Search results for: music interventions

Authors: Mercy Marimirofa, Farai Machinga, Alfred Zvoushe, Tsitsidzaishe Musvosvi

Abstract:

Adolescent Birth rate (ABR) is an important indicator of both gender equality and equity in the country. This is the number of births to women aged between 15 and 19 years per 1000 live births. There has been a decreasing trend in ABR in Zimbabwe since 2014. However, the difference between rural areas and urban areas has continued to widen. A secondary analysis was conducted to assess the differences in ABR between the rural areas of Zimbabwe and the urban areas. This was also done to determine the root causes of high ABR in rural areas compared to urban areas and the impact this may cause to the economic development of the nation. The analysis was done according to geographical characteristics (provinces). A total of 69,335 females aged 10 to 19 years had live births among a total population of 791,914 females aged 15 to 19 years. The total Adolescent Birth rate in Zimbabwe is 87/1000 live births, while in rural areas, it is 114.4/1000 live births compared to urban areas, which is 49.7/1000 live births. A decrease in the ABR trends has been recorded since 2014 from 143/1000 live births among adolescents in rural areas to 97/1000 live births in urban areas. This shows that rural areas still have high rates of ABR compared to their urban counterparts, and the gap is still wide. High ABR is a result of early child marriages, teenage pregnancies as well as poverty. Most of these marriages (46%) are intergenerational relationships and have resulted in an increase in gender-based violence cases among adolescents, poor health outcomes, including pregnancy complications such as eclampsia, Cephalous Pelvic Disproportion (CPD), and obstructed labour. Maternal deaths among adolescence is also high compared to adults. Furthermore, the increase of school dropouts among adolescent girls is on the rise due to teen pregnancies. These challenges are being faced mostly by rural adolescent girls as compared to their urban counterparts. The widening gap in ABR between urban areas and rural areas is a matter of concern and needs to be addressed. There is a need to inform policy, programming, and interventions targeting rural areas to address the challenges and gaps in reducing ABR. This abstract is to inform policymakers on the strategies and resources required to address the challenges currently distressing adolescents. There is a need to improve access to Sexual and Reproductive Health (SRH) Services by adolescents and reduce the age of consent to access SRH services should be reduced from 18 years for ease access to young people to reduce teenage pregnancies. Comprehensive sexuality education, both in-school and out of school, should be strengthened to increase knowledge among young people on sexuality.

Keywords: adolescence birth rate, live birth, teenage pregnancies, SRH services

Procedia PDF Downloads 80

Authors: Benedetta Caglioti

Abstract:

The ecclesiastical complex of San Paolo in Ferrara represents a monument of great historical, religious and architectural importance. Its long and articulated story, over time, is already manifested by the mere reading of its planimetric and altimetric configuration, apparently unitary but, in reality, marked by modifications and repeated additions, even of high quality. It follows, in terms of protection, restoration and enhancement, a commitment of due respect for how the ancient building was built and enriched over its centuries of life. Hence a rigorous methodological approach, while being aware of the fact that every monument, in order to live and make use of the indispensable maintenance, must always be enjoyed and visited, therefore it must enjoy, in the right measure and compatibly with its nature, the possibility of improvements and functional, distributive, technological adjustments and related to the safety of people and things. The methodological approach substantiates the different elements of the project (such as distribution functionality, safety, structural solidity, environmental comfort, the character of the site, building and urban planning regulations, financial resources and materials, the same organization methods of the construction site) through the guiding principles of restoration, defined for a long time: the 'minimum intervention,' the 'recognisability' or 'distinguishability' of old and new, the Physico-chemical and figurative 'compatibility,' the 'durability' and the, at least potential, 'reversibility' of what is done, leading to the definition of appropriate "critical choices." The project tackles, together with the strictly functional ones, also the directly conservative and restoration issues, of a static, structural and material technology nature, with special attention to precious architectural surfaces, In order to ensure the best architectural quality through conscious enhancement, the project involves a redistribution of the interior and service spaces, an accurate lighting system inside and outside the church and a reorganization of the adjacent urban space. The reorganization of the interior is designed with particular attention to the issue of accessibility for people with disabilities. To accompany the community to regain possession of the use of the church's own space, already in its construction phase, the project proposal has hypothesized a permeability and flexibility in the management of the works such as to allow the perception of the found Monument to gradually become more and more familiar at the citizenship. Once the interventions have been completed, it is expected that the Church of San Paolo, second in importance only to the Cathedral, from which it is a few steps away, will be inserted in an already existing circuit of use of the city which over the years has systematized the different aspects of culture, the environment and tourism for the creation of greater awareness in the perception of what Ferrara can offer in cultural terms.

Keywords: conservation, accessibility, regeneration, urban space

Procedia PDF Downloads 108

Authors: Maquiling Jhuvie Jane R., Ojastro Regine B., Peroja Loreille Marie B., Pinili Joy Angela., Salve Genial Gail M., Villavicencio Marielle Irene B., Yap Alther Francis Garth B.

Abstract:

Introduction: This study investigated the impact of prolonged device usage on wrist pain and perceived academic performance among college students in Computer Studies. The research aims to explore the correlation between the frequency of technological device use and the incidence of wrist pain, as well as how this pain affects students' academic performance. The study seeks to provide insights that could inform interventions to promote better musculoskeletal health among students engaged in intensive technology use to further improve their academic performance. Method: The study utilized descriptive-correlational and comparative design, focusing on bona fide students from Silliman University’s College of Computer Studies during the second semester of 2023-2024. Participants were recruited through a survey sent via school email, with responses collected until March 30, 2024. Data was gathered using a password-protected device and Google Forms, ensuring restricted access to raw data. The demographic profile was summarized, and the prevalence of wrist pain and device usage were analyzed using percentages and weighted means. Statistical analyses included Spearman’s rank correlation coefficient to assess the relationship between wrist pain and device usage and an Independent T-test to evaluate differences in academic performance based on wrist pain presence. Alpha was set at 0.05. Results: The study revealed that 40% of College of Computer Studies students experience wrist pain, with 2 out of every 5 students affected. Laptops and desktops were the most frequently used devices for academic work, achieving a weighted mean of 4.511, while mobile phones and tablets received lower means of 4.183 and 1.911, respectively. The average academic performance score among students was 29.7, classified as ‘Good Performance.’ Notably, there was no significant relationship between the frequency of device usage and wrist pain, as indicated by p-values exceeding 0.05. However, a significant difference in perceived academic performance was observed, with students without wrist pain scoring an average of 30.39 compared to 28.72 for those with wrist pain and a p-value of 0.0134 confirming this distinction. Conclusion: The study revealed that about 40% of students in the College of Computer Studies experience wrist pain, but there is no significant link between device usage and pain occurrence. However, students without wrist pain demonstrated better academic performance than those with pain, suggesting that wrist health may impact academic success. These findings imply that physical therapy practices in the Philippines should focus on preventive strategies and ergonomic education to improve student health and performance.

Keywords: wrist pain, frequency of use of technological devices, perceived academic performance, physical therapy

Procedia PDF Downloads 14

Authors: Heribert R. Kaijage, Samuel N. A. Codjoe, Simon H. D. Mamuya, Mangi J. Ezekiel

Abstract:

There is strong evidence that climate has changed significantly affecting various sectors including public health. The recommended feasible solution is adopting development trajectories which combine both mitigation and adaptation measures for improving resilience pathways. This approach demands a consideration for complex interactions between climate and social-ecological systems. While other sectors such as agriculture and water have developed climate resilience indices, the public health sector in Tanzania is still lagging behind. The aim of this study was to find out how can we use Demographic and Health Surveys (DHS) linked with Remote Sensing (RS) technology and metrological information as tools to inform climate change resilient development and evaluation for the health sector. Methodological review was conducted whereby a number of studies were content analyzed to find appropriate indicators and indices for climate resilience household and their integration approach. These indicators were critically reviewed, listed, filtered and their sources determined. Preliminary identification and ranking of indicators were conducted using participatory approach of pairwise weighting by selected national stakeholders from meeting/conferences on human health and climate change sciences in Tanzania. DHS datasets were retrieved from Measure Evaluation project, processed and critically analyzed for possible climate change indicators. Other sources for indicators of climate change exposure were also identified. For the purpose of preliminary reporting, operationalization of selected indicators was discussed to produce methodological approach to be used in resilience comparative analysis study. It was found that household climate resilient index depends on the combination of three indices namely Household Adaptive and Mitigation Capacity (HC), Household Health Sensitivity (HHS) and Household Exposure Status (HES). It was also found that, DHS alone cannot complement resilient evaluation unless integrated with other data sources notably flooding data as a measure of vulnerability, remote sensing image of Normalized Vegetation Index (NDVI) and Metrological data (deviation from rainfall pattern). It can be concluded that if these indices retrieved from DHS data sets are computed and scientifically integrated can produce single climate resilience index and resilience maps could be generated at different spatial and time scales to enhance targeted interventions for climate resilient development and evaluations. However, further studies are need to test for the sensitivity of index in resilience comparative analysis among selected regions.

