Search results for: Greek public hospital sector
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10189

Search results for: Greek public hospital sector

7579 Canada's "Flattened Curve": A Geospatial Temporal Analysis of Canada's Amelioration of the Sars-COV-2 Pandemic Through Coordinated Government Intervention

Authors: John Ahluwalia

Abstract:

As an affluent first-world nation, Canada took swift and comprehensive action during the outbreak of the SARS-CoV-2 (COVID-19) pandemic compared to other countries in the same socio-economic cohort. The United States has stumbled to overcome obstacles most developed nations have faced, which has led to significantly more per capita cases and deaths. The initial outbreaks of COVID-19 occurred in the US and Canada within days of each other and posed similar potentially catastrophic threats to public health, the economy, and governmental stability. On a macro level, events that take place in the US have a direct impact on Canada. For example, both countries tend to enter and exit economic recessions at approximately the same time, they are each other’s largest trading partners, and their currencies are inexorably linked. Why is it that Canada has not shared the same fate as the US (and many other nations) that have realized much worse outcomes relative to the COVID-19 pandemic? Variables intrinsic to Canada’s national infrastructure have been instrumental in the country’s efforts to flatten the curve of COVID-19 cases and deaths. Canada’s coordinated multi-level governmental effort has allowed it to create and enforce policies related to COVID-19 at both the national and provincial levels. Canada’s policy of universal healthcare is another variable. Health care and public health measures are enforced on a provincial level, and it is within each province’s jurisdiction to dictate standards for public safety based on scientific evidence. Rather than introducing confusion and the possibility of competition for resources such as PPE and vaccines, Canada’s multi-level chain of government authority has provided consistent policies supporting national public health and local delivery of medical care. This paper will demonstrate that the coordinated efforts on provincial and federal levels have been the linchpin in Canada’s relative success in containing the deadly spread of the COVID-19 virus.

Keywords: COVID-19, Canada, GIS, temporal analysis, ESRI

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7578 The Impact of Mergers and Acquisitions on Financial Deepening in the Nigerian Banking Sector

Authors: Onyinyechi Joy Kingdom

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Mergers and Acquisitions (M&A) have been proposed as a mechanism through which, problems associated with inefficiency or poor performance in financial institution could be addressed. The aim of this study is to examine the proposition that recapitalization of banks, which encouraged Mergers and Acquisitions in Nigeria banking system, would strengthen the domestic banks, improve financial deepening and the confidence of depositors. Hence, this study examines the impact of the 2005 M&A in the Nigerian-banking sector on financial deepening using mixed method (quantitative and qualitative approach). The quantitative process of this study utilised annual time series for financial deepening indicator for the period of 1997 to 2012. While, the qualitative aspect adopted semi-structured interview to collate data from three merged banks and three stand-alone banks to explore, understand and complement the quantitative results. Furthermore, a framework thematic analysis is employed to analyse the themes developed using NVivo 11 software. Using the quantitative approach, findings from the equality of mean test (EMT) used suggests that M&A have significant impact on financial deepening. However, this method is not robust enough given its weak validity as it does not control for other potential factors that may determine financial deepening. Thus, to control for other factors that may affect the level of financial deepening, a Multiple Regression Model (MRM) and Interrupted Times Series Analysis (ITSA) were applied. The coefficient for M&A dummy turned negative and insignificant using MRM. In addition, the estimated linear trend of the post intervention when ITSA was applied suggests that after M&A, the level of financial deepening decreased annually; however, this was statistically insignificant. Similarly, using the qualitative approach, the results from the interview supported the quantitative results from ITSA and MRM. The result suggests that interest rate should fall when capital base is increased to improve financial deepening. Hence, this study contributes to the existing literature the importance of other factors that may affect financial deepening and the economy when policies that will enhance bank performance and the economy are made. In addition, this study will enable the use of valuable policy instruments relevant to monetary authorities when formulating policies that will strengthen the Nigerian banking sector and the economy.

Keywords: mergers and acquisitions, recapitalization, financial deepening, efficiency, financial crisis

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7577 Predictors of Pelvic Vascular Injuries in Patients with Pelvic Fractures from Major Blunt Trauma

Authors: Osama Zayed

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Aim of the work: The aim of this study is to assess the predictors of pelvic vascular injuries in patients with pelvic fractures from major blunt trauma. Methods: This study was conducted as a tool-assessment study. Forty six patients with pelvic fractures from major blunt trauma will be recruited to the study arriving to department of emergency, Suez Canal University Hospital. Data were collected from questionnaire including; personal data of the studied patients and full medical history, clinical examinations, outcome measures (The Physiological and Operative Severity Score for enumeration of Mortality and morbidity (POSSUM), laboratory and imaging studies. Patients underwent surgical interventions or further investigations based on the conventional standards for interventions. All patients were followed up during conservative, operative and post-operative periods in the hospital for interpretation the predictive scores of vascular injuries. Results: Significant predictors of vascular injuries according to computed tomography (CT) scan include age, male gender, lower Glasgow coma (GCS) scores, occurrence of hypotension, mortality rate, higher physical POSSUM scores, presence of ultrasound collection, type of management, higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) POSSUM scores, presence of abdominal injuries, and poor outcome. Conclusions: There was higher frequency of males than females in the studied patients. There were high probability of morbidity and low probability of mortality among patients. Our study demonstrates that POSSUM score can be used as a predictor of vascular injury in pelvis fracture patients.

