 students with disability; it included questions about puberty, sexual health, and relationships. 34 teachers also completed a survey about their views of sexuality education and confidence in delivering it. Consent was facilitated by running information sessions with teachers and parents. The process of gaining consent and completing the surveys was designed to be accessible to students with disability. Given the sensitive nature of reproductive and sexual health, and the potential vulnerability of young people with disability, ethical considerations were important in the design and implementation of the surveys, and ethics approval was obtained. Results: Findings from the surveys suggest that students have mixed knowledge and awareness of sexual health issues. Most teachers reported a need for their students to learn about sexuality and relationships. A positive outcome of conducting the surveys was that RFHAF staff reported they have developed skills and confidence in communicating with young people with a range of disabilities. They have a greater understanding of what students want to learn, and what teachers feel is important. Conclusions: These survey findings will assist RFHAF in developing comprehensive sexuality education programs that are relevant and accessible to students in Special Schools, and to develop an appropriate professional development program for teachers. Findings may also be applicable to other Special Schools when developing sexuality education programs. The education programs developed for students as part of this project, and the professional development programs for teachers, may be relevant to other countries.

Keywords: comprehensive sexuality education, delivery, sexual and reproductive health and rights, special schools

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Authors: Hyeon-Kyo Lim, Tong-Il Jang, Yong-Hee Lee

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Human error is one of the most dreaded factors that may result in unexpected accidents, especially in nuclear power plants. For accident prevention, it is quite indispensable to analyze and to manage the influence of any factor which may raise the possibility of human errors. Out of lots factors, stress has been reported to have a significant influence on human performance. Therefore, this research aimed to develop a work-related stress management program which can guarantee Fitness-for-Duty (FFD) of the workers in nuclear power plants, especially those working in main control rooms. Major stress factors were elicited through literal surveys and classified into major categories such as demands, supports, and relationships. To manage those factors, a test and intervention program based on 4-level approaches was developed over the whole employment cycle including selection and screening of workers, job allocation, and job rotation. In addition, a managerial care program was introduced with the concept of Employee-Assistance-Program (EAP) program. Reviews on the program conducted by ex-operators in nuclear power plants showed responses in the affirmative, and suggested additional treatment to guarantee high performance of human workers, not in normal operations but also in emergency situations.

Keywords: human error, work performance, work stress, Fitness-For-Duty (FFD), Employee Assistance Program (EAP)

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Authors: Jayden R. Hunter, Alexander J. MacQuarrie, Samantha C. Sheridan, Richard High, Carolyn Waite

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Workplace exercise programs have been recommended to improve the musculoskeletal fitness of paramedics with the aim of reducing injury rates, and while they have shown efficacy in other occupations, they have not been delivered and evaluated in Australian paramedics to our best knowledge. This study investigated the effectiveness of a 6-month workplace exercise program (MedicFit; MF) to improve paramedic fitness with or without health coach (HC) support. A group of regional Australian paramedics (n=76; 43 male; mean ± SD 36.5 ± 9.1 years; BMI 28.0 ± 5.4 kg/m²) were randomised at the station level to either exercise with remote health coach support (MFHC; n=30), exercise without health coach support (MF; n=23), or no-exercise control (CON; n=23) groups. MFHC and MF participants received a 6-month, low-moderate intensity resistance and flexibility exercise program to be performed ƒ on station without direct supervision. Available exercise equipment included dumbbells, resistance bands, Swiss balls, medicine balls, kettlebells, BOSU balls, yoga mats, and foam rollers. MFHC and MF participants were also provided with a comprehensive exercise manual including sample exercise sessions aimed at improving musculoskeletal strength and flexibility which included exercise prescription (i.e. sets, reps, duration, load). Changes to upper-body (push-ups), lower-body (wall squat) and core (plank hold) strength and flexibility (back scratch and sit-reach tests) after the 6-month intervention were analysed using repeated measures ANOVA to compare changes between groups and over time. Upper-body (+20.6%; p < 0.01; partial eta squared = 0.34 [large effect]) and lower-body (+40.8%; p < 0.05; partial eta squared = 0.08 (moderate effect)) strength increased significantly with no interaction or group effects. Changes to core strength (+1.4%; p=0.17) and both upper-body (+19.5%; p=0.56) and lower-body (+3.3%; p=0.15) flexibility were non-significant with no interaction or group effects observed. While upper- and lower-body strength improved over the course of the intervention, providing a 6-month workplace exercise program with or without health coach support did not confer any greater strength or flexibility benefits than exercise testing alone (CON). Although exercise adherence was not measured, it is possible that participants require additional methods of support such as face-to-face exercise instruction and guidance and individually-tailored exercise programs to achieve adequate participation and improvements in musculoskeletal fitness. This presents challenges for more remote paramedic stations without regular face-to-face access to suitably qualified exercise professionals, and future research should investigate the effectiveness of other forms of exercise delivery and guidance for these paramedic officers such as remotely-facilitated digital exercise prescription and monitoring.

