Search results for: exclusion

Authors: Emad Mohammed Sani

Abstract:

Women encounter exclusion and discrimination in varying degrees, particularly those who marry as minors. The detrimental custom of getting married young is still prevalent worldwide and affects millions of people. It has been less common over time, although it is still widespread in underdeveloped nations. Oromia Regional State is the region in Ethiopia with the highest proportion of child brides. This study aimed at evaluating the effects of early marriage on its survivors’ life conditions – specifically, empowerment and household decision-making – in Eastern Hararghe Zone of Oromia Region. This study employed community-based cross-sectional study design. It adopted mixed method approach – survey, in-depth interview and focus group discussion (FGD) – to collect, analyses and interpret data on early marriage and its effects on household decision-making processes. Narratives and analytical descriptions were integrated to substantiate and/or explain observed quantitative results, or generate contextual themes. According to this study, married women who were married at or after the age of eighteen participated more in household decision-making than child brides. Child brides were more likely to be victims of violence and other types of spousal abuse in their marriages. These changes are mostly caused by an individual's age at first marriage. Delaying marriage had a large positive impact on women's empowerment at the household level, and age at first marriage had a considerable negative impact. In order to advance women's welfare and emancipation, we advise more research to concentrate on the relationship between the home and the social-structural forms that appear at the individual and communal levels.

Keywords: child-bride, early marriage, women, ethiopia

Procedia PDF Downloads 59

Authors: Abiola A. Ojesanmi, Eric O. Amonsou

Abstract:

The formation of soluble complexes is usually within a narrow pH range characterized by weak interactions. Moreover, the rigid conformation of globular proteins restricts the number of charged groups capable of interacting with polysaccharides, thereby limiting food applications. Hence, this study investigated the impact of tryptic-limited hydrolysis on the formation of Bambara protein-gum arabic soluble complexes formation. The electrostatic interactions were monitored through turbidimetry analysis. The Bambara protein hydrolysates at a specified degree of hydrolysis, and DHs (2, 5, and 7.5) were characterized using size exclusion chromatography, zeta potential, surface hydrophobicity, and intrinsic fluorescence. The stability of the complexes was investigated using differential scanning calorimetry and rheometry. The limited tryptic hydrolysis significantly widened the pH range of the formation of soluble complexes, with DH 5 having a wider range (pH 7.0 - 4.3) compared to DH 2 and DH 7.5, while there was no notable difference in the optimum complexation pH of the insoluble complexes. Larger peptides (140, 118 kDa) were detected in DH 2 relative to 144, 70, and 61 kDa in DH 5, which were larger than 140, 118, 48, and 32 kDa in DH 7. 5. An increase in net negative charge (- 30 Mv for DH 7.5) and a slight shift in the net neutrality (from pH 4.9 to 4.3) of the hydrolysates were observed which consequently impacted the electrostatic interaction with gum arabic. There was exposure of the hydrophobic amino acids up to 4-fold in comparison with the isolate and a red shift in maximum fluorescence wavelength in DH dependent manner following the hydrolysis. The denaturation temperature of the soluble complex from the hydrolysates shifted to higher values, having DH 5 with the maximum temperature (94.24 °C). A highly interconnected gel-like soluble complex network was formed having DH 5 with a better structure relative to DH 2 and 7.5. The study showed the use of limited tryptic hydrolysis at DH 5 as an effective approach to modify Bambara protein and provided a more stable and wider pH range of formation for soluble complex, thereby enhancing the food application.

Keywords: Bambara groundnut, gum arabic, interaction, soluble complex

Procedia PDF Downloads 27

Authors: Piyarat Parklug, Busaba Supawattanaobodee, Penpat Pinyowattanasilp

Abstract:

The radioactive iodine thyroid uptake (RAIU) has been widely used to differentiate the cause of thyrotoxicosis and treatment. Twenty-four hours RAIU is routinely used to calculate the dose of radioactive iodine (RAI) therapy; however, 2 days protocol is required. This study aims to evaluate the modification of Penpat Pinyowattanasilp equation application by the exclusion of outlier data, 3 hours RAIU less than 20% and more than 80%, to improve prediction of 24-hour uptake. The equation is predicted 24 hours RAIU (P24RAIU) = 32.5+0.702 (3 hours RAIU). Then calculating separation first and second therapeutic doses in Graves’ disease patients. Methods; This study was a retrospective study at Faculty of Medicine Vajira Hospital in Bangkok, Thailand. Inclusion were Graves’ disease patients who visited RAI clinic between January 2014-March 2019. We divided subjects into 2 groups according to first and second therapeutic doses. Results; Our study had a total of 151 patients. The study was done in 115 patients with first RAI dose and 36 patients with second RAI dose. The P24RAIU are highly correlated with actual 24-hour RAIU in first and second therapeutic doses (r = 0.913, 95% CI = 0.876 to 0.939 and r = 0.806, 95% CI = 0.649 to 0.897). Bland-Altman plot shows that mean differences between predictive and actual 24 hours RAI in the first dose and second dose were 2.14% (95%CI 0.83-3.46) and 1.37% (95%CI -1.41-4.14). The mean first actual and predictive therapeutic doses are 8.33 ± 4.93 and 7.38 ± 3.43 milliCuries (mCi) respectively. The mean second actual and predictive therapeutic doses are 6.51 ± 3.96 and 6.01 ± 3.11 mCi respectively. The predictive therapeutic doses are highly correlated with the actual dose in first and second therapeutic doses (r = 0.907, 95% CI = 0.868 to 0.935 and r = 0.953, 95% CI = 0.909 to 0.976). Bland-Altman plot shows that mean difference between predictive and actual P24RAIU in the first dose and second dose were less than 1 mCi (-0.94 and -0.5 mCi). This modification equation application is simply used in clinical practice especially patient with 3 hours RAIU in range of 20-80% in a Thai population. Before use, this equation for other population should be tested for the correlation.