Keywords: predictors, pelvic vascular injuries, pelvic fractures, major blunt trauma, POSSUM

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7576 Evidence-Triggers for Care of Patients with Cleft Lip and Palate in Srinagarind Hospital: The Tawanchai Center and Out-Patients Surgical Room

Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

Abstract:

Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

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7575 Marketing and Customer Relationship in Post Consolidation Banking Sector of Nigeria

Authors: Nnedum Obiajuru Anthony Ugochukwu, Ezechukwu Emmanuel Ntomchukwu

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The research investigated the importance of marketing and customer relationship management in post-consolidated banks in achieving success and survival in the face of intense competition and global economic meltdown. The problem lies in the fact that during the pre-consolidation era in the banking industry in Nigeria, banks were comfortable transacting their businesses from their armchairs. Little attention was paid to marketing by banks as a veritable means of achieving and consolidating their profit position. This situation, no doubt sustained because banks were more or less currency exchange centers where customers buy and sell foreign exchange which was highly demanded, but in very short supply. Today, deregulation and consolidation of banks in Nigeria have tremendously increased the tempo of activities in the banking industry, and competition has become very severe among banks. The weak link in the success of post-consolidated banks in Nigeria is the utter neglect, and light or unserious consideration of customer relationship marketing by banks. Armchair banking which banks have been practicing has no regard for marketing as a means to survival. However, in order to survive, post-consolidated banks must take relationship marketing and customer relationship management seriously especially in the face of the current global economic crisis. This paper aims at exploring the role of marketing in building and managing customer relationships as a means to survival in post-consolidation banking in Nigeria.

Keywords: marketing, customer relationships, banking sector, Nigeria

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7574 Public Functions of Kazakh Modern Literature

Authors: Erkingul Soltanaeva, Omyrkhan Abdimanuly, Alua Temirbolat

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In this article, the public and social functions of literature and art in the Republic of Kazakhstan were analyzed on the basis of formal and informal literary organizations. The external and internal, subjective and objective factors which influenced the modern literary process were determined. The literary forces, their consolidation, types of organization in the art of word were examined. The periods of the literary process as planning, organization, promotion, and evaluation and their leading forces and approaches were analyzed. The right point of view to the language and mentality of the society force will influence to the literary process. The Ministry of Culture, the Writers' Union of RK and various non-governmental organizations are having different events for the promotion of literary process and to glorify literary personalities in the entire territory of Kazakhstan. According to the cultural plan of different state administration, there was a big program in order to publish their literary encyclopedia, to glorify and distribute books of own poets and writers of their region to the country. All of these official measures will increase the reader's interest in the book and will also bring up people to the patriotic education and improve the status of the native language. The professional literary publications such as the newspaper ‘Kazakh literature’, magazine ‘Zhuldyz’, and journal ‘Zhalyn’ materials which were published in the periods 2013-2015 on the basis of statistical analysis of the Kazakh literature topical to the issues and the field of themes are identified and their level of connection with the public situations are defined. The creative freedom, relations between society and the individual, the state of the literature, the problems of advantages and disadvantages were taken into consideration in the same articles. The level of functions was determined through the public role of literature, social feature, personal peculiarities. Now the stages as the literature management planning, organization, motivation, as well as the evaluation are forming and developing in Kazakhstan. But we still need the development of literature management to satisfy the actual requirements of the today’s agenda.

Keywords: literature management, material, literary process, social functions

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7573 Frequency of BCR-ABL Fusion Transcript Types with Chronic Myeloid Leukemia by Multiplex Polymerase Chain Reaction in Srinagarind Hospital, Khon Kaen Thailand

Authors: Kanokon Chaicom, Chitima Sirijerachai, Kanchana Chansung, Pinsuda Klangsang, Boonpeng Palaeng, Prajuab Chaimanee, Pimjai Ananta

Abstract:

Chronic myeloid leukemia (CML) is characterized by the consistent involvement of the Philadelphia chromosome (Ph), which is derived from a reciprocal translocation between chromosome 9 and 22, the main product of the t(9;22) (q34;q11) translocation, is found in the leukemic clone of at least 95% of CML patients. There are two major forms of the BCR/ABL fusion gene, involving ABL exon 2, but including different exons of BCR gene. The transcripts b2a2 (e13a2) or b3a2 (e14a2) code for a p210 protein. Another fusion gene leads to the expression of an e1a2 transcript, which codes for a p190 protein. Other less common fusion genes are b3a3 or b2a3, which codes for a p203 protein and e19a2 (c3a2) transcript, which codes for a p230 protein. Its frequency varies in different populations. In this study, we aimed to report the frequency of BCR-ABL fusion transcript types with CML by multiplex PCR (polymerase chain reaction) in Srinagarind Hospital, Khon Kaen, Thailand. Multiplex PCR for BCR-ABL was performed on 58 patients, to detect different types of BCR-ABL transcripts of the t (9; 22). All patients examined were positive for some type of BCR/ABL rearrangement. The majority of the patients (93.10%) expressed one of the p210 BCR-ABL transcripts, b3a2 and b2a2 transcripts were detected in 53.45% and 39.65% respectively. The expression of an e1a2 transcript showed 3.75%. Co-expression of p210/p230 was detected in 3.45%. Co-expression of p210/p190 was not detected. Multiplex PCR is useful, saves time and reliable in the detection of BCR-ABL transcript types. The frequency of one or other rearrangement in CML varies in different population.

