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Commenced in January 2007
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Edition: International
Paper Count: 4477

Search results for: line search

1327 High Phosphate-Containing Foods and Beverages: Perceptions of the Future Healthcare Providers on Their Harmful Effect in Excessive Consumption

Authors: ATM Emdadul Haque

Abstract:

Phosphorus is an essential nutrient which is regularly consumed with food and exists in the body as phosphate. Phosphate is an important component of cellular structures and needed for bone mineralization. Excessive accumulation of phosphate is an important driving factor of mortality in chronic renal failure patients; of relevance, these patients are usually provided health care by doctors, nurses, and pharmacists. Hence, this study was planned to determine the level of awareness of the future healthcare providers about the phosphate-containing foods and beverages and to access their knowledge on the harmful effects of excess phosphate consumption. A questionnaire was developed and distributed among the year-1 medical, nursing and pharmacy students. 432 medical, nursing and pharmacy students responded with age ranging from 18-24 years. About 70% of the respondents were female with a majority (90.7%) from Malay ethnicity. Among the respondents, 29.9% were medical, 35.4% were the pharmacy and 34.7% were nursing students. 79.2% students knew that phosphate was an important component of the body, but only 61.8% knew that consuming too much phosphate could be harmful to the body. Despite 97% of the students knew that carbonated soda contained high sugar, surprisingly 77% of them did not know the presence of high phosphate in the same soda drinks; in the similar line of observation, 67% did not know the presence of it in the fast food. However, it was encouraging that 94% of the students wanted to know more about the effects of phosphate consumption, 74.3% were willing to give up drinking soda and eating fast food, and 52% considered taking green coconut water instead of soda drinks. It is, therefore, central to take an educational initiative to increase the awareness of the future healthcare providers about phosphate-containing food and its harmful effects in excessive consumptions.

Keywords: high phosphate containing foods and beverages, excessive consumption, future health care providers, phosphorus

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1326 Potential Climate Change Impacts on the Hydrological System of the Harvey River Catchment

Authors: Hashim Isam Jameel Al-Safi, P. Ranjan Sarukkalige

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Climate change is likely to impact the Australian continent by changing the trends of rainfall, increasing temperature, and affecting the accessibility of water quantity and quality. This study investigates the possible impacts of future climate change on the hydrological system of the Harvey River catchment in Western Australia by using the conceptual modelling approach (HBV mode). Daily observations of rainfall and temperature and the long-term monthly mean potential evapotranspiration, from six weather stations, were available for the period (1961-2015). The observed streamflow data at Clifton Park gauging station for 33 years (1983-2015) in line with the observed climate variables were used to run, calibrate and validate the HBV-model prior to the simulation process. The calibrated model was then forced with the downscaled future climate signals from a multi-model ensemble of fifteen GCMs of the CMIP3 model under three emission scenarios (A2, A1B and B1) to simulate the future runoff at the catchment outlet. Two periods were selected to represent the future climate conditions including the mid (2046-2065) and late (2080-2099) of the 21st century. A control run, with the reference climate period (1981-2000), was used to represent the current climate status. The modelling outcomes show an evident reduction in the mean annual streamflow during the mid of this century particularly for the A1B scenario relative to the control run. Toward the end of the century, all scenarios show a relatively high reduction trends in the mean annual streamflow, especially the A1B scenario, compared to the control run. The decline in the mean annual streamflow ranged between 4-15% during the mid of the current century and 9-42% by the end of the century.

Keywords: climate change impact, Harvey catchment, HBV model, hydrological modelling, GCMs, LARS-WG

Procedia PDF Downloads 264
1325 Relationship Between Reading Comprehension and Achievement in Science Among Grade Eleven Bilingual Students in a Secondary School, Thailand

Authors: Simon Mauma Efange

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The main aims of this research were to describe, in co-relational terms, the relationship, if any, between reading comprehension and academic achievement in science studied at the secondary level and, secondly, to find out possible trends in gender differences, such as whether boys would perform better than girls or vice versa. This research employed a quantitative design. Two kinds of instruments were employed: the Oxford Online Placement Test and the Local Assessment System Test. The Oxford Online Placement Test assesses students' English level quickly and easily. The results of these tests were subjected to statistical analysis using a special statistical software called SPSS. Statistical tools such as mean, standard deviation, percentages, frequencies, t-tests, and Pearson’s coefficient of correlation were used for the analysis of the results. Results of the t-test showed that the means are significantly different. Calculating the p-value revealed that the results were extremely statistically significant at p <.05. The value of r (Pearson correlation coefficient) was 0.2868. Although technically there is a positive correlation, the relationship between the variables is only weak (the closer the value is to zero, the weaker the relationship). However, in conclusion, calculations from the t-test using SPSS revealed that the results were statistically significant at p <.05, confirming a relationship between the two variables, and high scores in reading will give rise to slightly high scores in science. The research also revealed that having a high score in reading comprehension doesn’t necessarily mean having a high score in science or vice versa. Female subjects performed much better than male subjects in both tests, which is in line with the literature reviewed for this research.

Keywords: achievement in science, achievement in English, and bilingual students, relationship

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1324 Synergistic Effect of Curcumin and Insulin on GLUT4 Translocation in C2C12 Cell

Authors: Javad Mohiti-Ardekani, Shabodin Asadii, Ali Moradi

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Introduction: Curcumin, the yellow pigment in turmeric, has been shown as an anti-diabetic agent for centuries but only in recent few years, its mechanism of action has been under investigation. Some studies showed that curcumin might exert its anti-diabetic effect via increasing glucose transporter isotype-4 (GLUT4) gene and glycoprotein contents in cells. To investigate this possibility, we investigate the effects of extract and commercial curcumin with and without insulin on GLUT4 translocation from intracellular compartments of nuclear or endoplasmic reticulum membranes (N/ER) into the cytoplasmic membrane (CM). Methods and Material: C2C12 myoblastic cell line were seeded in DMEM plus 20 % FBS and differentiated to myotubes using 2 % horse serum. After myotubes formation, 40 µmolar Extract and Commercial curcumin, with or without insulin as intervention, and as control 1 % DMSO were added for 3 h. Cells were washed and homogenized followed by ultracentrifuge fractionation, protein separation by SDS-PAGE and GLUT4 detection using semi-quantitative Western blotting. Data analysis was done by two independent samples t-test for comparison of mean ± SD of GLUT4 percent in categories. GLUT4 contents were higher in CM groups curcumin and curcumin with insulin in comparison to 1 % DMSO-treated myotubes control group. Results: As our results have shown extract and commercial curcumin induces GLUT4 translocation from intra-cell into cell surface. The results have also shown synergic effect of curcumin on translocation of GLUT4 from intra-cell into cell surface in the presence of 100 nm insulin. Discussion: We conclude that curcumin may be a choice of type-2 diabetes mellitus treatment because its extract and commercial enhances GLUT4 contents in CM where it facilitates glucose entrance into the cell. However, it is necessary to trace the signaling pathways which are activated by curcumin.

