Search results for: nutritional indicators

Authors: Ana L. Gonzalez-Celis, Edgardo Ruiz-Carrillo, Karina Reyes-Jarquin, Margarita Chavez-Becerra

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Since recent decades, the aging has been viewed from a more positive perspective, where is not only about losses and damage, but also about being on a stage where you can enjoy life and live with well-being and quality of life. The challenge to feel better is to find those resources that seniors have. For that reason, psychological well-being has shown interest in the study of the affect and life satisfaction (hedonic well-being), while from a more recent tradition, focus on the development of capabilities and the personal growth, considering both as the main indicators of the quality of life. A resource that can be used in the later age is generativity, which refers to the ability of older people to develop and grow through activities that contribute with the improvement of the context in which they live and participate. In this way the generative interest is understood as a favourable attitude that contribute to the common benefit while strengthening and enriching the social institutions, to ensure continuity between generations and social development. On the other hand, generative behavior, differentiating from generative interest, is the expression of that attitude reflected in activities that make a social contribution and a benefit for generations to come. Hence the purpose of the research was to test if there is an association between the generative behaviour type and the psychological well-being with their dimensions. For this reason 188 Mexican adults from 60 to 94 years old (M = 69.78), 67% women, 33% men, completed two instruments: The Ryff’s Well-Being Scales to measure psychological well-being with 39 items with two dimensions (Hedonic and Eudaimonic well-being), and the Loyola’s Generative Behaviors Scale, grouped in five categories: Knowledge transmitted to the next generation, things to be remember, creativity, be productive, contribution to the community, and responsibility of other people. In addition, the socio-demographic data sheet was tested, and self-reported health status. The results indicated that the psychological well-being and its dimensions were significantly associated with the presence of generative behavior, where the level of well-being was higher when the frequency of some generative behaviour excelled; finding that the behavior with greater psychological well-being (M = 81.04, SD = 8.18) was "things to be remembered"; while with greater hedonic well-being (M = 73.39, SD = 12.19) was the behavior "responsibility of other people"; and with greater Eudaimonic well-being (M = 84.61, SD = 6.63), was the behavior "things to be remembered”. The most important findings highlight the importance of generative behaviors in adulthood, finding empirical evidence that the generativity in the last stage of life is associated with well-being. However, by finding differences in the types of generative behaviors at the level of well-being, is proposed the idea that generativity is not situated as an isolated construct, but needs other contextualized and related constructs that can simultaneously operate at different levels, taking into account the relationship between the environment and the individual, encompassing both the social and psychological dimension.

Keywords: eudaimonic well-being, generativity, hedonic well-being, Mexican elders, psychological well-being

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Authors: E. Gopi, E. Devaindran

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Objective: Non-operative management of blunt splenic trauma have started to overtake the traditional splenectomy in recent years across the grade of splenic injury. The two main non-operative methods are observation and angioembolisation. However, the post management convalescence in these groups are still being investigated. The study attempts to quantify the clinical indicators among the two in particular complications, mortalities, conversions to operative management and duration of inpatient stay. Methodology: A systematic search was done via PUBMED, MEDLINE, and EMBASE. A total of 639 articles identified and subsequently 68 articles were identified post duplicates, full text, and inclusion and exclusion criteria. Main exclusions were non-English articles without English translation, pure observational or angioembolisation articles of which no comparison data could be identified and articles looking into pure hemodynamically unstable patients. Results: 24 non randomized controlled trial, 5 clinical control trial and 39 retrospective studies analyzing a total of 23700 patients with blunt splenic trauma. Discrepancies in data were noted in the group who had observational management versus angioembolisation in particular as data was compared among the classes of splenic rupture, the protocol of management in different centers, availability of angiogram suite, and the study design. Further variability was also noted in the angioembolisation arm as the preference for treatment differs between distal versus proximal splenic artery involvement. Overall the cumulative mortality in both observational and angioembolisation group were similar, 2.78% and 5.97% respectively. The cause of death however is not directly attributed to the management itself but rather patient comorbidities, other associated injuries and conversions to splenectomy leading to post splenectomy complications. The cumulative morbidity among each group appears to be same approximately 12% in observational versus 15% in angioembolisation. However, the type of complications varies with the observational group having higher rates of inpatient stay and intrabdominal hematoma infection and angioembolisation group developing more splenic infarcts and bleeds. There were significant disparity in reporting the actual data on duration of inpatient stay and complications to allow a statistically significant quantitative analysis to be done, 15 articles however are currently being considered. Conclusions: Observational management appears to be much effective in managing lower grade splenic trauma (grade 1 and 2) where else angioembolisation appears to play a bigger role in intermediate grades (grade 3-4) in ensuring splenic function preservation. Care has to be taken however in the angioembolisation group in view of distal splenic infarct group compromising splenic function. The cumulated data of 15 articles are now being considered for a meta-analysis.

Keywords: blunt splenic trauma, conservative, non-operative, angioembolisation

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Authors: Sayantan Khanra, Rojers P. Joseph

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Background and Significance: This study is aimed at analyzing the role of demographic and service quality variables in the adoption and diffusion of e-government services among the users in India. The study proposes to examine the users' perception about e-Government services and investigate the key variables that are most salient to the Indian populace. Description of the Basic Methodologies: The methodology to be adopted in this study is Hierarchical Regression Analysis, which will help in exploring the impact of the demographic variables and the quality dimensions on the willingness to use e-government services in two steps. First, the impact of demographic variables on the willingness to use e-government services is to be examined. In the second step, quality dimensions would be used as inputs to the model for explaining variance in excess of prior contribution by the demographic variables. Present Status: Our study is in the data collection stage in collaboration with a highly reliable, authentic and adequate source of user data. Assuming that the population of the study comprises all the Internet users in India, a massive sample size of more than 10,000 random respondents is being approached. Data is being collected using an online survey questionnaire. A pilot survey has already been carried out to refine the questionnaire with inputs from an expert in management information systems and a small group of users of e-government services in India. The first three questions in the survey pertain to the Internet usage pattern of a respondent and probe whether the person has used e-government services. If the respondent confirms that he/she has used e-government services, then an aggregate of 15 indicators are used to measure the quality dimensions under consideration and the willingness of the respondent to use e-government services, on a five-point Likert scale. If the respondent reports that he/she has not used e-government services, then a few optional questions are asked to understand the reason(s) behind the same. Last four questions in the survey are dedicated to collect data related to the demographic variables. An indication of the Major Findings: Based on the extensive literature review carried out to develop several propositions; a research model is prescribed to start with. A major outcome expected at the completion of the study is the development of a research model that would help to understand the relationship involving the demographic variables and service quality dimensions, and the willingness to adopt e-government services, particularly in an emerging economy like India. Concluding Statement: Governments of emerging economies and other relevant agencies can use the findings from the study in designing, updating, and promoting e-government services to enhance public participation, which in turn, would help to improve efficiency, convenience, engagement, and transparency in implementing these services.

Keywords: adoption and diffusion of e-government services, demographic variables, hierarchical regression analysis, service quality dimensions

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Authors: Muhammad Irfan

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The rise of radicalization within Islam has spawned a new era of global terror. The battlefield Successes of ISIS and the Taliban are fuelled by an ideological war waged, largely and successfully, in the media arena. This research will examine how Islamic extremist groups are using media modalities and populist narratives to influence migrant Muslim populations in Europe towards extremism. In 2014, ISIS shocked the world in exporting horrifically graphic forms of violence on social media. Their Muslim support base was largely disgusted and reviled. In response, they reconfigured their narrative by introducing populist 'hooks', astutely portraying the Muslim populous as oppressed and exploited by unjust, corrupt autocratic regimes and Western power structures. Within this crucible of real and perceived oppression, hundreds of thousands of the most desperate, vulnerable and abused migrants left their homelands, risking their lives in the hope of finding peace, justice, and prosperity in Europe. Instead, many encountered social stigmatization, detention and/or discrimination for being illegal migrants, for lacking resources and for simply being Muslim. This research will examine how Islamic extremist groups are exploiting the disenfranchisement of these migrant populations and using populist messaging on social media to influence them towards violent extremism. ISIS, in particular, formulates specific encoded messages for newly-arriving Muslims in Europe, preying upon their vulnerability. Violence is posited, as a populist response, to the tyranny of European oppression. This research will analyze the factors and indicators which propel Muslim migrants along the spectrum from resilience to violence extremism. Expected outcomes are identification of factors which influence vulnerability towards violent extremism; an early-warning detection framework; predictive analysis models; and de-radicalization frameworks. This research will provide valuable tools (practical and policy level) for European governments, security stakeholders, communities, policy-makers, and educators; it is anticipated to contribute to a de-escalation of Islamic extremism globally.