Keywords: chronic myeloid leukemia, BCR-ABL fusion transcript types, multiplex PCR, frequency of BCR-ABL fusion

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7572 Designing a Legal Framework for Social Innovation

Authors: Prapin Nuchpiam

Abstract:

The importance of social innovation has become increasingly significant as the process of developing effective solutions to social problems and being a force of change for people’s better quality of life. In order to promote social innovation, active collaboration between government, business organizations, and the civil society sector is needed. A proper legal framework also plays an important role in building the social innovation ecosystem. Currently, there is no specific law designed for social innovation or a so-called “social innovation law”. One of the legal frameworks for social innovation is the development of hybrid legal forms for social enterprises such as the UK’s Community Interest Company (CIC), the US’s Low-Profit Limited Liability Company (L3C) and the US’s Benefit Corporation (B-Corp), among others. This is because social enterprise is recognized as an organizational form of social innovation with its aim for social benefit goals and the achievement of financial sustainability. Nonetheless, there has been a debate over the differences and similarities between social innovation and social enterprise. Thus, social enterprise law might not fit well with social innovation, resulting in a search for a legal framework specially designed for social innovation. This paper aims to study the interrelationship between social innovation, social enterprise, and the role of law to see whether we need a specific law for social innovation. If so, what should such a legal framework look like? The paper will provide a critical analysis of innovative legal forms for social enterprise as a type of social innovation law. A proper legal framework for social innovation could help promote the sector, which could result in finding new solutions to social problems. It will also bring about a greater common understanding of the exciting development of legal scholarship in this way, which will, in turn, serve as a productive basis or direction for further research on this increasingly important topic.

Keywords: social innovation, social enterprise, legal framework, regulation

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7571 Association of Vascular Endothelial Growth Factor Gene +405 C>G and -460 T>C Polymorphism with Type 2 Diabetic Foot Ulcer Patient in Cipto Mangunkusumo National Hospital Jakarta

Authors: Dedy Pratama, Akhmadu Muradi, Hilman Ibrahim, Raden Suhartono, Alexander Jayadi Utama, Patrianef Darwis, S. Dwi Anita, Luluk Yunaini, Kemas Dahlan

Abstract:

Introduction: Vascular endothelial growth factor (VEGF) gene shows association with various angiogenesis conditions including Diabetic Foot Ulcer (DFU) disease. In this study, we performed this study to examine VEGF gene polymorphism associated with DFU. Methods: Case-control study of polymorphism of VEGF gene +405 C>G and -460 T>C, of diabetes mellitus (DM) type 2 with Diabetic Foot Ulcer (DFU) in Cipto Mangunkusumo National Hospital (RSCM) Jakarta from June to December 2016. Results: There were 203 patients, 102 patients with DFU and 101 patients without DFU. Forty-nine point 8 percent of total samples is male and 50,2% female with mean age 56,06 years. Distribution of the wild-type genotype VEGF +405 C>G wild type CC was found in 6,9% of respondents, the number of mutant heterozygote CG was 69,5% and mutant homozygote GG was 19,7%. Cumulatively, there were 6,9% wild-type and 85,2% mutant and 3,9% of total blood samples could not be detected on PCR-RFLP. Distribution of VEGF allele +405 C>G C alleles were 43% and G alleles were 57%. Distribution of genotype from VEGF gene -460 T>C is wild type TT 42,9%, mutant heterozygote TC 37,9% and mutant homozygote CC 13,3%. Cumulatively, there were 42,9% wild-type and 51% mutant type. Distribution of VEGF -460 T>C were 62% T allele and 38% C allele. Conclusion: In this study we found the distribution of alleles from VEGF +405 C>G is C 43% and G 57% and from VEGF -460 T>C; T 62% and C 38%. We propose that G allele in VEGF +405 C>G can act as a protective allele and on the other hands T allele in VEGF -460 T>C could be acted as a risk factor for DFU in diabetic patients.

Keywords: diabetic foot ulcer, diabetes mellitus, polymorphism, VEGF

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7570 Climate Change Adaptation of the Portuguese Viticultural Sector

Authors: H. Fraga, J. A. Santos

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Vitiviniculture in Portugal is a key socio-economic sector, with a strong connection to local traditions and culture. Despite being a relatively small country, with prevailing Mediterranean environments, Portugal comprises an exceptionally large diversity of growth conditions (Terroirs). The vineyard area in Portugal is over 190 thousand hectares, being the eleventh wine producer and ninth wine exporter worldwide. Owing to the strong impact of weather and climate conditions on grapevine physiological development, grape berry quantity and quality show important inter-annual variability. Grapevines are also susceptible to climate change, as their responses will be unavoidably different under future climates. These impacts may change wine typicity of a given region or even its viticultural suitability. The current study reveals that the projected warming and drying trends for Portugal under the Representative Concentration Pathway (RCP) 4.5 and 8.5, are projected to 1) significantly shift current grapevine growing thermal conditions (e.g., heat and chill accumulation), 2) enhance water stress, 3) anticipate phenological timings and 4) modify yields. Moreover, the present study provides some hints regarding the effectiveness of mulching and irrigation as climate change adaptation measures. Our results show that the effectiveness of these adaptation measures will strongly rest on the strength of the climate change signal at a local scale, thus emphasizing the need for local-to-regional climate change assessments.

Keywords: viticulture, climate change, adaptation measures, Portugal

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7569 Splinting in Plastic Surgery Hand Trauma Setting

Authors: Samar Mousa, Rebecca Shirley

Abstract:

Injuries to the hand account for 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. Functional impairments as a result of hand injuries often necessitate absence from employment, resulting in reduced productivity estimated to incur an additional £600m loss to the UK economy. Appropriate and early management is vital to preserve anatomy, prevent stiffness and allow function. The initial assessment and management of hand injuries are usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In our plastic surgery department at Stoke Mandeville hospital Buckinghamshire trust, we carried out an audit project to detect errors in hand splinting in the period between April 2022 and July 2022 and find out measures to support junior doctors, nurses and hand therapists in providing the best possible care for hand trauma patients. Our standards were The British Society for Surgery of the Hand (BSSH) standard of care in hand trauma, AO surgery reference and Stoke Mandeville hospital hand therapy mini protocol Feb 2022 During the period of 4 months, 5 cases were identified. Two cases of wrong splint choice, two cases of early removal of the splint and one tight splint that required change. In order to avoid those mistakes, a training program was given to junior doctors and nurses in collaboration with the hand therapy team regarding ways of splinting the hand in different injuries like fractures, tendons injuries, muscle injuries and ligamentous injuries. In addition to, a poster hung in the examination rooms and theatres to help junior doctors reach the correct decision.