Keywords: workplace exercise, paramedic health, strength training, flexibility training

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Authors: Navarro, Delaup, Lacreusette, Jahier, Destaing, Gard

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Background: A complementary feed designed to support joint metabolism and contribute to cartilage integrity in dogs was evaluated through a pet-owner study involving 21 senior dogs experiencing a decrease in mobility. The study aimed to assess the product's benefits, ease of use, and impact on quality of life over a 56-day period. Methods: Privately owned dogs over six years old with reduced mobility and no change in their mobility management within the last three months were recruited. They received a chicken cartilage hydrolysate complementary feed containing a complex of glycosaminoglycans and type II collagen (Glycosane®, MP Labo, France. One capsule per dog up to 40 kg, 2 capsules beyond) once a day for 56 days. Assessments were performed at baseline (D0), and subsequent follow-ups at D7, D28, and D56: revised LOAD (Liverpool Osteoarthritis in Dogs) and CBPI (Canine Brief Pain Inventory) were used to evaluate mobility, pain intensity, and pain interference. Owners also completed a questionnaire on quality of life (QoL), comprising 7 questions on the animal’s well-being (QoL1) and 7 questions on the owner’s well-being (QoL2). Statistical analyses were performed using mixed models for repeated measures. The significance levels were set at p<0.05. Results: (1) Population: 21 dogs were included. The mean age was 10.2 years [6 – 14.5]. (2) Mobility: 71% of owners reported enhanced mobility by D56. Improvements were observed in half of the cases after 21 days of supplementation, with notable changes evident as early as 14 days in 39% of cases. LOAD scores showed significant improvement over time (p=0.0019). (3) Comfort: CBPI severity scores decreased significantly from baseline to D28 and D56 (p=0.0300 and p=0.0271, respectively). CBPI QoL score was also significantly improved at D56 compared to D7 (p=0.0440). (4) Quality of life: The QoL total score improved significantly by D56 compared to baseline (p=0.0089), with a specific improvement of the QoL1 (p=0.0015). (4) Owners' insights: Glycosane® received a high ease-of-use rating (mean score 4.4/5), with excellent compliance (95%). Oral intake was rated at 4.3/5. Willingness to walk (19%), Increased activity, Ability to run and/or jump from short heights and a Happier animal (11%) were among the most cited benefits. Owners noted enhanced comfort (78%) and happiness (79%) in their dogs, with a 60% perception of restored good mobility. Conclusion: The complementary feed demonstrates significant benefits in enhancing mobility and quality of life in senior dogs. Its high ease of administration supports owner compliance and satisfaction. These findings support Glycosane® as a valuable nutritional aid in helping to maintain canine mobility. Further studies with larger cohorts and a controlled group are recommended to validate these results.

