Search results for: female sex worker
287 A Lung Cancer Patient Grief Counseling Nursing Experience
Authors: Syue-Wen Lin
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Objective: This article explores the nursing experience of a 64-year-old female lung cancer patient who underwent a thoracoscopic left lower lobectomy and treatment. The patient has a history of diabetes. The nursing process included cancer treatment, postoperative pain management, wound care and healing, and family grief counseling. Methods: The nursing period is from March 11 to March 15, 2024. During this time, strict aseptic wound dressing procedures and advanced wound care techniques are employed to promote wound healing and prevent infection. Postoperatively, due to the development of aspiration pneumonia and worsening symptoms, re-intubation was necessary. Given the patient's advanced cancer and deteriorating condition, the nursing team provided comprehensive grief counseling and care tailored to both the patient's physical and psychological needs, as well as the emotional needs of the family. Considering the complexity of the patient's condition, including advanced cancer, palliative care was also integrated into the overall nursing process to alleviate discomfort and provide psychological support. Results: Using Gordon's Functional Health Patterns for assessment, including evaluating the patient's medical history, physical assessment, and interviews, to provide individualized nursing care, it is important to collect data that will help understand the patient's physical, psychological, social, and spiritual dimensions. The interprofessional critical care team collaborates with the hospice team to help understand the psychological state of the patient's family and develop a comprehensive approach to care. Family meetings should be convened, and support should be provided to patients during the final stages of their lives. Additionally, the combination of cancer care, pain management, wound care, and palliative care ensures comprehensive support for the patient throughout her recovery, thereby improving her quality of life. Conclusion: Lung cancer and aspiration pneumonia present significant challenges to patients, and the nursing team not only provides critical care but also addresses individual patient needs through cancer care, pain management, wound care, and palliative care interventions. These measures have effectively improved the quality of life of patients, provided compassionate palliative care to terminally ill patients, and allowed them to spend the last mile of their lives with their families. Nursing staff work closely with families to develop comprehensive care plans to ensure patients receive high-quality medical care as well as psychological support and a comfortable recovery environment.Keywords: grief counseling, lung cancer, palliative care, nursing experience
Procedia PDF Downloads 26286 Ergonomic Assessment of Workplace Environment of Flour Mill Workers
Authors: Jayshree P. Zend, Ashatai B. Pawar
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The study was carried out in Parbhani district of Maharashtra state, India with the objectives to study environmental problems faced by flour mill workers, prevalence of work-related health hazards and the physiological cost of workers while performing work in flour mill in traditional method as well as improved method. The use of flour presser, dust controlling bag and noise and dust controlling mask developed by AICRP College of Home Science, VNMKV, Parbhani was considered as an improved method. This investigation consisted survey and experiment which was conducted in the respective locations of flour mills. Healthy, non-smoking 30 flour mill workers ranged between the age group of 20-50 yrs comprising 16 female and 14 male working at flour mill for 4-8 hrs/ day and 6 days/ week and had minimum five years experience of work in flour mill were selected for the study. Pulmonary function test of flour mill workers was carried out by trained technician at Dr. ShankarraoChavan Government Medical College, Nanded by using Electronic Spirometer. The data regarding heart rate (resting, working and recovery), energy expenditure, musculoskeletal problems and occupational health hazards and accidents were recorded by using pretested questionnaire. Scientific equipment used in the experiment were polar sport test heart rate monitor, Hygrometer, Goniometer, Dialed Thermometer, Sound Level Meter, Lux Meter, Ambient Air Sampler and Air Quality Monitor. The collected data were subjected to appropriate statistical analysis such as 't' test and correlation coefficient test. Results indicated that improved method i.e. use of noise and dust controlling mask, flour presser and dust controlling bag were effective in reducing physiological cost of work of flour mill workers. Lung function test of flour mill workers showed decreased values of all parameters, hence the results of present study support paying attention to use of personal protective noise and dust controlling mask by flour mill workers and also to the working conditions in flour mill especially ventilation and illumination level needs to be enhanced in flour mill. The study also emphasizes the need to develop some mechanism for lifting load of grains and unloading in the hopper. It is also suggested that the flour mill workers should use flour presser suitable to their height to avoid frequent bending and should use dust controlling bag to flour outlet of machine to reduce inhalable flour dust level in the flour mill.Keywords: physiological cost, energy expenditure, musculoskeletal problems
Procedia PDF Downloads 401285 Stuttering Persistence in Children: Effectiveness of the Psicodizione Method in a Small Italian Cohort
Authors: Corinna Zeli, Silvia Calati, Marco Simeoni, Chiara Comastri
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Developmental stuttering affects about 10% of preschool children; although the high percentage of natural recovery, a quarter of them will become an adult who stutters. An effective early intervention should help those children with high persistence risk for the future. The Psicodizione method for early stuttering is an Italian behavior indirect treatment for preschool children who stutter in which method parents act as good guides for communication, modeling their own fluency. In this study, we give a preliminary measure to evaluate the long-term effectiveness of Psicodizione method on stuttering preschool children with a high persistence risk. Among all Italian children treated with the Psicodizione method between 2018 and 2019, we selected 8 kids with at least 3 high risk persistence factors from the Illinois Prediction Criteria proposed by Yairi and Seery. The factors chosen for the selection were: one parent who stutters (1pt mother; 1.5pt father), male gender, ≥ 4 years old at onset; ≥ 12 months from onset of symptoms before treatment. For this study, the families were contacted after an average period of time of 14,7 months (range 3 - 26 months). Parental reports were gathered with a standard online questionnaire in order to obtain data reflecting fluency from a wide range of the children’s life situations. The minimum worthwhile outcome was set at "mild evidence" in a 5 point Likert scale (1 mild evidence- 5 high severity evidence). A second group of 6 children, among those treated with the Piscodizione method, was selected as high potential for spontaneous remission (low persistence risk). The children in this group had to fulfill all the following criteria: female gender, symptoms for less than 12 months (before treatment), age of onset <4 years old, none of the parents with persistent stuttering. At the time of this follow-up, the children were aged 6–9 years, with a mean of 15 months post-treatment. Among the children in the high persistence risk group, 2 (25%) hadn’t had stutter anymore, and 3 (37,5%) had mild stutter based on parental reports. In the low persistency risk group, the children were aged 4–6 years, with a mean of 14 months post-treatment, and 5 (84%) hadn’t had stutter anymore (for the past 16 months on average).62,5% of children at high risk of persistence after Psicodizione treatment showed mild evidence of stutter at most. 75% of parents confirmed a better fluency than before the treatment. The low persistence risk group seemed to be representative of spontaneous recovery. This study’s design could help to better evaluate the success of the proposed interventions for stuttering preschool children and provides a preliminary measure of the effectiveness of the Psicodizione method on high persistence risk children.Keywords: early treatment, fluency, preschool children, stuttering
Procedia PDF Downloads 215284 Effects of Gender on Kinematics Kicking in Soccer
Authors: Abdolrasoul Daneshjoo
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Soccer is a game which draws more attention in different countries especially in Brazil. Kicking among different skills in soccer and soccer players is an excellent role for the success and preference of a team. The way of point gaining in this game is passing the ball over the goal lines which are gained by shoot skill in attack time and or during the penalty kicks.Regarding the above assumption, identifying the effective factors in instep kicking in different distances shoot with maximum force and high accuracy or pass and penalty kick, may assist the coaches and players in raising qualitative level of performing the skill.The aim of the present study was to study of a few kinematical parameters in instep kicking from 5 and 7 meter distance among the male and female elite soccer players.24 right dominant lower limb subjects (12 males and 12 females) among Tehran elite soccer players with average and the standard deviation (22.5 ± 1.5) & (22.08± 1.31) years, height of (179.5 ± 5.81) & (164.3 ± 4.09) cm, weight of (69.66 ± 4.09) & (53.16 ± 3.51) kg, %BMI (21.06 ± .731) & (19.67 ± .709), having playing history of (4 ± .73) & (3.08 ± .66) years respectively participated in this study. They had at least two years of continuous playing experience in Tehran soccer league.For sampling player's kick; Kinemetrix Motion analysis with three cameras with 1000 Hz was used. Five reflective markers were placed laterally on the kicking leg over anatomical points (the iliac crest, major trochanter, lateral epicondyle of femur, lateral malleolus, and lateral aspect of distal head of the fifth metatarsus). Instep kick was filmed, with one step approach and 30 to 45 degrees angle from stationary ball. Three kicks were filmed, one kick selected for further analyses. Using Kinemetrix 3D motion analysis software, the position of the markers was analyzed. Descriptive statistics were used to describe the mean and standard deviation, while the analysis of variance, and independent t-test (P < 0.05) were used to compare the kinematic parameters between two genders.Among the evaluated parameters, the knee acceleration, the thigh angular velocity, the angle of knee proportionately showed significant relationship with consequence of kick. While company performance on 5m in 2 genders, significant differences were observed in internal – external displacement of toe, ankle, hip and the velocity of toe, ankle and the acceleration of toe and the angular velocity of pelvic, thigh and before time contact . Significant differences showed the internal – external displacement of toe, the ankle, the knee and the hip, the iliac crest and the velocity of toe, the ankle and acceleration of ankle and angular velocity of the pelvic and the knee.Keywords: biomechanics, kinematics, instep kicking, soccer
Procedia PDF Downloads 502283 Photovoice-Through Photographs to Feelings: Investigation of Experience Reporting in a Randomized Controlled Study