Keywords: splinting, hand trauma, plastic surgery, tendon injury, hand fracrture

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7568 Exclusive Breastfeeding Abandonment among Adolescent Mothers: A Cohort Study

Authors: Maria I. Nuñez-Hernández, Maria L. Riesco

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Background: Exclusive breastfeeding (EBF) up to 6 months old infant have been considered one of the most important factors in the overall development of children. Nevertheless, as resources are scarce, it is essential to identify the most vulnerable groups that have major risk of EBF abandonment, in order to deliver the best strategies. Children of adolescent mothers are within these groups. Aims: To determine the EBF abandonment rate among adolescent mothers and to analyze the associated factors. Methods: Prospective cohort study of adolescent mothers in the southern area of Santiago, Chile, conducted in primary care services of public health system. The cohort was established from 2014 to 2015, with a sample of 105 adolescent mothers and their children at 2 months of life. The inclusion criteria were: adolescent mother from 14 to 19 years old; not twin babies; mother and baby leaving the hospital together after birthchild; correct attachment of the baby to the breast; no difficulty understanding the Spanish language or communicating. Follow-up was performed at 4 and 6 months old infant. Data were collected by interviews, considering EBF as breastfeeding only, without adding other milk, tea, juice, water or other product that not breast milk, except drugs. Data were analyzed by descriptive and inferential statistics, by Kaplan-Meier estimator and Log-Rank test, admitting the probability of occurrence of type I error of 5% (p-value = 0.05). Results: The cumulative EBF abandonment rate at 2, 4 and 6 months was 33.3%, 52.2% and 63.8%, respectively. Factors associated with EBF abandonment were maternal perception of the quality of milk as poor (p < 0.001), maternal perception that the child was not satisfied after breastfeeding (p < 0.001), use of pacifier (p < 0.001), maternal consumption of illicit drugs after delivery (p < 0.001), mother return to school (p = 0.040) and presence of nipple trauma (p = 0.045). Conclusion: EBF abandonment rate was higher in the first 4 months of life and is superior to the population of women who breastfeed. Among the EBF abandonment factors, one of them is related to the adolescent condition, and two are related to the maternal subjective perception.

Keywords: adolescent, breastfeeding, midwifery, nursing

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7567 Effect of Credit Use on Technical Efficiency of Cassava Farmers in Ondo State, Nigeria

Authors: Adewale Oladapo, Carolyn A. Afolami

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Agricultural production should be the major financial contributor to the Nigerian economy; however, the petroleum sector had taken the importance attached to this sector. The situation tends to be more worsening unless necessary attention is given to adequate credit supply among food crop farmers. This research analyses the effect of credit use on the technical efficiency of cassava farmers in Ondo State, Nigeria. Primary data were collected from two hundred randomly selected cassava farmers through a multistage sampling procedure in the study area. Data were analysed using descriptive statistics and stochastic frontier analysis (SFA). Findings revealed that 95.0% of the farmers were male while 56.0% had no formal education and were married. The SFA showed that cassava farmer’s efficiency increased with farm size, herbicide and planting material at 5%,10% and 1% respectively but decreased with fertilizer application at 1% level while farmers’ age, education, household size, experience and access to credit increased technical inefficiency at 10%. The study concluded that cassava farmers are technically inefficient in the use of farm resources and recommended that adequate and workable agricultural policy measures that will ensure availability and efficient fertilizer distribution should be put in place to increase efficiency. Furthermore, the government should encourage youth participation in cassava production and ensure improvement in farmer’s access to credit to increase farmer’s technical efficiency.

Keywords: agriculture, access to credit, cassava farmers, technical efficiency

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7566 A Study of Student Affairs Services across Baghdad Universities: Exploring Best Practices and Impact on Student Success

Authors: Jelena Zivkovic, Haidar Mohammed, Elaf Saeed

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Student affairs services play a critical role in contributing to the wholistic development and success of students as they progress through their academic careers. The study encompasses a multifaceted examination of student affairs service offerings amongst 10 private and 3 public Baghdad universities. Student affairs administrators (13) were surveyed along with over 300 students to determine university-sponsored services and student satisfaction and awareness. The student affairs service research findings varied significantly between private and public institutions and those that followed a national and international curriculum. Universities need to persist to adapt to changing demographics and technological advancements to enhance students' personal and academic successes, and student affairs services are key to preparing graduates to thrive in a diverse global world.

Keywords: student affairs, student success, higher education, Iraq, universities, Baghdad

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7565 Organizational Change in the FBI after 9/11: An Institutional Theoretical Analysis

Authors: Ben D. Atkins

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This study will examine the impact of September 11, 2001, terrorist attacks on the organizational development of American federal law enforcement through focusing on the Federal Bureau of Investigation. Content analysis of discourse in a federal law enforcement practitioner publication along with official FBI statements will be used to gain a better understanding of FBI organizational changes that have taken place since the events of September 11, 2001. Analysis of content trends in the FBI Law Enforcement Bulletin and public discourse of FBI officials from 1999 to 2005 indicate that, in addition to structural changes, the bureau has also undergone a variety of cultural changes. The results offer some support for the institutional theoretical perspective, suggesting that post-9/11 organizational changes such as new mission priorities and the establishment of new branches were partially initiated due to a variety external pressures, which lends support for coercive isomorphism. Furthermore, structural changes are discussed in relation to the attainment and maintenance of organizational legitimacy.