Keywords: Curcumin, insulin, Diabetes type-2, GLUT4

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1323 A Qualitative Exploration into Australian Muslims Emerging into Adulthood

Authors: Nuray Okcum, Jenny Sharples

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While the scrutinization towards marginalized groups throughout the globe has been existent for decades, prejudice towards Muslims in Western countries has been increasing dramatically. The vicious attacks across the globe by perpetrators who identify with Islam as well as popular political discourse by politicians in Western countries claiming and portraying Muslims as being dangerous, oppressed, or lacking the ability to assimilate into the community, adds to the exclusion and lack of belonging Muslims living in Western countries experience. The early stages of adulthood which have recently been conceptualized as emerging adulthood is a critical and socially ambiguous transition. For a young Muslim emerging into adulthood in a Western country, a variety of different challenges and demands that can exceed their coping abilities can arise. While in search for their identity and in a bid to structure themselves with their past childhood experiences together with their newly forming values, the emerging adult may attempt to direct or change the way in which they are viewed by others. This can be done to gain approval from others and to feel a sense of belonging. A change in the emerging adult’s interpersonal interactions and relationships, the way in which they view themselves and others, their sense of belonging, and their identity, also occurs during this developmental stage. To explore the manner in which Muslims emerging into adulthood carve their identity, their experiences, and representation of their Muslim identity, social identification, and their sense of belonging in Australia, an interpretative phenomenological methodology was utilized. This allowed participants to offer their own subjective experiences. A total of eight emerging adults took part in the study whilst four adults who work with emerging adults took part. Adult participants who work with emerging adults took part in the study to bring forth their insight and experiences. Common experiences were organized into themes. Themes included identifying as a Muslim, social identification, and belonging. Identification included visual identification and name, discrimination and resilience. Findings clearly indicated that Muslims emerging into adulthood in Australia do face various hurdles while they try to retain and represent their religious identity. Despite the unique challenges that they face, they still feel a sense of belonging and identity as being Australian.

Keywords: Muslim, Islam, emerging adulthood, Australia

Procedia PDF Downloads 136
1322 Bridging Cultures in Distance Education: A Confluence of Critical Pedagogy of Place and Indigenous Education Philosophy (Case-Study Reference in Fiji and Vanuatu)

Authors: Dan Frederick Orcherton

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This research explores the fusion of "Critical Pedagogy of Place" and "Indigenous Education Philosophy" to create a holistic pedagogical framework within Instructional Theory, focusing on its application in Distance Education, specifically within two Pacific Island cultures. The study's objectives included investigating culturally relevant instructional techniques, strategies, and technologies for the Itaukei (Indigenous Fijian) and ni-Vanuatu cultures, enhancing appreciation for culturally sensitive pedagogical methods. Methodologically, a qualitative inquiry phenomenological approach was employed within a constructivist paradigm, utilizing a comprehensive qualitative scoping review and online literature search. Key findings include the prioritization of cultural inclusivity and indigenous knowledge integration in both indigenous education philosophies and various instructional approaches. Learner-centered methods like constructivist andragogy and the learning cycle are applicable and effective in distance education within these cultures, aligning with indigenous learners' values and preferences. Place-based education and critical pedagogy of place are particularly pertinent, fostering a deeper connection between education, local environments, and social justice. Integrating digital technologies in culturally responsive education bridges geographical gaps and preserves cultural knowledge. Lastly, blending Western and Indigenous Science, influenced by a Two-Eyed Seeing approach, informs pedagogy by combining Western and Indigenous Science. This research underscores the importance of acknowledging cultural diversity and respecting indigenous knowledge in distance education. It highlights the value of learner-centered approaches, place-based education, and technology integration. The study enriches the educational experience within the Itaukei and niVanuatu cultures and provides insights for educators and policymakers aiming to bridge cultural gaps in distance education.

Keywords: critical pedegory of place, Itaukei (indigenous Fijian) and ni-Vanuatu cultures, placed-based education, indigenous knowledge, distance education

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1321 The Effect of Undernutrition on Sputum Culture Conversion and Treatment Outcomes among People with Multidrug-Resistant Tuberculosis: A Systematic Review and Meta-Analysis

Authors: Fasil Wagnew, Kerri Viney, Kefyalew Addis Alene, Matthew Kelly, Darren Gray

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Background: Undernutrition is a risk factor for tuberculosis (TB), including poor treatment outcomes. However, evidence regarding the effect of undernutrition on TB treatment outcomes is not well understood. We aimed to evaluate the effect of undernutrition on sputum culture conversion and treatment outcomes among people with multi-drug resistance (MDR)-TB. Methods: We searched for publications in the Medline, Embase, Scopus, and Web of Science databases without restrictions on geography or year of publication. We conducted a random-effect meta-analysis to estimate the effects of undernutrition on sputum culture conversion and treatment outcomes. Two reviewers independently assessed the study eligibility, extracted the necessary information, and assessed the risk of bias. Depending on the nature of the data, odds ratio (OR) and hazard ratio (HR) with 95% confidence intervals (CIs) were used to summarize the effect estimates. Potential publication bias was checked using funnel plots and Egger’s tests. Results: Of 2358 records screened, 59 studies comprising a total of 31,254 people with MDR-TB were included. Undernutrition was significantly associated with a lower sputum culture conversion rate (HR 0·7, 95% CI 0·6–0·9, I2=67·1%) and a higher rate of mortality (OR 2·9, 95%CI 2·1–3·8, I2=23·7%) and unfavourable treatment outcomes (OR 1·8, 95%CI 1·5–2·0, I2=72·7%). There was no statistically significant publication bias in the included studies. Three studies were low, forty-two studies were moderate, and fourteen studies were high quality. Interpretations: Undernutrition was significantly associated with unfavourable treatment outcomes, including mortality and lower sputum culture conversion among people with MDR-TB. These findings have implications for supporting targeted nutritional interventions alongside standardised second-line TB drugs.