Keywords: equation, Graves’disease, prediction, 24-hour uptake

Procedia PDF Downloads 135

Authors: Olivia Rachel Hwang, Yu-Hsuan Joni Shao

Abstract:

Androgen Deprivation Therapy (ADT) has been a primary treatment for patients with advanced prostate cancer. However, it is associated with numerous adverse effects related to Metabolic Syndrome (MetS), including hypertension, diabetes, hyperlipidaemia, heart diseases and ischemic strokes. However, complications associated with ADT for prostate cancer in Taiwan is not well documented. The purpose of this study is to utilize the data from NHIRD (National Health Insurance Research Database) to examine the trajectory changes of MetS-related complications in men receiving ADT. The risks of developing complications after the treatment were analyzed with multivariate Cox regression model. Covariates including in the model were the complications before the diagnosis of prostate cancer, the age, and the year at cancer diagnosis. A total number of 17268 patients from 1997-2013 were included in this study. The exclusion criteria were patients with any other types of cancer or with the existing MetS-related complications. Changes in MetS-related complications were observed among two treatment groups: 1) ADT (n=9042), and 2) non-ADT (n=8226). The ADT group appeared to have an increased risk in hypertension (hazard ratio 1.08, 95% confidence interval 1.03-1.13, P = 0.001) and hyperlipidemia (hazard ratio 1.09, 95% confidence interval 1.01-1.17, P = 0.02) when compared with non-ADT group in the multivariate Cox regression analyses. In the risk of diabetes, heart diseases, and ischemic strokes, ADT group appeared to have an increased but not significant hazard ratio. In conclusion, ADT was associated with an increased risk in hypertension and hyperlipidemia in prostate cancer patients in Taiwan. The risk of hypertension and hyperlipidemia should be considered while deciding on ADT, especially those with the known history of hypertension and hyperlipidemia.

Keywords: androgen deprivation therapy, ADT, complications, metabolic syndrome, MetS, prostate cancer

Procedia PDF Downloads 284

Authors: A. Banerjee, C. Grazon, B. Nadal, T. Pons, Y. Krishnan, B. Dubertret

Abstract:

Quantum Dots (QDs) have emerged as novel fluorescent probes for biomedical applications. The photophysical properties of QDs such as broad absorption, narrow emission spectrum, reduced blinking, and enhanced photostability make them advantageous over organic fluorophores. However, for some biological applications, QDs need to be first targeted to specific intracellular locations. It parallel, base pairing properties and biocompatibility of DNA has been extensively used for biosensing, targetting and intracellular delivery of numerous bioactive agents. The combination of the photophysical properties of QDs and targettability of DNA has yielded fluorescent, stable and targetable nanosensors. QD-DNA conjugates have used in drug delivery, siRNA, intracellular pH sensing and several other applications; and continue to be an active area of research. In this project, a novel method to synthesise QD-DNA conjugates and their applications in bioimaging are investigated. QDs are first solubilized in water using a thiol based amphiphilic co-polymer and, then conjugated to amine functionalized DNA using a heterobifunctional linker. The conjugates are purified by size exclusion chromatography and characterized by UV-Vis absorption and fluorescence spectroscopy, electrophoresis and microscopy. Parameters that influence the conjugation yield such as reducing agents, the excess of salt and pH have been investigated in detail. In optimized reaction conditions, up to 12 single-stranded DNA (15 mer length) can be conjugated per QD. After conjugation, the QDs retain their colloidal stability and high quantum yield; and the DNA is available for hybridization. The reaction has also been successfully tested on QDs emitting different colors and on Gold nanoparticles and therefore highly generalizable. After extensive characterization and robust synthesis of QD-DNA conjugates in vitro, the physical properties of these conjugates in cellular milieu are being invistigated. Modification of QD surface with DNA appears to remarkably alter the fate of QD inside cells and can have potential implications in therapeutic applications.

Keywords: bioimaging, cellular targeting, drug delivery, photostability

Procedia PDF Downloads 416

Authors: Lubena Achmad, Herman Kristanto, Julian Dewantiningrum

Abstract:

Background: The Bishop score is a standard method used to predict the success of induction. This examination tends to be subjective with high inter and intraobserver variability, so it was presumed to have a low predictive value in terms of the outcome of labor induction. Cervical length measurement using transvaginal ultrasound is considered to be more objective to assess the cervical length. Meanwhile, this examination is not a complicated procedure and less invasive than vaginal touché. Objective: To compare transvaginal ultrasound and Bishop score in predicting successful induction. Methods: This study was a prospective cohort study. One hundred and twenty women with singleton pregnancies undergoing induction of labor at 37 – 42 weeks and met inclusion and exclusion criteria were enrolled in this study. Cervical assessment by both transvaginal ultrasound and Bishop score were conducted prior induction. The success of labor induction was defined as an ability to achieve active phase ≤ 12 hours after induction. To figure out the best cut-off point of cervical length and Bishop score, receiver operating characteristic (ROC) curves were plotted. Logistic regression analysis was used to determine which factors best-predicted induction success. Results: This study showed significant differences in terms of age, premature rupture of the membrane, the Bishop score, cervical length and funneling as significant predictors of successful induction. Using ROC curves found that the best cut-off point for prediction of successful induction was 25.45 mm for cervical length and 3 for Bishop score. Logistic regression was performed and showed only premature rupture of membranes and cervical length ≤ 25.45 that significantly predicted the success of labor induction. By excluding premature rupture of the membrane as the indication of induction, cervical length less than 25.3 mm was a better predictor of successful induction. Conclusion: Compared to Bishop score, cervical length using transvaginal ultrasound was a better predictor of successful induction.

Keywords: Bishop Score, cervical length, induction, successful induction, transvaginal sonography

Procedia PDF Downloads 322

Authors: Joao Paulo Matheus, Renan Fangel

Abstract:

Rheumatoid arthritis is a chronic, inflammatory, systemic and progressive disease that affects the synovial joints bilaterally, causing definitive orthopedic damage. It has a higher prevalence in postmenopausal female patients. It is a disabling disease that causes joint deformities that may compromise the functionality of the affected segment. The aim of this study was to evaluate the influence of low-intensity therapeutic laser on the perception of pain and quality of life in patients with rheumatoid arthritis. This is a randomized clinical study involving 6 women with a mean age of 56.8+6.3 years. Exclusion criteria: patients with acute pain, chronic infectious disease, underlying acute or chronic underlying disease. An AsGaAl laser with 808nm wavelength, 100mW power, beam output area of 0.028cm2, power density of 3.57W/cm2 was used. The laser was applied at pre-defined points in the interphalangeal and metacarpophalangeal joints, totaling 24 points, 2 times a week, for 4 weeks, totaling 8 sessions. The Pain Inventory (IBD) and Visual Analogue Scale (VAS) were used for the analysis of pain and for the WHOQOL-bref quality of life assessment. There was no statistical difference between the onset (5.67±2.66) and the final (4.67±3.78) of treatments (p=0.70). There was also no statistical difference between the beginning (5.67±2.66) and the final (4.67±3.78) of the treatments in the VAS analysis (p=0.68). The overall mean quality of life obtained by the questionnaire at the start of treatment was 42.3±7.6, while at the end of treatment it was 58.5±7.6 (p=0.01) and the domains of the questionnaire with significant differences were: psychological domain 42.9±6.8 and 66.7±12.9 (p=0.004), social domain 39.9±5.7 and 68.1±6.3 (p=0,0005) and environmental domain 36.3±7.3 and 56.3±12.5 (p=0.003). It can be concluded that the low-intensity therapeutic laser did not produce significant changes in the painful period of rheumatoid arthritis patients. However, there was an improvement in patients' quality of life in the psychological, social and environmental aspects.