Keywords: institutional theory, organizational theory, law enforcement, public administration

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7564 Food Bolus Obstruction: A Rural Hospital’s Experience

Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

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Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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7563 Genomic and Transcriptomic Analysis of Antibiotic Resistance Genes in Biological Wastewater Treatment Systems Treating Domestic and Hospital Effluents

Authors: Thobela Conco, Sheena Kumari, Chika Nnadozie, Mahmoud Nasr, Thor A. Stenström, Mushal Ali, Arshad Ismail, Faizal Bux

Abstract:

The discharge of antibiotics and its residues into the wastewater treatment plants (WWTP’s) create a conducive environment for the development of antibiotic resistant pathogens. This presents a risk of potential dissemination of antibiotic resistant pathogens and antibiotic resistance genes into the environment. It is, therefore, necessary to study the level of antibiotic resistance genes (ARG’s) among bacterial pathogens that proliferate in biological wastewater treatment systems. In the current study, metagenomic and meta-transcriptomic sequences of samples collected from the influents, secondary effluents and post chlorinated effluents of three wastewater treatment plants treating domestic and hospital effluents in Durban, South Africa, were analyzed for profiling of ARG’s among bacterial pathogens. Results show that a variety of ARG’s, mostly, aminoglycoside, β-lactamases, tetracycline and sulfonamide resistance genes were harbored by diverse bacterial genera found at different stages of treatment. A significant variation in diversity of pathogen and ARGs between the treatment plant was observed; however, treated final effluent samples from all three plants showed a significant reduction in bacterial pathogens and detected ARG’s. Both pre- and post-chlorinated samples showed the presence of mobile genetic elements (MGE’s), indicating the inefficiency of chlorination to remove of ARG’s integrated with MGE’s. In conclusion, the study showed the wastewater treatment plant efficiently caused the reduction and removal of certain ARG’s, even though the initial focus was the removal of biological nutrients.

Keywords: antibiotic resistance, mobile genetic elements, wastewater, wastewater treatment plants

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7562 Effect of a Polyherbal Gut Therapy Protocol in Changes of Gut and Behavioral Symptoms of Antibiotic Induced Dysbiosis of Autistic Babies

Authors: Dinesh K. S., D. R. C. V. Jayadevan

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Autism is the most prevalent of a subset of the disorders organized under the umbrella of pervasive developmental disorders. After the publication of Andrew Wakefield's paper in lancet, many critiques deny this connection even without looking in to the matter. The British Medical Journal even put an editorial regarding this issue. BMJ 2010; 340:c1807. But ayurveda has ample of evidences to believe this connectivity. Dysbiosis, yeast growth of the gut, nutritional deficiencies, enzyme deficiencies, essential fatty acid deficiencies, Gastro esophageal reflux disease, indigestion, inflammatory bowel, chronic constipation & its cascade are few of them to note. The purpose of this paper is to present the observed changes in the behavioural symptoms of autistic babies after a gut management protocol which is a usual programme of our autism treatment plan especially after dysbiotic changes after antibiotic administration. Is there any correlation between changes (if significant) in gut symptoms and behavioral problems of autistic babies especially after a dysbiosis induced by antibiotics. Retrospective analysis of the case sheets of autistic patients admitted in Vaidyaratnam P.S.Varier Ayurveda College hospital, kottakkal,kerala, india from September 2010 are taken for the data processing. Autistic patients are used to come to this hospital as a part of their usual course of treatment. We investigated 40 cases diagnosed as autistic by clinical psychologists from different institutions who had dysbiosis induced by antibiotics. Significant change in gut symptoms before and after treatment p<0.05 in most of its components Significant change in behavioral symptoms before and after treatments p<0.05 in most of the components Correlation between gut symptoms change and behavioral symptoms changes after treatment is + 0.86. Conclusion : Selected Polyherbal Ayurveda treatment has significant role to play to make changes abnormal behaviors in autistic babies and has a positive correlation with changes in gut symptoms induced by dysbiosis of antibiotic intake.

Keywords: ayurveda, autism, dysbiosis, antibiotic

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7561 Impact of Agricultural Infrastructure on Diffusion of Technology of the Sample Farmers in North 24 Parganas District, West Bengal

Authors: Saikat Majumdar, D. C. Kalita

Abstract:

The Agriculture sector plays an important role in the rural economy of India. It is the backbone of our Indian economy and is the dominant sector in terms of employment and livelihood. Agriculture still contributes significantly to export earnings and is an important source of raw materials as well as of demand for many industrial products particularly fertilizers, pesticides, agricultural implements and a variety of consumer goods, etc. The performance of the agricultural sector influences the growth of Indian economy. According to the 2011 Agricultural Census of India, an estimated 61.5 percentage of rural populations are dependent on agriculture. Proper Agricultural infrastructure has the potential to transform the existing traditional agriculture into a most modern, commercial and dynamic farming system in India through its diffusion of technology. The rate of adoption of modern technology reflects the progress of development in agricultural sector. The adoption of any improved agricultural technology is also dependent on the development of road infrastructure or road network. The present study was consisting of 300 sample farmers out which 150 samples was taken from the developed area and rest 150 samples was taken from underdeveloped area. The samples farmers under develop and underdeveloped areas were collected by using Multistage Random Sampling procedure. In the first stage, North 24 Parganas District have been selected purposively. Then from the district, one developed and one underdeveloped block was selected randomly. In the third phase, 10 villages have been selected randomly from each block. Finally, from each village 15 sample farmers was selected randomly. The extents of adoption of technology in different areas were calculated through various parameters. These are percentage area under High Yielding Variety Cereals, percentage area under High Yielding Variety pulses, area under hybrids vegetables, irrigated area, mechanically operated area, amount spent on fertilizer and pesticides, etc. in both developed and underdeveloped areas of North 24 Parganas District, West Bengal. The percentage area under High Yielding Variety Cereals in the developed and underdeveloped areas was 34.86 and 22.59. 42.07 percentages and 31.46 percentages for High Yielding Variety pulses respectively. In the case the area under irrigation it was 57.66 and 35.71 percent while for the mechanically operated area it was 10.60 and 3.13 percent respectively in developed and underdeveloped areas of North 24 Parganas district, West Bengal. It clearly showed that the extent of adoption of technology was significantly higher in the developed area over underdeveloped area. Better road network system helps the farmers in increasing his farm income, farm assets, cropping intensity, marketed surplus and the rate of adoption of new technology. With this background, an attempt is made in this paper to study the impact of Agricultural Infrastructure on the adoption of modern technology in agriculture in North 24 Parganas District, West Bengal.

