Search results for: fiscal distress

Authors: Michael Daly

Abstract:

Background/Aims: The interplay of childhood self-control and early life social background in predicting adult health is currently unclear. We drew on rich data from two large nationally representative cohort studies to test whether individual differences in childhood self-control may: (i) buffer the health impact of social disadvantage, (ii) act as a mediating pathway underlying the emergence of health disparities, or (iii) compensate for the health consequences of socioeconomic disadvantage across the lifespan. Methods: We examined data from over 25,000 participants from the British Cohort Study (BCS) and the National Child Development Study (NCDS). Child self-control was teacher-rated at age 10 in the BCS and ages 7/11 in the NCDS. The Early life social disadvantage was indexed using measures of parental education, occupational prestige, and housing characteristics (i.e. housing tenure, home crowding). A range of health outcomes was examined: the presence of chronic conditions, whether illnesses were limiting, physiological dysregulation (gauged by clinical indicators), mortality, and perceptions of pain, psychological distress, and general health. Results: Childhood self-control and social disadvantage predicted each measure of adult health, with similar strength on average. An examination of mediating factors showed that adult smoking, obesity, and socioeconomic status explained the majority of these linkages. There was no systematic evidence that self-control moderated the health consequences of early social disadvantage and limited evidence that self-control acted as a key pathway from disadvantage to later health. Conclusions: Childhood self-control predicts adult health and may compensate for early life social disadvantage by shaping adult health behaviour and social status.

Keywords: personality and health, social disadvantage, health psychology, life-course development

Procedia PDF Downloads 194

Authors: Solomon Assefa Huluka

Abstract:

Wounds account for severe morbidity, socioeconomic distress, and mortality around the globe.For several years, various herbal products are used to expediteand augment the innate wound healing process. In Ethiopian folkloricmedicine, Verbascum sinaiticum L. (V. sinaiticum) is commonlyapplied as a wound-healing agent. The present study investigated the potential wound healing and antioxidant properties of hydroalcoholic leaf extract of V. sinaiticum. The 80% methanol extract, formulated as 5% (w/w) and 10% (w/w) ointments, was evaluated in excision and incision wound models using nitrofurazone and simple ointment as positive and negative controls, respectively. Parameters such as wound contraction, period of epithelialization, and tensile strength were determined. Moreover, its in vitro antioxidant property was evaluated using a DPPH assay. In the excision model, both doses (5% and 10% w/w) of the extract showed a significant (p<0.001) wound healing efficacy compared to the negative control, as evidenced by enhanced wound contraction rate and shorter epithelialization time records. In the incision model, the lower dose (5% w/w) ointment formulation of the extract exhibited the maximum increment in tensile strength (85.6%) that was significant (p<0.001)compared to negative and untreated controls. Animals treated with 5% w/wointment, furthermore, showed a significantly (p < 0.05) higher percentage of tensile strength than nitrofurazone treated ones. Moreover, the hydroalcoholic extract of the plant showed a noticeable free radical scavenging property. The result of the present study upholds the folkloric use of V. sinaiticum in the treatment of wounds.

Keywords: wound healing, antioxidant, excision wound model, incision wound model, verbascum sinaiticum

Procedia PDF Downloads 58

Authors: Anne Giles

Abstract:

Trauma is generally defined as an experience, or multiple experiences, overwhelming a person's ability to cope. Over time, many people recover from the neurobiological, physical, and emotional effects of trauma on their own. For some people, however, troubling symptoms develop over time that can result in distress and disability. This cluster of symptoms is classified as Post-traumatic Stress Disorder (PTSD). People who meet the criteria for PTSD and other trauma-related disorder diagnoses often hold a set of understandable but unfounded beliefs about traumatic events that cause undue suffering. Becoming aware of unhelpful beliefs—termed "cognitive distortions"—and challenging them is the realm of Cognitive Behavior Therapy (CBT). A form of CBT found by researchers to be especially effective for PTSD is Cognitive Processing Therapy (CPT). Through the compassionate use of CPT, people identify, examine, challenge, and relinquish unhelpful beliefs, thereby reducing symptoms and suffering. Widely-held cultural beliefs can interfere with the progress of recovery from trauma-related disorders. Although highly revered, largely unquestioned, and often stabilizing, cultural beliefs can be founded in simplistic, dichotomous thinking, i.e., things are all right, or all wrong, all good, or all bad. The reality, however, is nuanced and complex. After studying examples of cultural beliefs from China and the United States and how these might interfere with trauma recovery, trauma counselors can help clients derive criteria for preserving helpful beliefs, discover, examine, and jettison unhelpful beliefs, reduce trauma symptoms, and live their lives more freely and fully.

Keywords: cognitive processing therapy (CPT), cultural beliefs, post-traumatic stress disorder (PTSD), trauma recovery

Procedia PDF Downloads 216

Authors: Nuhu Bitrus Mailabari

Abstract:

Nigeria is a highly multifarious nation trapped between affluence and affliction. On one hand, the state has vast territorial size, economic strength, relative internal cohesion, and good external linkages. On the other, it is bedeviled with enormous challenges. It is common knowledge that the North-East geo-political zone has suffered colossal destruction for the most part of the last ten years due to the activities of the insurgent group Boko Haram. Several factors (political, economic, religious, socio-cultural) have been credited with the heightened insecurity in the region. Without a doubt, the security crisis in the region has rekindled several discussions critical to Nigeria’s security architecture. However, the debate on finding an enduring solution to the devastation in the North East continually neglects the nexus between cross border migration and national security. Using content analysis, this paper debates two main issues that continue to affect security in the North East. One, the cumulative impact of the Economic Community of West African States (ECOWAS) protocol on the free movement of people and goods. Two, the porous nature of Nigeria’s borders. Theoretically, the paper will rely on the systems theory because of its broad focus on structure, linkage, and process. The work concludes in twofold. First, that cross border migration and poor border management processes further worsened the political and socio-economic conditions of a region that is already in a bad state. Secondly, in addition to the existing strategies, Nigeria must develop a holistic approach including new methods of handling cross border movements in solving the security issues.

