Search results for: home zone parking pilot

Authors: Saule Balmagambetova, Zhenisgul Tlegenova, Saule Madinova

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Cardiotoxicity associated with anticancer treatment, now defined as cancer therapy-related cardiac dysfunction (CTRCD), accompanies cancer patients and negatively impacts their survivorship. Currently, a cardio-oncological service is being created in Kazakhstan based on the provisions of the European Society of Cardio-oncology (ESC) Guidelines. In the frames of a pilot project, a cohort study on CTRCD conditions was initiated at the Aktobe Cancer center. One hundred twenty-eight newly diagnosed breast cancer patients started on doxorubicin and/or trastuzumab were recruited. Echocardiography with global longitudinal strain (GLS) assessment, biomarkers panel (cardiac troponin (cTnI), brain natriuretic peptide (BNP), myeloperoxidase (MPO), galectin-3 (Gal-3), D-dimers, C-reactive protein (CRP)), and other tests were performed at baseline and every three months. Patients were stratified by the cardiovascular risks according to the ESC recommendations and allocated into the risk groups during the pre-treatment visit. Of them, 10 (7.8%) patients were assigned to the high-risk group, 48 (37.5%) to the medium-risk group, and 70 (54.7%) to the low-risk group, respectively. High-risk patients have been receiving their cardioprotective treatment from the outset. Patients were also divided by treatment - in the anthracycline-based 83 (64.8%), in trastuzumab- only 13 (10.2%), and in the mixed anthracycline/trastuzumab group 32 individuals (25%), respectively. Mild symptomatic CTRCD was revealed and treated in 2 (1.6%) participants, and a mild asymptomatic variant in 26 (20.5%). Mild asymptomatic conditions are defined as left ventricular ejection fraction (LVEF) ≥50% and further relative reduction in GLS by >15% from baseline and/or a further rise in cardiac biomarkers. The listed biomarkers were assessed longitudinally in repeated-measures linear regression models during 12 months of observation. The associations between changes in biomarkers and CTRCD and between changes in biomarkers and LVEF were evaluated. Analysis by risk groups revealed statistically significant differences in baseline LVEF scores (p 0.001), BNP (p 0.0075), and Gal-3 (p 0.0073). Treatment groups found no statistically significant differences at baseline. After 12 months of follow-up, only LVEF values showed a statistically significant difference by risk groups (p 0.0011). When assessing the temporal changes in the studied parameters for all treatment groups, there were statistically significant changes from visit to visit for LVEF (p 0.003); GLS (p 0.0001); BNP (p<0.00001); MPO (p<0.0001); and Gal-3 (p<0.0001). No moderate or strong correlations were found between the biomarkers values and LVEF, between biomarkers and GLS. Between the biomarkers themselves, a moderate, close to strong correlation was established between cTnI and D-dimer (r 0.65, p<0.05). The dose-dependent effect of anthracyclines has been confirmed: the summary dose has a moderate negative impact on GLS values: -r 0.31 for all treatment groups (p<0.05). The present study found myeloperoxidase as a promising biomarker of cardiac dysfunction in the mixed anthracycline/trastuzumab treatment group. The hazard of CTRCD increased by 24% (HR 1.21; 95% CI 1.01;1.73) per doubling in baseline MPO value (p 0.041). Increases in BNP were also associated with CTRCD (HR per doubling, 1.22; 95% CI 1.12;1.69). No cases of chemotherapy discontinuation due to cardiotoxic complications have been recorded. Further observations are needed to gain insight into the ability of biomarkers to predict CTRCD onset.

Keywords: breast cancer, chemotherapy, cardiotoxicity, Kazakhstan

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Authors: Anudeep Appe, Bhanu Poluparthi, Lakshmi Kasivajjula, Udai Mv, Sobha Bagadi, Punya Modi, Aditya Singh, Hemanth Gunupudi, Spenser Troiano, Jeff Paul, Justin Stovall, Justin Yamamoto

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The necessity of data-driven decisions in healthcare strategy formulation is rapidly increasing. A reliable framework which helps identify factors impacting a healthcare provider facility or a hospital (from here on termed as facility) market share is of key importance. This pilot study aims at developing a data-driven machine learning-regression framework which aids strategists in formulating key decisions to improve the facility’s market share which in turn impacts in improving the quality of healthcare services. The US (United States) healthcare business is chosen for the study, and the data spanning 60 key facilities in Washington State and about 3 years of historical data is considered. In the current analysis, market share is termed as the ratio of the facility’s encounters to the total encounters among the group of potential competitor facilities. The current study proposes a two-pronged approach of competitor identification and regression approach to evaluate and predict market share, respectively. Leveraged model agnostic technique, SHAP, to quantify the relative importance of features impacting the market share. Typical techniques in literature to quantify the degree of competitiveness among facilities use an empirical method to calculate a competitive factor to interpret the severity of competition. The proposed method identifies a pool of competitors, develops Directed Acyclic Graphs (DAGs) and feature level word vectors, and evaluates the key connected components at the facility level. This technique is robust since its data-driven, which minimizes the bias from empirical techniques. The DAGs factor in partial correlations at various segregations and key demographics of facilities along with a placeholder to factor in various business rules (for ex. quantifying the patient exchanges, provider references, and sister facilities). Identified are the multiple groups of competitors among facilities. Leveraging the competitors' identified developed and fine-tuned Random Forest Regression model to predict the market share. To identify key drivers of market share at an overall level, permutation feature importance of the attributes was calculated. For relative quantification of features at a facility level, incorporated SHAP (SHapley Additive exPlanations), a model agnostic explainer. This helped to identify and rank the attributes at each facility which impacts the market share. This approach proposes an amalgamation of the two popular and efficient modeling practices, viz., machine learning with graphs and tree-based regression techniques to reduce the bias. With these, we helped to drive strategic business decisions.

Keywords: competition, DAGs, facility, healthcare, machine learning, market share, random forest, SHAP

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Authors: Monika Jurkeviciute, Amia Enam, Johanna Torres Bonilla, Henrik Eriksson

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Introduction: Many evaluations of eHealth interventions conclude that the evidence for improved clinical outcomes is limited, especially when the intervention is short, such as one year. Often, evaluation design does not address the feasibility of achieving clinical outcomes. Evaluations are designed to reflect upon clinical goals of intervention without utilizing the opportunity to illuminate effects on organizations and cost. A comprehensive design of evaluation can better support decision-making regarding the effectiveness and potential transferability of eHealth. Hence, the purpose of this paper is to present a feasible and comprehensive design of evaluation for eHealth intervention, including the design process in different contexts. Methodology: The situation of limited feasibility of clinical outcomes was foreseen in the European Union funded project called “DECI” (“Digital Environment for Cognitive Inclusion”) that is run under the “Horizon 2020” program with an aim to define and test a digital environment platform within corresponding care models that help elderly people live independently. A complex intervention of eHealth implementation into elaborate care models in four different countries was planned for one year. To design the evaluation, a participative approach was undertaken using Pettigrew’s lens of change and transformations, including context, process, and content. Through a series of workshops, observations, interviews, and document analysis, as well as a review of scientific literature, a comprehensive design of evaluation was created. Findings: The findings indicate that in order to get evidence on clinical outcomes, eHealth interventions should last longer than one year. The content of the comprehensive evaluation design includes a collection of qualitative and quantitative methods for data gathering which illuminates non-medical aspects. Furthermore, it contains communication arrangements to discuss the results and continuously improve the evaluation design, as well as procedures for monitoring and improving the data collection during the intervention. The process of the comprehensive evaluation design consists of four stages: (1) analysis of a current state in different contexts, including measurement systems, expectations and profiles of stakeholders, organizational ambitions to change due to eHealth integration, and the organizational capacity to collect data for evaluation; (2) workshop with project partners to discuss the as-is situation in relation to the project goals; (3) development of general and customized sets of relevant performance measures, questionnaires and interview questions; (4) setting up procedures and monitoring systems for the interventions. Lastly, strategies are presented on how challenges can be handled during the design process of evaluation in four different countries. The evaluation design needs to consider contextual factors such as project limitations, and differences between pilot sites in terms of eHealth solutions, patient groups, care models, national and organizational cultures and settings. This implies a need for the flexible approach to evaluation design to enable judgment over the effectiveness and potential for adoption and transferability of eHealth. In summary, this paper provides learning opportunities for future evaluation designs of eHealth interventions in different national and organizational settings.