Keywords: agricultural infrastructure, adoption of technology, farm income, road network

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7560 Impact of Entrepreneurship Education on Entrepreneurial Intention: A Case Study of Al Akhawayn University

Authors: Sara atibi, Azzeddine Atibi, Salim Ahmed, Khadija El Kababi

Abstract:

Given the crucial impact of entrepreneurship on socio-economic development, nations are making various efforts to support and encourage it. Entrepreneurship education has proven to be a vital lever in stimulating business creation. This research is part of this dynamic, which is increasingly attracting the attention of educational policymakers. Indeed, entrepreneurship education provides students with the skills, knowledge, and motivation needed to succeed in various entrepreneurial contexts. it objective is to demonstrate the impact of entrepreneurship education on the development of entrepreneurial intention among students at Al Akhawayn University and to determine whether introducing this discipline at the secondary school level can strengthen this intention, with the aim of proposing measures to foster entrepreneurship. To achieve this objective, it conducted a literature review on entrepreneurship, entrepreneurial intention, and entrepreneurship education to draw from existing experiences in the field. it then carried out an exploratory study through a qualitative survey. it collected real data via an online questionnaire hosted on Google Drive. This questionnaire was tested on a sample of 100 students, adjusted, and validated by three university professors who are experts in the field, and then administered to the students of Al Akhawayn University. The results of our survey among students at Al Akhawayn University clearly show that the development of entrepreneurial intention increases among students who have taken entrepreneurship courses or participated in seminars, thus promoting business creation and entrepreneurship. A minority of these students still choose to work in the private or public sector; however, the majority express a strong desire to become entrepreneurs. We also noted that some students believe entrepreneurship depends solely on entrepreneurial training, while others think it relies on a combination of training, resources, and personal will.

Keywords: entrepreneurship education, entrepreneurial intention, business creation, al akhawayn university, secondary school curriculum

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7559 Empirical Evidence to Beliefs and Perceptions on Mental Health Disorder and Substance Abuse: The Role of a Social Worker

Authors: Helena Baffoe

Abstract:

The US has developed numerous programs over the past 50 years to enhance the lives of those who suffer from mental health illnesses and substance abuse, as well as the effectiveness of their treatments. Despite these advances over the past 50 years, there hasn't been a corresponding improvement in American public attitudes and beliefs about mental health disorders and substance abuse. Highly publicized acts of violence frequently elicit comments that blame the perpetrator's perceived mental health disorder since such people are thought to be substance abusers. Despite these strong public beliefs and perception about mental disorder and substance abuse, concreate empirical evidence that entail this perception is lacking, and evidence of their effectiveness has not been integrated. A rich data was collected from Substance Abuse and Mental Health Services Administration (SAMHSA) with a hypothesis that people who are diagnosed with a mental health disorder are likely to be diagnosed with substance abuse using logit regression analysis and Instrumental Variable. It was found that depressive, anxiety, and trauma/stressor mental disorders constitute the most common mental disorder in the United States, and the study could not find statistically significant evidence that being diagnosed with these leading mental health disorders in the United States does necessarily imply that such a patient is diagnosed with substances abuse. Thus, the public has a misconception of mental health and substance abuse issues, and social workers' responsibilities are outlined in order to assist ameliorate this attitude and perception.

Keywords: mental health disorder, substance abuse, role of a social worker, evidence based research

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7558 Retrospective Insight on the Changing Status of the Romanian Language Spoken in the Republic of Moldova

Authors: Gina Aurora Necula

Abstract:

From its transformation into a taboo and its hiding under the so-called “Moldovan language” or under the euphemistic expression “state language” to its regained status recognition as an official language, the Romanian language spoken in the Republic of Moldova has undergone impressive reforms in the last 60 years. Meant to erase the awareness of citizens’ ethnic identity and turn a majority language into a minority one, all the laws and regulations issued on the field succeeded into setting numerous barriers for speakers of Romanian. Either manifested as social constraints or materialized into assumed rejection of mother tongue usage, all these laws have demonstrated their usefulness and major impact on the Romanian-speaking population. This article is the result of our research carried out over 10 years with the support of students, and Moldovan citizens, from the master's degree program "Romanian language - identity and cultural awareness." We present here a retrospective insight of the reforms, laws, and regulations that contributed to the shifted status of the Romanian language from the official language, seen as the language of common use both in the public and private spheres, in the minority language that surrendered its privileged place to the Russian language, firstly in the public sphere, and then, slowly but surely, in the private sphere. Our main goal here is to identify and make speakers understand what the barriers to learning Romanian language are nowadays when the social pressure on using Russian no longer exists.