Keywords: climate change, resilience, remote sensing, demographic and health surveys

Procedia PDF Downloads 165

Authors: Bronwyn Griffin, Caroline Acton, Tona Gillen, Roy Kimble

Abstract:

Background: Bicycle riding is a common recreational activity enjoyed by many children throughout Australia that has been associated with the usual caveat of benefits related to exercise and recreation. Given Australia was the first country in the world to introduce cyclist helmet laws in 1991, very few publications have reviewed paediatric cycling injuries (fatal or non-fatal) since. Objectives: To identify trends in children (0-16 years) who required admission for greater than 24 hours following a bicycle-related injury (fatal and non-fatal) in Queensland. Further, to discuss changes that have occurred in paediatric cycling injury trends in Queensland since a prominent local study/publication in 1995. This paper aims to establish evidence to inform interventions promoting safer riding to parents, children and communities. Methods: Data on paediatric (0-16 years) cycling injuries in Queensland resulting in hospital admission more than 24 hours across three tertiary paediatric hospitals in Brisbane between November 2008-June 2015 was compiled by the Paediatric Trauma Data Registry for non-fatal injuries. The Child Death Review Team at the Queensland Families and Childhood Commission provided data on fatalities in children <17years from (June 2004 –June 2015). Comparing trends to a local study published in 1995 Results: Between 2008-2015 there were 197 patients admitted for greater than 24 hours following a cycling injury. The median age was 11 years, with males more frequently involved (n=139, 87%) compared to females. Mean length of stay was three days, with 47 (28%) children admitted to PICU, location of injury was most often the street (n=63, 37%). Between 2004 –2015 there were 15 fatalities (Incidence rate 0.25/100,000); all were male, 14/15 occurred on the street, with eight stated to have not been wearing a helmet, 11/15 children came from the least advantaged socio-economic group (SEIFA) compared to a local publication in 1995, finding of 94 fatalities between (1981-1992). Conclusions: There has been a notable decrease in incidence of fatalities between the two time periods with incidence rates dropping from 1.75-0.25/100,000. More statistics need to be run to ascertain if this is a true reduction or perhaps a decrease in children riding bicycles. Injuries that occur on the street that come in contact with a car remain of serious concern. The purpose of this paper is not to discourage bicycle riding among child and adolescent populations, rather, inform parents and the wider community about the risks associated with cycling in order to reduce injuries associated with this sport, whilst promoting safe cycling.

Keywords: paediatric, cycling, trauma, prevention, emergency

Procedia PDF Downloads 249

Authors: Evgeny Pokushalov, Andrey Ponomarenko, John Smith, Michael Johnson, Claire Garcia, Inessa Pak, Evgenya Shrainer, Dmitry Kudlay, Sevda Bayramova, Richard Miller

Abstract:

Background: Obesity is a complex, multifactorial chronic disease that poses significant health risks. Recent advancements in artificial intelligence (AI) offer the potential for more personalized and effective dietary supplement (DS) regimens to promote weight loss. This study aimed to evaluate the efficacy of AI-guided DS prescriptions compared to standard physician-guided DS prescriptions in obese patients. Methods: This randomized, parallel-group pilot study enrolled 60 individuals aged 40 to 60 years with a body mass index (BMI) of 25 or greater. Participants were randomized to receive either AI-guided DS prescriptions (n = 30) or physician-guided DS prescriptions (n = 30) for 180 days. The primary endpoints were the percentage change in body weight and the proportion of participants achieving a ≥5% weight reduction. Secondary endpoints included changes in BMI, fat mass, visceral fat rating, systolic and diastolic blood pressure, lipid profiles, fasting plasma glucose, hsCRP levels, and postprandial appetite ratings. Adverse events were monitored throughout the study. Results: Both groups were well balanced in terms of baseline characteristics. Significant weight loss was observed in the AI-guided group, with a mean reduction of -12.3% (95% CI: -13.1 to -11.5%) compared to -7.2% (95% CI: -8.1 to -6.3%) in the physician-guided group, resulting in a treatment difference of -5.1% (95% CI: -6.4 to -3.8%; p < 0.01). At day 180, 84.7% of the AI-guided group achieved a weight reduction of ≥5%, compared to 54.5% in the physician-guided group (Odds Ratio: 4.3; 95% CI: 3.1 to 5.9; p < 0.01). Significant improvements were also observed in BMI, fat mass, and visceral fat rating in the AI-guided group (p < 0.01 for all). Postprandial appetite suppression was greater in the AI-guided group, with significant reductions in hunger and prospective food consumption, and increases in fullness and satiety (p < 0.01 for all). Adverse events were generally mild-to-moderate, with higher incidences of gastrointestinal symptoms in the AI-guided group, but these were manageable and did not impact adherence. Conclusion: The AI-guided dietary supplement regimen was more effective in promoting weight loss, improving body composition, and suppressing appetite compared to the physician-guided regimen. These findings suggest that AI-guided, personalized supplement prescriptions could offer a more effective approach to managing obesity. Further research with larger sample sizes is warranted to confirm these results and optimize AI-based interventions for weight loss.

Keywords: obesity, AI-guided, dietary supplements, weight loss, personalized medicine, metabolic health, appetite suppression

Procedia PDF Downloads 8

Authors: Celine Davis

Abstract:

The novel coronavirus 2019 (COVID-19) is an infectious disease caused by the virus SARS-CoV-2, which has detrimental respiratory, cardiovascular, and neurological effects impacting over one million lives in the United States. New researches has emerged indicating long-term neurologic consequences in those who survive COVID-19 infections, including more than seven million Americans and another 27 million people worldwide. These consequences include attentional deficits, memory impairments, executive function deficits and aphasia-like symptoms which fall within the purview of speech-language pathology. The National Health Interview Survey (NHIS) is a comprehensive annual survey conducted by the National Center for Health Statistics (NCHS), a branch of the Centers for Disease Control and Prevention (CDC) in the United States. The NHIS is one of the most significant sources of health-related data in the country and has been conducted since 1957. The longitudinal nature of the study allows for analysis of trends in various variables over the years, which can be essential for understanding societal changes and making treatment recommendations. This current study will utilize NHIS data from 2020-2022 which contained interview questions specifically related to COVID-19. Adult cases of individuals between the ages of 18-50 diagnosed with COVID-19 in the United States during 2020-2022 will be identified using the National Health Interview Survey (NHIS). Multiple regression analysis of self-reported data confirming COVID-19 infection status and challenges with concentration, communication, and memory will be performed. Latent class analysis will be utilized to identify subgroups in the population to indicate whether certain demographic groups have higher susceptibility to cognitive-linguistic deficits associated with COVID-19. Completion of this study will reveal whether there is an association between confirmed COVID-19 diagnosis and heightened incidence of cognitive deficits and subsequent implications, if any, on activities of daily living. This study is distinct in its aim to utilize national survey data to explore the relationship between confirmed COVID-19 diagnosis and the prevalence of cognitive-communication deficits with a secondary focus on resulting activity limitations. To the best of the author’s knowledge, this will be the first large-scale epidemiological study investigating the associations between cognitive-linguistic deficits, COVID-19 and implications on activities of daily living in the United States population. These findings will highlight the need for targeted interventions and support services to address the cognitive-communication needs of individuals recovering from COVID-19, thereby enhancing their overall well-being and functional outcomes.