Keywords: canine mobility, complementary feed, LOAD, CBPI, quality of life, Glycosane

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Authors: Matthew Fleet, Savannah Elliott

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Background: This study investigates the use of teaching and learning to meet the needs of deaf children in the UK PE curriculum. Research has illustrated that deaf students in mainstream schools do not receive sufficient support from teachers in lessons. This research examines the impact of different types of hearing loss and its implications within Physical Education (PE) in secondary schools. Purpose: The purpose of this study is to highlight challenges PE teachers face and make recommendations for more inclusive learning environments for deaf students. The aims and objectives of this research are: to critically analyse the current situation for deaf students accessing the PE curriculum, by identifying barriers deaf students face; to identify the challenges for PE teachers in providing appropriate support for deaf students; to provide recommendations for deaf awareness training, to enhance PE teachers’ understanding and knowledge. Method: Semi-structured interviews collected data from both PE teachers and deaf students, to examine: the support available and coping mechanisms deaf students use when they do not receive support; strategies PE teachers use to provide support for deaf students; areas for improvement and potential strategies PE teachers can apply to their practice. Results & Conclusion: The findings from the study concluded that PE teachers were inconsistent in providing appropriate support for deaf students in PE lessons. Evidence illustrated that PE teachers had limited exposure to deaf awareness training. This impacted on their ability to support deaf students effectively. Communication was a frequent barrier for deaf students, affecting their ability to retain and learn information. Also, the use of assistive technology was found to be compromised in practical PE lessons.

Keywords: physical education, deaf, inclusion, education

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Authors: Robyn L. Curran, Joanne R. Naidoo, Gugu Mchunu

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Along with the increasing awareness of human trafficking, is the acknowledgement that it is no longer just a social problem but also a significant public health problem that requires both increased knowledge and the specialist equipping of aftercare providers such as nurses who care for human trafficking survivors. Current discourse regarding aftercare of human trafficking survivors, is that approaches do not clearly explain the function or content of aftercare and what aftercare entails. Although psychological and medical aftercare are emphasized as important components, little practical attention is devoted to what these components actually involve and the effectiveness of current practice in aftercare. Review of the literature on the processes that take place from aftercare to empowerment, revealed the need for emphasis to be placed on the voices of survivors concerning their liberation from oppression. The aim of the study was to develop a theory for aftercare of human trafficking survivors, through analyzing the experiences of survivors and aftercare providers in shelters in three provinces in South Africa. Through using a Straussian grounded theory approach, the researcher developed a theory to inform care of human trafficking survivors in low resource settings using the voice of the survivors and those experienced in direct care of human trafficking survivors. Four human trafficking survivors and three aftercare providers from three shelters in three provinces in South Africa were individually interviewed in order for the theory to emerge. The findings of the study elicited a theoretical model of the renewed self, and the conditions that facilitate this process in care of human trafficking survivors. The process that human trafficking survivors navigate to empowerment require mutual collaboration of the aftercare provider and survivor as the survivor awakens vision, confronts reality, re-salvages autonomy and liberates self. Psychological resilience of the survivor facilitates the transition to renewed self. The recommendations of this study may improve the nursing care provided to human trafficking survivors and equip professionals with knowledge and skills to promote the process of renewing self for survivors.

Keywords: aftercare, aftercare providers, grounded theory, human trafficking survivors

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Authors: Cátia Regina Branco da Fonseca, Maria Wany Louzada Strufaldi, Lídia Raquel de Carvalho, Rosana Fiorini Puccini

