High Level Of Discrepancy Research Articles

Mediating Effect of Gender Based Violence on the Fit of Public Health Consequences and Societal Impact of Refugees in Uganda

Purpose: The current study was undertaken to establish the mediating effect of gender based violence on the fit of public health consequences and societal impact of refugees in Uganda so as to come up with a unified model for improvements in Uganda. The main objective was to investigate the mediating effect of gender based violence on the fit of public health consequences and societal impact of refugees in Uganda.
 Materials and Methods: In an effort to address the set objective, a cross-sectional survey design which followed both quantitative and qualitative research approaches was adopted. Data was collected from a total quantitative sample of 311 refugees. A qualitative sample of 68 of refugee stakeholders’ and officials from office of the Prime Minister in Uganda was determined by saturation point approach. The data was analysed at descriptive and inferential level, and later a Path Equation Model was fitted through Structural Equation Modelling in Stata Version 14.0.
 Findings: The key references in the study are (Moretti, S.,2021) who aver that in accordance with Division of International Protection, Gender based violence is preventable and UNHCR is committed to promoting gender equality and human rights and to protecting refugees and other persons of concern from GBV as well as (Heise,2018) who had earlier found Gender based violence brings negative public health consequences thus impacting society negatively. The overall result in regard to Gender Based Violence among refugees in Bidibidi camp indicate that it is highly practiced (M = 5.32, SD = 0.88). The results also indicated exists there exists a positive significant influence of Gender Based violence on public health consequences of the refugees (r = 0.379). The study results on the overall shows average level of social impact amongst the refugees (Mean = 3.26) but with a very high level of discrepancy (SD = 1.07> 0.5) with some refugees and stakeholders reporting good levels of society impact. This relationship is statistically significant since the associated p – value of 0.000 is less than 0.05 (p < 0.001). The study concluded that that sufficient evidence substantiates significant relationship exists between gender based violence and societal impact.
 Implications to Theory, Practice and Policy: Finally, the gender based violence and the other strategies had a total causal effect of 11.57% on societal impact. However, the society impact referred to only applied to the current environment which did not promise continued Survival into the future. Given that fact the study has proposed the Protracted Gender based Violence Diminution Model (PROGBVD MODEL) which guarantees not only societal impact but also tremendous reduction in gender based violence to an additional 21.2% to make it 32.77% sustained reduction. This, therefore, means that if the new Model is adopted, the refugees will not only be provided reduced Gender based Violence for a short period of time but will get it for many years to come. The Protracted Gender based Violence Diminution Model (PROGBVD MODEL) is, henceforth, the current study contribution to knowledge.

Factors associated with the Big 5 personality traits in Alzheimer’s disease and related dementias (ADRD)

AbstractBackgroundInformant ratings of behavior and personality change are the gold standard of measurement in Alzheimer’s disease and related dementias (ADRD) where insight is often impaired, but informant report can be biased by psychosocial factors such as caregiver burden. This study assessed the impact of caregiver burden on informant ratings of patient Big 5 personality traits (Extraversion, Agreeableness, Conscientiousness, Neuroticism, Openness) and associations between degree of discrepancy between informant and patient ratings with cortical volume in regions implicated in loss of insight.MethodA sample of 70 ADRD participants with heterogeneous neurodegenerative clinical phenotypes (Figure 1) and their informants completed the NEO Personality Inventory (NEO‐PI). Disease severity was measured using the Clinical Dementia Rating Scale (CDR). Caregiver burden was measured using the Zarit Burden Interview (ZBI). Discrepancy scores were computed for all NEO‐PI Big 5 scores and a global discrepancy score. Participants were classified as having high/low discrepancy using a median split for each NEO‐PI discrepancy score. T1‐weighted 3T MRI grey matter volumes were normalized to intracranial volume for all ROIs in the Schaefer100×17 parcellation, and linear regression analyses related global difference score to Bonferroni‐corrected atrophy regions.ResultHigher levels of caregiver burden were associated with higher informant ratings of patient Neuroticism (ß = 0.02, p = .013) and lower informant ratings of patient Agreeableness (ß = ‐0.02, p = .0004), Conscientiousness (ß = ‐0.02, p = .005), and Openness (ß = ‐0.01, p = .014) independent of disease severity. Patients with high global discrepancy scores showed reduced cortical volumes in left ventral PFC, right medial PFC, and right superior temporal gyrus. Patients with low discrepancy scores showed relatively preserved cortical volumes in bilateral somatomotor cortex, right posterior cingulate, and left supplementary motor, superior parietal lobule, and postcentral gyrus (all p‐values<.05, Figure 2). Reduced volumes in the high discrepancy group were driven by patients with bvFTD (Figure 3).ConclusionInformant ratings of Big 5 personality factors may be confounded by caregiver burden, highlighting the need for more objective measures of personality and behavior in ADRD. Additionally, high levels of discrepancy between informant and patient ratings of personality may reflect loss of insight secondary to cortical atrophy in frontal and temporal structures.

