Search results for: out-of-plane free vibration analysis
785 Strategic Interventions to Address Health Workforce and Current Disease Trends, Nakuru, Kenya
Authors: Paul Moses Ndegwa, Teresia Kabucho, Lucy Wanjiru, Esther Wanjiru, Brian Githaiga, Jecinta Wambui
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Health outcome has improved in the country since 2013 following the adoption of the new constitution in Kenya with devolved governance with administration and health planning functions transferred to county governments. 2018-2022 development agenda prioritized universal healthcare coverage, food security, and nutrition, however, the emergence of Covid-19 and the increase of non-communicable diseases pose a challenge and constrain in an already overwhelmed health system. A study was conducted July-November 2021 to establish key challenges in achieving universal healthcare coverage within the county and best practices for improved non-communicable disease control. 14 health workers ranging from nurses, doctors, public health officers, clinical officers, and pharmaceutical technologists were purposely engaged to provide critical information through questionnaires by a trained duo observing ethical procedures on confidentiality. Data analysis. Communicable diseases are major causes of morbidity and mortality. Non-communicable diseases contribute to approximately 39% of deaths. More than 45% of the population does not have access to safe drinking water. Study noted geographic inequality with respect to distribution and use of health resources including competing non-health priorities. 56% of health workers are nurses, 13% clinical officers, 7% doctors, 9%public health workers, 2% are pharmaceutical technologists. Poor-quality data limits the validity of disease-burdened estimates and research activities. Risk factors include unsafe water, sanitation, hand washing, unsafe sex, and malnutrition. Key challenge in achieving universal healthcare coverage is the rise in the relative contribution of non-communicable diseases. Improve targeted disease control with effective and equitable resource allocation. Develop high infectious disease control mechanisms. Improvement of quality data for decision making. Strengthen electronic data-capture systems. Increase investments in the health workforce to improve health service provision and achievement of universal health coverage. Create a favorable environment to retain health workers. Fill in staffing gaps resulting in shortages of doctors (7%). Develop a multi-sectional approach to health workforce planning and management. Need to invest in mechanisms that generate contextual evidence on current and future health workforce needs. Ensure retention of qualified, skilled, and motivated health workforce. Deliver integrated people-centered health services.Keywords: multi-sectional approach, equity, people-centered, health workforce retention
Procedia PDF Downloads 98784 Road Map to Health: Palestinian Workers in Israel's Construction Sector
Authors: Maya de Vries Kedem, Abir Jubran, Diana Baron
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Employment in Israel offers Palestinian workers an income double what they can earn in the West Bank. The need to support their families leads many educated Palestinians to forgo finding work in their profession in the Palestinian Authority and instead look for employment in those sectors open to them in Israel, particularly the construction, agriculture, and industry sectors. The International Labor Organization estimated that about 1,200 workers in Israel die every year because of occupational diseases (diseases caused by working conditions). Construction workers in Israel are constantly exposed to dust, noise, chemical materials, and work in awkward postures, which require prolonged bending, repetitive motion, and other risk factors that can lead to illnesses and death. Occupational health is vastly neglected in Israel and construction workers are particularly at risk . As of June 2022, the Israeli quota in the construction sector for Palestinian workers stood at 80,000. Kav LaOved released a new study on the state of occupational health among Palestinian workers employed in construction in Israel. The study Roadmap to Health: Palestinian Workers in Israel's Construction Sector reviews the extent to which the health of Palestinian workers is protected at work in Israel. The report includes analysis of a survey administered to 256 workers as well as interviews with 10 workers and with 5 Israeli occupational health experts. Report highlights: • Among survey respondents, 63.9% stated that safety procedures to protect their health are rarely followed in their workplace (e.g., taking breaks, using protective gear, following restrictions on lifting heavy items, and having inspectors regularly on site to monitor safety). • All 256 Palestinian workers who participated to the survey said that their health has been directly or indirectly harmed by working in Israel and reported suffering from the following problems: orthopedic problems such as joint, hand, leg or knee problems (100%); headaches (75%); back problems (36.3%); eye problems (23.8%); breathing problems (17.6%); chronic pain (14.8%); heart problems (7.8%); and skin problems (3.5%). • Workers who are injured or do not feel well often continue working for fear of losing their payment for that day. About half of the 256 survey respondents reported that they pay brokerage fees to find an employer with a work permit, often paying between 2,000 and 3,000 NIS per month. “I have an obligation—I pay about NIS 120 a day for my permit, [and] I have to pay for it whether I work or not" a worker said. • Most Palestinian construction workers suffer from stress and mental health problems. Workers pointed to several issues that greatly affect their mood and mental state: daily crossings at crowded checkpoints where workers stand for hours; lack of sleep due to leaving home daily at 3:00-3:30 am; commuting two to four hours to work in each direction; and abusive work environments. A worker told KLO that the sight of thousands of workers standing together at the checkpoint causes “high blood pressure and the feeling that you are going to be squeezed.” Another said, “I felt that my bones would break.” In the survey workers reported suffering from insomnia (70.1%), breathing difficulties (35.8%), chest pressure (27.6%), or rapid pulse rate (12.2%).Keywords: construction sector, palestinian workers, occupational health, Israel, occupation
Procedia PDF Downloads 77783 Applying Innovation in FP Counselling: Results from A360 Amplify Matasan Matan Arewa Implementation of Counseling for Choice to Improve Contraceptive Adoption and Continuation among Married Adolescent Girls (15-19 years) in Northern Nigeria
Authors: Bulama Alhaji Alhassan, Roselyn Odeh, Rakiya Idris Labaran, Dorcas Yemi Danladi, Faith Ochonu
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Introduction: Contraceptive use has numerous health benefits such as preventing unplanned pregnancies thereby supporting women to achieve their life goals, maintaining the ideal amount of time between pregnancies, lowering the death rate for both mothers and children and generally enhancing the lives of women and children. Despite the numerous advantages of modern contraception and numerous initiatives by the government and development partners to promote its adoption, Nigeria's use of these methods has remained persistently low. Counseling about contraception is essential to providing high-quality treatment ensuring informed choice, and voluntarism for family planning is the key. The goal of the contraceptive counseling approach known as Counseling for Choice (C4C) is to ensure that people have the agency and voice to choose the contraceptive methods that best suit their requirements by altering the way both clients and providers engage in family planning counseling sessions. Aim: To evaluate the effect of counseling for choice on Modern Contraceptive adoption and continuation among married adolescent girls aged 15-19 years in 61 health facilities, within a 6-month period in Northern Nigeria. Methodology: Data from the NDHIS was obtained from selected facilities Pre & Post commencement of C4C intervention from 36 facilities Kaduna and 25 Nasarawa Matasan Matan Arewa (MMA) core implementation states putting into consideration the specific period of initiation of intervention, six months after deployment of the C4C, data was obtained from these facilities for post analysis. Data was analyzed on SPSS using paired sample t-test. Result: C4C resulted to improved access to FP services via increasing contraceptive adoption and continued used by 15% and 27% respectively (p<0.05) in Nasarawa state. While in Kaduna state we observed 11% and 28% improvement in adoption and continued use respectively as well with statistical significance (p<0.05) depicting that the increase is highly correlated (0.99 Nasarawa and 0.75 Kaduna) with the C4C intervention where the provider uses the NORMAL AND 3Ws Rubric to explain to the client in a simplified manner what to do with chosen method, what to expect with her method of adoption and when to return for a refill. Conclusion: In Northern Nigeria, it was observed that most clients discontinue their methods due to bleeding side effect and that was related to lack of appropriate and comprehensive information during counselling about what to expect with the clients method of adoption but with the intervention of the program, through capacity strengthening of PHC providers on counselling skills using the Counselling for Choice, it has helped to improve modern contraceptive uptake among young married women in northern Nigeria.Keywords: continuation, counselling, uptake, adolescent, modern & implementation
Procedia PDF Downloads 61782 From Victim to Ethical Agent: Oscar Wilde's The Ballad of Reading Gaol as Post-Traumatic Writing
Authors: Mona Salah El-Din Hassanein
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Faced with a sudden, unexpected, and overwhelming event, the individual's normal cognitive processing may cease to function, trapping the psyche in "speechless terror", while images, feelings and sensations are experienced with emotional intensity. Unable to master such situation, the individual becomes a trauma victim who will be susceptible to traumatic recollections like intrusive thoughts, flashbacks, and repetitive re-living of the primal event in a way that blurs the distinction between past and present, and forecloses the future. Trauma is timeless, repetitious, and contagious; a trauma observer could fall prey to "secondary victimhood". Central to the process of healing the psychic wounds in the aftermath of trauma is verbalizing the traumatic experience (i.e., putting it into words) – an act which provides a chance for assimilation, testimony, and reevaluation. In light of this paradigm, this paper proposes a reading of Oscar Wilde's The Ballad of Reading Gaol, written shortly after his release from prison, as a post-traumatic text which traces the disruptive effects of the traumatic experience of Wilde's imprisonment for homosexual offences and the ensuing reversal of fortune he endured. Post-traumatic writing demonstrates the process of "working through" a trauma which may lead to the possibility of ethical agency in the form of a "survivor mission". This paper draws on fundamental concepts and key insights in literary trauma theory which is characterized by interdisciplinarity, combining the perspectives of different fields like critical theory, psychology, psychiatry, psychoanalysis, history, and social studies. Of particular relevance to this paper are the concepts of "vicarious traumatization" and "survivor mission", as The Ballad of Reading Gaol was written in response to Wilde's own prison trauma and the indirect traumatization he experienced as a result of witnessing the execution of a fellow prisoner whose story forms the narrative base of the poem. The Ballad displays Wilde's sense of mission which leads him to recognize the social as well as ethical implications of personal tragedy. Through a close textual analysis of The Ballad of Reading Gaol within the framework of literary trauma theory, the paper aims to: (a) demonstrate how the poem's thematic concerns, structure and rhetorical figures reflect the structure of trauma; (b) highlight Wilde's attempts to come to terms with the effects of the cataclysmic experience which transformed him into a social outcast; and (c) show how Wilde manages to transcend the victim status and assumes the role of ethical agent to voice a critique of the Victorian penal system and the standards of morality underlying the cruelties practiced against wrong doers and to solicit social action.Keywords: ballad of reading of reading, post-traumatic writing, trauma theory, Wilde