Authors: Selina Studer, Maria Kleinstäuber, Cornelia Weise
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Background: Finding words to report what you have been through may be challenging, especially when dealing with stressful or highly emotional experiences. Photovoice (PV) represents a possible way of facilitating experience reporting. In this approach, people take photos about a particular topic (in our study: worries about the future) and talk about the topic based on the photos. So far, the benefits of Photovoice have been quantitatively insufficiently tested. There is a lack of randomized controlled trials investigating PV in comparison to other methods. This study aimed to fill this research gap. Methods: 65 participants took part in the study and were randomly assigned to the PV group, the writing group (WG), or the control group (CG). The PV group received the task to take photos of worries regarding the future for one week and send max. 5 of them to the interviewer before the interview. The WG had to write down the worries about the future and send max. 5 of them to the interviewer before the interview. The control group did not receive a specific assignment. The semi-structured interview consisted of six open-ended questions and was applied to all future worries. The questions included the content of the future worries, the meaning, and how the worry expressed itself emotionally and physically. The interview was recorded and later transcribed. After the interview, online questionnaires were filled out. They covered a range of variables such as access to emotional content, ability to describe feelings, the extent of self-disclosure, and relationship quality. Results: Contrary to our hypotheses, one-way ANOVA revealed no differences between the three conditions concerning all variables (access to emotional content, ability to describe feelings, the extent of self-disclosure, and so on), all p's > 0.14, BF₀₁ = 1.78-7.66. In a subsequent step, the words in the transcribed interviews were analyzed. The LIWC program counted how many emotional words occurred in the text and assigned them to predefined categories. Planned contrasts revealed that the PV reported more negative emotional words compared to the two groups t(62) = 2.62, p = .011, and also compared to the WG only, t(62) = 2.36, p = .022, BF₀₁ = 0.62. Conclusions and implications: The applied self-report instruments did not reveal any differences between the groups. However, the PV group used more negative emotional words than the other two groups. The discrepancy between self-report and observation variables regarding emotionality is noticeable. It is suggested that the highly educated and above-average female sample may not have needed PV to access emotional content. It is possible that the approach would yield clearer results in a clinical sample. This and other approaches are currently being investigated in a follow-up study.Keywords: photovoice, controlled randomized study, online intervention, emotional awareness, self-disclosure, data triangulation, interviews
Procedia PDF Downloads 72282 Prevalence of Emotional Problems among Adolescent Students of Corporation Schools in Chennai
Authors: Vithya Veeramani, Karunanidhi Subbaiah
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Emotional problems were found to be the predominant cause of suicide and second leading cause of death among adolescents in India. Emotional problems seem to be the underlying cause for various other severe psycho-social problems experienced in adolescence and also in later years of life. The Corporation schools in Chennai city are named as Chennai High School or Chennai Higher Secondary School run by the Corporation of Chennai. These schools fulfill the educational needs of students who hail from lower socio-economic status living in slums of the Chennai city. Adolescent students of Chennai schools tend to lack basic needs like food, clothes, shelter, etc. Some of the other significant problems faced by them are broken family, lack of parental support, frequent quarrel between parents, alcoholic parents, drug abuse and substance abuse among parents and neighbors, extended family, illiterate parents, deprivation of love and care, and lack of sense of belongingness. This prevailing condition may affect them emotionally and could lead to maladaptive behaviour, aggressiveness, poor interpersonal relationship with others, school refusal behaviour, school drop-out, suicide, etc. Therefore, it is very important to investigate the emotional problems faced by the adolescent students studying in Chennai schools, Chennai. A cross-sectional survey design was used to find the prevalence of emotional problems among adolescent students. Cluster sampling technique was used to select the schools for the present study considering the school as a cluster. In total, there are 15 zones, under the control of Chennai Corporation, of which only 7 zones have Corporation Schools in Chennai city, comprising of 32 Chennai Higher Secondary Schools and 38 Chennai High Schools. Out of these 70 schools, 29 schools comprising of 17 high schools and 12 higher secondary schools were selected randomly using lottery method. A sample of 2594 adolescent students from 9th standard and 11th standard was chosen for the study. Percentage analysis was done to find out the prevalence rate of emotional problems among adolescents students studying in Chennai Schools. Results of the study revealed that, out of 2594 students surveyed, 21.04% adolescent students were found to have academic problems (n = 546), 15.99% adolescent students had social problems (n = 415), behaviour problems was found to be prevalent among 12.87% adolescent students (n = 334), depression was prevalent among 15.88% adolescent students (n = 412) and anxiety was prevalent among 14.42% adolescent students (n = 374). Prevalence of emotional problems among male and female revealed that academic problems were more prevalent compared to other problems. Behaviour problems were least prevalent among boys and anxiety was least prevalent among girls than other problems. The overall prevalence rate of emotional problems was found to be on an increasing trend among adolescent students of low socio-economic status in Chennai city. The findings indicated the need for intervention to prevent and rehabilitate these adolescent students.Keywords: adolescents, corporation schools, emotional problems, prevalence
Procedia PDF Downloads 222281 The Relationships among Self-Efficacy, Critical Thinking and Communication Skills Ability in Oncology Nurses for Cancer Immunotherapy in Taiwan
Authors: Yun-Hsiang Lee
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Cancer is the main cause of death worldwide. With advances in medical technology, immunotherapy, which is a newly developed advanced treatment, is currently a crucial cancer treatment option. For better quality cancer care, the ability to communicate and critical thinking plays a central role in clinical oncology settings. However, few studies have explored the impact of communication skills on immunotherapy-related issues and their related factors. This study was to (i) explore the current status of communication skill ability for immunotherapy-related issues, self-efficacy for immunotherapy-related care, and critical thinking ability; and (ii) identify factors related to communication skill ability. This is a cross-sectional study. Oncology nurses were recruited from the Taiwan Oncology Nursing Society, in which nurses came from different hospitals distributed across four major geographic regions (North, Center, South, East) of Taiwan. A total of 123 oncology nurses participated in this study. A set of questionnaires were used for collecting data. Communication skill ability for immunotherapy issues, self-efficacy for immunotherapy-related care, critical thinking ability, and background information were assessed in this survey. Independent T-test and one-way ANOVA were used to examine different levels of communication skill ability based on nurses having done oncology courses (yes vs. no) and education years (< 1 year, 1-3 years, and > 3 years), respectively. Spearman correlation was conducted to understand the relationships between communication skill ability and other variables. Among the 123 oncology nurses in the current study, the majority of them were female (98.4%), and most of them were employed at a hospital in the North (46.8%) of Taiwan. Most of them possessed a university degree (78.9%) and had at least 3 years of prior work experience (71.7%). Forty-three of the oncology nurses indicated in the survey that they had not received oncology nurses-related training. Those oncology nurses reported moderate to high levels of communication skill ability for immunotherapy issues (mean=4.24, SD=0.7, range 1-5). Nurses reported moderate levels of self-efficacy for immunotherapy-related care (mean=5.20, SD=1.98, range 0-10) and also had high levels of critical thinking ability (mean=4.76, SD=0.60, range 1-6). Oncology nurses who had received oncology training courses had significantly better communication skill ability than those who had not received oncology training. Oncology nurses who had higher work experience (1-3 years, or > 3 years) had significantly higher levels of communication skill ability for immunotherapy-related issues than those with lower work experience (<1 year). When those nurses reported better communication skill ability, they also had significantly better self-efficacy (r=.42, p<.01) and better critical thinking ability (r=.47, p<.01). Taken altogether, courses designed to improve communication skill ability for immunotherapy-related issues can make a significant impact in clinical settings. Communication skill ability for oncology nurses is the major factor associated with self-efficacy and critical thinking, especially for those with lower work experience (< 1 year).Keywords: communication skills, critical thinking, immunotherapy, oncology nurses, self-efficacy
Procedia PDF Downloads 105280 Poisoning in Morocco: Evolution and Risk Factors
Authors: El Khaddam Safaa, Soulaymani Abdelmajid, Mokhtari Abdelghani, Ouammi Lahcen, Rachida Soulaymani-Beincheikh
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The poisonings represent a problem of health in the world and Morocco, The exact dimensions of this phenomenon are still poorly recorded that we see the lack of exhaustive statistical data. The objective of this retrospective study of a series of cases of the poisonings declared at the level of the region of Tadla-Azilal and collected by the Moroccan Poison Control and Pharmacovigilance Center. An epidemiological profile of the poisonings was to raise, to determine the risk factors influencing the vital preview of the poisoned And to follow the evolution of the incidence, the lethality, and the mortality. During the period of study, we collected and analyzed 9303 cases of poisonings by different incriminated toxic products with the exception of the scorpion poisonings. These poisonings drove to 99 deaths. The epidemiological profile which we raised, showed that the poisoned were of any age with an average of 24.62±16.61 years, The sex-ratio (woman/man) was 1.36 in favor of the women. The difference between both sexes is highly significant (χ2 = 210.5; p<0,001). Most of the poisoned which declared to be of urban origin (60.5 %) (χ2=210.5; p<0,001). Carbon monoxide was the most incriminated among the cases of poisonings (24.15 %), them putting in head, followed by some pesticides and farm produces (21.44 %) and food (19.95 %). The analysis of the risk factors showed that the grown-up patients whose age is between 20 and 74 years have twice more risk of evolving towards the death (RR=1,57; IC95 % = 1,03-2,38) than the other age brackets, so the male genital organ was the most exposed (explained) to the death that the female genital organ (RR=1,59; IC95 % = 1,07-2,38) The patients of rural origin had presented 5 times more risk (RR=4,713; IC95 % = 2,543-8,742). Poisoned by the mineral products had presented the maximum of risk on the vital preview death (RR=23,19, IC95 % = 2,39-224,1). The poisonings by pesticides produce a risk of 9 (RR=9,31; IC95 % = 6,10-14,18). The incidence was 3,3 cases of 10000 inhabitants, and the mortality was 0,004 cases of 1000 inhabitants (that is 4 cases by 1000 000 inhabitants). The rate of lethality registered annually was 10.6 %. The evolution of the indicators of health according to the years showed that the rate of statement measured by the incidence increased by a significant way. We also noted an improvement in the coverage which (who) ended up with a decrease in the rate of the lethality and the mortality during last years. The fight anti-toxic is a work of length time. He asks for a lot of work various levels. It is necessary to attack the delay accumulated by our country on the various legal, institutional and technical aspects. The ideal solution is to develop and to set up a national strategy.Keywords: epidemiology, poisoning, risk factors, indicators of health, Tadla-Azilal grated by anti-toxic fight