Keywords: ehealth, elderly, evaluation, intervention, multi-cultural

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Authors: Kadidiatou Toure

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Mali has started experimentation of teaching the national languages at school through the convergent pedagogy in 1987. Then, it is in 1994 that it will become widespread with eleven of the thirteen former national languages used at primary school. The aim was to improve the Malian educational system because the use of French as the only medium of instruction was considered a contributing factor to the significant number of student dropouts and the high rate of repetition. The Convergent pedagogy highlights the knowledge acquired by children at home, their vision of the world and especially the knowledge they have of their mother tongue. That pedagogy requires the use of a specific medium only during classroom practices and teachers have been trained in this sense. The specific medium depends on the learning content, which sometimes is French, other times, it is the national language. Research has shown that bilingual learners do not only use the required medium in their learning activities, but they code switch. It is part of their learning processes. Currently, many scholars agree on the importance of CS in bilingual classes, and teachers have been told about the necessity of integrating it into their classroom practices. One of the challenges of the Malian bilingual education curriculum is the question of ‘effective languages management’. Theoretically, depending on the classrooms, an average have been established for each of the involved language. Following that, teachers make use of CS differently, sometimes, it favors the learners, other times, it contributes to the development of some linguistic weaknesses. The present research tries to fill that gap through a tentative model of didactization of CS, which simply means the practical management of the languages involved in the bilingual classrooms. It is to know how to use CS for effective learning. Moreover, the didactization of CS tends to sensitize the teachers about the functional role of CS so that they may overcome their own weaknesses. The overall goal of this research is to make code switching a real tool for bilingual education. The specific objectives are: to identify the types of CS used during classroom activities to present the functional role of CS for the teachers as well as the pupils. to develop a tentative model of code-switching, which will help the teachers in transitional classes of bilingual schools to recognize the appropriate moment for making use of code switching in their classrooms. The methodology adopted is a qualitative one. The study is based on recorded videos of teachers of 3rd year of primary school during their classroom activities and interviews with the teachers in order to confirm the functional role of CS in bilingual classes. The theoretical framework adopted is the typology of CS proposed by Poplack (1980) to identify the types of CS used. The study reveals that teachers need to be trained on the types of CS and the different functions they assume and on the consequences of inappropriate use of language alternation.

Keywords: bilingual curriculum, code switching, didactization, national languages

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Authors: Lin-Han Chiang Hsieh, Hsiao-Yi Lin

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This study aims to determine the impact of the disclosure of flood potential map on housing prices. The disclosure is supposed to mitigate the market failure by reducing information asymmetry. On the other hand, opponents argue that the official disclosure of simulated results will only create unnecessary disturbances on the housing market. This study identifies the impact of the disclosure of the flood potential map by comparing the hedonic price of flood potential before and after the disclosure. The flood potential map used in this study is published by Taipei municipal government in 2015, which is a result of a comprehensive simulation based on geographical, hydrological, and meteorological factors. The residential property sales data of 2013 to 2016 is used in this study, which is collected from the actual sales price registration system by the Department of Land Administration (DLA). The result shows that the impact of flood potential on residential real estate market is statistically significant both before and after the disclosure. But the trend is clearer after the disclosure, suggesting that the disclosure does have an impact on the market. Also, the result shows that the impact of flood potential differs by the severity and frequency of precipitation. The negative impact for a relatively mild, high frequency flood potential is stronger than that for a heavy, low possibility flood potential. The result indicates that home buyers are of more concern to the frequency, than the intensity of flood. Another contribution of this study is in the methodological perspective. The classic hedonic price analysis with OLS regression suffers from two spatial problems: the endogeneity problem caused by omitted spatial-related variables, and the heterogeneity concern to the presumption that regression coefficients are spatially constant. These two problems are seldom considered in a single model. This study tries to deal with the endogeneity and heterogeneity problem together by combining the spatial fixed-effect model and geographically weighted regression (GWR). A series of literature indicates that the hedonic price of certain environmental assets varies spatially by applying GWR. Since the endogeneity problem is usually not considered in typical GWR models, it is arguable that the omitted spatial-related variables might bias the result of GWR models. By combing the spatial fixed-effect model and GWR, this study concludes that the effect of flood potential map is highly sensitive by location, even after controlling for the spatial autocorrelation at the same time. The main policy application of this result is that it is improper to determine the potential benefit of flood prevention policy by simply multiplying the hedonic price of flood risk by the number of houses. The effect of flood prevention might vary dramatically by location.

Keywords: flood potential, hedonic price analysis, endogeneity, heterogeneity, geographically-weighted regression

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Authors: Abduladim Maitieg, Kevin Lynch, Mark Johnson

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The goal of the Libyan Environmental General Authority (EGA) and National Oil Corporation (Department of Health, Safety & Environment) during the last 5 years has been to adopt a common approach to coastal and marine spatial planning. Protection and planning of the coastal zone is a significant for Libya, due to the length of coast and, the high rate of oil export, and spills’ potential negative impacts on coastal and marine habitats. Coastal resource scenarios constitute an important tool for exploring the long-term and short-term consequences of oil spill impact and available response options that would provide an integrated perspective on mitigation. To investigate that, this paper reviews the Misratah coastal parameters to present the physical and human controls and attributes of coastal habitats as the first step in understanding how they may be damaged by an oil spill. This paper also investigates costal resources, providing a better understanding of the resources and factors that impact the integrity of the ecosystem. Therefore, the study described the potential spatial distribution of oil spill risk and the coastal resources value, and also created spatial maps of coastal resources and their vulnerability to oil spills along the coast. This study proposes an analysis of coastal resources condition at a local level in the Misratah region of the Mediterranean Sea, considering the implementation of coastal and marine spatial planning over time as an indication of the will to manage urban development. Oil spill contamination analysis and their impact on the coastal resources depend on (1) oil spill sequence, (2) oil spill location, (3) oil spill movement near the coastal area. The resulting maps show natural, socio-economic activity, environmental resources along of the coast, and oil spill location. Moreover, the study provides significant geodatabase information which is required for coastal sensitivity index mapping and coastal management studies. The outcome of study provides the information necessary to set an Environmental Sensitivity Index (ESI) for the Misratah shoreline, which can be used for management of coastal resources and setting boundaries for each coastal sensitivity sectors, as well as to help planners measure the impact of oil spills on coastal resources. Geographic Information System (GIS) tools were used in order to store and illustrate the spatial convergence of existing socio-economic activities such as fishing, tourism, and the salt industry, and ecosystem components such as sea turtle nesting area, Sabkha habitats, and migratory birds feeding sites. These geodatabases help planners investigate the vulnerability of coastal resources to an oil spill.

Keywords: coastal and marine spatial planning advancement training, GIS mapping, human uses, ecosystem components, Misratah coast, Libyan, oil spill

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Authors: Abdel-Monem Sayed Mohamed

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Lake Aswan is one of the largest man-made reservoirs in the world. The reservoir began to fill in 1964 and the level rose gradually, with annual irrigation cycles, until it reached a maximum water level of 181.5 m in November 1999, with a capacity of 160 km3. The filling of such large reservoir changes the stress system either through increasing vertical compressional stress by loading and/or increased pore pressure through the decrease of the effective normal stress. The resulted effect on fault zones changes stability depending strongly on the orientation of pre-existing stress and geometry of the reservoir/fault system. The main earthquake occurred on November 14, 1981, with magnitude 5.5. This event occurred after 17 years of the reservoir began to fill, along the active part of the Kalabsha fault and located not far from the High Dam. Numerous of small earthquakes follow this earthquake and continue till now. For this reason, 13 seismograph stations (radio-telemetry network short-period seismometers) were installed around the northern part of Lake Aswan. The main purpose of the network is to monitor the earthquake activity continuously within Aswan region. The data described here are obtained from the continuous record of earthquake activity and lake-water level variation through the period from 1982 to 2015. The seismicity is concentrated in the Kalabsha area, where there is an intersection of the easterly trending Kalabsha fault with the northerly trending faults. The earthquake foci are distributed in two seismic zones, shallow and deep in the crust. Shallow events have focal depths of less than 12 km while deep events extend from 12 to 28 km. Correlation between the seismicity and the water level variation in the lake provides great suggestion to distinguish the micro-earthquakes, particularly, those in shallow seismic zone in the reservoir–triggered seismicity category. The water loading is one factor from several factors, as an activating medium in triggering earthquakes. The common factors for all cases of induced seismicity seem to be the presence of specific geological conditions, the tectonic setting and water loading. The role of the water loading is as a supplementary source of earthquake events. So, the earthquake activity in the area originated tectonically (ML ≥ 4) and the water factor works as an activating medium in triggering small earthquakes (ML ≤ 3). Study of the inducing seismicity from the water level variation in Aswan Lake is of great importance and play great roles necessity for the safety of the High Dam body and its economic resources.