Procedia PDF Downloads 177781 Single Cell Rna Sequencing Operating from Benchside to Bedside: An Interesting Entry into Translational Genomics
Authors: Leo Nnamdi Ozurumba-Dwight
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Single-cell genomic analytical systems have proved to be a platform to isolate bulk cells into selected single cells for genomic, proteomic, and related metabolomic studies. This is enabling systematic investigations of the level of heterogeneity in a diverse and wide pool of cell populations. Single cell technologies, embracing techniques such as high parameter flow cytometry, single-cell sequencing, and high-resolution images are playing vital roles in these investigations on messenger ribonucleic acid (mRNA) molecules and related gene expressions in tracking the nature and course of disease conditions. This entails targeted molecular investigations on unit cells that help us understand cell behavoiur and expressions, which can be examined for their health implications on the health state of patients. One of the vital good sides of single-cell RNA sequencing (scRNA seq) is its probing capacity to detect deranged or abnormal cell populations present within homogenously perceived pooled cells, which would have evaded cursory screening on the pooled cell populations of biological samples obtained as part of diagnostic procedures. Despite conduction of just single-cell transcriptome analysis, scRNAseq now permits comparison of the transcriptome of the individual cells, which can be evaluated for gene expressional patterns that depict areas of heterogeneity with pharmaceutical drug discovery and clinical treatment applications. It is vital to strictly work through the tools of investigations from wet lab to bioinformatics and computational tooled analyses. In the precise steps for scRNAseq, it is critical to do thorough and effective isolation of viable single cells from the tissues of interest using dependable techniques (such as FACS) before proceeding to lysis, as this enhances the appropriate picking of quality mRNA molecules for subsequent sequencing (such as by the use of Polymerase Chain Reaction machine). Interestingly, scRNAseq can be deployed to analyze various types of biological samples such as embryos, nervous systems, tumour cells, stem cells, lymphocytes, and haematopoietic cells. In haematopoietic cells, it can be used to stratify acute myeloid leukemia patterns in patients, sorting them out into cohorts that enable re-modeling of treatment regimens based on stratified presentations. In immunotherapy, it can furnish specialist clinician-immunologist with tools to re-model treatment for each patient, an attribute of precision medicine. Finally, the good predictive attribute of scRNAseq can help reduce the cost of treatment for patients, thus attracting more patients who would have otherwise been discouraged from seeking quality clinical consultation help due to perceived high cost. This is a positive paradigm shift for patients’ attitudes primed towards seeking treatment.Keywords: immunotherapy, transcriptome, re-modeling, mRNA, scRNA-seq
Procedia PDF Downloads 166780 A Socio-Spatial Analysis of Financialization and the Formation of Oligopolies in Brazilian Basic Education
Authors: Gleyce Assis Da Silva Barbosa
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In recent years, we have witnessed a vertiginous growth of large education companies. Daughters of national and world capital, these companies expand both through consolidated physical networks in the form of branches spread across the territory and through institutional networks such as business networks through mergers, acquisitions, creation of new companies and influence. They do this by incorporating small, medium and large schools and universities, teaching systems and other products and services. They are also able to weave their webs directly or indirectly in philanthropic circles, limited partnerships, family businesses and even in public education through various mechanisms of outsourcing, privatization and commercialization of products for the sector. Although the growth of these groups in basic education seems to us a recent phenomenon in peripheral countries such as Brazil, its diffusion is closely linked to higher education conglomerates and other sectors of the economy forming oligopolies, which began to expand in the 1990s with strong state support and through political reforms that redefined its role, transforming it into a fundamental agent in the formation of guidelines to boost the incorporation of neoliberal logic. This expansion occurred through the objectification of education, commodifying it and transforming students into consumer clients. Financial power combined with the neo-liberalization of state public policies allowed the profusion of social exclusion, the increase of individuals without access to basic services, deindustrialization, automation, capital volatility and the indetermination of the economy; in addition, this process causes capital to be valued and devalued at rates never seen before, which together generates various impacts such as the precariousness of work. Understanding the connection between these processes, which engender the economy, allows us to see their consequences in labor relations and in the territory. In this sense, it is necessary to analyze the geographic-economic context and the role of the facilitating agents of this process, which can give us clues about the ongoing transformations and the directions of education in the national and even international scenario since this process is linked to the multiple scales of financial globalization. Therefore, the present research has the general objective of analyzing the socio-spatial impacts of financialization and the formation of oligopolies in Brazilian basic education. For this, the survey of laws, data, and public policies on the subject in question was used as a methodology. As a methodology, the work was based on some data from these companies available on websites for investors. Survey of information from global and national companies that operate in Brazilian basic education. In addition to mapping the expansion of educational oligopolies using public data on the location of schools. With this, the research intends to provide information about the ongoing commodification process in the country. Discuss the consequences of the oligopolization of education, considering the impacts that financialization can bring to teaching work.Keywords: financialization, oligopolies, education, Brazil
Procedia PDF Downloads 55779 From Forked Tongues to Tinkerbell Ears: Rethinking the Criminalization of Alternative Body Modification in the UK
Authors: Luci V. Hyett
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The criminal law of England and Wales currently deems that a person cannot consent to the infliction of injury upon their own body, where the level of harm is considered to be Actual or Grevious. This renders the defence of consent of the victim as being unavailable to those persons carrying out an Alternative Body Modification procedure. However, the criminalization of consensual injury is more appropriately deemed as being categorized as an offense against public morality and not one against the person, which renders the State’s involvement in the autonomous choices of a consenting adult, when determining what can be done to one’s own body, an arbitrary one. Furthermore, to recognise in law that a person is capable of giving a valid consent to socially acceptable cosmetic interventions that largely consist of procedures designed to aesthetically please men and, not those of people who want to modify their bodies for other reasons means that patriarchal attitudes are continuing to underpin public repulsion and inhibit social acceptance of such practices. Theoretical analysis will begin with a juridical examination of R v M(B) [2019] QB 1 where the High Court determined that Alternative Body Modification was not a special category exempting a person so performing from liability for Grevious Bodily Harm using the defence of consent. It will draw from its reasoning which considered that ‘the removal of body parts were medical procedures being carried out for no medical reason by someone not qualified to carry them out’ which will form the basis of this enquiry. It will consider the philosophical work of Georgio Agamben when analysing whether the biopolitical climate in the UK, which places the optimization of the perfect, healthy body at the centre of political concern can explain why those persons who wish to engage in Alternative Body Modification are treated as the ‘Exception’ to that which is normal using the ‘no medical reason’ canon to justify criminalisation, rather than legitimising the industry through regulation. It will consider, through a feminist lens, the current conflict in law between traditional cosmetic interventions which alter one’s physical appearance for socially accepted aesthetic purposes such as those to the breast, lip and buttock and, modifications described as more outlandish such as earlobe stretching, tooth filing and transdermal implants to create horns and spikes under the skin. It will assert that ethical principles relating to the psychological impact of body modification described as ‘alternative’ is used as a means to exclude person’s seeking such a procedure from receiving safe and competent treatment via a registered cosmetic surgeon which leads to these increasingly popular surgery’s being performed in Tattoo parlours throughout the UK as an extension to other socially acceptable forms of self-modification such as piercings. It will contend that only by ‘inclusive exclusion’ will those ‘othered’ through ostracisation be welcomed into the fold of normality and this can only be achieved through recognition of alternative body modification as a legitimate cosmetic intervention, subject to the same regulatory framework as existing practice. This would assist in refocusing the political landscape by erring on the side of liberty rather than that of biology.Keywords: biopolitics, body modification, consent, criminal law
Procedia PDF Downloads 100778 Isolation and Structural Elucidation of 20 Hydroxyecdystone from Vitex doniana Sweet Stem Bark
Authors: Mustapha A. Tijjani, Fanna I. Abdulrahman, Irfan Z. Khan, Umar K. Sandabe, Cong Li
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Air dried sample V. doniana after collection and identification was extracted with ethanol and further partition with chloroform, ethyl acetate and n-butanol. Ethanolic extract (11.9g) was fractionated on a silica gel accelerated column chromatography using solvents such as n-hexane, ethyl acetate and methanol. Each eluent fractions (150ml aliquots) were collected and monitored with thin layer chromatography. Fractions with similar Rf values from same solvents system were pooled together. Phytochemical test of all the fractions were performed using standard procedure. Complete elution yielded 48 fractions (150ml/fraction) which were pooled to 24 fractions base on the Rf values. It was further recombined and 12 fractions were obtained on the basis on Rf values and coded Vd1 to Vd12 fractions. Vd8 was further eluted with ethylacetate and methanol and gave fourteen sub fractions Vd8-a, -Vd8-m. Fraction Vd8-a (56mg) gave a white crystal compound coded V1. It was further checked on TLC and observed under ultraviolet lamp and was found to give a single spot. The Rf values were calculated to be 0.433. The melting point was determined using Gallenkamp capillary melting point apparatus and found to be 241-243°C uncorrected. Characterization of the isolated compound coded V1 was done using FT-infra-red spectroscopy, HNMR, 13CNMR(1and 2D) and HRESI-MS. The IR spectrum of compound V1 shows prominent peaks that corresponds to OHstr (3365cm-1) and C=0 (1652cm-1) etc. This spectrum suggests that among the functional moiety in compound V1 are the carbonyl and hydroxyl group. The 1H NMR (400 MHz) spectrum of compound V1 in DMSO-d6 displayed five singlet signals at δ 0.72 (3H, s, H-18), 0.79 (3H, s, H-19), 1.03 (3H, s, H-21), 1.04 (3H, s, H-26), 1.06 (3H, s, H-27) each integrating for three protons indicating the five methyl functional groups present in the compound. It further showed a broad singlet at δ 5.58 integrated for 1 H due to an olefinic H-atom adjacent to the carbonyl carbon atom. Three signals at δ 3.10 (d, J = 9.0 Hz, H-22), 3.59 (m, 1H, 2H-a) and 3.72 (m, 1H, 3H-e), each integrating for one proton is due to oxymethine protons indicating that three oxymethine H-atoms are present in the compound. These all signals are characteristic to the ecdysteroid skeletons. The 13C-NMR spectrum showed the presence of 27 carbon atoms, suggesting that may be steroid skeleton. The DEPT-135 experiment showed the presence of five CH3, eight CH2, and seven CH groups, and seven quaternary C-atoms. The molecular formula was established as C27H44O7 by high resolution electron spray ionization-mass spectroscopy (HRESI-MS) positive ion mode m/z 481.3179. The signals in mass spectrum are 463, 445, and 427 peaks corresponding to losses of one, two, three, or four water molecules characteristic for ecdysterone skeleton reported in the literature. Based on the spectral analysis (HNMR, 13CNMR, DEPT, HMQC, IR, HRESI-MS) the compound V1 is thus concluded to have ecdysteriod skeleton and conclusively conforms with 2β, 3β 14α, 20R, 22R, 25-hexahydroxy-5 β cholest-7-ene-6- one, or 2, 3, 14, 20, 22, 25 hexahydroxy cholest-7-ene-6-one commonly known as 20-hydroxyecdysone.Keywords: vitex, phytochemical, purification, isolation, chromatography, spectroscopy