Keywords: undernutrition, MDR-TB, sputum culture conversion, treatment outcomes, meta-analysis

Procedia PDF Downloads 156
1320 Role of Onion Extract for Neuro-Protection in Experimental Stroke Model

Authors: Richa Shri, Varinder Singh, Kundan Singh Bora, Abhishek Bhanot, Rahul Kumar, Amit Kumar, Ravinder Kaur

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The term ‘neuroprotection’ means preserving/salvaging function and structure of neurons. Neuroprotection is an adjunctive treatment option for neurodegenerative disorders. Oxidative stress is considered a major culprit in neurodegenerative disorders; hence, management strategies include use of antioxidants. Our search for a neuroprotective agent began with Allium cepa L. or onions, (family Amaryllidaceae) - a potent antioxidant. We have investigated the neuroprotective potential of onions in experimental models of ischemic stroke, diabetic neuropathy, neuropathic pain, and dementia. In pre and post-ischemic stroke model, the methanol extract of outer scales of onion bulbs (MEOS) prevented memory loss and motor in-coordination; reduced oxidative stress and cerebral infarct size. This also prevented and ameliorated diabetic neuropathy in mice. The MEOS was fractionated to yield a flavonoid rich fraction (FRF) that successfully reversed ischemia-reperfusion induced neuronal damage, thereby demonstrating that the flavonoids are responsible for the activity. The FRF effectively ameliorated chronic constriction induced neuropathic pain in rats. The FRF was subjected to bioactivity-guided fractionated. It was seen that FRF is more effective as compared to the isolated components probably due to synergism among the constituents (i.e., quercetin and quercetin glucosides) in the FRF. The outer scales of onion bulbs have great potential for prevention as well as for treatment of neuronal disorders. Red onions, with higher amounts of flavonoids as compared to the white onions, produced more significant neuroprotection. Thus, the standardized FRF from the waste material of a commonly used vegetable, especially the red variety, may be developed as a valuable neuroprotective agent.

Keywords: Allium cepa, antioxidant activity, flavonoid rich fraction, neuroprotection

Procedia PDF Downloads 154
1319 Experimental Investigation for Reducing Emissions in Maritime Industry

Authors: Mahmoud Ashraf Farouk

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Shipping transportation is the foremost imperative mode of transportation in universal coordination. At display, more than 2/3 of the full worldwide exchange volume accounts for shipping transportation. Ships are utilized as an implies of marine transportation, introducing large-power diesel motors with exhaust containing nitrogen oxide NOx, sulfur oxide SOx, carbo di-oxide CO₂, particular matter PM10, hydrocarbon HC and carbon mono-oxide CO which are the most dangerous contaminants found in exhaust gas from ships. Ships radiating a large amount of exhaust gases have become a significant cause of pollution in the air in coastal areas, harbors and oceans. Therefore, IMO (the International Maritime Organization) has established rules to reduce this emission. This experiment shows the measurement of the exhaust gases emitted from the Aida IV ship's main engine using marine diesel oil fuel (MDO). The measurement is taken by the Sensonic2000 device on 85% load, which is the main sailing load. Moreover, the paper studies different emission reduction technologies as an alternative fuel, which as liquefied natural gas (LNG) applied to the system and reduction technology which is represented as selective catalytic reduction technology added to the marine diesel oil system (MDO+SCR). The experiment calculated the amount of nitrogen oxide NOx, sulfur oxide SOx, carbon-di-oxide CO₂, particular matter PM10, hydrocarbon HC and carbon mono-oxide CO because they have the most effect on the environment. The reduction technologies are applied on the same ship engine with the same load. Finally, the study found that MDO+SCR is the more efficient technology for the Aida IV ship as a training and supply ship due to low consumption and no need to modify the engine. Just add the SCR system to the exhaust line, which is easy and cheapest. Moreover, the differences between them in the emission are not so big.

Keywords: marine, emissions, reduction, shipping

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1318 Design and Simulation of an Inter-Satellite Optical Wireless Communication System Using Diversity Techniques

Authors: Sridhar Rapuru, D. Mallikarjunreddy, Rajanarendra Sai

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In this reign of the internet, the access of any multimedia file to the users at any time with a superior quality is needed. To achieve this goal, it is very important to have a good network without any interruptions between the satellites along with various earth stations. For that purpose, a high speed inter-satellite optical wireless communication system (IsOWC) is designed with space and polarization diversity techniques. IsOWC offers a high bandwidth, small size, less power requirement and affordable when compared with the present microwave satellite systems. To improve the efficiency and to reduce the propagation delay, inter-satellite link is established between the satellites. High accurate tracking systems are required to establish the reliable connection between the satellites as they have their own orbits. The only disadvantage of this IsOWC system is laser beam width is narrower than the RF because of this highly accurate tracking system to meet this requirement. The satellite uses the 'ephemerides data' for rough pointing and tracking system for fine pointing to the other satellite. In this proposed IsOWC system, laser light is used as a wireless connectedness between the source and destination and free space acts as the channel to carry the message. The proposed system will be designed, simulated and analyzed for 6000km with an improvement of data rate over previously existing systems. The performance parameters of the system are Q-factor, eye opening, bit error rate, etc., The proposed system for Inter-satellite Optical Wireless Communication System Design Using Diversity Techniques finds huge scope of applications in future generation communication purposes.

Keywords: inter-satellite optical wireless system, space and polarization diversity techniques, line of sight, bit error rate, Q-factor

Procedia PDF Downloads 270
1317 Assessment of Air Quality Around Western Refinery in Libya: Mobile Monitoring

Authors: A. Elmethnani, A. Jroud

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This coastal crude oil refinery is situated north of a big city west of Tripoli; the city then could be highly prone to downwind refinery emissions where the NNE wind direction is prevailing through most seasons of the year. Furthermore, due to the absence of an air quality monitoring network and scarce emission data available for the neighboring community, nearby residents have serious worries about the impacts of the oil refining operations on local air quality. In responding to these concerns, a short term survey has performed for three consecutive days where a semi-continues mobile monitoring approach has developed effectively in this study; the monitoring station (Compact AQM 65 AeroQual) was mounted on a vehicle to move quickly between locations, measurements of 10 minutes averaging of 60 seconds then been taken at each fixed sampling point. The downwind ambient concentration of CO, H₂S, NOₓ, NO₂, SO₂, PM₁, PM₂.₅ PM₁₀, and TSP were measured at carefully chosen sampling locations, ranging from 200m nearby the fence-line passing through the city center up to 4.7 km east to attain best spatial coverage. Results showed worrying levels of PM₂.₅ PM₁₀, and TSP at one sampling location in the city center, southeast of the refinery site, with an average mean of 16.395μg/m³, 33.021μg/m³, and 42.426μg/m³ respectively, which could be attributed to road traffic. No significant concentrations have been detected for other pollutants of interest over the study area, as levels observed for CO, SO₂, H₂S, NOₓ, and NO₂ haven’t respectively exceeded 1.707 ppm, 0.021ppm, 0.134 ppm, 0.4582 ppm, and 0.0018 ppm, which was at the same sampling locations as well. Although it wasn’t possible to compare the results with the Libyan air quality standards due to the difference in the averaging time period, the technique was adequate for the baseline air quality screening procedure. Overall, findings primarily suggest modeling of dispersion of the refinery emissions to assess the likely impact and spatial-temporal distribution of air pollutants.