Procedia PDF Downloads 365279 Loss of Green Space in Urban Metropolitan and Its Alarming Impacts on Teenagers' Life: A Case Study on Dhaka
Authors: Nuzhat Sharmin
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Human being is the most integral part of the nature and responsible for maintaining ecological balance both in rural and urban areas. But unfortunately, we are not doing our job with a holistic approach. The rapid growth of urbanization is making human life more isolated from greenery. Nowadays modern urban living involves sensory deprivation and overloaded stress. In many cities and towns of the world are expanding unabated in the name of urbanization and industrialization and in fact becoming jungles of concrete. Dhaka is one of the examples of such cities where open and green spaces are decreasing because of accommodating the overflow of population. This review paper has been prepared based on interviewing 30 teenagers, both male and female in Dhaka city. There were 12 open-ended questions in the questionnaire. For the literature review information had been gathered from scholarly papers published in various peer-reviewed journals. Some information was collected from the newspapers and some from fellow colleagues working around the world. Ideally about 25% of an urban area should be kept open or with parks, fields and/or plants and vegetation. But currently Dhaka has only about 10-12% open space and these also are being filled up rapidly. Old Dhaka has only about 5% open space while the new Dhaka has about 12%. Dhaka is now one of the most populated cities in the world. Accommodating this huge influx of people Dhaka is continuously losing its open space. As a result, children and teenagers are losing their interest in playing games and making friends, rather they are mostly occupied by television, gadgets and social media. It has been known from the interview that only 28% of teenagers regularly play. But the majority of them have to play on the street and rooftop for the lack of open space. On an average they are occupied with electronic devices for 8.3 hours/day. 64% of them has chronic diseases and often visit doctors. Most shockingly 35% of them claimed for not having any friends. Green space offers relief from stress. Areas of natural environment in towns and cities are theoretically seen providing setting for recovery and recuperation from anxiety and strains of the urban environment. Good quality green spaces encourage people to walk, run, cycle and play. Green spaces improve air quality and reduce noise, while trees and shrubbery help to filter out dust and pollutants. Relaxation, contemplation and passive recreation are essential to stress management. All city governments that are losing its open spaces should immediately pay attention to this aesthetic issue for the benefit of urban people. All kinds of development must be sustainable both for human being and nature.Keywords: greenery, health, human, urban
Procedia PDF Downloads 175278 Communication Barriers in Midwifery Students in the Field of Perinatal Palliative Care
Authors: Magdalena Hasplova, Katerina Ivanova
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Perinatal palliative care is a relatively young and developing field that includes the care of a fetus or newborn with a life-threatening or limiting defect and his family. However, the training of midwives in perinatal palliative care is insufficient and midwives do not feel prepared for this aspect of their work. This fact can affect the barriers to communication with the mother or family of the endangered child. The main aim was to analyze the awareness of midwifery students on the issue of perinatal palliative care in the Czech Republic. Based on the analysis, draw attention to possible communication barriers that may be caused by insufficient information. The research was carried out using a qualitative method, the method of data collection was a semi-structured interview. Eleven female students took part in the research, and the respondents were selected using the Snowballing method. Some methods of grounded theory (open coding and category creation) were used to analyze the data. Based on the results of the research, questions were set in a questionnaire focused on communication barriers between mothers (family) and health care professionals in the care of newborns with life-threatening or limiting disabilities. Based on the analysis of data, categories 1 were determined. Knowledge of perinatal palliative care 2. Education 3. Practical experience 4. Readiness and concerns in the provision of perinatal palliative care 6. Supervision. The questions in the questionnaire were then derived taking into account the data obtained, and the operationalization of health literacy in the field of perinatal palliative care was performed. The analysis of the interviews revealed that the education of midwives in the Czech Republic in the issue of perinatal palliative care is not uniform. The research confirmed the insufficient knowledge and skills of midwifery students preparing to provide perinatal palliative care. Respondents reported feelings of unpreparedness in the areas of communication with a woman after perinatal loss, psychological support for a woman and her family, the care of a stillborn or dying child, or self-coping with death. The questions in the questionnaire then develop these areas. We assumed that by analyzing and interpreting the data obtained from our research, we will help to better understand the concerns and motivations of students in providing holistic perinatal palliative care. We came to the conclusion that it would be appropriate to set up a unified and comprehensive education on this issue in the Czech Republic. Healthcare professionals are in a unique position that can positively or negatively affect the intensity of perinatal loss. Already properly set up education of health professionals leads to overcoming barriers in communication between health professionals and the family, experiencing perinatal loss.Keywords: midwife, perinatal loss, perinatal palliative care, communication, barriers, mothers, family
Procedia PDF Downloads 116277 Differences in Patient Satisfaction Observed between Female Japanese Breast Cancer Patients Who Receive Breast-Conserving Surgery or Total Mastectomy
Authors: Keiko Yamauchi, Motoyuki Nakao, Yoko Ishihara
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The increase in the number of women with breast cancer in Japan has required hospitals to provide a higher quality of medicine so that patients are satisfied with the treatment they receive. However, patients’ satisfaction following breast cancer treatment has not been sufficiently studied. Hence, we investigated the factors influencing patient satisfaction following breast cancer treatment among Japanese women. These women underwent either breast-conserving surgery (BCS) (n = 380) or total mastectomy (TM) (n = 247). In March 2016, we conducted a cross-sectional internet survey of Japanese women with breast cancer in Japan. We assessed the following factors: socioeconomic status, cancer-related information, the role of medical decision-making, the degree of satisfaction regarding the treatments received, and the regret arising from the medical decision-making processes. We performed logistic regression analyses with the following dependent variables: extreme satisfaction with the treatments received, and regret regarding the medical decision-making process. For both types of surgery, the odds ratio (OR) of being extremely satisfied with the cancer treatment was significantly higher among patients who did not have any regrets compared to patients who had. Also, the OR tended to be higher among patients who chose to play a wanted role in the medical decision-making process, compared with patients who did not. In the BCS group, the OR of being extremely satisfied with the treatment was higher if, at diagnosis, the patient’s youngest child was older than 19 years, compared with patients with no children. The OR was also higher if patient considered the stage and characteristics of their cancer significant. The OR of being extremely satisfied with the treatments was lower among patients who were not employed on full-time basis, and among patients who considered the second medical opinions and medical expenses to be significant. These associations were not observed in the TM group. The OR of having regrets regarding the medical decision-making process was higher among patients who chose to play a role in the decision-making process as they preferred, and was also higher in patients who were employed on either a part-time or contractual basis. For both types of surgery, the OR was higher among patients who considered a second medical opinion to be significant. Regardless of surgical type, regret regarding the medical decision-making process decreases treatment satisfaction. Patients who received breast-conserving surgery were more likely to have regrets concerning the medical decision-making process if they could not play a role in the process as they preferred. In addition, factors associated with the satisfaction with treatment in BCS group but not TM group included the second medical opinion, medical expenses, employment status, and age of the youngest child at diagnosis.Keywords: medical decision making, breast-conserving surgery, total mastectomy, Japanese
Procedia PDF Downloads 147276 Transgenerational Impact of Intrauterine Hyperglycaemia to F2 Offspring without Pre-Diabetic Exposure on F1 Male Offspring
Authors: Jun Ren, Zhen-Hua Ming, He-Feng Huang, Jian-Zhong Sheng
