Iris Publishers- Open access Journal of Textile Science & Fashion Technology | Reduction of Garments Bottleneck Processing Time on the Sewing Line of the Garments Industries

 

Authored by Md Dulal Hosen*

Abstract

Operation management is one among the foremost powerful technique for deciding in production floor management and therefore the sewing stage is that the most vital and crucial stage in garment production floor, involves tons of operations having a special cycle times within the traditional sewing line of clothes , all of the workers aren’t equally expert to try to all the method . As a result, the problematic zones arise within the assembly line, which is typically referred to as the bottleneck workstation or operation. This study deals with bottleneck detection in sewing line. A bottle neck may be a point of congestion during a production system that happens when workloads arrive too quickly for the assembly process to handle, denotes as, rock bottom output point in assembly line. Reducing bottle neck is additionally related with increasing productivity it’s proven that with the assistance of various bottleneck elimination technique like line balancing, lean application technique, has been possible to spot non-value-added process and eliminate them from production process. During this paper, we’ve taken the assembly data of various apparel products like sport shirt and T-shirt. By applying lean technique, ensures maximum space utilization, inventory & transportation reduction and thus reduces cycle time & increases efficiency. The experimental results show significant improvement in productivity and line efficiency as compared to the prevailing system.

Keywords: Method Study; Lean; SMV; Improvement; Productivity

Introduction

Over the past 150 years, garment structures have changed from the manual fitting and assembly of individual hand sewn garments to mechanized, automated and sometimes robotized for batch production. Recently, to satisfy customer’s demands through the assembly of excellence garments product at lowest possible cost are the foremost focuses in RMG industry [1,2]. Appropriate planning or controlling system can contribute to understand better performance during this area. The assembly process of garments industry is often grouped into three main stages cutting, sewing and finishing. The stitching stage is that the foremost vital and crucial stage among them [3]. Sewing stages involves plenty of operations having a unique cycle time to perform within the traditional sewing line of garments, all of the workers aren’t equally expert to undertake to all or any the tactic [2]. As a result, the problematic zones arise within the mechanical system, which is usually remarked because the bottleneck workstation or operation [4]. Bottleneck is an operation having longer cycle time and where process goes slow within the stitching mechanical system. This process that have bottleneck problem, is that the main reason for reducing the efficiency of the assembly line. Line balancing is one quite technique for balancing the assembly line. At present, traditional production system possesses to urge replaced with assembly lines for greater product variability and shorter cycle time. The aim of this study is to unravel the bottleneck problem of sewing line during a garment manufacturing company [1]. The layout of the road was modified using the road balancing and time and examination technique. The world elimination of quotient on has greatly enhanced the opportunities for sourcing from Bangladesh.

Bangladesh supplies over US$28 billion worth of textiles and apparel to the world markets. And exports are growing rapidly as more and more buyers around the turn to India as an alternative to China. In 2005, spurred by the worldwide elimination of quotas shipments to the EU soared by 30% and people to the USA shot up by 34%. These increases are remarkable, as long as EU imports from all sources rose by only 8% while US import growth was just 6% [5]. Consumer spending is slowing down everywhere the planet. Retailers are trying to find real innovation from their suppliers. They want really new garments made from new fabrics and yarns. They want new services to offer their customers [6].

Competition within the late 1990’s are going to be supported the capabilities and core competences of textile and clothing companies and on the building of long-term supply relationships [7]. There are many opportunities to be addressed. Textile and clothing machinery will still be improved butt the foremost interesting technologies for the 2000s are within the areas of fibers, fabrics, measurement, control and multimedia. We can say an apparel industry is an independent industry from the essential requirement of staple to final products, with huge value addition at every stage of processing [8]. Apparel industry is of the total country export. The largest foreign exchange earning sector contributing 15% in this scenario, the Bangladeshi garment industries have witnessed substantial improvements in recent years. But the unnecessary capital investment isn’t getting to solve the matter entirely; moderately this may end up the waste in end of the day [9]. The aim of this study is to unravel the bottleneck problem of stitching line during a garment manufacturing company. For reducing bottleneck in apparel sewing line, different elimination techniques have been used [10]. Such as work sharing method, line balancing method, implementation of lean. We reveal that how above-mentioned techniques can be integrated to show a best picture of non-valueadded activities present in the system and, hereby eliminating the problem that causes bottleneck.

