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Commenced in January 2007
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Edition: International
Paper Count: 496

Search results for: registered

46 Searching Knowledge for Engagement in a Worker Cooperative Society: A Proposal for Rethinking Premises

Authors: Soumya Rajan

Abstract:

While delving into the heart of any organization, the structural pre-requisites which form the framework of its system, allures and sometimes invokes great interest. In an attempt to understand the ecosystem of Knowledge that existed in organizations with diverse ownership and legal blueprints, Cooperative Societies, which form a crucial part of the neo-liberal movement in India, was studied. The exploration surprisingly led to the re-designing of at least a set of premises of the researcher on the drivers of engagement in an otherwise structured trade environment. The liberal organizational structure of Cooperative Societies has been empowered with certain terminologies: Voluntary, Democratic, Equality and Distributive Justice. To condense in Hubert Calvert’ words, ‘Co-operation is a form of organization wherein persons voluntarily associated together as human beings on the basis of equality for the promotion of the economic interest of themselves.’ In India, largely the institutions which work under this principle is registered under Cooperative Societies Act of the Central or State laws. A Worker Cooperative Society which originated as a movement in the state of Kerala and spread its wings across the country - Indian Coffee House was chosen as the enterprise for further inquiry for it being a living example and a highly successful working model in the designated space. The exploratory study reached out to employees and key stakeholders of Indian Coffee House to understand the nuances of the structure and the scope it provides for engagement. The key questions which formed shape in the mind of researcher while engaging in the inquiry were: How has the organization sustained despite its principle of accepting employees with no skills into employment and later training and empowering them? How can a system which has pre-independence and post-independence (independence here means the colonial independence from Great Britain) existence seek to engage employees within the premise of equality? How was the value of socialism ingrained in a commercial enterprise which has a turnover of several hundreds of Crores each year? How did the vision of a flat structure, way back in the 1940’s find its way into the organizational structure and has continued to remain as the way of life? These questions were addressed by the Case study research that ensued and placing Knowledge as the key premise, the possibilities of engagement of the organization man was pictured. Understanding that although the macro or holistic unit of analysis is the organization, it is pivotal to understand the structures and processes which best reflect on the actors. The embedded design which was adopted in this study delivered insights from the different stakeholder actors from diverse departments. While moving through variables which define and sometimes defy bounds in rationality, the study brought to light the inherent features of the organization structure and how it influences the actors who form a crucial part of the scheme of things. The research brought forth the key enablers for engagement and specifically explored the standpoint of knowledge in the larger structure of the Cooperative Society.

Keywords: knowledge, organizational structure, engagement, worker cooperative

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45 The Effect of Environmental Assessment Learning in Evacuation Centers on the COVID-19 Situation

Authors: Hiromi Kawasaki, Satoko Yamasaki, Mika Iwasa, Tomoko Iki, Akiko Takaki

Abstract:

In basic nursing, the conditions necessary for maintaining human health -temperature, humidity, illumination, distance from others, noise, moisture, meals, and excretion- were explained. Nursing students often think of these conditions in the context of a hospital room. In order to make students think of these conditions in terms of an environment necessary for maintaining health and preventing illness for residents, in the third year of community health nursing, students learned how to assess and improve the environment -particularly via the case of shelters in the event of a disaster. The importance of environmental management has increased in 2020 as a preventive measure against COVID-19 infection. We verified the effect of the lessons, which was decided to be conducted through distance learning. Sixty third-year nursing college students consented to participate in this study. Environmental standard knowledge for conducting environmental assessment was examined before and after class, and the percentage of correct answers was compared. The χ² test was used for the test, with a 5% significance level employed. Measures were evaluated via a report submitted by the students after class. Student descriptions were analyzed both qualitatively and descriptively with respect to expected health problems and suggestions for improvement. Students have already learned about the environment in terms of basic nursing in their second year. The correct answers for external environmental values concerning interpersonal distance, illumination, noise, and room temperature (p < 0.001) increased significantly after taking the class. Humidity was registered 83.3% before class and 93.3% after class (p = 0.077). Regarding the body, the percentage of students who answered correctly was 70% or more, both before and after the class. The students’ reports included overcrowding, high humidity/high temperature, and the number of toilets as health hazards. Health disorders to be prevented were heat stroke, infectious diseases, and economy class syndrome; improvement methods were recommended for hyperventilation, stretching, hydration, and waiting at home. After the public health nursing class, the students were able to not only propose environmental management of a hospital room but also had an understanding of the environment in terms of the lives of individuals, environmental assessment, and solutions to health problems. The response rate for basic items learned in the second year was already high before and after class, and interpersonal distance and ventilation were described by students. Students were able to use what they learned in basic nursing about the standards of the human mind and body. In the external environment, the memory of specific numerical values was ambiguous. The environment of the hospital room is controlled, and interest in numerical values may decrease. Nursing staff needs to maintain and improve human health as well as hospital rooms. With COVID-19, it was thought that students would continue to not only consider this point in reference to hospital rooms but also in regard to places where people gather. Even in distance learning, students were able to learn the important issues and lessons.

Keywords: environmental assessment, evacuation center, nursing education, nursing students

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44 Reconstruction of Signal in Plastic Scintillator of PET Using Tikhonov Regularization

Authors: L. Raczynski, P. Moskal, P. Kowalski, W. Wislicki, T. Bednarski, P. Bialas, E. Czerwinski, A. Gajos, L. Kaplon, A. Kochanowski, G. Korcyl, J. Kowal, T. Kozik, W. Krzemien, E. Kubicz, Sz. Niedzwiecki, M. Palka, Z. Rudy, O. Rundel, P. Salabura, N.G. Sharma, M. Silarski, A. Slomski, J. Smyrski, A. Strzelecki, A. Wieczorek, M. Zielinski, N. Zon

Abstract:

The J-PET scanner, which allows for single bed imaging of the whole human body, is currently under development at the Jagiellonian University. The J-PET detector improves the TOF resolution due to the use of fast plastic scintillators. Since registration of the waveform of signals with duration times of few nanoseconds is not feasible, a novel front-end electronics allowing for sampling in a voltage domain at four thresholds was developed. To take fully advantage of these fast signals a novel scheme of recovery of the waveform of the signal, based on ideas from the Tikhonov regularization (TR) and Compressive Sensing methods, is presented. The prior distribution of sparse representation is evaluated based on the linear transformation of the training set of waveform of the signals by using the Principal Component Analysis (PCA) decomposition. Beside the advantage of including the additional information from training signals, a further benefit of the TR approach is that the problem of signal recovery has an optimal solution which can be determined explicitly. Moreover, from the Bayes theory the properties of regularized solution, especially its covariance matrix, may be easily derived. This step is crucial to introduce and prove the formula for calculations of the signal recovery error. It has been proven that an average recovery error is approximately inversely proportional to the number of samples at voltage levels. The method is tested using signals registered by means of the single detection module of the J-PET detector built out from the 30 cm long BC-420 plastic scintillator strip. It is demonstrated that the experimental and theoretical functions describing the recovery errors in the J-PET scenario are largely consistent. The specificity and limitations of the signal recovery method in this application are discussed. It is shown that the PCA basis offers high level of information compression and an accurate recovery with just eight samples, from four voltage levels, for each signal waveform. Moreover, it is demonstrated that using the recovered waveform of the signals, instead of samples at four voltage levels alone, improves the spatial resolution of the hit position reconstruction. The experiment shows that spatial resolution evaluated based on information from four voltage levels, without a recovery of the waveform of the signal, is equal to 1.05 cm. After the application of an information from four voltage levels to the recovery of the signal waveform, the spatial resolution is improved to 0.94 cm. Moreover, the obtained result is only slightly worse than the one evaluated using the original raw-signal. The spatial resolution calculated under these conditions is equal to 0.93 cm. It is very important information since, limiting the number of threshold levels in the electronic devices to four, leads to significant reduction of the overall cost of the scanner. The developed recovery scheme is general and may be incorporated in any other investigation where a prior knowledge about the signals of interest may be utilized.

Keywords: plastic scintillators, positron emission tomography, statistical analysis, tikhonov regularization

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43 From Forked Tongues to Tinkerbell Ears: Rethinking the Criminalization of Alternative Body Modification in the UK

Authors: Luci V. Hyett

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The criminal law of England and Wales currently deems that a person cannot consent to the infliction of injury upon their own body, where the level of harm is considered to be Actual or Grevious. This renders the defence of consent of the victim as being unavailable to those persons carrying out an Alternative Body Modification procedure. However, the criminalization of consensual injury is more appropriately deemed as being categorized as an offense against public morality and not one against the person, which renders the State’s involvement in the autonomous choices of a consenting adult, when determining what can be done to one’s own body, an arbitrary one. Furthermore, to recognise in law that a person is capable of giving a valid consent to socially acceptable cosmetic interventions that largely consist of procedures designed to aesthetically please men and, not those of people who want to modify their bodies for other reasons means that patriarchal attitudes are continuing to underpin public repulsion and inhibit social acceptance of such practices. Theoretical analysis will begin with a juridical examination of R v M(B) [2019] QB 1 where the High Court determined that Alternative Body Modification was not a special category exempting a person so performing from liability for Grevious Bodily Harm using the defence of consent. It will draw from its reasoning which considered that ‘the removal of body parts were medical procedures being carried out for no medical reason by someone not qualified to carry them out’ which will form the basis of this enquiry. It will consider the philosophical work of Georgio Agamben when analysing whether the biopolitical climate in the UK, which places the optimization of the perfect, healthy body at the centre of political concern can explain why those persons who wish to engage in Alternative Body Modification are treated as the ‘Exception’ to that which is normal using the ‘no medical reason’ canon to justify criminalisation, rather than legitimising the industry through regulation. It will consider, through a feminist lens, the current conflict in law between traditional cosmetic interventions which alter one’s physical appearance for socially accepted aesthetic purposes such as those to the breast, lip and buttock and, modifications described as more outlandish such as earlobe stretching, tooth filing and transdermal implants to create horns and spikes under the skin. It will assert that ethical principles relating to the psychological impact of body modification described as ‘alternative’ is used as a means to exclude person’s seeking such a procedure from receiving safe and competent treatment via a registered cosmetic surgeon which leads to these increasingly popular surgery’s being performed in Tattoo parlours throughout the UK as an extension to other socially acceptable forms of self-modification such as piercings. It will contend that only by ‘inclusive exclusion’ will those ‘othered’ through ostracisation be welcomed into the fold of normality and this can only be achieved through recognition of alternative body modification as a legitimate cosmetic intervention, subject to the same regulatory framework as existing practice. This would assist in refocusing the political landscape by erring on the side of liberty rather than that of biology.