Keywords: populism, radicalization, de-radicalization, social media, ISIS, Taliban, shariah, jihad, Islam, Europe, political communication, terrorism, migrants, refugees, extremism, global terror, predictive analysis, early warning detection, models, strategic communication, populist narratives, Islamic extremism

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Authors: Manjula Kola, K. Chandralekha

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Anaemia is one of the world’s most widespread health problems. Prevalence of anemia in south Asia is among the highest in the world. Iron deficiency anemia accounts for almost 85 percent of all types of anemia in India and affects more than half of the total population. Women of childbearing age particularly pregnant women, infants, preschool children and adolescents are at greatest risk of developing iron deficiency anemia. In India, 74 percent children between 6-35 months of age are anemic. Children between 1-6 years in major cities are found with a high prevalence rate of 64.8 percent. Iron deficiency anemia is not only a public health problem, but also a development problem. Its prevention and reduction must be viewed as investment in human capital that will enhance development and reduce poverty. Ending this hidden hunger in the form of iron deficiency is the most important achievable international health goal. Eliminating the underlying problem is essential to the sustained elimination of the iron deficiency anemia. The intervention programmes toward the sustained elimination need to be broadly based so that interventions become accepted community practices. Hence, intervention strategies need to go well beyond traditional health and nutrition systems and based upon empowering people and communities so that they will be capable of arranging for and sustaining an adequate intake of foods with respect to iron, independent of external support. Such strategies must necessarily be multisectoral and integrate interventions with social communications, evaluation and surveillance. The main objective of the study was to design a community based Nutrition intervention using theoretical framework of social marketing to sustain improvement of iron nutriture among preschool children. In order to carryout the study eight rural communities In Chittoor district of Andhra Pradesh, India were selected. A formative research was carryout for situational analysis and baseline data was generated with regard to demographic and socioeconomic status, dietary intakes, Knowledge, Attitude and Practices of the mothers of preschool children, clinical and hemoglobin status of the target group. Based on the formative research results, the research area was divides into four groups as experimental area I,II,III and control area. A community based, integrated and comprehensive social marketing intervention was designed based on various theories and models of nutrition education/ communication. In Experimental area I, Nutrition intervention using social marketing and a weekly iron folic acid supplementation was given to improve iron nutriture of preschool children. In experimental area II, Social marketing alone was implemented and in experimental area III Iron supplementation alone was given. No intervention was given in control area. The Impact evaluation revealed that among different interventions tested, the integrated social marketing intervention resulted best outcomes. The overall observations of the study state that social marketing, an integrated and functional strategy for nutrition communication to prevent and control iron deficiency. Various theoretical frame works / models for nutrition communication facilitate to design culturally appropriate interventions thus achieved improvements in the knowledge, attitude and practices there by resulting successful impact on nutritional status of the target groups.

Keywords: anemia, iron deficiency, social marketing, theoretical framework

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Authors: Irina M. Kolesnikova, Andrey M. Gaponov, Sergey A. Roumiantsev, Tatiana V. Grigoryeva, Alexander V. Laikov, Alexander V. Shestopalov

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Background. Neuropathy is a common complication of obesity. In this regard, the content of neurotrophins in such patients is of particular interest. Neurotrophins are the proteins that regulate neuron survival and neuroplasticity and include brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF). However, the risk of complications depends on the metabolic type of obesity. Metabolically unhealthy obesity (MUHO) is associated with a high risk of complications, while this is not the case with metabolically healthy obesity (MHO). Therefore, the aim of our work was to study the effect of the obesity metabolic type on serum neurotrophins levels. Patients, materials, methods. The study included 134 healthy donors and 104 obese patients. Depending on the metabolic type of obesity, the obese patients were divided into subgroups with MHO (n=40) and MUHO (n=55). In the blood serum, the concentration of BDNF and NGF was determined. In addition, the content of adipokines (leptin, asprosin, resistin, adiponectin), myokines (irisin, myostatin, osteocrin), indicators of carbohydrate, and lipid metabolism were measured. Correlation analysis revealed the relationship between the studied parameters. Results. We found that serum BDNF concentration was not different between obese patients and healthy donors, regardless of obesity metabolic type. At the same time, in obese patients, there was a decrease in serum NGF level versus control. A similar trend was characteristic of both MHO and MUHO. However, MUHO patients had a higher NGF level than MHO patients. The literature indicates that obesity is associated with an increase in the plasma concentration of NGF. It can be assumed that in obesity, there is a violation of NGF storage in platelets, which accelerates neurotrophin degradation. We found that BDNF concentration correlated with irisin levels in MUHO patients. Healthy donors had a weak association between NGF and VEGF levels. No such association was found in obese patients, but there was an association between NGF and leptin concentrations. In MHO, the concentration of NHF correlated with the content of leptin, irisin, osteocrin, insulin, and the HOMA-IR index. But in MUHO patients, we found only the relationship between NGF and adipokines (leptin, asprosin). It can be assumed that in patients with MHO, the replenishment of serum NGF occurs under the influence of muscle and adipose tissue. In the MUHO patients only the effect of adipose tissue on NGF was observed. Conclusion. Obesity, regardless of metabolic type, is associated with a decrease in serum NGF concentration. We showed that muscle and adipose tissues make a significant contribution to the serum NGF pool in the MHO patients. In MUHO there is no effect of muscle on the NGF level, but the effect of adipose tissue remains.

Keywords: neurotrophins, nerve growth factor, NGF, brain-derived neurotrophic factor, BDNF, obesity, metabolically healthy obesity, metabolically unhealthy obesity

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Authors: Derek Wardle, Tarik Al-Shemmeri, Neil Packer

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This paper presents a small tube/wire type electrostatic precipitator (ESP). In the ESPs present form, particle charging and collecting voltages and airflow rates were individually varied throughout 200 ambient temperature test runs ranging from 10 to 30 kV in increments on 5 kV and 0.5 m/s to 1.5 m/s, respectively. It was repeatedly observed that, at input air velocities of between 0.5 and 0.9 m/s and voltage settings of 20 kV to 30 kV, the collection efficiency remained above 95%. The outcomes of preliminary tests at combustion flue temperatures are, at present, inconclusive although indications are that there is little or no drop in comparable performance during ideal test conditions. A limited set of similar tests was carried out during which the collecting electrode was grounded, having been disconnected from the static generator. The collecting efficiency fell significantly, and for that reason, this approach was not pursued further. The collecting efficiencies during ambient temperature tests were determined by mass balance between incoming and outgoing dry PM. The efficiencies of combustion temperature runs are determined by analysing the difference in opacity of the flue gas at inlet and outlet compared to a reference light source. In addition, an array of Leit tabs (carbon coated, electrically conductive adhesive discs) was placed at inlet and outlet for a number of four-day continuous ambient temperature runs. Analysis of the discs’ contamination was carried out using scanning electron microscopy and ImageJ computer software that confirmed collection efficiencies of over 99% which gave unequivocal support to all the previous tests. The average efficiency for these runs was 99.409%. Emissions collected from a woody biomass combustion unit, classified to a diameter of 100 µm, were used in all ambient temperature trials test runs apart from two which collected airborne dust from within the laboratory. Sawdust and wood pellets were chosen for laboratory and field combustion trials. Video recordings were made of three ambient temperature test runs in which the smoke from a wood smoke generator was drawn through the precipitator. Although these runs were visual indicators only, with no objective other than to display, they provided a strong argument for the device’s claimed efficiency, as no emissions were visible at exit when energised.  The theoretical performance of ESPs, when applied to the geometry and configuration of the tested model, was compared to the actual performance and was shown to be in good agreement with it.

Keywords: electrostatic precipitators, air quality, particulates emissions, electron microscopy, image j

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Authors: John Hardy

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A range of future-oriented intelligence techniques is commonly used by states to assess their national security and develop strategies to detect and manage threats, to develop and sustain capabilities, and to recover from attacks and disasters. Although homeland security organizations use future's intelligence tools to generate scenarios and simulations which inform their planning, there have been relatively few studies of the methods available or their applications for homeland security purposes. This study presents an assessment of one category of strategic intelligence techniques, termed Multi-Path Futures Analyses (MPFA), and how it can be applied to three distinct tasks for the purpose of analyzing homeland security issues. Within this study, MPFA are categorized as a suite of analytic techniques which can include effects-based operations principles, general morphological analysis, multi-path mapping, and multi-criteria decision analysis techniques. These techniques generate multiple pathways to potential futures and thereby generate insight into the relative influence of individual drivers of change, the desirability of particular combinations of pathways, and the kinds of capabilities which may be required to influence or mitigate certain outcomes. The study assessed eighteen uses of MPFA for homeland security purposes and found that there are five key applications of MPFA which add significant value to analysis. The first application is generating measures of success and associated progress indicators for strategic planning. The second application is identifying homeland security vulnerabilities and relationships between individual drivers of vulnerability which may amplify or dampen their effects. The third application is selecting appropriate resources and methods of action to influence individual drivers. The fourth application is prioritizing and optimizing path selection preferences and decisions. The fifth application is informing capability development and procurement decisions to build and sustain homeland security organizations. Each of these applications provides a unique perspective of a homeland security issue by comparing a range of potential future outcomes at a set number of intervals and by contrasting the relative resource requirements, opportunity costs, and effectiveness measures of alternative courses of action. These findings indicate that MPFA enhances analysts’ ability to generate tangible measures of success, identify vulnerabilities, select effective courses of action, prioritize future pathway preferences, and contribute to ongoing capability development in homeland security assessments.