Materials and Methods

Materials

In this Research was conducted in a selected garment located in Tongi, Gazipur, Bangladesh. Here quantitative data used for the analysis of this research. The collected data tabled the data firstly in accordance with traditional operation break down then according to work sharing method and then Lean line operational break down. Finally, the results are compared with the help of Time study, Bar chart, Histogram etc. In this research some very normal materials are used to carry out the data collection and analysis. Those materials are:-

1. Statistical data

2. Foreign Trade Source

3. Paper

4. Pencil

5. Calculator

6. Pen

7. Scale and

8. Stop watch etc.

Methods

The following Line Balancing Techniques are being used in this research:-

• Method Improvement

• Share Capacity

• Add Additional Manpower or Machine

• Improve Workstation Layout

• Better Operator

• Work for Extra Hours

• Use Time Saving Tricks

• Reduce Bottleneck by Work Sharing Method

At first, a stitching line of t-shirts was chosen for balancing and required information was gathered from the road like number of operator and helper, cycle time, target, and SMV. Then we took the time of every process needed for the completion of every worker. Then we found out the bottleneck area. At the numbers 6, 10, 12, and 17 operators, the capacity was above the previous operators, thus, add process was high there. Two operators were reduced from the operation hem sleeve and attached sleeve to body and the number 6 operation was shared with number 5. Moreover, number 17 was removed and shared with the number 18 operator. Therefore, the work process development of line balancing is done by this flow process:-

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Iris Publishers- Open access Journal of Addiction and Psychology | Perceptual Accuracy and Thought Complexity of a Correctional Population with the Wechsler IQ Test and the Rorschach

 

Authored by Alberto Miranda*

Abstract

The purpose of this study was to examine the differences between incarcerated and non-incarcerated individuals on the cognitive measures of the Rorschach Inkblot Test (i.e., FQ-%, FQo%, FQu%, WD-%, Complexity, F%, WSumCog, TP-Comp, and EII-3) to help determine how the two groups process information. In addition, it involved an investigation of performance on the Rorschach variables among different levels of intellectual and perceptual ability as determined by the WAIS-IV to understand how the variables relate to underlying cognitive processes. The study involved the use of archival data from 36 incarcerated males and 43 males receiving community mental health services. Several multivariate analyses of variance (MANOVAs) were used to determine whether differences existed between the two groups, as well as between different levels of intellectual and perceptual ability for each of the specified Rorschach variables. Findings demonstrated differences in Complexity and WSumCog scores among levels of intellectual ability, suggesting more effective processing and synthesis of information with advanced cognitive ability. Differences among perceptual ability levels were found in Complexity, WSumCog, F%, and EII-3 scores. Differences between incarcerated and non-incarcerated individuals were not significant, suggesting Rorschach variables may be less influenced by external factors such as quality of education. Nevertheless, important qualitative distinctions specific to offender cognitive style were identified, which led to recommendations regarding treatment interventions, including the incorporation of cognitive rehabilitation models. Differences within the incarcerated sample based on the level of care needed by the inmate were found for Complexity, F%, WSumCog, EII-3, and TP-Comp, demonstrating a relationship between perceptual dysfunction and adaptability within the correctional environment. Finally, an interaction effect was found between intellectual ability and incarceration status on FQu%, suggesting a preference for more conventional responses with increasing levels of cognitive ability. Future investigations are recommended to consider specific factors involved in the experience of incarceration that may help to explain this relationship.

Introduction

The United States maintains the world’s largest population of prisoners [1]. According to Carson, “U.S. state and federal correctional facilities held an estimated 1,574,700 prisoners on December 31, 2013, an increase of 4,300 prisoners from yearend 2012” [2]. Recidivism rates in the United States are also among the highest. Results of a 2002 study showed that among the 275,000 prisoners released in 1994, 67.5% were rearrested within 3 years, 51.8% of whom were serving prison terms [3]. Additionally, minority groups account for a major portion of the prison population in the United States. In 2009, African Americans represented 39.4% of the prison and jail population while Hispanics represented 20.6% [4]. Taken together, these statistics encompass the continued need for research geared toward the development of assessment measures to improve rehabilitation and psychological treatment programs for the prison population in the United States.

One important component of rehabilitation may involve the cognitive functioning of prisoners. Studies have demonstrated a significant number of prisoners within secure forensic settings exhibit cognitive difficulties related to problematic thinking styles. Lindsay, Hastings, Griffiths, and Hayes, for instance, found a significant number of offenders in their study had an intellectual disability (IQ < 70) or were within the borderline range (IQ between 70 and 79) of intellectual functioning [5]. Similarly, Sinclair, Blencowe, McCaig, and Misch found prisoners tend to have significantly lower mean scores on the Full Scale Intelligence Quotient (FSIQ) and Verbal Comprehension Index (VCI) on the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) than the general population [6,7]. Prisoners in that study also demonstrated greater neuropsychological deficits in behavioral inhibition, cognitive flexibility, and problem-solving [6]. Such difficulties are likely to underlie problem behaviors or cognitive distortions that result in criminal activity or other issues that affect social functioning. Understanding the relationship between cognitive deficits and criminal behavior thus has important implications for the conceptualization and rehabilitation of offenders.

have significantly lower mean scores on the Full Scale Intelligence Quotient (FSIQ) and Verbal Comprehension Index (VCI) on the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) than the general population [6,7]. Prisoners in that study also demonstrated greater neuropsychological deficits in behavioral inhibition, cognitive flexibility, and problem-solving [6]. Such difficulties are likely to underlie problem behaviors or cognitive distortions that result in criminal activity or other issues that affect social functioning. Understanding the relationship between cognitive deficits and criminal behavior thus has important implications for the conceptualization and rehabilitation of offenders.