Keywords: border, cross border, migration, Nigeria, northeast region, security

Procedia PDF Downloads 137

Authors: Aroona Hashmi

Abstract:

An economic recession can lead people to feel more insecure about their financial situation. The series of events leading into a recession can be especially distressing for Educated Youth. One of the most salient factors linking economic recession to psychological distress is unemployment. It is proved that a large number of educated young people are facing higher unemployment rate in Pakistan. Young people are likely to get frustrated at the lack of opportunities made available to them. If the young population increases more rapidly than job opportunities, then number of unemployment is likely to increase. The aim of present study was to investigate the relationship between economic instability, growing rate of aggression and frustration among educated youth. The study aimed to find out the impact of increased economic instability on the learning abilities of the students. Data was gathered from six university students of Punjab, Pakistan. The sample of the study consisted of three hundred male and female university students. The data was analyzed by applying Chi -square test. The results of the research indicate that there is a significant relationship between low household income and growing rate of aggression among educated youth. The increasing trend of economic instability significantly influences the learning abilities of the students. The study concludes that feeling of deprivation produce frustration and could be expressed through aggression. Therefore, if factors that are responsible for youth unemployment in Pakistan are addressed, psychological effects will be reduced. The right way of tackling the youth bulge is to turn the youth into a productive workforce. There is a dire need to transform the education system to societal needs. At the same time creating demand for the young workforce is achieved through dynamic changes in the economic structure.

Keywords: psychological effects, economic recession, educated youth, environmental factors

Procedia PDF Downloads 353

Authors: Haykal. Kay-Anne

Abstract:

The health and well-being of students is a priority for the Faculty of Medicine at the University of Ottawa. The demands of medical studies are extreme, and many studies confirm that the prevalence of psychological distress is very high among medical students and that it is higher than that of the general population of the same age. The main goal is to identify risk factors for mental health among medical students at the University of Ottawa. The secondary objectives are to determine the variation of these risk factors according to demographic variables, as well as to determine if there is a change in the mental health of students during the 1st and 3rd years of their study. Medical students have a mandatory first and third-year wellness check meeting. This assessment includes a questionnaire on demographic information, mental health, and risk factors such as physical health, sleep, social support, financial stress, education and career, stress and drug use and/or alcohol. Student responses were converted to numerical values and analyzed statistically. The results show that 61% of the variation in the mean of the mental health score is explained by the following risk factors (R2 = 0.61, F (9.396) = 67.197, p < 0.01): lack of sleep and fatigue (β = 0.281, p < 0.001), lack of social support (β = 0.217, p <0.001), poor study or career development (β = 0.195, p < 0.001) and an increase stress and drug and alcohol use (β = -0.239, p < 0.001). No demographic variable has a significant effect on the presence of risk factors. In addition, fixed-effects regression demonstrated significantly lower mental health (p < 0.1) among first-year students (M = 0.587, SD = 0.072) than among third-year students (M = 0.719, SD = 0.071). This preliminary study indicates the need to continue data collection and analysis to increase the significance of the study results. As risk factors are present at the beginning of medical studies, it is important to offer resources to students very early in their medical studies and to have close monitoring and supervision.

Keywords: assessment of mental health, medical students, risk factors for mental health, wellness assessment

Procedia PDF Downloads 97

Authors: Chia-Chen Hsieh, Fei-Hsiu Hsiao

Abstract:

Objective: To examine the effects of supportive care interventions on depressive symptoms in patients with lung cancer. Methods: The databases of Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and Chinese Electronic Periodical Services (CEPS) were searched from their inception until September 2015. We included the studies with randomized controlled trial design that compared standard care with supportive care interventions using psychotherapeutic or exercises approach. The standardized mean differences (SMD) (Cohen’s d) were calculated to estimate the treatment effects. The Cochrane Risk of Bias Tool was used for quality assessment and subgroup analysis was conducted to identify possible sources of heterogeneity. Results: A total of 1472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms (SMD = -0.74 with 95% CI = -1.07 to -0.41), and the effect was maintained at the 4th, 8th, and 12th weeks of follow-up. Either psychotherapy combined with psychoeducation or exercise alone produced significant improvements in depressive symptoms, while psychoeducation alone did not. The greater improvements in depressive symptoms occurred in lung cancer patients with severe depressive symptoms at baseline, total duration of interventions of less than ten weeks, and intervention provided through face-to-face delivery. Conclusions: Psychotherapy combined with psychoeducation can help patients manage the causes of depressive symptoms, including both symptom distress and psychological trauma due to lung cancer. Exercise can target the impaired respiratory function that is a cause of depressive symptoms in lung cancer patients.

Keywords: supportive care intervention, depressive symptoms, lung cancer, meta-analysis

Procedia PDF Downloads 274

Authors: Sateesh Kumar Pisini, Swetha Priya Darshini, Sanjay Kumar Shukla

Abstract:

This paper seeks to present a research study on sustainability in construction of retaining wall using geosynthetics. Sustainable construction is a way for the building and infrastructure industry to move towards achieving sustainable development, taking into account environmental, socioeconomic and cultural issues. Geotechnical engineering, being very resource intensive, warrants an environmental sustainability study, but a quantitative framework for assessing the sustainability of geotechnical practices, particularly at the planning and design stages, does not exist. In geotechnical projects, major economic issues to be addressed are in the design and construction of stable slopes and retaining structures within space constraints. In this paper, quantitative indicators for assessing the environmental sustainability of retaining wall with geosynthetics are compared with conventional concrete retaining wall through life cycle assessment (LCA). Geosynthetics can make a real difference in sustainable construction techniques and contribute to development in developing countries in particular. Their imaginative application can result in considerable cost savings over the use of conventional designs and materials. The acceptance of geosynthetics in reinforced retaining wall construction has been triggered by a number of factors, including aesthetics, reliability, simple construction techniques, good seismic performance, and the ability to tolerate large deformations without structural distress. Reinforced retaining wall with geosynthetics is the best cost-effective and eco-friendly solution as compared with traditional concrete retaining wall construction. This paper presents an analysis of the theme of sustainability applied to the design and construction of traditional concrete retaining wall and presenting a cost-effective and environmental solution using geosynthetics.