Keywords: homeland security, intelligence, national security, operational design, strategic intelligence, strategic planning

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Authors: Roya Yumul, Ofelia Loani Elvir-Lazo, Sevan Komshian, Ruby Wang, Jun Tang

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BACKGROUND: An objective means for monitoring the anti-nociceptive effects of perioperative medications has long been desired as a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively. To this end, electroencephalogram (EEG) based tools including BIS and qCON were designed to provide information about the depth of sedation while qNOX was produced to inform on the degree of antinociception. The goal of this study was to compare the reliability of qCON/qNOX to BIS as specific indicators of response to nociceptive stimulation. METHODS: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board (IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to the endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed on all patients prior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. RESULTS: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from 74 ±13 mm Hg at baseline to 84 ± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76 ± 12 BPM at baseline to 80 ± 13 BPM during noxious stimuli [p=0.078] respectively). CONCLUSION: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices

Keywords: antinociception, BIS, general anesthesia, LMA, qCON/qNOX

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Authors: Michelle Rippy

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Medicolegal death investigation historically is a field that does not receive much research attention or advancement, as all of the subjects are deceased. Public health threats, drug epidemics and contagious diseases are typically recognized in decedents first, with thorough and accurate death investigations able to assist in epidemiology research and prevention programs. One vital component of medicolegal death investigation is determining the decedent’s time of death. An accurate time of death can assist in corroborating alibies, determining sequence of death in multiple casualty circumstances and provide vital facts in civil situations. Popular television portrays an unrealistic forensic ability to provide the exact time of death to the minute for someone found deceased with no witnesses present. The actuality of unattended decedent time of death determination can generally only be narrowed to a 4-6 hour window. In the mid- to late-20th century, liver temperatures were an invasive action taken by death investigators to determine the decedent’s core temperature. The core temperature was programmed into an equation to determine an approximate time of death. Due to many inconsistencies with the placement of the thermometer and other variables, the accuracy of the liver temperatures was dispelled and this once common place action lost scientific support. Currently, medicolegal death investigators utilize three major after death or post-mortem changes at a death scene. Many factors are considered in the subjective determination as to the time of death, including the cooling of the decedent, stiffness of the muscles, release of blood internally, clothing, ambient temperature, disease and recent exercise. Current research is utilizing non-invasive hospital grade tympanic thermometers to measure the temperature in the each of the decedent’s ears. This tool can be used at the scene and in conjunction with scene indicators may provide a more accurate time of death. The research is significant and important to investigations and can provide an area of accuracy to a historically inaccurate area, considerably improving criminal and civil death investigations. The goal of the research is to provide a scientific basis to unwitnessed deaths, instead of the art that the determination currently is. The research is currently in progress with expected termination in December 2018. There are currently 15 completed case studies with vital information including the ambient temperature, decedent height/weight/sex/age, layers of clothing, found position, if medical intervention occurred and if the death was witnessed. This data will be analyzed with the multiple variables studied and available for presentation in January 2019.

Keywords: algor mortis, forensic pathology, investigations, medicolegal, time of death, tympanic

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Authors: Mareen Brosterhaus, Antje Hammer, Steffen Kalina, Stefan Grau, Anjali A. Roeth, Hany Ashmawy, Thomas Gross, Marcel Binnebosel, Wolfram T. Knoefel, Tanja Manser

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Background: The identification of critical incidents in hospitals is an essential component of improving patient safety. To date, various methods have been used to measure and characterize such critical incidents. These methods are often viewed by physicians and nurses as external quality assurance, and this creates obstacles to the reporting events and the implementation of recommendations in practice. One way to overcome this problem is to use tools that directly involve staff in measuring indicators of quality and safety of care in the department. One such instrument is the global trigger tool (GTT), which helps physicians and nurses identify adverse events by systematically reviewing randomly selected patient records. Based on so-called ‘triggers’ (warning signals), indications of adverse events can be given. While the tool is already used internationally, its implementation in German hospitals has been very limited. Objectives: This study aimed to assess the feasibility and potential of the global trigger tool for identifying adverse events in German hospitals. Methods: A total of 120 patient records were randomly selected from two surgical, and one neurosurgery, departments of three university hospitals in Germany over a period of two months per department between January and July, 2017. The records were reviewed using an adaptation of the German version of the Institute for Healthcare Improvement Global Trigger Tool to identify triggers and adverse event rates per 1000 patient days and per 100 admissions. The severity of adverse events was classified using the National Coordinating Council for Medication Error Reporting and Prevention. Results: A total of 53 adverse events were detected in the three departments. This corresponded to adverse event rates of 25.5-72.1 per 1000 patient-days and from 25.0 to 60.0 per 100 admissions across the three departments. 98.1% of identified adverse events were associated with non-permanent harm without (Category E–71.7%) or with (Category F–26.4%) the need for prolonged hospitalization. One adverse event (1.9%) was associated with potentially permanent harm to the patient. We also identified practical challenges in the implementation of the tool, such as the need for adaptation of the global trigger tool to the respective department. Conclusions: The global trigger tool is feasible and an effective instrument for quality measurement when adapted to the departmental specifics. Based on our experience, we recommend a continuous use of the tool thereby directly involving clinicians in quality improvement.

Keywords: adverse events, global trigger tool, patient safety, record review

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Authors: Yael Wolff Sagy, Yiska Loewenberg Weisband, Vered Kaufman Shriqui, Michal Krieger, Arie Ben Yehuda, Ronit Calderon Margalit

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Background: Obesity is both a risk factor and common comorbidity of diabetes. Obesity impedes the achievement of glycemic control, and enhances damage caused by hyperglycemia to blood vessels; thus it increases diabetes-related complications. This study assessed the prevalence of obesity and morbid obesity among Israeli adults with diabetes, and estimated disparities associated with sex and socioeconomic position (SEP). Methods: A cross-sectional study was conducted in the setting of the Israeli National Program for Quality Indicators in Community Healthcare. Data on all the Israeli population is retrieved from electronic medical records of the four health maintenance organizations (HMOs). The study population included all Israeli patients with diabetes aged 20-64 with documented body mass index (BMI) in 2016 (N=180,451). Diabetes was defined as the existence of one or more of the following criteria: (a) Plasma glucose level >200 mg% in at least two tests conducted at least one month apart in the previous year; (b) HbA1c>6.5% at least once in the previous year (c) at least three prescriptions of diabetes medications were dispensed during the previous year. Two measures were included: the prevalence of obesity (defined as last BMI≥ 30 kg/m2 and <35 kg/m2) and the prevalence of morbid obesity (defined as last BMI≥ 35 kg/m2) in individuals aged 20-64 with diabetes. The cut-off value for morbid obesity was set in accordance with the eligibility criteria for bariatric surgery in diabetics. Data were collected by the HMOs and aggregated by age, sex and SEP. SEP was based on statistical areas ranking by the Israeli Central Bureau of Statistics and divided into 4 categories, ranking from 1 (lowest) to 4 (highest). Results: BMI documentation among adults with diabetes was 84.9% in 2016. The prevalence of obesity in the study population was 30.5%. Although the overall rate was similar in both sexes (30.8% in females, 30.3% in males), SEP disparities were stronger in females (32.7% in SEP level 1 vs. 27.7% in SEP level 4; 18.1% relative difference) compared to males (30.6% in SEP level 1 vs. 29.3% in SEP level 4; 4.4% relative difference). The overall prevalence of morbid obesity in this population was 20.8% in 2016. The rate among females was almost double compared to the rate in males (28.1% and 14.6%, respectively). In both sexes, the prevalence of morbid obesity was strongly associated with lower SEP. However, in females, disparities between SEP levels were much stronger (34.3% in SEP level 1 vs. 18.7% in SEP level 4; 83.4% relative difference) compared to SEP-disparities in males (15.7% in SEP level 1 vs. 12.3% in SEP level 4; 27.6% relative difference). Conclusions: The overall prevalence of BMI≥ 30 kg/m2 among adults with diabetes in Israel exceeds 50%; and the prevalence of morbid obesity suggests that 20% meet the BMI-criteria for bariatric surgery. Prevalence rates show major SEP- and sex-disparities; especially strong SEP disparities in morbid obesity among females. These findings highlight the need for greater consideration of different population groups when implementing interventions.