Keywords: air quality, mobil monitoring, oil refinery

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1316 Emotional Intelligence in Educational Arena and Its Pragmatic Concerns

Authors: Mehar Fatima

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This study intends to make analysis of Emotional Intelligence (EI) in the process of pedagogy and look into its repercussions in different educational institutions including school, college, and university in the capital state of India, Delhi in 2015. Field of education is a complex area with challenging issues in a modern society. Education is the breeding ground for nurturing human souls, and personalities. Since antiquity, man has been in search of truth, wisdom, contentment, peace. His efforts have brought him to acquire these through hardship, evidently through the process of teaching and learning. Computer aids and artificial intelligence have made life easy but complex. Efficient pedagogy involves direct human intervention despite the flux of technological advancements. Time and again, pedagogical practices demand sincere human efforts to understand and improve upon life’s many pragmatic concerns. Apart from the intense academic scientific approaches, EI in academia plays a vital role in the growth of education, positively achieving national progression; ‘pedagogy of pragmatic purpose.’ Use of literature is found to be one of the valuable pragmatic tools of Emotional Intelligence. This research examines the way literature provides useful influence in building better practices in teaching-learning process. The present project also scrutinizes various pieces of world literature and translation, incorporating efforts of intellectuals in promoting comprehensive amity. The importance of EI in educational arena with its pragmatic uses was established by the study of interviews, and questionnaire collected from teachers and students. In summary the analysis of obtained empirical data makes it possible to accomplish that the use Emotional Intelligence in academic scenario yields multisided positive pragmatic outcomes; positive attitude, constructive aptitude, value-added learning, enthusiastic participation, creative thinking, lower apprehension, diminished fear, leading to individual as well as collective advancement, progress, and growth of pedagogical agents.

Keywords: emotional intelligence, human efforts, pedagogy, pragmatic concerns

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1315 Job in Modern Arabic Poetry: A Semantic and Comparative Approach to Two Poems Referring to the Poet Al-Sayyab

Authors: Jeries Khoury

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The use of legendary, folkloric and religious symbols is one of the most important phenomena in modern Arabic poetry. Interestingly enough, most of the modern Arabic poetry’s pioneers were so fascinated by the biblical symbols and they managed to use many modern techniques to make these symbols adequate for their personal life from one side and fit to their Islamic beliefs from the other. One of the most famous poets to do so was al-Sayya:b. The way he employed one of these symbols ‘job’, the new features he adds to this character and the link between this character and his personal life will be discussed in this study. Besides, the study will examine the influence of al-Sayya:b on another modern poet Saadi Yusuf, who, following al-Sayya:b, used the character of Job in a special way, by mixing its features with al-Sayya:b’s personal features and in this way creating a new mixed character. A semantic, cultural and comparative analysis of the poems written by al-Sayya:b himself and the other poets who evoked the mixed image of al-Sayya:b-Job, can reveal the changes Arab poets made to the original biblical figure of Job to bring it closer to Islamic culture. The paper will make an intensive use of intertextuality idioms in order to shed light on the network of relations between three kinds of texts (indeed three palimpsests’: 1- biblical- the primary text; 2- poetic- al-Syya:b’s secondary version; 3- re-poetic- Sa’di Yusuf’s tertiary version). The bottom line in this paper is that that al-Sayya:b was directly influenced by the dramatic biblical story of Job more than the brief Quranic version of the story. In fact, the ‘new’ character of Job designed by al-Sayya:b himself differs from the original one in many aspects that we can safely say it is the Sayyabian-Job that cannot be found in the poems of any other poets, unless they are evoking the own tragedy of al-Sayya:b himself, like what Saadi Yusuf did.

Keywords: Arabic poetry, intertextuality, job, meter, modernism, symbolism

Procedia PDF Downloads 200
1314 Factors Affecting Online Tourism Services in Israel

Authors: Shlomit Hon-Snir, Shosh Shahrabai, Sharon Teitler Regev, Anabel Friedlander-Lifszyc

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Today, online travel sites account for a large share of the orders for tourism services, leading to the expectation that many traditional travel agencies will become redundant in the future. Technological changes are offering customers a wider variety and better prices, and the improved competition in the industry has increased customer well-being significantly. Therefore, the question is whether all customers can enjoy this change, specifically whether different groups in the Israeli population enjoy the changes similarly. The purpose of this study is to identify the factors that affect the collection of data and the purchase of tourism products online and in particular to identify the barriers and limitations of technology usage among the population. The results of the current research are of great importance both economically and socially. The theory of Reasoned Action assumes that actual behavior is based on intention. Volitional behavior is predicted by individuals' attitudes to that behavior and by the way they think other people will look at them. Two cognitive variables regarding the use of technology are: perceived usefulness and perceived ease-of-use. Moreover, early adopters of innovations have different characteristics than people that adopt an innovation at a later stage. In the study, we analyze four groups of factors: Customer characteristics, internet usage, technology acceptance and product characteristics. Some of the parameters are gender, age, income level, frequency and type of internet use, proficiency in English, traveler type, number of trips abroad, perceived ease of use, perceived usefulness, perceived risk, perceived trust and product type. We investigate online purchasing and online information search separately. Data will be collected using an online questionnaire distributed among a representative sample of 600 citizens in Israel. Some of the research questions will be based on previous research studies (that underwent reliability and validity testing). Those questions will be translated into Hebrew and adjusted for the tested population.

Keywords: customer characteristics, online travel sites, technology acceptance, tourism

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1313 A Meta-Analysis of the Academic Achievement of Students With Emotional/Behavioral Disorders in Traditional Public Schools in the United States

Authors: Dana Page, Erica McClure, Kate Snider, Jenni Pollard, Tim Landrum, Jeff Valentine

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Extensive research has been conducted on students with emotional and behavioral disorders (EBD) and their rates of challenging behavior. In the past, however, less attention has been given to their academic achievement and outcomes. Recent research examining outcomes for students with EBD has indicated that these students receive lower grades, are less likely to pass classes, and experience higher rates of school dropout than students without disabilities and students with other high incidence disabilities. Given that between 2% and 20% of the school-age population is likely to have EBD (though many may not be identified as such), this is no small problem. Despite the need for increased examination of this population’s academic achievement, research on the actual performance of students with EBD has been minimal. This study reports the results of a meta-analysis of the limited research examining academic achievement of students with EBD, including effect sizes of assessment scores and discussion of moderators potentially impacting academic outcomes. Researchers conducted a thorough literature search to identify potentially relevant documents before screening studies for inclusion in the systematic review. Screening identified 35 studies that reported results of academic assessment scores for students with EBD. These studies were then coded to extract descriptive data across multiple domains, including placement of students, participant demographics, and academic assessment scores. Results indicated possible collinearity between EBD disability status and lower academic assessment scores, despite a lack of association between EBD eligibility and lower cognitive ability. Quantitative analysis of assessment results yielded effect sizes for academic achievement of student participants, indicating lower performance levels and potential moderators (e.g., race, socioeconomic status, and gender) impacting student academic performance. In addition to discussing results of the meta-analysis, implications and areas for future research, policy, and practice are discussed.