Procedia PDF Downloads 348777 Disrupting Traditional Industries: A Scenario-Based Experiment on How Blockchain-Enabled Trust and Transparency Transform Nonprofit Organizations
Authors: Michael Mertel, Lars Friedrich, Kai-Ingo Voigt
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Based on principle-agent theory, an information asymmetry exists in the traditional donation process. Consumers cannot comprehend whether nonprofit organizations (NPOs) use raised funds according to the designated cause after the transaction took place (hidden action). Therefore, charity organizations have tried to appear transparent and gain trust by using the same marketing instruments for decades (e.g., releasing project success reports). However, none of these measures can guarantee consumers that charities will use their donations for the purpose. With awareness of misuse of donations rising due to the Ukraine conflict (e.g., funding crime), consumers are increasingly concerned about the destination of their charitable purposes. Therefore, innovative charities like the Human Rights Foundation have started to offer donations via blockchain. Blockchain technology has the potential to establish profound trust and transparency in the donation process: Consumers can publicly track the progress of their donation at any time after deciding to donate. This ensures that the charity is not using donations against its original intent. Hence, the aim is to investigate the effect of blockchain-enabled transactions on the willingness to donate. Sample and Design: To investigate consumers' behavior, we use a scenario-based experiment. After removing participants (e.g., due to failed attention checks), 3192 potential donors participated (47.9% female, 62.4% bachelor or above). Procedure: We randomly assigned the participants to one of two scenarios. In all conditions, the participants read a scenario about a fictive charity organization called "Helper NPO." Afterward, the participants answered questions regarding their perception of the charity. Manipulation: The first scenario (n = 1405) represents a typical donation process, where consumers donate money without any option to track and trace. The second scenario (n = 1787) represents a donation process via blockchain, where consumers can track and trace their donations respectively. Using t-statistics, the findings demonstrate a positive effect of donating via blockchain on participants’ willingness to donate (mean difference = 0.667, p < .001, Cohen’s d effect size = 0.482). A mediation analysis shows significant effects for the mediation of transparency (Estimate = 0.199, p < .001), trust (Estimate = 0.144, p < .001), and transparency and trust (Estimate = 0.158, p < .001). The total effect of blockchain usage on participants’ willingness to donate (Estimate = 0.690, p < .001) consists of the direct effect (Estimate = 0.189, p < .001) and the indirect effects of transparency and trust (Estimate = 0.501, p < .001). Furthermore, consumers' affinity for technology moderates the direct effect of blockchain usage on participants' willingness to donate (Estimate = 0.150, p < .001). Donating via blockchain is a promising way for charities to engage consumers for several reasons: (1) Charities can emphasize trust and transparency in their advertising campaigns. (2) Established charities can target new customer segments by specifically engaging technology-affine consumers in the future. (3) Charities can raise international funds without previous barriers (e.g., setting up bank accounts). Nevertheless, increased transparency can also backfire (e.g., disclosure of costs). Such cases require further research.Keywords: blockchain, social sector, transparency, trust
Procedia PDF Downloads 88776 Working Memory and Audio-Motor Synchronization in Children with Different Degrees of Central Nervous System's Lesions
Authors: Anastasia V. Kovaleva, Alena A. Ryabova, Vladimir N. Kasatkin
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Background: The most simple form of entrainment to a sensory (typically auditory) rhythmic stimulus involves perceiving and synchronizing movements with an isochronous beat with one level of periodicity, such as that produced by a metronome. Children with pediatric cancer usually treated with chemo- and radiotherapy. Because of such treatment, psychologists and health professionals declare cognitive and motor abilities decline in cancer patients. The purpose of our study was to measure working memory characteristics with association with audio-motor synchronization tasks, also involved some memory resources, in children with different degrees of central nervous system lesions: posterior fossa tumors, acute lymphoblastic leukemia, and healthy controls. Methods: Our sample consisted of three groups of children: children treated for posterior fossa tumors (PFT-group, n=42, mean age 12.23), children treated for acute lymphoblastic leukemia (ALL-group, n=11, mean age 11.57) and neurologically healthy children (control group, n=36, mean age 11.67). Participants were tested for working memory characteristics with Cambridge Neuropsychological Test Automated Battery (CANTAB). Pattern recognition memory (PRM) and spatial working memory (SWM) tests were applied. Outcome measures of PRM test include the number and percentage of correct trials and latency (speed of participant’s response), and measures of SWM include errors, strategy, and latency. In the synchronization tests, the instruction was to tap out a regular beat (40, 60, 90 and 120 beats per minute) in synchrony with the rhythmic sequences that were played. This meant that for the sequences with an isochronous beat, participants were required to tap into every auditory event. Variations of inter-tap-intervals and deviations of children’s taps from the metronome were assessed. Results: Analysis of variance revealed the significant effect of group (ALL, PFT and control) on such parameters as short-term PRM, SWM strategy and errors. Healthy controls demonstrated more correctly retained elements, better working memory strategy, compared to cancer patients. Interestingly that ALL patients chose the bad strategy, but committed significantly less errors in SWM test then PFT and controls did. As to rhythmic ability, significant associations of working memory were found out only with 40 bpm rhythm: the less variable were inter-tap-intervals of the child, the more elements in memory he/she could retain. The ability to audio-motor synchronization may be related to working memory processes mediated by the prefrontal cortex whereby each sensory event is actively retrieved and monitored during rhythmic sequencing. Conclusion: Our results suggest that working memory, tested with appropriate cognitive methods, is associated with the ability to synchronize movements with rhythmic sounds, especially in sub-second intervals (40 per minute).Keywords: acute lymphoblastic leukemia (ALL), audio-motor synchronization, posterior fossa tumor, working memory
Procedia PDF Downloads 290775 Performance of the Abbott RealTime High Risk HPV Assay with SurePath Liquid Based Cytology Specimens from Women with Low Grade Cytological Abnormalities
Authors: Alexandra Sargent, Sarah Ferris, Ioannis Theofanous
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The Abbott RealTime High Risk HPV test (RealTime HPV) is one of five assays clinically validated and approved by the English NHS Cervical Screening Programme (CSP) for HPV triage of low grade dyskaryosis and test-of-cure of treated Cervical Intraepithelial Neoplasia. The assay is a highly automated multiplex real-time PCR test for detecting 14 high risk (hr) HPV types, with simultaneous differentiation of HPV 16 and HPV 18 versus non-HPV 16/18 hrHPV. An endogenous internal control ensures sample cellularity, controls extraction efficiency and PCR inhibition. The original cervical specimen collected in SurePath (SP) liquid-based cytology (LBC) medium (BD Diagnostics) and the SP post-gradient cell pellets (SPG) after cytological processing are both CE marked for testing with the RealTime HPV test. During the 2011 NHSCSP validation of new tests only the original aliquot of SP LBC medium was investigated. Residual sample volume left after cytology slide preparation is low and may not always have sufficient volume for repeat HPV testing or for testing of other biomarkers that may be implemented in testing algorithms in the future. The SPG samples, however, have sufficient volumes to carry out additional testing and necessary laboratory validation procedures. This study investigates the correlation of RealTime HPV results of cervical specimens collected in SP LBC medium from women with low grade cytological abnormalities observed with matched pairs of original SP LBC medium and SP post-gradient cell pellets (SPG) after cytology processing. Matched pairs of SP and SPG samples from 750 women with borderline (N = 392) and mild (N = 351) cytology were available for this study. Both specimen types were processed and parallel tested for the presence of hrHPV with RealTime HPV according to the manufacturer´s instructions. HrHPV detection rates and concordance between test results from matched SP and SPGCP pairs were calculated. A total of 743 matched pairs with valid test results on both sample types were available for analysis. An overall-agreement of hrHPV test results of 97.5% (k: 0.95) was found with matched SP/SPG pairs and slightly lower concordance (96.9%; k: 0.94) was observed on 392 pairs from women with borderline cytology compared to 351 pairs from women with mild cytology (98.0%; k: 0.95). Partial typing results were highly concordant in matched SP/SPG pairs for HPV 16 (99.1%), HPV 18 (99.7%) and non-HPV16/18 hrHPV (97.0%), respectively. 19 matched pairs were found with discrepant results: 9 from women with borderline cytology and 4 from women with mild cytology were negative on SPG and positive on SP; 3 from women with borderline cytology and 3 from women with mild cytology were negative on SP and positive on SPG. Excellent correlation of hrHPV DNA test results was found between matched pairs of SP original fluid and post-gradient cell pellets from women with low grade cytological abnormalities tested with the Abbott RealTime High-Risk HPV assay, demonstrating robust performance of the test with both specimen types and reassuring the utility of the assay for cytology triage with both specimen types.Keywords: Abbott realtime test, HPV, SurePath liquid based cytology, surepath post-gradient cell pellet
Procedia PDF Downloads 243774 Optimization of the Jatropha curcas Supply Chain as a Criteria for the Implementation of Future Collection Points in Rural Areas of Manabi-Ecuador
Authors: Boris G. German, Edward Jiménez, Sebastián Espinoza, Andrés G. Chico, Ricardo A. Narváez