Keywords: cognition, COVID-19, language, limitations, memory, NHIS

Procedia PDF Downloads 53

Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

Abstract:

Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

Procedia PDF Downloads 151

Authors: H. A. J. Nguyen, V. A. Pham

Abstract:

RE:SOUNDING is an ongoing research project and artwork seeking to return the sound and knowledge of Dong Son bronze drums back to contemporary musicians. Colonial collections of ethnographic instruments are problematic in how they commit acts of conceptual, cultural, and acoustic silencing. The collection (or more honestly), the plagiarism, and pillaging of these instruments have systemically separated them from living and breathing cultures. This includes diasporic communities, who have come to resettle in close proximity - but still have little access - to the museums and galleries that display their cultural objects. Despite recent attempts to 'open up' and 'recognise' the tensions and violence of these ethnographic collections, many museums continue to structurally organize and reproduce knowledge with the same procedural distance and limitations of imperial condescension. Impatient with the slowness of these museums, our diaspora led collaborations participated in the opaque economy of the auction market to gain access and begin the process of digitally recording and archiving the actual sounds of the ancient Dong Son drum. This self-directed, self-initiated artwork not only acoustically reinvigorated an ancient instrument but redistributed these sonic materials back to contemporary musicians, composers, and their diasporic communities throughout Vietnam, South East Asia, and Australia. Our methodologies not only highlight the persistent inflexibility of museum infrastructures but demand that museums refrain from their paternalistic practice of risk-averse ownership, to seriously engage with new technologies and political formations that require all public institutions to be held accountable for the ethical and intellectual viability of their colonial collections. The integrated and practical resolve of diasporic artists and their communities are more than capable of working with new technologies to reclaim and reinvigorate what is culturally and spiritually theirs. The motivation to rematriate – as opposed to merely repatriate – the acoustic legacies of these instruments to contemporary musicians and artists is a new model for decolonial and restorative practices. Exposing the inadequacies of western scholarship that continues to treat these instruments as discreet, disembodied, and detached artifacts, these collaborative strategies have thus far produced a wealth of new knowledge – new to the west perhaps – but not that new to these, our own communities. This includes the little-acknowledged fact that the Dong Son drum were political instruments of war and technology, rather than their simplistic description in the museum and western academia as agrarian instruments of fertility and harvest. Through the collective and continued sharing of knowledge and sound materials produced from this research, these drums are gaining a contemporary relevance beyond the cultural silencing of the museum display cabinet. Acknowledgement: We acknowledge the Wurundjeri and Boon Wurrung of the Kulin Nation and the Gadigal of the Eora Nation where we began this project. We pay our respects to the Peoples, Lands, Traditional Custodians, Practices, and Creator Ancestors of these Great Nations, as well as those First Nations peoples throughout Australia, Vietnam, and Indonesia, where this research continues, and upon whose stolen lands and waterways were never ceded.

Keywords: acoustic archaeology, decolonisation, museum collections, rematriation, repatriation, Dong Son, experimental music, digital recording

Procedia PDF Downloads 151

Authors: Eisa Younes Alblooshi

Abstract:

Counterterrorism strategies, to be effective and efficient, require a sound understanding of the dynamics, the interlinked organizational elements of the terrorist outfits being combated, with a view to having cognizance of their strong points to be guarded against, as well as the vulnerable zones that can be targeted for optimal results in a timely fashion by counterterrorism agencies. A unique model regarding the organizational imperatives was evolved in this research through likening the terrorist organizations with the traditional commercial ones, with a view to understanding in detail the dynamics of interconnectivity and dependencies, and the related compulsions facing the leaderships of such outfits that provide counterterrorism agencies with opportunities for forging better strategies. It involved assessing the evolving organizational dynamics and imperatives of different types of terrorist organizations, to enable the researcher to construct a prototype model that defines the progression and linkages of the related organizational elements of such organizations. It required detailed analysis of how the various elements are connected, with sequencing identified, as any outfit positions itself with respect to its external environment and internal dynamics. A case study focusing on a transnational radical religious state-sponsored terrorist organization was conducted to validate the research findings and to further strengthen the specific counterterrorism strategies. Six different variants of the business model of terrorist organizations were identified, categorized based on their outreach, mission, and status of any state sponsorship. The variants represent vast majority of the range of terrorist organizations acting locally or globally. The model shows the progression and dynamics of these organizations through various dimensions including mission, leadership, outreach, state sponsorship status, resulting in the organizational structure, state of autonomy, preference divergence in its fold, recruitment core, propagation avenues, down to their capacity to adapt, resulting critically in their own life cycles. A major advantage of the model is the utility of mapping terrorist organizations according to their fits to the sundry identified variants, allowing for flexibility and differences within, enabling the researchers and counterterrorism agencies to observe a neat blueprint of the organization’s footprint, along with highlighting the areas to be evaluated for focused target zone selection and timing of counterterrorism interventions. Special consideration is given to the dimension of financing, keeping in context the latest developments regarding cryptocurrencies, hawala, and global anti-money laundering initiatives. Specific counterterrorism strategies and intervention points have been identified for each of the respective model variants, with a view to efficient and effective deployment of resources.

Keywords: terrorism, counterterrorism, model, strategy

Procedia PDF Downloads 158

Authors: Bhavana Gulaty, Arshia Chaudhri

Abstract:

Great civic projects contribute integrally to a city, and every city undergoes a recurring cycle of urban transformations and regeneration by their insertion. The M.I.C.E. (Meetings, Incentives, Convention and Exhibitions) industry is the forbearer of one category of such catalytic civic projects. Through a specific focus on M.I.C.E. destinations, this paper illustrates the multifarious dimensions that urban catalysts impact the city on S.P.U.R. (Seed. Profile. Urbane. Reflections), the theoretical framework of this paper aims to unearth these dimensions in the realm of the COEX (Convention & Exhibition) biosphere. The ‘COEX Biosphere’ is the filter of such catalysts being ecosystems unto themselves. Like a ripple in water, the impact of these strategic interventions focusing on art, culture, trade, and promotion expands right from the trigger; the immediate context to the region and subsequently impacts the global scale. These ripples are known to bring about significant economic, social, and political and network changes. The COEX inventory in the Asian context has one such prominent addition; the proposed India International Convention and Exhibition Centre (IICC) at New Delhi. It is envisioned to be the largest facility in Asia currently and would position India on the global M.I.C.E map. With the first phase of the project scheduled to open for use in the end of 2019, this flagship project of the Government of India is projected to cater to a peak daily footfall of 3,20,000 visitors and estimated to generate 5,00,000 jobs. While the economic benefits are yet to manifest in real time and ‘Good design is good business’ holds true, for the urban transformation to be meaningful, the benefits have to go beyond just a balance sheet for the city’s exchequer. This aspect has been found relatively unexplored in research on these developments. The methodology for investigation will comprise of two steps. The first will be establishing an inventory of the global success stories and associated benefits of COEX projects over the past decade. The rationale for capping the timeframe is the significant paradigm shift that has been observed in their recent conceptualization; for instance ‘Innovation Districts’ conceptualised in the city of Albuquerque that converges into the global economy. The second step would entail a comparative benchmarking of the projected transformations by IICC through a toolkit of parameters. This is posited to yield a matrix that can form the test bed for mapping the catalytic trajectory for projects in the pipeline globally. As a ready reckoner, it purports to be a catalyst to substantiate decision making in the planning stage itself for future projects in similar contexts.

Keywords: catalysts, COEX, M.I.C.E., urban transformations

Procedia PDF Downloads 158

Authors: Anisur Rahman, Sabyasachi Behera, Pawan Pathak, Benazir Patil, Rajesh Khanna

Abstract:

Background: Nearly half of India’s population is expected to reside in urban areas by 2030. The extent to which India's health system can provide for this large and growing city-based population will determine the country's success in achieving universal health coverage and improved national health indices. National Urban Health Mission (NUHM) strive for improving access to primary health care in urban areas. Implementation of NUHM solicits sensitive, effective and sustainable strategies to strengthen the service delivery mechanisms. The Challenge Initiative for Healthy Cities (TCIHC) is working with the Government of India and three provincial states to develop effective service delivery mechanisms for reproductive, maternal, newborn and child health (RMNCH) through a health systems approach for the urban poor. Method: A rapid assessment study was conceptualized and executed to generate evidence in order to address the challenges impeding in functioning of urban health facilities to deliver effective, efficient and equitable health care services in 7 cities spread across two project States viz. Madhya Pradesh and Odisha. Results: The findings of the assessment reflect: 1. The overall ecosystem pertaining to planning and management of public health interventions is not conducive. 2. The challenges regarding population dynamics like migration keeps on influencing the demand-supply-enabling environment triangle for both public and private service providers. 3. Lack of norms for planning and benchmark for service delivery further impedes urban health system as a whole. 4. Operationalization of primary level services have enough potential to meet the demand of slum dwellers at large. 5. Lack of policy driven strategies on how to integrate the NUHM with other thematic areas of Maternal, Newborn & Child Health (MNCH) and Family Planning (FP). 5. The inappropriate capacity building and acute shortage of Human Resources has huge implication on service provisioning and adherence to the service delivery protocols. Conclusion: The findings from rapid assessment are aimed to inform pertinent stakeholders to develop a multiyear city health action plan to strengthen the health systems in order to improve the efficacy of service delivery mechanism in urban settings.