Keywords: linguistic barriers, lingua franca, private sphere, public sphere, reformation

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7557 Asymmetrical Informative Estimation for Macroeconomic Model: Special Case in the Tourism Sector of Thailand

Authors: Chukiat Chaiboonsri, Satawat Wannapan

Abstract:

This paper used an asymmetric informative concept to apply in the macroeconomic model estimation of the tourism sector in Thailand. The variables used to statistically analyze are Thailand international and domestic tourism revenues, the expenditures of foreign and domestic tourists, service investments by private sectors, service investments by the government of Thailand, Thailand service imports and exports, and net service income transfers. All of data is a time-series index which was observed between 2002 and 2015. Empirically, the tourism multiplier and accelerator were estimated by two statistical approaches. The first was the result of the Generalized Method of Moments model (GMM) based on the assumption which the tourism market in Thailand had perfect information (Symmetrical data). The second was the result of the Maximum Entropy Bootstrapping approach (MEboot) based on the process that attempted to deal with imperfect information and reduced uncertainty in data observations (Asymmetrical data). In addition, the tourism leakages were investigated by a simple model based on the injections and leakages concept. The empirical findings represented the parameters computed from the MEboot approach which is different from the GMM method. However, both of the MEboot estimation and GMM model suggests that Thailand’s tourism sectors are in a period capable of stimulating the economy.

Keywords: TThailand tourism, Maximum Entropy Bootstrapping approach, macroeconomic model, asymmetric information

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7556 Shattering Negative Stigmas, Creating Empathy and Willingness to Advocate for Unpopular Endangered Species: Evidence from Shark Watching in Israel

Authors: Nurit Carmi

Abstract:

There are many endangered species that are not popular but whose conservation is, nonetheless, important. The present study deals with sharks who suffer from demonization and, accordingly, from public indifference to the deteriorating state of their conservation. We used the seasonal appearance of sharks in the Israeli coastal zone to study public perceptions and attitudes towards sharks prior to ("control group") and after ("visitors") shark watching during a visit in an information center. We found that shark’s image was significantly more positive among the "visitors" compared to the control group. We found that visiting in the information center was strongly related to a more positive shark image, attitudes toward shark conservation, and willingness to act to preserve them.

Keywords: wildlife tourism, shark conservation, attitudes towards animals, human-animal relationships, Smith's salience index

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7555 Reliability of Social Support Measurement Modification of the BC-SSAS among Women with Breast Cancer Who Undergone Chemotherapy in Selected Hospital, Central Java, Indonesia

Authors: R. R. Dewi Rahmawaty Aktyani Putri, Earmporn Thongkrajai, Dedy Purwito

Abstract:

There were many instruments have been developed to assess social support which has the different dimension in breast cancer patients. The Issue of measurement is a challenge to determining the component of dimensional concept, defining the unit of measurement, and establishing the validity and reliability of the measurement. However, the instruments where need to know how much support which obtained and perceived among women with breast cancer who undergone chemotherapy which it can help nurses to prevent of non-adherence in chemotherapy. This study aimed to measure the reliability of BC-SSAS instrument among 30 Indonesian women with breast cancer aged 18 years and above who undergone chemotherapy for six cycles in the oncological unit of Outpatient Department (OPD), Margono Soekardjo Hospital, Central Java, Indonesia. Data were collected during October to December 2015 by using modified the Breast Cancer Social Support Assessment (BC-SSAS). The Cronbach’s alpha analysis was carried out to measure internal consistency for reliability test of BC-SSAS instrument. This study used five experts for content validity index. The results showed that for content validity, I-CVI was 0.98 and S-CVI was 0.98; Cronbach’s alpha value was 0.971 and the Cronbach’s alpha coefficients for the subscales were high, with 0.903 for emotional support, 0.865 for informational support, 0.901 for tangible support, 0.897 for appraisal support and 0.884 for positive interaction support. The results confirmed that the BC-SSAS instrument has high reliability. BC-SSAS instruments were reliable and can be used in health care services to measure the social support received and perceived among women with breast cancer who undergone chemotherapy so that preventive interventions can be developed and the quality of health services can be improved.

Keywords: BC-SSAS, women with breast cancer, chemotherapy, Indonesia

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7554 Prevalence of Diabetes Mellitus Among Human Immune Deficiency Virus-Positive Patients Under Anti-retroviral Attending in Rwanda, a Case Study of University Teaching Hospital of Butare

Authors: Venuste Kayinamura, V. Iyamuremye, A. Ngirabakunzi

Abstract:

Anti-retroviral therapy (ART) for HIV patient can cause a deficiency in glucose metabolism by promoting insulin resistance, glucose intolerance, and diabetes, diabetes mellitus keep increasing among HIV-infected patients worldwide but there is limited data on levels of blood glucose and its relationship with antiretroviral drugs (ARVs) and HIV-infection worldwide, particularly in Rwanda. A convenient sampling strategy was used in this study and it involved 323 HIV patients (n=323). Patients who are HIV positive under ARVs were involved in this study. The patient’s blood glucose was analyzed using an automated machine or glucometer (COBAS C 311). Data were analyzed using Microsoft Excel and SPSS V. 20.0 and presented in percentages. The highest diabetes mellitus prevalence was 93.33 % in people aged >40 years while the lowest diabetes mellitus prevalence was 6.67% in people aged between 21-and 40 years. The P-value was (0.021). Thus, there is a significant association between age and diabetes occurrence. The highest diabetes mellitus prevalence was 28.2% in patients under ART treatment for more than 10 years, 16.7% were <5years while 20% of patients were on ART treatment between 5-10 years. The P-value here is (0.03), thus the incidence of diabetes is associated with long-term ART use in HIV-infected patients. This study assessed the prevalence of diabetes among HIV-infected patients under ARVs attending the University Teaching Hospital of Butare (CHUB), it shows that the prevalence of diabetes is high in HIV-infected patients under ARTs. This study found no significant relationship between gender and diabetes mellitus growth. Therefore, regular assessment of diabetes mellitus especially among HIV-infected patients under ARVs is highly recommended to control other health issues caused by diabetes mellitus.