Keywords: students with emotional behavioral disorders, academic achievement, systematic review, meta-analysis

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1312 Use of the Occupational Repetitive Action Method in Different Productive Sectors: A Literature Review 2007-2018

Authors: Aanh Eduardo Dimate-Garcia, Diana Carolina Rodriguez-Romero, Edna Yuliana Gonzalez Rincon, Diana Marcela Pardo Lopez, Yessica Garibello Cubillos

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Musculoskeletal disorders (MD) are the new epidemic of chronic diseases, are multifactorial and affect the different productive sectors. Although there are multiple instruments to evaluate the static and dynamic load, the method of repetitive occupational action (OCRA) seems to be an attractive option. Objective: It is aimed to analyze the use of the OCRA method and the prevalence of MD in workers of various productive sectors according to the literature (2007-2018). Materials and Methods: A literature review (following the PRISMA statement) of studies aimed at assessing the level of biomechanical risk (OCRA) and the prevalence of MD in the databases Scielo, Science Direct, Scopus, ProQuest, Gale, PubMed, Lilacs and Ebsco was realized; 7 studies met the selection criteria; the majority are quantitative (cross section). Results: it was evidenced (gardening and flower-growers) in this review that 79% of the conditions related to the task require physical requirements and involve repetitive movements. In addition, of the high appearance of DM in the high-low back, upper and lower extremities that are produced by the frequency of the activities carried out (footwear production). Likewise, there was evidence of 'very high risks' of developing MD (salmon industry) and a medium index (OCRA) for repetitive movements that require special care (U-Assembly line). Conclusions: the review showed the limited use of the OCRA method for the detection of MD in workers from different sectors, and this method can be used for the detection of biomechanical risk and the appearance of MD.

Keywords: checklist, cumulative trauma disorders, musculoskeletal diseases, repetitive movements

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1311 Usage of Internet Technology in Financial Education and Financial Inclusion by Students of Economics Universities

Authors: B. Frączek

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The paper analyses the usage of the Internet by university students in Visegrad Countries (4V Countries) who study economic fields in their formal and informal financial education and captures the areas of untapped potential of Internet in educational processes. Higher education and training, technological readiness, and the financial market development are in the group of pillars, that are key for efficiency driven economies. These three pillars have become an inspiration to the research on using the Internet in the financial education among economic university students as the group of the best educated people in finance. The financial education is a process that allows for improving the level of financial literacy. In turn, the financial literacy it is the set of financial knowledge, skills, awareness and patterns influencing the financial decisions. The level of financial literacy influences the level of financial well-being of individuals, determines the scale of saving of households and at the same time gives the greater chance for sustainable and more predictable development of the financial market with the positive impact on economy. The financial literacy is necessary for each group of society but its appropriate level is desirable especially in respect of economics students as future participants of financial markets as well as the experts and advisors in financial decision making. The low level of financial literacy is the great problem of many target groups in both developing and developed countries and the financial education is seen as the best way of improving this situation. Also the financial inclusion plays the special role in enhancing the level of financial literacy in the aspect of education by practice as well as due to interrelation between level of financial literacy and degree of financial inclusion. Despite many initiatives under financial education, the level of financial literacy is still very low. Scientists still search for new ways of solving this problem. One of the proposal is more effective usage of the new technology in financial education, especially the Internet, because of the growing popularity of e-learning and the increasing number of Internet users, especially among young people who are called the Generation Net. Due to special role of the university students studying the economics fields for the future financial markets, students of four universities from Visegrad Countries (Czech Republic, Hungary, Poland and Slovakia) were invited to participate in the survey. The aim of the article is to present the level and ways of using the Internet technology in financial education and indicating the so far unused or underused opportunities.

Keywords: financial education, financial inclusion, financial literacy, internet and university education

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1310 An Analysis of Prefabricated Construction Waste: A Case Study Approach

Authors: H. Hakim, C. Kibert, C. Fabre, S. Monadizadeh

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Construction industry is an industry saddled with chronic problems of high waste generation. Waste management that is to ensure materials are utilized in an efficient manner would make a major contribution to mitigating the negative environmental impacts of construction waste including finite resources depletion and growing occupied landfill areas to name a few. Furthermore, ‘material resource efficiency’ has been found an economically smart approach specially when considered during the design phase. One effective strategy is to utilizing off-site construction process which includes a series of prefabricated systems such as mobile, modular, and HUD construction (Department of Housing and Urban Development manufactured buildings). These types of buildings are by nature material and resource-efficient. Despite conventional construction that is exposed to adverse weather conditions, manufactured construction production line is capable of creating repetitive units in a factory controlled environment. A factory can have several parallel projects underway with a high speed and in a timely manner which simplifies the storage of excess materials and re-allocating to the next projects. The literature reports that prefabricated construction significantly helps reduce errors, site theft, rework, and delayed problems and can ultimately lead to a considerable waste reduction. However, there is not sufficient data to quantify this reduction when it comes to a regular modular house in the U.S. Therefore, this manuscript aims to provide an analysis of waste originated from a manufactured factory trend. The analysis was made possible with several visits and data collection of Homes of Merits, a Florida Manufactured and Modular Homebuilder. The results quantify and verify a noticeable construction waste reduction.

Keywords: construction waste, modular construction, prefabricated buildings, waste management

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1309 Metoo in China: An Analysis of the Metoo Movement in China's Social Media

Authors: Xinrui Zhao

Abstract:

Connective actions acquired a completely different outlook of a social movement which credited with the rapid developed of social media technologies. New social movements amalgamate and mobilize around hashtags, memes, and personalized action frames. In 2017, the #MeToo movements from America spread to a variety of countries as a hashtag on social media. It attempted to demonstrate the widespread prevalence of sexual assault and harassment movement. It also encouraged Chinese women to participate by devoting and contributing their voices and acts. Furthermore, China’s #MeToo movement shows certain characteristics which are strongly shaped by particular political and cultural backgrounds, that also need to be studied. This paper serves as supplementary materials of connective action studies by addressing the #MeToo movement issues in China, which is rarely mentioned previously in the literature, it also supports a view that suggests that ideological and cultural drivers both strategically contribute to personalized action frames. This paper combines textual analysis methods, collecting attached materials from search engines in China’s social media, portrays the structure of China’s #MeToo movements by showing prominent activists, scholars, organization and the public’s action frame in China’s social media(Weibo, wechat, zhihu, douban). In doing so, it seeks to find how China’s #MeToo movements are organized and reveal diversities of social action approaches among those three subjects, digs out the correlations of their actions related to different social media platforms. This analysis suggests that while facing the government's censorship and moral judgments from the public, China’s #MeToo movement combines with few influential sexual assault and harassment events and is lead by the prominent activists who also are the victims in the events. The debates and critiques among Chinese scholars concerned the outcomes and significance of China’s #MeToo movement are divided into sides. Organizations still show less power in participating China’s movement social media. Public’s participation is varied of platforms which hugely affected by their personal experiences and knowledge.