Keywords: city health plan, health system, rapid assessment, urban mission

Procedia PDF Downloads 169

Authors: Tatyana Savchuk, Yelena Grinvald, Mohamed Ali, Ramune Sepetiene, Dinara Sadvakassova, Saniya Saussakova, Kuralay Zhangazieva, Dulat Imashpayev

Abstract:

Introduction. The problem of viral hepatitis B (HBV) takes a vital place in the global health system. The existing risk of HBV transmission through blood transfusions is associated with transfusion of blood taken from infected individuals during the “serological window” period or from patients with latent HBV infection, the marker of which is anti-HBcore. In the absence of information about other markers of hepatitis B, the presence of anti-HBcore suggests that a person may be actively infected or has suffered hepatitis B in the past and has immunity. Aim. To study the risk factors influencing the positive anti-HBcore indicators among the donor population. Materials and Methods. The study was conducted in 2021 in the Scientific and Production Center of Transfusiology of the Ministry of Healthcare in Kazakhstan. The samples taken from blood donors were tested for anti-HBcore, by CLIA on the Architect i2000SR (ABBOTT). A special questionnaire was developed for the blood donors’ socio-demographic characteristics. Statistical analysis was conducted by the R software (version 4.1.1, USA, 2021). Results.5709 people aged 18 to 66 years were included in the study, the proportion of men and women was 68.17% and 31.83%, respectively. The average age of the participants was 35.7 years. A weighted multivariable mixed effects logistic regression analysis showed that age (p<0.001), ethnicity (p<0.05), and marital status (p<0.05) were statistically associated with anti-HBcore positivity. In particular, analysis adjusting for gender, nationality, education, marital status, family history of hepatitis, blood transfusion, injections, and surgical interventions, with a one-year increase in age (adjOR=1.06, 95%CI:1.05-1.07), showed an 6% growth in odds of having anti-HBcore positive results. Those who were russian ethnicity (adjOR=0.65, 95%CI:0.46-0.93) and representatives of other nationality groups (adjOR=0.56, 95%CI:0.37-0.85) had lower odds of having anti-HBcore when compared to Kazakhs when controlling for other covariant variables. Among singles, the odds of having a positive anti-HBcore were lower by 29% (adjOR = 0.71, 95%CI:0.57-0.89) compared to married participants when adjusting for other variables. Conclusions.Kazakhstan is one of the countries with medium endemicity of HBV prevalence (2%-7%). Results of the study demonstrated the possibility to form a profile of risk factors (age, nationality, marital status). Taking into account the data, it is recommended to increase attention to donor questionnaires by adding leading questions and to improve preventive measures to prevent HBV. Funding. This research was supported by a grant from Abbott Laboratories.

Keywords: anti-HBcore, blood donor, donation, hepatitis B virus, occult hepatitis

Procedia PDF Downloads 107

Authors: Ting-I Lin

Abstract:

Purpose: This article explores the care experience of a 34-year-old female breast cancer patient who was admitted to the intensive care unit after undergoing a modified radical mastectomy. The patient discovered a lump in her right breast during a self-examination and, after mammography and ultrasound-guided biopsy, was diagnosed with a malignant tumor in the right breast. The tumor measured 1.5 x 1.4 x 2 cm, and the patient underwent a modified radical mastectomy. Postoperatively, she exhibited feelings of inferiority due to changes in her appearance. Method: During the care period, we engaged in conversations, observations, and active listening, using Gordon's Eleven Functional Health Patterns for a comprehensive assessment. In collaboration with the critical care team, a psychologist, and an oncology case manager, we conducted an interdisciplinary discussion and reached a consensus on key nursing issues. These included pain related to postoperative tumor excision and disturbed body image due to changes in appearance after surgery. Result: During the care period, a private space was provided to encourage the patient to express her feelings about her altered body image. Communication was conducted through active listening and a non-judgmental approach. The patient's anxiety level, as measured by the depression and anxiety scale, decreased from moderate to mild, and she was able to sleep for 6-8 hours at night. The oncology case manager was invited to provide education on breast reconstruction using breast models and videos to both the patient and her husband. This helped rebuild the patient's confidence. With the patient's consent, a support group was arranged where a peer with a similar experience shared her journey, offering emotional support and encouragement. This helped alleviate the psychological stress and shock caused by the cancer diagnosis. Additionally, pain management was achieved through adjusting the dosage of analgesics, administering Ultracet 37.5 mg/325 mg 1# Q6H PO, along with distraction techniques and acupressure therapy. These interventions helped the patient relax and alleviate discomfort, maintaining her pain score at a manageable level of 3, indicating mild pain. Conclusion: Disturbance in body image can cause significant psychological stress for patients. Through support group discussions, encouraging patients to express their feelings, and providing appropriate education on breast reconstruction and dressing techniques, the patient's self-concept was positively reinforced, and her emotions were stabilized. This led to renewed self-worth and confidence.

Keywords: breast cancer, modified radical mastectomy, acupressure therapy, Gordon's 11 functional health patterns

Procedia PDF Downloads 28

Authors: Mohammad H. Taheri, David J. Brown, Nasser Sherkat

Abstract:

Engagement is one of the most important factors in determining successful outcomes and deep learning in students. Existing approaches to detect student engagement involve periodic human observations that are subject to inter-rater reliability. Our solution uses real-time multimodal multisensor data labeled by objective performance outcomes to infer the engagement of students. The study involves four students with a combined diagnosis of cerebral palsy and a learning disability who took part in a 3-month trial over 59 sessions. Multimodal multisensor data were collected while they participated in a continuous performance test. Eye gaze, electroencephalogram, body pose, and interaction data were used to create a model of student engagement through objective labeling from the continuous performance test outcomes. In order to achieve this, a type of continuous performance test is introduced, the Seek-X type. Nine features were extracted including high-level handpicked compound features. Using leave-one-out cross-validation, a series of different machine learning approaches were evaluated. Overall, the random forest classification approach achieved the best classification results. Using random forest, 93.3% classification for engagement and 42.9% accuracy for disengagement were achieved. We compared these results to outcomes from different models: AdaBoost, decision tree, k-Nearest Neighbor, naïve Bayes, neural network, and support vector machine. We showed that using a multisensor approach achieved higher accuracy than using features from any reduced set of sensors. We found that using high-level handpicked features can improve the classification accuracy in every sensor mode. Our approach is robust to both sensor fallout and occlusions. The single most important sensor feature to the classification of engagement and distraction was shown to be eye gaze. It has been shown that we can accurately predict the level of engagement of students with learning disabilities in a real-time approach that is not subject to inter-rater reliability, human observation or reliant on a single mode of sensor input. This will help teachers design interventions for a heterogeneous group of students, where teachers cannot possibly attend to each of their individual needs. Our approach can be used to identify those with the greatest learning challenges so that all students are supported to reach their full potential.