Keywords: biopolitics, body modification, consent, criminal law

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42 Analytical, Numerical, and Experimental Research Approaches to Influence of Vibrations on Hydroelastic Processes in Centrifugal Pumps

Authors: Dinara F. Gaynutdinova, Vladimir Ya Modorsky, Nikolay A. Shevelev

Abstract:

The problem under research is that of unpredictable modes occurring in two-stage centrifugal hydraulic pump as a result of hydraulic processes caused by vibrations of structural components. Numerical, analytical and experimental approaches are considered. A hypothesis was developed that the problem of unpredictable pressure decrease at the second stage of centrifugal pumps is caused by cavitation effects occurring upon vibration. The problem has been studied experimentally and theoretically as of today. The theoretical study was conducted numerically and analytically. Hydroelastic processes in dynamic “liquid – deformed structure” system were numerically modelled and analysed. Using ANSYS CFX program engineering analysis complex and computing capacity of a supercomputer the cavitation parameters were established to depend on vibration parameters. An influence domain of amplitudes and vibration frequencies on concentration of cavitation bubbles was formulated. The obtained numerical solution was verified using CFM program package developed in PNRPU. The package is based on a differential equation system in hyperbolic and elliptic partial derivatives. The system is solved by using one of finite-difference method options – the particle-in-cell method. The method defines the problem solution algorithm. The obtained numerical solution was verified analytically by model problem calculations with the use of known analytical solutions of in-pipe piston movement and cantilever rod end face impact. An infrastructure consisting of an experimental fast hydro-dynamic processes research installation and a supercomputer connected by a high-speed network, was created to verify the obtained numerical solutions. Physical experiments included measurement, record, processing and analysis of data for fast processes research by using National Instrument signals measurement system and Lab View software. The model chamber end face oscillated during physical experiments and, thus, loaded the hydraulic volume. The loading frequency varied from 0 to 5 kHz. The length of the operating chamber varied from 0.4 to 1.0 m. Additional loads weighed from 2 to 10 kg. The liquid column varied from 0.4 to 1 m high. Liquid pressure history was registered. The experiment showed dependence of forced system oscillation amplitude on loading frequency at various values: operating chamber geometrical dimensions, liquid column height and structure weight. Maximum pressure oscillation (in the basic variant) amplitudes were discovered at loading frequencies of approximately 1,5 kHz. These results match the analytical and numerical solutions in ANSYS and CFM.

Keywords: computing experiment, hydroelasticity, physical experiment, vibration

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41 Clinical and Analytical Performance of Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase L1 Biomarkers for Traumatic Brain Injury in the Alinity Traumatic Brain Injury Test

Authors: Raj Chandran, Saul Datwyler, Jaime Marino, Daniel West, Karla Grasso, Adam Buss, Hina Syed, Zina Al Sahouri, Jennifer Yen, Krista Caudle, Beth McQuiston

Abstract:

The Alinity i TBI test is Therapeutic Goods Administration (TGA) registered and is a panel of in vitro diagnostic chemiluminescent microparticle immunoassays for the measurement of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) in plasma and serum. The Alinity i TBI performance was evaluated in a multi-center pivotal study to demonstrate the capability to assist in determining the need for a CT scan of the head in adult subjects (age 18+) presenting with suspected mild TBI (traumatic brain injury) with a Glasgow Coma Scale score of 13 to 15. TBI has been recognized as an important cause of death and disability and is a growing public health problem. An estimated 69 million people globally experience a TBI annually1. Blood-based biomarkers such as glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) have shown utility to predict acute traumatic intracranial injury on head CT scans after TBI. A pivotal study using prospectively collected archived (frozen) plasma specimens was conducted to establish the clinical performance of the TBI test on the Alinity i system. The specimens were originally collected in a prospective, multi-center clinical study. Testing of the specimens was performed at three clinical sites in the United States. Performance characteristics such as detection limits, imprecision, linearity, measuring interval, expected values, and interferences were established following Clinical and Laboratory Standards Institute (CLSI) guidance. Of the 1899 mild TBI subjects, 120 had positive head CT scan results; 116 of the 120 specimens had a positive TBI interpretation (Sensitivity 96.7%; 95% CI: 91.7%, 98.7%). Of the 1779 subjects with negative CT scan results, 713 had a negative TBI interpretation (Specificity 40.1%; 95% CI: 37.8, 42.4). The negative predictive value (NPV) of the test was 99.4% (713/717, 95% CI: 98.6%, 99.8%). The analytical measuring interval (AMI) extends from the limit of quantitation (LoQ) to the upper LoQ and is determined by the range that demonstrates acceptable performance for linearity, imprecision, and bias. The AMI is 6.1 to 42,000 pg/mL for GFAP and 26.3 to 25,000 pg/mL for UCH-L1. Overall, within-laboratory imprecision (20 day) ranged from 3.7 to 5.9% CV for GFAP and 3.0 to 6.0% CV for UCH-L1, when including lot and instrument variances. The Alinity i TBI clinical performance results demonstrated high sensitivity and high NPV, supporting the utility to assist in determining the need for a head CT scan in subjects presenting to the emergency department with suspected mild TBI. The GFAP and UCH-L1 assays show robust analytical performance across a broad concentration range of GFAP and UCH-L1 and may serve as a valuable tool to help evaluate TBI patients across the spectrum of mild to severe injury.

Keywords: biomarker, diagnostic, neurology, TBI

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40 Mixing Students: an Educational Experience with Future Industrial Designers and Mechanical Engineers

Authors: J. Lino Alves, L. Lopes

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It is not new that industrial design projects are a result of cooperative work from different areas of knowledge. However, in the academic teaching of Industrial Design and Mechanical Engineering courses, it is not recurrent that those competences are mixed before the professional life arrives. This abstract intends to describe two semester experiences carried out by two professors - a mechanical engineer and an industrial designer - in the last two academic years, for which they created mixed teams of Industrial Design and Mechanical Engineering (UPorto University). The two experiences differ in several factors; the main one is related to the challenges of online education, a constraint that affected the second experience. In the first year, even before foreseeing the effects that the pandemic would reconfigure the education system, a partnership with the Education Service of Águas do Porto was established. The purpose of the exercise was the project development of a game that could be an interaction element oriented to potentiate a positive experience and as an educational contribution to the children. In the second year, already foreseeing that the teaching experience would be carried out online, it was decided to design an open briefing, which allowed the groups to choose among three themes: a hand scale game using additive manufacturing; a modular system for ventilated facade using a parametric design basis; or, a modular system for vertical gardens. In methodological terms, besides the weekly follow-up, with the simultaneous support of the two professors, a group self-evaluation was requested; and a form to be filled individually to evaluate other groups. One of the first conclusions is related to the briefing format. Industrial Design students seem comfortable working on an open briefing that allows them to draw the project on a conceptual basis created for that purpose; on the other hand, Mechanical Engineering students were uncomfortable and insecure in the initial phase due to the absence of concrete, closed "order." In other words, it is not recurrent for Mechanical Engineering students that the creative component is stimulated, seemingly leaving them reserved to the technical solution and execution, depriving them of the co-creation phase during the conceptual construction of the project's own brief. Another fact that was registered is related to the leadership positions in the groups, which alternated according to the state of development of the project: design students took the lead during the ideation/concept phase, while mechanical engineering ones took a greater lead during the intermediate development process, namely in the definition of constructive solutions, mass/volume calculations, manufacturing, and material resistance. Designers' competences were again more evident and assumed in the final phase, especially in communication skills, as well as in simulations in the context of use. However, at some moments, it was visible the capacity for quite balanced leadership between engineering and design, in a constant debate centered on the human factor of the project - evidenced in the final solution, in the compromise and balance between technical constraints, functionality, usability, and aesthetics.

Keywords: education, industrial design, mechanical engineering, teaching ethodologies

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39 Computer Based Identification of Possible Molecular Targets for Induction of Drug Resistance Reversion in Multidrug Resistant Mycobacterium Tuberculosis

Authors: Oleg Reva, Ilya Korotetskiy, Marina Lankina, Murat Kulmanov, Aleksandr Ilin

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Molecular docking approaches are widely used for design of new antibiotics and modeling of antibacterial activities of numerous ligands which bind specifically to active centers of indispensable enzymes and/or key signaling proteins of pathogens. Widespread drug resistance among pathogenic microorganisms calls for development of new antibiotics specifically targeting important metabolic and information pathways. A generally recognized problem is that almost all molecular targets have been identified already and it is getting more and more difficult to design innovative antibacterial compounds to combat the drug resistance. A promising way to overcome the drug resistance problem is an induction of reversion of drug resistance by supplementary medicines to improve the efficacy of the conventional antibiotics. In contrast to well established computer-based drug design, modeling of drug resistance reversion still is in its infancy. In this work, we proposed an approach to identification of compensatory genetic variants reducing the fitness cost associated with the acquisition of drug resistance by pathogenic bacteria. The approach was based on an analysis of the population genetic of Mycobacterium tuberculosis and on results of experimental modeling of the drug resistance reversion induced by a new anti-tuberculosis drug FS-1. The latter drug is an iodine-containing nanomolecular complex that passed clinical trials and was admitted as a new medicine against MDR-TB in Kazakhstan. Isolates of M. tuberculosis obtained on different stages of the clinical trials and also from laboratory animals infected with MDR-TB strain were characterized by antibiotic resistance, and their genomes were sequenced by the paired-end Illumina HiSeq 2000 technology. A steady increase in sensitivity to conventional anti-tuberculosis antibiotics in series of isolated treated with FS-1 was registered despite the fact that the canonical drug resistance mutations identified in the genomes of these isolates remained intact. It was hypothesized that the drug resistance phenotype in M. tuberculosis requires an adjustment of activities of many genes to compensate the fitness cost of the drug resistance mutations. FS-1 cased an aggravation of the fitness cost and removal of the drug-resistant variants of M. tuberculosis from the population. This process caused a significant increase in genetic heterogeneity of the Mtb population that was not observed in the positive and negative controls (infected laboratory animals left untreated and treated solely with the antibiotics). A large-scale search for linkage disequilibrium associations between the drug resistance mutations and genetic variants in other genomic loci allowed identification of target proteins, which could be influenced by supplementary drugs to increase the fitness cost of the drug resistance and deprive the drug-resistant bacterial variants of their competitiveness in the population. The approach will be used to improve the efficacy of FS-1 and also for computer-based design of new drugs to combat drug-resistant infections.