Keywords: diabetes, health disparities, health policy, obesity, socio-economic position

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Authors: Crystal Hoole

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Employee well-being has become an area of concern for top executives and organizations worldwide. In developing countries such as South Africa, and especially in the educational sector, employees have to deal with anxiety, stress, fear, student protests, political and economic turmoil and excessive work demands on a daily basis. Research has shown that workplaces with higher resilience and better well-being strategies also report higher productivity, increased innovation, better employee retention and better employee engagement. Many organisations offer standard employee assistance programs and once-off short interventions. However, most of these well-being initiatives are perceived as ineffective. Some of the criticism centers around a lack of holistic well-being approaches, no proof of the success of well-being initiatives, not being part of the organization’s strategies and a lack of genuine leadership support. This study attempts to illustrate how a holistic well-being intervention, over a period of 100 days, is far more effective in impacting organizational outcomes. A quasi-experimental design, with a pre-test and pro-test design with a randomization strategy, will be used. Measurements of organizational outcomes are taken at three-time points throughout the study, before, middle and after. The constructs that will be measured are employee engagement, psychological well-being, organizational culture and trust, and perceived stress. The well-being is imitative follows a salutogenesis approach and is aimed at building resilience through focusing on six focal areas, namely sleep, mindful eating, exercise, love, gratitude and appreciation, breath work and mindfulness, and finally, purpose. Certain organizational constructs, including employee engagement, psychological well-being, organizational culture and trust and perceived stress, will be measured at three-time points during the study, namely before, middle and after. A quasi-experimental, pre-test and post-test design will be applied, also using a randomization strategy to limit potential bias. Repeated measure ANCOVA will be used to determine whether any change occurred over the period of 100 days. The study will take place in a Higher Education institution in South Africa. The sample will consist of academic and administrative staff. Participants will be assigned to a test and control group. All participants will complete a survey measuring employee engagement, psychological well-being, organizational culture and trust, and perceived stress. Only the test group will undergo the well-being intervention. The study envisages contributing on several levels: Firstly, the study hopes to find a positive increase in the various well-being indicators of the participants who participated in the study and secondly to illustrate that a longer more holistic approach is successful in improving organisational success (as measured in the various organizational outcomes).

Keywords: wellbeing, resilience, organizational success, intervention

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Authors: Steven Hidalgo, Patricio Neumann

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The growth of societies has increased the consumption of raw materials and food obtained from nature. This has influenced the services offered by ecosystems to humans, mainly supply and regulation services. One of the indicators used to evaluate these services is Net Primary Productivity (NPP), which is understood as the energy stored in the form of biomass by primary organisms through the process of photosynthesis and respiration. The variation of NPP by defined area produces changes in the properties of terrestrial and aquatic ecosystems, which alter factors such as biodiversity, nutrient cycling, carbon storage and water quality. The analysis of NPP to evaluate variations in ecosystem services includes harvested NPP (understood as provisioning services), which is the raw material from agricultural systems used by humans as a source of energy and food, and the remaining NPP (expressed as a regulating service) or the amount of biomass that remains in ecosystems after the harvesting process, which is mainly related to factors such as biodiversity. Given that agriculture is a fundamental pillar of Chile's integral development, the purpose of this study is to evaluate provisioning and regulating ecosystem services in the agricultural sector, specifically in cereal production, in the communes of the central-southern regions of Chile through a conceptual framework based on the quantification of the fraction of Human Appropriation of Net Primary Productivity (HANPP) and the fraction remaining in the ecosystems (NPP remaining). A total of 161 communes were analyzed in the regions of O'Higgins, Maule, Ñuble, Bio-Bío, La Araucanía and Los Lagos, which are characterized by having the largest areas planted with cereals. It was observed that the region of La Araucanía produces the greatest amount of dry matter, understood as provisioning service, where Victoria is the commune with the highest cereal production in the country. In addition, the maximum value of HANPP was in the O'Higgins region, highlighting the communes of Coltauco, Quinta de Tilcoco, Placilla and Rengo. On the other hand, the communes of Futrono, Pinto, Lago Ranco and Pemuco, whose cereal production was important during the study, had the highest values of remaining NPP as a regulating service. Finally, an inverse correlation was observed between the provisioning and regulating ecosystem services, i.e., the higher the cereal or dry matter production in a defined area, the lower the net primary production remaining in the ecosystems. Based on this study, future research will focus on the evaluation of ecosystem services associated with other crops, such as forestry plantations, whose activity is an important part of the country's productive sector.

Keywords: provisioning services, regulating services, net primary productivity, agriculture

Procedia PDF Downloads 64

Authors: Tae Young Jin, Jin Soo Kim

Abstract:

Carbon emissions have emerged as global concerns. Intergovernmental Panel of Climate Change (IPCC) have published reports about Green House Gases (GHGs) emissions regularly. United Nations Framework Convention on Climate Change (UNFCCC) have held a conference yearly since 1995. Especially, COP21 held at December 2015 made the Paris agreement which have strong binding force differently from former COP. The Paris agreement was ratified as of 4 November 2016, they finally have legal binding. Participating countries set up their own Intended Nationally Determined Contributions (INDC), and will try to achieve this. Thus, carbon emissions must be reduced. The energy sector is one of most responsible for carbon emissions and fossil fuels particularly are. Thus, this paper attempted to examine the relationship between natural gas consumption and economic growth. To achieve this, we adopted the Cobb-Douglas production function that consists of natural gas consumption, economic growth, capital, and labor using dependent panel analysis. Data were preprocessed with Principal Component Analysis (PCA) to remove cross-sectional dependency which can disturb the panel results. After confirming the existence of time-trended component of each variable, we moved to cointegration test considering cross-sectional dependency and structural breaks to describe more realistic behavior of volatile international indicators. The cointegration test result indicates that there is long-run equilibrium relationship between selected variables. Long-run cointegrating vector and Granger causality test results show that while natural gas consumption can contribute economic growth in the short-run, adversely affect in the long-run. From these results, we made following policy implications. Since natural gas has positive economic effect in only short-run, the policy makers in developing countries must consider the gradual switching of major energy source, from natural gas to sustainable energy source. Second, the technology transfer and financing business suggested by COP must be accelerated. Acknowledgement—This work was supported by the Energy Efficiency & Resources Core Technology Program of the Korea Institute of Energy Technology Evaluation and Planning (KETEP) granted financial resource from the Ministry of Trade, Industry & Energy, Republic of Korea (No. 20152510101880) and by the National Research Foundation of Korea Grant funded by the Korean Government (NRF-205S1A3A2046684).

Keywords: developing countries, economic growth, natural gas consumption, panel data analysis

Procedia PDF Downloads 206

Authors: Debasish Chowdhury, Sunil Mekale, Sarvanamurthy Sakthivel, Sukhvinder Kaur, Rambabu Khambampati, Ashok Agarwal

Abstract:

Introduction: The migrant intervention in India was initiated during the National AIDS Control Program (NACP) Phase-2 (2002-2007). HIV Sentinel surveillance Studies (HSS) conducted in 2012-13 indicated higher HIV prevalence among migrants (0.99%) compared to general populations (0.35%). Migrants continue to bear a heightened risk of HIV infection which results from the condition and structure of the migration process. USAID PHFI-PIPPSE project in collaboration with the National AIDS Control Organization (NACO) developed a unique system called Migrant Service Delivery System (MSDS) to capture migrants profile with respect to their risk profile and to provide tailor made services to them. Description: MSDS is a web-based system, designed and implemented to increase service uptake among migrants through evidence based planning. 110 destination migrants Targeted Intervention (TI) from 11 states were selected for study with varied target populations in terms of occupations; to understand occupation related risk behaviors among the migrants. Occupation wise registration data of high risk vulnerable migrants were analyzed through MSDS for the period April 2014–June 2016. Analysis was made on specific indicators among these occupational groups to understand the risk behavior and their vulnerability to HIV and STIs. Findings: Out of total HIV positive migrant’s workers (N= 847) enrolled in MSDS HIV rate is found to be highest among Auto-Rickshaw (18.66%) followed by Daily wage laborers (14.46%), Loom workers (10.73%), Industrial workers (10.04%) and Construction worker 7.93%. With 45.14% positivity, industrial workers are found to be most vulnerable to Sexually Transmitted Infections (STIs) (N=10057) among all occupational categories followed by loom workers (16.28%), Skilled worker (Furniture, Jeweler)-7.14%, daily wage laborers (5.45%). Conclusion: MSDS is an effective tool to assess migrants’ risk and their vulnerability to HIV for designing evidence informed program. This system calls for a replication across all destination TIs by NACO for differential strategies for different occupation groups to ensure better yield through scientific planning of intervention among high risk and high vulnerable migrants.