While the association between low intellectual functioning and criminal activity has long been demonstrated, standard neuropsychological measures have limitations in specifically assessing the prison population. Intellectual measures like the WAIS-IV are often insensitive to demographic variables such as ethnicity and educational attainment [11,12]. Lower scores may be representative of factors such as low socioeconomic status and poor quality of educational experience rather than true cognitive deficits. This is likely to result in the misclassification of many prisoners based on their perceived level of intellectual ability. Important aspects of cognitive functioning that pertain to treatment may also be overshadowed by the low base rates of the prison population. For this reason, additional measures and techniques, such as performance-based measures, may be necessary to supplement the assessment of prisoners to ensure greater accuracy.

Perceptual reasoning is one important aspect of cognition that plays a critical role in problem-solving. Perceptual reasoning is generally considered to be less affected by educational experience when compared to verbal comprehension tasks [13]. Measures that assess components of perceptual ability (i.e., accuracy and complexity) may therefore offer critical information about the cognitive ability of disadvantaged populations, such as offenders. The Rorschach is a behavioral problem-solving task in which respondents must use reasoning and problem-solving skills to make sense of the perceptual regularities and irregularities found in inkblots. In creating a response to the ambiguous and complex stimuli, respondents must utilize their internal cognitions and underlying schema. According to Perry, Viglione, and Braff, this makes the Rorschach a good technique for assessing thought disorder, psychological complexity when problem-solving, and interpersonal understanding of human representations [14].

The Rorschach includes several scales that incorporate cognitive functional abilities. The complexity scale from the Rorschach Performance Assessment System (R-PAS), for instance, provides information regarding a person’s cognitive capacity for problem-solving and organizing his or her environment. Responses that integrate different locations and have multiple descriptive variables result in higher complexity scores. The form quality scale represents adaptive functioning in how the individual interprets or organizes external stimuli from the environment. In a sense, this scale allows researchers to examine how an individual organizes ambiguous information into some type of order. Creating some type of order when information is random and disparate is important for successful problem-solving. According to Frank, form quality may also reflect an individual’s “capacity for better functioning in the world” [15]. Together, these scales may provide a key interpretation of the functioning of a person in his or her environment, as well as the ability to approach a situation that is unfamiliar, organize it, and respond cohesively. In this manner, performance-based measures, such as the Rorschach, tap into crucial components of cognitive style, or rather the preferred way in which an individual processes information.

Statement of the Problem

Current cognitive assessment of the prison population is hindered by a variety of factors, including test bias of intellectual measures, subcultural components of the prison environment that influence performance, and the underrepresentation of prisoner normative data on the standard measures used. The Rorschach, however, may offer a unique opportunity to enhance the assessment of intellectual and cognitive ability specific to the prison population. Contemporary intelligence tests appear to be better indicators of socioeconomic status and education, thus giving clinicians information on the limitations or relative cognitive strengths of their patients. These measures, however, do not provide a window into how a subject processes stimulus. The Rorschach demonstrates where the perceptual processing problems are located and indicates how faulty processing may lead to problematic thinking and judgment. In other words, intelligence tests indicate the result of cognitive processes whereas the Rorschach demonstrates the underlying cognitive processes that (in combination with other factors such as education and socioeconomic status) result in the IQ test scores a person ultimately obtains. Thus, the Rorschach may potentially give unique information to provide better intervention strategies and treatment that will address patients’ specific needs, because focus can be brought to specific cognitive processes that need to be modified if people are to make better intellectual analyses and decisions. However, limited empirical support, especially in relation to the prison population, exists to support this claim. While perceptual accuracy appears to play an important role in the development and maintenance of cognitive distortions, it remains unclear as to how perceptual problems specifically relate to social functioning and criminal behavior.

While the prison population and recidivism rates remain high, it is necessary to understand how problems with social and cognitive functioning may result in criminal behavior for some individuals. The present study was designed to address two specific goals. The first was to uncover how intellectual ability relates to performance within the cognitive domains of the Rorschach (i.e., perceptual accuracy, thought complexity, and thought disturbance). The second goal was to investigate how perceptual inaccuracy relates to problems with social functioning or criminal behavior. The current study was guided by a quantitative design in which the researcher examined archival data from two assessment sites. In doing so, the researcher compared the intellectual functioning, perceptual accuracy, thought complexity, and thought disturbance of adult male prisoners from a California prison for men to those of an adult male sample from an outpatient clinic. Each participant previously had been administered a neuropsychological battery that included the WAIS-IV, Rorschach (using the R-PAS scoring method), and the Personality Assessment Inventory (PAI) or the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). These measures were used separately to determine overall intellectual abilities (WAIS-IV FSIQ, VCI, PRI, WMI, PSI), perceptual reasoning (WAIS-IV PRI), perceptual accuracy (R-PAS FQo%, FQu%, FQ-%, WD-%), perceptual complexity (R-PAS Complexity and F%), and thought disturbance (R-PAS WSumCog, TP-Comp, EII-3).