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Background: Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. The purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil. Methods: A case-control study was conducted in Botucatu, São Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the official medical records of pregnant women). The study population consisted of two groups, each with 860 newborns. The case group comprised newborns weighing less than 2,500 grams, while the control group comprised live newborns weighing greater than or equal to 2,500 grams. Adequacy of ANC was evaluated according to three measurements: 1. Adequacy of the number of ANC visits adjusted to gestational age; 2. Modified Kessner Index; and 3. Adequacy of ANC laboratory studies and exams summary measure according to parameters defined by the Ministry of Health in the Program for Prenatal and Birth Care Humanization. Results: Analyses revealed that LBW was associated with the number of ANC visits adjusted to gestational age (OR = 1.78, 95% CI 1.32-2.34) and the ANC laboratory studies and exams summary measure (OR = 4.13, 95% CI 1.36-12.51). According to the modified Kessner Index, 64.4% of antenatal visits in the LBW group were adequate, with no differences between groups. Conclusions: Our data corroborate the association between inadequate number of ANC visits, laboratory studies and exams, and increased risk of LBW newborns. No association was found between the modified Kessner Index as a measure of adequacy of ANC and LBW. This finding reveals the low indices of coverage for basic actions already well regulated in the Health System in Brazil. Despite the association found in the study, we cannot conclude that LBW would be prevented only by an adequate ANC, as LBW is associated with factors of complex and multifactorial etiology. The results could be used to plan monitoring measures and evaluate programs of health care assistance during pregnancy, at delivery and to newborns, focusing on reduced LBW rates.

Keywords: low birth weight, antenatal care, prenatal care, adequacy of health care, health evaluation, public health system

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Authors: Hassan Nour, Nouh Mounadi, Oussama Abchir, Belaidi Salah, Samir Chtita

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Cholinesterase enzymes are biological catalysts essential for the transformation of acetylcholine, which is a neurotransmitter implicated in memory and learning, into acetic acid and choline, altering the neurotransmission process in Alzheimer’s disease patients. Therefore, inhibition of cholinesterase enzymes is a relevant strategy for the symptomatic treatment of Alzheimer’s disease. The current investigation aims to explore potential Cholinesterase (ChE) inhibitors through a comprehensive computational approach. Forty-nine phytoconstituents extracted from Cannabis sativa L were in-silico screened using molecular docking, pharmacokinetic and toxicological analysis to evaluate their possible inhibitory effect towards the cholinesterase enzymes. Two phytoconstituents belonging to cannabinoid derivatives were revealed to be promising candidates for Alzheimer therapy by acting as cholinesterase inhibitors. They have exhibited high binding affinities towards the cholinesterase enzymes and showed their ability to interact with key residues involved in cholinesterase enzymatic activity. In addition, they presented good ADMET profiles allowing them to be promising oral drug candidates. Furthermore, molecular dynamics (MD) simulations were executed to explore their interactions stability under mimetic biological conditions and thus support our findings. To corroborate the docking results, the binding free energy corresponding to the more stable ligand-ChE complexes was re-estimated by applying the MM-PBSA method. MD and MM-PBSA studies affirmed that the ligand-ChE recognition is spontaneous reaction leading to stable complexes. The conducted investigations have led to great findings that would strongly guide the pharmaceutical industries towards the rational development of potent anti-Alzheimer agents.

Keywords: alzheimer’s disease, molecular docking, cannabis sativa l, cholinesterase inhibitors

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Authors: Josephine Aikpitanyi, Friday Okonofua, Lorrettantoimo, Sandy Tubeuf