Keywords: affective computing in education, affect detection, continuous performance test, engagement, flow, HCI, interaction, learning disabilities, machine learning, multimodal, multisensor, physiological sensors, student engagement

Procedia PDF Downloads 94

Authors: Haidy Weliam Megaly Gouda

Abstract:

Dermatology is often a neglected specialty in low-resource settings despite the high morbidity associated with skin disease. This becomes even more significant when associated with HIV infection, as dermatological conditions are more common and aggressive in HIV-positive patients. African countries have the highest HIV infection rates, and skin conditions are frequently misdiagnosed and mismanaged because of a lack of dermatological training and educational material. The frequent lack of diagnostic tests in the African setting renders basic clinical skills all the more vital. This project aimed to improve the diagnosis and treatment of skin disease in the HIV population in a district hospital in Malawi. A basic dermatological clinical tool was developed and produced in collaboration with local staff and based on available literature and data collected from clinics. The aim was to improve diagnostic accuracy and provide guidance for the treatment of skin disease in HIV-positive patients. A literature search within Embassy, Medline and Google Scholar was performed and supplemented through data obtained from attending 5 Antiretroviral clinics. From the literature, conditions were selected for inclusion in the resource if they were described as specific, more prevalent, or extensive in the HIV population or have more adverse outcomes if they develop in HIV patients. Resource-appropriate treatment options were decided using Malawian Ministry of Health guidelines and textbooks specific to African dermatology. After the collection of data and discussion with local clinical and pharmacy staff, a list of 15 skin conditions was included, and a booklet was created using the simple layout of a picture, a diagnostic description of the disease and treatment options. Clinical photographs were collected from local clinics (with full consent of the patient) or from the book ‘Common Skin Diseases in Africa’ (permission granted if fully acknowledged and used in a not-for-profit capacity). This tool was evaluated by the local staff alongside an educational teaching session on skin disease. This project aimed to reduce uncertainty in diagnosis and provide guidance for appropriate treatment in HIV patients by gathering information into one practical and manageable resource. To further this project, we hope to review the effectiveness of the tool in practice.

Keywords: prevalence and pattern of skin diseases, impact on quality of life, rural Nepal, interventions, quality switched ruby laser, skin color river blindness, clinical signs, circularity index, grey level run length matrix, grey level co-occurrence matrix, local binary pattern, object detection, ring detection, shape identification

Procedia PDF Downloads 62

Authors: Haiqiao Du, Qian Wang, Shuwei Wang, Jianan Li

Abstract:

Purpose: The aim is to evaluate the effect of cochlear implantation (CI) in patients with unilateral hearing loss, with a view to providing data support for the selection of therapeutic interventions for patients with single-sided deafness (SSD)/asymmetric hearing loss (AHL) and the broadening of the indications for CI. Methods: The study subjects were patients with unilateral hearing loss who underwent cochlear implantation surgery in our hospital in August 2022 and were willing to cooperate with the test and were divided into 2 groups: SSD group and AHL group. The enrolled patients were followed up for hearing level, tinnitus changes, speech recognition ability, sound source localization ability, and quality of life at five-time points: preoperatively, and 1, 3, 6, and 12 months after postoperative start-up. Results: As of June 30, 2024, a total of nine patients completed follow-up, including four in the SSD group and five in the AHL group. The mean postoperative hearing aid thresholds on the CI side were 31.56 dB HL and 34.75 dB HL in the two groups, respectively. Of the four patients with preoperative tinnitus symptoms (three patients in the SSD group and one patient in the AHL group), all showed a degree of reduction in Tinnitus Handicap Inventory (THI) scores, except for one patient who showed no change. In both the SSD and AHL groups, the sound source localization results (expressed as RMS error values, with smaller values indicating better ability) were 66.87° and 77.41° preoperatively and 29.34° and 54.60° 12 months after postoperative start-up, respectively, which showed that the ability to localize the sound source improved significantly with longer implantation time. The level of speech recognition was assessed by 3 test methods: speech recognition rate of monosyllabic words in a quiet environment and speech recognition rate of different sound source directions at 0° and 90° (implantation side) in a noisy environment. The results of the 3 tests were 99.0%, 72.0%, and 36.0% in the preoperative SSD group and 96.0%, 83.6%, and 73.8% in the AHL group, respectively, whereas they fluctuated in the postoperative period 3 months after start-up, and stabilized at 12 months after start-up to 99.0%, 100.0%, and 100.0% in the SSD group and 99.5%, 96.0%, and 99.0%. Quality of life was subjectively evaluated by three tests: the Speech Spatial Quality of Sound Auditory Scale (SSQ-12), the Quality-of-Life Bilateral Listening Questionnaire (QLBHE), and the Nijmegen Cochlear Implantation Inventory (NCIQ). The results of the SSQ-12 (with a 10-point score out of 10) showed that the scores of preoperative and postoperative 12 months after start-up were 6.35 and 6.46 in the SSD group, while they were 5.61 and 9.83 in the AHL group. The QLBHE scores (100 points out of 100) were 61.0 and 76.0 in the SSD group and 53.4 and 63.7 in the AHL group for the preoperative versus the postoperative 12 months after start-up. Conclusion: Patients with unilateral hearing loss can benefit from cochlear implantation: CI implantation is effective in compensating for the hearing on the affected side and reduces the accompanying tinnitus symptoms; there is a significant improvement in sound source localization and speech recognition in the presence of noise; and the quality of life is improved.

Keywords: single-sided deafness, asymmetric hearing loss, cochlear implant, unilateral hearing loss

Procedia PDF Downloads 14

Authors: Amar Ramesh Wayal

Abstract:

Marathi cinema, an integral part of India’s diverse film industry, has significantly evolved in its storytelling and aesthetics, with the Tamasha genre being central to this evolution. Tamasha, a traditional form of Marathi theatre, features vibrant dance and music, especially the rhythmic and often suggestive musical genre, lavani. It gained cinematic prominence in the 1960s with Anant Mane’s Sangtye Aika (1959), which brought and popularized Tamasha to the silver screen, and V. Shantaram’s Pinjra (1972), an iconic Tamasha drama. Despite early success, Tamasha films declined in popularity until Natarang (2010) revitalized interest in this traditional form. This study examines the relevance and evolution of the Tamasha genre in Marathi cinema through contemporary films like Ek Hota Vidushak by Jabbar Patel (1992), Natarang (2010) by Ravi Jadhav, and Tamasha Live (2022) by Sanjay Jadhav. The selection of the films is based on their significant roles in the evolution of the Tamasha in Marathi cinema. Ek Hota Vidushak explores socio-political themes through Tamasha, Natarang depicts the struggles and emotional depth of Tamasha performers, and Tamasha Live integrates traditional Tamasha into modern cinema. By analysing films from different periods, this study highlights the genre’s reinterpretation and adaptation over time. The study employs a qualitative approach, utilizing textual analysis and cultural critique to examine the portrayal and evolution of Tamasha in selected films. It aims to illuminate the complex relationship between tradition and modernity in Marathi cinema through Foucauldian discourse analysis and Pierre Bourdieu’s concept of “vernacular habitus,” which refers to local, indigenous cultural spaces that shape people’s perceptions and expressions. By analyzing these films, the study seeks to understand how traditional cultural forms are integrated into contemporary cinematic narratives. However, this method has limitations, such as subjectivity in interpretation and the need for extensive contextual knowledge. Qualitative research can be subject to researcher bias, affecting analysis and conclusions. To mitigate this, this study maintains rigorous reflexivity and transparency regarding the researcher’s positionality. Furthermore, findings from specific film analyses may not be universally applicable to all Tamasha films or broader Marathi cinema. To enhance the study’s robustness, future research could incorporate comparative or quantitative data to complement qualitative insights. Despite these challenges, qualitative research is crucial for exploring cultural artifacts and their significance within specific contexts. By triangulating qualitative findings with diverse perspectives and acknowledging limitations, this study aims to provide a nuanced understanding of how Tamasha cinema preserves and revitalizes Maharashtra’s folk traditions while adapting them to contemporary contexts. Analyzing films by Jabbar Patel, Ravi Jadhav, and Sanjay Jadhav shows how these filmmakers balance traditional aesthetics with modern storytelling, bridging historical continuity with contemporary relevance. This study offers insights into how indigenous traditions like Tamasha continue to shape and define cinematic narratives in Maharashtra.