Keywords: sustainability, retaining wall, geosynthetics, life cycle assessment

Procedia PDF Downloads 2021

Authors: Veliswa Nonfundo Hoho, Jabulani Gilford Kheswa

Abstract:

HIV/AIDS has been a long-term condition worldwide, which does not only affect physical health but also causes psychological and social challenges in people living with this condition. In Sub-Saharan countries, namely; Nigeria, Uganda, Zimbabwe and South Africa, people living with HIV/AIDS come across different challenges especially after one has disclosed his/her status. They experience stigma and discrimination, isolation, lack of accessing and receiving treatment, lack of support and experience psychological distress. By using the evidence-based systematic review as a form of methodology, journal articles, dissertations, internet, and books were explored. This paper seeks to describe the challenges faced by people living with HIV/AIDS after disclosure, which forms a critical component of HIV/AIDS prevention and treatment interventions. The disclosure process model is used to underpin the study. This theory allows one to understand when and why interpersonal and verbal self-disclosure is beneficial for individuals who live with concealable stigmatized identities such as HIV/AIDS. Literature findings advocate that both negative and positive results were noted after disclosing one’s HIV status and psychosocial well-being of the majority of people living with HIV/AIDS also get affected especially in societies which subscribe HIV/AIDS pandemic to witchcraft. As for the infected homosexuals, research indicates that they suffer in silence and to cover their emotional emptiness due to ostracism, they often report low- self-efficacy with regard to condom use and become susceptible to reinfections which further place their lives at heightened risk for low immune system. In this regard, this paper challenges the policies which protect the dignity of people living with HIV/AIDS and calls for unity and financial support in favour of psychoeducational programmes and support groups aimed at curbing discrimination.

Keywords: disclosure, discrimination, homosexuality, self-efficacy

Procedia PDF Downloads 197

Authors: Yujun Liu, Maosheng Ran

Abstract:

Background: Chinese rural-to-urban migrant workers’ mental health problems raise attentions from different social sectors. However, situation of present mental health services provided to this population has not been discovered. This study attempts to describe the current mental health service situation, identify the gaps and give the future directions based on the quantitative data. Methods: Questionnaire surveys were conducted among 2017 rural-to-urban migrant workers in 13 cities and 100 social work service organizations in 5 cities in 2014. Data was collected by face-to-face structured interview by trained interviewers. Findings: Migrant workers’ mental health status was not good. Compared to the severity of mental distress, mental health service for this population was lacking and insufficient, which accounted for only 14.4% of all services in our sample. And the group work and case work were the most frequently-used methods. By estimating a series of regression models, we revealed that life experiences and working conditions were significantly associated with migrant workers’ mental health status. Therefore, the macro social work practices aimed at this whole group were advocated to promote their mental wellbeing. That is, practitioners should not only focus on the improvement of migrant workers’ emotion management capacity, but also pay attention to raise awareness and improve their living and working condition; not only concentrate on the solving of individuals’ dilemma, but also promote gradual reformation of present labor regime and hukou system in China.

Keywords: Chinese rural-to-urban migrant workers, macro social work practice, mental health service needs, mental health status

Procedia PDF Downloads 255

Authors: Rosy Chaudhary, Pushpa Parajuli

Abstract:

Background and Objectives: Informational support to family members has a significant potential for reducing this distress related to hospitalization of their patient into the critical care unit, enabling them to cope better and support the patient. The objective of the study is to assess family members’ perception of informational support, anxiety, satisfaction with care and to reveal the association with selected socio-demographic variables and to investigate the correlation between informational support, anxiety and satisfaction with care. Materials and Methods: A descriptive cross-sectional study was conducted in 39 family caregivers of patients admitted in critical care unit of BPKIHS(B.P. Koirala Institute of Health Sciences). Consecutive sampling technique was used wherein data was collected over duration of one month using interview schedule. Descriptive and inferential statistics were used. Results: The mean age of the respondents was 34.97 ± 10.64 and two third (66.70%) were male. Mean score for informational support was 25.72(SD = 5.66; theoretical range of 10 - 40). Mean anxiety was 10.41 (SD = 5.02; theoretical range of 7 - 21). Mean score for satisfaction with care was 40.77 (SD = 6.77; theoretical range of 14 - 64). A moderate positive correlation was found between informational support and satisfaction with care (r = 0.551, p < .001) and a moderate negative correlation was found between anxiety and satisfaction with care (r = -0.590; p = 0.000). No relationship was noted between informational support and anxiety. Conclusion: The informational support and satisfaction of the family caregivers with the care provided to their patients was satisfactory. More than three fourth of the family caregivers had anxiety; the factors associated being educational status of the caregivers, the family income and duration of visiting hours. There was positive correlation between informational support and satisfaction with care provided justifying the need for comprehensive information to the family caregivers by the health personnel. There was negative correlation between anxiety and satisfaction with care.