Keywords: anti-retroviral, diabetes mellitus, antiretroviral therapy, human immune deficiency virus

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7553 An Exploratory of the Use of English in Contemporary Society

Authors: Saksit Saengboon

Abstract:

The study of English in Thailand receives comparatively little attention in the world of Englishes scholarship despite a complex and dynamic linguistic landscape. Like many countries in the region, English is used in predictable contexts, such as schools and at work. However, English is being increasingly used as a contact language among Thais and non-Thais, requiring much needed empirical attention. This study aims to address this neglected issue by examining how Thais perceive and use English in contemporary Thai society. This study explored the ways in which English has been used in public signage, mass media, especially about Thai food, and perceptions of Thais (N = 80) regarding English. Findings indicate that English in Thailand is used in a complicated manner portraying both standard and non-standard English. Thais still hold a static or traditional view of English, making it impractical, if not impossible, to have Thai English as an established variety.

Keywords: Thai english, thainess in english, public signage, mass media, thai food, thai linguistic landscape

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7552 The Academic-Practitioner Nexus in Countering Terrorism in New Zealand

Authors: John Battersby, Rhys Ball

Abstract:

After the 15 March 2019 Mosque attacks in Christchurch, the New Zealand security sector has had to address its training and preparedness levels for dealing with contemporary terrorist threats as well as potential future manifestations of terrorism. From time to time, members of the academic community from Australia and New Zealand have been asked to assist agencies in this endeavour. In the course of 2018, New Zealand security sector professionals working in the counter-terrorism area were interviewed about how they regarded academic contributions to understanding terrorism and counter-terrorism. Responses were mixed, ranging from anti-intellectualism, a belief that the inability to access classified material rendered academic work practically useless - to some genuine interest and desire for broad based academic studies on issues practitioners did not have the time to look at. Twelve months later, researchers have revisited those spoken to prior to the Brenton Tarrant 15 March shooting to establish if there has been a change in the way academic research is perceived, viewed and valued, and what key factors have contributed to this shift in thinking. This paper takes this data, combined with a consideration of the literature on higher education within professional police and intelligence forces, and on the general perception of academics by practitioners, to present a series of findings that will contribute to a more proactive and effective set of engagements, between two distinct but important security sectors, that reflect more closely with international practice.

Keywords: academic, counter terrorism, intelligence, practitioner, research, security

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7551 Measuring Human Perception and Negative Elements of Public Space Quality Using Deep Learning: A Case Study of Area within the Inner Road of Tianjin City

Authors: Jiaxin Shi, Kaifeng Hao, Qingfan An, Zeng Peng

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Due to a lack of data sources and data processing techniques, it has always been difficult to quantify public space quality, which includes urban construction quality and how it is perceived by people, especially in large urban areas. This study proposes a quantitative research method based on the consideration of emotional health and physical health of the built environment. It highlights the low quality of public areas in Tianjin, China, where there are many negative elements. Deep learning technology is then used to measure how effectively people perceive urban areas. First, this work suggests a deep learning model that might simulate how people can perceive the quality of urban construction. Second, we perform semantic segmentation on street images to identify visual elements influencing scene perception. Finally, this study correlated the scene perception score with the proportion of visual elements to determine the surrounding environmental elements that influence scene perception. Using a small-scale labeled Tianjin street view data set based on transfer learning, this study trains five negative spatial discriminant models in order to explore the negative space distribution and quality improvement of urban streets. Then it uses all Tianjin street-level imagery to make predictions and calculate the proportion of negative space. Visualizing the spatial distribution of negative space along the Tianjin Inner Ring Road reveals that the negative elements are mainly found close to the five key districts. The map of Tianjin was combined with the experimental data to perform the visual analysis. Based on the emotional assessment, the distribution of negative materials, and the direction of street guidelines, we suggest guidance content and design strategy points of the negative phenomena in Tianjin street space in the two dimensions of perception and substance. This work demonstrates the utilization of deep learning techniques to understand how people appreciate high-quality urban construction, and it complements both theory and practice in urban planning. It illustrates the connection between human perception and the actual physical public space environment, allowing researchers to make urban interventions.

Keywords: human perception, public space quality, deep learning, negative elements, street images

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7550 Understanding the Architecture of Hindu Temples: A Philosophical Interpretation

Authors: A. Bandyopadhyay

Abstract:

Vedic philosophy is one of the oldest existing philosophies of the world. Started around 6500 BC, in Western Indian subcontinent, the Indus valley Civilizations developed a theology which, gradually developed into a well-established philosophy of beliefs, popularly known as ‘Hindu religion’. In Vedic theology, the abstract concept of God was formulated mostly by close observation of the dynamicity and the recurrence of natural and universal phenomena. Through the ages, the philosophy of this theology went through various discursions, debates, and questionings and the abstract concept of God was, in time, formalized into more representational forms by the means of various signs and symbols. Often, these symbols were used in more subtle ways in the construction of “sacred” sculptures and structures. Apparently, two different philosophies were developed from the Vedic philosophy and these two philosophies are mostly seen in the northern part and southern part of the Indian subcontinent. This paper tries to summarize the complex philosophical treaties of Hinduism of northern and southern India and seeks to understand the meanings of the various signs and symbolisms that were incorporated in the architecture of Hindu temples, including the names given to various parts of the temples. The Hindu temples are not only places of worship or ‘houses of Gods’ like the Greek and Roman temples but are also structures that symbolize the dynamicity and also spiritual upliftment of human beings.

Keywords: Hindu, philosophy, temple, Vedic

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