This study offers several important implications for clinical practice. Determining whether the Rorschach cognitive variables correlated with other neuropsychological measures was designed to support its utility to enhance the understanding of a patient’s cognitive style. As measures such as the WAIS-IV may be limited in terms of assessing certain populations, the Rorschach may help to correctly classify individuals with poor intellectual functioning specific to problems with perceptual accuracy or complexity. Furthermore, by uncovering the relationship between perceptual accuracy and problems with social functioning, clinicians in correctional settings can better address the specific needs of their patients.

The present study

While it appears that perceptual accuracy may relate to adaptive functioning, it is unclear whether severe deficits lead to more problem behaviors, including criminal activity. The present study was designed to address two specific goals. The first was to uncover how the Rorschach variables of form quality, complexity, and thought disturbance underlie the cognitive processes that influence IQ score as measured by the WAIS-IV. The second goal was to investigate how perceptual accuracy, thought complexity, and thought disturbance scores relate to problems with social functioning or criminal behavior. The current quantitative study involved an examination of archival data from two assessment sites to observe differences between the intellectual functioning, perceptual accuracy, and thought complexity of adult male prisoners compared to a normal sample. Data from adult male inmates from the men’s prison and adult male clients from the outpatient clinic were used. Each participant previously had been administered a psychodiagnostic battery that included the WAIS-IV, Rorschach (using the R-PAS scoring method), and the PAI or MMPI- 2. The study involved exploring the relationship between Rorschach cognitive variables (perceptual accuracy, thought complexity, and thought disturbance) and intellectual/perceptual ability as measured by the WAIS-IV. In addition, it involved an examination of differences between the two samples on R-PAS performance, as well as differences that existed within the incarcerated sample by designated level of care.

Null hypotheses

Five hypotheses (stated in null form) were determined based on the findings from the literature:

A. Hypothesis 1: There will be no significant difference between participants’ performance on Rorschach cognitive variables (form quality, thought complexity, and thought disturbance scores) based on intellectual ability.

B. Hypothesis 2: There will be no significant difference between participants’ performance on Rorschach cognitive variables (form quality, thought complexity, and thought disturbance scores) based on perceptual ability (PRI).

C. Hypothesis 3: There will be no significant difference in R-PAS variables (form quality, thought complexity, and thought disturbance) between offenders and outpatient subjects.

D. Hypothesis 4: There will be no significant difference in R-PAS variables (form quality, thought complexity, and thought disturbance) between varying degrees of institutional care level for offenders (GOB, CCCSM, MHCB).

E. Hypothesis 5: There will be no significant interaction effect between incarceration status and level of cognitive functioning on R-PAS variables.

Considering that the Rorschach variables of form quality, thought complexity, and thought disturbance have demonstrated some relation to intellectual ability, it was expected that participants with lower FSIQ and PRI scores would show greater impairment levels on these Rorschach variables. Furthermore, as problems with perceptual accuracy, thought complexity, and thought disturbance have been demonstrated to be related to psychopathology, learning disabilities, and poor social functioning, it was expected that offenders would demonstrate greater problems on these variables when compared to an outpatient sample.

Methods

Participants

A purposeful and convenient sample was collected using archival data from the men’s prison in California, and from the outpatient clinic in California. The archival data from the prison consisted of previously collected test batteries that were administered by psychodiagnostic practicum students with adult male offenders who were referred for psychodiagnostic assessment. Archival data from the outpatient clinic consisted of previously obtained test batteries also administered by psychodiagnostic practicum students with adult males (>18 years) who were referred for psychodiagnostic or neuroeducational assessment. All testing completed from both sites was supervised by a licensed psychologist. Only complete batteries were considered for the current study. A complete battery consisted of a WAIS-IV, PAI or MMPI-2, and a Rorschach using the R-PAS scoring system. Data from participants were excluded if the presence of a previously diagnosed brain injury, psychotic disorder, or dementia was indicated in their case file. Data collected from the outpatient clinic were also excluded for those participants with a reported history of arrest. Test validity of the remaining participants was then screened using the validity scales of either the PAI or MMPI-2. Only those participants with valid profiles were used for this study, resulting in 36 participants from the CIM and 43 from AUTAPS for a total of 79 participants.