Keywords: Marathi cinema, Tamasha genre, vernacular habitus, discourse analysis, cultural evolution

Procedia PDF Downloads 32

Authors: Jacob Dangerfield, Jacob Pollard, Jennifer DeCou

Abstract:

Introduction: Burnout, anxiety, and depression are three conditions that are prevalent in medical providers. This is especially the case in the field of anesthesia, which has a high number of providers suffering from burnout and burnout syndrome. A major contributor to this issue is isolation in the workplace, with a perceived lack of peer support as a major risk factor for burnout. Two organizational interventions that can be done to help improve this issue are small group sessions and providing affordable mental health services. Per American College of Graduate Medical Education (ACGME) Guidelines, these affordable mental health services are a requirement of all residency programs, but for a variety of reasons, many residents do not access them. As physicians, we are often not good at asking for help. With this in mind, we hypothesized that carrying out small group resiliency sessions facilitated by Graduate Medical Education (GME) Wellness Counselors would improve both resident peer support as well as the likelihood that a resident will reach out to GME Wellness in a time of need. Methods: We held small group resiliency sessions with the GME Wellness Mental Health Professionals during protected didactic time. These sessions were small groups, including the members of one’s class (i.e., first-year residents on their own), and were facilitated by 1-2 mental health professionals. After these sessions, we surveyed residents who attended using a short Google Forms survey and using a 5-point Likert Scale, asked residents about some outcomes from the session. A “strongly agree” or “agree” was considered a positive response. Results: Results from our survey showed that the resident sessions had multiple positive outcomes. This survey was sent to 29 residents, and we had a 62% response rate. We found out through this survey that these small group sessions had a perceived positive impact on resident personal well-being, increased perceived peer support from classmates, and made residents more likely to reach out to GME Wellness in the future. Perceived positive impact on well-being was found in 83% of resident respondents, improved perceived peer support in 83% of respondents, and 78% of resident respondents stated that this session increased their likelihood of reaching out to mental health professionals. Conclusions: Through this study, we can conclude that our hypothesis was correct in that Small Group Resiliency Sessions that are facilitated by GME Wellness Counselors improve both resident peer support as well as the likelihood a resident reaches out to these mental health professionals in time of need. We believe these findings are very important as they address two important factors that can aid in decreasing a provider’s risk of experiencing burnout. Through this simple means, we believe other residency programs can help the well-being of their residents, and together, we can decrease the number of cases of burnout in anesthesia.

Keywords: anesthesiology, burnout, wellness, depression, residents, trainees, mental health

Procedia PDF Downloads 54

Authors: Joe Kallas

Abstract:

It is now widely accepted that the preservation of cultural heritage must go beyond simple restoration and renovation actions. While some historic monuments have been preserved for millennia, many of them, less important or simply neglected because of lack of money, have disappeared. As a result, the adaptation of monuments and archaeological sites to new functions allow them to 'survive'. Temporary activities or 'ephemeral' re-use, are increasingly recognized as a means of vitalization of deprived areas and enhancement of historic sites that became obsolete. They have the potential to increase economic and cultural value while making the best use of existing resources. However, there are often conservation and preservation issues related to the implementation of this type of re-use, which can also threaten the integrity and authenticity of archaeological sites and monuments if they have not been properly managed. This paper aims to get a better knowledge of the ephemeral re-use of heritage, and more specifically the subject of the incorporation of the festival phenomenon within the monuments and archaeological sites in Lebanon, a topic that is not yet studied enough. This paper tried to determine the elements that compose it, in order to analyze this phenomenon and to trace its good practices, by comparing international study cases to important national cases: the International Festival of Baalbek, the International Festival of Byblos and the International Festival of Beiteddine. Various factors have been studied and analyzed in order to best respond to the main problematic of this paper: 'How can we preserve the integrity of sites and monuments after the integration of an ephemeral function? And what are the preventive conservation measures to be taken when holding festivals in archaeological sites with fragile structures?' The impacts of the technical problems were first analyzed using various data and more particularly the effects of mass tourism, the integration of temporary installations, sound vibrations, the effects of unstudied lighting, until the mystification of heritage. Unfortunately, the DGA (General Direction of Antiquities in Lebanon) does not specify any frequency limit for the sound vibrations emitted by the speakers during musical festivals. In addition, there is no requirement from its part regarding the installations of the lighting systems in the historic monuments and no monitoring is done in situ, due to the lack of awareness of the impact that could be generated by such interventions, and due to the lack of materials and tools needed for the monitoring process. The study and analysis of the various data mentioned above led us to the elaboration of the main objective of this paper, which is the establishment of a list of recommendations. This list enables to define various preventive conservation measures to be taken during the holding of the festivals within the cultural heritage sites in Lebanon. We strongly hope that this paper will be an awareness document to start taking into consideration several factors previously neglected, in order to improve the conservation practices in the archaeological sites and monuments during the incorporation of the festival phenomenon.

Keywords: archaeology, authenticity, conservation, cultural heritage, festival, historic sites, integrity, monuments, tourism

Procedia PDF Downloads 118

Authors: Deborah Bailey-Rodriguez, Maria Paula Valdivieso Rueda, Gemma Reynolds

Abstract:

In recent years, the mental health of Higher Education (HE) students has been a growing concern. This has been further exacerbated by the stresses associated with the Covid-19 pandemic, placing students at even greater risk of developing mental health issues. Support available to students in HE tends to follow an established and traditional route. The demands for counseling services have grown, not only with the increase in student numbers but with the number of students seeking support for mental health issues, with 94% of HE institutions recently reporting an increase in the need for counseling services. One way of improving the well-being and mental health of HE students is through the use of brief interventions, such as expressive writing (EW). This intervention involves encouraging individuals to write continuously for at least 15-20 minutes for three to five sessions (often on consecutive days) about their deepest thoughts and feelings to explore significant personal experiences in a meaningful way. Given the brevity, simplicity and cost-effectiveness of EW, this intervention has considerable potential as an intervention for HE populations. The current study, therefore, employed a mixed-methods design to explore the effectiveness of EW in reducing anxiety, general stress, academic stress and depression in HE students while improving well-being. HE students at MDX were randomly assigned to one of three conditions: (1) The UniExp-EW group was required to write about their emotions and thoughts about any stressors they have faced that are directly relevant to their university experience (2) The NonUniExp-EW group was required to write about their emotions and thoughts about any stressors that are NOT directly relevant to their university experience, and (3) The Control group were required to write about how they spent their weekend, with no reference to thoughts or emotions, and without thinking about university. Participants were required to carry out the EW intervention for 15 minutes per day for four consecutive days. Baseline mental health and well-being measures were taken before the intervention via a battery of standardized questionnaires. Following completion of the intervention on day four, participants were required to complete the questionnaires a second time and again one week later. Participants were also invited to attend focus groups to discuss their experience of the intervention. This will allow an in-depth investigation into students’ perceptions of EW as an effective intervention to determine whether they would choose to use this intervention in the future. Preliminary findings will be discussed at the conference as well as a discussion of the important implications of the findings. The study is fundamental because if EW is an effective intervention for improving mental health and well-being in HE students, its brevity and simplicity mean it can be easily implemented and can be freely available to students. Improving the mental health and well-being of HE students can have knock-on implications for improving academic skills and career development.

Keywords: expressive writing, higher education, psychology in education, mixed-methods, mental health, academic stress

Procedia PDF Downloads 69

Authors: Jiabei Zhang

Abstract:

Although adapted physical education (APE) teacher preparation programs are available in the nation, a consistent standards-based competency evaluation scale for preparing of qualified personnel for teaching children with disabilities in APE cannot be identified in the literature. The purpose of this study was to develop a standard-based competency evaluation scale for assessing qualifications for teaching children with disabilities in APE. Standard-based competencies were reviewed and identified based on research evidence documented as effective in teaching children with disabilities in APE. A standard-based competency scale was developed for assessing qualifications for teaching children with disabilities in APE. This scale included 20 standard-based competencies and a 4-point Likert-type scale for each standard-based competency. The first standard-based competency is knowledgeable of the causes of disabilities and their effects. The second competency is the ability to assess physical education skills of children with disabilities. The third competency is able to collaborate with other personnel. The fourth competency is knowledgeable of the measurement and evaluation. The fifth competency is to understand federal and state laws. The sixth competency is knowledgeable of the unique characteristics of all learners. The seventh competency is the ability to write in behavioral terms for objectives. The eighth competency is knowledgeable of developmental characteristics. The ninth competency is knowledgeable of normal and abnormal motor behaviors. The tenth competency is the ability to analyze and adapt the physical education curriculums. The eleventh competency is to understand the history and the philosophy of physical education. The twelfth competency is to understand curriculum theory and development. The thirteenth competency is the ability to utilize instructional designs and plans. The fourteenth competency is the ability to create and implement physical activities. The fifteenth competency is the ability to utilize technology applications. The sixteenth competency is to understand the value of program evaluation. The seventeenth competency is to understand professional standards. The eighteenth competency is knowledgeable of the focused instruction and individualized interventions. The nineteenth competency is able to complete a research project independently. The twentieth competency is to teach children with disabilities in APE independently. The 4-point Likert-type scale ranges from 1 for incompetent to 4 for highly competent. This scale is used for assessing if one completing all course works is eligible for receiving an endorsement for teaching children with disabilities in APE, which is completed based on the grades earned on three courses targeted for each standard-based competency. A mean grade received in three courses primarily addressing a standard-based competency will be marked on a competency level in the above scale. The level 4 is marked for a mean grade of A one receives over three courses, the level 3 for a mean grade of B over three courses, and so on. One should receive a mean score of 3 (competent level) or higher (highly competent) across 19 standard-based competencies after completing all courses specified for receiving an endorsement for teaching children with disabilities in APE. The validity, reliability, and objectivity of this standard-based competency evaluation scale are to be documented.