Keywords: migrants, migrant service delivery system, risk, vulnerability

Procedia PDF Downloads 245

Authors: Georgios A. Fragkiadakis, Antonia Psaroudaki, Theodora Mouratidou, Eirini Sfakianaki

Abstract:

Research: Within the project "Actions for the optimal utilization of the potential of carob in the Region of Crete" which is financed-supervised by the Region, with collaboration of Crete University and Hellenic Mediterranean University, a SWOT (strengths, weaknesses, opportunities, threats) survey was carried out, to evaluate the prospects of carob in human nutrition, in Crete. Results and conclusions: 1). Strengths: There exists a local production of carob for human consumption, based on international reports, and local-product reports. The data on products in the market (over 100 brands of carob food), indicates a sufficiency of carob materials offered in Crete. The variety of carob food products retailed in Crete indicates a strong demand-production-consumption trend. There is a stable number (core) of businesses that invest significantly (Creta carob, Cretan mills, etc.). The great majority of the relevant food stores (bakery, confectionary etc.) do offer carob products. The presence of carob products produced in Crete is strong on the internet (over 20 main professionally designed websites). The promotion of the carob food-products is based on their variety and on a few historical elements connected with the Cretan diet. 2). Weaknesses: The international prices for carob seed affect the sector; the seed had an international price of €20 per kg in 2021-22 and fell to €8 in 2022, causing losses to carob traders. The local producers do not sort the carobs they deliver for processing, causing 30-40% losses of the product in the industry. The occasional high price triggers the collection of degraded raw material; large losses may emerge due to the action of insects. There are many carob trees whose fruits are not collected, e.g. in Apokoronas, Chania. The nutritional and commercial value of the wild carob fruits is very low. Carob trees-production is recorded by Greek statistical services as "other cultures" in combination with prickly pear i.e., creating difficulties in retrieving data. The percentage of carob used for human nutrition, in contrast to animal feeding, is not known. The exact imports of carob are not closely monitored. We have no data on the recycling of carob by-products in Crete. 3). Opportunities: The development of a culture of respect for carob trade may improve professional relations in the sector. Monitoring carob market and connecting production with retailing-industry needs may allow better market-stability. Raw material evaluation procedures may be implemented to maintain carob value-chain. The state agricultural services may be further involved in carob-health protection. The education of farmers on carob cultivation/management, can improve the quality of the product. The selection of local productive varieties, may improve the sustainability of the culture. Connecting the consumption of carob with health-food products, may create added value in the sector. The presence and extent of wild carob threes in Crete, represents, potentially, a target for grafting. 4). Threats: The annual fluctuation of carob yield challenges the programming of local food industry activities. Carob is a forest species also - there is danger of wrong classification of crops as forest areas, where land ownership is not clear.

Keywords: human nutrition, carob food, SWOT analysis, crete, greece

Procedia PDF Downloads 52

Authors: Mohammad Ali Al Qatawneh, Bespalchuk Pavel Ivanovich

Abstract:

Computer navigation has been introduced in total knee arthroplasty to improve the accuracy of the procedure. Computer navigation improves the accuracy of bone resection in the coronal and sagittal planes. It was also noted that it normalizes the rotational alignment of the femoral component and fully assesses and balances the deformation of soft tissues in the coronal plane. The work is devoted to the advantages of using computer navigation technology in total knee arthroplasty in 62 patients (11 men and 51 women) suffering from gonarthrosis, aged 51 to 83 years, operated using a computer navigation system, followed up to 3 years from the moment of surgery. During the examination, the deformity variant was determined, and radiometric parameters of the knee joints were measured using the Knee Society Score (KSS), Functional Knee Society Score (FKSS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scales. Also, functional stress tests were performed to assess the stability of the knee joint in the frontal plane and functional indicators of the range of motion. After surgery, improvement was observed in all scales; firstly, the WOMAC values decreased by 5.90 times, and the median value to 11 points (p < 0.001), secondly KSS increased by 3.91 times and reached 86 points (p < 0.001), and the third one is that FKSS data increased by 2.08 times and reached 94 points (p < 0.001). After TKA, the axis deviation of the lower limbs of more than 3 degrees was observed in 4 patients at 6.5% and frontal instability of the knee joint just in 2 cases at 3.2%., The lower incidence of sagittal instability of the knee joint after the operation was 9.6%. The range of motion increased by 1.25 times; the volume of movement averaged 125 degrees (p < 0.001). Computer navigation increases the accuracy of the spatial orientation of the endoprosthesis components in all planes, reduces the variability of the axis of the lower limbs within ± 3 °, allows you to achieve the best results of surgical interventions, and can be used to solve most basic tasks, allowing you to achieve excellent and good outcomes of operations in 100% of cases according to the WOMAC scale. With diaphyseal deformities of the femur and/or tibia, as well as with obstruction of their medullary canal, the use of computer navigation is the method of choice. The use of computer navigation prevents the occurrence of flexion contracture and hyperextension of the knee joint during the distal sawing of the femur. Using the navigation system achieves high-precision implantation for the endoprosthesis; in addition, it achieves an adequate balance of the ligaments, which contributes to the stability of the joint, reduces pain, and allows for the achievement of a good functional result of the treatment.

Keywords: knee joint, arthroplasty, computer navigation, advantages

Procedia PDF Downloads 57

Authors: Tania Chalton

Abstract:

In June 2013, an independent review of the Liverpool Care Pathway (LCP) identified a number of problems with the implementation of the LCP in the UK and recommended that it be replaced by individual care plans for each patient. As a result of the UK findings, in November 2013 the Ministry of Health (MOH) commissioned the Palliative Care Council to initiate a programme of work to investigate an appropriate approach for the care of people in their last days of life in New Zealand (NZ). The Last Days of Life Working Group commenced a process to develop national consensus on the care of people in their last days of life in April 2014. In order to develop its advice for the future provision of care to people in their last days of life, the Working Group (WG) established a comprehensive work programme and as a result has developed a series of working papers. Specific areas of focus included: An analysis of the UK Independent Review findings and an assessment of these findings to the NZ context. A stocktake of services providing care to people in their last days of life, including aged residential care (ARC); hospices; hospitals; and primary care. International and NZ literature reviews of evidence and best practice. Survey of family to understand the consumer perspective on the care of people in their last days of life. Key aspects of care that required further considerations for NZ were: Terminology: clarify terminology used in the last days of life and in relation to death and dying. Evidenced based: including specific review of evidence regarding, spiritual, culturally appropriate care as well as dementia care. Diagnosis of dying: need for both guidance around the diagnosis of dying and communication with family. Workforce issues: access to an appropriate workforce after hours. Nutrition and hydration: guidance around appropriate approaches to nutrition and hydration. Symptom and pain management: guidance around symptom management. Documentation: documentation of the person’s care which is robust enough for data collection and auditing requirements, not ‘tick box’ approach to care. Education and training: improved consistency and access to appropriate education and training. Leadership: A dedicated team or person to support and coordinate the introduction and implementation of any last days of life model of care. Quality indicators and data collection: model of care to enable auditing and regular reviews to ensure on-going quality improvement. Cultural and spiritual: address and incorporate any cultural and spiritual aspects. A final document was developed incorporating all the evidence which provides guidance to the health sector on best practice for people at end of life: “Principles and guidance for the last days of life: Te Ara Whakapiri”.