The mean subject age of the inmate sample (n = 36) was 44.33 (SD = 14.48) years. The mean subject age of the outpatient sample (n = 43) was 28.51 (SD = 9.95) years. Education for the entire sample (N = 79) ranged from 6-22 years. The mean education level for the inmate sample was 11.64 (SD = 2.53) years, while the mean education level for the outpatient sample was 14.16 (SD = 2.71) years. Ethnic background for the sample demonstrated a diverse pool with 54.5% identifying as White, 15% as Latino, 4% as African American, 4% as Asian, 2% as Native American, 5% as multiracial, and 1% as another ethnic background.

Measures

Wechsler adult intelligence scale-IV: The Wechsler Adult Intelligence Scale-IV (WAIS-IV [7]) was used to provide a measure of general intellectual functioning and perceptual reasoning ability. The WAIS is a well-established scale with high consistency. According to the test manual, over a 2-12-week time period, test– retest reliabilities ranged from 0.70 (seven subscales) to 0.90 (two subscales). Inter-rater coefficients were high, all being above 0.90. The WAIS-IV is also correlated highly with the Stanford-Binet IV test (0.88).

Rorschach inkblot technique: The Rorschach was used to assess perceptual accuracy, complexity of thought processes, and thought disturbance using the R-PAS scoring system [16]. The R-PAS scoring system was normalized using an international reference sample of 640 individuals. About one fifth came from the United States and about two thirds from nine European countries. Validity was established by correlating the scales with other known measures. For instance, Weiner found an effect size “almost identical” to the MMPI [17]. Viglione and Taylor demonstrated a strong inter-rater reliability between 85% and 99% [18]. Exner (as cited in Groth-Marnat) reported test–retest reliabilities from 26-92 over a 1-year interval considering 41 variables [19].

Several specific R-PAS variables were used in this study to investigate perception and thinking domains. Form quality (FQ) is designed to measure the accuracy of the forms involved in a response; in other words, how well a response fits the blot contours at the location on the card. As such, form quality percentages (FQ-%, WD-%, FQo%, and FQu%) generally measure the conventionality of perception and reality testing. FQ-% is a measure of distortion or misinterpretation, often leading to poor judgments or unconventional behavior. WD-% more specifically indicates whether distortion or misinterpretation occurs even in perceptual situations that are more commonly selected. FQo% is a measure of conventional judgment, while FQu% measures unconventional and individualistic ways of interpreting the world. Additional cognitive variables were used that are generally associated with thought complexity and thought disturbance. Complexity is a variable that measures differentiation, integration, and productivity at the response level. It is derived from the sophistication of location, space, and object qualities within one’s response. The Form % variable relates to the proportion of pure form responses in a record and is generally considered to be the opposite of the Complexity variable (i.e., simplicity). The Ego Impairment Index-3 (EII-3) is a broad measure of thinking disturbance with the components of reality testing, thought disturbance, crude and disturbing thought content, and measures of interpersonal misunderstanding and disturbance. The Thought & Perception Composite (TP-Comp) assesses reality testing and thought disorganization. Finally, the Weighted Sum of the Six Cognitive Codes (WSumCog) is a measure of disturbed and disordered thought. Procedures.

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Iris Publishers- Open access Journal of Addiction and Psychology | From Stressed Self-Esteem to Emotional Climate Change

 

Authored by Georg Franck*

Abstract

In a world of global interdependence, in addition to the well-known climate change, another form of pollution threatens coexistence on the planet: an increasing heating of the emotional climate and concomitant corruption of cooperative behaviour. Waves of hostility, incitement and disinformation circulate around the world, massive threats and baseless allegations spread virally. They threaten our coexistence on the planet no less than the careless handling of natural resources. We risk a dangerous erosion of the social context. In addition to the ecology of material natural resources, we urgently need an ecology of emotion. The parallels and connections between physical global warming and mental climate warming are astonishing, and it is astounding that they have been ignored for so long (see Dorothea Franck, Emotional Climate Heater, online https: //dorotheafranck.word press.com/a-plea-for-awareness-watch-your-emotional-footprint /).

The Fight for The Victim Role

Globally networked communication connects everyone and everything. At the same time, prosperity gaps and global shifts in labour markets are causing an unprecedented rise in global migration. The complexity, confusion and speed of globalization overburdens our emotional even more than our rational competence. The extent to which anxiety and diffuse indignation can be exploited for obscure purposes is shown by the political shifts of recent years.

Crucial to understanding these shifts is the question of whether they have a common denominator. The answer is a resounding ‘yes’. In the foreground is the ubiquitous fight for the victim role. The diffuse fears and confused defensive postures come together in a shared sense of being overlooked and abandoned. They manifest themselves not only in the struggle for the material benefits of globalization, but also in the struggle for media attention. The lack of social recognition is so hurtful because it strikes at the heart of the person: the way in which a person conceives of their-self: their self esteem.

But if withdrawal symptoms from lack of social recognition are behind the rampant willingness to be incited to anger, one should reconsider those accusations of irrationality and regressiveness on the part of the agitated masses. Instead, we should take the opportunity of venturing a meaningful and understanding interpretation––one which may also open up new perspectives of resistance.