Keywords: anxiety, caregivers, critical care unit, informational support, family

Procedia PDF Downloads 313

Authors: Scott R. Butler

Abstract:

Ontario, Canada’s largest province, is in the midst of an interesting experiment in mandated asset management planning for local governments. At the beginning of 2021, Ontario’s 444 municipalities were responsible for the management of 302,864 lane kilometers of roads that have a replacement cost of $97.545 billion CDN. Roadways are by far the most complex, expensive, and extensive assets that a municipality is responsible for overseeing. Since adopting Ontario Regulation 588/47: Asset Management Planning for Municipal Infrastructure in 2017, the provincial government has established prescriptions for local road authorities regarding asset category and levels of service being provided. This provincial regulation further stipulates that asset data such as extent, condition, and life cycle costing are to be captured in manner compliant with qualitative descriptions and technical metrics. The Ontario Good Roads Association undertook an exercise to aggregate the road-related data contained within the 444 asset management plans that municipalities have filed with the provincial government. This analysis concluded that collectively Ontario municipal roadways have a $34.7 billion CDN in deferred maintenance. The ill-state of repair of Ontario municipal roads has lasting implications for province’s economic competitiveness and has garnered considerable political attention. Municipal efforts to address the maintenance backlog are stymied by the extremely limited fiscal parameters municipalities must operate within in Ontario. Further exacerbating the program are provincially designed programs that are ineffective, administratively burdensome, and not necessarily aligned with local priorities or strategies. This paper addresses how municipal asset management plans – and more specifically, the data contained in these plans – can be used to design innovative policy frameworks, flexible funding programs, and new levels of service that respond to these funding challenges, as well as emerging issues such as local economic development and climate change. To fully unlock the potential that Ontario Regulation 588/17 has imposed will require a resolute commitment to data standardization and horizontal collaboration between municipalities within regions.

Keywords: transportation, municipal asset management, subnational policy design, subnational funding program design

Procedia PDF Downloads 67

Authors: Sandra Figueiredo, Margarida Alves Martins, Carlos Silva, Cristina Simões

Abstract:

This study integrates a larger research empirical project that examines second language (SL) learners’ profiles and valid procedures to perform complete and diagnostic assessment in schools. 102 learners of Portuguese as a SL aged 7 and 17 years speakers of distinct home languages were assessed in several linguistic tasks. In this article, we focused on writing performance in the specific task of narrative essay composition. The written outputs were measured using the score in six components adapted from an English SL assessment context (Alberta Education): linguistic vocabulary, grammar, syntax, strategy, socio-linguistic, and discourse. The writing processes and strategies in Portuguese language used by different immigrant students were analysed to determine features and diversity of deficits on authentic texts performed by SL writers. Differentiated performance was based on the diversity of the following variables: grades, previous schooling, home language, instruction in first language, and exposure to Portuguese as Second Language. Indo-Aryan languages speakers showed low writing scores compared to their peers and the type of language and respective cognitive mapping (such as Mandarin and Arabic) was the predictor, not linguistic distance. Home language instruction should also be prominently considered in further research to understand specificities of cognitive academic profile in a Romance languages learning context. Additionally, this study also examined the teachers representations that will be here addressed to understand educational implications of second language teaching in psychological distress of different minorities in schools of specific host countries.

Keywords: home language, immigrant students, Portuguese language, second language, writing assessment

Procedia PDF Downloads 436

Authors: Gemma Postil, Claire Zanin, Michael Halpin, Caroline Ritter

Abstract:

Illness experience research typically focuses on people that are living with a medical condition; however, the broad consequences of the COVID-19 pandemic are impacting those without the virus itself, as many experienced extensive lockdowns, social isolation, and distress. Drawing on conceptual work in the illness experience literature, we argue that policy and social changes tied to COVID-19 produce biographical disruptions. In this sense, we argue that the COVID-19 pandemic produces illness experience without illness, as the pandemic comprehensively impacts health and biography. This paper draws on 30 in-depth interviews with young adults living in Prince Edward Island (PEI), which were conducted as part of a larger project to understand how young adults navigate compliance with the COVID-19 pandemic. We then inductively analyzed the interviews with a constructivist grounded theory approach. Specifically, we demonstrate that young adults living in PEI during the COVID-19 pandemic experienced biographical disruptions throughout the pandemic despite not contracting the virus. First, we detail how some participants experience biographical acceleration, with the pandemic accelerating relationships, home buying, and career planning. Second, we demonstrate biographical stagnation, wherein participants report being unable to pursue major life milestones. Lastly, we describe biographical regression, wherein participants feel they are losing ground during the pandemic and are actively falling behind their peers. These findings provide the novel application of illness experience concepts to the context of the COVID-19 pandemic, contribute to work on illness experience and ambiguity, and extend Bury’s conceptualization of biographical disruption. In conclusion, we demonstrate that young adults experienced the biographical disruption expected from having COVID-19 without having an illness, highlighting the depth to which the pandemic affected young adults.

Keywords: illness experience, lived experience, biographical disruption, COVID-19, young adults

Procedia PDF Downloads 129

Authors: Agustyas Tjiptaningrum, Intanri Kurniati, Fadilah Fadilah, Linda Erlina, Tiwuk Susantiningsih

Abstract:

Coronavirus disease-19 (COVID-19) is still one of the health problems. It can be a severe condition that is caused by a cytokine storm. In a cytokine storm, several proinflammatory cytokines are released massively. It destroys epithelial cells, and subsequently, it can cause death. The anti-inflammatory agent can be used to decrease the number of severe Covid-19 conditions. Melaleuca cajuputi is a plant that has antiviral, antibiotic, antioxidant, and anti-inflammatory activities. This study was carried out to analyze the prediction mechanism of the M. cajuputi extract from Lampung, Indonesia, as an anti-inflammatory agent for COVID-19. This study constructed a database of protein host target that was involved in the inflammation process of COVID-19 using data retrieval from GeneCards with the keyword “SARS-CoV2”, “inflammation,” “cytokine storm,” and “acute respiratory distress syndrome.” Subsequent protein-protein interaction was generated by using Cytoscape version 3.9.1. It can predict the significant target protein. Then the analysis of the Gene Ontology (GO) and KEGG pathways was conducted to generate the genes and components that play a role in COVID-19. The result of this study was 30 nodes representing significant proteins, namely NF-κβ, IL-6, IL-6R, IL-2RA, IL-2, IFN2, C3, TRAF6, IFNAR1, and DOX58. From the KEGG pathway, we obtained the result that NF-κβ has a role in the production of proinflammatory cytokines, which play a role in the COVID-19 cytokine storm. It is an important factor for macrophage transcription; therefore, it will induce inflammatory gene expression that encodes proinflammatory cytokines such as IL-6, TNF-α, and IL-1β. In conclusion, the blocking of NF-κβ is the prediction mechanism of the M. cajuputi extract as an anti-inflammation agent for COVID-19.

Keywords: antiinflammation, COVID-19, cytokine storm, NF-κβ, M. cajuputi

Procedia PDF Downloads 53

Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong

Abstract:

Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.

Keywords: goals of care conversations, communication skills, emodule, medical education

Procedia PDF Downloads 116

Authors: Riko Wahyudi, Rezky Lasekti Wicaksono, Ayu Satya Damayanti, Ridhasepta Multi Kenrosa

Abstract:

Implementing Forest Management Unit (FMU) is considered as the best solution for forest management in developing countries. However, when FMU has been formed, many parties then blame the FMU and assume it is not working on. Currently, there are two main issues that make FMU not be functional i.e. institutional and financial issues. This paper is addressing financial issues to make FMUs in Aceh Province can be functional. A mixed financing scheme is proposed here, both direct and indirect financing. The direct financing scheme derived from two components i.e. public funds and businesses. Non-tax instruments of intergovernmental fiscal transfer (IFT) system and FMU’s businesses are assessed. Meanwhile, indirect financing scheme is conducted by assessing public funds within villages around forest estate as about 50% of total villages in Aceh Province are located surrounding forest estate. Potential instruments under IFT system are forest and mining utilization royalties. In order to make these instruments become direct financing for FMU, interventions on allocation and distribution aspects of them are conducted. In the allocation aspect, alteration in proportion of allocation is required as the authority to manage forest has shifted from district to province. In the distribution aspect, Government of Aceh can earmark usage of the funds for FMUs. International funds for climate change also encouraged to be domesticated and then channeled through these instruments or new instrument under public finance system in Indonesia. Based on FMU’s businesses both from forest products and forest services, FMU can impose non-tax fees for each forest product and service utilization. However, for doing business, the FMU need to be a Public Service Agency (PSA). With this status, FMU can directly utilize the non-tax fees without transferring them to the state treasury. FMU only need to report the fees to Ministry of Finance. Meanwhile, indirect financing scheme is conducted by empowering villages around forest estate as villages in Aceh Province is receiving average village fund of IDR 800 million per village in 2017 and the funds will continue to increase in subsequent years. These schemes should be encouraged in parallel to establish a mixed financing scheme in order to ensure sustainable financing for FMU in Aceh Province, Indonesia.

Keywords: forest management, public funds, mixed financing, village

Procedia PDF Downloads 162

Authors: Hossam Mohammed Abdelfattah

Abstract:

In ancient Egypt, poverty, recognized as the foremost challenge, was extensively addressed in teachings, wisdom, and literary texts. These sources vividly depicted the suffering of a class deprived of life's pleasures. The ancient Egyptian language evolved to introduce terms reflecting poverty and hunger, underscoring the society's commitment to acknowledging and cautioning against this prevalent issue. Among the notable expressions, iwty.f emerged during the Middle Kingdom, symbolizing "the one without property" and signifying the destitute poor. iwty n.f traced back to the Pyramid Texts era, referred to "the one who has nothing" or simply, the poor. Another term, , iwty-sw emphasized the state of possessing nothing. rA-awy originating in the Middle Kingdom Period, initially meant "poverty and poor," expanding to signify poverty in various texts with the addition of the preposition "in," conveying strength given to the poor. During the First Intermediate Period, sny - mnt denoted going through a crisis or suffering, possibly referencing a widespread disease or plague. It encompassed meanings of sickness, pain, and anguish. The term .” sq-sn introduced in Middle Kingdom texts, conveyed the notion of becoming miserable. sp-Xsy . represented a temporal expression reflecting a period of misery or poverty, with Xsy ,indicating distress or misery. The term qsnt appearing in Middle Kingdom texts, held meanings of painful, difficult, harsh, miserable, emaciated, and in bad condition. Its feminine form, qsn denoted anxiety and turmoil. Finally, tp-qsn encapsulated the essence of misery and unhappiness. In essence, these expressions provide linguistic insights into the multifaceted experience of poverty in ancient Egypt, illustrating the society's keen awareness and efforts to address this pervasive challenge.