Keywords: complete genome sequencing, computational modeling, drug resistance reversion, Mycobacterium tuberculosis

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38 Solar Power Forecasting for the Bidding Zones of the Italian Electricity Market with an Analog Ensemble Approach

Authors: Elena Collino, Dario A. Ronzio, Goffredo Decimi, Maurizio Riva

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The rapid increase of renewable energy in Italy is led by wind and solar installations. The 2017 Italian energy strategy foresees a further development of these sustainable technologies, especially solar. This fact has resulted in new opportunities, challenges, and different problems to deal with. The growth of renewables allows to meet the European requirements regarding energy and environmental policy, but these types of sources are difficult to manage because they are intermittent and non-programmable. Operationally, these characteristics can lead to instability on the voltage profile and increasing uncertainty on energy reserve scheduling. The increasing renewable production must be considered with more and more attention especially by the Transmission System Operator (TSO). The TSO, in fact, every day provides orders on energy dispatch, once the market outcome has been determined, on extended areas, defined mainly on the basis of power transmission limitations. In Italy, six market zone are defined: Northern-Italy, Central-Northern Italy, Central-Southern Italy, Southern Italy, Sardinia, and Sicily. An accurate hourly renewable power forecasting for the day-ahead on these extended areas brings an improvement both in terms of dispatching and reserve management. In this study, an operational forecasting tool of the hourly solar output for the six Italian market zones is presented, and the performance is analysed. The implementation is carried out by means of a numerical weather prediction model, coupled with a statistical post-processing in order to derive the power forecast on the basis of the meteorological projection. The weather forecast is obtained from the limited area model RAMS on the Italian territory, initialized with IFS-ECMWF boundary conditions. The post-processing calculates the solar power production with the Analog Ensemble technique (AN). This statistical approach forecasts the production using a probability distribution of the measured production registered in the past when the weather scenario looked very similar to the forecasted one. The similarity is evaluated for the components of the solar radiation: global (GHI), diffuse (DIF) and direct normal (DNI) irradiation, together with the corresponding azimuth and zenith solar angles. These are, in fact, the main factors that affect the solar production. Considering that the AN performance is strictly related to the length and quality of the historical data a training period of more than one year has been used. The training set is made by historical Numerical Weather Prediction (NWP) forecasts at 12 UTC for the GHI, DIF and DNI variables over the Italian territory together with corresponding hourly measured production for each of the six zones. The AN technique makes it possible to estimate the aggregate solar production in the area, without information about the technologic characteristics of the all solar parks present in each area. Besides, this information is often only partially available. Every day, the hourly solar power forecast for the six Italian market zones is made publicly available through a website.

Keywords: analog ensemble, electricity market, PV forecast, solar energy

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37 Contrastive Analysis of Parameters Registered in Training Rowers and the Impact on the Olympic Performance

Authors: Gheorghe Braniste

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The management of the training process in sports is closely related to the awareness of the close connection between performance and the morphological, functional and psychological characteristics of the athlete's body. Achieving high results in Olympic sports is influenced, on the one hand, by the genetically determined characteristics of the body and, on the other hand, by the morphological, functional and motor abilities of the athlete. Taking into account the importance of properly understanding the evolutionary specificity of athletes to assess their competitive potential, this study provides a comparative analysis of the parameters that characterize the growth and development of the level of adaptation of sweeping rowers, considering the growth interval between 12 and 20 years. The study established that, in the multi-annual training process, the bodies of the targeted athletes register significant adaptive changes while analyzing parameters of the morphological, functional, psychomotor and sports-technical spheres. As a result of the influence of physical efforts, both specific and non-specific, there is an increase in the adaptability of the body, its transfer to a much higher level of functionality within the parameters, useful and economical adaptive reactions influenced by environmental factors, be they internal or external. The research was carried out for 7 years, on a group of 28 athletes, following their evolution and recording the specific parameters of each age stage. In order to determine the level of physical, morpho-functional, psychomotor development and technical training of rowers, the screening data were applied at the State University of Physical Education and Sports in the Republic of Moldova. During the research, measurements were made on the waist, in the standing and sitting position, arm span, weight, circumference and chest perimeter, vital capacity of the lungs, with the subsequent determination of the vital index (tolerance level to oxygen deficiency in venous blood in Stange and Genchi breath-taking tests that characterize the level of oxygen saturation, absolute and relative strength of the hand and back, calculation of body mass and morphological maturity indices (Kettle index), body surface area (body gait), psychomotor tests (Romberg test), test-tepping 10 s., reaction to a moving object, visual and auditory-motor reaction, recording of technical parameters of rowing on a competitive distance of 200 m. At the end of the study it was found that highly performance is sports is to be associated on the one hand with the genetically determined characteristics of the body and, on the other hand, with favorable adaptive reactions and energy saving, as well as morphofunctional changes influenced by internal and external environmental factors. The importance of the results obtained at the end of the study was positively reflected in obtaining the maximum level of training of athletes in order to demonstrate performance in large-scale competitions and mostly in the Olympic Games.

Keywords: olympics, parameters, performance, peak

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36 Pushover Analysis of a Typical Bridge Built in Central Zone of Mexico

Authors: Arturo Galvan, Jatziri Y. Moreno-Martinez, Daniel Arroyo-Montoya, Jose M. Gutierrez-Villalobos

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Bridges are one of the most seismically vulnerable structures on highway transportation systems. The general process for assessing the seismic vulnerability of a bridge involves the evaluation of its overall capacity and demand. One of the most common procedures to obtain this capacity is by means of pushover analysis of the structure. Typically, the bridge capacity is assessed using non-linear static methods or non-linear dynamic analyses. The non-linear dynamic approaches use step by step numerical solutions for assessing the capacity with the consuming computer time inconvenience. In this study, a nonlinear static analysis (‘pushover analysis’) was performed to predict the collapse mechanism of a typical bridge built in the central zone of Mexico (Celaya, Guanajuato). The bridge superstructure consists of three simple supported spans with a total length of 76 m: 22 m of the length of extreme spans and 32 m of length of the central span. The deck width is of 14 m and the concrete slab depth is of 18 cm. The bridge is built by means of frames of five piers with hollow box-shaped sections. The dimensions of these piers are 7.05 m height and 1.20 m diameter. The numerical model was created using a commercial software considering linear and non-linear elements. In all cases, the piers were represented by frame type elements with geometrical properties obtained from the structural project and construction drawings of the bridge. The deck was modeled with a mesh of rectangular thin shell (plate bending and stretching) finite elements. The moment-curvature analysis was performed for the sections of the piers of the bridge considering in each pier the effect of confined concrete and its reinforcing steel. In this way, plastic hinges were defined on the base of the piers to carry out the pushover analysis. In addition, time history analyses were performed using 19 accelerograms of real earthquakes that have been registered in Guanajuato. In this way, the displacements produced by the bridge were determined. Finally, pushover analysis was applied through the control of displacements in the piers to obtain the overall capacity of the bridge before the failure occurs. It was concluded that the lateral deformation of the piers due to a critical earthquake occurred in this zone is almost imperceptible due to the geometry and reinforcement demanded by the current design standards and compared to its displacement capacity, they were excessive. According to the analysis, it was found that the frames built with five piers increase the rigidity in the transverse direction of the bridge. Hence it is proposed to reduce these frames of five piers to three piers, maintaining the same geometrical characteristics and the same reinforcement in each pier. Also, the mechanical properties of materials (concrete and reinforcing steel) were maintained. Once a pushover analysis was performed considering this configuration, it was concluded that the bridge would continue having a “correct” seismic behavior, at least for the 19 accelerograms considered in this study. In this way, costs in material, construction, time and labor would be reduced in this study case.

Keywords: collapse mechanism, moment-curvature analysis, overall capacity, push-over analysis

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35 Antiinflammatory and Wound Healing Activity of Sedum Essential Oils Growing in Kazakhstan

Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

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The last decade the growth of severe and disseminated forms of inflammatory diseases is observed in Kazakhstan, in particular, septic shock, which progresses on 3-15% of patients with infectious complications of postnatal period. In terms of the rate of occurrence septic shock takes third place after hemorrhagic and cardiovascular shock, in terms of lethality it takes first place. The structure of obstetric sepsis has significantly changed. Currently the first place is taken by postabortive sepsis (40%) that is connected with usage of imperfect methods of artificial termination of pregnancy in late periods (intraamnial injection of sodium chloride, glucose). The second place is taken by postnatal sepsis (32%); the last place is taken by septic complications of caesarean section (28%). In this connection, search for and assessment of effectiveness of new medicines for treatment of postoperative infectious complications, having biostimulating effect and speeding up regeneration processes, is very promising and topical. Essential oil was obtained by the method hydrodistillation air-dry aerial part of Sedum L. plants using Clevenger apparatus. Pilot batch of plant medicinal product based on Sedum essential oils was produced by Chimpharm JSC, Santo Member of Polpharma Group (Kazakhstan). During clinical test of the plant medicinal product based on Sedum L. essential oils 37 female patients at the age from 35 to 57 with clinical signs of complicated postoperative processes and 12 new mothers with clinical signs of inflammatory process on sutures on anterior abdominal wall after caesarean section and partial disruption of surgical suture line on perineum were examined. Medicine usage methods - surgical wound treatment 2 times a day, treatment with other medicines of local action was not performed. Before and after treatment general clinical test, determination of immune status, bacterioscopic test of wound fluid was performed to all women, medical history data was taken into account, wound cleansing and healing time, full granulations, side effects and complications, satisfaction with the used medicine was assessed. On female patients with inflammatory infiltration and partial disruption of surgical suture line anesthetic wound healing effect of plant medicinal product based on Sedum L. essential oils was observed as early as on the second day after beginning of using it, wound cleansing took place, as a rule, within the first row days. Hyperemia in the area of suture line also was not observed for 2-3-d day of usage of medicine, good constant course was observed. The absence of clinical effect on this group of patients was not registered. The represented data give evidence of that clinical effect was accompanied with normalization of changed laboratory findings. No allergic responses or side effects were observed during usage of the plant medicinal products based on Sedum L. essential oils.