Keywords: Aswan lake, Aswan seismic network, seismicity, water level variation

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Authors: Afolabi K. Esther, Kuye Tolulope, Babafemi, L. Olayemi, Omikunle Yemisi

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Background: Cervical cancer is a potentially preventable disease of public significance. All sexually active women are at risk of cervical cancer; however, the uptake and coverage are low in low-middle resource countries. Hence, the programme explored the feasibility of demonstrating an innovative and low-cost system approach to cervical cancer screening service delivery among reproductive-aged women in low–resource settings in Southwestern Nigeria. This was to promote the uptake and quality improvement of cervical cancer screening services. Methods: This study was an intervention project in three senatorial districts in Osun State that have primary, secondary and tertiary health facilities. The project was in three phases; Pre-intervention, Intervention, and Post-intervention. The study utilised the existing infrastructure, facilities and staff in project settings. The study population was nurse-midwives, community health workers and reproductive-aged women (30-49 years). The intervention phase entailed using innovative, culturally appropriate strategies to create awareness of cervical cancer and preventive health-seeking behaviour among women in the reproductive-aged group (30-49) years. Also, the service providers (community health workers, Nurses, and Midwives) were trained on screening methods and treatment of pre-cancerous lesions, and there was the provision of essential equipment and supplies for cervical cancer screening services at health facilities. Besides, advocacy and engagement were made with relevant stakeholders to integrate the cervical cancer screening services into related reproductive health services and greater allocation of resources. The expected results compared the pre and post-intervention using the baseline and process indicators and the effect of the intervention phase on screening coverage using a plausibility assessment design. The project lasted 12 months; visual Inspection with Acetic acid (VIA) screening for the women for six months and follow-up in 6 months for women receiving treatment. Results: The pre-intervention phase assessed baseline service delivery statistics in the previous 12 months drawn from the retrospective data collected as part of the routine monitoring and reporting systems. The uptake of cervical cancer screening services was low as the number of women screened in the previous 12 months was 156. Service personnel's competency level was fair (54%), and limited availability of essential equipment and supplies for cervical cancer screening services. At the post-intervention phase, the level of uptake had increased as the number of women screened was 1586 within six months in the study settings. This showed about a 100-%increase in the uptake of cervical cancer screening services compared with the baseline assessment. Also, the post-intervention level of competency of service delivery personnel had increased to 86.3%, which indicates quality improvement of the cervical cancer screening service delivery. Conclusion: the findings from the study have shown an effective approach to strengthening and improving cervical cancer screening service delivery in Southwestern Nigeria. Hence, the intervention promoted a positive attitude and health-seeking behaviour among the target population, significantly influencing the uptake of cervical cancer screening services.

Keywords: cervical cancer, screening, nigeria, health system strengthening

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Authors: Zhe Li, Tao Ju, Liguo Zhang, Zehong Zhang, Baoshun Zhang

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In-grow stacking-faults (IGSFs) in 4H-SiC epilayers can cause increased leakage current and reduce the blocking voltage of 4H-SiC power devices. Double Shockley stacking fault (2SSF) is a common type of IGSF with double slips on the basal planes. In this study, a 2SSF in the 4H-SiC epilayer grown by chemical vaper deposition (CVD) is characterized. The nucleation site of the 2SSF is discussed, and a model for the 2SSF nucleation is proposed. Homo-epitaxial 4H-SiC is grown on a commercial 4 degrees off-cut substrate by a home-built hot-wall CVD. Defect-selected-etching (DSE) is conducted with melted KOH at 500 degrees Celsius for 1-2 min. Room temperature cathodoluminescence (CL) is conducted at a 20 kV acceleration voltage. Low-temperature photoluminescence (LTPL) is conducted at 3.6 K with the 325 nm He-Cd laser line. In the CL image, a triangular area with bright contrast is observed. Two partial dislocations (PDs) with a 20-degree angle in between show linear dark contrast on the edges of the IGSF. CL and LTPL spectrums are conducted to verify the IGSF’s type. The CL spectrum shows the maximum photoemission at 2.431 eV and negligible bandgap emission. In the LTPL spectrum, four phonon replicas are found at 2.468 eV, 2.438 eV, 2.420 eV and 2.410 eV, respectively. The Egx is estimated to be 2.512 eV. A shoulder with a red-shift to the main peak in CL, and a slight protrude at the same wavelength in LTPL are verified as the so called Egx- lines. Based on the CL and LTPL results, the IGSF is identified as a 2SSF. Back etching by neutral loop discharge and DSE are conducted to track the origin of the 2SSF, and the nucleation site is found to be a threading screw dislocation (TSD) in this sample. A nucleation mechanism model is proposed for the formation of the 2SSF. Steps introduced by the off-cut and the TSD on the surface are both suggested to be two C-Si bilayers height. The intersections of such two types of steps are along [11-20] direction from the TSD, while a four-bilayer step at each intersection. The nucleation of the 2SSF in the growth is proposed as follows. Firstly, the upper two bilayers of the four-bilayer step grow down and block the lower two at one intersection, and an IGSF is generated. Secondly, the step-flow grows over the IGSF successively, and forms an AC/ABCABC/BA/BC stacking sequence. Then a 2SSF is formed and extends by the step-flow growth. In conclusion, a triangular IGSF is characterized by CL approach. Base on the CL and LTPL spectrums, the estimated Egx is 2.512 eV and the IGSF is identified to be a 2SSF. By back etching, the 2SSF nucleation site is found to be a TSD. A model for the 2SSF nucleation from an intersection of off-cut- and TSD- introduced steps is proposed.

Keywords: cathodoluminescence, defect-selected-etching, double Shockley stacking fault, low-temperature photoluminescence, nucleation model, silicon carbide

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Authors: Hanee Ryu

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The supporting policies for renewable energy have been designed to deploy renewable energy technology targeting domestic market. The government encourages market creation through obligations such as FIT or RPS on an energy supplier. With these policy measures, the securing vast market needs to induce technology development. Furthermore, it is crucial that ensuring developing market can make the environment nurture the renewable energy industry. Overseas expansion to countries being in demand is essential under immature domestic market. Extending its business abroad can make the domestic company get the knowledge through learning-by-doing. Besides, operation in the countries to be rich in renewable resources such as weather conditions helps to develop proven track record required for verifying technologies. This paper figures out the factor to hamper the global market entry and build up the strategies to overcome difficulties. Survey conducted renewable energy company having overseas experiences at least once. Based on the survey we check the obstacle against exporting home goods and services. As a result, securing funds is salient fact to proceed to business. It is difficult that only private bank or investment agencies participate in the project under uncertainty which renewable energy development project bears inherently. These uncertainties need public fund such as ODA to encourage private sectors to start a business. Furthermore, international organizations such as IRENA or multilateral development banks as WBG play a role to guarantee the investment including risk insurance against uncertainty. It can also manage excavation business cooperating with developing countries and supplement inadequate government funding involved. With survey results strategies to obtain the order, the international organization places are categorized according to the type of getting a contract. This paper suggests 3 types approaching to the international organization project (going through international competitive bidding, using ODA and project financing) and specifies the role of government to support the domestic firms with running out of funds. Under renewable energy industry environment where hard to being created as a spontaneous market, government policy approach needs to motivate the actors to get into the business. It is one of the good strategies that countries with the low demand of renewable energies participate in the project international agencies order in the developing countries having abundant resources. This provides crucial guidance for the formulation of renewable energy development policy and planning with consideration of business opportunities and funding.