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Adverse intrauterine stimulus during critical or sensitive periods in early life, may lead to health risk not only in later life span, but also further generations. Intrauterine hyperglycaemia, as a major feature of gestational diabetes mellitus (GDM), is a typical adverse environment for both F1 fetus and F1 gamete cells development. However, there is scare information of phenotypic difference of metabolic memory between somatic cells and germ cells exposed by intrauterine hyperglycaemia. The direct transmission effect of intrauterine hyperglycaemia per se has not been assessed either. In this study, we built a GDM mice model and selected male GDM offspring without pre-diabetic phenotype as our founders, to exclude postnatal diabetic influence on gametes, thereby investigate the direct transmission effect of intrauterine hyperglycaemia exposure on F2 offspring, and we further compared the metabolic difference of affected F1-GDM male offspring and F2 offspring. A GDM mouse model of intrauterine hyperglycemia was established by intraperitoneal injection of streptozotocin after pregnancy. Pups of GDM mother were fostered by normal control mothers. All the mice were fed with standard food. Male GDM offspring without metabolic dysfunction phenotype were crossed with normal female mice to obtain F2 offspring. Body weight, glucose tolerance test, insulin tolerance test and homeostasis model of insulin resistance (HOMA-IR) index were measured in both generations at 8 week of age. Some of F1-GDM male mice showed impaired glucose tolerance (p < 0.001), none of F1-GDM male mice showed impaired insulin sensitivity. Body weight of F1-GDM mice showed no significance with control mice. Some of F2-GDM offspring exhibited impaired glucose tolerance (p < 0.001), all the F2-GDM offspring exhibited higher HOMA-IR index (p < 0.01 of normal glucose tolerance individuals vs. control, p < 0.05 of glucose intolerance individuals vs. control). All the F2-GDM offspring exhibited higher ITT curve than control (p < 0.001 of normal glucose tolerance individuals, p < 0.05 of glucose intolerance individuals, vs. control). F2-GDM offspring had higher body weight than control mice (p < 0.001 of normal glucose tolerance individuals, p < 0.001 of glucose intolerance individuals, vs. control). While glucose intolerance is the only phenotype that F1-GDM male mice may exhibit, F2 male generation of healthy F1-GDM father showed insulin resistance, increased body weight and/or impaired glucose tolerance. These findings imply that intrauterine hyperglycaemia exposure affects germ cells and somatic cells differently, thus F1 and F2 offspring demonstrated distinct metabolic dysfunction phenotypes. And intrauterine hyperglycaemia exposure per se has a strong influence on F2 generation, independent of postnatal metabolic dysfunction exposure.Keywords: inheritance, insulin resistance, intrauterine hyperglycaemia, offspring
Procedia PDF Downloads 238275 Successful Excision of Lower Lip Mucocele Using 2780 nm Er,Cr:YSGG Laser
Authors: Lubna M. Al-Otaibi
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Mucocele is a common benign neoplasm of the oral cavity and the most common after fibroma. The lesion develops as a result of retention or extravasation of mucous material from minor salivary glands. Extravasation type of mucocele results from trauma and mostly occurs in the lower lip of young patients. The various treatment options available for the treatment of mucocele are associated with a relatively high incidence of recurrence making surgical intervention necessary for a permanent cure. The conventional surgical procedure, however, arouses apprehension in the patient and is associated with bleeding and postoperative pain. Recently, treatment of mucocele with lasers has become a viable treatment option. Various types of lasers are being used and are preferable over the conventional surgical procedure as they provide good hemostasis, reduced postoperative swelling and pain, reduced bacterial population, lesser need for suturing, faster healing and low recurrence rates. Er,Cr:YSGG is a solid-state laser with great affinity to water molecule. Its hydrokinetic cutting action allows it to work effectively on hydrated tissues without any thermal damage. However, up to date, only a few studies have reported its use in the removal of lip mucocele, especially in children. In this case, a 6 year old female patient with history of trauma to the lower lip presented with a soft, sessile, whitish-bluish 4 mm papule. The lesion was present for approximately four months and was fluctuant in size. The child developed a habit of biting the lesion causing injury, bleeding and discomfort. Surgical excision under local anaesthesia was performed using 2780 nm Er,Cr:YSGG Laser (WaterLase iPlus, Irvine, CA) with a Gold handpiece and MZ6 tip (3.5w, 50 Hz, 20% H2O, 20% Air, S mode). The tip was first applied in contact mode with focused beam using the Circumferential Incision Technique (CIT) to excise the tissue followed by the removal of the underlying causative minor salivary gland. Bleeding was stopped using Laser Dry Bandage setting (0.5w, 50 Hz, 1% H2O, 20% Air, S mode) and no suturing was needed. Safety goggles were worn and high-speed suction was used for smoke evacuation. Mucocele excision using 2780 nm Er,Cr:YSGG laser was rapid, easy to perform with excellent precision and allowed for histopathological examination of the excised tissue. The patient was comfortable and there were minimum bleeding and no sutures, postoperative pain, scarring or recurrence. Laser assisted mucocele excision appears to have efficient and reliable benefits in young patients and should be considered as an alternative to conventional surgical and non-surgical techniques.Keywords: Erbium, excision, laser, lip, mucocele
Procedia PDF Downloads 236274 Immigrant Women's Voices and Integrating Feminism into Migration Theory
Authors: Florence Nyemba, Rufaro Chitiyo
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This work features the voices of women as they describe their experiences living in the diaspora either with their families or alone. The contributing authors of this work pursued this project to understand how the women’s personal lives (and those of their families back home) changed (both positively and negatively). The work addressed the following important questions, what is female migration? What are the factors causing women to migrate? What types of migration do women engage in? What is the influence of family relationships on migration? What are the challenges of migration? How do migrant women maintain ties with their home countries? What is the role of social networks in migration? How can feminist theories and methodologies be incorporated in migration studies? Women continue to contribute significantly to mass movements of people across the yet, their voices silent in the literature on migration. History shows that women have always been on the move trying to make a living just like their male counterparts. Whether they migrate as spouses, daughters, or alone, women make up a sizeable portion of migration statistics around the world. These women are migrating independently without the accompaniment of male relatives. This calls for the need to expand research on women as independent migrants without generalizing their experiences as in the case with early studies on international migration. The goal of this work is to offer a rich and detailed description of the lives of immigrant women across the globe using theoretical frameworks that advance gender and migration research. Methodology: This work invited scholars and researchers from across the globe whose research interests were in gender and migration. The work incorporated a variety of methodologies for data collection and analysis, which included oral narratives, interviews, systematic literature reviews and interviews. Conclusion: There is a considerable amount of interest in various topics on gender, violence, and equality throughout social science disciplines in higher education. Therefore, the three major topics covered in this work, Women’s Immigration: Theories and Methodologies, Women as Migrant Workers, and Women as Refugees, Asylees, and Permanent Migrants, can be of interest across social sciences disciplines. Feminist theories can expand the curriculum on identity and gendered roles and norms in societies. Findings of this work advance knowledge of population movements across the globe. This work will also appeal to students and scholars wanting to expand their knowledge on women and migration, migration theories, gender violence, and women empowerment. The topics and issues presented in this work will also assist the international community and lawyers concerned with global migration.Keywords: gender, feminism, identity formation, international migration
Procedia PDF Downloads 140273 The Igbo People's Dual Religion Identity on Rite of Marriage in Imo State
Authors: Henry Okechukwu Onyeiwu, Arfah Ab. Majid
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To fully understand the critical role of marriage in society, it is important to view it as a social institution that provides some basic social needs for society. A ‘social institution’ is the network of shared meanings, norms, definitions, expectations, and understandings held by the members of society. It is what guides and governs how the members of the society are expected to act and interact, what is socially desirable and legitimate, what they should be striving for, and so on. One of the major social institutions is marriage. Marriage is and has often focused on children and what is best for them because the rising generation literally is the future of every society. However, according to the aforementioned definition, which notes that marriage may also be a union between two persons of the same sex with legal support, this study stands with the definitions that are based on marriage being a union between a man and woman that is the most appropriate in Igbo land and not the other way round. The issue to be evaluated concerns marriage as it associates with Igbo Catholic Christians in Nigeria. Pasts of Igbo culture should be better organized into the Christian faith. Igbo Christians actually convey a significant number of their customary thoughts, customs, and social qualities, particularly regarding marriage, in the aftermath of switching to Christianity. The analyst agrees that marriage among Igbo Christians warrants adequate evolution. This study, therefore, concentrates on the Igbo community’s interpretation of the concept of culture and religion and the religious implications of traditional marriage and Christian marriage ceremonies in Igbo. The research design of this study is a qualitative design that provides in-depth information on the dual religious identity of the Igbo people on the rite of marriage in Imo state. The study population was composed of both male and female members from each selected local government area in Imo State. Thematic analysis was used to elaborate on the result from the respondents. This survey found that reputation is a major concern for Ibo people. Parental discomfort can lead to the use of coping strategies such as displacement, in which parents pass on their own vulnerable sentiments to their children. Those who participate in marriage negotiations feel the pain of their parents because they are unable to communicate their own feelings. As a result, participants experience increased stress and a range of negative emotions related to their marriage, including worry, dissatisfaction, and ambivalence. It was concluded that when it comes to Igbo culture, marriage is seen as a need for the continuation of the family’s lineage of descent, according to the outcome. The Task at hand was to discover how the locals preparing to get married define the impending transition. Imo State is home to the practice of Igba-nkwu, where the woman is either inherited or taken in the place of another.Keywords: Igbo, culture, Christianity, traditional marriage, Christian wedding
Procedia PDF Downloads 161272 Correlation Between Cytokine Levels and Lung Injury in the Syrian Hamster (Mesocricetus Auratus) Covid-19 Model
Authors: Gleb Fomin, Kairat Tabynov, Nurkeldy Turebekov, Dinara Turegeldiyeva, Rinat Islamov