Worldwide Regulations and Guidelines for Agricultural Water Reuse: A Critical Review

Water reuse is gaining momentum as a beneficial practice to address the water crisis, especially in the agricultural sector as the largest water consumer worldwide. With recent advancements in wastewater treatment technologies, it is possible to produce almost any water quality. However, the main human and environmental concerns are still to determine what constituents must be removed and to what extent. The main objectives of this study were to compile, evaluate, and compare the current agricultural water reuse regulations and guidelines worldwide, and identify the gaps. In total, 70 regulations and guidelines, including Environmental Protection Agency (EPA), International Organization for Standardization (ISO), Food and Agriculture Organization of the United Nations (FAO), World Health Organization (WHO), the United States (state by state), European Commission, Canada (all provinces), Australia, Mexico, Iran, Egypt, Tunisia, Jordan, Palestine, Oman, China, Kuwait, Israel, Saudi Arabia, France, Cyprus, Spain, Greece, Portugal, and Italy were investigated in this study. These regulations and guidelines were examined to compile a comprehensive database, including all of the water quality monitoring parameters, and necessary treatment processes. In summary, results showed that the regulations and guidelines are mainly human-health centered, insufficient regarding some of the potentially dangerous pollutants such as emerging constituents, and with large discrepancies when compared with each other. In addition, some of the important water quality parameters such as some of the pathogens, heavy metals, and salinity are only included in a small group of regulations and guidelines investigated in this study. Finally, specific treatment processes have been only mentioned in some of the regulations and guidelines, and with high levels of discrepancy.

Somatization Level Among Psychosomatic Dermatology Patients: Relationship With Dyadic Adjustment, Gratitude, Forgiveness, and Perfectionism.

This study aimed to investigate the relationship between the somatization level and dyadic adjustment, gratitude, forgiveness, and perfectionism in patients with psychosomatic dermatologic complaints. In this correlational survey study, participants were recruited using the purposive sampling method from patients with psychosomatic dermatologic complaints, who were 18 or older, married, and living in the Turkish Republic of Northern Cyprus. Data were collected from patients diagnosed as having a dermatological disease with probable psychological etiology by a dermatologist at the dermatology outpatient unit of Nicosia Dr. Burhan Nalbantoğlu Hospital during April-December 2018. The demographic information form, symptom checklist, dyadic adjustment scale, gratitude questionnaire, Heartland forgiveness scale, and almost perfect scale were administered to the participants. In this study, female sex, low education level, being an immigrant, low dyadic adjustment, perfectionism with a high level of discrepancy, low forgiveness of self and situations, and low gratitude levels were found to be probable risk factors for somatization. During the psychiatric treatment of patients with somatic complaints, marital problems, forgiveness, and perfectionism with a high level of discrepancy should be considered.