Keywords: exporting strategies, multilateral development banks, promoting in developing countries, renewable energy technologies

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Authors: Xavier Louis, Madhava Soma Sundaram

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The Palk Bay, a narrow strip of water, separates the state of Tamil Nadu in India from north Sri Lanka. The bay, which is 137 km in length and varies from 64 to 137 kilometers in width and is home to more than 580 fish species and chunks of shrimp’s resources, is divided by the International Maritime Boundary Line (IMBL). The bay, bordering it are five Tamil Nadu districts of India and three Sri Lankan districts and assumes importance as it is one of the areas presenting permanent and serious challenges to both India and Sri Lanka with respect to the fishing rights in the Bay. Fishermen from both sides were enjoying fishing with hormones for centuries. Katchchadeevu is a tiny Island located in the Bay, which was a part of India. After the Katchchadeevu agreement 1974 it became a part of Sri Lanka and a fishing conflict arose between the two countries' fishermen. Fuelling the dispute over Katchatheevu is the overfishing of Indian mechanized trawlers in Palk Bay and the damaging environmental and economic effects of trawling. Since 2008, more than 300 Indian fishermen have been killed by firing by Sri Lankan Navy, nearly 100 fishermen have gone missing and more than 3000 fishermen were arrested and later released after the trials for trespassing into Sri Lankan waters. Currently, more than 120 fishing boats and 29 fishermen are in Sri Lankan custody. This paper attempts to find out the causes of fishing conflict and who has the fishing rights in the mentioned waters, how the international treaties are complied with at the time of arrest and trials, how the arrested fishermen are treated by them and how they suffer from fishermen families without a breadwinner. A Semi-structured interview schedule tool was prepared by the researcher, which is suitable for measuring quantitative and qualitative aspects of the above-mentioned theme. One hundred arrested fishermen were interviewed and recorded their prison experiences in Sri Lanka. The research found that the majority of the fishermen believe that they have the right to fish in the historical water and that the Sri Lankan Naval personnel have brutally attacked the Indian fishermen at the time of the arrest. The majority of the fishermen accepted that they had limited fishing grounds. As a result, they entered Sri Lankan waters for their livelihood. The majority of the fishermen expected that they would also get their belongings back at the time of release, primarily the boats. Most of the arrested fishermen's families face financial crises in the absence of their breadwinners and this situation has created conditions for child labor among the affected families and some fishers migrate to different places for different occupations. The majority of the fishers have trauma about their victimization and face uncertainty in the future of their occupation. We can discuss more the causes and nature of the fishing conflict and the financial and psychological victimization of Indian fishermen in relation to the conflict.

Keywords: palk bay, historical water, fishing conflict, arrested fishermen, victimization

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Authors: Joo-Heon Lee, Ho-Won Jang, Hyung-Won Cho, Tae-Woong Kim

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Drought is a recurrent climatic feature that occurs in virtually every climatic zone around the world. Korea experiences the drought almost every year at the regional scale mainly during in the winter and spring seasons. Moreover, extremely severe droughts at a national scale also occurred at a frequency of six to seven years. Various drought indices had developed as tools to quantitatively monitor different types of droughts and are utilized in the field of drought analysis. Since drought is closely related with climatological and topographic characteristics of the drought prone areas, the basins where droughts are frequently occurred need separate drought preparedness and contingency plans. In this study, an analysis using statistical methods was carried out for the historical droughts occurred in the five major river basins in Korea so that drought characteristics can be quantitatively investigated. It was also aimed to provide information with which differentiated and customized drought preparedness plans can be established based on the basin level analysis results. Conventional methods which quantifies drought execute an evaluation by applying a various drought indices. However, the evaluation results for same drought event are different according to different analysis technique. Especially, evaluation of drought event differs depend on how we view the severity or duration of drought in the evaluation process. Therefore, it was intended to draw a drought history for the most severely affected five major river basins of Korea by investigating a magnitude of drought that can simultaneously consider severity, duration, and the damaged areas by applying drought run theory with the use of SPI (Standardized Precipitation Index) that can efficiently quantifies meteorological drought. Further, quantitative analysis for the historical extreme drought at various viewpoints such as average severity, duration, and magnitude of drought was attempted. At the same time, it was intended to quantitatively analyze the historical drought events by estimating the return period by derived SDF (severity-duration-frequency) curve for the five major river basins through parametric regional drought frequency analysis. Analysis results showed that the extremely severe drought years were in the years of 1962, 1988, 1994, and 2014 in the Han River basin. While, the extreme droughts were occurred in 1982 and 1988 in the Nakdong river basin, 1994 in the Geumg basin, 1988 and 1994 in Youngsan river basin, 1988, 1994, 1995, and 2000 in the Seomjin river basin. While, the extremely severe drought years at national level in the Korean Peninsula were occurred in 1988 and 1994. The most damaged drought were in 1981~1982 and 1994~1995 which lasted for longer than two years. The return period of the most severe drought at each river basin was turned out to be at a frequency of 50~100 years.

Keywords: drought magnitude, regional frequency analysis, SPI, SDF(severity-duration-frequency) curve

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Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

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Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

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Authors: İlknur Gökşin, Sultan Ayaz Alkaya

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Objective: Progressive muscle relaxation (PMR) include the deliberate stretching and relaxation of the major muscle groups of the human body. This study was conducted to evaluate the effect of PMR applied in women on the postpartum depression and general comfort level. Methods: The study population of this quasi-experimental study with pre-test, post-test and control group consisted of primipara women who had vaginal delivery in the obstetric service of a university hospital. The experimental and control groups consisted of 35 women each. The data were collected by questionnaire, the Edinburgh Postnatal Depression Scale (EPDS) and the General Comfort Questionnaire (GCQ). The women were matched according to their age and education level and divided into the experimental and control groups by simple random selection. Postpartum depression risk and general comfort was evaluated at the 2nd and 5th days, 10th and 15th days, fourth week and eighth week after birth. The experimental group was visited at home and PMR was applied. After the first visit, women were asked to apply PMR regularly three times a week for eight weeks. During the application, the researcher called the participants twice a week to follow up the continuity of the application. No intervention was performed in the control group. For data analysis, descriptive statistics such as number, percentage, mean, standard deviation, significance test of difference between two means and ANOVA were used. Approval of the ethics committee and permission of the institution were obtained for the study. Results: There were no significant differences between the women in the experimental and control groups in terms of age, education status and employment status (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of EPDS pre-test, 1st, 2nd and 3rd follow-up mean scores (p>0.05). There was a statistically significant difference between EPDS pre-test and 3rd follow-up scores of the experimental group (p<0.05), whereas there was no such difference in the control group (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of mean GCQ pre-test scores (p>0.05), whereas in the 1st, 2nd and 3rd follow-ups there was a statistically significant difference between the mean GCQ scores (p<0.05). It was found that there was a significant increase in the GCQ physical, psychospiritual and sociocultural comfort sub-scales, relief and relaxation levels of the experimental group between the pre-test and 3rd follow-ups scores (p<0.05). And, a significant decrease was found between pre-test and 3rd follow-up GCQ psychospiritual, environmental and sociocultural comfort sub-scale, relief, relaxation and superiority levels (p<0.05). Conclusion: Progressive muscle relaxation was effective on reducing the postpartum depression risk and increasing general comfort. It is recommended to provide progressive muscle relaxation training to women in the postpartum period as well as ensuring the continuity of this practice.