Keywords: laser therapy, pain, quality of life, rheumatoid arthritis

Procedia PDF Downloads 245

Authors: David Polcari, Samuel C. Perry, Loredano Pollegioni, Matthias Geissler, Janine Mauzeroll

Abstract:

ᴅ-serine acts as an endogenous co-agonist for N-methyl-ᴅ-aspartate receptors in neuronal synapses. This makes it a key component in the development and function of a healthy brain, especially given its role in several neurodegenerative diseases such as Alzheimer’s disease and dementia. Despite such clear research motivations, the primary site and mechanism of ᴅ-serine release is still currently unclear. For this reason, we are developing a biosensor for the detection of ᴅ-serine utilizing a microelectrode in combination with a ᴅ-amino acid oxidase enzyme, which produces stoichiometric quantities of hydrogen peroxide in response to ᴅ-serine. For the fabrication of a biosensor with good selectivity, we use a permselective poly(meta-phenylenediamine) film to ensure only the target molecule is reacted, according to the size exclusion principle. In this work, we investigated the effect of the electrodeposition conditions used on the biosensor’s response time and selectivity. Careful optimization of the fabrication process allowed for enhanced biosensor response time. This allowed for the real time sensing of ᴅ-serine in a bulk solution, and also provided in means to map the efflux of ᴅ-serine in real time. This was done using scanning electrochemical microscopy (SECM) with the optimized biosensor to measure localized release of ᴅ-serine from an agar filled glass capillary sealed in an epoxy puck, which acted as a model system. The SECM area scan simultaneously provided information regarding the rate of ᴅ-serine flux from the model substrate, as well as the size of the substrate itself. This SECM methodology, which provides high spatial and temporal resolution, could be useful to investigate the primary site and mechanism of ᴅ-serine release in other biological samples.

Keywords: ᴅ-serine, enzymatic biosensor, microelectrode, scanning electrochemical microscopy

Procedia PDF Downloads 224

Authors: Oksana Razina, Shakeel Ahmad, Jessie Qun Ren, Olufemi Isiaq

Abstract:

The modern life of businesses is categorically reliant on their established position online, where digital (and particularly website) content plays a significant role as the first point of information. Digital content, therefore, becomes essential – from making the first impression to the building and development of client relationships. Despite a number of valuable papers suggesting a strategic approach when dealing with digital data, other sources often do not view or accept the approach to digital content as a holistic or continuous process. Associations are frequently made with merely a one-off marketing campaign or similar. The challenge is to establish an agreed definition for the notion of Digital Content Strategy, which currently does not exist, as DCS is viewed from an excessive number of different angles. A strategic approach to content, nonetheless, is required, both practically and contextually. The researchers, therefore, aimed at attempting to identify the key content components comprising a digital content strategy to ensure all the aspects were covered and strategically applied – from the company’s understanding of the content value to the ability to display flexibility of content and advances in technology. This conceptual project evaluated existing literature on the topic of Digital Content Strategy (DCS) and related aspects, using the PRISMA Systematic Review Method, Document Analysis, Inclusion and Exclusion Criteria, Scoping Review, Snow-Balling Technique and Thematic Analysis. The data was collected from academic and statistical sources, government and relevant trade publications. Based on the suggestions from academics and trading sources related to the issues discussed, the researchers revealed the key actions for content creation and attempted to define the notion of DCS. The major finding of the study presented Key Content Components of Digital Content Strategy and can be considered for implementation in a business retail setting.

Keywords: digital content strategy, key content components, websites, digital marketing strategy

Procedia PDF Downloads 139

Authors: Mira Kaneva

Abstract:

The ongoing migration crisis polemic opens up the debate to the ambivalent essence of borders due to both the legality and legitimacy of the displacement of vast masses of people across the European continent. In neoliberal terms, migration is seen as an economic opportunity, or, on the opposite, as a social disparity; in realist terms, it is regarded as a security threat that calls for mobilization; from a critical standpoint, it is a matter of discourse on democratic governance. This paper sets the objective of analyzing borders through the Foucauldian prism of biopolitics. It aims at defining the specifics of the management of the human body by producing both the irregular migrant as a subject (but prevalently as an object in the discourse) and the political subjectivity by exercising state power in repressive practices, including hate speech. The study relies on the conceptual framework of Bigo, Agamben, Huysmans, among others, and applies the methodology of qualitative comparative analysis between the cases of borders (fences, enclaves, camps and other forms of abnormal spatiality) in Italy, Spain, Greece, the Republic of Macedonia, Serbia and Bulgaria. The paper thus tries to throw light on these cross- and intra-regional contexts that share certain similarities and differences. It tries to argue that the governmentality of the masses of refugees and economic immigrants through the speech acts of their exclusion leads to a temporary populist backlash; a tentative finding is that the status-quo in terms of social and economic measures remains relatively balanced, whereas, values such as freedom, openness, and tolerance are consecutively marginalized.

Keywords: Balkans, biopolitical borders, cross- and intra-regional discourse analysis, irregular migration, Mediterranean Europe, securitization vs. humanitarianism

Procedia PDF Downloads 207

Authors: Sujata Gupta Kedar, J. N. Tulika

Abstract:

Early researchers suggested that imprisonment had negative psychological and physical effects on its inmates, leading to psychological deterioration. The term “prisons” in the Consensus Statement of WHO is intended to denote, as those institutions which hold people who have been sentenced to a period of imprisonment by the courts for offences against the law. Thus “prisons” if local circumstances justify it, may also be taken to include secure institutions holding on a compulsory basis on any of the following categories of people: remand prisoners; civil prisoners; juvenile detainees; immigration detainees; some categories of mentally disordered patients; asylum seekers; refugees; people detained pending expulsion, deportation, exile, exclusion or any other form of compulsory transfer to other countries or areas of the country; people detained in police cells; and any other compulsorily detained group. Prisons are aimed to cure the criminal and their behavior but their records are not encouraging. Instead the imprisonment affects all prisoners in different way. From withstanding the shock of entry to the new culture, which is very different from their own, prisoners must try to determine how to spend the time in prison, since the hours appears to be endless in prisons. There is also the fear of deterioration. This article aims to provide an overview of the psychological well being of female prisoners in the prison environment in five areas- satisfaction, efficiency, sociability, mental health and interpersonal relations. Research was done on two different types of imprisonment- under trial prisoner and convict. Total sample included 22 female prisoners of Nagaon Special Jail of Assam. The instrument used for the study was based on Psychological Well Being Scale. Statistical analysis was done with t-test and one way anova test. The result demonstrated that there is no significant difference in the psychological wellbeing of female prisoners in the prison and that there is no significant difference in the psychological well being of different types of female prisoners involved in different crimes but there is significant difference in the mental health of the female prisoners in prison.