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The level of major cytokines in the blood of patients with COVID-19 varies greatly depending on age, gender, duration and severity of infection, and comorbidity. There are two clinically significant cytokines, IL-6 and TNF-α, which increase in levels in patients with severe COVID-19. However, in a model of COVID-19 in hamsters, TNF-α levels are unchanged or reduced, while the expression of other cytokines reflects the profile of cytokines found in patients’ plasma. The aim of our study was to evaluate the relationship between the level of cytokines in the blood, lungs, and lung damage in the model of the Syrian hamster (Mesocricetus auratus) infected with the SARS-CoV-2 strain. The study used outbred female and male Syrian hamsters (n=36, 4 groups) weighing 80-110 g and 5 months old (protocol IACUC, #4, 09/22/2020). Animals were infected intranasally with the hCoV-19/Kazakhstan/KazNAU-NSCEDI-481/2020 strain and euthanized at 3 d.p.i. The level of cytokines IL-6, TNF-α, IFN-α, and IFN-γ was determined by ELISA MyBioSourse (USA) for hamsters. Lung samples were subjected to histological processing. The presence of pathological changes in histological preparations was assessed on a 3-point scale. The work was carried out in the ABSL-3 laboratory. The data were analyzed in GraphPad Prism 6.00 (GraphPad Software, La Jolla, California, USA). The work was supported by the MES RK grant (AP09259865). In the blood, the level of TNF-α increased in males (p=0.0012) and IFN-γ in males and females (p=0.0001). On the contrary, IFN-α production decreased (p=0.0006). Only TNF-α level increased in lung tissues (p=0.0011). Correlation analysis showed a negative relationship between the level of IL-6 in the blood and lung damage in males (r -0.71, p=0.0001) and females (r-0.57, p=0.025). On the contrary, in males, the level of IL-6 in the lungs and score is positively correlated (r 0.80, p=0.01). The level of IFN-γ in the blood (r -0.64, p=0.035) and lungs (r-0.72, p=0.017) in males has a negative correlation with lung damage. No links were found for TNF-α and IFN-α. The study showed a positive association between lung injury and tissue levels of IL-6 in male hamsters. It is known that in humans, high concentrations of IL-6 in the lungs are associated with suppression of cellular immunity and, as a result, with an increase in the severity of COVID-19. TNF-α and IFN-γ play a key role in the pathogenesis of COVID-19 in hamsters. However, the mechanisms of their activity require more detailed study. IFN-α plays a lesser role in direct lung injury in a Syrian hamster model. We have shown the significance of tissue IL-6 and IFN-γ as predictors of the severity of lung damage in COVID-19 in the Syrian hamster model. Changes in the level of cytokines in the blood may not always reflect pathological processes in the lungs with COVID-19.Keywords: syrian hamster, COVID-19, cytokines, biological model
Procedia PDF Downloads 92271 Conservative and Surgical Treatment of Antiresorptive Drug-Related Osteonecrosis of the Jaw with Ultrasonic Piezoelectric Bone Surgery under Polyvinylpyrrolidone Iodine Irrigation: A Case Series of 13 Treated Sites
Authors: Esra Yuce, Isil D. S. Yamaner, Murude Yazan
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Aims and objective: Antiresorptive agents including bisphosphonates and denosumab as strong suppressors of osteoclasts are the most commonly used antiresorptive medications for the treatment of osteoporosis which counteract the negative quantitative alteration of trabecular and cortical bone by inhibition of bone turnover. Oral bisphosphonate therapy for the treatment of osteopenia, osteoporosis or Paget's disease is associated with the low-grade risk of osteonecrosis of the jaw, while higher-grade risk is associated with receiving intravenous bisphosphonates therapy in the treatment of multiple myeloma and bone metastases. On the other hand, there has been a remarkable increase in incidences of antiresorptive related osteonecrosis of the jaw (ARONJ) in oral bisphosphonate users. This clinical presentation will evaluate the healing outcomes via piezoelectric bone surgery under the irrigation of PVP-I solution irrigation in patients received bisphosphonate therapy. Material-Method: The study involved 8 female and 5 male patients that have been treated for ARONJ. Among 13 necrotic sites, 9 were in the mandible and 4 were in the maxilla. All of these 13 patients treated with surgical debridement via piezoelectric bone surgery under irrigation by solution with 3% PVP-I concentration in combination with long-term antibiotic therapy and 5 also underwent removal of mobile segments of bony sequestrum. All removable prosthesis in 8 patients were relined with soft liners during the healing periods in order to eliminate chronic minor traumas. Results: All patients were on oral bisphosphonate therapy for at least 2 years and 5 of which had received intravenous bisphosphonates up to 1 year before therapy with oral bisphosphonates was started. According to the AAOMS staging system, four cases were stage II, eight cases were stage I, and one case was stage III. The majority of lesions were identified at sites of dental prostheses (38%) and dental extractions (62%). All patients diagnosed with ARONJ stage I had used unadjusted removable prostheses. No recurrence of the symptoms was observed during the present follow-up (9–37 months). Conclusion: Despite their confirmed effectiveness, the prevention and treatment of osteonecrosis of the jaw secondary to oral bisphosphonate therapy remain major medical challenges. Treatment with piezoelectric bone surgery with irrigation of povidone-iodine solution was effective for management of bisphosphonate-related osteonecrosis of the jaw. Taking precautions for patients treated with oral bisphosphonates, especially also denture users, may allow for a reduction in the rate of developing osteonecrosis of the maxillofacial region.Keywords: antiresorptive drug related osteonecrosis, bisphosphonate therapy, piezoelectric bone surgery, povidone iodine
Procedia PDF Downloads 265270 To Compare the Visual Outcome, Safety and Efficacy of Phacoemulsification and Small-Incision Cataract Surgery (SICS) at CEITC, Bangladesh
Authors: Rajib Husain, Munirujzaman Osmani, Mohammad Shamsal Islam
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Purpose: To compare the safety, efficacy and visual outcome of phacoemulsification vs. manual small-incision cataract surgery (SICS) for the treatment of cataract in Bangladesh. Objectives: 1. To assess the Visual outcome after cataract surgery 2. To understand the post-operative complications and early rehabilitation 3. To identified which surgical procedure more attractive to the patients 4. To identify which surgical procedure is occurred fewer complications. 5. To find out the socio-economic and demographic characteristics of study patients Setting: Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh. Design: Retrospective, randomised comparison of 300 patients with visually significant cataracts. Method: The present study was designed as a retrospective hospital-based research. The sample size was 300 and study period was from July, 2012 to July, 2013 and assigned randomly to receive either phacoemulsification or manual small-incision cataract surgery (SICS). Preoperative and post-operative data were collected through a well designed collection format. Three follow-up were done; i) during discharge ii) 1-3 weeks & iii) 4-11 weeks post operatively. All preoperative and surgical complications, uncorrected and best-corrected visual acuity (BCVA) and astigmatism were taken into consideration for comparison of outcome Result: Nearly 95% patients were more than 40 years of age. About 52% patients were female, and 48% were male. 52% (N=157) patients came to operate their first eye where 48% (N=143) patients were visited again to operate their second eye. Postoperatively, five eyes (3.33%) developed corneal oedema with >10 Descemets folds, and six eyes (4%) had corneal oedema with <10 Descemets folds for Phacoemulsification surgeries. For SICS surgeries, seven eyes (4.66%) developed corneal oedema with >10 Descemets folds and eight eyes (5.33%) had corneal oedema with < 10 descemets folds. However, both the uncorrected and corrected (4-11 weeks) visual acuities were better in the eyes that had phacoemulsification (p=0.02 and p=0.03), and there was less astigmatism (p=0.001) at 4-11 weeks in the eye that had phacoemulsification. Best-corrected visual acuity (BCVA) of final follow-up 95% (N=253) had a good outcome, borderline 3.10% (N=40) and poor outcome was 1.6% (N=7). The individual surgeon outcome were closer, 95% (BCVA) in SICS and 96% (BCVA) in Phacoemulsification at 4-11 weeks follow-up respectively. Conclusion: outcome of cataract surgery both Phacoemulsification and SICS in CEITC was more satisfactory according to who norms. Both Phacoemulsification and manual small-incision cataract surgery (SICS) shows excellent visual outcomes with low complication rates and good rehabilitation. Phacoemulsification is significantly faster, and modern technology based surgical procedure for cataract treatment.Keywords: phacoemulsification, SICS, cataract, Bangladesh, visual outcome of SICS
Procedia PDF Downloads 348269 Calcium Biochemical Indicators in a Group of Schoolchildren with Low Socioeconomic Status from Barranquilla, Colombia
Authors: Carmiña L. Vargas-Zapata, María A. Conde-Sarmiento, Maria Consuelo Maestre-Vargas
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Calcium is an essential element for good growth and development of the organism, and its requirement is increased at school age. Low socio-economic populations of developing countries such as Colombia may have food deficiency of this mineral in schoolchildren that could be reflected in calcium biochemical indicators, bone alterations and anthropometric indicators. The objective of this investigation was to evaluate some calcium biochemical indicators in a group of schoolchildren of low socioeconomic level from Barranquilla city and to correlate with body mass index. 60 schoolchildren aged 7 to 15 years were selected from Jesus’s Heart Educational Institution in Barranquilla-Atlántico, apparently healthy, without suffering from infectious or gastrointestinal diseases, without habits of drinking alcohol or smoking another hallucinogenic substance and without taking supplementation with calcium in the last six months or another substance that compromises bone metabolism. The research was approved by the ethics committee at Universidad del Atlántico. The selected children were invited to donate a blood and urine sample in a fasting time of 12 hours, the serum was separated by centrifugation and frozen at ˗20 ℃ until analyzed and the same was done with the urine sample. On the day of the biological collections, the weight and height of the students were measured to determine the nutritional status by BMI using the WHO tables. Calcium concentrations in serum and urine (SCa, UCa), alkaline phosphatase activity total and of bone origin (SAPT, SBAP) and urinary creatinine (UCr) were determined by spectrophotometric methods using commercial kits. Osteocalcin and Cross-linked N-telopeptides of type I collagen (NTx-1) in serum were measured with an enzyme-linked inmunosorbent assay. For statistical analysis the Statgraphics software Centurium XVII was used. 63% (n = 38) and 37% (n = 22) of the participants were male and female, respectively. 78% (n = 47), 5% (n = 3) and 17% (n = 10) had a normal, malnutrition and high nutritional status, respectively. The averages of evaluated indicators levels were (mean ± SD): 9.50 ± 1.06 mg/dL for SCa; 181.3 ± 64.3 U/L for SAPT, 143.8 ± 73.9 U/L for SBAP; 9.0 ± 3.48 ng/mL for osteocalcin and 101.3 ± 12.8 ng/mL for NTx-1. UCa level was 12.8 ± 7.7 mg/dL that adjusted with creatinine ranged from 0.005 to 0.395 mg/mg. Considering serum calcium values, approximately 7% of school children were hypocalcemic, 16% hypercalcemic and 77% normocalcemic. The indicators evaluated did not correlate with the BMI. Low values were observed in calcium urinary excretion and high in NTx-1, suggesting that mechanisms such as increase in renal retention of calcium and in bone remodeling may be contributing to calcium homeostasis.Keywords: calcium, calcium biochemical, indicators, school children, low socioeconomic status