Keywords: poverty, poor, suffering, misery, painful, ancient Egypt

Procedia PDF Downloads 20

Authors: Maria Albuquerque, Miguel Matias, Ângelo Sá, Juliana Sousa, Maria Manuel Mouzinho

Abstract:

Obesity is a frequent disease in Portugal. The surgical treatment is very effective and has an indication when there is a failure of the medical treatment. Although massive weight loss is associated with considerable health gains, these patients are characterized by a variable degree of dermolipodistrophy. In some cases, there is even the development of physical symptoms such as intertriginous, and some degree of psychological distress is present. In almost all cases, a desire for a better body contour, which inhibits some aspects of social life, is a fact. A prospective study was made to access the impact of body contouring surgery in the quality of life of patients who underwent a massive weight lost correction surgical procedure at Centro Hospitalar de Lisboa Central between January 2020 and December 2021. The patients were submitted to the Body Q subjective questionnaire adapted for the Portuguese language and accessed for the following categories: Anguish with Appearance, Contempt with Body Image, Satisfaction with the Abdomen, and Overall Satisfaction with the Body. The questionnaire was repeated at the 6 months mark. A total of 80 patients were sampled. The sex distribution was 79 female and 1 male. The median BMI index before surgery was inferior to 28%. The pre operatory questionnaire showed high scores for Anguish with Appearance and low scores for the body image self-evaluation. Overall, there was an improvement of at least 50% in all the evaluated scores. Additionally, a correlation was found between abdominoplasty and the contempt with body image and satisfaction with the abdomen (p-value <0.05). Massive weight loss is associated with important body deformities that have a significant impact on the patient’s personal and social life. Body contouring surgery is then vital for these patients as it implicates major aesthetic and functional benefits.

Keywords: abdominoplasty, cruroplasty, obesity, massive weight loss

Procedia PDF Downloads 128

Authors: Po-Ching Chou, Wen-Chen Liang, I. Chen Chen, Jong-Hau Hsu, Yuh-Jyh Jong

Abstract:

Background：Cardiopulmonary complications seem to cause high morbidity and mortality in patients with neuromuscular diseases (NMD) but so far there is no domestic data reported in Taiwan. We, therefore attempted to analyze the factors to cause the death in NMD patients from our cohort. Methods：From 1998 to 2013, we retrospectively collected the information of the NMD patients treated and followed up in Kaohsiung Medical University Hospital. Forty-two patients with NMD who expired during these fifteen years were enrolled. The medical records of these patients were reviewed and the causes of death and the associated affecting factors were analyzed. Results：Eighteen patients with NMD (mean age=13.3, SD=12.4) with complete medical record and detailed information were finally included in this study, including spinal muscular atrophy (SMA) (n=9, 7/9: type 1), Duchenne muscular dystrophy (n=6), congenital muscular dystrophy (n=1), carnitine acyl-carnitine translocase (CACT) deficiency (n=1) and spinal muscular atrophy with respiratory distress (SMARD)(n=1). The place of death was in ICU (n=11, 61%), emergency room (n=3, 16.6%) or home (n=4, 22.2%). For SMA type 1 patients, most of them (71.4%, 5/7) died in emergency room or home and the other two expired during an ICU admission. The causes of death included acute respiratory failure due to pneumonia (n=13, 72.2 %), ventilator failure or dislocation (n=2, 11.1%), suffocation/choking (n=2, 11.1%), and heart failure with hypertrophic cardiomyopathy (n=1, 5.55%). Among the 15 patients died of respiratory failure or choking, 73.3% of the patients (n=11) received no ventilator care at home. 80% of the patients (n=12) received no cough assist at home. The patient died of cardiomyopathy received no medications for heart failure until the last admission. Conclusion: Respiratory failure and choking are the leading causes of death in NMD patients. Appropriate respiratory support and airway clearance play the critical role to reduce the mortality.

Keywords: neuromuscular disease, cause of death, tertiary care hospital, medical sciences

Procedia PDF Downloads 504

Authors: Inam Ridha, Christine L. Kuryla, Madhuranga Thilakasiri Madugoda Ralalage Don, Norman J. Kleiman, Yunro Chung, Jin Park, Vel Murugan, Joshua LaBaer

Abstract:

To date, more than 275 million people worldwide have been diagnosed with COVID-19 and the rapid spread of the omicron variant suggests many millions more will soon become infected. Many infections are asymptomatic, while others result in mild to moderate illness. Unfortunately, some infected individuals exhibit more serious symptoms including respiratory distress, thrombosis, cardiovascular disease, multi-organ failure, cognitive difficulties, and, in roughly 2% of cases, death. Studies indicate other coronaviruses can alter the host cell's epigenetic profile and lead to alterations in the immune response. To better understand the mechanism(s) by which SARS-CoV-2 infection causes serious illness, DNA methylation profiles in peripheral blood mononuclear cells (PBMCs) from 90 hospitalized severely ill COVID-19 patients were compared to profiles from uninfected control subjects. Exploratory epigenome-wide DNA methylation analyses were performed using multiplexed methylated DNA immunoprecipitation (MeDIP) followed by pathway enrichment analysis. The findings demonstrated significant DNA methylation changes in infected individuals as compared to uninfected controls. Pathway analysis indicated that apoptosis, cell cycle control, Toll-like receptors (TLR), cytokine interactions, and T cell differentiation were among the most affected metabolic processes. In addition, changes in specific gene methylation were compared to SARS-CoV-2 induced changes in RNA expression using published RNA-seq data from 3 patients with severe COVID-19. These findings demonstrate significant correlations between differentially methylated and differentially expressed genes in a number of critical pathways.

Keywords: COVID19, epigenetics, DNA mathylation, viral infection

Procedia PDF Downloads 149

Authors: Florge Francis A. Sy

Abstract:

Physicians develop emotional and psychological distress after facing a patient’s death. This can result in stress or burnout. Coping mechanisms in dealing with these deaths may be maladaptive. Determining grief, emotional impact, and coping strategies in physicians is necessary to identify those needing intervention. This can be done by employing validated assessment tools such as the Texas Revised Inventory of Grief (TRIG) scale, Impact of Events Scale (IES), and BriefCOPE tool, respectively. This prospective, observational study was done in a private hospital in Cebu City. Fifty-five internal medicine residents were included and tasked to answer a survey based on their most memorable patient death encounter. The TRIG, IES, and BriefCOPE scores were determined. Participants were divided into severe grief and non-severe grief based on TRIG scores, low-impact, moderate-impact, and high-impact based on IES, and low-use, moderate-use, and high-use based on the BriefCOPE. The differences in the groups’ characteristics were statistically determined, and a p-value of < 0.05 was significant. The participants’ average age was 28.45 years. Most were female and single. Most belonged to the non-severe group based on TRIG, a moderate-impact group based on the IES, and high-use group based on the BriefCOPE. However, 21.8% reported severe grief, 27.3% reported high-impact, and 10.9% had low use of coping strategies. The proportion of residents who encountered CPR prior to the patient’s death was greater in the severe group. Proportions of both high-impact and non-high impact groups were comparable. The proportion of female residents was higher in the high-use group. There were a number of residents who reported severe grief, high emotional impact, and low coping strategies. This highlights the need for interventions such as debriefing after CPR or formal training in residency programs in dealing with emotional burden to counteract maladaptive coping behaviors and prevent negative outcomes.