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The unique flora and fauna of The Galapagos Islands has leveraged a tourism-driven growth in the islands. Nonetheless, such development is energy-intensive and requires thousands of gallons of diesel each year for thermoelectric electricity generation. The needed transport of fossil fuels from the continent has generated oil spillages and affectations to the fragile ecosystem of the islands. The Zero Fossil Fuels initiative for The Galapagos proposed by the Ecuadorian government as an alternative to reduce the use of fossil fuels in the islands, considers the replacement of diesel in thermoelectric generators, by Jatropha curcas vegetable oil. However, the Jatropha oil supply cannot entirely cover yet the demand for electricity generation in Galapagos. Within this context, the present work aims to provide an optimization model that can be used as a selection criterion for approving new Jatropha Curcas collection points in rural areas of Manabi-Ecuador. For this purpose, existing Jatropha collection points in Manabi were grouped under three regions: north (7 collection points), center (4 collection points) and south (9 collection points). Field work was carried out in every region in order to characterize the collection points, to establish local Jatropha supply and to determine transportation costs. Data collection was complemented using GIS software and an objective function was defined in order to determine the profit associated to Jatropha oil production. The market price of both Jatropha oil and residual cake, were considered for the total revenue; whereas Jatropha price, transportation and oil extraction costs were considered for the total cost. The tonnes of Jatropha fruit and seed, transported from collection points to the extraction plant, were considered as variables. The maximum and minimum amount of the collected Jatropha from each region constrained the optimization problem. The supply chain was optimized using linear programming in order to maximize the profits. Finally, a sensitivity analysis was performed in order to find a profit-based criterion for the acceptance of future collection points in Manabi. The maximum profit reached a value of $ 4,616.93 per year, which represented a total Jatropha collection of 62.3 tonnes Jatropha per year. The northern region of Manabi had the biggest collection share (69%), followed by the southern region (17%). The criteria for accepting new Jatropha collection points in the rural areas of Manabi can be defined by the current maximum profit of the zone and by the variation in the profit when collection points are removed one at a time. The definition of new feasible collection points plays a key role in the supply chain associated to Jatropha oil production. Therefore, a mathematical model that assists decision makers in establishing new collection points while assuring profitability, contributes to guarantee a continued Jatropha oil supply for Galapagos and a sustained economic growth in the rural areas of Ecuador.Keywords: collection points, Jatropha curcas, linear programming, supply chain
Procedia PDF Downloads 418773 Co-Evolution of Urban Lake System and Rapid Urbanization: Case of Raipur, Chhattisgarh
Authors: Kamal Agrawal, Ved Prakash Nayak, Akshay Patil
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Raipur is known as a city of water bodies. The city had around 200 man-made and natural lakes of varying sizes. These structures were constructed to collect rainwater and control flooding in the city. Due to the transition from community participation to state government, as well as rapid urbanisation, Raipur now has only about 80 lakes left. Rapid and unplanned growth has resulted in pollution, encroachment, and eutrophication of the city's lakes. The state government keeps these lakes in good condition by cleaning them and proposing lakefront developments. However, maintaining individual lakes is insufficient because urban lakes are not distinct entities. It is a system comprised of the lake, shore, catchment, and other components. While Urban lake system (ULS) is a combination of multiple such lake systems interacting in a complex urban setting. Thus, the project aims to propose a co-evolution model for urban lake systems (ULS) and rapid urbanization in Raipur. The goals are to comprehend the ULS and to identify elements and dimensions of urbanization that influence the ULS. Evaluate the impact of rapid urbanization on the ULS & vice versa in the study area. Determine how to maximize the positive impact while minimizing the negative impact identified in the study area. Propose short-, medium-, and long-term planning interventions to support the ULS's co-evolution with rapid urbanization. A complexity approach is used to investigate the ULS. It is a technique for understanding large, complex systems. A complex system is one with many interconnected and interdependent elements and dimensions. Thus, elements of ULS and rapid urbanization are identified through a literature study to evaluate statements of their impacts (Beneficial/ Adverse) on one another. Rapid urbanization has been identified as having elements such as demography, urban legislation, informal settlement, urban infrastructure, and tourism. Similarly, the catchment area of the lake, the lake's water quality, the water spread area, and lakefront developments are all being impacted by rapid urbanisation. These nine elements serve as parameters for the subsequent analysis. Elements are limited to physical parameters only. The city has designated a study area based on the definition provided by the National Plan for the Conservation of Aquatic Ecosystems. Three lakes are discovered within a one-kilometer radius, establishing a tiny urban lake system. Because the condition of a lake is directly related to the condition of its catchment area, the catchment area of these three lakes is delineated as the study area. Data is collected to identify impact statements, and the interdependence diagram generated between the parameters yields results in terms of interlinking between each parameter and their impact on the system as a whole. The planning interventions proposed for the ULS and rapid urbanisation co-evolution model include spatial proposals as well as policy recommendations for the short, medium, and long term. This study's next step will be to determine how to implement the proposed interventions based on the availability of resources, funds, and governance patterns.Keywords: urban lake system, co-evolution, rapid urbanization, complex system
Procedia PDF Downloads 65772 Policy Evaluation of Republic Act 9502 “Universally Accessible Cheaper and Quality Medicines Act of 2008”
Authors: Trina Isabel D. Santiago, Juan Raphael M. Perez, Maria Angelica O. Soriano, Teresita B. Suing, Jumee F. Tayaban
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To achieve universal healthcare for everyone, the World Health Organization has emphasized the importance of National Medicines Policies for increased accessibility and utilization of high-quality and affordable medications. In the Philippines, significant challenges have been identified surrounding the sustainability of essential medicines, resulting in limited access such as high cost and dominance and market dominance and monopoly of multinational companies (MNCs) in the Philippine pharmaceutical industry. These identified challenges have been addressed by several initiatives, such as the Philippine National Drug Policy and Generics Act of 1988 (Republic Act 6675), to attempt to reduce drug prices. Despite these efforts, the concerns with drug accessibility and affordability continue to persist; hence, Republic Act 9502 was enacted. This paper attempts to review RA 9502 in the pursuit of making medicines more affordable for Filipinos, analyze and critique the problems and challenges associated with the law, and provide recommendations to address identified problems and challenges. A literature search and review, as well as an analysis of the law, has been done to evaluate the policy. RA 9502 recognizes the importance of market competition in drug price reduction and quality medicine accessibility. Contentious issues prior to enactment of the law include 1) parallel importation, pointing out that the drug price will depend on the global market price, 2) contrasting approaches in the drafting of the law as the House version focused on medicine price control while the Senate version prioritized market competition, and 3) MNCs opposing the amendments with concerns on discrimination, constitutional violations, and noncompliance with international treaty obligations. There are also criticisms and challenges with the implementation of the law in terms of content or modeling, interpretation and implementation, and other external factors or hindrances. The law has been criticized for its narrow scope as it only covers specific essential medicines with no cooperation with the national health insurance program. Moreover, the law has sections taking advantage of the TRIPS flexibilities, which disallow smaller countries to reap the benefits of flexibilities. The sanctions and penalties have an insignificant role in implementation as they only ask for a small portion of the income of MNCs. Proposed recommendations for policy improvement include aligning existing legislation through strengthened price regulation and expanded law coverage, strengthening penalties to promote law adherence, and promoting research and development to encourage and support local initiatives. Through these comprehensive recommendations, the issues surrounding the policy can be addressed, and the goal of enhancing the affordability and accessibility of medicines in the country can be achieved.Keywords: drug accessibility, drug affordability, price regulation, Republic Act 9502
Procedia PDF Downloads 36771 Hybridization of Mathematical Transforms for Robust Video Watermarking Technique
Authors: Harpal Singh, Sakshi Batra
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The widespread and easy accesses to multimedia contents and possibility to make numerous copies without loss of significant fidelity have roused the requirement of digital rights management. Thus this problem can be effectively solved by Digital watermarking technology. This is a concept of embedding some sort of data or special pattern (watermark) in the multimedia content; this information will later prove ownership in case of a dispute, trace the marked document’s dissemination, identify a misappropriating person or simply inform user about the rights-holder. The primary motive of digital watermarking is to embed the data imperceptibly and robustly in the host information. Extensive counts of watermarking techniques have been developed to embed copyright marks or data in digital images, video, audio and other multimedia objects. With the development of digital video-based innovations, copyright dilemma for the multimedia industry increases. Video watermarking had been proposed in recent years to serve the issue of illicit copying and allocation of videos. It is the process of embedding copyright information in video bit streams. Practically video watermarking schemes have to address some serious challenges as compared to image watermarking schemes like real-time requirements in the video broadcasting, large volume of inherently redundant data between frames, the unbalance between the motion and motionless regions etc. and they are particularly vulnerable to attacks, for example, frame swapping, statistical analysis, rotation, noise, median and crop attacks. In this paper, an effective, robust and imperceptible video watermarking algorithm is proposed based on hybridization of powerful mathematical transforms; Fractional Fourier Transform (FrFT), Discrete Wavelet transforms (DWT) and Singular Value Decomposition (SVD) using redundant wavelet. This scheme utilizes various transforms for embedding watermarks on different layers by using Hybrid systems. For this purpose, the video frames are portioned into layers (RGB) and the watermark is being embedded in two forms in the video frames using SVD portioning of the watermark, and DWT sub-band decomposition of host video, to facilitate copyright safeguard as well as reliability. The FrFT orders are used as the encryption key that allows the watermarking method to be more robust against various attacks. The fidelity of the scheme is enhanced by introducing key generation and wavelet based key embedding watermarking scheme. Thus, for watermark embedding and extraction, same key is required. Therefore the key must be shared between the owner and the verifier via some safe network. This paper demonstrates the performance by considering different qualitative metrics namely Peak Signal to Noise ratio, Structure similarity index and correlation values and also apply some attacks to prove the robustness. The Experimental results are presented to demonstrate that the proposed scheme can withstand a variety of video processing attacks as well as imperceptibility.Keywords: discrete wavelet transform, robustness, video watermarking, watermark
Procedia PDF Downloads 217770 Rehabilitation of Orthotropic Steel Deck Bridges Using a Modified Ortho-Composite Deck System