Procedia PDF Downloads 112268 Intensive Care Unit Patient Self-Determination When Facing Cardiovascular Surgery for the First Time
Authors: Hsiao-Lin Fang
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The Patient Self-Determination Act is based on the belief that each life is unique. The act regards each patient as an autonomous entity and explicitly protects the patient’s rights to know and make decisions and choices while ensuring that the patient’s wish for a peaceful end is granted. Even when the patient is unconscious and unable to express himself/herself, the patient’s self-determination and its exercise are still protected under the law. The act also ensures that healthcare professionals (HCPs) have a specific set of rules to follow and complete legal protection when their patients are unable to express themselves clearly. This report is about a 55-year-old female patient who weighed 110 kg and was diagnosed with acute type A aortic dissection. The case was that the patient suddenly felt backache and nausea during sleep before daybreak and was therefore transferred to this hospital from the original one. After the doctor explained the patient’s conditions, it was concluded that surgery was necessary. However, the patient’s family was immediately against the surgery after having heard its possible complications. Nevertheless, the patient was still willing to receive the surgery. Being at odds with her family, the patient decided to sign the surgery agreement herself and agreed to receive the two surgical procedures: (1) ascending aorta replacement and (2) innominate artery debranching. After the surgery, the patient did not regain consciousness and therefore received computed tomography scanning of the brain, which revealed false lumen involving proximal left common carotid artery, left subclavian artery and innominate artery, and severe compression of the true lumen with total/subtotal occlusion in the left common carotid artery. On the following day, the doctor discussed two further surgical procedures: (1) endografting for descending aorta and (2) endografting for left common carotid artery and subclavian artery with the family. However, as the patient’s postoperative recovery of consciousness only reached the level of stupor and her family had no intention of subsequent healthcare for the patient, the family made the joint decision three days later to have the endotracheal tube removed from the patient and let her die a natural death. Suggestion: An advance directive (AD) can be created beforehand. Once the patient is in a special clinical state (e.g., terminal illness, permanent vegetative state, etc.), the AD can determine whether to sustain the patient’s life through ‘medical intervention’ or to respect the patient’s rights to choose a peaceful end and receive palliative care. Through the expression of self-determination, it is possible to respect the patient’s medical practice autonomy and protect the patient’s dignity and right to a peaceful end, thereby respecting and supporting the patient’s decision. This also allows the three sides: the patient, the family and the medical team to understand the patient’s true wish in the process of advance care planning (ACP) and thereby promote harmony in the HCP-patient relationship.Keywords: intensive care unit patient, cardiovascular surgery, self-determination, advance directive
Procedia PDF Downloads 176267 Unlocking Intergenerational Abortion Stories in Gardiennes By Fanny Cabon
Authors: Lou Gargouri
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This paper examines how Fanny Cabon's solo performance, Gardiennes (2018) strategically crafts empathetic witnessing through the artist's vocal and physical embodiment of her female ancestors' testimonies, dramatizing the cyclical inheritance of reproductive trauma across generations. Drawing on affect theory and the concept of ethical co-presence, we argue that Cabon's raw voicing of illegal abortions, miscarriages, and abuse through her shape-shifting presence generates an intimate energy loop with the audience. This affective resonance catalyzes recognition of historical injustices, consecrating each singular experience while building collective solidarity. Central to Cabon's political efficacy is her transparent self-revelation through intimate impersonation, which fosters identification with diverse characters as interconnected subjects rather than objectified others. Her solo form transforms the isolation often associated with women's marginalization into radical inclusion, repositioning them from victims to empowered survivors. Comparative analysis with other contemporary works addressing abortion rights illuminates how Gardiennes subverts the traditional medical and clerical gazes that have long governed women's bodies. Ultimately, we contend Gardiennes models the potential of solo performance to harness empathy as a subversive political force. Cabon's theatrical alchemy circulates the effects of injustice through the ethical co-presence of performer and spectator, forging intersubjective connections that reframe marginalized groups traditionally objectified within dominant structures of patriarchal power. In dramatizing how the act of witnessing another's trauma can generate solidarity and galvanize resistance, Cabon's work demonstrates the role of embodied performance in catalyzing social change through the recuperation of women's voices and lived experiences. This paper thus aims to contribute to the emerging field of feminist solo performance criticism by illuminating how Cabon's innovative dramaturgy bridges the personal and the political. Her strategic mobilization of intimacy, identification, and co-presence offers a model for how the affective dynamics of autobiographical performance can be harnessed to confront gendered oppression and imagine more equitable futures. Gardiennes invites us to consider how the circulation of empathy through ethical spectatorship can foster the collective alliances necessary for advancing the unfinished project of women's liberation.Keywords: gender and sexuality studies, solo performance, trauma studies, affect theory
Procedia PDF Downloads 65266 Examining the Investment Behavior of Arab Women in the Stock Market
Authors: Razan Salem
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Gender plays a vital role in the stock markets because men and women differ in their behavior when investing in stocks. Accordingly, the role of gender differences in investment behavior is an increasingly important strand in the field of behavioral finance research. The investment behaviors of women relative to men have been examined in the behavioral finance literature, mainly for comparison purposes. Women's roles in the stock market have not been examined in the behavioral finance literature, however, particularly with respect to the Arab region. This study aims to contribute towards a better understanding of the investment behavior of Arab women (in regards to their risk tolerance, investment confidence, and investment literacy levels) relative to Arab men; using a sample from Arab women and men investors living in Saudi Arabia and Jordan. In order to achieve the study's main aim, the researcher used non-parametric tests, as Mann-Whitney U test, along with frequency distribution analysis to analyze the study’s primary data. The researcher distributed close-ended online questionnaires to a sample of 550 Arab male and female individuals investing in stocks in both Saudi Arabia and Jordan. The results confirm that the sample Arab women invest less in stocks compared to Arab men due to their risk-averse behaviors and limited confidence levels. The results also reveal that due to Arab women’s very low investment literacy levels, they fear from taking the risk and invest often in stocks relative to Arab men. Overall, the study’s main variables (risk tolerance, investment confidence, and investment literacy levels) have a combined effect on the investment behavior of Arab women and their limited participation in the stock market. Hence, this study is one of the very first studies that indicate the combined effect of the three main variables (which are usually studied separately in the existing literature) on the investment behavior of women, particularly Arab women. This study makes three important contributions to the growing literature on gender differences in investment behavior. First, while the behavioral finance literature documents evidence on gender differences in investment behaviors in many developed countries, there are very limited studies that investigate such differences in Arab countries. Arab women investors, generally, are ignored from the behavioral finance literature due probably to cultural barriers and data collection difficulties. Thus, this study extends the literature to include Arab women and their investment behaviors when trading stock relative to Arab men. Moreover, the study associates women investment literacy and confidence levels with their financial risk behaviors and participation in the stock market. This study provides direct evidence on Arab women's investment behaviors when trading stocks. Overall, studying Arab women investors is important to investigate whether the investment behavior identified for Western women investors are also found in Arab women investors.Keywords: Arab women, gender differences, investment behavior, stock markets
Procedia PDF Downloads 181265 Studies On Triazole Resistant Candida Albicans Expressing ERG11 Gene Among Adult Females In Abakaliki; Nigeria
Authors: Agumah N. B. Orji, M. U., Oru C. M., Ugbo, E. N., Onwuliri E. A Nwakaeze, E. A.,
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ERG11 gene has been reported to be one of the genes whose expression is responsible for resistance of Candida to various triazole drugs, which are first line treatment for candidiasis. This study was carried out to determine the prevalence of Triazole (Fluconazole and voriconazole) resistant Candida albicans expressing ERG11 gene from adult females in Abakaliki. Urine and vaginal swab samples were randomly collected from volunteers after obtaining their consent to participate in the study. A total of 565 adult females participated in the study. A total of 340 urine specimens and 288 vaginal swab specimens were collected. Direct wet mount technique, as well as culture in Trichomonas broth, were used to examine the urine and vaginal swab specimens for the presence of motile Trichomonads. The Trichomonas broth used was selective for both T. vaginalis and C. albicans. Broths that yielded budding yeast cells after microscopy were subcultured on to Sabouraud dextrose agar, after which Germ tube test was carried out to confirm the presence of C. albicans. Biochemical tests, including carbohydrate fermentation and urease utilization, were also performed. Antibiogram of C. albicans isolates obtained from this study was carried out using commercially available azole drugs. Fluconazole and voriconazole were selected as Triazole drugs used for this study. Nystatin was used as a tangential control. An MIC test was carried out with E-strips on some of the resistant C. albicans isolates A total of 6 isolates that resisted all the azole drugs were selected and screened for the presence of ERG11 gene using Reverse transcriptase polymerase chain reaction technique. The total prevalence recorded for C. albicans was 13.0%. Frequency was statistically higher in Pregnant (7.96%) than non pregnant (5.09%) volunteers (X2=0.94 at P=0.05). With respect to clinical samples, frequency was higher in vaginal swabs samples (7.96%) than Urine samples (5.09%) (X2=9.05 at P=0.05). Volunteers within the age group 26-30 years recorded the highest prevalence (4.46%), while those within the age group 36-40 years recorded the lowest at 1.27%(X2=4.34 at P=0.05). In pregnant female participants, the highest frequency was recorded with those in their 3rd trimester (4.14%), while lowest incidence was recorded for those in their first trimester (0.80%). Antibiogram results from this study showed that C. albicans isolates obtained from this study resisted Fluconazole (72%) more than Voriconazole (57%). Only one out of the six selected isolates yielded resistance in the MIC test. Results obtained from the RT-PCR showed that there was no expression of ERG11 gene among the fluconazole resistant isolates of C. albicans. Observed resistance may be due to other factors other than expression of ERG11 gene.Keywords: candida, ERG11, triazole, nigeria