Keywords: residents, grief, emotional impact, coping, patient death

Procedia PDF Downloads 87

Authors: D. Jagath Kumari, K. Srinivasa Rao

Abstract:

Reinforced concrete column is an important structural element in a building. Concrete usually performs well in building fires. However, when it is subjected to prolonged fire exposure or unusually high temperatures, and then it will suffer significant distress. Because concrete pre-fire compressive strength generally exceeds design requirements, therefore an average strength reduction can be tolerated. However high temperature reduces the compressive strength of concrete so much that the concrete retains no useful structural strength. Therefore the residual strength and its performance of structure can be assed by NDT testing. In this paper, rebound hammer test and the ultrasonic pulse velocity (UPV) are used to evaluate the residual compressive strength and material integrity of post-fire-curing concrete subjected to elevated temperatures. Also considering the large availability of fly ash in most of the countries, an attempt was made to study the effect of high volume fly ash concrete exposed to elevated temperatures. 32 RC column specimens were made with a M20 grade concrete mix. Out of 32 column specimens 16 column specimens were made with OPC concrete and other 16 column specimens were made with HVFA concrete. All specimens having similar cross-section details. Columns were exposed to fire for temperatures from 100oC to 800o C with increments of 100o C for duration of 3 hours. Then the specimens allowed cooling to room temperature by two methods natural air cooling method and immediate water quenching method. All the specimens were tested identically, for the compressive strengths and material integrity by rebound hammer and ultrasonic pulse velocity meter respectively for study. These two tests were carried out on preheating and post heating of the column specimens. The percentage variation of compressive strengths of RCC columns with the increase in temperature has been studied and compared the results for both OPC and HVFA concretes. Physical observations of the heated columns were observed.

Keywords: HVFA concrete, NDT testing, residual strength

Procedia PDF Downloads 362

Authors: Paul D. Facey, Claire Morgan

Abstract:

Speech anxiety is thought to be deep-seated within the human evolutionary lineage.As a result, almost all people display high levels of anxiety when asked to communicate in front of an audience.However, proficiency in oral communication is considered as an essential skill for a graduate career and significant emphasis is placed on developing these skills in many degree programs.Because of this, many degree schemes incorporate some form of assessed dialogic presentation. Yet, a student’s anxiety over public speaking, especially if severe, can be so great that at worst it can cause the student to withdraw from their study. This study investigated how students perceive their own levels of anxiety when faced with public speaking using the Personal Report of Public Speaking Anxiety (PRPSA) questionnaire developed by McCroskey. Additionally, students were asked to provide examples of adjustments that could be implemented that they felt would alleviate some/all of their anxiety. The results of the study indicated that the majority of the students experienced a moderate level of anxiety. However, further analysis showed that of those who were in the moderate anxiety’ group, 43% fell into the higher range suggesting that overall more students experience higher levels of anxiety when faced with public speaking than maybe first envisaged. Thus, it is essential that steps are taken to address student anxiety in order that students engage with presentations, are motivated and encouraged and do not avoid such assignments. The feedback from our students indicated a need to implement systematic desensitization programs where students learn to overcome their anxiety through a series of sessions that gradually increase their anxiety levels. Furthermore, these sessions should be run in parallel with skills sessions in order for students to be better prepared and allow self-reflection and self-analysis.This study highlights the paucity of these sessions on many degree schemes and suggests that they should form an integral part of a students’ early academic learning.

Keywords: student anxiety, communication anxiety, public speaking, higher education, desensitisation

Procedia PDF Downloads 214

Authors: Abdulraaof H. Alqaili, Hamad A. Alsoliman

Abstract:

Through progress in pavement design developments, a pavement design method was developed, which is titled the Mechanistic Empirical Pavement Design Guide (MEPDG). Nowadays, the evolution in roads network and highways is observed in Saudi Arabia as a result of increasing in traffic volume. Therefore, the MEPDG currently is implemented for flexible pavement design by the Saudi Ministry of Transportation. Implementation of MEPDG for local pavement design requires the calibration of distress models under the local conditions (traffic, climate, and materials). This paper aims to prepare data for calibration of MEPDG in Central Saudi Arabia. Thus, the first goal is data collection for the design of flexible pavement from the local conditions of the Riyadh region. Since, the modifying of collected data to input data is needed; the main goal of this paper is the analysis of collected data. The data analysis in this paper includes processing each: Trucks Classification, Traffic Growth Factor, Annual Average Daily Truck Traffic (AADTT), Monthly Adjustment Factors (MAFi), Vehicle Class Distribution (VCD), Truck Hourly Distribution Factors, Axle Load Distribution Factors (ALDF), Number of axle types (single, tandem, and tridem) per truck class, cloud cover percent, and road sections selected for the local calibration. Detailed descriptions of input parameters are explained in this paper, which leads to providing of an approach for successful implementation of MEPDG. Local calibration of MEPDG to the conditions of Riyadh region can be performed based on the findings in this paper.