Keywords: general comfort, postpartum depression, postpartum period, progressive muscle relaxation

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Authors: Janice Keener, Christine Houlihan

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Over the last several years, there has been an increase in children identified as having Autism Spectrum Disorder (ASD). Specialists across several disciplines: mental health and medical professionals have been tasked with ensuring accurate and timely evaluations for children with suspected ASD. Due to the nature of the ASD symptom presentation, an interdisciplinary assessment and treatment approach best addresses the needs of the whole child. During the unprecedented COVID-19 Pandemic, clinicians were faced with how to continue with interdisciplinary assessments in a telehealth arena. Instruments that were previously used to assess ASD in-person were no longer appropriate measures to use due to the safety restrictions. For example, The Autism Diagnostic Observation Schedule requires examiners and children to be in very close proximity of each other and if masks or face shields are worn, they render the evaluation invalid. Similar issues arose with the various cognitive measures that are used to assess children such as the Weschler Tests of Intelligence and the Differential Ability Scale. Thus the need arose to identify measures that are able to be safely and accurately administered using safety guidelines. The incidence of ASD continues to rise over time. Currently, the Center for Disease Control estimates that 1 in 59 children meet the criteria for a diagnosis of ASD. The reasons for this increase are likely multifold, including changes in diagnostic criteria, public awareness of the condition, and other environmental and genetic factors. The rise in the incidence of ASD has led to a greater need for diagnostic and treatment services across the United States. The uncertainty of the diagnostic process can lead to an increased level of stress for families of children with suspected ASD. Along with this increase, there is a need for diagnostic clarity to avoid both under and over-identification of this condition. Interdisciplinary assessment is ideal for children with suspected ASD, as it allows for an assessment of the whole child over the course of time and across multiple settings. Clinicians such as Psychologists and Developmental Pediatricians play important roles in the initial evaluation of autism spectrum disorder. An ASD assessment may consist of several types of measures such as standardized checklists, structured interviews, and direct assessments such as the ADOS-2 are just a few examples. With the advent of telehealth clinicians were asked to continue to provide meaningful interdisciplinary assessments via an electronic platform and, in a sense, going to the family home and evaluating the clinical symptom presentation remotely and confidently making an accurate diagnosis. This poster presentation will review the benefits, limitations, and interpretation of these various instruments. The role of other medical professionals will also be addressed, including medical providers, speech pathology, and occupational therapy.

Keywords: Autism Spectrum Disorder Assessments, Interdisciplinary Evaluations , Tele-Assessment with Autism Spectrum Disorder, Diagnosis of Autism Spectrum Disorder

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Authors: Najlaa Yousef Qusti, Steven J. Brookes, Paul A. Brunton

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Background: Tooth discoloration can be an aesthetic problem, and tooth whitening using carbamide peroxide bleaching agents are a popular treatment option. However, there are concerns about possible adverse effects such as demineralisation of the bleached enamel; however, the cause of this demineralisation is unclear. Introduction: Teeth can become stained or discoloured over time. Tooth whitening is an aesthetic solution for tooth discoloration. Bleaching solutions of 10% carbamide peroxide (CP) have become the standard agent used in dentist-prescribed and home-applied ’vital bleaching techniques’. These materials release hydrogen peroxide (H₂O₂), the active whitening agent. However, there is controversy in the literature regarding the effect of bleaching agents on enamel integrity and enamel mineral content. The purpose of this study was to establish if carbamide peroxide bleaching agents affect the acid solubility of enamel (i.e., make teeth more prone to demineralisation). Materials and Methods: Twelve human premolar teeth were sectioned longitudinally along the midline and varnished to leave the natural enamel surface exposed. The baseline behavior of each tooth half in relation to its demineralisation in acid was established by sequential exposure to 4 vials containing 1ml of 10mM acetic acid (1 minute/vial). This was followed by exposure to 10% CP for 8 hours. After washing in distilled water, the tooth half was sequentially exposed to 4 further vials containing acid to test if the acid susceptibility of the enamel had been affected. The corresponding tooth half acted as a control and was exposed to distilled water instead of CP. The mineral loss was determined by measuring [Ca²⁺] and [PO₄³⁻] released in each vial using a calcium ion-selective electrode and the phosphomolybdenum blue method, respectively. The effect of bleaching on the tooth surfaces was also examined using SEM. Results: Exposure to carbamide peroxide did not significantly alter the susceptibility of enamel to acid attack, and SEM of the enamel surface revealed a slight alteration in surface appearance. SEM images of the control enamel surface showed a flat enamel surface with some shallow pits, whereas the bleached enamel appeared with an increase in surface porosity and some areas of mild erosion. Conclusions: Exposure to H₂O₂ equivalent to 10% CP does not significantly increase subsequent acid susceptibility of enamel as determined by Ca²⁺ release from the enamel surface. The effects of bleaching on mineral loss were indistinguishable from distilled water in the experimental system used. However, some surface differences were observed by SEM. The phosphomolybdenum blue method for phosphate is compromised by peroxide bleaching agents due to their oxidising properties. However, the Ca²⁺ electrode is unaffected by oxidising agents and can be used to determine the mineral loss in the presence of peroxides.

Keywords: bleaching, carbamide peroxide, demineralisation, teeth whitening

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Authors: A. T. Muruviwa

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Empirical studies of the current CSR agenda have been dominated by literature from the North at the expense of the nations from the South where most TNCs are located. Therefore, owing to the limitations of the current discourse that is dominated by Western ideas such as voluntarism, philanthropy, business case and economic gains, scholars have been calling for a new CSR agenda that is South-centred and addresses the needs of developing nations. The development theme has dominated in the recent literature as scholars concerned with the relationship between business and society have tried to understand its relationship with CSR. Despite a plethora of literature on the roles of corporations in local communities and the impact of CSR initiatives, there is lack of adequate empirical evidence to help us understand the nexus between CSR and development. For all the claims made about the positive and negative consequences of CSR, there is surprisingly little information about the outcomes it delivers. This study is a response to these claims made about the developmental aspect of CSR in developing countries. It offers some empirical bases for assessing the major CSR projects that have been fulfilled by a major mining company, Zimplats in Mhondoro-Ngezi Zimbabwe. The neo-liberal idea of capitalism and market dominations has empowered TNCs to stamp their authority in the developing countries. TNCs have made their mark in developing nations as they stamp their global private authority, rivalling or implicitly challenging the state in many functions. This dominance of corporate power raises great concerns over their tendencies of abuses in terms of environmental, social and human rights concerns as well as how to make them increasingly accountable. The hegemonic power of TNCs in the developing countries has had a tremendous impact on the overall CSR practices. While TNCs are key drivers of globalization they may be acting responsibly in their Global Northern home countries where there is a combination of legal mechanisms and the fear of civil society activism associated with corporate scandals. Using a triangulated approach in which both qualitative and quantitative methods were used the study found out that most CSR projects in Zimbabwe are dominated and directed by Zimplats because of the power it possesses. Most of the major CSR projects are beneficial to the mining company as they serve the business plans of the mining company. What was deduced from the study is that the infrastructural development initiatives by Zimplats confirm that CSR is a tool to advance business obligations. This shows that although proponents of CSR might claim that business has a mandate for social obligations to society, we need not to forget the dominant idea that the primary function of CSR is to enhance the firm’s profitability.

Keywords: hegemonic power, projects, reciprocity, stakeholders

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Authors: I. Nanako, Mariko Era, Hiroshi Morita