Keywords: antiinflammatory, bioactive substances, essential oils, isolation, sedum L., wound healing

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34 Bridging the Gap between Teaching and Learning: A 3-S (Strength, Stamina, Speed) Model for Medical Education

Authors: Mangala. Sadasivan, Mary Hughes, Bryan Kelly

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Medical Education must focus on bridging the gap between teaching and learning when training pre-clinical year students in skills needed to keep up with medical knowledge and to meet the demands of health care in the future. The authors were interested in showing that a 3-S Model (building strength, developing stamina, and increasing speed) using a bridged curriculum design helps connect teaching and learning and improves students’ retention of basic science and clinical knowledge. The authors designed three learning modules using the 3-S Model within a systems course in a pre-clerkship medical curriculum. Each module focused on a bridge (concept map) designed by the instructor for specific content delivered to students in the course. This with-in-subjects design study included 304 registered MSU osteopathic medical students (3 campuses) ranked by quintile based on previous coursework. The instructors used the bridge to create self-directed learning exercises (building strength) to help students master basic science content. Students were video coached on how to complete assignments, and given pre-tests and post-tests designed to give them control to assess and identify gaps in learning and strengthen connections. The instructor who designed the modules also used video lectures to help students master clinical concepts and link them (building stamina) to previously learned material connected to the bridge. Boardstyle practice questions relevant to the modules were used to help students improve access (increasing speed) to stored content. Unit Examinations covering the content within modules and materials covered by other instructors teaching within the units served as outcome measures in this study. This data was then compared to each student’s performance on a final comprehensive exam and their COMLEX medical board examinations taken some time after the course. The authors used mean comparisons to evaluate students’ performances on module items (using 3-S Model) to non-module items on unit exams, final course exam and COMLEX medical board examination. The data shows that on average, students performed significantly better on module items compared to non-module items on exams 1 and 2. The module 3 exam was canceled due to a university shut down. The difference in mean scores (module verses non-module) items disappeared on the final comprehensive exam which was rescheduled once the university resumed session. Based on Quintile designation, the mean scores were higher for module items than non-module items and the difference in scores between items for Quintiles 1 and 2 were significantly better on exam 1 and the gap widened for all Quintile groups on exam 2 and disappeared in exam 3. Based on COMLEX performance, all students on average as a group, whether they Passed or Failed, performed better on Module items than non-module items in all three exams. The gap between scores of module items for students who passed COMLEX to those who failed was greater on Exam 1 (14.3) than on Exam 2 (7.5) and Exam 3 (10.2). Data shows the 3-S Model using a bridge effectively connects teaching and learning

Keywords: bridging gap, medical education, teaching and learning, model of learning

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33 Abdominal Exercises Can Modify Abdominal Function in Postpartum Women: A Randomized Control Trial Comparing Curl-up to Drawing-in Combined With Diaphragmatic Aspiration

Authors: Yollande Sènan Djivoh, Dominique de Jaeger

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Background: Abdominal exercises are commonly practised nowadays. Specific techniques of abdominal muscles strengthening like hypopressive exercises have recently emerged and their practice is encouraged against the practice of Curl-up especially in postpartum. The acute and the training effects of these exercises did not allow to advise one exercise to the detriment of another. However, physiotherapists remain reluctant to perform Curl-up with postpartum women because of its potential harmful effect on the pelvic floor. Design: This study was a randomized control trial registered under the number PACTR202110679363984. Objective: to observe the training effect of two experimental protocols (Curl-up versus Drawing-in+Diaphragmatic aspiration) on the abdominal wall (interrecti distance, rectus and transversus abdominis thickness, abdominal strength) in Beninese postpartum women. Pelvic floor function (tone, endurance, urinary incontinence) will be assessed to evaluate potential side effects of exercises on the pelvic floor. Method: Postpartum women diagnosed with diastasis recti were randomly assigned to one of three groups (Curl-up, Drawingin+Diaphragmatic aspiration and control). Abdominal and pelvic floor parameters were assessed before and at the end of the 6-week protocol. The interrecti distance and the abdominal muscles thickness were assessed by ultrasound and abdominal strength by dynamometer. Pelvic floor tone and strength were assessed with Biofeedback and urinary incontinence was quantified by pad test. To compare the results between the three groups and the two measurements, a two-way Anova test with repeated measures was used (p<0.05). When interaction was significant, a posthoc using Student t test, with Bonferroni correction, was used to compare the three groups regarding the difference (end value minus initial value). To complete these results, a paired Student t test was used to compare in each group the initial and end values. Results: Fifty-eight women participated in this study, divided in three groups with similar characteristics regarding their age (29±5 years), parity (2±1 children), BMI (26±4 kg/m2 ), time since the last birth (10±2 weeks), weight of their baby at birth (330±50 grams). Time effect and interaction were significant (p<0.001) for all abdominal parameters. Experimental groups improved more than control group. Curl-up group improved more (p=0.001) than Drawing-in+Diaphragmatic aspiration group regarding the interrecti distance (9.3±4.2 mm versus 6.6±4.6 mm) and abdominal strength (20.4±16.4 Newton versus 11.4±12.8 Newton). Drawingin+Diaphragmatic aspiration group improved (0.8±0.7 mm) more than Curl-up group (0.5±0.7 mm) regarding the transversus abdominis thickness (p=0.001). Only Curl-up group improved (p<0.001) the rectus abdominis thickness (1.5±1.2 mm). For pelvic floor parameters, both experimental groups improved (p=0.01) except for tone which improved (p=0.03) only in Drawing-in+Diaphragmatic aspiration group from 19.9±4.1 cmH2O to 22.2±4.5 cmH2O. Conclusion: Curl-up was more efficient to improve abdominal function than Drawingin+Diaphragmatic aspiration. However, these exercises are complementary. None of them degraded the pelvic floor, but Drawing-in+Diaphragmatic aspiration improved further the pelvic floor function. Clinical implications: Curl-up, Drawing-in and Diaphragmatic aspiration can be used for the management of abdominal function in postpartum women. Exercises must be chosen considering the specific needs of each woman’s abdominal and pelvic floor function.

Keywords: curl-up, drawing-in, diaphragmatic aspiration, hypopressive exercise, postpartum women

Procedia PDF Downloads 54
32 Urban Enclaves Caused by Migration: Little Aleppo in Ankara, Turkey

Authors: Sezen Aslan, N. Aydan Sat

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The society of 21st century constantly faces with complex otherness that emerges in various forms and justifications. Otherness caused by class, race or ethnicity inevitably reflects to urban areas, and in this way, cities are diversified into totally self-centered and closed-off urban enclaves. One of the most important dynamics that creates otherness in contemporary society is migration. Immigration on an international scale is one of the most important events that have reshaped the world, and the number of immigrants in the world is increasing day by day. Forced migration and refugee statements constitute the major part of countries' immigration policies and practices. Domestic problems such as racism, violence, war, censorship and silencing, attitudes contrary to human rights, different cultural or religious identities cause populations to migrate. Immigration is one of the most important reasons for the formation of urban enclaves within cities. Turkey, which was used to face a higher rate of outward migration, has begun to host immigrant groups from foreign countries. 1980s is the breaking point about the issue as a result of internal disturbances in the Middle East. After Iranian, Iraqi and Afghan immigrants, Turkey faces the largest external migration in its story with Syrian population. Turkey has been hosting approximate three million Syrian people after Syrian Civil War which started in 2011. 92% of Syrian refugees are currently living in different urban areas in Turkey instead of camps. Syrian refugees are experiencing a spontaneous spatiality due to the lack of specific settlement and housing policies of the country. This spontaneity is one of the most important factors in the creation of urban enclaves. From this point of view, the aim of this study is to clarify processes that lead the creation of urban enclaves and to explain socio-spatial effects of these urban enclaves to the other parts of the cities. Ankara, which is one of the most registered Syrian hosting Province in Turkey, is selected as a case study area. About 55% of the total Syrian population lives in the Altındağ district in Ankara. They settled specifically in two neighborhoods in Altındağ district, named as Önder and Ulubey. These neighborhoods are old slum areas, and they were evacuated due to urban renewal on the same dates with the migration of the Syrians. Before demolition of these old slums, Syrians are settled into them as tenants. In the first part of the study, a brief explanation of the concept of urban enclave, its occurrence parameters and possible socio-spatial threats, examples from previous immigrant urban enclaves caused internal migration will be given. Emergence of slums, planning history and social processes in the case study area will be described in the second part of the study. The third part will be focused on the Syrian refugees and their socio-spatial relationship in the case study area and in-depth interviews with refugees and spatial analysis will be realized. Suggestions for the future of the case study area and recommendations to prevent immigrant groups from social and spatial exclusion will be discussed in the conclusion part of the study.