Keywords: psychological effect, female prisoners, prison, well being of prisoners

Procedia PDF Downloads 398

Authors: Darren Edwards, Thomas Pinna

Abstract:

Background: Interoception and heart rate variability have been found to predict outcomes of mental health and well-being. However, these have usually been investigated independently of one another. Objectives: This review aimed to explore the associations between interoception and heart rate variability (HRV) with emotion regulation (ER) and ER strategies within the existing literature and utilizing systematic review methodology. Methods: The process of article retrieval and selection followed the preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines. Databases PsychINFO, Web of Science, PubMed, CINAHL, and MEDLINE were scanned for papers published. Preliminary inclusion and exclusion criteria were specified following the patient, intervention, comparison, and outcome (PICO) framework, whilst the checklist for critical appraisal and data extraction for systematic reviews of prediction modeling studies (CHARMS) framework was used to help formulate the research question, and to critically assess for bias in the identified full-length articles. Results: 237 studies were identified after initial database searches. Of these, eight studies were included in the final selection. Six studies explored the associations between HRV and ER, whilst three investigated the associations between interoception and ER (one of which was included in the HRV selection too). Overall, the results seem to show that greater HRV and interoception are associated with better ER. Specifically, high parasympathetic activity largely predicted the use of adaptive ER strategies such as reappraisal, and better acceptance of emotions. High interoception, instead, was predictive of effective down-regulation of negative emotions and handling of social uncertainty, there was no association with any specific ER strategy. Conclusions: Awareness of one’s own bodily feelings and vagal activation seem to be of central importance for the effective regulation of emotional responses.

Keywords: emotional regulation, vagal tone, interoception, chronic conditions, health and well-being, psychological flexibility

Procedia PDF Downloads 108

Authors: Ganetsou Evanthia, Koutsikos Emmanouil, Austin Anna Maria

Abstract:

Information technology has long served the needs of individuals for learning and entertainment, but much less for children in sickness. The aim of the proposed online video game is to provide immersive learning opportunities as well as essential social and emotional scenarios for hospital-bound children with long-term illness. Online self-paced courses on chosen school subjects, including specialised software and multisensory assessments, aim at enhancing children’s academic achievement and sense of inclusion, while doctor minigames familiarise and educate young patients on their medical conditions. Online ethical dilemmas will offer children opportunities to contemplate on the importance of medical procedures and following assigned medication, often challenging for young patients; they will therefore reflect on their condition, reevaluate their perceptions about hospitalisation, and assume greater personal responsibility for their progress. Children’s emotional and psychosocial needs are addressed by engaging in social conventions, such as interactive, daily, collaborative mini games with other hospitalised peers, like virtual competitive sports games, weekly group psychodrama sessions, and online birthday parties or sleepovers. Social bonding is also fostered by having a virtual pet to interact with and take care of, as well as a virtual nurse to discuss and reflect on the mood of the day, engage in constructive dialogue and perspective taking, and offer reminders. Access to the platform will be available throughout the day depending on the patient’s health status. The program is designed to minimise escapism and feelings of exclusion, and can flexibly be adapted to offer post-treatment and a support online system at home.

Keywords: long-term illness, children, hospital, interactive games, cognitive, socioemotional development

Procedia PDF Downloads 74

Authors: Karun Karki

Abstract:

The Lhotshampa are Bhutanese people of Nepali origin who have been in Bhutan since the early 1600s. A significant number of these people migrated to Bhutan in the nineteenth century. The 1958 Nationality Law of Bhutan granted citizenship to many Lhotshampa people; however, in the late 1970s, the government of Bhutan introduced a series of laws and policies intended for the socio-political and cultural exclusion of the Lhotshampa due to their ancestry. These exclusionary policies and ethnic and racial injustices not only removed the rights and citizenship of the Lhotshampa but also forcibly displaced thousands of families with no choice but to seek refuge in Nepal. In this context, racism becomes a biopolitical tool designed to govern and regulate populations in a way that determines who may live and who must die. The governance and the management of the population, what Stephan Scheel terms as biopolitical bordering, depends on boundaries between residents and non-residents, citizens and non-citizens, and emigrants and immigrants. Drawing on Foucault’s biopolitics and Mbembe’s necropolitics, this paper argues that the concept of racism should be examined within the context of political discourses because it is intertwined with the colonial project, enslavement, and diaspora. This paper critically explores ethnic and racial injustices the Lhotshampa people experienced and the ways in which they negotiated and resisted such injustices in their resettlement processes, including before displacement, in refugee camps, and after the third-country resettlement. Critical examination of these issues helps shed light on the notion of racial difference that justifies dehumanization, discrimination, and racist attitudes against the Lhotshampa people. The study's findings are critical in promoting human rights, social justice, and the health and well-being of the Lhotshampa community in the context of trauma and stressors in their resettlement processes.

Keywords: lhotshampa people, bhutanese refugees, racism, dehumanization, social justice, biopower, necropower

Procedia PDF Downloads 48

Authors: Meron Okbandrias

Abstract:

The South African formal economy is rule-based economy, unlike most African and Asian markets. It has a highly developed financial market. In such a market, foreign migrants have dominated the small or spaza shops that service the poor. They are highly competitive and capture significant market share in South Africa. This paper analyses the factors that assisted the foreign migrants in having a competitive age. It does that by interviewing Somali, Bangladesh, and Ethiopian shop owners in Cape Town analysing the data through a narrative analysis. The paper also analyses the 2019 South African consumer report. The three migrant nationalities mentioned above dominate the spaza shop business and have significant distribution networks. The findings of the paper indicate that family, ethnic, and nationality based network, in that order of importance, form bases for a relationship-based business network that has trust as its mainstay. Therefore, this network ensures the pooling of resources and abiding by certain principles outside the South African rule-based system. The research identified practises like bulk buying within a community of traders, sharing information, buying from a within community distribution business, community based transportation system and providing seed capital for people from the community to start a business is all based on that relationship-based system. The consequences of not abiding by the rules of these networks are social and economic exclusion. In addition, these networks have their own commercial and social conflict resolution mechanisms aside from the South African justice system. Network theory and relationship based systems theory form the theoretical foundations of this paper.