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Objectives: Japanese uses TATAMI rather than flooring at home. Igusa ( Juncus effuses var. decipiens ), which is commonly known in the forms of TATAMI. Juncus spp. grow at a relatively high humidity area (Japan, China and Southeast Asia ). Yatsushiro region in the southern part of Kumamoto prefecture is major produing area of Igusa. Igusa found to have honeycomb structure and was also shown to have the ability to control humidity. And Igusa has been used as a medicinal herb for diuretic and antiphlogistic agent. In previous study, we investigated antimicrobial effects of Igusa, and showed high antimicrobial activity against food poisoning bacteria. Therefore, the food trays blended Igusa can be kept clean by antimicrobial activity of Igusa. We focus on ‘Igusa foam materials’. In this study, we investigated the antibacterial and antifungal activity of Igusa, and new application to foam materials for food industry. Materials and method: We used Igusa foam materials (3 × 3 × 3 cm) as a sample. We set about fifteen types of samples combined with a commercial antibacterial agent A, a commercial antibacterial agent B, potassium laurate (C12K) and a commercial antifungal agent C, a commercial antifungal agent D and a commercial antifungal agent E. We selected four bacteria strains (Escherichia coli NBRC 3972, Staphylococus aureus NBRC 12732, Salmonella typhimurium NBRC 13245, Bacillus subtilis NBRC 3335 ) and three fungus strains (Penicillium pinophilum NBRC 6345, Cladosporium cladosporioides NBRC 30314, Aspergillus oryzae NBRC 5238 ). The fungus was cultured at 30 °C on Igusa foam materials after inoculation of the fungus for fourteen days. The bacteria was cultured at 30 °C on Igusa foam materials after inoculation of the bacteria for three days. And the Igusa foam materials were washed with 10 mL normal saline after three days. The normal saline washed Igusa foam materials plated the NA medium. After, It was cultured at 30 °C and used colony counting method. Result and Conclusion: The fifteen types of sample of Igusa foam materials had antifungal activity against C. cladosporioides, A. oryzae and P. pinophilum for fourteen days. The four types of sample contained potassium laurate and antibacterial agent A, sample contained antibacterial agent B and antifungal agent D, sample contained A and antifungal agent E, sample contained B and E had antibacterial activity against B. subtilis. The three types of sample contained potassium laurate and A, sample contained B and D, sample contained A and E had antibacterial activity against S. typhimurium. The five types of sample contained potassium laurate and A, sample contained B and D, sample contained A and E, sample contained B and E, sample contained B and antifungal agent C had antibacterial activity against E. coli and S. aureus. These results indicate that Igusa of Igusa foam materials had high antifungal activity. In addition, Igusa foam materials combined with a commercial antibacterial agent had antibacterial activity. In the future, we consider that use of Igusa foam materials may be spread from food industry.

Keywords: antibacterial, antifungal, foam materials, Igusa

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Authors: Md Iqbal Hossain, Tahmeed Ahmed, Kenneth H. Brown

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Objective: To assess the effect of community-based follow up, with or without food-supplementation and/or psychosocial stimulation, as an alternative to current hospital-based follow-up of children with moderate-acute-malnutrition (WHZ < -2 to -3) (MAM). Design/methods: The study was conducted at the ICDDR,B Dhaka Hospital and in four urban primary health care centers of Dhaka, Bangladesh during 2005-2007. The efficacy of five different randomly assigned interventions was compared with respect to the rate of completion of follow-up, growth and morbidity in 227 MAM children aged 6-24 months who were initially treated at ICDDR,B for diarrhea and/or other morbidities. The interventions were: 1) Fortnightly follow-up care (FFC) at the ICDDR,B’s outpatient-unit, including growth monitoring, health education, and micro-nutrient supplementation (H-C, n=49). 2) FFC at community follow-up unit (CNFU) [established in the existing urban primary health-care centers close to the residence of the child] but received the same regimen as H-C (C-C, n=53). 3) As per C-C plus cereal-based supplementary food (SF) (C-SF, n=49). The SF packets were distributed on recruitment and at every visit in CNFU [@1 packet/day for 6–11 and 2 packets/day for 12-24 month old children. Each packet contained 20g toasted rice-powder, 10g toasted lentil-powder, 5g molasses, and 3g soy bean oil, to provide a total of ~ 150kcal with 11% energy from protein]. 4) As per C-C plus psychosocial stimulation (PS) (C-PS, n=43). PS consisted of child-stimulation and parental-counseling conducted by trained health workers. 5) As per C-C plus both SF+PS (C-SF+PS, n=33). Results: A total of 227children (48.5% female), with a mean ± SD age of 12.6 ±3.8 months, and WHZ of - 2.53±0.28 enrolled. Baseline characteristics did not differ by treatment group. The rate of spontaneous attendance at scheduled follow-up visits gradually decreased in all groups. Follow-up attendance and gain in weight and length were greater in groups C-SF, C-SF+PS, and C-PS than C-C, and these indicators were observed least in H-C. Children in the H-C group more often suffered from diarrhea (25 % vs. 4-9%) and fever (28% vs. 8-11%) than other groups (p < 0.05). Children who attended at least five of the total six scheduled follow-up visits gained more in weight (median: 0.86 vs. 0.62 kg, p=0.002), length (median: 2.4 vs. 2.0 cm, p=0.009) than those who attended fewer. Conclusions: Community-based service delivery, especially including supplementary food with or without psychosocial stimulation, permits better rehabilitation of children with MAM compared to current hospital outpatients-based care. By scaling the community-based follow-up including food supplementation with or without psychosocial stimulation, it will be possible to rehabilitate a greater number of MAM children in a better way.

Keywords: community-based management, moderate acute malnutrition, psychosocial stimulation, supplementary food

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Authors: Sharmistha Chanda, Anindita Choudhuri

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This exploratory study highlights the psychological aspects of women's empowerment to find the importance of the psychological dimension of empowerment, such as; meaning, competence, self-determination, impact, and assumption, especially in the weaker marginalized section of women. A large proportion of rural, suburban, and urban poor survive by working in unorganized sectors of metropolitan cities. Relative Poverty and lack of employment in rural areas and small towns drive many people to the metropolitan city for work and livelihood. Women working in that field remain unrecognized as people of low socio-economic status. They are usually willing to do domestic work as daily wage workers, single wage earners, street vendors, family businesses like agricultural activities, domestic workers, and self-employed. Usually, these women accept such jobs because they do not have such an opportunity as they lack the basic level of education that is required for better-paid jobs. The unorganized sector, on the other hand, has no such clear-cut employer-employee relationships and lacks most forms of social protection. Having no fixed employer, these workers are casual, contractual, migrant, home-based, own-account workers who attempt to earn a living from whatever meager assets and skills they possess. Women have become more empowered both financially and individually through small-scale business ownership or entrepreneurship development and in household-based work. In-depth interviews have been done with 10 participants in order to understand their living styles, habits, self-identity, and empowerment in their society in order to evaluate the key challenges that they may face following by qualitative research approach. Transcription has been done from the collected data. The three-layer coding technique guides the data analysis process, encompassing – open coding, axial coding, and selective coding. Women’s Entrepreneurship is one of the foremost concerns as the Government, and non-government institutions are readily serving this domain with the primary objectives of promoting self-employment opportunities in general and empowering women in specific. Thus, despite hardship and unrecognition unorganized sector provides a huge array of opportunities for rural and sub-urban poor to earn. Also, the upper section of society tends to depend on this working force. This study gave an idea about the well-being, and meaning in life, life satisfaction on the basis of their lived experience.

Keywords: marginalized women, psychological empowerment, relative poverty, unorganized sector

Procedia PDF Downloads 49

Authors: Brogan Guest, Amy Donaldson-Perrott

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The Master’s of Physician Associate Studies (MPAS) programme at St George’s, University of London (SGUL), is an intensive two-year course that trains students to become physician associates (PAs). PAs are generalized healthcare providers who work in primary and secondary care across the UK. PA programmes face the difficult task of preparing students to become safe medical providers in two short years. Our goal is to teach students to develop clinical reasoning early on in their studies and historically, this has been done predominantly though problem-based learning (PBL). We have had an increase concern about student engagement in PBL and difficulty recruiting facilitators to maintain the low student to facilitator ratio required in PBL. To address this issue, we created ‘Clinical Application of Anatomy and Physiology (CAAP)’. These peer-led, interactive, problem-based, small group sessions were designed to facilitate students’ clinical reasoning skills. The sessions were designed using the concept of Team-Based Learning (TBL). Students were divided into small groups and each completed a pre-session quiz consisting of difficult questions devised to assess students’ application of medical knowledge. The quiz was completed in small groups and they were not permitted access of external resources. After the quiz, students worked through a series of openended, clinical tasks using all available resources. They worked at their own pace and the session was peer-led, rather than facilitator-driven. For a group of 35 students, there were two facilitators who observed the sessions. The sessions utilised an infinite space whiteboard software. Each group member was encouraged to actively participate and work together to complete the 15-20 tasks. The session ran for 2 hours and concluded with a post-session quiz, identical to the pre-session quiz. We obtained subjective feedback from students on their experience with CAAP and evaluated the objective benefit of the sessions through the quiz results. Qualitative feedback from students was generally positive with students feeling the sessions increased engagement, clinical understanding, and confidence. They found the small group aspect beneficial and the technology easy to use and intuitive. They also liked the benefit of building a resource for their future revision, something unique to CAAP compared to PBL, which out students participate in weekly. Preliminary quiz results showed improvement from pre- and post- session; however, further statistical analysis will occur once all sessions are complete (final session to run December 2022) to determine significance. As a post-graduate healthcare professional programme, we have a strong focus on self-directed learning. Whilst PBL has been a mainstay in our curriculum since its inception, there are limitations and concerns about its future in view of student engagement and facilitator availability. Whilst CAAP is not TBL, it draws on the benefits of peer-led, small group work with pre- and post- team-based quizzes. The pilot of these sessions has shown that students are engaged by CAAP, and they can make significant progress in clinical reasoning in a short amount of time. This can be achieved with a high student to facilitator ratio.