Criticality Analysis of Medical Equipment: A Case Study at King Hussein Cancer Center (KHCC) Amman-Jordan

Proper maintenance management of medical equipment is of prime importance to the health sector as otherwise this would result in poor treatment, longer waiting times and patients suffering as well as draining, the normally limited, financial resources of most public medical institutions. King Hussein Cancer Center (KHCC), Amman-Jordan is a unique medical institution where treatment of different types of cancer is provided and where equipment unavailability is considered a risky event which may result in life-threatening complications. This is especially true for critical treatment equipment. Criticality analysis was performed on a representative sample of medical equipment at KHCC in order to assess and improve the effectiveness of current maintenance management policy. A sample of twenty-one medical devices was selected for this study. Past failure and maintenance data, in addition to relevant financial information, were collected for these devices and compiled into criticality ranks. In order to take account of the special nature of these equipment medical criticality (in terms of risk score) values were also calculated based on relevant tables of the American Society for Healthcare Engineering (ASHE). Overall criticality ranking of medical equipment was then determined based on equipment cost, ASHE risk score, reliability and maintenance cost. The present results have revealed major flaws within the purchase and maintenance policies at KHCC. For example, some extremely expensive devices with extremely high-cost maintenance contracts were revealed to exhibit low reliability values and suffer from repeated failures. These were within patient-sensitive equipment cancer treatment devices. The results also have shown that under "less than optimum" maintenance practice, the ASHE risk score may be a misleading measure of equipment criticality. This was shown by comparing the obtained overall equipment criticality to their ASHE risk score where high level of discrepancy was present between the two measures.

The implications of variability in the instruction and practice of the Rinne test

PurposePrior to graduation, all medical students are expected to master the delivery of two basic hearing examinations: the Rinne and Weber tuning fork tests. Throughout basic science years, these tests are routinely examined to determine student competency in clinical skills. However, there exists a high level of variation between practitioners in their modes of implementing these examinations. Materials and methodsUtilizing online databases, YouTube and PubMed, the phrases “Rinne tuning fork test” and “Weber tuning fork test” were searched to find instructional guidelines on how to perform these hearing examinations. Each medium was assessed on five different parameters related to clinical implementation of the hearing exam. In total, 31 of 35 videos met inclusion criteria with views ranging from 1,000 to 1,100,000 and were subsequently assessed for data collection. ResultsThrough our research investigating instructional video resources of the Rinne test, as well as guidelines in textbooks and journal articles, we were able to determine the major source of incongruity in the instructional process. Of the 31 videos analyzed, bone conduction was tested prior to air conduction in 30 of the 31 videos, while 20 of 31 practitioners held the fork tines parallel to the axis of hearing with the point of reference being the external auditory canal. Only 3 of 31 videos provided guidance regarding the distance the tuning fork should be held away from the patient. A high level of variability exists concerning the purported best approach to testing air and bone conduction in the educational materials available. ConclusionAfter reviewing and cross-referencing multiple sources from different mediums, the conclusion was drawn that specific parameters of delivery did not impact the diagnostic reliability of the Rinne test. The major commonality amongst these educational sources was that patients must be able to identify air conduction being louder that bone conduction in order to have a “positive” Rinne test. Given the high level of discrepancy that exists and the likelihood that these examinations will be replaced by audiometry, are these screening tests necessary to teach medical students?