Keywords: migrant, spaza shops, relationship-based system, South Africa

Procedia PDF Downloads 124

Authors: Nour S. Abdelrahman, Seunghyun Hong, Hassan A. Arafat, Daniel Choi, Faisal Al Marzooqi

Abstract:

Abstract—The advancement of lithium extraction methods from water sources, particularly saltwater brine, is gaining prominence in the lithium recovery industry due to its cost-effectiveness. Traditional techniques like recrystallization, chemical precipitation, and solvent extraction for metal recovery from seawater or brine are energy-intensive and exhibit low efficiency. Moreover, the extensive use of organic solvents poses environmental concerns. As a result, there's a growing demand for environmentally friendly lithium recovery methods. Membrane-based separation technology has emerged as a promising alternative, offering high energy efficiency and ease of continuous operation. In our study, we explored the potential of lithium-selective sieve channels constructed from layers of 2D graphene oxide and MXene (transition metal carbides and nitrides), integrated with surface – SO₃₋ groups. The arrangement of these 2D sheets creates interplanar spacing ranging from 0.3 to 0.8 nm, which forms a barrier against multivalent ions while facilitating lithium-ion movement through nano capillaries. The introduction of the sulfonate group provides an effective pathway for Li⁺ ions, with a calculated binding energy of Li⁺ – SO³⁻ at – 0.77 eV, the lowest among monovalent species. These modified membranes demonstrated remarkably rapid transport of Li⁺ ions, efficiently distinguishing them from other monovalent and divalent species. This selectivity is achieved through a combination of size exclusion and varying binding affinities. The graphene oxide channels in these membranes showed exceptional inter-cation selectivity, with a Li⁺/Mg²⁺ selectivity ratio exceeding 104, surpassing commercial membranes. Additionally, these membranes achieved over 94% rejection of MgCl₂.

Keywords: ion permeation, lithium extraction, membrane-based separation, nanotechnology

Procedia PDF Downloads 66

Authors: Amani Waheed, Adel Mishriky, Rasha Farouk, Essam Abdallah, Sarah Hussein

Abstract:

Background: Occupational stress plays a crucial role in professional drivers' health. They are exposed to high workloads, low physical activity, high demand and low decisions as well as poor lifestyle factors including poor diet, sedentary work, and smoking. Dyslipidemia is a well-established modifiable cardiovascular risk factor. Occupational stress and other forms of chronic stress have been associated with raised levels of atherogenic lipids. Although stress management has some evidence in improving lipid profile, the association between occupational stress and dyslipidemia is not clear. Objectives: To assess the relational between occupational stress and lipid profile among professional drivers. Methodology: A cross-sectional study conducted at a large company in Ismailia City, Egypt, where, 131 professional drivers divided into 44 car drivers, 43 bus drivers, and 44 truck drivers were eligible after applying exclusion criteria. Occupational stress index (OSI), non-occupational risk factors of dyslipidemia were assessed using interview structured questionnaire. Blood pressure, body mass index (BMI) and lipid profile were measured. Results: The mean of total OSI score was 79.98 ± 6.14. The total OSI score is highest among truck drivers (82.16 ± 4.62), then bus drivers (80.26 ± 6.02) and lowest among car drivers (77.55 ± 6.79) with statistically significant. Eighty percent had Dyslipidemia. The duration of driving hours per day, exposure to passive smoking and increased BMI were the risk factors. No statistical significance between Total OSI score and dyslipidemia. Using, logistic regression analysis, occupational stress, duration of driving hours per day, and BMI were positive significant predictors for dyslipidemia. Conclusion: Professional drivers are exposed to occupational stress. A high proportion of drivers have dyslipidemia. Total OSI score doesn't have statistically significant relation with dyslipidemia.

Keywords: body mass index, dyslipidaemia, occupational stress, professional drivers

Procedia PDF Downloads 160

Authors: Petronella Lunda, Catharina Susanna Minnie, Welma Lubbe

Abstract:

Background This review aimed to provide healthcare professionals with a scientific summary of the best available research evidence on factors influencing respectful perinatal care. The review question was ‘What were the perceptions of midwives and doctors on factors that influence respectful perinatal care?’ Methods A detailed search was done on electronic databases: EBSCOhost: Medline, OAlster, Scopus, SciELO, Science Direct, PubMed, Psych INFO, and SocINDEX. The databases were searched for available literature using a predetermined search strategy. Reference lists of included studies were analysed to identify studies missing from databases. The phenomenon of interest was factors influencing maternity care practices according to midwives and doctors. Pre-determined inclusion and exclusion criteria were used during the selection of potential studies. In total, 13 studies were included in the data analysis and synthesis. Three themes were identified and a total of nine sub-themes. Results Studies conducted in various settings were included in the study. Multiple factors influencing respectful perinatal care were identified. During data synthesis, three themes emerged: healthcare institution, healthcare professionals, and women-related factors. Alongside the themes were sub-themes human resources, medical supplies, norms and practices, physical infrastructure, healthcare professional competencies and attributes, women’s knowledge, and preferences. The three factors influence the provision of respectful perinatal care; addressing them might improve the provision of the care. Conclusion Addressing factors that influence respectful perinatal care is vital towards the prevention of compromised patient care during the perinatal period as these factors have the potential to accelerate or hinder provision of respectful care.

Keywords: doctors, maternity care, midwives, obstetrician, perceptions, perinatal care, respectful care

Procedia PDF Downloads 11

Authors: Luleka Dlamini, Olivier Crespo, Jos van Dam

Abstract:

Accurately estimating crop growth and yield is pivotal for timely sustainable agricultural management and ensuring food security. Crop models and remote sensing can complement each other and form a robust analysis tool to improve crop growth and yield estimations when combined. This study thus aims to systematically evaluate how research that exclusively focuses on assimilating RS data into crop models varies among countries, crops, data assimilation methods, and farming conditions. A strict search string was applied in the Scopus and Web of Science databases, and 497 potential publications were obtained. After screening for relevance with predefined inclusion/exclusion criteria, 123 publications were considered in the final review. Results indicate that over 81% of the studies were conducted in countries associated with high socio-economic and technological advancement, mainly China, the United States of America, France, Germany, and Italy. Many of these studies integrated MODIS or Landsat data into WOFOST to improve crop growth and yield estimation of staple crops at the field and regional scales. Most studies use recalibration or updating methods alongside various algorithms to assimilate remotely sensed leaf area index into crop models. However, these methods cannot account for the uncertainties in remote sensing observations and the crop model itself. l. Over 85% of the studies were based on commercial and irrigated farming systems. Despite a great global interest in data assimilation into crop models, limited research has been conducted in resource- and data-limited regions like Africa. We foresee a great potential for such application in those conditions. Hence facilitating and expanding the use of such an approach, from which developing farming communities could benefit.