Keywords: migration, immigration, Syrian refugees, urban enclaves, Ankara

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31 Fort Conger: A Virtual Museum and Virtual Interactive World for Exploring Science in the 19th Century

Authors: Richard Levy, Peter Dawson

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Ft. Conger, located in the Canadian Arctic was one of the most remote 19th-century scientific stations. Established in 1881 on Ellesmere Island, a wood framed structure established a permanent base from which to conduct scientific research. Under the charge of Lt. Greely, Ft. Conger was one of 14 expeditions conducted during the First International Polar Year (FIPY). Our research project “From Science to Survival: Using Virtual Exhibits to Communicate the Significance of Polar Heritage Sites in the Canadian Arctic” focused on the creation of a virtual museum website dedicated to one of the most important polar heritage site in the Canadian Arctic. This website was developed under a grant from Virtual Museum of Canada and enables visitors to explore the fort’s site from 1875 to the present, http://fortconger.org. Heritage sites are often viewed as static places. A goal of this project was to present the change that occurred over time as each new group of explorers adapted the site to their needs. The site was first visited by British explorer George Nares in 1875 – 76. Only later did the United States government select this site for the Lady Franklin Bay Expedition (1881-84) with research to be conducted under the FIPY (1882 – 83). Still later Robert Peary and Matthew Henson attempted to reach the North Pole from Ft. Conger in 1899, 1905 and 1908. A central focus of this research is on the virtual reconstruction of the Ft. Conger. In the summer of 2010, a Zoller+Fröhlich Imager 5006i and Minolta Vivid 910 laser scanner were used to scan terrain and artifacts. Once the scanning was completed, the point clouds were registered and edited to form the basis of a virtual reconstruction. A goal of this project has been to allow visitors to step back in time and explore the interior of these buildings with all of its artifacts. Links to text, historic documents, animations, panorama images, computer games and virtual labs provide explanations of how science was conducted during the 19th century. A major feature of this virtual world is the timeline. Visitors to the website can begin to explore the site when George Nares, in his ship the HMS Discovery, appeared in the harbor in 1875. With the emergence of Lt Greely’s expedition in 1881, we can track the progress made in establishing a scientific outpost. Still later in 1901, with Peary’s presence, the site is transformed again, with the huts having been built from materials salvaged from Greely’s main building. Still later in 2010, we can visit the site during its present state of deterioration and learn about the laser scanning technology which was used to document the site. The Science and Survival at Fort Conger project represents one of the first attempts to use virtual worlds to communicate the historical and scientific significance of polar heritage sites where opportunities for first-hand visitor experiences are not possible because of remote location.

Keywords: 3D imaging, multimedia, virtual reality, arctic

Procedia PDF Downloads 389
30 Heat Accumulation in Soils of Belarus

Authors: Maryna Barushka, Aleh Meshyk

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The research analyzes absolute maximum soil temperatures registered at 36 gauge stations in Belarus from 1950 to 2013. The main method applied in the research is cartographic, in particular, trend surface analysis. Warming that had never been so long and intensive before started in 1988. The average temperature in January and February of that year exceeded the norm by 7-7.5 С, in March and April by 3-5С. In general, that year, as well as the year of 2008, happened to be the hottest ones in the whole period of instrumental observation. Yearly average air temperature in Belarus in those years was +8.0-8.2 С, which exceeded the norm by 2.0 – 2.2 С. The warming has been observed so far. The only exception was in 1996 when the yearly average air temperature in Belarus was below normal by 0.5 С. In Belarus the value of trend line of standard temperature deviation in the warmest months (July-August) has been positive for the past 25 years. In 2010 absolute maximum air and soil temperature exceeded the norm at 15 gauge stations in Belarus. The structure of natural processes includes global, regional, and local constituents. Trend surface analysis of the investigated characteristics makes it possible to determine global, regional, and local components. Linear trend surface shows the occurrence of weather deviations on a global scale, outside Belarus. Maximum soil temperature appears to be growing in the south-west direction with the gradient of 5.0 С. It is explained by the latitude factor. Polynomial trend surfaces show regional peculiarities of Belarus. Extreme temperature regime is formed due to some factors. The prevailing one is advection of turbulent flow of the ground layer of the atmosphere. In summer influence of the Azores High producing anticyclones is great. The Gulf Stream current forms the values of temperature trends in a year period. The most intensive flow of the Gulf Stream in the second half of winter and the second half of summer coincides with the periods of maximum temperature trends in Belarus. It is possible to estimate a local component of weather deviations in the analysis of the difference in values of the investigated characteristics and their trend surfaces. Maximum positive deviation (up to +4 С) of averaged soil temperature corresponds to the flat terrain in Pripyat Polesie, Brest Polesie, and Belarusian Poozerie Area. Negative differences correspond to the higher relief which partially compensates extreme heat regime of soils. Another important factor for maximum soil temperature in these areas is peat-bog soils with the least albedo of 8-15%. As yearly maximum soil temperature reaches 40-60 С, this could be both negative and positive factors for Belarus’s environment and economy. High temperature causes droughts resulting in crops dying and soil blowing. On the other hand, vegetation period has lengthened thanks to bigger heat resources, which allows planting such heat-loving crops as melons and grapes with appropriate irrigation. Thus, trend surface analysis allows determining global, regional, and local factors in accumulating heat in the soils of Belarus.

Keywords: soil, temperature, trend surface analysis, warming

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29 The Employment of Unmanned Aircraft Systems for Identification and Classification of Helicopter Landing Zones and Airdrop Zones in Calamity Situations

Authors: Marielcio Lacerda, Angelo Paulino, Elcio Shiguemori, Alvaro Damiao, Lamartine Guimaraes, Camila Anjos

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Accurate information about the terrain is extremely important in disaster management activities or conflict. This paper proposes the use of the Unmanned Aircraft Systems (UAS) at the identification of Airdrop Zones (AZs) and Helicopter Landing Zones (HLZs). In this paper we consider the AZs the zones where troops or supplies are dropped by parachute, and HLZs areas where victims can be rescued. The use of digital image processing enables the automatic generation of an orthorectified mosaic and an actual Digital Surface Model (DSM). This methodology allows obtaining this fundamental information to the terrain’s comprehension post-disaster in a short amount of time and with good accuracy. In order to get the identification and classification of AZs and HLZs images from DJI drone, model Phantom 4 have been used. The images were obtained with the knowledge and authorization of the responsible sectors and were duly registered in the control agencies. The flight was performed on May 24, 2017, and approximately 1,300 images were obtained during approximately 1 hour of flight. Afterward, new attributes were generated by Feature Extraction (FE) from the original images. The use of multispectral images and complementary attributes generated independently from them increases the accuracy of classification. The attributes of this work include the Declivity Map and Principal Component Analysis (PCA). For the classification four distinct classes were considered: HLZ 1 – small size (18m x 18m); HLZ 2 – medium size (23m x 23m); HLZ 3 – large size (28m x 28m); AZ (100m x 100m). The Decision Tree method Random Forest (RF) was used in this work. RF is a classification method that uses a large collection of de-correlated decision trees. Different random sets of samples are used as sampled objects. The results of classification from each tree and for each object is called a class vote. The resulting classification is decided by a majority of class votes. In this case, we used 200 trees for the execution of RF in the software WEKA 3.8. The classification result was visualized on QGIS Desktop 2.12.3. Through the methodology used, it was possible to classify in the study area: 6 areas as HLZ 1, 6 areas as HLZ 2, 4 areas as HLZ 3; and 2 areas as AZ. It should be noted that an area classified as AZ covers the classifications of the other classes, and may be used as AZ, HLZ of large size (HLZ3), medium size (HLZ2) and small size helicopters (HLZ1). Likewise, an area classified as HLZ for large rotary wing aircraft (HLZ3) covers the smaller area classifications, and so on. It was concluded that images obtained through small UAV are of great use in calamity situations since they can provide data with high accuracy, with low cost, low risk and ease and agility in obtaining aerial photographs. This allows the generation, in a short time, of information about the features of the terrain in order to serve as an important decision support tool.

Keywords: disaster management, unmanned aircraft systems, helicopter landing zones, airdrop zones, random forest

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28 Implementation of Hybrid Curriculum in Canadian Dental Schools to Manage Child Abuse and Neglect

Authors: Priyajeet Kaur Kaleka

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Introduction: A dentist is often the first responder in the battle for a patient’s healthy body and maybe the first health professional to observe signs of child abuse, be it physical, emotional, and/or sexual mistreatment. Therefore, it is an ethical responsibility for the dental clinician to detect and report suspected cases of child abuse and neglect (CAN). The main reasons for not reporting suspected cases of CAN, with special emphasis on the third: 1) Uncertainty of the diagnosis, 2) Lack of knowledge of the reporting procedure, and 3) Child abuse and neglect somewhat remained the subject of ignorance among dental professionals because of a lack of advance clinical training. Given these epidemic proportions, there is a scope of further research about dental school curriculum design. Purpose: This study aimed to assess the knowledge and attitude of dentists in Canada regarding signs and symptoms of child abuse and neglect (CAN), reporting procedures, and whether educational strategies followed by dental schools address this sensitive issue. In pursuit of that aim, this abstract summarizes the evidence related to this question. Materials and Methods: Data was collected through a specially designed questionnaire adapted and modified from the author’s previous cross-sectional study on (CAN), which was conducted in Pune, India, in 2016 and is available on the database of PubMed. Design: A random sample was drawn from the targeted population of registered dentists and dental students in Canada regarding their knowledge, professional responsibilities, and behavior concerning child abuse. Questionnaire data were distributed to 200 members. Out of which, a total number of 157 subjects were in the final sample for statistical analysis, yielding response of 78.5%. Results: Despite having theoretical information on signs and symptoms, 55% of the participants indicated they are not confident to detect child physical abuse cases. 90% of respondents believed that recognition and handling the CAN cases should be a part of undergraduate training. Only 4.5% of the participants have correctly identified all signs of abuse due to inadequate formal training in dental schools and workplaces. Although nearly 96.3% agreed that it is a dentist’s legal responsibility to report CAN, only a small percentage of the participants reported an abuse case in the past. While 72% stated that the most common factor that might prevent a dentist from reporting a case was doubt over the diagnosis. Conclusion: The goal is to motivate dental schools to deal with this critical issue and provide their students with consummate training to strengthen their capability to care for and protect children. The educational institutions should make efforts to spread awareness among dental students regarding the management and tackling of CAN. Clinical Significance: There should be modifications in the dental school curriculum focusing on problem-based learning models to assist graduates to fulfill their legal and professional responsibilities. CAN literacy should be incorporated into the dental curriculum, which will eventually benefit future dentists to break this intergenerational cycle of violence.