Authors: Mozhdeh Shirinzadeh, Richard Stroetmann
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Orthotropic steel deck bridge consists of a deck plate, longitudinal stiffeners under the deck plate, cross beams and the main longitudinal girders. Due to the several advantages, Orthotropic Steel Deck (OSD) systems have been utilized in many bridges worldwide. The significant feature of this structural system is its high load-bearing capacity while having relatively low dead weight. In addition, cost efficiency and the ability of rapid field erection have made the orthotropic steel deck a popular type of bridge worldwide. However, OSD bridges are highly susceptible to fatigue damage. A large number of welded joints can be regarded as the main weakness of this system. This problem is, in particular, evident in the bridges which were built before 1994 when the fatigue design criteria had not been introduced in the bridge design codes. Recently, an Orthotropic-composite slab (OCS) for road bridges has been experimentally and numerically evaluated and developed at Technische Universität Dresden as a part of AIF-FOSTA research project P1265. The results of the project have provided a solid foundation for the design and analysis of Orthotropic-composite decks with dowel strips as a durable alternative to conventional steel or reinforced concrete decks. In continuation, while using the achievements of that project, the application of a modified Ortho-composite deck for an existing typical OSD bridge is investigated. Composite action is obtained by using rows of dowel strips in a clothoid (CL) shape. Regarding Eurocode criteria for different fatigue detail categories of an OSD bridge, the effect of the proposed modification approach is assessed. Moreover, a numerical parametric study is carried out utilizing finite element software to determine the impact of different variables, such as the size and arrangement of dowel strips, the application of transverse or longitudinal rows of dowel strips, and local wheel loads. For the verification of the simulation technique, experimental results of a segment of an OCS deck are used conducted in project P1265. Fatigue assessment is performed based on the last draft of Eurocode 1993-2 (2024) for the most probable detail categories (Hot-Spots) that have been reported in the previous statistical studies. Then, an analytical comparison is provided between the typical orthotropic steel deck and the modified Ortho-composite deck bridge in terms of fatigue issues and durability. The load-bearing capacity of the bridge, the critical deflections, and the composite behavior are also evaluated and compared. Results give a comprehensive overview of the efficiency of the rehabilitation method considering the required design service life of the bridge. Moreover, the proposed approach is assessed with regard to the construction method, details and practical aspects, as well as the economic point of view.Keywords: composite action, fatigue, finite element method, steel deck, bridge
Procedia PDF Downloads 66769 Barriers and Facilitators of Implementing Digital Mental Health Resources in Underserved Regions of Ontario during the COVID-19 Pandemic
Authors: Samaneh Abedini, Diana Urajnik, Nicole Naccarato
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A high prevalence of mental health problems was observed in marginalized youth living in underserved regions of Ontario during the COVID-19 pandemic. To address this issue, a growing number of community-based traditional mental health services are offering digital mental health resources due to their accessibility, affordability, and scalability. The feasibility of providing these resources in underserved regions has been examined by researchers rather than by representatives of effective services within a mental health system. Indeed, digitalized mental health contents are not routinely embedded within local mental health organizations' services in Northern Ontario, where they can make a substantial impact. To date, many technology-based mental health initiatives have not been effectively implemented in this region. The obstacles associated with implementing digitalized mental health resources in Northern Ontario may be unique to that region. Thus, specific context-based considerations might need to be applied for developing and implementing digital resources by regional mental health organizations in Northern Ontario. The target population was child-serving organizations situated in northeastern Ontario, specifically within Greater Sudbury and the Sudbury District. A sample of six organizations were selected with representation from the mental health, social, and healthcare sectors. The project supervisor was in a unique position to access the organizations by virtue of existing relationships with the practice and lay communities at large. Thus, recruitment was conducted through professional outreach in partnership with the Center for Rural and Northern Health Research (CRaNHR). Semi-structured interviews were conducted with 1-2 key personnel (e.g., administrator, clinician) from participating organizations. Audio recordings from the semi-structured interviews were transcribed verbatim and thematically analyzed supported by NVivo. Thematic analysis of the data resulted in a total of 13 excerpts which were categorized into two major themes including 1) digital mental health services as a valuable resource for organizations both during and after the pandemic, and 2) barriers and facilitators to a successful implementation of digital mental health resources in northern Ontario. Four secondary themes were identified: 1) perceived barriers to implementation of digital mental health resources to the offered services by mental health agencies; 2) acceptability and feasibility of digital health sources for people living in northern Ontario; 3) data security, safety, and risk; and 4) connecting with clients. The employees of mental health organizations in northern Ontario considered digital mental health resources as generally acceptable to youth. However, they raised several concerns that may affect their implementation into routine practice and service delivery. The implementation of digital systems should be simple and straightforward and should enhance rather than hinder clinical workflows for staff. A clear plan for implementing technological services is also required for the successful adoption of digital systems. For successful adoption and implementation of digital systems, staff views must be considered.Keywords: COVID-19 pandemic, digital mental health resources, Ontario, underserved
Procedia PDF Downloads 95768 Technology Assessment of the Collection of Cast Seaweed and Use as Feedstock for Biogas Production- The Case of SolrøD, Denmark
Authors: Rikke Lybæk, Tyge Kjær
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The Baltic Sea is suffering from nitrogen and phosphorus pollution, which causes eutrophication of the maritime environment and hence threatens the biodiversity of the Baltic Sea area. The intensified quantity of nutrients in the water has created challenges with the growth of seaweed being discarded on beaches around the sea. The cast seaweed has led to odor problems hampering the use of beach areas around the Bay of Køge in Denmark. This is the case in, e.g., Solrød Municipality, where recreational activities have been disrupted when cast seaweed pile up on the beach. Initiatives have, however, been introduced within the municipality to remove the cast seaweed from the beach and utilize it for renewable energy production at the nearby Solrød Biogas Plant, thus being co-digested with animal manure for power and heat production. This paper investigates which type of technology application’s have been applied in the effort to optimize the collection of cast seaweed, and will further reveal, how the seaweed has been pre-treated at the biogas plant to be utilized for energy production the most efficient, hereunder the challenges connected with the content of sand. Heavy metal contents in the seaweed and how it is managed will also be addressed, which is vital as the digestate is utilized as soil fertilizer on nearby farms. Finally, the paper will outline the energy production scheme connected to the use of seaweed as feedstock for biogas production, as well as the amount of nitrogen-rich fertilizer produced. The theoretical approach adopted in the paper relies on the thinking of Circular Bio-Economy, where biological materials are cascaded and re-circulated etc., to increase and extend their value and usability. The data for this research is collected as part of the EU Interreg project “Cluster On Anaerobic digestion, environmental Services, and nuTrients removAL” (COASTAL Biogas), 2014-2020. Data gathering consists of, e.g., interviews with relevant stakeholders connected to seaweed collection and operation of the biogas plant in Solrød Municipality. It further entails studies of progress and evaluation reports from the municipality, analysis of seaweed digestion results from scholars connected to the research, as well as studies of scientific literature to supplement the above. Besides this, observations and photo documentation have been applied in the field. This paper concludes, among others, that the seaweed harvester technology currently adopted is functional in the maritime environment close to the beachfront but inadequate in collecting seaweed directly on the beach. New technology hence needs to be developed to increase the efficiency of seaweed collection. It is further concluded that the amount of sand transported to Solrød Biogas Plant with the seaweed continues to pose challenges. The seaweed is pre-treated for sand in a receiving tank with a strong stirrer, washing off the sand, which ends at the bottom of the tank where collected. The seaweed is then chopped by a macerator and mixed with the other feedstock. The wear down of the receiving tank stirrer and the chopper are, however, significant, and new methods should be adopted.Keywords: biogas, circular bio-economy, Denmark, maritime technology, cast seaweed, solrød municipality
Procedia PDF Downloads 278767 Moving beyond Learner Outcomes: Culturally Responsive Recruitment, Training and Workforce Development
Authors: Tanya Greathosue, Adrianna Taylor, Lori Darnel, Eileen Starr, Susie Ryder, Julie Clockston, Dawn Matera Bassett, Jess Retrum
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The United States has an identified need to improve the social work mental and behavioral health workforce shortage with a focus on culturally diverse and responsive mental and behavioral health practitioners to adequately serve its rapidly growing multicultural communities. The U.S. is experiencing rapid demographic changes. Ensuring that mental and behavioral health services are effective and accessible for diverse communities is essential for improving overall health outcomes. In response to this need, we developed a training program focused on interdisciplinary collaboration, evidence-based practices, and culturally responsive services. The success of the training program, funded by the Health Resource Service Administration (HRSA) Behavioral Health Workforce Education and Training (BHWET), has provided the foundation for stage two of our programming. In addition to HRSA/BHWET, we are receiving funding from Colorado Access, a state workforce development initiative, and Kaiser Permanente, a healthcare provider network in the United States. We have moved beyond improved learner outcomes to increasing recruitment of historically excluded, disproportionately mistreated learners, mentorship of students to improve retention, and successful, culturally responsive, diverse workforce development. These authors will utilize a pretest-posttest comparison group design and trend analysis to evaluate the success of the training program. Comparison groups will be matched based on age, gender identification, race, income, as well as prior experience in the field, and time in the degree program. This article describes our culturally responsive training program. Our goals are to increase the recruitment and retention of historically excluded, disproportionately mistreated learners. We achieve this by integrating cultural humility and sensitivity training into educational curricula for our scholars who participate in cohort classroom and seminar learning. Additionally, we provide our community partners who serve as internship sites with ongoing continuing education on how to promote and develop inclusive and supportive work environments for our learners. This work will be of value to mental and behavioral health care practitioners who serve historically excluded and mistreated populations. Participants will learn about culturally informed best practices to increase recruitment and retention of culturally diverse learners. Additionally, participants will hear how to create a culturally responsive training program that encourages an inclusive community for their learners through cohort learning, mentoring, community networking, and critical accountability.Keywords: culturally diverse mental health practitioners, recruitment, mentorship, workforce development, underserved clinics, professional development