Keywords: crop models, remote sensing, data assimilation, crop yield estimation

Procedia PDF Downloads 121

Authors: Luleka Dlamini, Olivier Crespo, Jos van Dam

Abstract:

Accurately estimating crop growth and yield is pivotal for timely sustainable agricultural management and ensuring food security. Crop models and remote sensing can complement each other and form a robust analysis tool to improve crop growth and yield estimations when combined. This study thus aims to systematically evaluate how research that exclusively focuses on assimilating RS data into crop models varies among countries, crops, data assimilation methods, and farming conditions. A strict search string was applied in the Scopus and Web of Science databases, and 497 potential publications were obtained. After screening for relevance with predefined inclusion/exclusion criteria, 123 publications were considered in the final review. Results indicate that over 81% of the studies were conducted in countries associated with high socio-economic and technological advancement, mainly China, the United States of America, France, Germany, and Italy. Many of these studies integrated MODIS or Landsat data into WOFOST to improve crop growth and yield estimation of staple crops at the field and regional scales. Most studies use recalibration or updating methods alongside various algorithms to assimilate remotely sensed leaf area index into crop models. However, these methods cannot account for the uncertainties in remote sensing observations and the crop model itself. l. Over 85% of the studies were based on commercial and irrigated farming systems. Despite a great global interest in data assimilation into crop models, limited research has been conducted in resource- and data-limited regions like Africa. We foresee a great potential for such application in those conditions. Hence facilitating and expanding the use of such an approach, from which developing farming communities could benefit.

Keywords: crop models, remote sensing, data assimilation, crop yield estimation

Procedia PDF Downloads 77

Authors: Atsebaha Gebrekidan Kahsay, Tsehaye Asmelash, Enquebaher Kassaye

Abstract:

Background: Salmonella remains a global public health problem with a significant burden in sub-Saharan African countries. Human restricted cause of typhoid and paratyphoid fever are S. Typhi and S. Paratyphi, whereas S. Enteritidis and S. Typhimurium is the causative agent of invasive nontyphoidal diseases among humans and animals are their reservoir. The antibiotic resistance of Salmonella is another public health threat around the globe. To come up with full information about human and animal salmonellosis, we made a systematic review of the prevalence, serotypes, and antibiotic resistance of Salmonella in Ethiopia. Methods: This systematic review used Google Scholar and PubMed search engines to search articles from Ethiopia that were published in English in peer-reviewed international journals from 2010 to 2022. We used keywords to identify the intended research articles and used a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to ensure the inclusion and exclusion criteria. Frequencies and percentages were analyzed using Microsoft Excel. Results: Two hundred seven published articles were searched, and 43 were selected for a systematic review, human (28) and animals (15). The prevalence of Salmonella in humans and animals was 434 (5.2%) and 641(10.1%), respectively. Fourteen serotypes were identified from animals, and S. Typhimurium was among the top five. Among the ciprofloxacin-resistant isolates in human studies, 16.7% was the highest, whereas, for ceftriaxone, 100% resistance was reported. Conclusions: The prevalence of Salmonella among diarrheic patients and food handlers (5.2%) was lower than the prevalence in food animals (10.1%). We did not find serotypes of Salmonella in human studies, although fourteen serotypes were included in food-animal studies, and S. Typhimurium was among the top five. Salmonella species from some human studies revealed a non-susceptibility to ceftriaxone. We recommend further study about invasive nontyphoidal Salmonella and predisposing factors among humans and animals in Ethiopia.

Keywords: antibiotic resistance, prevalence, systematic review, serotypes, Salmonella, Ethiopia

Procedia PDF Downloads 75

Authors: Wen Hsin Hsu, Pin Lin

Abstract:

Objective: Thirst discomfort is the most common yet often overlooked symptom in patients in the intensive care unit (ICU), with an incidence rate of 69.8%. If not properly cared for, it can easily lead to irritability, affect sleep quality, and increase the incidence of delirium, thereby extending the length of hospital stay. Research points out that the sensation of coldness is an effective strategy to alleviate thirst. Using a combined care approach for thirst can prolong the sensation of coldness in the mouth and reduce thirst discomfort. Therefore, it needs to be further analyzed and its effectiveness reviewed. Methods: This study uses systematic literature review and meta-analysis methodologies and searched databases including PubMed, MEDLINE, EMBASE, Cochrane, CINAHL, and two Chinese databases (CEPS and CJTD) based on keywords. JBI was used to appraise the quality of the literature. RevMen 5.4 software package was used, and Fix Effect Model was applied for data analysis. We selected experimental articles, including those in English and Chinese, that met the inclusion and exclusion criteria. Three research articles were included in total, with a sample size of 416 people. Two were randomized controlled trials, and one was a quasi-experimental design. Results: The results show that the combined care for thirst, which includes ice water spray or oral swab wipes, menthol mouthwash, and lip balm, can significantly relieve thirst intensity MD=-1.36 (3 studies, 95% CI (-1.77, -0.95), p <0.001) and thirst distress MD=-0.71 (2 studies, 95% CI (-1.32, -0.10), p =0.02). Therefore, it is recommended that medical staff identify high-risk groups for thirst early on. Implications for Practice: For patients who cannot eat orally, providing combined care for thirst can increase oral comfort and improve the quality of care.

Keywords: thirst bundle care, intensive care units, meta-analysis, ice water spray, menthol

Procedia PDF Downloads 66

Authors: Philippa Hunter

Abstract:

How might history education support teachers and students to see the past as a provocation, be open to possible futures, and act differently? As teacher educators in an age of diversity and uncertainty, we need to question history’s curriculum nature, pedagogy, and policy intent. The cultural politics of history’s identity in the senior secondary curriculum influences educational socialization (disciplinary, professional, research) and engagement with curriculum decision-making. This paper reflects on curriculum disturbance that shaped a critical pedagogy stance to problematize school history’s certainties. The context is situated in an Aotearoa New Zealand university-based initial teacher education programme. A pedagogic innovation was activated whereby problematized history pedagogy [PHP] was conceptualized as the phenomenon and method of inquiry and storied in doctoral work. The PHP was a reciprocal research process involving history class’ participants and the teacher as researcher, in fashioning teaching identities, identifying with, and thinking critically about history pedagogy. PHP findings revealed evocative discourses of embodiment, nostalgia, and connectedness about living ‘inside the past’. Participants expressed certainty about their abilities as teachers living ‘outside the past’ to interpret historical perspectives. However, discomfort was evident in relation to ‘difficult knowledge’ or unfamiliar contexts of the past that exposed exclusion, powerlessness, or silenced voices. Participants identified history programmes as strongly masculine and conflict-focused. A normalized inquiry-transmission approach to history pedagogy was identified and critiqued. Individuals’ reflexive accounts of PHP implemented whilst on practicum indicate possibilities of history pedagogy as; inclusive and democratic, social and ethical reconstruction, and as a critical project. The PHP sought to reimagine history curriculum and identify spaces of possibility in secondary postgraduate teacher education.