Keywords: problem based learning, team based learning, active learning, peer-to-peer teaching, engagement

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Authors: Aude Gounelle, Gloria Senfaute, Ludivine Saint-Mard, Thomas Chartier

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The long-term deformation rates of faults are not fully captured by Probabilistic Seismic Hazard Assessment (PSHA). PSHA that use catalogues to develop area or smoothed-seismicity sources is limited by the data available to constraint future earthquakes activity rates. The integration of faults in PSHA can at least partially address the long-term deformation. However, careful treatment of fault sources is required, particularly, in low strain rate regions, where estimated seismic hazard levels are highly sensitive to assumptions concerning fault geometry, segmentation and slip rate. When integrating faults in PSHA various constraints on earthquake rates from geologic and seismologic data have to be satisfied. For low strain rate regions where such data is scarce it would be especially challenging. Faults in PSHA requires conversion of the geologic and seismologic data into fault geometries, slip rates and then into earthquake activity rates. Several approaches exist for translating slip rates into earthquake activity rates. In the most frequently used approach, the background earthquakes are handled using a truncated approach, in which earthquakes with a magnitude lower or equal to a threshold magnitude (Mw) occur in the background zone, with a rate defined by the rate in the earthquake catalogue. Although magnitudes higher than the threshold are located on the fault with a rate defined using the average slip rate of the fault. As high-lighted by several research, seismic events with magnitudes stronger than the selected magnitude threshold may potentially occur in the background and not only at the fault, especially in regions of slow tectonic deformation. It also has been known that several sections of a fault or several faults could rupture during a single fault-to-fault rupture. It is then essential to apply a consistent modelling procedure to allow for a large set of possible fault-to-fault ruptures to occur aleatory in the hazard model while reflecting the individual slip rate of each section of the fault. In 2019, a tool named SHERIFS (Seismic Hazard and Earthquake Rates in Fault Systems) was published. The tool is using a methodology to calculate the earthquake rates in a fault system where the slip-rate budget of each fault is conversed into rupture rates for all possible single faults and faultto-fault ruptures. The objective of this paper is to compare the SHERIFS method with one other frequently used model to analyse the impact on the seismic hazard and through sensibility studies better understand the influence of key parameters and assumptions. For this application, a simplified but realistic case study was selected, which is in an area of moderate to hight seismicity (South Est of France) and where the fault is supposed to have a low strain.

Keywords: deformation rates, faults, probabilistic seismic hazard, PSHA

Procedia PDF Downloads 38

Authors: Madelyn N. Moawad, Hermine R. Z. Tadros, Mary G. Ghobrial, Ahmad R. Bassiouny, Kamal M. Kandeel, Athar Ata

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Seaweeds are potential renewable resources in marine environment. They provide an excellent source of bioactive substances such as dietary fibers and various functional polysaccharides that could potentially be used as ingredients for both human and animal health applications. The observations suggested that these bioactive compounds have strong antioxidant properties, which have beneficial effects on human health. The present research aimed at finding new chemical products from local marine macroalgae for natural medicinal uses and consumption for their nutritional values. Macroalgae samples were collected manually mainly from the Mediterranean Sea at shallow subtidal zone of Abu Qir Bay, Alexandria, Egypt. The chemical compositions of lyophilized materials of six selected macroalgal species; Colpomenia sinuosa, Sargassum linifolium, Padina pavonia, Pterocladiella capillacea, Laurencia pinnatifidia, and Caulerpa racemosa, were investigated for proteins using bovine serum albumin, and carbohydrates were assayed by phenol-sulfuric acid reaction. The macroalgae lipid was extracted with chloroform, methanol and phosphate buffer. Vitamins were extracted using trichloroacetic acid. Chlorophylls and total carotenoids were determined spectrophotometrically and total phenols were extracted with methanol. In addition, lipid-soluble, and water-soluble antioxidant, and anti α-glucosidase activities were measured spectrophotometrically. The antioxidant activity of hexane extracts was investigated using phosphomolybdenum reagent. The anti-α-glucosidase effect measurement was initiated by mixing α-glucosidase solution with p-nitrophenyl α-D-glucopyranoside. The results showed that the ash contents varied from 11.2 to 35.4 % on dry weight basis for P. capillacea and Laurencia pinnatifidia, respectively. The protein contents ranged from 5.63 % in brown macroalgae C. sinuosa to 8.73 % in P. pavonia. A relative wide range in carbohydrate contents was observed (20.06–46.75 %) for the test algal species. The highest lipid percentage was found in green alga C. racemosa (5.91%) followed by brown algae P. pavonia (3.57%) and C. sinuosa (2.64%). The phenolic contents varied from 1.32 mg GAE/g for C. sinuosa to 4.00 mg GAE/g in P. pavonia. The lipid-soluble compounds exhibited higher antioxidant capacity (73.18-145.95 µM/g) than that of the water-soluble ones ranging from 24.83 µM/g in C. racemosa to 74.07 µM/g in S. linifolium. The most potent anti-α-glucosidase activity was observed for P. pavonia with IC50 of 17.12 μg/ml followed by S. linifolium (IC50 = 71.75 μg/ml), C. racemosa (IC50 = 84.73 μg/ml), P. capillacea (IC50 = 92.16 μg/ml), C. sinuosa (IC50 = 112.44 μg/ml), and L. pinnatifida (IC50 = 115.11 μg/ml).

Keywords: α-glucosidase, lyophilized, macroalgae, spectrophotometrically

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Authors: Narjis Kahtoon

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The issue of the wage discrimination on the basis of gender and social problem has been a significant research problem for several decades. Whereas lots of have explored reasons for the persistence of an inequality in the wages of male and female, none has successfully explained away the entire differentiation. The wage discrimination on the basis of gender and social problem of working women is a global issue. Although inequality in political and economic and social make-up of countries all over the world, the gender wage discrimination, and social constraint is present. The aim of the research is to examine the gender wage discrimination and social constraint from an international perspective and to determine whether any pattern exists among cultural dimensions of a country and the man and women remuneration gap in Readymade Garment Sector of Pakistan. Population growth rate is significant indicator used to explain the change in population and play a crucial point in the economic development of a country. In Pakistan, readymade garment sector consists of small, medium and large sized firms. With an estimated 30 percent of the workforce in textile- Garment is females’. Readymade garment industry is a labor intensive industry and relies on the skills of individual workers and provides highest value addition in the textile sector. In the Garment sector, female workers are concentrated in poorly paid, labor-intensive down-stream production (readymade garments, linen, towels, etc.), while male workers dominate capital- intensive (ginning, spinning and weaving) processes. Gender wage discrimination and social constraint are reality in Pakistan Labor Market. This research allows us not only to properly detect the size of gender wage discrimination and social constraint but to also fully understand its consequences in readymade garment sector of Pakistan. Furthermore, research will evaluated this measure for the three main clusters like Lahore, Karachi, and Faisalabad. These data contain complete details of male and female workers and supervisors in the readymade garment sector of Pakistan. These sources of information provide a unique opportunity to reanalyze the previous finding in the literature. The regression analysis focused on the standard 'Mincerian' earning equation and estimates it separately by gender, the research will also imply the cultural dimensions developed by Hofstede (2001) to profile a country’s cultural status and compare those cultural dimensions to the wage inequalities. Readymade garment of Pakistan is one of the important sectors since its products have huge demand at home and abroad. These researches will a major influence on the measures undertaken to design a public policy regarding wage discrimination and social constraint in readymade garment sector of Pakistan.