Procedia PDF Downloads 11766 Redefining Surgical Innovation in Urology: A Historical Perspective of the Original Publications on Pioneering Techniques in Urology
Authors: Samuel Sii, David Homewood, Brendan Dittmer, Tony Nzembela, Jonathan O’Brien, Niall Corcoran, Dinesh Agarwal
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Introduction: Innovation is key to the advancement of medicine and improvement in patient care. This is particularly true in surgery, where pioneering techniques have transformed operative management from a historically highly risky peri-morbid and disfiguring to the contemporary low-risk, sterile and minimally invasive treatment modality. There is a delicate balance between enabling innovation and minimizing patient harm. Publication and discussion of novel surgical techniques allow for independent expert review. Recent journals have increasingly stringent requirements for publications and often require larger case volumes for novel techniques to be published. This potentially impairs the initial publication of novel techniques and slows innovation. The historical perspective provides a better understanding of how requirements for the publication of new techniques have evolved over time. This is essential in overcoming challenges in developing novel techniques. Aims and Objectives: We explore how novel techniques in Urology have been published over the past 200 years. Our objective is to describe the trend and publication requirements of novel urological techniques, both historical and present. Methods: We assessed all major urological operations using multipronged historical analysis. An initial literature search was carried out through PubMed and Google Scholar for original literature descriptions, followed by reference tracing. The first publication of each pioneering urological procedure was recorded. Data collected includes the year of publication, description of the procedure, number of cases and outcomes. Results: 65 papers describing pioneering techniques in Urology were identified. These comprised of 2 experimental studies, 17 case reports and 46 case series. These papers described various pioneering urological techniques in urological oncology, reconstructive urology and endourology. We found that, historically, techniques were published with smaller case numbers. Often, the surgical technique itself was a greater focus of the publication than patient outcome data. These techniques were often adopted prior to larger publications. In contrast, the risks and benefits of recent novel techniques are often well-defined prior to adoption. This historical perspective is important as recent journals have requirements for larger case series and data outcomes. This potentially impairs the initial publication of novel techniques and slows innovation. Conclusion: A better understanding of historical publications and their effect on the adoption of urological techniques into common practice could assist the current generation of Urologists in formulating a safe, efficacious process in promoting surgical innovation and the development of novel surgical techniques. We propose the reassessment of requirements for the publication of novel operative techniques by splitting technical perspectives and data-orientated case series. Existing frameworks such as IDEAL and ASERNIP-S should be integrated into current processes when investigating and developing new surgical techniques to ensure efficacious and safe innovation within surgery is encouraged.Keywords: urology, surgical innovation, novel surgical techniques, publications
Procedia PDF Downloads 29765 Racial Distress in the Digital Age: A Mixed-Methods Exploration of the Effects of Social Media Exposure to Police Brutality on Black Students
Authors: Amanda M. McLeroy, Tiera Tanksley
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The 2020 movement for Black Lives, ignited by anti-Black police brutality and exemplified by the public execution of George Floyd, underscored the dual potential of social media for political activism and perilous exposure to traumatic content for Black students. This study employs Critical Race Technology Theory (CRTT) to scrutinize algorithmic anti-blackness and its impact on Black youth's lives and educational experiences. The research investigates the consequences of vicarious exposure to police brutality on social media among Black adolescents through qualitative interviews and quantitative scale data. The findings reveal an unprecedented surge in exposure to viral police killings since 2020, resulting in profound physical, socioemotional, and educational effects on Black youth. CRTT forms the theoretical basis, challenging the notion of digital technologies as post-racial and neutral, aiming to dismantle systemic biases within digital systems. Black youth, averaging over 13 hours of daily social media use, face constant exposure to graphic images of Black individuals dying. The study connects this exposure to a range of physical, socioemotional, and mental health consequences, emphasizing the urgent need for understanding and support. The research proposes questions to explore the extent of police brutality exposure and its effects on Black youth. Qualitative interviews with high school and college students and quantitative scale data from undergraduates contribute to a nuanced understanding of the impact of police brutality exposure on Black youth. Themes of unprecedented exposure to viral police killings, physical and socioemotional effects, and educational consequences emerge from the analysis. The study uncovers how vicarious experiences of negative police encounters via social media lead to mistrust, fear, and psychosomatic symptoms among Black adolescents. Implications for educators and counselors are profound, emphasizing the cultivation of empathy, provision of mental health support, integration of media literacy education, and encouragement of activism. Recognizing family and community influences is crucial for comprehensive support. Professional development opportunities in culturally responsive teaching and trauma-informed approaches are recommended for educators. In conclusion, creating a supportive educational environment that addresses the emotional impact of social media exposure to police brutality is crucial for the well-being and development of Black adolescents. Counselors, through safe spaces and collaboration, play a vital role in supporting Black youth facing the distressing effects of social media exposure to police brutality.Keywords: black youth, mental health, police brutality, social media
Procedia PDF Downloads 43764 Development of Three-Dimensional Bio-Reactor Using Magnetic Field Stimulation to Enhance PC12 Cell Axonal Extension
Authors: Eiji Nakamachi, Ryota Sakiyama, Koji Yamamoto, Yusuke Morita, Hidetoshi Sakamoto
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The regeneration of injured central nerve network caused by the cerebrovascular accidents is difficult, because of poor regeneration capability of central nerve system composed of the brain and the spinal cord. Recently, new regeneration methods such as transplant of nerve cells and supply of nerve nutritional factor were proposed and examined. However, there still remain many problems with the canceration of engrafted cells and so on and it is strongly required to establish an efficacious treating method of a central nerve system. Blackman proposed the electromagnetic stimulation method to enhance the axonal nerve extension. In this study, we try to design and fabricate a new three-dimensional (3D) bio-reactor, which can load a uniform AC magnetic field stimulation on PC12 cells in the extracellular environment for enhancement of an axonal nerve extension and 3D nerve network generation. Simultaneously, we measure the morphology of PC12 cell bodies, axons, and dendrites by the multiphoton excitation fluorescence microscope (MPM) and evaluate the effectiveness of the uniform AC magnetic stimulation to enhance the axonal nerve extension. Firstly, we designed and fabricated the uniform AC magnetic field stimulation bio-reactor. For the AC magnetic stimulation system, we used the laminated silicon steel sheets for a yoke structure of 3D chamber, which had a high magnetic permeability. Next, we adopted the pole piece structure and installed similar specification coils on both sides of the yoke. We searched an optimum pole piece structure using the magnetic field finite element (FE) analyses and the response surface methodology. We confirmed that the optimum 3D chamber structure showed a uniform magnetic flux density in the PC12 cell culture area by using FE analysis. Then, we fabricated the uniform AC magnetic field stimulation bio-reactor by adopting analytically determined specifications, such as the size of chamber and electromagnetic conditions. We confirmed that measurement results of magnetic field in the chamber showed a good agreement with FE results. Secondly, we fabricated a dish, which set inside the uniform AC magnetic field stimulation of bio-reactor. PC12 cells were disseminated with collagen gel and could be 3D cultured in the dish. The collagen gel were poured in the dish. The collagen gel, which had a disk shape of 6 mm diameter and 3mm height, was set on the membrane filter, which was located at 4 mm height from the bottom of dish. The disk was full filled with the culture medium inside the dish. Finally, we evaluated the effectiveness of the uniform AC magnetic field stimulation to enhance the nurve axonal extension. We confirmed that a 6.8 increase in the average axonal extension length of PC12 under the uniform AC magnetic field stimulation at 7 days culture in our bio-reactor, and a 24.7 increase in the maximum axonal extension length. Further, we confirmed that a 60 increase in the number of dendrites of PC12 under the uniform AC magnetic field stimulation. Finally, we confirm the availability of our uniform AC magnetic stimulation bio-reactor for the nerve axonal extension and the nerve network generation.Keywords: nerve regeneration, axonal extension , PC12 cell, magnetic field, three-dimensional bio-reactor
Procedia PDF Downloads 160763 Forced Migrants in Israel and Their Impact on the Urban Structure of Southern Neighborhoods of Tel Aviv
Authors: Arnon Medzini, Lilach Lev Ari
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Migration, the driving force behind increased urbanization, has made cities much more diverse places to live in. Nearly one-fifth of all migrants live in the world’s 20 largest cities. In many of these global cities, migrants constitute over a third of the population. Many of contemporary migrants are in fact ‘forced migrants,’ pushed from their countries of origin due to political or ethnic violence and persecution or natural disasters. During the past decade, massive numbers of labor migrants and asylum seekers have migrated from African countries to Israel via Egypt. Their motives for leaving their countries of origin include ongoing and bloody wars in the African continent as well as corruption, severe conditions of poverty and hunger, and economic and political disintegration. Most of the African migrants came to Israel from Eritrea and Sudan as they saw Israel the closest natural geographic asylum to Africa; soon they found their way to the metropolitan Tel-Aviv area. There they concentrated in poor neighborhoods located in the southern part of the city, where they live under conditions of crowding, poverty, and poor sanitation. Today around 45,000 African migrants reside in these neighborhoods, and yet there is no legal option for expelling them due to dangers they might face upon returning to their native lands. Migration of such magnitude to the weakened neighborhoods of south Tel-Aviv can lead to the destruction of physical, social and human infrastructures. The character of the neighborhoods is changing, and the local population is the main victim. These local residents must bear the brunt of the failure of both authorities and the government to handle the illegal inhabitants. The extremely crowded living conditions place a heavy burden on the dilapidated infrastructures in the weakened areas where the refugees live and increase the distress of the veteran residents of the neighborhoods. Some problems are economic and some stem from damage to the services the residents are entitled to, others from a drastic decline in their standard of living. Even the public parks no longer serve the purpose for which they were originally established—the well-being of the public and the neighborhood residents; they have become the main gathering place for the infiltrators and a center of crime and violence. Based on secondary data analysis (for example: The Israel’s Population, Immigration and Border Authority, the hotline for refugees and migrants), the objective of this presentation is to discuss the effects of forced migration to Tel Aviv on the following tensions: between the local population and the immigrants; between the local population and the state authorities, and between human rights groups vis-a-vis nationalist local organizations. We will also describe the changes which have taken place in the urban infrastructure of the city of Tel Aviv, and discuss the efficacy of various Israeli strategic trajectories when handling human problems arising in the marginal urban regions where the forced migrant population is concentrated.Keywords: African asylum seekers, forced migrants, marginal urban regions, urban infrastructure