Keywords: curriculum, pedagogy, problematise, reciprocal

Procedia PDF Downloads 159

Authors: L. Freeman, D. Bax, V. K. Sapong

Abstract:

Community-based, preventative approaches to violent extremism may be effective and yet remain an underutilised method. In a realm where security approaches dominate, with the focus on countering violence extremism and combatting radicalisation, community resilience programming remains sparse. This paper will present a survey tool that aims to measure the risk and protective factors that can lead to violent extremism in Mozambique and Tanzania. Conducted in four districts in the Cabo Delgado region of Mozambique and one district in Pwani, Tanzania, the survey uses a combination of BRAVE-14, Afrocentric and context-specific questions in order to more fully understand community resilience opportunities and challenges in preventing and countering violent extremism. Developed in Australia and Canada to measure radicalisation risks in individuals and communities, BRAVE-14 is a tool not yet applied in the African continent. Given the emerging threat of Islamic extremism in Northern Mozambique and Eastern Tanzania, which both experience a combination of socio-political exclusion, resource marginalisation and religious/ideological motivations, the development of the survey is timely and fills a much-needed information gap in these regions. Not only have these Islamist groups succeeded in tapping into the grievances of communities by radicalising and recruiting individuals, but their presence in these regions has been characterised by extreme forms of violence, leaving isolated communities vulnerable to attack. The expected result of these findings will facilitate the contextualisation and comparison of the protective and risk factors that inhibit or promote the radicalisation of the youth in these communities. In identifying sources of resilience and vulnerability, this study emphasises the implementation of context-specific intervention programming and provides a strong research tool for understanding youth and community resilience to violent extremism.

Keywords: community resilience, Mozambique, preventing violent extremism, radicalisation, Tanzania

Procedia PDF Downloads 129

Authors: D. Naranchimeg, G. Ulziisaikhan

Abstract:

Student dropout problem has not been recently investigated within the Mongolian higher education. A student dropping out is a personal decision, but it may cause unemployment and other social problems including low quality of life because students who are not completed a degree cannot find better-paid jobs. The research aims to determine percentage of at-risk students, and understand reasons for dropouts and to find a way to predict. The study based on the students of the Mongolian National University of Education including its Arkhangai branch school, National University of Mongolia, Mongolian University of Life Sciences, Mongolian University of Science and Technology, Mongolian National University of Medical Science, Ikh Zasag International University, and Dornod University. We conducted the paper survey by method of random sampling and have surveyed about 100 students per university. The margin of error - 4 %, confidence level -90%, and sample size was 846, but we excluded 56 students from this study. Causes for exclusion were missing data on the questionnaire. The survey has totally 17 questions, 4 of which was demographic questions. The survey shows that 1.4% of the students always thought to dropout whereas 61.8% of them thought sometimes. Also, results of the research suggest that students’ dropouts from university do not have relationships with their sex, marital and social status, and peer and faculty climate, whereas it slightly depends on their chosen specialization. Finally, the paper presents the reasons for dropping out provided by the students. The main two reasons for dropouts are personal reasons related with choosing wrong study program, not liking the course they had chosen (50.38%), and financial difficulties (42.66%). These findings reveal the importance of early prevention of dropout where possible, combined with increased attention to high school students in choosing right for them study program, and targeted financial support for those who are at risk.

Keywords: at risk students, dropout, faculty climate, Mongolian universities, peer climate

Procedia PDF Downloads 395

Authors: Aytakin Huseynli

Abstract:

The paper reports findings of the study which examined under-five mortality rate among resource-rich countries. Typically when countries obtain wealth citizens gain increased wellbeing. Societies with new wealth create equal opportunities for everyone including vulnerable groups. But scholars claim that this is not the case for developing resource-rich countries and natural resources become the curse for them rather than the blessing. Spillovers from natural resource curse affect the social wellbeing of vulnerable people negatively. They get excluded from the mainstream society, and their situation becomes tangible. In order to test this hypothesis, the study compared under-5 mortality rate among resource-rich countries by using independent sample one-way ANOVA. The data on under-five mortality rate came from the World Bank. The natural resources for this study are oil, gas and minerals. The list of 67 resource-rich countries was taken from Natural Resource Governance Institute. The sample size was categorized and 4 groups were created such as low, low-middle, upper middle and high-income countries based on income classification of the World Bank. Results revealed that there was a significant difference in the scores for low, middle, upper-middle and high-income countries in under-five mortality rate (F(3(29.01)=33.70, p=.000). To find out the difference among income groups, the Games-Howell test was performed and it was found that infant mortality was an issue for low, middle and upper middle countries but not for high-income countries. Results of this study are in agreement with previous research on resource curse and negative effects of resource-based development. Policy implications of the study for social workers, policy makers, academicians and social development specialists are to raise and discuss issues of marginalization and exclusion of vulnerable groups in developing resource-rich countries and suggest interventions for avoiding them.

Keywords: children, natural resource, extractive industries, resource-based development, vulnerable groups

Procedia PDF Downloads 250

Authors: Rukia Yosuf

Abstract:

Diabetes is a national healthcare crisis related to both macrovascular and microvascular complications. We hypothesized that higher levels of physical activity are associated with lower total and visceral fat mass, lower systolic blood pressure, and increased insulin sensitivity. Participant inclusion criteria: 21-50 years old, BMI ≥ 30 kg/m2, hemoglobin A1C 5.7-6.4, fasting glucose 100-125 mg/dL, and HOMA IR ≥ 2.5. Exclusion criteria: history of diabetes, hypertension, HIV, renal disease, hearing loss, alcoholic intake over four drinks daily, use of organic nitrates or PDE5 inhibitors, and decreased cardiac function. Total physical activity was measured using accelerometers, body composition using DXA, and insulin resistance via fsIVGTT. Clinical and biochemical cardiometabolic risk factors, blood pressure and heart rate were obtained using a calibrated sphygmomanometer. Anthropometric measures, fasting glucose, insulin, lipid profile, C-reactive protein, and BMP were analyzed using standard procedures. Within our study, we found correlations between levels of physical activity in a heterogeneous group of prediabetic adults. Patients with more physical activity had a higher degree of insulin sensitivity, lower blood pressure, total visceral adipose tissue, and overall lower total mass. Total physical activity levels showed small, but significant correlations with systolic blood pressure, visceral fat, lean mass and insulin sensitivity. After normalizing for the race, age, and gender using multiple regression, these associations were no longer significant considering our small sample size. More research into prediabetes will decrease the population of diabetics overall. In the future, we could increase sample size and conduct cross sectional and longitudinal studies in various populations with prediabetes.