Keywords: connective action, China, MeToo movement, social media

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1308 Multiple-Channel Piezoelectric Actuated Tunable Optical Filter for WDM Application

Authors: Hailu Dessalegn, T. Srinivas

Abstract:

We propose new multiple-channel piezoelectric (PZT) actuated tunable optical filter based on racetrack multi-ring resonators for wavelength de-multiplexing network applications. We design tunable eight-channel wavelength de-multiplexer consisting of eight cascaded PZT actuated tunable multi-ring resonator filter with a channel spacing of 1.6 nm. The filter for each channel is basically structured on a suspended beam, sandwiched with piezoelectric material and built in integrated ring resonators which are placed on the middle of the beam to gain uniform stress and linearly varying longitudinal strain. A reference single mode serially coupled multi stage racetrack ring resonator with the same radii and coupling length is designed with a line width of 0.8974 nm with a flat top pass band at 1dB of 0.5205 nm and free spectral range of about 14.9 nm. In each channel, a small change in the perimeter of the rings is introduced to establish the shift in resonance wavelength as per the defined channel spacing. As a result, when a DC voltage is applied, the beams will elongate, which involves mechanical deformation of the ring resonators that induces a stress and a strain, which brings a change in refractive index and perimeter of the rings leading to change in the output spectrum shift providing the tunability of central wavelength in each channel. Simultaneous wave length shift as high as 45.54 pm/V has been achieved with negligible tunability variation in the eight channel tunable optical filter proportional to the DC voltage applied in the structure, and it is capable of tuning up to 3.45 nm in each channel with a maximum loss difference of 0.22 dB in the tuning range and out of band rejection ratio of 35 dB, with a low channel crosstalk ≤ 30 dB.

Keywords: optical MEMS, piezoelectric (PZT) actuation, tunable optical filter, wavelength de-multiplexer

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1307 Hybrid Renewable Power Systems

Authors: Salman Al-Alyani

Abstract:

In line with the Kingdom’s Vision 2030, the Saudi Green initiative was announced aimed at reducing carbon emissions by more than 4% of the global contribution. The initiative included plans to generate 50% of its energy from renewables by 2030. The geographical location of Saudi Arabia makes it among the best countries in terms of solar irradiation and has good wind resources in many areas across the Kingdom. Saudi Arabia is a wide country and has many remote locations where it is not economically feasible to connect those loads to the national grid. With the improvement of battery innovation and reduction in cost, different renewable technologies (primarily wind and solar) can be integrated to meet the need for energy in a more effective and cost-effective way. Saudi Arabia is famous for high solar irradiations in which solar power generation can extend up to six (6) hours per day (25% capacity factor) in some locations. However, the net present value (NPV) falls down to negative in some locations due to distance and high installation costs. Wind generation in Saudi Arabia is a promising technology. Hybrid renewable generation will increase the net present value and lower the payback time due to additional energy generated by wind. The infrastructure of the power system can be capitalized to contain solar generation and wind generation feeding the inverter, controller, and load. Storage systems can be added to support the hours that have an absence of wind or solar energy. Also, the smart controller that can help integrate various renewable technologies primarily wind and solar, to meet demand considering load characteristics. It could be scalable for grid or off-grid applications. The objective of this paper is to study the feasibility of introducing a hybrid renewable system in remote locations and the concept for the development of a smart controller.

Keywords: battery storage systems, hybrid power generation, solar energy, wind energy

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1306 Circumstantial Loneliness and Existential Isolation in the Works of Flutura Açka

Authors: Elvira Lumi, Hans Jazxhi

Abstract:

In the works of the writer Flutura Açka, the play with these questions is acute, and in almost each of them, the act of loneliness and isolation builds in a completely involuntary way unique and frequent conceptual spaces. Because the object of study is too broad to grasp all the works, this study lays out a rapid paradox of our access to three of the novels in the line of numerous authorial works. The novel "Woman Loneliness" (2001), also marked as the first work in prose by the author, declares in the title the paradigm of what she has decided to confess. The gender segregation proclaimed in the title will be revealed step by step in the work as conventional human segregation without gender. In this novel, the analysis of the state of "loneliness" will require a contemplation beyond man, when the role of the environment and the distance from the center of the narrative base will be extremely visible in the work. The novel "Cross of Oblivion" (2004) has another form of perception of loneliness, which, unlike the one built by the characters themselves in the novel "Woman Loneliness," is imposed and obligatory to live by the circumstances. Its characters are trapped in loneliness, as loneliness that comes from impossibility, from the past, from dependence on fate, from fear of change, and from the obligation to accept it. At the heart of the novel, the plot of the novel game is dictated by the Kanun and its rules and the loneliness of the basis of life in unbroken waves towards the periphery of the event, a periphery that has very large geography and is played in today's Europe. The novel "Where are you?" (2009) has a completely different form of constructing the concept of loneliness and isolation that comes under conditions of repression and political pressure. The loneliness in this novel takes the form of the protective element from the circumstances that actually require a social inclusion; it is personal loneliness that ensures relative mental health of the characters, up to a new trap created by the circumstances, thus building life fragmentary “healthy” in the order of a mentally ill and socially ill society.

Keywords: loneliness, existential, isolation, woman, prose

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1305 US-China Competition in South China Sea and International Law

Authors: Mubashra Shaheen

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The conflict over the South China Sea (SCS) is a complex imbroglio spanning over several territorial and maritime claims involving two major island groups, the Paracels and the Spratlys. It has become a major source of geopolitical competition between the United States and China. The study's overall objective is to understand China's land reclamations and assertive behavior in the South China Sea, which lies between both the Western Pacific and the Indian Ocean. Over half of global commerce passes through these waterways, which host a great amount of marine life and hydrocarbon deposits. China's sand-filling and island-building strategy in the South China Sea is motivated by its goal of privatizing all these riches as well as the routes. It would raise China to the pinnacle of world power status as well as allow it to threaten the dominance of the U.S. The study will examine China's assertive behavior and modernization plans as well as the United States' quest for supremacy through the lens of realists. While using a qualitative method of analysis, the study will examine China's nine-dash line claims and Exclusive Economic Zones (EEZs), UNCLOS, and U.S.-China divergence over international law considerations to pacify the tensions in the South China Sea. This paper is intended to explore the possible answers to the following questions: (1) Why does China’s rise necessitate the US's efforts to contain and encircle it through the lending of a hand to strategic partners and allies in the South China Sea? (2) Why South China Sea dispute is so complex imbroglio? (3) What are US-China international law considerations regarding the South China Sea? The study will further follow the bellow research procedure: 1: Comparative Legal Method: This method simply chalk-outs the follow of few steps that discarnate the positive and negative effects of the great power competitions. 2: Conceptualization: The conceptualization of the policies of containment defines and differentiates two different problems behind the persuasive means of hegemony and dominance in the strategic milieu.