Social Recognition and The Economy of Self-Worth

Self-esteem is the affective side of self-awareness. And it has its own logic. In contrast to the cognitive side of self-awareness, affective self-awareness must not claim autonomy. It eminently depends on outer esteem. It has become perfectly obvious that the ego one can afford depends on its income of appreciative attention. Affective self-awareness’ own logic is that of the psychic economy, which converts the flow of attention received into the asset of selfworth.

Decreasing incomes put pressure on this economy, as do rising demands. In the case that the economy collapses under stress and becomes unpredictable, our original diagnosis is correct, certifying the sheer irrationality and regressiveness suffered as withdrawal symptoms. And yet, our self-esteem is resilient, and shows itself equipped to weather the storm. How, then, does the economy of self-worth withstand such stress?

The conversion of attention income into self-esteem proves itself truly an economy of sorts with its inclination to resort to tricks of ‘creative accounting’ under stress. Since the stress in the case of affective self-awareness can originate both from the income side and from one’s own claim of self-esteem, different forms of ‘cooking the books’ should be observed.

In fact, fraudulent accounting of self-worth knows two common tricks. One is called vanity, the other resentment. Vanity comes into play when the inner claim overdraws the outer means. The trick, then, is to double standards in evaluating income depending on whether it comes from flattering or critical quarters. If you adapt the appreciation opportunistically, the flatterers’ attention rises in book value. One can, therefore, butter up one’s balance by choosing one’s friends according to their preparedness to dole out adulation.

We all know the corruption wrought by flattering praise; but equally we all have made acquaintance with the terrible distress brought about when the attention we believe we cannot do without is denied. We no longer know what else to do than to resort to an act of self-help: we try to persuade ourselves and others that those who deny us the longed-for attention are themselves unworthy of respect. We make unreserved use of the trick that vanity resorts to only furtively. In taking this recourse we feel ourselves unquestionably to be victims, and give ourselves thereby the license to unrestrained bullying.

Is not the insurrection of the insulted masses something of a mobilization of such self-defence? Is it not a mass release of resentment that is behind the emotional climate change? For those who feel pressed to denigrate others in order to save his or her own self-esteem, truth is of secondary concern. Now that reasons, however flimsy, for resentment are established, the ‘victim’ now has a quite another problem––namely that of a new attention dependency. Resentment is in need of resonance. If the denunciation is to be effective, it must be absorbed by others who are seeking confirmation of their own grievances, and who will in turn pass it on further.

The mass release of resentment may therefore be said to have two main drivers. First, significant parts of the population must have become acquainted with the distress of keeping self-esteem intact in the context of their income of attention. Secondly, and equally vitally, the rapid dissemination of resentment must be possible. With the advent of social media in an increasingly politically and economically volatile world, both these conditions now apply in those societies that most violently encounter this emotional climate change. To look at it another way, it is no surprise that inherent in the most technically advanced societies, which profit most from globalization, is a huge gulf between the winners and losers.

The concerns of those worried about job losses and labour migration have a hard time getting into the leading media of public opinion. It is not only the case that the articulation of their reservations might fail to make it through the filter of political correctness––but that their ability to reach out to a wider audience has also remained systematically curbed as long as the mainstream has been controlled by the paternalism of dedicated journalism. It belonged to the professional honour of the classical journalist to serve the audience with objectivity and reflection instead of merely aiming to please the crowd. For a long time now the medium of classic journalism has been under existential pressure, having now to compete with the rapid rise of new media. New media can be defined as those media that have left the sale of information for money behind to focus on the attraction of attention to be sold as a service to the advertising industry. Under the pressure of producing attraction services in the first place, a shift of power between journalism, public relations and advertising has taken place, associated with a sustained loss of trust in journalism (as sharply analysed by Fengler, Susanne & Stephan Ruß-Mohl, Journalists and the information-attention markets: Towards an economic theory of journalism, in: Journalism, 2008 - journals.sagepub.com). Where the service of attraction becomes more important than the production of news and reflected opinion, the vox populi consequently gets new chances to assail the bastion of journalistic virtue.

A real breach of the dam occurred with the arrival of social media. The business idea of Facebook, Twitter & Co is to scale the business model of ad-financed mass media down to the vendor’s tray. They make it possible to publish anything and everything online with nothing more than a smartphone at hand, and to profiteer by exploiting the attraction performance measured by the medium. Anyone who can publish on the World Wide Web is able to participate in the global battle for attention with measured results. Anyone can become a star by uploading a video on Youtube or serving up a misleading story on Facebook to fit a particular vulgar narrative. It suffices that the number and rate of increase of the clicks is noticed; the content is secondary. The new media succeed less in providing significant content than in exploiting our tendency to pay attention to what others pay attention to. In this way success in attracting attention becomes self-perpetuating.