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Every day, 800 women die from conditions related to pregnancy and childbirth, resulting in an estimated 300,000 maternal deaths worldwide per year. Over 99 percent of all maternal deaths occur in developing countries, with more than half of them occurring in sub-Saharan Africa. Nigeria being the most populous nation in sub-Saharan Africa bears a significant burden of worsening maternal and child health outcomes with a maternal mortality rate of 917 per 100,000 live births and child mortality rate of 117 per 1,000 live births. While several studies have documented that financial barriers disproportionately discourage poor women from seeking needed maternal and child healthcare, other studies have indicated otherwise. Evidence shows that there are instances where health facilities with skilled healthcare providers exist, and yet maternal, and child health outcomes remain abysmally low, indicating the presence of non-cognitive and behavioural factors that may affect the utilization of healthcare services. This study investigated the influence of locus of control and self-esteem on utilization of maternal and child healthcare services in Nigeria. Specifically, it explored the differences in utilization of antenatal care, skilled birth care, postnatal care, and child vaccination by women having an internal and external locus of control and women having high and low self-esteem. We collected information on non-cognitive traits of 1411 randomly selected women, along with information on utilization of the various indicators of maternal and child healthcare. Estimating logistic regression models for various components of healthcare services utilization, we found that women’s internal locus of control was a significant predictor of utilization of antenatal care, skilled birth care, and completion of child vaccination. We also found that having high self-esteem was a significant predictor of utilization of antenatal care, postnatal care, and completion of child vaccination after adjusting for other control variables. By improving our understanding of non-cognitive traits as possible barriers to maternal and child healthcare utilization, our findings offer important insights for enhancing participant engagement in intervention programs that are initiated to improve maternal and child health outcomes in low-and-middle-income countries.

Keywords: behavioural economics, health-seeking behaviour, locus of control and self-esteem, maternal and child healthcare, non-cognitive traits, and healthcare utilization

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Authors: Giga Phartenadze

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In the legal framework of regulation of electronic governance, those norms are considered which include measures for improvement of functions of public institutions and a complex of actions for raising their standard such as websites of public institutions, online services, some forms of internet interactions and higher level of internet services. An important legal basis for electronic governance in Georgia is Georgian Law about Electronic Communications which defines legal and economic basis for utilizing electronic communication systems in Georgia. As for single electronic basis for e-governance regulation, it can be said that it does not exist at all. The official websites of public institutions do not have standards for proactive spreading of information. At the same time, there is no common legal norm which would make all public institutions have an official website for public relations, accountability, publicity, and raising information quality. Electronic governance in Georgia needs comprehensive legal regulation. Public administration in electronic form is on the initial stage of development. Currently existing legal basis has a low quality for public institutions and officials as well as citizens and business. Services of e-involvement and e-consultation have also low quality. So far there is no established legal framework for e-governance. Therefore, a single legislative system of e-governance should be created which will help develop effective, comprehensive and multi component electronic systems in the country (central, regional, local levels). Such comprehensive legal framework will provide relevant technological, institutional, and informational conditions.

Keywords: law, e-government, public administration, Georgia

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Authors: Erin Lynne Plettenberg, Jeremy Vickery

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In an access-control situation, the role of a user determines whether a data request is appropriate. This paper combines vetted web mining and logic modeling to build a lightweight system for determining the role of a health care provider based only on their prior authorized requests. The model identifies provider roles with 100% recall from very little data. This shows the value of vetted web mining in AI systems, and suggests the impact of the ICD classification on medical practice.

Keywords: electronic medical records, information extraction, logic modeling, ontology, vetted web mining

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Authors: Stanley Yap, Chong Wei Ying, Leow Hon Wei

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Purpose: In Malaysia, an effective financial planning is vital to accumulate wealth and financial independence. However, retirees are required to resume working due to insufficient pension fund. This study examines how the financial decision in retirement planning is being made based on the net worth from the household. Design/methodology/approach: This study uses financial data from a married working couple with children to evaluate their composition of financial position. Numerous financial methods are made pertaining to net worth analysis, insurance needs analysis, investment portfolio rebalancing, estate planning, education planning and retirement planning to enhance the financial decision. Findings: Our results show, firstly, financial planning is essential to achieve financial independence; secondly, insurance needs, education and retirement funding are the most significant for household. Thirdly, current resources are critical to maintain family lifestyle after retirement, emergency funds for critical illness, and the long term children education funding. Practical implications: Refer to the findings, sufficient net worth is priority in financial planning. Different suggestions for household include reduction of unnecessary expenses, re-allocate of cash flow, adequate insurance coverage and re-balancing of investment portfolios to accumulate wealth. It is a challenge to obtain financial independence, hence, there is a need to increase the literature on financial planning. Originality/value: To the best of our knowledge, this is the important paper that uses financial information from household to provide solutions to enhance the efficiency of financial planning industry.