Reproducible protocols for metagenomic analysis of human faecal phageomes

BackgroundRecent studies have demonstrated that the human gut is populated by complex, highly individual and stable communities of viruses, the majority of which are bacteriophages. While disease-specific alterations in the gut phageome have been observed in IBD, AIDS and acute malnutrition, the human gut phageome remains poorly characterised. One important obstacle in metagenomic studies of the human gut phageome is a high level of discrepancy between results obtained by different research groups. This is often due to the use of different protocols for enriching virus-like particles, nucleic acid purification and sequencing.The goal of the present study is to develop a relatively simple, reproducible and cost-efficient protocol for the extraction of viral nucleic acids from human faecal samples, suitable for high-throughput studies. We also analyse the effect of certain potential confounding factors, such as storage conditions, repeated freeze-thaw cycles, and operator bias on the resultant phageome profile. Additionally, spiking of faecal samples with an exogenous phage standard was employed to quantitatively analyse phageomes following metagenomic sequencing. Comparative analysis of phageome profiles to bacteriome profiles was also performed following 16S rRNA amplicon sequencing.ResultsFaecal phageome profiles exhibit an overall greater individual specificity when compared to bacteriome profiles. The phageome and bacteriome both exhibited moderate change when stored at + 4 °C or room temperature. Phageome profiles were less impacted by multiple freeze-thaw cycles than bacteriome profiles, but there was a greater chance for operator effect in phageome processing. The successful spiking of faecal samples with exogenous bacteriophage demonstrated large variations in the total viral load between individual samples.ConclusionsThe faecal phageome sequencing protocol developed in this study provides a valuable additional view of the human gut microbiota that is complementary to 16S amplicon sequencing and/or metagenomic sequencing of total faecal DNA. The protocol was optimised for several confounding factors that are encountered while processing faecal samples, to reduce discrepancies observed within and between research groups studying the human gut phageome. Rapid storage, limited freeze-thaw cycling and spiking of faecal samples with an exogenous phage standard are recommended for optimum results.

Recent trends in the productivity of the Italian trawl fishery: The importance of the socio-economic context and overexploitation

The aim of this paper is to highlight the productivity of Italian trawl fishery, one of the most important sector in the Italian fishing fleet. As shown in this study, three variables play a significant effect on Total Factor Productivity (TFP) in a given year: the actual number of fishing days, the average market prices of commercial species and the stock of physical capital. While the number of fishing days can have a negative impact on the TFP, a positive correlation occurs instead with the other two variables. It is also possible to observe a high variability in TFP among different regions of Italy, a finding that is to be expected given the dual nature of the Italian economy, characterized by a high level of discrepancy in prosperity between the North and the South. This lends support to the hypothesis that significant positive externalities may occur in a more dynamic business environment, one which is both open to innovation and increased international and social relations.

Variations in eating habits between Ecuadorian parents and children related to excess weight

Abstract Objectives: to evaluate the concordance of food consumption habits declared by parents and by their children, and relate it to excess weight prevalence. Methods: cross-sectional study. Concordance was analysed by Kappa and McNemar tests. The analysis of the discrepancies against excess weight was made by logistic regression. Results: we found high levels of discrepancy between parents and children: Kappa -0.02-0.31 (p≤0.01), McNemar p≤0.01. Excess weight did not vary in terms of the discrepancies, except for the affirmation of following a diet (ORadjusted: 1.79; CI95%: 1.49-2.14). Conclusions: agreement between parents and their children demonstrated discordance, but did not influenced on excess weight.

How Should Discrepancy Be Assessed in Perfectionism Research? A Psychometric Analysis and Proposed Refinement of the Almost Perfect Scale–Revised

Research on perfectionism with the Almost Perfect Scale–Revised (APS-R) distinguishes adaptive perfectionists versus maladaptive perfectionists based primarily on their responses to the 12-item unidimensional APS-R Discrepancy subscale, which assesses the sense of falling short of standards. People described as adaptive perfectionists have high standards but low levels of discrepancy (i.e., relatively close to attaining these standards). Maladaptive perfectionists have perfectionistic high standards and high levels of discrepancy. In the current work, we re-examine the psychometric properties of the APS-R Discrepancy subscale and illustrate that this supposedly unidimensional discrepancy measure may actually consists of more than one factor. Psychometric analyses of data from student and community samples distinguished a pure five-item discrepancy factor and a second four-item factor measuring dissatisfaction. The five-item factor is recommended as a brief measure of discrepancy from perfection and the four-item factor is recommended as a measure of dissatisfaction with being imperfect. Overall, our results confirm past suggestions that most people with maladaptive perfectionism are characterized jointly by chronic dissatisfaction as well as a sense of being discrepant due to having fallen short of expectations. These findings are discussed in terms of their implications for the assessment of perfectionism, as well as the implications for research and practice.