This tendency of self-reinforced conspicuousness is particularly conducive to that resentment which seeks validation. By itself, this search is charged with potential synergy since it is only in its resonance that resentment is in its element. Where the willingness to revolt is common, it requires just a spark of confirmation to release avalanches of aggressive insults, hatred and suspicion, which, once released, sweep through the new media and engulf the already-weakened edifice of old media. The uproar consuming social media and the widespread sharing of negative emotions have blossomed into real recipes for success in the battle for likes and followers.

So, what it falls to us to explore is not only the alignment of rampant frustration and media resonance, but how the use of resentment has come to be the dominant strategy of overweening narcissists. The facilitation of popular outrage and a promise of revenge on the arrogant elites seems to be the very best way to capture the masses of attention with which the greedy ego enriches itself. Thus, even as part of these elites and in unsurpassed arrogance, one can rise to be the leader of the storm on the bastions of these same elites––and this only for the purpose of setting the crown on one’s own vanity.

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Iris Publishers- Open access Journal of Biomedical Engineering & Biotechnology | Characterization of Patients in Fertile Age with Vaginal Flow Syndrome

 

Authored by  Pedro Rolando Lopez Rodriguez*

Summary

Introduction: Vaginal discharge syndrome is an infectious process of the vagina with a florid symptomatology and psychosocial impact on the female population. Objective: To characterize the patients of childbearing age with vaginal discharge syndrome in the Basic Working Group number 2 of the Párraga polyclinic between January and December 2018. Method: Observational, descriptive, and cross-sectional study. 195 patients of childbearing age [between 15 and 49 years of age] of the medical office 10 were studied in the period from January to December 2018 who attended the medical consultation referring to presenting vaginal discharge and / or associated symptoms performing anamnesis, physical examination, and microbiological study.

Result: 32.8% were between 25 and 29 years old and 41.7% were black. At least half were 52.3% pre-university, more than 59.0% were workers. The majority began sexual intercourse before the age of 20. 90.3% presented risk factors associated with vaginal discharge. The white, lumpy caseous flow represented 63.1%. At least 9 out of 10 patients presented vaginitis. More than 75% had Monilia or Gardnerella vaginalis. It was found that 95% of patients with vaginitis had risk factors.

Conclusion: Patients predominated between the second and third decade of life, of the black race, with the pre-university concluded and workers. The majority were single or accompanied, had begun their sexual life at an early age and presented risk factors. Patients with vaginitis prevailed, with white, lumpy, case-like discharge and with Monilia as the germ causing vaginal discharge. There was a statistically significant relationship between the presence of risk factors and the flow classification.

Keywords: Vaginal discharge syndrome; Risk factor; Sexual risk behavior

Introduction

Vaginal discharge is a common reason for gynecological consultation at any age, being highly frequent in women of childbearing age, who are concerned about their reproductive health [1]. Vaginal discharge syndrome is an infectious process of the vagina characterized by one or more of the following symptoms: leucorrhoea, vulvar pruritus, burning, irritation, dysuria, dyspareunia, vaginal fetus, determined by the invasion and multiplication of any microorganism and as a result of an environmental imbalance in the vaginal ecosystem [2]. This pathology has a wide range of causal germs and is easy to diagnose and its complications are frequently related to infantile and reproductive maternal morbidity [2,3]. They continue to be a public health problem in the world, they are more frequent in young, single adults and in urban areas, but without anyone with active sex life being exempt from suffering them. They can also cause complications or sequelae in both women and men and children, for example orchiepidimitis, acute pelvic inflammatory disease [hereinafter EIPA], sterility in both sexes, penile or cervix cancer, pregnancy complications, miscarriages, death fetal and / or maternal, premature birth, low birth weight, neonatal infections, congenital malformations and at risk of transmitting or becoming infected by the human immunodeficiency virus [hereinafter HIV] as demonstrated by several studies. [4-7]. In medical practice, vaginal infections represent a frequent health problem, representing approximately 75% of the patients who are consulted by vaginal discharge, according to the number of patients attending the medical consultation of some studies in Venezuela. Taking into account that in the same woman more than one clinical form can coexist [vaginitis and / or cervicitis] and if the gynecological examination does not allow to affirm the presence of a particular causative agent, the treatment should be focused in a syndromic way, at three infections most frequently associated with vaginal discharge syndrome: trichomoniasis, candidiasis and bacterial vaginosis; less frequently, these infections are caused by Neisseria Gonorrhoeae and Clamydia trachomatis [6,8].