Keywords: evaluation scale, teacher preparation, adapted physical education teachers, and children with disabilities

Procedia PDF Downloads 116

Authors: Celeste E. van Rinsum, Sanne M. P. L. Gerards, Geert M. Rutten, Ien A. M. van de Goor, Stef P. J. Kremers

Abstract:

Combined lifestyle interventions have shown to be effective in changing and maintaining behavioral lifestyle changes and reducing overweight and obesity. A lifestyle coach is expected to promote lifestyle changes in adults related to physical activity and diet. The present Coaching on Lifestyle (CooL) study examined participants’ physical activity level, dietary behavioral, and motivational changes immediately after the intervention and at 1.5 years after baseline. In CooL intervention a lifestyle coach coaches individuals from eighteen years and older with (a high risk of) obesity in group and individual sessions. In addition a process evaluation was conducted in order to examine the implementation process and to be able to interpret the changes within the participants. This action-oriented research has a pre-post design. Participants of the CooL intervention (N = 200) completed three questionnaires: at baseline, immediately after the intervention (on average after 44 weeks), and at 1.5 years after baseline. T-tests and linear regressions were conducted to test self-reported changes in physical activity (IPAQ), dietary behaviors, their quality of motivation for physical activity (BREQ-3) and for diet (REBS), body mass index (BMI), and quality of life (EQ-5D-3L). For the process evaluation, we used individual and group interviews, observations and document analyses to gain insight in the implementation process (e.g. the recruitment) and how the intervention was valued by the participants, lifestyle coaches, and referrers. The study is currently ongoing and therefore the results presented here are preliminary. On average, the participants that finished the intervention and those that have completed the long-term measurement improved their level of vigorous-intense physical activity, sedentary behavior, sugar-sweetened beverage consumption and BMI. Mixed results were observed in motivational regulation for physical activity and nutrition. Moreover, an improvement on the quality of life dimension anxiety/depression was found, also in the long-term. All the other constructs did not show significant change over time. The results of the process evaluation have shown that recruitment of clients was difficult. Participants evaluated the intervention positively and the lifestyle coaches have continuously adapted the structure and contents of the intervention throughout the study period, based on their experiences and feedback from research. Preliminary results indicate that the CooL-intervention may have beneficial effects on overweight and obese participants in terms of energy balance-related behaviors, weight reduction, and quality of life. Recruitment of participants and embedding the position of the lifestyle coach in traditional care structures is challenging.

Keywords: combined lifestyle intervention, effect evaluation, lifestyle coaching, process evaluation, overweight, the Netherlands

Procedia PDF Downloads 229

Authors: Mary Elizabeth Bernardin, Margie Batek, Joseph Moen, David Schnadower

Abstract:

Background: Injuries due to interpersonal violence are a common reason for emergency department (ED) visits amongst the American pediatric population. Gun violence, in particular, is associated with high morbidity, mortality as well as financial costs. Patterns of pediatric ED usage may be an indicator of risk for future violence, but very little data on the topic exists. Objective: The aims of this study were to assess for frequencies of ED usage for previous interpersonal violence, mental/behavioral issues, sexual/reproductive issues and concerns for abuse in youths presenting to EDs due to physical assault injuries (PAIs) compared to firearm injuries (FIs). Methods: In this retrospective case-control study, ED charts of children ages 8-19 years who presented with injuries due to interpersonal violent encounters from 2014-2017 were reviewed. Data was collected regarding all previous ED visits for injuries due to interpersonal violence (including physical assaults and firearm injuries), mental/behavioral health visits (including depression, suicidal ideation, suicide attempt, homicidal ideation and violent behavior), sexual/reproductive health visits (including sexually transmitted infections and pregnancy related issues), and concerns for abuse (including physical abuse or domestic violence, neglect, sexual abuse, sexual assault, and intimate partner violence). Logistic regression was used to identify predictors of gun violence based on previous ED visits amongst physical assault injured versus firearm injured youths. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed, 251 (62%) of which were due to physical assault injuries (PAIs) and 156 (38%) due to firearm injuries (FIs). The majority of both PAI and FI patients had no previous history of ED visits for violence, mental/behavioral health, sexual/reproductive health or concern for abuse (60.8% PAI, 76.3% FI). 19.2% of PAI and 13.5% of FI youths had previous ED visits for physical assault injuries (OR 0.68, P=0.24, 95% CI 0.36 to 1.29). 1.6% of PAI and 3.2% of FI youths had a history of ED visits for previous firearm injuries (OR 3.6, P=0.34, 95% CI 0.04 to 2.95). 10% of PAI and 3.8% of FI youths had previous ED visits for mental/behavioral health issues (OR 0.91, P=0.80, 95% CI 0.43 to 1.93). 10% of PAI and 2.6% of FI youths had previous ED visits due to concerns for abuse (OR 0.76, P=0.55, 95% CI 0.31 to 1.86). Conclusions: There are no statistically significant differences between physical assault-injured and firearm-injured youths in terms of ED usage for previous violent injuries, mental/behavioral health visits, sexual/reproductive health visits or concerns for abuse. However, violently injured youths in this study have more than twice the number of previous ED usage for physical assaults and mental health visits than previous literature indicates. Data comparing ED usage of victims of interpersonal violence to nonviolent ED patients is needed, but this study supports the notion that EDs may be a useful place for identification of and enrollment in interventions for youths most at risk for future violence.

Keywords: child abuse, emergency department usage, pediatric gun violence, pediatric interpersonal violence, pediatric mental health, pediatric reproductive health

Procedia PDF Downloads 235

Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert

Abstract:

The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.

Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy

Procedia PDF Downloads 144

Authors: Birendra Kumar Bista, Rhitik Bista, Prafulla Koirala, Lokendra Mandal, Nikrsh Raj Shrestha, Vivek Kattel

Abstract:

Introduction: Poorly controlled diabetes is associated with cause and poor outcome of stroke. High blood sugar reduces cerebral blood flow, increases intracranial pressure, cerebral edema and neuronal death, especially among patients with poorly controlled diabetes.1 SGLT2 inhibitors are associated with 50% reduction in hemorrhagic stroke compared with placebo. SGLT2 inhibitors decrease cardiovascular events via reducing glucose, blood pressure, weight, arteriosclerosis, albuminuria and reduction of atrial fibrillation.2,3 No study has been documented in low income countries to see the role of post stroke SGLT2 inhibitors on diabetic patients at and after ICU admission. Aims: The aim of the study was to measure the 12 months outcome of diabetic patients with acute stroke admitted in ICU set up with naïve SGLT2 inhibitors add on therapy. Method: It was prospective cohort study carried out in a 250 bedded tertiary neurology care hospital at the province capital Biratnagar Nepal. Diabetic patient with acute stroke admitted in ICU from 1st January 2022 to 31st December 2022 who were not under SGLT2 inhibitors were included in the study. These patients were managed as per hospital protocol. Empagliflozin was added to the alternate enrolled patients. Empagliflozin was continued at the time of discharged and during follow up unless contraindicated. These patients were followed up for 12 months. Outcome measured were mortality, morbidity requiring readmission or hospital visit other than regular follow up, SGLT2 inhibitors related adverse events, neuropsychiatry comorbidity, functional status and biochemical parameters. Ethical permission was taken from hospital administration and ethical board. Results: Among 147 diabetic cases 68 were not treated with empagliflozin whereas 67 cases were started the SGLT2 inhibitors. HbA1c level and one year mortality was significantly low among patients on empaglifozin arm. Over a period of 12 months 427 acute stroke patients were admitted in the ICU. Out of them 44% were female, 61% hypertensive, 34% diabetic, 57% dyslipidemia, 26% smoker and with median age of 45 years. Among 427 cases 4% required neurosurgical interventions and 76% had hemorrhagic CVA. The most common reason for ICU admission was GCS<8 (51%). The median ICU stay was 5 days. ICU mortality was 21% whereas 1 year mortality was 41% with most common reason being pneumonia. Empaglifozin related adverse effect was seen in 11% most commonly lower urinary tract infection in 6%. Conclusion: Empagliflozin can safely be started among acute stroke with better Hba1C control and low mortality outcome compared to treatment without SGLT2 inhibitor.