Analysis of Turbulence Modelling Approaches to Simulate Single-phase Buoyancy Driven Counter-current Flow in a Tilted Tube

In the present paper, both Large Eddy Simulation (LES) and unsteady-RANS (uRANS) CFD studies of single-phase buoyancy-driven counter-current flow in a pipe are presented for an Atwood number of 1.15×10−2 and an inclination angle of 15 degrees from the vertical. The basic flow phenomena involved are fundamentally the same as those encountered in various industrial applications including passive coolant flow in the loops of a nuclear reactor. Earlier work on this type of flow was focused on its physical aspects using both experimental measurements and Direct Numerical Simulation (DNS). The present work investigates the performance of several commonly used LES eddy viscosity subgrid-scale models. The results show that LES is able to reproduce accurately the experimental results and that the dynamic Smagorinsky subgrid-scale model gives the best predictions. The results of those calculations were then used to obtain more information on the physics of such flow. As regards uRANS simulations, a range of classic two-equation linear eddy viscosity models, based on low-y + formulation at the wall and the single gradient diffusion hypothesis for the turbulent density fluxes were compared against experimental data available in the literature. An elliptic blending Reynolds stresses model (EBRSM) with generalised gradient diffusion hypothesis (GGDH) for the scalar fluxes was then implemented and compared with experiments. The latter showed very good agreement for the first order moment with the experimental data whereas all the two-equation eddy viscosity based models showed rather high levels of discrepancy. The main cause of discrepancy was found to be the underprediction of the axial turbulent buoyancy production effect, which has a more detrimental impact on the eddy viscosity models than the second moment closure one.

Parent–child acculturation, parenting, and adolescent depressive symptoms in Chinese immigrant families.

Using a sample of 388 father-adolescent and 399 mother-adolescent dyads in Chinese immigrant families, the current investigation tested Portes and Rumbaut's (1996) assertion that generational dissonance may indicate a family context that places children at increased risk for adverse outcomes. Study findings suggest that a high discrepancy in father-adolescent acculturation levels relates significantly to more adolescent depressive symptoms. The study further demonstrates that the quality of the parenting relationship between fathers and adolescents operates as a mediator between father-adolescent acculturation discrepancy and adolescent depressive symptoms. Specifically, a high level of discrepancy in American orientation between fathers and adolescents is associated with unsupportive parenting practices, which, in turn, are linked to more adolescent depressive symptoms. These relationships are significant even after controlling for the influence of family socioeconomic status and parents' and adolescents' sense of discrimination within the larger society.

Relationship Between Perceived Needs and Assessed Needs for Services in Community-Dwelling Older Persons

We examine the relationship between the perceived needs and assessed needs of community-dwelling seniors. Trained research assistants administered the Naturally Occurring Retirement Community Baseline Survey to 268 community-dwelling older adults in suburban Maryland. Perceived and assessed needs were measured in the domains of health and function (memory, health, functional needs, mobility, and financial management), mental health (depression and loneliness), sensory functioning (vision), and health behaviors (nutrition and exercise). In the areas of functional needs, mobility, financial management, loneliness, and vision, persons who scored as more needy were already utilizing significantly more services. Of persons not receiving services, participants in need of memory, physical health, functional, loneliness, and nutrition services were more likely to indicate they would use those services. Although there were significant relationships between assessed needs and perceived needs, there was also a high level of discrepancy, such that a substantial proportion of those participants screened as not needing services requested those services, and a sizable proportion of those who screened as needing services did not request them. The results also show a high prevalence of needs among older adults and yet low service use by those with needs for these services. Both assessed and perceived needs should be examined in future need assessment surveys. Further investigations into the nature of discrepancies will likely result in improvement in the methodologies of screening assessed and perceived needs. Services targeted to older adults must be made more available to those dwelling in the community.