Keywords: abuse, child abuse and neglect, dentist knowledge, dental school curriculum, problem-based learning

Procedia PDF Downloads 172
27 Developing Telehealth-Focused Advanced Practice Nurse Educational Partnerships

Authors: Shelley Y. Hawkins

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Introduction/Background: As technology has grown exponentially in healthcare, nurse educators must prepare Advanced Practice Registered Nurse (APRN) graduates with the knowledge and skills in information systems/technology to support and improve patient care and health care systems. APRN’s are expected to lead in caring for populations who lack accessibility and availability through the use of technology, specifically telehealth. The capacity to effectively and efficiently use technology in patient care delivery is clearly delineated in the American Association of Colleges of Nursing (AACN) Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) Essentials. However, APRN’s have minimal, or no, exposure to formalized telehealth education and lack necessary technical skills needed to incorporate telehealth into their patient care. APRN’s must successfully master the technology using telehealth/telemedicine, electronic health records, health information technology, and clinical decision support systems to advance health. Furthermore, APRN’s must be prepared to lead the coordination and collaboration with other healthcare providers in their use and application. Aim/Goal/Purpose: The purpose of this presentation is to establish and operationalize telehealth-focused educational partnerships between one University School of Nursing and two health care systems in order to enhance the preparation of APRN NP students for practice, teaching, and/or scholarly endeavors. Methods: The proposed project was initially presented by the project director to selected multidisciplinary stakeholders including leadership, home telehealth personnel, primary care providers, and decision support systems within two major health care systems to garner their support for acceptance and implementation. Concurrently, backing was obtained from key university-affiliated colleagues including the Director of Simulation and Innovative Learning Lab and Coordinator of the Health Care Informatics Program. Technology experts skilled in design and production in web applications and electronic modules were secured from two local based technology companies. Results: Two telehealth-focused APRN Program academic/practice partnerships have been established. Students have opportunities to engage in clinically based telehealth experiences focused on: (1) providing patient care while incorporating various technology with a specific emphasis on telehealth; (2) conducting research and/or evidence-based practice projects in order to further develop the scientific foundation regarding incorporation of telehealth with patient care; and (3) participating in the production of patient-level educational materials related to specific topical areas. Conclusions: Evidence-based APRN student telehealth clinical experiences will assist in preparing graduates who can effectively incorporate telehealth into their clinical practice. Greater access for diverse populations will be available as a result of the telehealth service model as well as better care and better outcomes at lower costs. Furthermore, APRN’s will provide the necessary leadership and coordination through interprofessional practice by transforming health care through new innovative care models using information systems and technology.

Keywords: academic/practice partnerships, advanced practice nursing, nursing education, telehealth

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26 Early Biological Effects in Schoolchildren Living in an Area of Salento (Italy) with High Incidence of Chronic Respiratory Diseases: The IMP.AIR. Study

Authors: Alessandra Panico, Francesco Bagordo, Tiziana Grassi, Adele Idolo, Marcello Guido, Francesca Serio, Mattia De Giorgi, Antonella De Donno

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In the Province of Lecce (Southeastern Italy) an area with unusual high incidence of chronic respiratory diseases, including lung cancer, was recently identified. The causes of this health emergency are still not entirely clear. In order to determine the risk profile of children living in five municipalities included in this area an epidemiological-molecular study was performed in the years 2014-2016: the IMP.AIR. (Impact of air quality on health of residents in the Municipalities of Sternatia, Galatina, Cutrofiano, Sogliano Cavour and Soleto) study. 122 children aged 6-8 years attending primary school in the study area were enrolled to evaluate the frequency of micronuclei (MNs) in their buccal exfoliated cells. The samples were collected in May 2015 by rubbing the oral mucosa with a soft bristle disposable toothbrush. At the same time, a validated questionnaire was administered to parents to obtain information about health, lifestyle and eating habits of the children. In addition, information on airborne pollutants, routinely detected by the Regional Environmental Agency (ARPA Puglia) in the study area, was acquired. A multivariate analysis was performed to detect any significant association between frequency of MNs (dependent variable) and behavioral factors (independent variables). The presence of MNs was highlighted in the buccal exfoliated cells of about 42% of recruited children with a mean frequency of 0.49 MN/1000 cells, greater than in other areas of Salento. The survey on individual characteristics and lifestyles showed that one in three children was overweight and that most of them had unhealthy eating habits with frequent consumption of foods considered ‘risky’. Moreover many parents (40% of fathers and 12% of mothers) were smokers and about 20% of them admitted to smoking in the house where the children lived. Information regarding atmospheric contaminants was poor. Of the few substances routinely detected by the only one monitoring station located in the study area (PM2.5, SO2, NO2, CO, O3) only ozone showed high concentrations exceeding the limits set by the legislation for 67 times in the year 2015. The study showed that the level of early biological effect markers in children was not negligible. This critical condition could be related to some individual factors and lifestyles such as overweight, unhealthy eating habits and exposure to passive smoking. At present, no relationship with airborne pollutants can be established due to the lack of information on many substances. Therefore, it would be advisable to modify incorrect behaviors and to intensify the monitoring of airborne pollutants (e.g. including detection of PM10, heavy metals, aromatic polycyclic hydrocarbons, benzene) given the epidemiology of chronic respiratory diseases registered in this area.

Keywords: chronic respiratory diseases, environmental pollution, lifestyle, micronuclei

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25 The Influence of Perinatal Anxiety and Depression on Breastfeeding Behaviours: A Qualitative Systematic Review

Authors: Khulud Alhussain, Anna Gavine, Stephen Macgillivray, Sushila Chowdhry

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Background: Estimates show that by the year 2030, mental illness will account for more than half of the global economic burden, second to non-communicable diseases. Often, the perinatal period is characterised by psychological ambivalence and a mixed anxiety-depressive condition. Maternal mental disorder is associated with perinatal anxiety and depression and affects breastfeeding behaviors. Studies also indicate that maternal mental health can considerably influence a baby's health in numerous aspects and impact the newborn health due to lack of adequate breastfeeding. However, studies reporting factors associated with breastfeeding behaviors are predominantly quantitative. Therefore, it is not clear what literature is available to understand the factors affecting breastfeeding and perinatal women’s perspectives and experiences. Aim: This review aimed to explore the perceptions and experiences of women with perinatal anxiety and depression, as well as how these experiences influence their breastfeeding behaviours. Methods: A systematic literature review of qualitative studies in line with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). Four electronic databases (CINAHL, PsycINFO, Embase, and Google Scholar) were explored for relevant studies using a search strategy. The search was restricted to studies published in the English language between 2000 and 2022. Findings from the literature were screened using a pre-defined screening criterion and the quality of eligible studies was appraised using the Walsh and Downe (2006) checklist. Findings were extracted and synthesised based on Braun and Clark. The review protocol was registered on PROSPERO (Ref: CRD42022319609). Result: A total of 4947 studies were identified from the four databases. Following duplicate removal and screening 16 studies met the inclusion criteria. The studies included 87 pregnant and 302 post-partum women from 12 countries. The participants were from a variety of economic, regional, and religious backgrounds, mainly from the age of 18 to 45 years old. Three main themes were identified: Barriers to breastfeeding, breastfeeding facilitators, emotional disturbance, and breastfeeding. Seven subthemes emerged from the data: expectation versus reality, uncertainly about maternal competencies, body image and breastfeeding, lack of sufficient breastfeeding support for family and caregivers’ support, influences positive breastfeeding practices, breastfeeding education, and causes of mental strain among breastfeeding women. Breastfeeding duration is affected in women with mental health disorders, irrespective of their desire to breastfeed. Conclusion: There is significant empirical evidence that breastfeeding behaviour and perinatal mental disturbance are linked. However, there is a lack of evidence to apply the findings to Saudi women due to lack of empirical qualitative information. To improve the psychological well-being of mothers, it is crucial to explore and recognise any concerns with their mental, physical, and emotional well-being. Therefore, robust research is needed so that breastfeeding intervention researchers and policymakers can focus on specifically what needs to be done to help mentally distressed perinatal women and their new-born.

Keywords: pregnancy, perinatal period, anxiety, depression, emotional disturbance, breastfeeding

Procedia PDF Downloads 55
24 On the Limits of Board Diversity: Impact of Network Effect on Director Appointments

Authors: Vijay Marisetty, Poonam Singh

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Research on the effect of director's network connections on investor welfare is inconclusive. Some studies suggest that directors' connections are beneficial, in terms of, improving earnings information, firms valuation for new investors. On the other hand, adverse effects of directorial networks are also reported, in terms of higher earnings management, options back dating fraud, reduction in firm performance, lower board monitoring. From regulatory perspective, the role of directorial networks on corporate welfare is crucial. Cognizant of the possible ill effects associated with directorial networks, large investors, for better representation on the boards, are building their own database of prospective directors who are highly qualified, however, sourced from outside the highly connected directorial labor market. For instance, following Dodd-Frank Reform Act, California Public Employees' Retirement Systems (CalPERs) has initiated a database for registering aspiring and highly qualified directors to nominate them for board seats (proxy access). Our paper stems from this background and tries to explore the chances of outside directors getting directorships who lack established network connections. The paper is able to identify such aspiring directors' information by accessing a unique Indian data sourced from an online portal that aims to match the supply of registered aspirants with the growing demand for outside directors in India. The online portal's tie-up with stock exchanges ensures firms to access the new pool of directors. Such direct access to the background details of aspiring directors over a period of 10 years, allows us to examine the chances of aspiring directors without corporate network, to enter directorial network. Using this resume data of 16105 aspiring corporate directors in India, who have no prior board experience in the directorial labor market, the paper analyses the entry dynamics in corporate directors' labor market. The database also allows us to investigate the value of corporate network by comparing non-network new entrants with incumbent networked directors. The study develops measures of network centrality and network degree based on merit, i.e. network of individuals belonging to elite educational institutions, like Indian Institute of Management (IIM) or Indian Institute of Technology (IIT) and based on job or company, i.e. network of individuals serving in the same company. The paper then measures the impact of these networks on the appointment of first time directors and subsequent appointment of directors. The paper reports the following main results: 1. The likelihood of becoming a corporate director, without corporate network strength, is only 1 out 100 aspirants. This is inspite of comparable educational background and similar duration of corporate experience; 2. Aspiring non-network directors' elite educational ties help them to secure directorships. However, for post-board appointments, their newly acquired corporate network strength overtakes as their main determinant for subsequent board appointments and compensation. The results thus highlight the limitations in increasing board diversity.