Syndromic management represents an alternative to efficiently address this problem and with this type of approach the treatment of the causes most frequently associated with the syndrome in question is achieved and therefore the solution of more than 95% of cases is guaranteed [9]. The World Health Organization [WHO] estimated that 333 million new cases of curable sexually transmitted diseases annually in people aged 15 to 49, mostly in developing countries, which include member countries of the European community. On the other hand, recent calculations report that each year more than 340 million Cases of curable sexually transmitted infections [STIs] [including only those fungal and parasitic bacterial infections], which have as a manifestation the vaginal discharge syndrome, susceptible to effective treatments and that at least one million infections occur every day. For Latin America and the Caribbean alone, between 35 and 40 million cases of this group of Sexually Transmitted Infection were infected with more than 100 thousand infections per day [4,5]. Vaginal candidiasis is caused by a fungus or yeast found in the vulvo-vaginal mucosa that proliferates favored by broad-spectrum antibiotics, oral contraceptives, pregnancy, menstruation, diabetes mellitus, tight clothing, HIV infection, poor hygiene habits, etc. Women usually present with vulvar irritation and scarce exudate. The vulva may appear inflamed with excoriations and fissures. The vaginal wall may be covered by white, sticky and sticky yeast colonies. This entity began to be considered as a Sexually Transmitted Infection as of 1967 and it is currently accepted that 50% of the reported cases are the product of sexual contact. Its treatment consists in the use of clotrimazole 100 mg, intravaginal twice a day for 3 days or nystatin 100 000 U [vaginal ovum] intravaginally, once a day for 14 days [10]. In primary health care services these infections in adolescents are among the first causes of consultation, with a much higher incidence in those young people with active sexual life, although they have also been found in virgin adolescents. [eleven]. Vaginal symptoms are the most frequent reason for gynecology, being responsible for 6 to 10 million medical visits a year in the world [7]. In the United States about 30% of women of reproductive age have bacterial vaginosis [BV]. Almost 75% of all adult women have had at least one fungal infection in their lives. About 3% of women of reproductive age have trichomoniasis. Many women with vaginal infections have no symptoms, for example, only 16% of women with bacterial vaginosis report having vaginal symptoms, while out of every 100 women who have symptoms, such as pain, itching and discharge; 40 to 45 women have bacterial vaginitis; 20 to 25 women have a fungal infection; 15 to 20 women have trichomoniasis [7-12]. The World Health Organization reported that since 2006 approximately 15,700 women annually go to vaginal health problems in primary care facilities in West African countries [Ghana, Guinea, Mali and Togo], with very low cure rates associated with the costs and non-compliances of the treatment [7]. The results in European countries are also relevant with an estimated 250,000 women who, of childbearing age, go annually to vaginal discharge consultations. Being the most significant figure in women during pregnancy [7].

In Colombia, the prevalence in Colombia of bacterial vaginosis has varied between 9% in asymptomatic pregnant pregnant women and 30% in non-pregnant women from the general population [8]. Cuba does not escape this situation, reporting 831787 consultations by these entities [7-12] Havana reports in 2017; 627 251 patients assessed by obstetrics consultation, while gynecology attended 208,589 women of childbearing age, if we take into account that approximately 75% of the consultations are due to vaginal discharge, the total number of patients treated is 156 441 [13]. In the Municipality, 19407 patients treated for vaginal infections in the analyzed period are reported [14]. Regarding the Párraga Polyclinic, they behave with 4317 patients assisted in gynecology due to this identity [15].

Methods

A descriptive and cross-sectional observational study was carried out. 195 patients of childbearing age [between 15 and 49 years of age] of the medical office 10 were studied in the period from January to December 2018 who attended the medical consultation referring to presenting vaginal discharge and / or associated symptoms performing anamnesis, physical examination, and microbiological study.

Inclusion and exclusion criteria

Inclusion criteria

Female patients of childbearing age with vaginal discharge who agreed to physical examination with speculum and attended vaginal and endocervical exudate.

Exclusion criteria Patients who do not belong to the health area.

Pregnant patients. Patients who have refused to participate in the investigation

Technical and procedures

Sources of obtaining the information

Application of a data collection form [Annex 1] to the patients from which the related variables were studied.

Data register

A database was created in the Microsoft Office Excel 2010 program where the variables contained in the Form being investigated were included.

Processing and analysis of information

The variables included in the Return were entered into a database in Excel and the statistical processing was carried out in the statistical package Stadistical Package for Social Science for Personal Computer [SPSS-PC] in its version 19.1 for Windows, from which it They will prepare tables that summarize quantitative variables in absolute values and percentages. In addition, statistical tests of independence χ2 [Chi-Square] will be performed on qualitative variables.

Ethical aspects

The research was endorsed by the Commission of Medical Ethics in Research of the Faculty of Medical Sciences “Julio Trigo López”. No new or experimental medications or techniques were used, which were not yet certified or endorsed for use. No experimental surgical procedures were performed

Result

(Table 1) The results in relation to the age groups reflect that the majority were found in the group between 25 and 29 years old with 64 cases [32.8%] and that less than 5.0% of the patients studied were between 45 and 49 years old (Table 2).

Source: Data collection form.

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