Procedia PDF Downloads 244762 Voices of the Students From a Fully Inclusive Classroom
Authors: Ashwini Tiwari
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Introduction: Inclusive education for all is a multifaceted approach that requires system thinking and the promotion of a "Culture of Inclusion." Such can only be achieved through the collaboration of multiple stakeholders at the community, regional, state, national, and international levels. Researchers have found effective practices used in inclusive general classrooms are beneficial to all students, including students with disabilities, those who experience challenges academically and socially, and students without disabilities as well. However, to date, no statistically significant effects on the academic performance of students without disabilities in the presence of students with disabilities have been revealed. Therefore, proponents against inclusive education practices, based solely on their beliefs regarding the detrimental effects of students without disabilities, appears to have unfounded perceptions. This qualitative case study examines students' perspectives and beliefs about inclusive education in a middle school in South Texas. More specifically, this study examined students understanding of how inclusive education practices intersect with the classroom community. The data was collected from the students attending fully inclusive classrooms through interviews and focus groups. The findings suggest that peer integration and friendships built during classes are an essential part of schooling for both disabled and non-disabled students. Research Methodology: This qualitative case study used observations and focus group interviews with 12 middle school students attending an inclusive classroom at a public school located in South Texas. The participant of this study includes eight females and five males. All the study participants attend a fully inclusive middle school with special needs peers. Five of the students had disabilities. The focus groups and interviews were conducted during for entire academic year, with an average of one focus group and observation each month. The data were analyzed using the constant comparative method. The data from the focus group and observation were continuously compared for emerging codes during the data collection process. Codes were further refined and merged. Themes emerged as a result of the interpretation at the end of the data analysis process. Findings and discussion: This study was conducted to examine disabled and non-disabled students' perspectives on the inclusion of disabled students. The study revealed that non-disabled students generally have positive attitudes toward their disabled peers. The students in the study did not perceive inclusion as a special provision; rather, they perceived inclusion as a way of instructional practice. Most of the participants in the study spoke about the multiple benefits of inclusion. They emphasized that peer integration and friendships built during classes are an essential part of their schooling. Students believed that it was part of their responsibility to assist their peers in the ways possible. This finding is in line with the literature that the personality of children with disabilities is not determined by their disability but rather by their social environment and its interaction with the child. Interactions with peers are one of the most important socio-cultural conditions for the development of children with disabilities.Keywords: inclusion, special education, k-12 education, student voices
Procedia PDF Downloads 71761 Characterization of Alloyed Grey Cast Iron Quenched and Tempered for a Smooth Roll Application
Authors: Mohamed Habireche, Nacer E. Bacha, Mohamed Djeghdjough
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In the brick industry, smooth double roll crusher is used for medium and fine crushing of soft to medium hard material. Due to opposite inward rotation of the rolls, the feed material is nipped between the rolls and crushed by compression. They are subject to intense wear, known as three-body abrasion, due to the action of abrasive products. The production downtime affecting productivity stems from two sources: the bi-monthly rectification of the roll crushers and their replacement when they are completely worn out. Choosing the right material for the roll crushers should result in longer machine cycles, and reduced repair and maintenance costs. All roll crushers are imported from outside Algeria. This results in sometimes very long delivery times which handicap the brickyards, in particular in respecting delivery times and honored the orders made by customers. The aim of this work is to investigate the effect of alloying additions on microstructure and wear behavior of grey lamellar cast iron for smooth roll crushers in brick industry. The base gray iron was melted in an induction furnace with low frequency at a temperature of 1500 °C, in which return cast iron scrap, new cast iron ingot, and steel scrap were added to the melt to generate the desired composition. The chemical analysis of the bar samples was carried out using Emission Spectrometer Systems PV 8050 Series (Philips) except for the carbon, for which a carbon/sulphur analyser Elementrac CS-i was used. Unetched microstructure was used to evaluate the graphite flake morphology using the image comparison measurement method. At least five different fields were selected for quantitative estimation of phase constituents. The samples were observed under X100 magnification with a Zeiss Axiover T40 MAT optical microscope equipped with a digital camera. SEM microscope equipped with EDS was used to characterize the phases present in the microstructure. The hardness (750 kg load, 5mm diameter ball) was measured with a Brinell testing machine for both treated and as-solidified condition test pieces. The test bars were used for tensile strength and metallographic evaluations. Mechanical properties were evaluated using tensile specimens made as per ASTM E8 standards. Two specimens were tested for each alloy. From each rod, a test piece was made for the tensile test. The results showed that the quenched and tempered alloys had best wear resistance at 400 °C for alloyed grey cast iron (containing 0.62%Mn, 0.68%Cr, and 1.09% Cu) due to fine carbides in the tempered matrix. In quenched and tempered condition, increasing Cu content in cast irons improved its wear resistance moderately. Combined addition of Cu and Cr increases hardness and wear resistance for a quenched and tempered hypoeutectic grey cast iron.Keywords: casting, cast iron, microstructure, heat treating
Procedia PDF Downloads 96760 Window Opening Behavior in High-Density Housing Development in Subtropical Climate
Authors: Minjung Maing, Sibei Liu
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This research discusses the results of a study of window opening behavior of large housing developments in the high-density megacity of Hong Kong. The methods used for the study involved field observations using photo documentation of the four cardinal elevations (north, south-east, and west) of two large housing developments in a very dense urban area of approx. 46,000 persons per square meter within the city of Hong Kong. The targeted housing developments (A and B) are large public housing with a population of about 13,000 in each development of lower income. However, the mean income level in development A is about 40% higher than development B and home ownership is 60% in development A and 0% in development B. Mapping of the surrounding amenities and layout of the developments were also studied to understand the available activities to the residents. The photo documentation of the elevations was taken from November 2016 to February 2018 to gather a full spectrum of different seasons and both in the morning and afternoon (am/pm) times. From the photograph, the window opening behavior was measured by counting the amount of windows opened as a percentage of all the windows on that façade. For each date of survey data collected, weather data was recorded from weather stations located in the same region to collect temperature, humidity and wind speed. To further understand the behavior, simulation studies of microclimate conditions of the housing development was conducted using the software ENVI-met, a widely used simulation tool by researchers studying urban climate. Four major conclusions can be drawn from the data analysis and simulation results. Firstly, there is little change in the amount of window opening during the different seasons within a temperature range of 10 to 35 degrees Celsius. This means that people who tend to open their windows have consistent window opening behavior throughout the year and high tolerance of indoor thermal conditions. Secondly, for all four elevations the lower-income development B opened more windows (almost two times more units) than higher-income development A meaning window opening behavior had strong correlations with income level. Thirdly, there is a lack of correlation between outdoor horizontal wind speed and window opening behavior, as the changes of wind speed do not seem to affect the action of opening windows in most conditions. Similar to the low correlation between horizontal wind speed and window opening percentage, it is found that vertical wind speed also cannot explain the window opening behavior of occupants. Fourthly, there is a slightly higher average of window opening on the south elevation than the north elevation, which may be due to the south elevation being well shaded from high angle sun during the summer and allowing heat into units from lower angle sun during the winter season. These findings are important to providing insight into how to better design urban environments and indoor thermal environments for a liveable high density city.Keywords: high-density housing, subtropical climate, urban behavior, window opening
Procedia PDF Downloads 119759 Combating the Practice of Open Defecation through Appropriate Communication Strategies in Rural India
Authors: Santiagomani Alex Parimalam