Keywords: aspiring corporate directors, board diversity, director labor market, director networks

Procedia PDF Downloads 282
23 Changes of Mitochondrial Potential in the Midgut Epithelium of Lithobius forficatus (Myriapoda, Chilopoda) Exposed to Cadmium Concentrated in Soil

Authors: Magdalena Rost-Roszkowska, Izabela Poprawa, Alina Chachulska-Zymelka, Lukasz Chajec, Grazyna Wilczek, Piotr Wilczek, Malgorzata Lesniewska

Abstract:

Lithobius forficatus, commonly known as the brown centipede, is a widespread European species, which lives in the upper layers of soil, under stones, litter, rocks, and leaves. As the soil organism, it is exposed to numerous stressors such as xenobiotics, including heavy metals, temperature, starvation, pathogens, etc. Heavy metals are treated as the environmental pollutants of the soil because of their toxic effects on plants, animals and human being. One of the heavy metals which is xenobiotic and can be taken up by plants or animals from the soil is cadmium. The digestive system of centipedes is composed of three distinct regions: fore-, mid- and hindgut. The salivary glands of centipedes are the organs which belong to the anterior region of the digestive system and take part in the synthesis, accumulation, and secretion of many substances. The middle region having contact with the food masses is treated as one of the barriers which protect the organism against any stressors which originate from the external environment, e.g., toxic metals. As the material for our studies, we chose two organs of the digestive system in brown centipede, the organs which take part in homeostasis maintenance: the salivary glands and the midgut. The main purpose of the project was to investigate the relationship between the percentage of depolarized mitochondria, mitophagy and ATP level in cells of mentioned above organs. The animals were divided into experimental groups: K – the control group, the animals cultured in a laboratory conditions in a horticultural soil and fed with Acheta domesticus larvae; Cd1 – the animals cultured in a horticultural soil supplemented with 80 mg/kg (dry weight) of CdCl2, fed with A. domesticus larvae maintained in tap water, 12 days – short-term exposure; Cd2 – the animals cultured in a horticultural soil supplemented with 80 mg/kg (dry weight) of CdCl2, fed with A. domesticus larvae maintained in tap water, 45 days – long-term exposure. The studies were conducted using transmission electron microscopy (TEM), flow cytometry and confocal microscopy. Quantitative analysis revealed that regardless of the organ, a progressive increase in the percentage of cells with depolarized mitochondria was registered, but only in the salivary glands. These were statistically significant changes from the control. In both organs, there were no differences in the level of the analyzed parameter depending on the duration of exposure of individuals to cadmium. Changes in the ultrastructure of mitochondria have been observed. With the extension of the body's exposure time to metal, an increase in the ADP/ATP index was recorded. However, changes statistically significant to the control were demonstrated in the intestine and salivary glands. The size of this intestinal index and salivary glands in the Cd2 group was about thirty and twenty times higher, respectively than in control. Acknowledgment: The study has been financed by the National Science Centre, Poland, grant no 2017/25/B/NZ4/00420.

Keywords: cadmium, digestive system, ultrastructure, centipede

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22 An Epidemiological Study on Cutaneous Melanoma, Basocellular and Epidermoid Carcinomas Diagnosed in a Sunny City in Southeast Brazil in a Five-Year Period

Authors: Carolina L. Cerdeira, Julia V. F. Cortes, Maria E. V. Amarante, Gersika B. Santos

Abstract:

Skin cancer is the most common cancer in several parts of the world; in a tropical country like Brazil, the situation isn’t different. The Brazilian population is exposed to high levels of solar radiation, increasing the risk of developing cutaneous carcinoma. Aimed at encouraging prevention measures and the early diagnosis of these tumors, a study was carried out that analyzed data on cutaneous melanomas, basal cell, and epidermoid carcinomas, using as primary data source the medical records of 161 patients registered in one pathology service, which performs skin biopsies in a city of Minas Gerais, Brazil. All patients diagnosed with skin cancer at this service from January 2015 to December 2019 were included. The incidence of skin carcinoma cases was correlated with the identification of histological type, sex, age group, and topographic location. Correlation between variables was verified by Fisher's exact test at a nominal significance level of 5%, with statistical analysis performed by R® software. A significant association was observed between age group and type of cancer (p=0.0085); age group and sex (0.0298); and type of cancer and body region affected (p < 0.01). Those 161 cases analyzed comprised 93 basal cell carcinomas, 66 epidermoid carcinomas, and only two cutaneous melanomas. In the group aged 19 to 30 years, the epidermoid form was most prevalent; from 31 to 45 and from 46 to 59 years, the basal cell prevailed; in 60-year-olds or over, both types had higher frequencies. Associating age group and sex, in groups aged 18 to 30 and 46 to 59 years, women were most affected. In the 31-to 45-year-old group, men predominated. There was a gender balance in the age group 60-year-olds or over. As for topography, there was a high prevalence in the head and neck, followed by upper limbs. Relating histological type and topography, there was a prevalence of basal cell and epidermoid carcinomas in the head and neck. In the chest, the basal cell form was most prevalent; in upper limbs, the epidermoid form prevailed. Cutaneous melanoma affected only the chest and upper limbs. About 82% of patients 60-year-olds or over had head and neck cancer; from 46 to 59 and 60-year-olds or over, the head and neck region and upper limbs were predominantly affected; the distribution was balanced in the 31-to 45-year-old group. In conclusion, basal cell carcinoma was predominant, whereas cutaneous melanoma was the rarest among the types analyzed. Patients 60-year-olds or over were most affected, showing gender balance. In young adults, there was a prevalence of the epidermoid form; in middle-aged patients, basal cell carcinoma was predominant; in the elderly, both forms presented with higher frequencies. There was a higher incidence of head and neck cancers, followed by malignancies affecting the upper limbs. The epidermoid type manifested significantly in the upper limbs. Body regions such as the thorax and lower limbs were less affected, which is justified by the lower exposure of these areas to incident solar radiation.

Keywords: basal cell carcinoma, cutaneous melanoma, skin cancer, squamous cell carcinoma, topographic location

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21 The Effectiveness of Prenatal Breastfeeding Education on Breastfeeding Uptake Postpartum: A Systematic Review

Authors: Jennifer Kehinde, Claire O’Donnell, Annmarie Grealish

Abstract:

Introduction: Breastfeeding has been shown to provide numerous health benefits for both infants and mothers. The decision to breastfeed is influenced by physiological, psychological, and emotional factors. However, the importance of equipping mothers with the necessary knowledge for successful breastfeeding practice cannot be ruled out. The decline in global breastfeeding rate can be linked to a lack of adequate breastfeeding education during the prenatal stage. This systematic review examined the effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum. Method: This review was undertaken and reported in conformity with the Preferred Reporting Items for Systemic Reviews and Meta-Analysis statement (PRISMA) and was registered on the international prospective register for systematic reviews (PROSPERO: CRD42020213853). A PICO analysis (population, intervention, comparison, outcome) was undertaken to inform the choice of keywords in the search strategy to formulate the review question, which was aimed at determining the effectiveness of prenatal breastfeeding educational programs in improving breastfeeding uptake following birth. A systematic search of five databases (Cumulative Index to Nursing and Allied Health Literature, Medline, Psych INFO, and Applied Social Sciences Index and Abstracts) was searched between January 2014 until July 2021 to identify eligible studies. Quality assessment and narrative synthesis were subsequently undertaken. Results: Fourteen studies were included. All 14 studies used different types of breastfeeding programs; eight used a combination of curriculum-based breastfeeding education programs, group prenatal breastfeeding counselling, and one-to-one breastfeeding educational programs, which were all delivered in person; four studies used web-based learning platforms to deliver breastfeeding education prenatally which were both delivered online and face to face over a period of 3 weeks to 2 months with follow-up periods ranging from 3 weeks to 6 months; one study delivered breastfeeding educational intervention using mother-to-mother breastfeeding support groups in promoting exclusive breastfeeding, and one study disseminated breastfeeding education to participants based on the theory of planned behaviour. The most effective interventions were those that included both theory and hands-on demonstrations. Results showed an increase in breastfeeding uptake, breastfeeding knowledge, an increase in a positive attitude to breastfeeding, and an increase in maternal breastfeeding self-efficacy among mothers who participated in breastfeeding educational programs during prenatal care. Conclusion: Prenatal breastfeeding education increases women’s knowledge of breastfeeding. Mothers who are knowledgeable about breastfeeding and hold a positive approach towards breastfeeding have the tendency to initiate breastfeeding and continue for a lengthened period. Findings demonstrate a general correlation between prenatal breastfeeding education and increased breastfeeding uptake postpartum. The high level of positive breastfeeding outcomes inherent in all the studies can be attributed to prenatal breastfeeding education. This review provides rigorous contemporary evidence that healthcare professionals and policymakers can apply when developing effective strategies to improve breastfeeding rates and ultimately improve the health outcomes of mothers and infants.

Keywords: breastfeeding, breastfeeding programs, breastfeeding self-efficacy, prenatal breastfeeding education

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20 Physical Activity and Nutrition Intervention for Singaporean Women Aged 50 Years and Above: A Study Protocol for a Community Based Randomised Controlled Trial

Authors: Elaine Yee Sing Wong, Jonine Jancey, Andy H. Lee, Anthony P. James

Abstract:

Singapore has a rapidly aging population, where the majority of older women aged 50 years and above, are physically inactive and have unhealthy dietary habits, placing them at ‘high risk’ of non-communicable diseases. Given the multiplicity of less than optimal dietary habits and high levels of physical inactivity among Singaporean women, it is imperative to develop appropriate lifestyle interventions at recreational centres to enhance both their physical and nutritional knowledge, as well as provide them with the opportunity to develop skills to support behaviour change. To the best of our knowledge, this proposed study is the first physical activity and nutrition cluster randomised controlled trial conducted in Singapore for older women. Findings from this study may provide insights and recommendations for policy makers and key stakeholders to create new healthy living, recreational centres with supportive environments. This 6-month community-based cluster randomised controlled trial will involve the implementation and evaluation of physical activity and nutrition program for community dwelling Singaporean women, who currently attend recreational centres to promote social leisure activities in their local neighbourhood. The intervention will include dietary education and counselling sessions, physical activity classes, and telephone contact by certified fitness instructors and qualified nutritionists. Social Cognitive Theory with Motivational Interviewing will inform the development of strategies to support health behaviour change. Sixty recreational centres located in Singapore will be randomly selected from five major geographical districts and randomly allocated to the intervention (n=30) or control (n=30) cluster. A sample of 600 (intervention n=300; control n=300) women aged 50 years and above will then be recruited from these recreational centres. The control clusters will only undergo pre and post data collection and will not receive the intervention. It is hypothesised that by the end of the intervention, the intervention group participants (n = 300) compared to the control group (n = 300), will show significant improvements in the following variables: lipid profile, body mass index, physical activity and dietary behaviour, anthropometry, mental and physical health. Data collection will be examined and compared via the Statistical Package for the Social Science version 23. Descriptive and summary statistics will be used to quantify participants’ characteristics and outcome variables. Multi-variable mixed regression analyses will be used to confirm the effects of the proposed health intervention, taking into account the repeated measures and the clustering of the observations. The research protocol was approved by the Curtin University Human Research Ethics Committee (approval number: HRE2016-0366). The study has been registered with the Australian and New Zealand Clinical Trial Registry (12617001022358).