Keywords: diabetes, ICU, mortality, SGLT2 inhibitors, stroke

Procedia PDF Downloads 60

Authors: Xuan (Iris) Li, Jenny Zhengye Hou, Greg Hearn

Abstract:

Food waste is a global issue, with an estimated 30% to 50% of food created never being consumed. Therefore, it is vital to reduce food waste and convert wasted food into recyclable outputs. TikTok provides a simple way of creating and duetting videos in just a few steps by using templates with the same sound/vision/caption effects to produce personalized content – this is called a duet, which is revealing to study the impact of TikTok on wasting more food or saving food. The research focuses on examining food-related content on TikTok, with particular attention paid to two distinct themes, food waste pranks and food-saving practices, to understand the potential impacts of these themes on adolescents and their attitudes toward sustainable food consumption practices. Specifically, the analysis explores how TikTok content related to food waste and/or food saving may contribute to the normalization and promotion of either positive or negative food behaviours among young viewers. The research employed content analysis and semi-structured interviews to understand what factors contribute to the difference in popularity between food pranks and food-saving videos and insights from the former can be applied to the latter to increase their communication effectiveness. The first category of food content on TikTok under examination pertains to food waste, including videos featuring pranks and mukbang. These forms of content have the potential to normalize or even encourage food waste behaviours among adolescents, exacerbating the already significant food waste problem. The second category of TikTok food content under examination relates to food saving, for example, videos teaching viewers how to maximize the use of food to reduce waste. This type of content can potentially empower adolescents to act against food waste and foster positive and sustainable food practices in their communities. The initial findings of the study suggest that TikTok content related to pranks appears to be more popular among viewers than content focused on teaching people how to save food. Additionally, these types of videos are gaining fans at a faster rate than content promoting more sustainable food practices. However, we argue there is a great potential for social media platforms like TikTok to play an educative role in promoting positive behaviour change among young people by sharing engaging content suitable to target audiences. This research serves as the first to investigate the potential utility of TikTok in food waste reduction and underscores the important role social media platforms can play in promoting sustainable food practices. The findings will help governments, organizations, and communities promote tailored and effective interventions to reduce food waste and help achieve the United Nations’ sustainable development goal of halving food waste by 2030.

Keywords: food waste reduction, behaviour, social media, TikTok, adolescents

Procedia PDF Downloads 77

Authors: Beth Vale

Abstract:

Academic research has often neglected the city after dark. Surprisingly little consideration has been given to the every night life of cities: the spatial tactics and creative insurgencies of urban residents when night falls. The focus on ‘pleasure’ in the nocturnal city has often negated the subtle politics of night-time play, embedded in expressions of identity, attachment and resistance. This paper investigates Johannesburg nightclubs as sites of quotidian political labour, through which young people contest social space and their place in it, thereby contributing to the city’s effective and socio-political cartography. The tactical remodelling of the nocturnal city through nightclubbing traces lines of desire (material, emotional, sexual), affiliation, and fear. These in turn map onto young people’s expressions of their social and political identities, as well as their attempts at place-making in a ‘post-apartheid’ context. By examining the micro-politics of the cities' nightclubs, this paper speaks back to an earlier post-94 literature, which regularly characterised Johannesburg youth as superficial, individualist and idealistic. Similarly, some might position nightclubs as sites of frivolous consumption or liberatory permissiveness. Yet because nightclub spaces are racialised, classed and gendered, historically-signified and socially regulated, they are also profoundly political. Through ordinary encounters on the cities' dancefloors, young Jo’burgers are imagining, contesting and negotiating their socio-political identities and indeed their claims to the city. Meanwhile, the politics of this generation of youth, who are increasingly critical of the utopian post-apartheid city, are being increasingly inserted and coopted into night-time cultures. Data for this study was gathered through five months of ethnographic fieldwork in Johannesburg nightclubs, including over 120 hours of participant observation and in-depth interviews with organisers and partygoers. Interviewees recognised that parties, rather than being simple frivolity, are a cacophony of celebration, mourning, worship, rage, rebellion and attachment. Countering standard associations between partying and escapism, party planners, venue owners and nightclub audiences were infusing night-time infrastructures with the aesthetics of politics and protest. Not unlike parties, local political assemblies so often rely on music, dance, the occupation of space, and a heaving crowd. References to social movements, militancy and anti-establishment emerged in nightclub themes, dress codes and décor. Metaphors of fire crossed over between party and protest, both of which could be described as having ‘been lit’ or having ‘brought flames’. More so, young people’s articulations of the city’s night-time geography, and their place in it, reflected articulations of race, class and ideological affiliation. The location, entrance fees and stylistic choices of one’s chosen club destination demarcated who was welcome, while also signalling membership to a particular politics (whether progressive or materialistic, inclusive or elitist, mainstream or counter-culture). Because of their ability to divide and unite, aggravate and titillate, mask and reveal, club cultures might offer a mirror to the complex socialities of a generation of Jo’burg youth, as they inhabit, and bring into being, a contemporary South African city.

Keywords: affect, Johannesburg, nightclub, nocturnal city, politics

Procedia PDF Downloads 227

Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

Abstract:

Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

Procedia PDF Downloads 114

Authors: Aziza Barnawi

Abstract:

Background: Regular exercise reduces risk factors associated with cardiovascular diseases. Over the past decade, exercise interventions have been introduced to reduce the risk of and prevent coronary artery disease (CAD). Elevated low-density lipoproteins (LDL) contribute to the formation of atherosclerosis, its manifestations on the endothelial narrow the coronary artery and affect the endothelial function. Therefore, flow-mediated dilation (FMD) technique is used to assess the function. The results of previous studies have been inconsistent and difficult to interpret across different types of exercise programs. The relationship between exercise therapy and lipid levels has been extensively studied, and it is known to improve the lipid profile and endothelial function. However, the effectiveness of exercise in altering LDL levels and improving blood flow is controversial. Objective: This review aims to explore the evidence and quantify the impact of exercise training on LDL levels and vascular function by FMD. Methods: Electronic databases were searched PubMed, Google Scholar, Web of Science, the Cochrane Library, and EBSCO using the keywords: “low and/or moderate aerobic training”, “blood flow”, “atherosclerosis”, “LDL mediated blood flow”, “Cardiac Rehabilitation”, “low-density lipoproteins”, “flow-mediated dilation”, “endothelial function”, “brachial artery flow-mediated dilation”, “oxidized low-density lipoproteins” and “coronary artery disease”. The studies were conducted for 6 weeks or more and influenced LDL levels and/or FMD. Studies with different intensity training and endurance training in healthy or CAD individuals were included. Results: Twenty-one randomized controlled trials (RCTs) (14 FMD and 7 LDL studies) with 776 participants (605 exercise participants and 171 control participants) met eligibility criteria and were included in the systematic review. Endurance training resulted in a greater reduction in LDL levels and their subfractions and a better FMD response. Overall, the training groups showed improved physical fitness status compared with the control groups. Participants whose exercise duration was ≥150 minutes /week had significant improvement in FMD and LDL levels compared with those with <150 minutes/week.Conclusion: In conclusion, although the relationship between physical training, LDL levels, and blood flow in CAD is complex and multifaceted, there are promising results for controlling primary and secondary prevention of CAD by exercise. Exercise training, including resistance, aerobic, and interval training, is positively correlated with improved FMD. However, the small body of evidence for LDL studies (resistance and interval training) did not prove to be significantly associated with improved blood flow. Increasing evidence suggests that exercise training is a promising adjunctive therapy to improve cardiovascular health, potentially improving blood flow and contributing to the overall management of CAD.

Keywords: exercise training, low density lipoprotein, flow mediated dilation, coronary artery disease

Procedia PDF Downloads 72