Keywords: mechanistic-empirical pavement design guide (MEPDG), traffic characteristics, materials properties, climate, Riyadh

Procedia PDF Downloads 201

Authors: Kyngäs Helvi, Patala-Pudas, Kaakinen Pirjo

Abstract:

It has been reported that COPD -patients may experience much emotional distress, which can compromise positive health outcomes. The aim of this study was to explore disease-related uncertainty as reported by Chronic Obstructive Pulmonary Disease (COPD) patients. Uncertainty was defined as a lack of confidence; negative feelings; a sense of confidence; and awareness of the sources of uncertainty. Research design was a non-experimental cross-sectional survey. The data (n=141) was collected by validated questionnaire during COPD -patients’ visits or admissions to a tertiary hospital. The response rate was 62%. The data was analyzed by statistical methods. Around 70% of the participants were male with COPD diagnosed many years ago. Fifty-four percent were under 65 years and used an electronic respiratory aid apparatus (52%) (oxygen concentrator, ventilator or electronic inhalation device). Forty-one percent of the participants smoked. Disease-related uncertainty was widely reported. Seventy-three percent of the participants had uncertainty about their knowledge of the disease, the pulmonary medication and nutrition. One-quarter (25%) did not feel sure about managing COPD exacerbation. About forty percent (43%) reported that they did not have a written exacerbation decision aid indicating how to act in relation to COPD symptoms. Over half of the respondents were uncertain about self-management behavior related to health habits such as exercise and nutrition. Over a third of the participants (37%) felt uncertain about self-management skills related to giving up smoking. Support from the care providers was correlated significantly with the patients’ sense of confidence. COPD -patients who felt no confidence stated that they received significantly less support in care. Disease-related uncertainty should be considered more closely and broadly in the patient care context, and those strategies within patient education that enhance adherence should be strengthened and incorporated into standard practice.

Keywords: adherence, COPD, disease-management, uncertainty

Procedia PDF Downloads 214

Authors: A. Lubis, R. Widayanti, Z. Hikmah, A. Endaryanto, A. Harsono, A. Harianto, R. Etika, D. K. Handayani, M. Sampurna

Abstract:

Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: neonatus lupus erythematous, maternal autoantibody, clinical characteristic, multiple organ manifestation

Procedia PDF Downloads 396

Authors: Wen Hsin Hsu, Pin Lin

Abstract:

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

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

Procedia PDF Downloads 41

Authors: Kathleen Canul

Abstract:

Bullying is on the rise according to several recent studies. Workplace bullying has garnered less attention than other forms yet incidence rates range from 35-45%. The consequences of being bullied at work are broad, ranging from physiological to psychological to occupational. As the bullying progresses, employees begin to exhibit physical and psychological symptoms. Blood pressure rises, along with other cardiac related concerns. For men, covert coping with job unfairness was associated with a four-fold risk of heart attack and death. Gastrointestinal distress, headaches, muscle tension, sleep disorders and exhaustion are also common. Workplace bullying appears to contribute to the risk of subsequent psychotropic medication, as well. Emotionally, anxiety and depression increase along with lowered self-esteem and problems concentrating on the duties of the job. In an attempt to cope, individuals may succumb to unhealthy practices involving food, alcohol and other drugs. Patterns of bullying vary by gender, race, and ethnicity, as well as sexual orientation, with women, ethnic minorities and LGBTQ employees reporting higher rates of bullying in the workplace. Not only is this an issue of inequity on the job, but also a problem of health disparities as there are few mental health professionals confident and competent in dealing with workplace bullying issues, and the lack of culturally competent clinicians exacerbates this inequality in receiving adequate care. Alone, the topic of workplace bullying is not unique; however, the diverse experiences of underrepresented groups who disproportionately are affected on the job and suffer untreated, health related concerns represent a significant and emerging problem requiring attention. Conference participants who have experienced, witnessed or help those bullied on the job would benefit most from this review of the literature on the consequences of bullying experienced by diverse and underrepresented groups in the workplace.

Keywords: bullying, ethnic minorities, health disparities, workplace conflict

Procedia PDF Downloads 254

Authors: A. Benedetto, P. Wong, N. Papouchis, L. W. Samstag

Abstract:

Bowen’s concept of self-differentiation describes a healthy balance of autonomy and intimacy in close relationships, and it has been widely researched in the context of family dynamics. The current study aimed to clarify the impact of family dysfunction on self-differentiation by specifically examining conflict between parents, and by including young adults, an underexamined age group in this domain (N = 300; ages 18 to 30). It also identified a protective factor for offspring from conflictual homes. The 300 young adults (recruited online through Mechanical Turk) completed the Differentiation of Self Inventory (DSI), the Children’s Perception of Interparental Conflict Scale (CPIC), the Parental Bonding Instrument (PBI), and the Symptom Checklist-90-Revised (SCL-90-R). Analyses revealed that interparental conflict significantly impairs self-differentiation among young adult offspring. Specifically, exposure to parental conflict showed a negative impact on young adults’ sense of self, emotional reactivity, and interpersonal cutoff in the context of close relationships. Parental conflict was also related to increased psychological distress among offspring. Surprisingly, the study found that parental divorce does not impair self-differentiation in offspring, demonstrating the distinctly harmful impact of conflict. These results clarify a unique type of family dysfunction that impairs self-differentiation, specifically in distinguishing it from parental divorce; it examines young adults, a critical age group not previously examined in this domain; and it identifies a moderating protective factor (a strong parent-child bond) for offspring exposed to conflict. Overall, results suggest the need for modifications in parental behavior in order to protect offspring at risk of lasting emotional and interpersonal damage.

Keywords: divorce, family dysfunction, parental conflict, parent-child bond, relationships, self-differentiation, young adults

Procedia PDF Downloads 130