Keywords: net worth, financial planning, wealth and financial independence, retirement planning

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Authors: Srikanth Pandurangi, Basheer Mohammed, Nezar Al Sayegh

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In order to meet the increasing demand for housing care for Kuwaiti citizens, the government authorities in Kuwait are undertaking a series of projects in the form of new large cities, outside the current urban area. Al Mutlaa City located to the north-west of the Kuwait Metropolitan Area is one such project out of the 15 planned new cities. The city accommodates a wide variety of residential developments, employment opportunities, commercial, recreational, health care and institutional uses. This paper examines the application of comprehensive transportation demand modeling works undertaken in VISUM platform to understand the future intracity and intercity travel distribution patterns in Kuwait. The scope of models developed varied in levels of detail: strategic model update, sub-area models representing future demand of Al Mutlaa City, sub-area models built to estimate the demand in the residential neighborhoods of the city. This paper aims at offering model update framework that facilitates easy integration between sub-area models and strategic national models for unified traffic forecasts. This paper presents the transportation demand modeling results utilized in informing the planning of multi-modal transportation system for Al Mutlaa City. This paper also presents the household survey data collection efforts undertaken using GPS devices (first time in Kuwait) and notebook computer based digital survey forms for interviewing representative sample of citizens and residents. The survey results formed the basis of estimating trip generation rates and trip distribution coefficients used in the strategic base year model calibration and validation process.

Keywords: innovative methods in transportation data collection, integrated public transportation system, traffic forecasts, transportation modeling, travel behavior

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Authors: Hadeer R. M. Tawfik, Rania A. K. Birry, Amani A. Saad

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Eyes are considered to be the most sensitive and important organ for human being. Thus, any eye disorder will affect the patient in all aspects of life. Cataract is one of those eye disorders that lead to blindness if not treated correctly and quickly. This paper demonstrates a model for automatic detection, classification, and grading of cataracts based on image processing techniques and artificial intelligence. The proposed system is developed to ease the cataract diagnosis process for both ophthalmologists and patients. The wavelet transform combined with 2D Log Gabor Wavelet transform was used as feature extraction techniques for a dataset of 120 eye images followed by a classification process that classified the image set into three classes; normal, early, and advanced stage. A comparison between the two used classifiers, the support vector machine SVM and the artificial neural network ANN were done for the same dataset of 120 eye images. It was concluded that SVM gave better results than ANN. SVM success rate result was 96.8% accuracy where ANN success rate result was 92.3% accuracy.

Keywords: cataract, classification, detection, feature extraction, grading, log-gabor, neural networks, support vector machines, wavelet

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Authors: Piyawan Srisuruk, Janya Boonmeeprasert, Romwarin Gamlunglert, Benjamaporn Choikhruea, Ornjira Jaraepram, Jarin Boonsuchat, Sakdadech Singkibud, Kusalaporn Chaiudomsom, Chanatiporn Chonprai, Pornchanaka Tana, Suchat Paholpak