Keywords: us, china, south china sea, unclos

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1304 Invistigation of Surface Properties of Nanostructured Carbon Films

Authors: Narek Margaryan, Zhozef Panosyan

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Due to their unique properties, carbon nanofilms have become the object of general attention and intensive research. In this case it plays a very important role to study surface properties of these films. It is also important to study processes of forming of this films, which is accompanied by a process of self-organization at the nano and micro levels. For more detailed investigation, we examined diamond-like carbon (DLC) layers deposited by chemical vapor deposition (CVD) method on Ge substrate and hydro-generated grapheme layers obtained on surface of colloidal solution using grouping method. In this report surface transformation of these CVD nanolayers is studied by atomic force microscopy (AFM) upon deposition time. Also, it can be successfully used to study surface properties of self-assembled grapheme layers. In turn, it is possible to sketch out their boundary line, which enables one to draw an idea of peculiarities of formation of these layers. Images obtained by AFM are investigated as a mathematical set of numbers and fractal and roughness analysis were done. Fractal dimension, Regne’s fractal coefficient, histogram, Fast Fourier transformation, etc. were obtained. The dependence of fractal parameters on the deposition duration for CVD films and on temperature of solution tribolayers was revealed. As an important surface parameter for our carbon films, surface energy was calculated as function of Regne’s fractal coefficient. Surface potential was also measured with Kelvin probe method using semi-contacting AFM. The dependence of surface potential on the deposition duration for CVD films and on temperature of solution for hydro-generated graphene was found as well. Results obtained by fractal analysis method was related with purly esperimental results for number of samples.

Keywords: nanostructured films, self-assembled grapheme, diamond-like carbon, surface potential, Kelvin probe method, fractal analysis

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1303 The Seeds of Limitlessness: Dambudzo Marechera's Utopian Thinking

Authors: Emily S. M. Chow

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The word ‘utopia’ was coined by Thomas More in Utopia (1516). Its Greek roots ‘ou’ means ‘not’ and ‘topos’ means ‘place.’ In other words, it literally refers to ‘no-place.’ However, the possibility of having an alternative and better future society has always been appealing. In fact, at the core of every utopianism is the search for a future alternative state with the anticipation of a better life. Nonetheless, the practicalities of such ideas have never ceased to be questioned. At times, building a utopia presents itself as a divisive act. In addition to the violence that must be employed to sweep away the old regime in order to make space for the new, all utopias carry within them the potential for bringing catastrophic consequences to human life. After all, every utopia seeks to remodel the individual in a very particular way for the benefit of the masses. In this sense, utopian thinking has the potential both to create and destroy the future. While writing during a traumatic transitional period in Zimbabwe’s history, Dambudzo Marechera witnessed an age of upheavals in which different parties battled for power over Zimbabwe. Being aware of the fact that all institutionalized narratives, be they originated from the governance of the UK, Ian Smith’s white minority regime or Zimbabwe’s revolutionary parties, revealed themselves to be nothing more than fiction, Marechera realized the impossibility of determining reality absolutely. As such, this thesis concerns the writing of the Zimbabwean maverick, Dambudzo Marechera. It argues that Marechera writes a unique vision of utopia. In short, for Marechera utopia is not a static entity but a moment of perpetual change. He rethinks utopia in the sense that he phrases it as an event that ceaselessly contests institutionalized and naturalized narratives of a post-colonial self and its relationship to society. Marechera writes towards a vision of an alternative future of the country. Yet, it is a vision that does not constitute a fully rounded sense of utopia. Being cautious about the world and the operation of power upon the people, rather than imposing his own utopian ideals, Marechera chooses to instead peeling away the narrative constitution of the self in relation to society in order to turn towards a truly radical utopian thinking that empowers the individual.

Keywords: African literature, Marechera, post-colonial literature, utopian studies

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1302 Extraskeletal Ewing Sarcoma- Experience in a Tertiary Cancer Care Centre of India

Authors: Himanshu Rohela

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BACKGROUND: Ewing sarcoma can arise in either bone or soft tissue. Extraskeletal Ewing sarcoma (EES) is an uncommon primary tumor of the soft tissues, accounting for 20 30% of all reported cases of ES. AIM: Was to investigate demographic distribution, survival analysis and factors affecting the survival and recurrence in patients of EES. METHODS: Retrospective study of 19 biopsy-proven EES was performed. Overall survival (OS) using log-rank test and factors affecting OS and local recurrence (LR) were evaluated for the entire cohort. RESULTS: Patients with EES had a mean age of 19.5 and it was more commonly seen in males (63%). Axial location (58%) and solitary presentation (84%) were more common. The average size was 11 cm, 3 of 19 were metastatic at presentation, with the lung beings the most common site for metastasis. 17 received NACT, 16 with VAC-IE regimen and 1 underwent a second line with GEM/DOCE regimen. Unplanned surgery was done in 2 of 19. 3 patients received definitive RT and 13 underwent surgical-wide local excision. 2 of 13 showed good response to NACT. 10 patients required readmission out of which 6 patients had chemotherapy-related complications, 2 had surgical site complications and one patient developed secondary AML post-completion of treatment. A total of 4 patients had a recurrence. One had local recurrence alone, one had distant recurrence alone and 2 patients had a distant and local recurrence both. Tumor size >10 cm, axial location, and previous unplanned surgery was associated with higher LR rate. The mean overall survival was 32 months (2.66 years), with higher rates seen in non-metastatic and non-recurrent settings. CONCLUSIONS: Early and accurate diagnosis is the key to the management of EES, with promising results seen via NACT and RO resection regimens. But further studies with larger study groups are needed to standardize the treatment protocol and evaluate its efficacy.