Procedia PDF Downloads 149264 Bioefficacy of Ocimum sanctum on Reproductive Performance of Red Cotton Bug, Dysdercus koenigii (Heteroptera: Pyrrhocoriedae)
Authors: Kamal Kumar Gupta, Sunil Kayesth
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Dysdercus koenigii is serious pest of cotton and other malvaceous crop. Present research work aimed at ecofriendly approach for management of pest by plant extracts. The impact of Ocimum sanctum was studied on reproductive performance of Dysdercus koenigii. The hexane extract of Ocimum leaves was prepared by ‘cold extraction method’. The newly emerged fifth instar nymphs were exposed to the extract of concentrations ranging from 0.1% to 0.00625% by ‘thin film residual method’ for a period of 24h. Reproductive fitness of the adults emerged from the treated nymphs was evaluated by assessing their courtship behaviour, oviposition behaviour, and fertility. The studies indicated that treatment of Dysdercus with the hexane extract of Ocimum altered their courtship behaviour. Consequently, the treated males exhibited less sexual activity, performed fewer mounting attempts, increased time to mate and showed decreased percent successful mating. The females often rejected courting treated male by shaking the abdomen. Similarly, the treated females in many cases remained non-receptive to the courting male. Premature termination of mating in the mating pairs prior to insemination further decreased the mating success of the treated adults. Maximum abbreviation of courtship behaviour was observed in the experimental set up where both the males and the females were treated. Only females which mate successfully were observed for study of oviposition behaviour. The treated females laid lesser number of egg batches and eggs in their life span. The eggs laid by these females were fertile indicating insemination of the female. However, percent hatchability was lesser than control. The effects of hexane extract were dose dependent. Treatment with 0.1% and 0.05% extract altered courtship behaviour. Doses of concentrations less than 0.05% did not affect courtship behaviour but altered the oviposition behaviour and fertility. Significant reduction in the fecundity and fertility was observed in the treatments at concentration as low as 0.00625%. The GCMS analysis of the extract revealed a plethora of phytochemicals including juvenile hormone mimics, and the intermediates of juvenile hormone biosynthesis. Therefore, some of these compounds individually or synergistically impair reproductive behaviour of Dysdercus. Alteration of courtship behaviour and suppression of fecundity and fertility with the help of plant extracts has wide potentials in suppression of pest population and ‘integrated pest management’.Keywords: courtship behaviour, Dysdercus koenigii, Ocimum sanctum, oviposition behaviour
Procedia PDF Downloads 266263 Management of Postoperative Pain, Intercultural Differences Among Registered Nurses: Czech Republic and Kingdom of Saudi Arabia
Authors: Denisa Mackova, Andrea Pokorna
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The management of postoperative pain is a meaningful part of quality care. The experience and knowledge of registered nurses in postoperative pain management can be influenced by local know-how. Therefore, the research helps to understand the cultural differences between two countries with the aim of evaluating the management of postoperative pain management among the nurses from the Czech Republic and the Kingdom of Saudi Arabia. Both countries have different procedures on managing postoperative pain and the research will provide an understanding of both the advantages and disadvantages of the procedures and also highlight the knowledge and experience of registered nurses in both countries. Between the Czech Republic and the Kingdom of Saudi Arabia, the expectation is for differing results in the usage of opioid analgesia for the patients postoperatively and in the experience of registered nurses with Patient Controlled Analgesia. The aim is to evaluate the knowledge and awareness of registered nurses and to merge the data with the postoperative pain management in the early postoperative period in the Czech Republic and the Kingdom of Saudi Arabia. Also, the aim is to assess the knowledge and experience of registered nurses by using Patient Controlled Analgesia and epidural analgesia treatment in the early postoperative period. The criteria for those providing input into the study, are registered nurses, working in surgical settings (standard departments, post-anesthesia care unit, day care surgery or ICU’s) caring for patients in the postoperative period. Method: Research is being conducted by questionnaires. It is a quantitative research, a comparative study of registered nurses in the Czech Republic and the Kingdom of Saudi Arabia. Questionnaire surveys were distributed through an electronic Bristol online survey. Results: The collection of the data in the Kingdom of Saudi Arabia has been completed successfully, with 550 respondents, 77 were excluded and 473 respondents were included for statistical data analysis. The outcome of the research is expected to highlight the differences in treatment through Patient Controlled Analgesia, with more frequent use in the Kingdom of Saudi Arabia. A similar assumption is expected for treatment conducted by analgesia. We predict that opioids will be used more regularly in the Kingdom of Saudi Arabia, whilst therapy through NSAID’s being the most common approach in the Czech Republic. Discussion/Conclusion: The majority of respondents from the Kingdom of Saudi Arabia were female registered nurses from a multitude of nations. We are expecting a similar split in gender between the Czech Republic respondents; however, there will be a smaller number of nationalities. Relevance for research and practice: Output from the research will assess the knowledge, experience and practice of patient controlled analgesia and epidural analgesia treatment. Acknowledgement: This research was accepted and affiliated to the project: Postoperative pain management, knowledge and experience registered nurses (Czech Republic and Kingdom of Saudi Arabia) – SGS05/2019-2020.Keywords: acute postoperative pain, epidural analgesia, nursing care, patient controlled analgesia
Procedia PDF Downloads 180262 Critical Discourse Analysis Approach to the Post-Feminist Representations in Ecommerce Livestreamings of Lipsticks
Authors: Haiyan Huang, Jan Blommaert, Ellen Van Praet
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The embrace of neoliberal economic system in China has engendered the entry of global commodity capitalism into domestic Chinese market and ushered in the post-feminism that is closely associated with consumerism from western culture. Chinese women are instilled and thus hold the belief of empowering themselves and expressing their individualism through consumption. To unravel the consumerist ideologies embedded in Li’s discursive practices, we rely on critical discourse analysis (CDA) as our research framework. The data analyses suggest that cosmopolitanism and class are two repeating themes when Li engages in persuading consumerist behaviors from the female audience. Through hints and cues such as “going on business trips”, “traveling abroad”, “international brands” and among others, Li provides the access to and possibility of imagining cosmopolitan and middle class identity for his audience. Such yearning for western culture and global citizen identity also implicates the aspiration for a well-off socioeconomic status, proving that post-feminism in China not only embodies western consumerism but also implicates the struggle of class movement. These defining elements of choice and freedom are well-situated in contemporary Chinese society where women are enjoying more educational and economic independence than before. However a closer examination reveals conflicts between hegemonic discourse of post-feminism and the status quo. First, propagating women’s power through consumption obscure the entrenched gender inequality in China. Philosophies such as employment discrimination, equal payment, education right, etc., the cornerstones of feminism did not exist in China, leading to historical gender issues unsolved. Second, the lengthy broadcastings (which normally last more than 2 hours) featured with big discounts on products beg the question who are the real audience of ecommerce livestreaming. Seemingly addressing to young well-off Chinese females, Li’s discursive practice can be targeting at young but not wealthy girls who aspire to mimic the lifestyle of middle class women. By selling the idea of empowering and constructing identity through consuming beauty products (e.g., lipsticks), capitalists are endeavoring to create the post-feminism illusion and cause anxieties among Chinese females. Through in-depth analyses of hegemonic discourse on ecommerce livestreaming of lipsticks, the paper contributes to a better understanding of post-feminism in contemporary China and meanwhile illustrates the problems Chinese women face in securing power and equality.Keywords: Chinese women, critical discourse analysis, ecommerce livestreaming, post-feminism
Procedia PDF Downloads 126261 Bruch’s Membrane Opening in High Myopia and Its Correlation with Axial Length
Authors: Sanjeeb Kumar Mishra, Aartee Jha, Madhu Thapa, Pragati Gautam