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Objective: To develop an Intensive and comprehensive program (ICP) for the Inclusive Class Teacher (ICPICT) to teach elementary students (ES) with ASD in order to enhance the students’ academic and social skills (ASS) and to study the effect of the teaching program. Methods: The purposive sample included 15 Khon Kaen inclusive class teachers and their 15 elementary students. All the students were diagnosed by a child and adolescent psychiatrist to have DSM-5 level 1 ASD. The study tools included 1) an ICP to teach teachers about ASD, a teaching method to enhance academic and social skills for ES with ASD, and an assessment tool to assess the teacher’s knowledge before and after the ICP. 2) an ICPICT to teach ES with ASD to enhance their ASS. The project taught 10 sessions, 3 hours each. The ICPICT had its teaching structure. Teaching media included: pictures, storytelling, songs, and plays. The authors taught and demonstrated to the participant teachers how to teach with the ICPICT until the participants could display the correct teaching method. Then the teachers taught ICPICT at school by themselves 3) an assessment tool to assess the students’ ASS before and after the completion of the study. The ICP to teach the teachers, the ICPICT, and the relevant assessment tools were developed by the authors and were adjusted until consensus agreed as appropriate for researching by 3 curriculum of teaching children with ASD experts. The data were analyzed by descriptive and analytic statistics via SPSS version 26. Results: After the briefing, the teachers increased the mean score, though not with statistical significance, of knowledge of ASD and how to teach ES with ASD on ASS (p = 0.13). Teaching ES with ASD with the ICPICT could increase the mean scores of the students’ skills in learning and expressing social emotions, relationships with a friend, transitioning, and skills in academic function 3.33, 2.27, 2.94, and 3.00 scores (full scores were 18, 12, 15 and 12, Paired T-Test p = 0.007, 0.013, 0.028 and 0.003 respectively). Conclusion: The program to teach academic and social skills simultaneously in an intensive and comprehensive structure could enhance both the academic and social skills of elementary students with ASD. Keywords: Elementary students, autism spectrum, academic skill, social skills, intensive program, comprehensive program, integration.

Keywords: academica and social skills, students with autism, intensive and comprehensive, teaching program

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Authors: V. Karuppaiah, J. C. Padaria, C. Srivastava

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The tobacco caterpillar, Spodoptera litura Fab (Lepidoptera: Noctuidae) is a polyphagous pest various field and horticulture crops in India. Pest had virtually developed resistance to all commonly used insecticides. Enhanced detoxification is the prime mechanism that is dictated by detoxification different enzymes and carboxylesterase is one of the major enzyme responsible development of resistance. In India, insecticide resistance studies on S. litura are mainly deployed on detoxification enzymes activity and investigation at gene level alteration i.e. at nucleotide level is very merger. In the present study, we collected the S. litura larvae from three different cauliflower growing belt viz., IARI, New Delhi (Delhi), Palari, Sonepat (Haryana) and Varanasi (Uttar Pradesh) to study the role of carboxylesterase activity and its gene level variation The CarE activity was measured using UV-VIS spectrophotometer with 3rd instar larvae of S. litura. The elevated activity of CarE was observed in Sonepat strain (28.09 ± 0.09 µmol/min/mg of protein) followed by Delhi (26.72 ± 0.04 µmol/min/mg of protein) and Varanasi strain (10.00 ± 0.44 µmol/min/mg of protein) of S. litura. The genomic DNA was isolated from 3rd instar larvae and CarE gene was amplified using a primer sequence, F:5’tccagagttccttgtcaggcac3’; R:5’ctgcatcaagcatgtctc3. CarE gene, about 500bp was partially amplified, sequenced and submitted to NCBI (Accession No. KF835886, KF835887 and KF835888). The sequence data revealed polymorphism at nucleotide level in all the three strains and gene found to have 88 to 97% similarity with previous available nucleotide sequences of S. litura, S. littoralis and S. exiqua. The polymorphism at the nucleotide level could be a reason for differential activity of carboxylesterase enzymes among the strains. However, investigation at gene expression level would be useful to analyze the overproduction of carboxylesterase enzyme.

Keywords: carboxylesterase, CarE gene, nucleotide polymorphism, insecticide resistance, spodoptera litura

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Authors: Michelangelo Liban, Debbie Liquete