Keywords: Ewings, sarcoma, extraskeletal, chemotherapy

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1301 Research on the Effectiveness of Online Guided Case Teaching in Problem-Based Learning: A Preschool Special Education Course

Authors: Chen-Ya Juan

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Problem-Based Learning uses vague questions to guide student thinking and enhance their self-learning and collaboration. Most teachers implement PBL in a physical classroom, where teachers can monitor and evaluate students’ learning progress and guide them to search resources for answers. However, the prevalence of the Covid-19 in the world had changed from physical teaching to distance teaching. This instruction used many cases and applied Problem-Based Learning combined on the distance teaching via the internet for college students. This study involved an experimental group with PBL and a control group without PBL. The teacher divided all students in PBL class into eight groups, and 7~8 students in each group. The teacher assigned different cases for each group of the PBL class. Three stages of instruction were developed, including background knowledge of Learning, case analysis, and solving problems for each case. This study used a quantitative research method, a two-sample t-test, to find a significant difference in groups with PBL and without PBL. Findings indicated that PBL incased the average score of special education knowledge. The average score was improved by 20.46% in the PBL group and 15.4% without PBL. Results didn’t show significant differences (0.589>0.05) in special education professional knowledge. However, the feedback of the PBL students implied learning more about the application, problem-solving skills, and critical thinking. PBL students were more likely to apply professional knowledge on the actual case, find questions, resources, and answers. Most of them understood the importance of collaboration, working as a team, and communicating with other team members. The suggestions of this study included that (a) different web-based teaching instruments influenced student’s Learning; (b) it is difficult to monitor online PBL progress; (c) online PBL should be implemented flexible and multi-oriented; (d) although PBL did not show a significant difference on the group with PBL and without PBL, it did increase student’s problem-solving skills and critical thinking.

Keywords: problem-based learning, college students, distance learning, case analysis, problem-solving

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1300 A Conceptual Framework for Vulnerability Assessment of Climate Change Impact on Oil and Gas Critical Infrastructures in the Niger Delta

Authors: Justin A. Udie, Subhes C. Bhatthacharyya, Leticia Ozawa-Meida

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The impact of climate change is severe in the Niger Delta and critical oil and gas infrastructures are vulnerable. This is partly due to lack of specific impact assessment framework to assess impact indices on both existing and new infrastructures. The purpose of this paper is to develop a framework for the assessment of climate change impact on critical oil and gas infrastructure in the region. Comparative and documentary methods as well as analysis of frameworks were used to develop a flexible, integrated and conceptual four dimensional framework underpinning; 1. Scoping – the theoretical identification of inherent climate burdens, review of exposure, adaptive capacities and delineation of critical infrastructure; 2. Vulnerability assessment – presents a systematic procedure for the assessment of infrastructure vulnerability. It provides real time re-scoping, practical need for data collection, analysis and review. Physical examination of systems is encouraged to complement the scoped data and ascertain the level of exposure to relevant climate risks in the area; 3. New infrastructure – consider infrastructures that are still at developmental level. It seeks to suggest the inclusion of flexible adaptive capacities in original design of infrastructures in line with climate threats and projections; 4. The Mainstreaming Climate Impact Assessment into government’s environmental decision making approach. Though this framework is designed specifically for the estimation of exposure, adaptive capacities and criticality of vulnerable oil and gas infrastructures in the Niger Delta to climate burdens; it is recommended for researchers and experts as a first-hand generic and practicable tool which can be used for the assessment of other infrastructures perceived as critical and vulnerable. The paper does not provide further tools that synch into the methodological approach but presents pointers upon which a pragmatic methodology can be developed.

Keywords: adaptation, assessment, conceptual, climate, change, framework, vulnerability

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1299 A Systematic Review on Orphan Drugs Pricing, and Prices Challenges

Authors: Seyran Naghdi

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Background: Orphan drug development is limited by very high costs attributed to the research and development and small size market. How health policymakers address this challenge to consider both supply and demand sides need to be explored for directing the policies and plans in the right way. The price is an important signal for pharmaceutical companies’ profitability and the patients’ accessibility as well. Objective: This study aims to find out the orphan drugs' price-setting patterns and approaches in health systems through a systematic review of the available evidence. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach was used. MedLine, Embase, and Web of Sciences were searched via appropriate search strategies. Through Medical Subject Headings (MeSH), the appropriate terms for pricing were 'cost and cost analysis', and it was 'orphan drug production', and 'orphan drug', for orphan drugs. The critical appraisal was performed by the Joanna-Briggs tool. A Cochrane data extraction form was used to obtain the data about the studies' characteristics, results, and conclusions. Results: Totally, 1,197 records were found. It included 640 hits from Embase, 327 from Web of Sciences, and 230 MedLine. After removing the duplicates, 1,056 studies remained. Of them, 924 studies were removed in the primary screening phase. Of them, 26 studies were included for data extraction. The majority of the studies (>75%) are from developed countries, among them, approximately 80% of the studies are from European countries. Approximately 85% of evidence has been produced in the recent decade. Conclusions: There is a huge variation of price-setting among countries, and this is related to the specific pharmacological market structure and the thresholds that governments want to intervene in the process of pricing. On the other hand, there is some evidence on the availability of spaces to reduce the very high costs of orphan drugs development through an early agreement between pharmacological firms and governments. Further studies need to focus on how the governments could incentivize the companies to agree on providing the drugs at lower prices.

Keywords: orphan drugs, orphan drug production, pricing, costs, cost analysis

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1298 Effect of Distance to Health Facilities on Maternal Service Use and Neonatal Mortality in Ethiopia

Authors: Getiye Dejenu Kibret, Daniel Demant, Andrew Hayen

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Introduction: In Ethiopia, more than half of newborn babies do not have access to Emergency Obstetric and Neonatal Care (EmONC) services. Understanding the effect of distance to health facilities on service use and neonatal survival is crucial to recommend policymakers and improve resource distribution. We aimed to investigate the effect of distance to health services on maternal service use and neonatal mortality. Methods: We implemented a data linkage method based on geographic coordinates and calculated straight-line (Euclidean) distances from the Ethiopian 2016 demographic and health survey clusters to the closest health facility. We computed the distance in ESRI ArcGIS Version 10.3 using the geographic coordinates of DHS clusters and health facilities. Generalised Structural Equation Modelling (GSEM) was used to estimate the effect of distance on neonatal mortality. Results: Poor geographic accessibility to health facilities affects maternal service usage and increases the risk of newborn mortality. For every ten kilometres (km) increase in distance to a health facility, the odds of neonatal mortality increased by 1.33% (95% CI: 1.06% to 1.67%). Distance also negatively affected antenatal care, facility delivery and postnatal counselling service use. Conclusions: A lack of geographical access to health facilities decreases the likelihood of newborns surviving their first month of life and affects health services use during pregnancy and immediately after birth. The study also showed that antenatal care use was positively associated with facility delivery service use and that both positively influenced postnatal care use, demonstrating the interconnectedness of the continuum of care for maternal and neonatal care services. Policymakers can leverage the findings from this study to improve accessibility barriers to health services.

Keywords: acessibility, distance, maternal health service, neonatal mortality

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