Chronic patients in undergraduate education: didactic value as perceived by students

Medical education should prepare students for future clinical practice. However, this preparation is inadequate for the most prevalent problem in health care: chronic disease. This applies to the continuous aspect of chronic disease. Within the context of a newly developed programme, we investigated what makes a chronic patient interesting in the eyes of medical students, what they learned from a specific programme in which each student had contact with a chronic patient 4 times in 8 months, and what they learned from their patients. A total of 240 Year 3 students were enrolled in the programme, 89 of whom filled in questionnaires at both the start and end of the programme. Topics included the characteristics of the ideal and the actual patient, the Ideal Physician Questionnaire, and several questions on the expected and actual amount of knowledge gained from the patient. Students preferred patients who demonstrated clear symptoms and had frequent contacts with health care professionals during the programme to 'well adapted' patients. The perceived knowledge obtained from the patient was less than they had expected at the start of the programme. A didactic gain perceived as low was mainly due to low expectations of gaining knowledge at the start of the programme, a doctor-centred attitude and a high level of discrepancy between the student's ideal patient and the actual patient. Programmes that aim to present chronic patients to medical students focus on patient selection so that patients who differ only very slightly from healthy persons are eliminated. In addition, realistic information on the types of patients with whom students can expect to have contact may help students appreciate the knowledge to be gained from these patients.

Repeatability of Phase 1 habitat survey

As the major part of a Habitat Survey of Wales, over 80% of the land surface was surveyed in the field between 1987 and 1997 using the Phase 1 method. A resurvey of 294 randomly selected points was carried out during the early stages to audit the quality of the data being collected, leading to the development of a set of recommendations for the surveyors to improve the consistency and accuracy of habitat mapping. Recent studies have indicated a high level of discrepancy between organisations in field habitat mapping using the Phase 1 method. The findings of the Phase 1 audit in Wales are presented here to show the level of repeatability that was achieved within an organisation. There was 76% correspondence in habitat mapping between ‘surveyor’ and ‘assessor’ at the level of individual Phase 1 habitat classes. The degree of repeatability varied according to habitat strata: it was highest for modified land cover types (88%), lowest for semi-improved types (56%) and intermediate for semi-natural types (75%). An overall estimate of the repeatability of Phase 1 survey in the study area of 83% was obtained by weighting the figures for the three strata by the proportion of land area occupied by each stratum. This figure increased to 85% when habitats were amalgamated into Broad Habitat groups. These results are considerably better than those reported by studies of consistency between organisations. Most of the discrepancies between surveyor and assessor were caused by differences in habitat identification. However, at almost two thirds of the points where such a difference occurred, the assessor noted that the vegetation was transitional or borderline with that mapped by the surveyor.

Self-instructional training for assertive-refusal behavior

The present study evaluated self-instructional training (SIT) for assertiverefusal behavior and investigated two variables which have been considered important determinants of attitude change: discrepancy and involvement. Forty nonassertive college women were randomly assigned to one of four conditions: High Assertion SIT, Moderate Assertion SIT, Behavioral Insight (placebo), and Delayed Treatment Control. The SIT conditions reflected two levels of discrepancy. Involvement was investigated as a within-subjects factor. SIT was significantly more effective than no treatment or placebo control on several measures including a behavioral test and self-reports of thoughts and behaviors. No generalization of treatment effects was found on two nonlaboratory measures. The high level of discrepancy advocated in the High Assertion condition was not detrimental and led to significantly greater behavioral change than the Moderate Assertion condition. The few significant effects for involvement reflected differential response to the placebo condition. Results highlighted the continued necessity of assessing nonspecific treatment effects.