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A case of a 93-year-old Filipina who experienced a sudden onset of left-sided hemichorea hemiballismus after falling from a standing height due to dizziness and then sought consult at the Emergency Room. She was not known to have diabetes mellitus nor experienced any symptoms of diabetes aside from its rare neurological manifestation of hemichorea-hemiballismus prior to this consult. On further workup, her baseline laboratory tests at the Emergency Room Department showed a CBG of 340mg/dL, an HbA1c of 15%, no ketones were detected in her urine but a hyperdensity with a Hounsfeld unit of 38 on CT, and hyperintensity on T1 weighted MRI on her right striatum with an incidental finding of a subdural hematoma measured as a 0.7cm hyperdensity on her right temporoparietal area with no midline shift. She was then treated with Clonazepam 2mg ¼ tab twice a day before bedtime and insulin 70/30 16 units in the morning and eight units in the evening, which provided good glycemic control maintained at 140-180 mg/dL, complete cessation of the left-sided hemichorea hemiballismus was also observed. The subdural hematoma was deemed non-surgical, and she refused admission into our institution; hence observation on an outpatient basis was done. This is a case of a rare neurological manifestation of diabetes mellitus but with good treatment response to anti-chorea medications combined with diabetes medications.

Keywords: hemichorea, hemiballismus, striatopathy, diabetes

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Authors: Arshad Hussain

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Background: Sukh Initiative is a multi-donor funded, family planning and reproductive health project, primed by Aman Healthcare Services; implemented through a consortium of local and international organizations, in a selected one million underserved peri-urban population of Karachi, Sindh; which aims at increasing modern contraceptive prevalence rate by 15 percentage point. Objective: To empower women to access contraception by increasing knowledge, improving quality of services and expanding the basket of choices; contributing to the goals of FP2020. Methods: A five years project has a multi-pronged approach with door to door services by LHWs and CHWs in an LHWs covered population and provision of quality FP/RH services both at public and private health care facilities. The project engages youth (12-16 years) both with community and at secondary schools to mentor them for responsible adulthood with life skilled base initiative. A 24/7 availability of youth and FP helpline service provides counselling, referrals in addition with a follow-up mechanism. Results: 131,810 MWRAs were reached by 191 community health workers through 29,693 of community support group meetings and 166,775 house hold visits. These MWRAs were counselled on FP related myths and misconception and referred to 216 providers trained for quality family planning services and maintaining average 64% quality scores in 43 public health and 35 private facilities in the project area. Of those referred 26% MWRAs opted modern contraception with 17.56% in LARCs and 41% PPFP as compared to baseline. Aman TeleHealth is linked with 24/7 counselling, referrals and post services follow-ups to clients, showing 14% proportion of FP call volume. Sukh has a unique role in engaging all partners on youth SRHR issues through family life education sessions, 30 higher sec. schools in Sukh area have been provided LSBE to 16,000 students (aged 15-17), and in community approximately 10, 496 girls and boys have received SRHR information. Conclusion: Through individual counselling, access to quality family planning services and involvement of stakeholders, Suk created an enabling environment to rapid increase in family planning in the project intervention area.

Keywords: family planning and reproductive health, married women with reproductive age, urban squatter, Pakistan

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Authors: Tipu Sultan

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The proposed research intends to explore the gender role attitudes and work-life balance among dual-earner couples in Pakistan. With the increase of female labor force participation in Pakistan, the trend of dual-earner couples has been increased than ever before. This new trend of dual-earner families has significantly affected the personal life of dual-earner couples. Due to major change in household structures, the traditions and the routine activities are in continuous transition. Balancing work and family life is more complex in the patriarchal society of Pakistan because of the social expectations of gender roles. A dichotomous behavioral reflection is being observed in Pakistani society. The one group of people having an egalitarian attitude are supporting the new gender roles of females, whereas the other group of people having a traditional mindset is still in the favor of patriarchy. Therefore, gender roles are re-evaluated, and it would be more interesting to raise questions on the interplay of new gender roles and work-life balance among dual-earners. The semi-structured interview guide will be utilized to explore gender role attitudes, ideal and in-practice gender roles, experiences of work-life imbalances/balances, possible strategies to create a balance between work and family life among dual-earner couples.

Keywords: dual-earner couples, gender role attitudes, Pakistan, work-life balance

Procedia PDF Downloads 151