Keywords: end of life, guidelines, New Zealand, palliative care

Procedia PDF Downloads 405

Authors: Zachary Cooper-Baldock, Paulo E. Santos, Russell S. A. Brinkworth, Karl Sammut

Abstract:

In recent years, large unmanned underwater vehicles such as the Boeing Voyager and Anduril Ghost Shark have been developed. These vessels can be structured to contain onboard internal payload bays. These payload bays can serve a variety of purposes – including the launch and recovery (LAR) of smaller underwater vehicles. The LAR of smaller vessels is extremely important, as it enables transportation over greater distances, increased time on station, data transmission and operational safety. The larger vessel and its payload bay structure complicate the LAR of UUVs in contrast to static docks that are affixed to the seafloor, as they actively impact the local flow field. These flow field impacts require analysis to determine if UUV vessels can be safely launched and recovered inside the motherships. This research seeks to determine the hydrodynamic forces exerted on a vertically over-actuated, small, unmanned underwater vehicle (OUUV) during an internal LAR manoeuvre and compare this to an under-actuated vessel (UUUV). In this manoeuvre, the OUUV is navigated through the stern wake region of the larger vessel to a set point within the internal payload bay. The manoeuvre is simulated using ANSYS Fluent computational fluid dynamics models, covering the entire recovery of the OUUV and UUUV. The analysis of the OUUV is compared against the UUUV to determine the differences in the exerted forces. Of particular interest are the drag, pressure, turbulence and flow field effects exerted as the OUUV is driven inside the payload bay of the larger vessel. The hydrodynamic forces and flow field disturbances are used to determine the feasibility of making such an approach. From the simulations, it was determined that there was no significant detrimental physical forces, particularly with regard to turbulence. The flow field effects exerted by the OUUV are significant. The vertical thrusters exert significant wake structures, but their orientation ensures the wake effects are exerted below the UUV, minimising the impact. It was also seen that OUUV experiences higher drag forces compared to the UUUV, which will correlate to an increased energy expenditure. This investigation found no key indicators that recovery via a mothership payload bay was not feasible. The turbulence, drag and pressure phenomenon were of a similar magnitude to existing static and towed dock structures.

Keywords: underwater vehicles, submarine, autonomous underwater vehicles, AUV, computational fluid dynamics, flow fields, pressure, turbulence, drag

Procedia PDF Downloads 55

Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Association between insulin resistance (IR) and hematological parameters has long been a matter of interest. Within this context, body mass index (BMI), red blood cells, white blood cells and platelets were involved in this discussion. Parameters related to platelets associated with IR may be useful indicators for the identification of IR. Platelet indices such as mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) are being questioned for their possible association with IR. The aim of this study was to investigate the association between platelet (PLT) count as well as PLT indices and the surrogate indices used to determine IR in morbid obese (MO) children. A total of 167 children participated in the study. Three groups were constituted. The number of cases was 34, 97 and 36 children in the normal BMI, MO and metabolic syndrome (MetS) groups, respectively. Sex- and age-dependent BMI-based percentile tables prepared by World Health Organization were used for the definition of morbid obesity. MetS criteria were determined. BMI values, homeostatic model assessment for IR (HOMA-IR), alanine transaminase-to-aspartate transaminase ratio (ALT/AST) and diagnostic obesity notation model assessment laboratory (DONMA-lab) index values were computed. PLT count and indices were analyzed using automated hematology analyzer. Data were collected for statistical analysis using SPSS for Windows. Arithmetic mean and standard deviation were calculated. Mean values of PLT-related parameters in both control and study groups were compared by one-way ANOVA followed by Tukey post hoc tests to determine whether a significant difference exists among the groups. The correlation analyses between PLT as well as IR indices were performed. Statistically significant difference was accepted as p-value < 0.05. Increased values were detected for PLT (p < 0.01) and PCT (p > 0.05) in MO group compared to those observed in children with N-BMI. Significant increases for PLT (p < 0.01) and PCT (p < 0.05) were observed in MetS group in comparison with the values obtained in children with N-BMI (p < 0.01). Significantly lower MPV and PDW values were obtained in MO group compared to the control group (p < 0.01). HOMA-IR (p < 0.05), DONMA-lab index (p < 0.001) and ALT/AST (p < 0.001) values in MO and MetS groups were significantly increased compared to the N-BMI group. On the other hand, DONMA-lab index values also differed between MO and MetS groups (p < 0.001). In the MO group, PLT was negatively correlated with MPV and PDW values. These correlations were not observed in the N-BMI group. None of the IR indices exhibited a correlation with PLT and PLT indices in the N-BMI group. HOMA-IR showed significant correlations both with PLT and PCT in the MO group. All of the three IR indices were well-correlated with each other in all groups. These findings point out the missing link between IR and PLT activation. In conclusion, PLT and PCT may be related to IR in addition to their identities as hemostasis markers during morbid obesity. Our findings have suggested that DONMA-lab index appears as the best surrogate marker for IR due to its discriminative feature between morbid obesity and MetS.

Keywords: children, insulin resistance, metabolic syndrome, plateletcrit, platelet indices

Procedia PDF Downloads 80

Authors: Khrystyna Pavlyk

Abstract:

In the OECD countries, percentage of adults with higher education degrees has increased by 10 % during 2000-2010. Continuously increasing demand for higher education gives universities a chance of becoming key players in socio-economic development of a territory (region or city) via knowledge creation, knowledge transfer, and knowledge spillovers. During previous decade, universities have tried to support spin-offs and start-ups, introduced courses on sustainability and corporate social responsibility. While much has been done, new trends are starting to emerge in search of better approaches. Recently a number of universities created centers that conduct research in a field social entrepreneurship, which in turn underpin educational programs run at these universities. The list includes but is not limited to the Centre for Social Economy at University of Liège, Institute for Social Innovation at ESADE, Skoll Centre for Social Entrepreneurship at Oxford, Centre for Social Entrepreneurship at Rosklide, Social Entrepreneurship Initiative at INSEAD. Existing literature already examined social entrepreneurship centers in terms of position in the institutional structure, initial and additional funding, teaching initiatives, research achievements, and outreach activities. At the same time, Universities can become social enterprises themselves. Previous research revealed that universities use both business and social entrepreneurship models. Universities which are mainly driven by a social mission are more likely to transform into social entrepreneurial institutions. At the same time, currently, there is no clear understanding of what social entrepreneurship in higher education is about and thus social entrepreneurship in higher education needs to be studied and promoted at the same time. Main roles which socially oriented university can play in city development include: buyer (implementation of socially focused local procurement programs creates partnerships focused on local sustainable growth.); seller (centers created by universities can sell socially oriented goods and services, e.g. in consultancy.); employer (Universities can employ socially vulnerable groups.); business incubator (which will help current student to start their social enterprises). In the paper, we will analyze these in more detail. We will also examine a number of indicators that can be used to assess the impact, both direct and indirect, that universities can have on city's economy. At the same time, originality of this paper mainly lies not in methodological approaches used, but in countries evaluated. Social entrepreneurship is still treated as a relatively new phenomenon in post-transitional countries where social services were provided only by the state for many decades. Paper will provide data and example’s both from developed countries (the US and EU), and those located in CIS and CEE region.

Keywords: social enterprise, university, regional economic development, comparative study

Procedia PDF Downloads 228

Authors: Thaminda Liyanage, Chamila Shamika Kurukulasuriya

Abstract:

Introduction: Morbid obesity has been successfully treated with bariatric surgery for over 60 years. Although operative procedures have improved and associated complications have reduced substantially, surgery still carries the risk of post-operative malabsorption, malnutrition and a range of gastrointestinal disorders. Overweight by itself can impair libido in both sexes and cause erectile dysfunction in males by inducing a state of hypogonadotropic hypogonadism, proportional to the degree of obesity. Impact of weight reduction on libido and sexual activity remains controversial, however it is broadly accepted that weight loss improves sexual drive. Zinc deficiency, subsequent to malabsorption, may lead to impaired testosterone synthesis in men while excessive and/or rapid weight loss in females may result in reversible amenorrhoea leading to sub-fertility. Methods: We describe a 37 year old male, 6 years post Roux-en-Y gastric bypass surgery, who presented with erectile dysfunction, loss of libido, worsening fatigue and generalized weakness for 4 months. He also complained of constipation and frequent muscle cramps but denied having headache, vomiting or visual disturbances. Patient had lost 38 kg of body weight post gastric bypass surgery over four years {135kg (BMI 42.6 kg/m2) to 97 kg (BMI 30.6 kg/m2)} and the weight had been stable for past two years. He had no recognised co-morbidities at the time of the surgery and noted marked improvement in general wellbeing, physical fitness and psychological confident post surgery, up until four months before presentation. Clinical examination revealed dry pale skin with normal body hair distribution, no thyroid nodules or goitre, normal size testicles and normal neurological examination with no visual field defects or diplopia. He had low serum testosterone, follicular stimulating hormone (FSH), luteinizing hormone (LH), T3, T4, thyroid stimulating hormone (TSH), insulin like growth factor 1 (IGF-1) and 24-hour urine cortisol levels. Serum cortisol demonstrated an appropriate rise to ACTH stimulation test but growth hormone (GH) failed increase on insulin tolerance test. Other biochemical and haematological studies were normal, except for low zinc and folate with minimally raised liver enzymes. MRI scan of the head confirmed a solid pituitary mass with no mass effect on optic chiasm. Results: In this patient clinical, biochemical and radiological findings were consistent with anterior pituitary dysfunction. However, there were no features of raised intracranial pressure or neurological compromise. He was commenced on appropriate home replacement therapy and referred for neurosurgical evaluation. Patient reported marked improvement in his symptoms, specially libido and erectile dysfunction, on subsequent follow up visits. Conclusion: Sexual dysfunction coupled with non specific constitutional symptoms has multiple aetiologies. Clinical symptoms out of proportion to nutritional deficiencies post bariatric surgery should be thoroughly investigated. Close long term follow up is crucial for overall success.