Keywords: community based, healthy aging, intervention, nutrition, older women, physical activity

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19 The Effectiveness of Prenatal Breastfeeding Education on Breastfeeding Uptake Postpartum: A Systematic Review.

Authors: Jennifer Kehinde, Claire O'donnell, Annmarie Grealish

Abstract:

Introduction: Breastfeeding has been shown to provide numerous health benefits for both infants and mothers. The decision to breastfeed is influenced by physiological, psychological, and emotional factors. However, the importance of equipping mothers with the necessary knowledge for successful breastfeeding practice cannot be ruled out. The decline in global breastfeeding rate can be linked to lack of adequate breastfeeding education during prenatal stage.This systematic review examined the effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum. Method: This review was undertaken and reported in conformity with the Preferred Reporting Items for Systemic Reviews and Meta-Analysis statement (PRISMA) and was registered on the international prospective register for systematic reviews (PROSPERO: CRD42020213853). A PICO analysis (population, intervention, comparison, outcome) was undertaken to inform the choice of keywords in the search strategy to formulate the review question which was aimed at determining the effectiveness of prenatal breastfeeding educational programs at improving breastfeeding uptake following birth. A systematic search of five databases (Cumulative Index to Nursing and Allied Health Literature, Medline, Psych INFO, and Applied Social Sciences Index and Abstracts) were searched between January 2014 until July 2021 to identify eligible studies. Quality assessment and narrative synthesis were subsequently undertaken. Results: Fourteen studies were included. All 14 studies used different types of breastfeeding programs; eight used a combination of curriculum based breastfeeding education program, group prenatal breastfeeding counselling and one-to-one breastfeeding educational programs which were all delivered in person; four studies used web-based learning platforms to deliver breastfeeding education prenatally which were both delivered online and face to face over a period of 3 weeks to 2 months with follow-up periods ranging from 3 weeks to 6 months; one study delivered breastfeeding educational intervention using mother-to-mother breastfeeding support groups in promoting exclusive breastfeeding and one study disseminated breastfeeding education to participants based on the theory of planned behaviour. The most effective interventions were those that included both theory and hands-on demonstrations. Results showed an increase in breastfeeding uptake, breastfeeding knowledge, increase in positive attitude to breastfeeding and an increase in maternal breastfeeding self-efficacy among mothers who participated in breastfeeding educational programs during prenatal care. Conclusion: Prenatal breastfeeding education increases women’s knowledge of breastfeeding. Mothers who are knowledgeable about breastfeeding and hold a positive approach towards breastfeeding have the tendency to initiate breastfeeding and continue for a lengthened period. Findings demonstrates a general correlation between prenatal breastfeeding education and increased breastfeeding uptake postpartum. The high level of positive breastfeeding outcome inherent in all the studies can be attributed to prenatal breastfeeding education. This review provides rigorous contemporary evidence that healthcare professionals and policymakers can apply when developing effective strategies to improve breastfeeding rates and ultimately improve the health outcomes of mothers and infants.

Keywords: breastfeeding, breastfeeding programs, breastfeeding self-efficacy, prenatal breastfeedng education

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18 The Evolving Changes of Religious Behavior: an Exploratory Study on Guanyin Worship of Contemporary Chinese Societies

Authors: Judith Sue Hwa Joo

Abstract:

Guanyin (Avalokiteśvara in Sanskrit), the Bodhisattva of Mercy and Compassion, is the most widely worshipped Buddhist Divinity in Chinese societies and is also believed by more than half of Asian populations across various countries. The most overwhelming reason for the popularity of Guanyin in Chinese societies is, according to the Lotus Sutra, that Guanyin would apperceive voices of those suffering from immense afflictions and troubles, and liberate them upon crying for his/her holy name with wholeheartedness. Its pervasive social influence has spanned more than two thousand years and is still deeply affecting the lives of most Chinese people. This study aimed to investigate whether Guanyin Worship has evolved and changed in modern Chinese societies across the Taiwan Strait. Taiwan and China, albeit having the same language and culture, have been territorially divided and governed by two different political regimes for over 70 years. It would be scientifically intriguing to unveil any substantial changes in religious behaviors in the context of Guanyin Worship. A comprehensive anonymous questionnaire survey in Chinese communities was conducted from October 2017 to May 2019 across various countries, mostly in China, Taiwan, and Hong Kong areas. Since the religious survey is officially prohibited in China, the study was difficult and could only be exercised by means of snowball sampling. Demographic data (age, sex, education, religious belief) were registered and Guanyin’s salvation functions under various confronting situations were investigated. Psychological dimensions of religious belief in Guanyin were probed in terms of the worship experience, the willingness of veneration, and egoistic or altruistic ideations. A literature review on documented functional attributes was carried out in parallel for comparison analyses with traditional roles. Effective 1123 out of 1139 samples were obtained. Statistical analysis revealed that Guanyin Worship is still commonly practiced and deeply rooted in the hearts of all Chinese people regardless of gender, age, education, and residential area, even though they may not enshrine Guanyin at home nowadays. The conventional roles of Guanyin Bodhisattva are still valid and best satisfy the real interests of lifestyles in modern times. When comparing the traditional Buddhist Sutra and the documented literature, the divine power of modern Guanyin has notably empowered to recover, protect and transform fetal and infant spirits due to the sexual liberation, increased abortion rate, gender awakening and enhanced female autonomy in the reproductive decision. However, the One-Child policy may have critically impacted the trajectory of Guanyin Worship so that people in China prevail over those in Taiwan praying for aborted lives or premature deaths. Furthermore, particularly in Hong Kong and Macao, Guanyin not only serves as the sea guardian for the fishermen but also additional services a new function as the God of Wealth. The divine powers and salvation functions of Guanyin are indeed evolving and expanding to comply with the modern psychosocial, cultural and societal needs. This study sheds light on the modernization process of the two-thousand-year-old Guanyin Worship of contemporary Chinese societies.

Keywords: Buddhism, Guanyin, religious behavior, salvation function

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17 Pregnancy Outcomes in Patients With Inflammatory Bowel Disease: Retrospective Data From a Greek National Registry

Authors: Evgenia Papathanasiou, Georgios Kokkotis, Georgios Axiaris, Theodoros Argyropoulos, Nikos Viazis, Olga Giouleme, Konstantinos Gkoumas, Αnthia Gatopoulou, Αggelos Theodoulou, Georgios Theocharis, Αngeliki Theodoropoulou, Μaria Κalogirou, Pantelis Karatzas, Κonstantinos Κatsanos, Theodora Kafetzi, Κonstantinos Κarmiris, Αnastasia Κourikou, Ιoannis E Κoutroubakis, Christos Liatsos, Gerassimos J. Mantzaris, Νicoletta Μathou, Georgia Bellou, George Michalopoulos Αikaterini Μantaka, Penelope Nikolaou, Μichael Oikonomou, Dimitrios Polymeros, George Papatheodoridis, Εvdoxia Stergiou, Κonstantinos Soufleris, Εpameinondas Skouloudis, Μaria Tzouvala, Georgia Tsiolakidou, Εftychia Tsironi, Styliani Tsafaraki, Kalliopi Foteinogiannopoulou, Konstantina Chalakatevaki, Αngeliki Christidou, Dimitrios K. Christodoulou, Giorgos Bamias, Spyridon Michopoulos, Εvanthia Zampeli

Abstract:

Background: Inflammatory bowel disease (IBD) commonly affects female patients of reproductive age, making the interaction between fertility, pregnancy and IBD an important issue in disease management. The effect of disease activity on the outcome of pregnancy and its impact on neonatal growth is a field of intense research. Close follow-up of pregnant IBD patients by a multidisciplinary team improves maternal and neonatal outcomes. Aim – Methods: Α national retrospective study of pregnancies in women with IBD between 2010-2020 was carried out in 22 IBD reference centers in Greece. Patient characteristics such as disease profile, type of treatment, and disease activity during gestation were analyzed in correlation to the method of delivery, pregnancy outcomes, as well as breastfeeding and offspring health. Results: Two-hundred and twenty-three pregnancies in 175 IBD patients were registered in the study. 122 with Crohn’s disease (CD). Median age during diagnosis was 25.6 years (12-44), with median disease duration of 7.4 years (0-23). One-hundred and twenty-nine patients (58%) were recorded during their first pregnancy. Early pregnancy termination was reported by 48 patients (22%). Pregnancy as a result of in vitro fertilization (IVF) occurred in 15 cases (6.7%). At the beginning of gestation, 165 patients (74%) were under treatment: 48 with anti-TNF agents (29%), 43 with azathioprine (26%), 101 with 5-aminosalicylic acid formulations (61%) and 12 with steroids (7%). We recorded 49 cases of IBD flares (22%) during pregnancy. Two-thirds of them (n=30) were in remission at the onset of the pregnancy. Almost half of them (n=22) required corticosteroid treatment. Patients with ulcerative colitis (UC) were in greater risk of disease flare during pregnancy (p<0.001). All but 3 pregnancies (99.1%) resulted in uncomplicated delivery. In 147 cases (67.1%), cesarean delivery was performed. Two late fetal deaths (0.9%) were reported, both in patients with continuously active disease since the beginning of pregnancy. After delivery, 75 patients (34%) presented with a disease flare, which was associated with active disease at the beginning of pregnancy (p <0.001). Conclusion: The majority of female, Greek IBD patients, had a favorable pregnancy outcome. Active inflammation during gestation and UC diagnosis were associated with a negative impact on pregnancy outcomes. The results of this study are in favor of the continuation of IBD treatment during pregnancy.

Keywords: pregnancy, ulcerative colitis, Crohn disease, flare

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