Keywords: diabetes, kidney disease, nephrology, prediabetes

Procedia PDF Downloads 185

Authors: Ioannis Panagiotopoulos, Efstathios Kastritis, Anastasia Katinioti, Georgios Efthymiadis, Argyrios Doumas, Maria Koutelou

Abstract:

Introduction: Transthyretin amyloidosis (ATTR) is a rare but serious infiltrative disease. Myocardial scintigraphy with DPD has emerged as the most effective, non-invasive, highly sensitive, and highly specific diagnostic method for cardiac ATTR amyloidosis. However, there are cases in which additional laboratory investigations reveal AL amyloidosis or other diseases despite a positive DPD scintigraphy. We describe the experience from the Onassis Cardiac Surgery Center and the monitoring center for infiltrative myocardial diseases of the cardiology clinic at AHEPA. Materials and Methods: All patients with clinical suspicion of cardiac or extracardiac amyloidosis undergo a myocardial scintigraphy scan with Tc-99m DPD. In this way, over 500 patients have been examined. Further diagnostic approach based on clinical and imaging findings includes laboratory investigation and invasive techniques (e.g., biopsy). Results: Out of 76 patients in total with positive myocardial scintigraphy Grade 2 or 3 according to the Perugini scale, 8 were proven to suffer from AL Amyloidosis during the investigation of paraproteinemia. Among these patients, 3 showed Grade 3 uptake, while the rest were graded as Grade 2, or 2 to 3. Additionally, one patient presented diffuse and unusual radiopharmaceutical uptake in soft tissues throughout the body without cardiac involvement. These findings raised suspicions, leading to the analysis of κ and λ light chains in the serum, as well as immunostaining of proteins in the serum and urine of these specific patients. The final diagnosis was AL amyloidosis. Conclusion: The value of DPD scintigraphy in the diagnosis of cardiac amyloidosis from transthyretin is undisputed. However, positive myocardial scintigraphy with DPD should not automatically lead to the diagnosis of ATTR amyloidosis. Laboratory differentiation between ATTR and AL amyloidosis is crucial, as both prognosis and therapeutic strategy are dramatically altered. Laboratory exclusion of paraproteinemia is a necessary and essential step in the diagnostic algorithm of ATTR amyloidosis for all positive myocardial scintigraphy with diphosphonate tracers since >20% of patients with Grade 3 and 2 uptake may conceal AL amyloidosis.

Keywords: AL amyloidosis, amyloidosis, ATTR, myocardial scintigraphy, Tc-99m DPD

Procedia PDF Downloads 71

Authors: Rosario Carmona

Abstract:

This article aims to discuss the importance of indigenous people participation in climate change mitigation and adaptation. Specifically, it analyses different understandings of climate vulnerability among diverse actors involved in climate change policies in Chile: indigenous people, state officials, and academics. These data were collected through participant observation and interviews conducted during October 2017 and January 2019 in Chile. Following Karen O’Brien, there are two types of vulnerability, outcome vulnerability and contextual vulnerability. How vulnerability to climate change is understood determines the approach, which actors are involved and which knowledge is considered to address it. Because climate change is a very complex phenomenon, it is necessary to transform the institutions and their responses. To do so, it is fundamental to consider these two perspectives and different types of knowledge, particularly those of the most vulnerable, such as indigenous people. For centuries and thanks to a long coexistence with the environment, indigenous societies have elaborated coping strategies, and some of them are already adapting to climate change. Indigenous people from Chile are not an exception. But, indigenous people tend to be excluded from decision-making processes. And indigenous knowledge is frequently seen as subjective and arbitrary in relation to science. Nevertheless, last years indigenous knowledge has gained particular relevance in the academic world, and indigenous actors are getting prominence in international negotiations. There are some mechanisms that promote their participation (e.g., Cancun safeguards, World Bank operational policies, REDD+), which are not absent from difficulties. And since 2016 parties are working on a Local Communities and Indigenous Peoples Platform. This paper also explores the incidence of this process in Chile. Although there is progress in the participation of indigenous people, this participation responds to the operational policies of the funding agencies and not to a real commitment of the state with this sector. The State of Chile omits a review of the structure that promotes inequality and the exclusion of indigenous people. In this way, climate change policies could be configured as a new mechanism of coloniality that validates a single type of knowledge and leads to new territorial control strategies, which increases vulnerability.

Keywords: indigenous knowledge, climate change, vulnerability, Chile

Procedia PDF Downloads 121

Authors: Gadia Duhita, Noorhana, Tjhin Wiguna

Abstract:

Background: ADHD is the most common behavioural disorder in Indonesia. A stimulant, specifically methylphenidate, has been the first drug of choice for an ADHD treatment more than half a century. During the last decade, non-stimulant therapy (atomoxetine) for ADHD treatment has been developing. Growing evidence of its efficacy and the difference in its side effects profile to stimulant therapy have made methylphenidate’s position as a first line therapy for ADHD in need of re-evaluation. Both methylphenidate and atomoxetine have proven themselves against placebos in reducing core symptoms of ADHD. More recent studies directly compare the efficacy of methylphenidate and atomoxetine. Objective: The objective of this paper is to find out if either methylphenidate or atomoxetine is superior to another. This paper will assess the validity, importance, and applicability of current available evidence which compare the effectivity, efficacy, and safety of methylphenidate to atomoxetine for treatment in children and adolescents with ADHD. Method: The articles were searched for through the PubMed and Cochrane databases with “attention deficit/hyperactivity disorder OR adhd”, “methylphenidate”, and “atomoxetine” as the search keywords. Two articles which were relevant and eligible were chosen by using inclusion and exclusion criterias to be critically appraised. Result: The study by Hazel et al. showed that the efficacy of methylphenidate and atomoxetine are comparable for treatment in child and adolescent ADHD. The result shows 53.6% (95% CI 48.5%-58.4%) of the patient responded to the treatment by atomoxetine and 54.4% (95% CI 47.6%-61.1%) patients responded to methylphenidate, with the difference in proportion of–0.9% (95% CI –9.2%-7.5%). The other study by Hanwella et al. also showed that the efficacy of atomoxetine was not inferior to metilphenidate (SMD = 0.09, 95% CI –0.08-0.26) (Z = 1.06, p = 0.29). However, the sub-group analysis showed that OROS methylphenidate is more effective compared to atomoxetine (SMD = 0.32, 95% CI 0.12-0.53) (Z = 3.05, p < 0.02). Conclusion: The efficacy of methylphenidate and atomoxetine in reducing symptoms of ADHD is comparable. None is proven inferior to another. The choice of pharmacological tratment children and adolescents with ADHD should be made based on contraindication and the side effects profile of each drug.

Keywords: attention deficit/hyperactivity disorder, ADHD, atomoxetine, methylphenidate

Procedia PDF Downloads 473