Keywords: obesity, bariatric surgery, erectile dysfunction, loss of libido

Procedia PDF Downloads 265

Authors: Mitakshara Sharma, S. K. Nema, Sanjeev Narang

Abstract:

Diabetes mellitus (DM) is a group of metabolic disorders characterized by metabolic abnormalities, chronic hyperglycaemia and long term macrovascular & microvascular complications. Vascular complications are due to platelet hyperactivity and dysfunction, increased inflammation, altered coagulation and endothelial dysfunction. Large proportion of patients with Type II DM suffers from preventable vascular angiopathies, and there is need to develop risk factor modifications and interventions to reduce impact of complications. These complications are attributed to platelet activation, recognised by increase in Platelet Volume Indices (PVI) including Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW). The current study is prospective analytical study conducted over 2 years. Out of 1100 individuals, 930 individuals fulfilled inclusion criteria and were segregated into three groups on basis of glycosylated haemoglobin (HbA1C): - (a) Diabetic, (b) Non-Diabetic and (c) Subjects with Impaired fasting glucose (IFG) with 300 individuals in IFG and non-diabetic groups & 330 individuals in diabetic group. Further, diabetic group was divided into two groups on the basis of presence or absence of known diabetes related vascular complications. Samples for HbA1c and PVI were collected using Ethylene diamine tetraacetic acid (EDTA) as anticoagulant and processed on SYSMEX-X-800i autoanalyser. The study revealed gradual increase in PVI from non-diabetics to IFG to diabetics. PVI were markedly increased in diabetic patients. MPV and PDW of diabetics, IFG and non diabetics were (17.60 ± 2.04)fl, (11.76 ± 0.73)fl, (9.93 ± 0.64)fl and (19.17 ± 1.48)fl, (15.49 ± 0.67)fl, (10.59 ± 0.67)fl respectively with a significant p value 0.00 and a significant positive correlation (MPV-HbA1c r = 0.951; PDW-HbA1c r = 0.875). MPV & PDW of subjects with diabetes related complications were higher as compared to those without them and were (17.51±0.39)fl & (15.14 ± 1.04)fl and (20.09 ± 0.98) fl & (18.96 ± 0.83)fl respectively with a significant p value 0.00. There was a significant positive correlation between PVI and duration of diabetes across the groups (MPV-HbA1c r = 0.951; PDW-HbA1c r = 0.875). However, a significant negative correlation was found between glycaemic levels and total platelet count (PC- HbA1c r =-0.164). This is multi-parameter and comprehensive study with an adequately powered study design. It can be concluded from our study that PVI are extremely useful and important indicators of impending vascular complications in all patients with deranged glycaemic control. Introduction of automated cell counters has facilitated the availability of PVI as routine parameters. PVI is a useful means for identifying larger & active platelets which play important role in development of micro and macro angiopathic complications of diabetes leading to mortality and morbidity. PVI can be used as cost effective markers to predict and prevent impending vascular events in patients with Diabetes mellitus especially in developing countries like India. PVI, if incorporated into protocols for management of diabetes, could revolutionize care and curtail the ever increasing cost of patient management.

Keywords: diabetes, IFG, HbA1C, MPV, PDW, PVI

Procedia PDF Downloads 233

Authors: Zachary Cooper-Baldock, Paulo E. Santos, Russell S. A. Brinkworth, Karl Sammut

Abstract:

- In recent years, large unmanned underwater vehicles such as the Boeing Voyager and Anduril Ghost Shark have been developed. These vessels can be structured to contain onboard internal payload bays. These payload bays can serve a variety of purposes – including the launch and recovery (LAR) of smaller underwater vehicles. The LAR of smaller vessels is extremely important, as it enables transportation over greater distances, increased time on station, data transmission and operational safety. The larger vessel and its payload bay structure complicate the LAR of UUVs in contrast to static docks that are affixed to the seafloor, as they actively impact the local flow field. These flow field impacts require analysis to determine if UUV vessels can be safely launched and recovered inside the motherships. This research seeks to determine the hydrodynamic forces exerted on a vertically over-actuated, small, unmanned underwater vehicle (OUUV) during an internal LAR manoeuvre and compare this to an under-actuated vessel (UUUV). In this manoeuvre, the OUUV is navigated through the stern wake region of the larger vessel to a set point within the internal payload bay. The manoeuvre is simulated using ANSYS Fluent computational fluid dynamics models, covering the entire recovery of the OUUV and UUUV. The analysis of the OUUV is compared against the UUUV to determine the differences in the exerted forces. Of particular interest are the drag, pressure, turbulence and flow field effects exerted as the OUUV is driven inside the payload bay of the larger vessel. The hydrodynamic forces and flow field disturbances are used to determine the feasibility of making such an approach. From the simulations, it was determined that there was no significant detrimental physical forces, particularly with regard to turbulence. The flow field effects exerted by the OUUV are significant. The vertical thrusters exert significant wake structures, but their orientation ensures the wake effects are exerted below the UUV, minimising the impact. It was also seen that OUUV experiences higher drag forces compared to the UUUV, which will correlate to an increased energy expenditure. This investigation found no key indicators that recovery via a mothership payload bay was not feasible. The turbulence, drag and pressure phenomenon were of a similar magnitude to existing static and towed dock structures.

Keywords: underwater vehicles, submarine, autonomous underwater vehicles, auv, computational fluid dynamics, flow fields, pressure, turbulence, drag

Procedia PDF Downloads 47

Authors: Iulianna Taritsa, Kuldeep Neote, Eric Fossel

Abstract:

Lysosome-induced immunogenic cell death (LIICD) is a powerful mechanism of targeting cancer cells that kills circulating malignant cells and primes the host’s immune cells against future remission. Current immunotherapies for cancer are limited in preventing recurrence – a gap that can be bridged by training the immune system to recognize cancer neoantigens. Lysosomal leakage can be induced therapeutically to traffic antigens from dying cells to dendritic cells, which can later present those tumorigenic antigens to T cells. Previous research has shown that oxidative agents administered in the tumor microenvironment can initiate LIICD. We generated a fusion protein between an oxidative agent known as xanthine oxidase (XO) and a mini-antibody specific for EGFR/HER2-sensitive breast tumor cells. The anti-EGFR single domain antibody fragment is uniquely sourced from llama, which is functional without the presence of a light chain. These llama micro-antibodies have been shown to be better able to penetrate tissues and have improved physicochemical stability as compared to traditional monoclonal antibodies. We demonstrate that the fusion protein created is stable and can induce early markers of immunogenic cell death in an in vitro human breast cancer cell line (SkBr3). Specifically, we measured overall cell death, as well as surface-expressed calreticulin, extracellular ATP release, and HMGB1 production. These markers are consensus indicators of ICD. Flow cytometry, luminescence assays, and ELISA were used respectively to quantify biomarker levels between treated versus untreated cells. We also included a positive control group of SkBr3 cells dosed with doxorubicin (a known inducer of LIICD) and a negative control dosed with cisplatin (a known inducer of cell death, but not of the immunogenic variety). We looked at each marker at various time points after cancer cells were treated with the XO/antibody fusion protein, doxorubicin, and cisplatin. Upregulated biomarkers after treatment with the fusion protein indicate an immunogenic response. We thus show the potential for this fusion protein to induce an anticancer effect paired with an adaptive immune response against EGFR/HER2+ cells. Our research in human cell lines here provides evidence for the success of the same therapeutic method for patients and serves as the gateway to developing a new treatment approach against breast cancer.

Keywords: apoptosis, breast cancer, immunogenic cell death, lysosome

Procedia PDF Downloads 174

Authors: Roshni Raha, Kavya P., Gayathri M.