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Introduction: High myopia has become a matter of global concern as it is a major risk factor for glaucoma. Various optic nerve head changes occur in high myopia over time. This might lead to difficulty in detecting pathologies associated with high myopia through conventional funduscopy examinations only. Bruch’s Membrane Opening (Area and Minimum Rim Width) is considered an anatomically more accurate and reliable landmark than the conventional clinical disc margin. Study Design: It was a hospital based cross-sectional and non-interventional type of study. Purpose: The purpose of our study was to measure Bruch’s Membrane Opening (area and Minimum Rim Width) in high myopic eyes and correlate it with axial length. Methods: A cross-sectional study was conducted at B.P Koirala Lions Center for Ophthalmic Studies, a tertiary-level eye center in Nepal. 80 eyes of 40 subjects (40% male and 60% female) aged 18-35 years with high myopia (Spherical Equivalent (SE) ≥ -6D) were taken as cases. Among them, RE of 39 and LE of 34 myopic subjects were included in the study. Spectral Domain-Optical Coherence Tomography of both the eyes of myopic patients was performed using Glaucoma Module Premiere Edition (GMPE) with Anatomic Positioning System (APS) to measure Bruch’s Membrane Opening (Area and Minimum Rim Width). Axial length in myopic patients was measured using Partial Coherence Interferometry (IOL Master). Results: Among 40 myopic subjects, 16 (40%) were males, whereas 24 (60%) were females. The mean age of myopic subjects was 24.64 ± 5.10 years, with minimum and maximum ages of 18 years and 35 years, respectively. The mean BMO area was 2.28 0.48 mm² in right eye and 2.15 0.59 mm² in left eye. BMO area in high myopic patient was significantly correlated with axial length. The correlation analysis of BMO area with axial length in RE and LE was found to be statistically significant at (r=0.465, p<0.003) and (r=0.374, p< 0.029), respectively. Likewise, the mean BMO-MRW was 325.69 ± 96µm in right eye and 339.20 ± 79.50µm in left eye. There was a significant correlation of BMO-MRW with axial length in both the eyes of myopic subjects. Moreover, a significant negative correlation of Inferior temporal, Nasal, and Inferior nasal quadrants (p<0.05) of BMO-MRW of right eye was found with axial length of right eye, whereas all the BMO-MRW quadrants of left eye were negatively correlated (p<0.05) with axial length in left eye. No significant differences were found between right eye and left eye on comparing means of refractive error, axial length, BMO area, and BMO-MRW. Conclusion: From this study, it can be concluded that BMO area enlarges in high myopia with an increase in axial length. Additionally, BMO-MRW thinning occurs along with the BMO enlargement and increases with axial length. There were no significant differences in refractive error, axial length, BMO area, and BMO-MRW between right eye and left eye.Keywords: high myopia, Bruch’s membrane opening, Bruch’s membrane opening minimum rim width, spectral domain optical coherence tomography
Procedia PDF Downloads 13260 A Road Map of Success for Differently Abled Adolescent Girls Residing in Pune, Maharashtra, India
Authors: Varsha Tol, Laila Garda, Neelam Bhardwaj, Malata Usar
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In India, differently- abled girls suffer from a “dual stigma” of being female and physically challenged. The general consensus is that they are incapable of standing on their own two feet. It was observed that these girls do not have access to educational programs as most hostels do not keep them after the tenth grade. They are forced to return to a life of poverty and are often considered a liability by their families. Higher education is completely ignored. Parents focus on finding a husband and passing on their ‘burden’ to someone else. An innovative, intervention for differently-abled adolescent girls with the express purpose of mainstreaming them into society was started by Helplife. The objective was to enrich the lives of these differently abled adolescent girls through precise research, focused intervention and professionalism. This programme addresses physical, mental and social rehabilitation of the girls who come from impoverished backgrounds. These adolescents are reached by word of mouth, snowball technique and through the network of the NGO. Applications are invited from potential candidates which are scrutinized by a panel of experts. Selection criteria include her disability, socio-economic status, and desire and drive to make a difference in her own life. The six main areas of intervention are accommodation, education, health, professional courses, counseling and recreational activities. Each girl on an average resides in Helplife for a period of 2-3 years. Analysis of qualitative data collected at various time points indicates holistic development of character. A quality of life questionnaire showed a significant improvement in scores at three different time points in 75% of the current population under intervention i.e. 19 girls. Till date, 25 girls have successfully passed out from the intervention program completing their graduation/post-graduation. Currently, we have 19 differently abled girls housed in three flats in Pune district of Maharashtra. Out of which 14 girls are pursuing their graduation or post-graduation. Six of the girls are working in jobs in various sectors. In conclusion it may be noted with adequate support and guidance the sky is the limit. This journey of 12 years has been a learning for us with ups and downs modifying the intervention at every step. Helplife has a belief of impacting positively, individual lives of differently abled girls in order to empower them in a holistic manner. The intervention has a positive impact on differently abled girls. They serve as role models to other differently abled girls indicating that this is a road map to success by getting empowered to live with full potential and get integrated in the society in a dignified way.Keywords: differently-abled, dual-stigma, empowerment, youth
Procedia PDF Downloads 172259 Gender-Transformative Education: A Pathway to Nourishing and Evolving Gender Equality in the Higher Education of Iran
Authors: Sepideh Mirzaee
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Gender-transformative (G-TE) education is a challenging concept in the field of education and it is a matter of hot debate in the contemporary world. Paulo Freire as the prominent advocate of transformative education considers it as an alternative to conventional banking model of education. Besides, a more inclusive concept has been introduced, namely, G-TE, as an unbiased education fostering an environment of gender justice. As its main tenet, G-TE eliminates obstacles to education and improves social shifts. A plethora of contemporary research indicates that G-TE could completely revolutionize education systems by displacing inequalities and changing gender stereotypes. Despite significant progress in female education and its effects on gender equality in Iran, challenges persist. There are some deficiencies regarding gender disparities in the society and, education, specifically. As an example, the number of women with university degrees is on the rise; thus, there will be an increasing demand for employment in the society by them. Instead, many job opportunities remain occupied by men and it is seen as intolerable for the society to assign such occupations to women. In fact, Iran is regarded as a patriarchal society where educational contexts can play a critical role to assign gender ideology to its learners. Thus, such gender ideologies in the education can become the prevailing ideologies in the entire society. Therefore, improving education in this regard, can lead to a significant change in a society subsequently influencing the status of women not only within their own country but also on a global scale. Notably, higher education plays a vital role in this empowerment and social change. Particularly higher education can have a crucial part in imparting gender neutral ideologies to its learners and bringing about substantial change. It has the potential to alleviate the detrimental effects of gender inequalities. Therefore, this study aims to conceptualize the pivotal role of G-TE and its potential power in developing gender equality within the higher educational system of Iran presented within a theoretical framework. The study emphasizes the necessity of stablishing a theoretical grounding for citizenship, and transformative education while distinguishing gender related issues including gender equality, equity and parity. This theoretical foundation will shed lights on the decisions made by policy-makers, syllabus designers, material developers, and specifically professors and students. By doing so, they will be able to promote and implement gender equality recognizing the determinants, obstacles, and consequences of sustaining gender-transformative approaches in their classes within the Iranian higher education system. The expected outcomes include the eradication of gender inequality, transformation of gender stereotypes and provision of equal opportunities for both males and females in education.Keywords: citizenship education, gender inequality, higher education, patriarchal society, transformative education
Procedia PDF Downloads 65258 Mitigating the Negative Health Effects from Stress - A Social Network Analysis
Authors: Jennifer A. Kowalkowski
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Production agriculture (farming) is a physically, emotionally, and cognitively stressful occupation, where workers have little control over the stressors that impact both their work and their lives. In an occupation already rife with hazards, these occupational-related stressors have been shown to increase farm workers’ risks for illness, injury, disability, and death associated with their work. Despite efforts to mitigate the negative health effects from occupational-related stress (ORS) and to promote health and well-being (HWB) among farmers in the US, marked improvements have not been attained. Social support accessed through social networks has been shown to buffer against the negative health effects from stress, yet no studies have directly examined these relationships among farmers. The purpose of this study was to use social network analysis to explore the social networks of farm owner-operators and the social supports available to them for mitigating the negative health effects of ORS. A convenience sample of 71 farm owner-operators from a Midwestern County in the US completed and returned a mailed survey (55.5% response rate) that solicited information about their social networks related to ORS. Farmers reported an average of 2.4 individuals in their personal networks and higher levels of comfort discussing ORS with female network members. Farmers also identified few connections (3.4% density) and indicated low comfort with members of affiliation networks specific to ORS. Findings from this study highlighted that farmers accessed different social networks and resources for their personal HWB than for issues related to occupational(farm-related) health and safety. In addition, farmers’ social networks for personal HWB were smaller, with different relational characteristics than reported in studies of farmers’ social networks related to occupational health and safety. Collectively, these findings suggest that farmers conceptualize personal HWB differently than farm health and safety. Therefore, the same research approaches and targets that guide occupational health and safety research may not be appropriate for personal HWB for farmers. Interventions and programming targeting ORS and HWB have largely been offered through the same platforms or mechanisms as occupational health and safety programs. This may be attributed to the significant overlap between the farm as a family business and place of residence, or that ORS stems from farm-related issues. However, these assumptions translated to health research of farmers and farm families from the occupational health and safety literature have not been directly studied or challenged. Thismay explain why past interventions have not been effective at improving health outcomes for farmers and farm families. A close examination of findings from this study raises important questions for researchers who study agricultural health. Findings from this study have significant implications for future research agendas focused on addressing ORS, HWB, and health disparities for farmersand farm families.Keywords: agricultural health, occupational-related stress, social networks, well-being
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