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Lack of awareness on the consequences of open defecation and myths and misconceptions related to use of toilets have led to the continued practice of open defecation in India. Government of India initiated a multi-pronged intensive communication campaign against the practice of open defecation in the last few years. The primary vision of this communication campaign was to provide increased demand for toilets and to ensure that all have access to safe sanitation. The campaign strategy included the use of mass media, group and folk media, and interpersonal communication to expedite achieving its objectives. The campaign included the use of various media such as posters, wall writings, slides in cinema theatres, kiosks, pamphlets, newsletters, flip charts and folk media to bring behavioural changes in the communities. The author did a concurrent monitoring and process documentation of the campaigns initiated by the state of Tamilnandu, India between 2013 and 2016 commissioned by UNICEF India. The study was carried out to assess the effectiveness of the communication campaigns in combating the practice of open defecation and promote construction of toilets in the state of Tamilnadu, India. Initial findings revealed the gap in understanding the audience and the use of appropriate media. The first phase of the communication campaign by name as Chi Chi Chollapa (bringing shame concept) also revealed that use of interpersonal communication, group and community media were the most effective strategy in reaching the rural masses. The failure of various other media used especially the print media (poster, handbills, newsletter, kiosks) provides insights as to where the government needs to invest its resources in bringing health-seeking behaviour in the community. The findings shared with the government enabled to strengthen the campaign resulting in improved response. Taking cues from the study, the government understood the potency of the women, school children, youth and community leaders as the effective carriers of the message. The government narrowed down its focus and invested on the voluntary workers (village poverty reduction committee workers VPRCs) in the community. The effectiveness of interpersonal communication and peer education by the credible community worker threw light on the need for localising the content and communicator. From this study, we could derive that only community and group media are preferred by the people in the rural community. Children, youth, women, and credible local leaders are proved to be ambassadors in behaviour change communication. This study discloses the lacunae involved in the communication campaign and points out that the state should have carried out a proper communication need analysis and piloting. The study used a survey method with random sampling. The study used both quantitative and qualitative tools such as interview schedules, in-depth interviews, and focus group discussions in rural areas of Tamilnadu in phases. The findings of the study would provide directions to future campaigns to any campaign concerning health and rural development.Keywords: appropriate, communication, combating, open defecation
Procedia PDF Downloads 120758 Assessment of Sleeping Patterns of Saudis with Type 2 Diabetes Mellitus in Ramadan and Non-Ramadan Periods Using a Wearable Device and a Questionnaire
Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris
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Background: Quantity and quality of sleep have been reported to be significant risk factors for obesity and development of metabolic disorders such as type 2 diabetes mellitus (T2DM). The relationship between diabetes and sleep quantity was reported to be U-shaped, which means increased or decreased sleeping hours can increase the risk of diabetes. The plasma glucagon levels were found to continuously decrease during night-time sleep in healthy individuals, independently of blood glucose and insulin levels. The disturbance of the circadian rhythm is also important and has been linked with an increased the chance of diabetes incidence. There is a lack of research on sleep patterns on Saudis with T2DM and how this is affected by Ramadan fasting. Aim: To assess the sleeping patterns of Saudis with T2DM (before, during, and after Ramadan), using two different techniques and relate this to their HbA1c levels. Method: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Their sleeping patterns were assessed by a self-administered questionnaire (before, during, and after Ramadan). The assessment included the daily total sleeping hours (DTSH), and total night-time sleeping hours (TNTSH) of the participants. In addition, sleeping patterns of 36 patients, randomly selected from the 82 participants, were further tracked during and after Ramadan by using Fitbit Flex 2™ accelerometer. Blood samples were collected in each period for measuring HbA1c. Results: Questionnaire analysis revealed that the sleeping patterns significantly changed between the periods, with shorter hours during Ramadan (P < 0.001 for DTSH, and P < 0.001 for TNTSH). These findings were confirmed by the Fitbit data, which also indicated significant shorter sleeping hours for the DTSH, and the TNTSH during Ramadan (P < 0.001 and P < 0.001, respectively). Although there were no significant correlations between the questionnaire and Fitbit data, the TNTSH were shorter among the participants in all periods by both techniques. The mean HbA1c significantly varied between periods, with lowest level during Ramadan. Although the statistical tests did not show significant variances in the mean HbA1c between the groups of participants regarding their hours of sleeping, the lowest mean HbA1c was observed in the group of participants who slept for 6-8 hours and had longer night-time sleeping hours. Conclusion: A short sleep duration, and absence of night-time sleep were significantly observed among the majority of the study population during Ramadan, which could suppress the full benefits of Ramadan fasting for diabetic patients. This study showed that there is a good agreement between the findings of the questionnaire and the Fitbit device for evaluating sleeping patterns in a Saudi population. A larger study is needed in the future to investigate the impact of Ramadan fasting on sleep quality and quantity and its relationship with health and disease.Keywords: Diabetes, Fasting, Fitbit, HbA1c, IPAQ, Ramadan, Sleep
Procedia PDF Downloads 104757 A Sociological Study of the Potential Role of Retired Soldiers in the Post War Development and Reconstruction in Sri Lanka
Authors: Amunupura Kiriwandeiye Gedara, Asintha Saminda Gnanaratne
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The security forces can be described as a workforce that goes beyond the role of ensuring the national security and contributes to the development process of the country. Soldiers are following combatant training courses during their tenure, they are equipped with a variety of vocational training courses to satisfy the needs of the army, to equip them with vocational training capabilities to achieve the development and reconstruction goals of the country as well as for the betterment of society in the event of emergencies. But with retirement, their relationship with the military is severed, and they are responsible for the future of their lives. The main purpose of this study was to examine how such professional capabilities can contribute to the development of the country, the current socio-economic status of the retired soldiers, and the current application of the vocational training skills they have mastered in the army to develop and rebuild the country in an effective manner. After analyzing the available research literature related to this field, a conceptual framework was developed and according to qualitative research methodology, and data obtained from Case studies and interviews are analyzed by using thematic analysis. Factors influencing early retirement include a lack of understanding of benefits, delays in promotions, not being properly evaluated for work, getting married on hasty decisions, and not having enough time to spend on family and household chores. Most of the soldiers are not aware about various programs and benefits available to retirees. They do not have a satisfactory attitude towards the retirement guidance they receive from the army at the time of retirement. Also, due to the lack of understanding about how to use their vocational capabilities successfully pursue their retirement life, the majority of people are employed in temporary jobs, and some are successful in post-retirement life due to their successful use of training received. Some live on pensions without engaging in any income-generating activities, and those who retire after 12 years of service are facing severe economic hardships as they do not get pensions. Although they have received training in various fields, they do not use them for their benefit due to lack of proper guidance. Although the government implements programs, they are not clearly aware of them. Barriers to utilization of training include an absence of a system to identify the professional skills of retired soldiers, interest in civil society affairs, exploration of opportunities in the civil and private sectors, and politicization of services. If they are given the opportunity, they will be able to contribute to the development and reconstruction process. The findings of the study further show that it has many social, economic, political, and psychological benefits not only for individuals but also for a country. Entrepreneurship training for all retired soldiers, improving officers' understanding, streamlining existing mechanisms, creating new mechanisms, setting up a separate unit for retirees, and adapting them to civil society, private and non-governmental contributions, and training courses can be identified as potential means to improve the current situation.Keywords: development, reconstruction, retired soldiers, vocational capabilities
Procedia PDF Downloads 118756 Validation of an Educative Manual for Patients with Breast Cancer Submitted to Radiation Therapy
Authors: Flavia Oliveira de A. M. Cruz, Edison Tostes Faria, Paula Elaine D. Reis
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When the breast is submitted to radiation therapy (RT), the most common effects are pain, skin changes, mobility restrictions, local sensory alteration, and fatigue. These effects, if not managed properly, may reduce the quality of life of cancer patients and may lead to the treatment discontinuation. Therefore, promoting knowledge and guidelines for symptom management remain a high priority for patients and a challenge for health professionals, due to the need to handle side effects in a population with a life-threatening disease. Printed materials are important strategies for supporting educative activities since they help the individual to assimilate and understand the amount of information transmitted. Nurses' behavior can be systematized through the use of an educative manual, which may be effective in promoting information regarding the treatment, self-care and how to control the effects of RT at home. In view of the importance of guaranteeing the validity of the material before its use, the objective of this research was to validate the content and appearance of an educative manual for breast cancer patients undergoing RT. The Theory of Psychometrics was used for the validation process in this descriptive methodological research. A minimum agreement rate (AR) of 80% was considered to guarantee the validity of the material. The data were collected from October to December 2017, by means of two assessments tools, constructed in the form of a Likert scale, with five levels of understanding. These instruments addressed different aspects of the evaluation, in view of two different groups of participants; 17 experts in the theme area of the educative manual, and 12 women that received RT previously to treat breast cancer. The manual was titled 'Orientation Manual: radiation therapy in breast', and was focused on breast cancer patients attended at the Department of Oncology of the Brasília University Hospital (UNACON/HUB). The research project was submitted to the Research Ethics Committee at the School of Health Sciences of the University of Brasília (CAAE: 24592213.1.0000.0030). Only two items of the assessment tool for the experts, one related to the manual's ability to promote behavioral and attitude changes and the other related to the extent of its use for other health services, obtained AR < 80% and were reformulated based on the participants' suggestions and in the literature. All other items were considered appropriate and/or complete appropriate in the three blocks proposed for the experts: objectives - 89%, structure and form - 93%, and relevance - 93%; and good and/or very good in the five blocks of analysis proposed for patients: objectives - 100%, organization - 100%, writing style - 100%, appearance - 100%, and motivation. The appearance and content validation of the educative manual proposed were attended to. The educative manual was considered relevant and pertinent and may contribute to the understanding of the therapeutic process by breast cancer patients during RT, as well as support clinical practice through the nursing consultation.Keywords: oncology nursing, nursing care, validation studies, educational technology
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