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India, with a humongous population, remains the world's poorest developing nation in terms of nutritional status, with iron deficiency anaemia (IDA) affecting the population. Despite efforts over the past decades, India's anaemia prevalence has not been reduced. Researchers are interested in developing therapies that will minimize the typical side effects of oral iron and optimize iron salts-based treatment through delivery methods based on the physiology of hepcidin regulation. However, they need to come up with iron therapies that will prevent making the infection worse. This article explores using bio-nanotechnology as the alternative, promising substitution of providing iron supplements for the treatment of diarrhoea and gut inflammation in kids and pregnant women. This article is an exploratory study using a literature survey and secondary research from review papers. In the realm of biotechnology, nanoparticles have become extremely famous due to unexpected variations in surface characteristics caused by particle size. Particle size distribution and shape exhibit unusual, enhanced characteristics when reduced to nanoscale. The article attempts to develop a model for a nanotechnology based solution in iron fortification to combat the problems of diarrhoea and gut inflammation. Certain dimensions that have been considered in the model include the size, shape, source, and biosynthesis of the iron nanoparticles. Another area of investigation addressed in the article is the cost-effective biocompatible production of these iron nanoparticles. Studies have demonstrated that a substantial reduction of metal ions to form nanoparticles from the bulk metal occurs in plants because of the presence of a wide diversity of biomolecules. Using this concept, the paper investigates the effectiveness and impact of how similar sources can be used for the biological synthesis of iron nanoparticles. Results showed that iron particles, when prepared in nano-metre size, offer potential advantages. When the particle size of the iron compound decreases and attains nano configuration, its surface area increases, which further improves its solubility in the gastric acid, leading to higher absorption, higher bioavailability, and producing the least organoleptic changes in food. It has no negative effects and possesses a safe, effective profile to reduce IDA. Considering all the parameters, it has been concluded that iron particles in nano configuration serve as alternative iron supplements for the complete treatment of IDA. Nanoparticles of ferric phosphate, ferric pyrophosphate, and iron oxide are the choices of iron supplements. From a sourcing perspective, the paper concludes green sources are the primary sources for the biological synthesis of iron nanoparticles. It will also be a cost-effective strategy since our goal is to treat the target population in rural India. Bio-nanotechnology serves as an alternative and promising substitution for iron supplements due to its low cost, excellent bioavailability, and strong organoleptic properties. One area of future research can be to explore the type of size and shape of iron nanoparticles that would be suitable for the different age groups of pregnant women and children and whether it would be influenced based on the topography in certain areas.

Keywords: anemia, bio-nanotechnology, iron-fortification, nanoparticle

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Authors: Baikuntha Prasad Acharya, Elizabeth Halpenny

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Small tourism enterprises (STEs) are primary providers of services and attractions in many destinations of less developed countries; they are considered the lifeblood of tourism sector. Furthermore, in rural community destinations of such countries including Nepal, STEs are regarded as alternative tools for advancing economic and sociocultural transformations. Many families in rural Nepali destinations are venturing into small tourism entrepreneurship so that their poverty can be reduced and they can live a sustained life. Most these communities are utilizing their lifestyles and natural and cultural heritages as tourism attractions. This study aimed to understand the sustainability of the STEs in rural destinations by synthesizing observations from Ghalegaon and Ghandruk of the Annapurna Conservation Area in western Nepal. Ghalegaon has community-based homestays and Ghandruk has independently owned and operated small tourism businesses such as cafes, tea houses, lodges, guest houses, and hotels, etc. The community-based homestays of Ghalegaon are compared with the independently owned and operated STEs of Ghandruk. The data were collected through multiple sources: 1) survey of tourists (n=112) and households (n=191); 2) interviews (n=14) with the locals, 3) group discussions (n=10) with different local groups including that of regional tourism players, experts and policy makers, 4) observations, and 5) document analysis. The STEs of both communities were first analyzed by understanding their level of sustainability as businesses, and then were explored how they were impacting on respective communities’ sustainability. The survey indicators and guidelines for interviews and group discussions were adapted to the Nepalese context based on four pillars of sustainability: economic, social, cultural and environmental; an additional dimension of management was also included, particularly for the STEs. The findings have shown a weaker economic and management dimensions of Ghalegaon’s Homestay than that of Ghandruk’s STEs. Some interesting social complexities of rural tourism and entrepreneurship were also revealed. This study’s findings do not much resonate to what Nepal government’s current rural tourism strategies that have been envisioned and prioritized for, particularly that the rural homestay tourism opportunities enhance inclusiveness of women and other deprived communities by spreading the benefits to the grassroots level. The study has highlighted several important applied implications to the local tourism management committees, tourism operators and associations, and regional and national tourism authorities. Further studies are advisable in other similar contexts in Nepal and in other countries to see whether there are variances in the findings.

Keywords: Nepal, rural tourism communities, small tourism enterprises, sustainability

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Authors: Marcelo T. Okano, Oduvaldo Vendrametto, Osmildo S. Santos, Marcelo E. Fernandes, Heide Landi

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Teaching of entrepreneurship and innovation in Brazilian universities has increased in recent years due to several factors such as the emergence of disciplines like biotechnology increased globalization reduced basic funding and new perspectives on the role of the university in the system of knowledge production Innovation is increasingly seen as an evolutionary process that involves different institutional spheres or sectors in society Entrepreneurship is a milestone on the road towards economic progress, and makes a huge contribution towards the quality and future hopes of a sector, economy or even a country. Entrepreneurship is as important in small and medium-sized enterprises (SMEs) and local markets as in large companies, and national and international markets, and is just as key a consideration for public companies as or private organizations. Entrepreneurship helps to encourage the competition in the current environment that leads to the effects of globalization. There is an increasing tendency for government policy to promote entrepreneurship for its apparent economic benefit. Accordingly, governments seek to employ entrepreneurship education as a means to stimulate increased levels of economic activity. Entrepreneurship education and training (EET) is growing rapidly in universities and colleges throughout the world, and governments are supporting it both directly and through funding major investments in advice-provision to would-be entrepreneurs and existing small businesses. The Triple Helix of university–industry–government relations is compared with alternative models for explaining the current research system in its social contexts. Communications and negotiations between institutional partners generate an overlay that increasingly reorganizes the underlying arrangements. To achieve the objective of this research was a survey of the literature on the entrepreneurship and innovation and then a field research with 100 students of Fatec. To collect the data needed for analysis, we used the exploratory research of a qualitative nature. We asked to respondents what degree of knowledge over ten related to entrepreneurship and innovation topics, responses were answered in a Likert scale with 4 levels, none, small, medium and large. We can conclude that the terms such as entrepreneurship and innovation are known by most students because the university propagates them across disciplines, lectures, and institutes innovation. The more specific items such as canvas and Design thinking model are unknown by most respondents. The importance of the University in teaching innovation and entrepreneurship in the transmission of this knowledge to the students in order to equalize the knowledge. As a future project, these items will be re-evaluated to create indicators for measuring the knowledge level.

Keywords: Brazilian universities, entrepreneurship, innovation, entrepreneurship, globalization

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Authors: Feng Yue, Fei Dai

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With the rapid development of urbanization process in China, its environmental protection pressure is severely tested. So, analyzing and optimizing the landscape pattern is an important measure to ease the pressure on the ecological environment. This paper takes Wuhan Urban Development Zone as the research object, and studies its landscape pattern evolution and quantitative optimization strategy. First, remote sensing image data from 1990 to 2015 were interpreted by using Erdas software. Next, the landscape pattern index of landscape level, class level, and patch level was studied based on Fragstats. Then five indicators of ecological environment based on National Environmental Protection Standard of China were selected to evaluate the impact of landscape pattern evolution on the ecological environment. Besides, the cost distance analysis of ArcGIS was applied to simulate wildlife migration thus indirectly measuring the improvement of ecological environment quality. The result shows that the area of land for construction increased 491%. But the bare land, sparse grassland, forest, farmland, water decreased 82%, 47%, 36%, 25% and 11% respectively. They were mainly converted into construction land. On landscape level, the change of landscape index all showed a downward trend. Number of patches (NP), Landscape shape index (LSI), Connection index (CONNECT), Shannon's diversity index (SHDI), Aggregation index (AI) separately decreased by 2778, 25.7, 0.042, 0.6, 29.2%, all of which indicated that the NP, the degree of aggregation and the landscape connectivity declined. On class level, the construction land and forest, CPLAND, TCA, AI and LSI ascended, but the Distribution Statistics Core Area (CORE_AM) decreased. As for farmland, water, sparse grassland, bare land, CPLAND, TCA and DIVISION, the Patch Density (PD) and LSI descended, yet the patch fragmentation and CORE_AM increased. On patch level, patch area, Patch perimeter, Shape index of water, farmland and bare land continued to decline. The three indexes of forest patches increased overall, sparse grassland decreased as a whole, and construction land increased. It is obvious that the urbanization greatly influenced the landscape evolution. Ecological diversity and landscape heterogeneity of ecological patches clearly dropped. The Habitat Quality Index continuously declined by 14%. Therefore, optimization strategy based on greenway network planning is raised for discussion. This paper contributes to the study of landscape pattern evolution in planning and design and to the research on spatial layout of urbanization.

Keywords: landscape pattern, optimization strategy, ArcGIS, Erdas, landscape metrics, landscape architecture

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