Keywords: gender wage differentials, decomposition, garment, cultural

Procedia PDF Downloads 190

Authors: Neha Pranav Kolhe, Harithapriya Vijaye, Arushi Kamle

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The economic growth engines are urban regions. As the economy expands, so does the need for peace and quiet, and noise pollution is one of the important social and environmental issue. Health and wellbeing are at risk from environmental noise pollution. Because of urbanisation, population growth, and the consequent rise in the usage of increasingly potent, diverse, and highly mobile sources of noise, it is now more severe and pervasive than ever before, and it will only become worse. Additionally, it will expand as long as there is an increase in air, train, and highway traffic, which continue to be the main contributors of noise pollution. The current study will be conducted in two zones of class I city of central India (population range: 1 million–4 million). Total 56 measuring points were chosen to assess noise pollution. The first objective evaluates the noise pollution in various urban habitats determined as formal and informal settlement. It identifies the comparison of noise pollution within the settlements using T- Test analysis. The second objective assess the noise pollution in silent zones (as stated in Central Pollution Control Board) in a hierarchical way. It also assesses the noise pollution in the settlements and compares with prescribed permissible limits using class I sound level equipment. As appropriate indices, equivalent noise level on the (A) frequency weighting network, minimum sound pressure level and maximum sound pressure level were computed. The survey is conducted for a period of 1 week. Arc GIS is used to plot and map the temporal and spatial variability in urban settings. It is discovered that noise levels at most stations, particularly at heavily trafficked crossroads and subway stations, were significantly different and higher than acceptable limits and squares. The study highlights the vulnerable areas that should be considered while city planning. The study demands area level planning while preparing a development plan. It also demands attention to noise pollution from the perspective of residential and silent zones. The city planning in urban areas neglects the noise pollution assessment at city level. This contributes to that, irrespective of noise pollution guidelines, the ground reality is far away from its applicability. The result produces incompatible land use on a neighbourhood scale with respect to noise pollution. The study's final results will be useful to policymakers, architects and administrators in developing countries. This will be useful for noise pollution in urban habitat governance by efficient decision making and policy formulation to increase the profitability of these systems.

Keywords: noise pollution, formal settlements, informal settlements, built environment, silent zone, residential area

Procedia PDF Downloads 100

Authors: Eric Awich Ochen

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The end of the conflict in Northern Uganda in 2006 brought about an opportunity for the youth to return to their original home and contribute to the peace building and development process of their communities. Post-conflict is used here to refer to the post-armed conflict situation and activities of rebels of Joseph Kony in northern Uganda. While the rebels remain very much active in the Sudan and Central African Republic, in Uganda the last confrontations occurred around 2006 or earlier, and communities have returned to their homes and began the process of rebuilding their lives. It is argued that socio-economic reconstruction is at the heart of peacebuilding and sustenance of positive peace in the aftermath of conflict, as it has a bearing on post-conflict stability and good governance. We recognize that several post-conflict interventions within Northern Uganda have targeted women and children with a strong emphasis on family socio-economic empowerment and capacity building, including access to micro finance. The aim of this study was to examine the participation of the youth in post-conflict peace building and development in Northern Uganda by assessing the breadth and width of their engagement and the stages of programming cycle that they are involved in, interrogating the space for participation and how they are facilitating or constraining participation. It was further aimed at examining the various dimensions of participation at play in Northern Uganda and where this fits within the conceptual debates on peace building and development in the region. Supporting young people emerging out of protracted conflict to re-establish meaningful socio-economic engagements and livelihoods is fundamental to their participation in the affairs of the community. The study suggests that in the post-conflict development context of Northern Uganda, participation has rarely been disaggregated or differentiated by sectors or groups. Where some disaggregation occurs, then the main emphasis has always been on either women or children. It appears therefore that little meaningful space has thus been created for young people to engage and participate in peace building initiatives within the region. In other cases where some space is created for youth participation, this has been in pre-conceived programs or interventions conceived by the development organizations with the youth or young people only invited to participate at particular stages of the project implementation cycle. Still within the implementation of the intervention, the extent to which young people participate is bounded, with little power to influence the course of the interventions or make major decisions. It is thus visible that even here young people mainly validate and legitimize what are predetermined processes only act as pawns in the major chess games played by development actors (dominant peace building partners). This paper, therefore, concludes that the engagement of the youth in post-conflict peace building has been quite problematic and tokenistic and has not given the adequate youth space within which they could ably participate and express themselves in the ensuing interventions.

Keywords: youth, conflict, peace building, participation

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Authors: Sarah Hazelwood, Janice Hay

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Methoxyflurane is an inhaled analgesic administered via a disposable inhaler, which has been used in Australia for 40 years for the management of pain in children & adults. However, there is a lack of data for methoxyflurane as a frontline analgesic medication within the emergency department (ED). This study will investigate the usefulness of methoxyflurane in a private inner-city ED. The study concluded that the inclusion of all key stakeholders in the prescribing, administering & use of this new process led to comprehensive uptake & vastly positive outcomes for consumer & health professionals. Method: A 12-week prospective pilot study was completed utilizing patients presenting to the ED in pain (numeric pain rating score > 4) that fit the requirement of methoxyflurane use (as outlined in the Australian Prescriber information package). Nurses completed a formatted spreadsheet for each interaction where methoxyflurane was used. Patient demographics, day, time, initial numeric pain score, analgesic response time, the reason for use, staff concern (free text), & patient feedback (free text), & discharge time was documented. When clinical concern was raised, the researcher retrieved & reviewed patient notes. Results: 140 methoxyflurane inhalers were used. 60% of patients were 31 years of age & over (n=82) with 16% aged 70+. The gender split; 51% male: 49% female. Trauma-related pain (57%) saw the highest use of administration, with the evening hours (1500-2259) seeing the greatest numbers used (39%). Tuesday, Thursday & Sunday shared the highest daily use throughout the study. A minimum numerical pain score of 4/10 (n=13, 9%), with the ranges of 5 - 7/10 (moderate pain) being given by almost 50% of patients. Only 3 instances of pain scores increased post use of methoxyflurane (all other entries showed pain score < initial rating). Patients & staff noted obvious analgesic response within 3 minutes (n= 96, 81%, of administration). Nurses documented a change in patient vital signs for 4 of the 15 patient-related concerns; the remaining concerns were due to “gagging” on the taste, or “having a coughing episode”; one patient tried to leave the department before the procedure was attended (very euphoric state). Upon review of the staff concerns – no adverse events occurred & return to therapeutic vitals occurred within 10 minutes. Length of stay for patients was compared with similar presentations (such as dislocated shoulder or ankle fracture) & saw an average 40-minute decrease in time to discharge. Methoxyflurane treatment was rated “positively” by > 80% of patients – with remaining feedback related to mild & transient concerns. Staff similarly noted a positive response to methoxyflurane as an analgesic & as an added tool for frontline analgesic purposes. Conclusion: Methoxyflurane should be used on suitable patient presentations requiring immediate, short term pain relief. As a highly portable, non-narcotic avenue to treat pain this study showed obvious therapeutic benefit, positive feedback, & a shorter length of stay in the ED. By partnering with key stake holders, this study determined methoxyflurane use decreased work load, decreased wait time to analgesia, and increased patient satisfaction.

Keywords: analgesia, benefits, emergency, methoxyflurane

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Authors: Ciaran Friel, Jerry Suls, Mark Butler, Patrick Robles, Samantha Gordon, Frank Vicari, Karina W. Davidson

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Physical activity guidelines focus on increasing moderate-intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence supports that any increase in physical activity is positively correlated with health benefits. Behavior change techniques (BCTs) have demonstrated effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a Personalized Trials (N-of-1) design to evaluate the efficacy of using four BCTs to promote an increase in low-intensity physical activity (2,000 steps of walking per day) in adults aged 45-75 years old. The 4 BCTs tested were goal setting, action planning, feedback, and self-monitoring. BCTs were tested in random order and delivered by text message prompts requiring participant engagement. The study recruited health system employees in the target age range, without mobility restrictions and demonstrating interest in increasing their daily activity by a minimum of 2,000 steps per day for a minimum of five days per week. Participants were sent a Fitbit® fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7 but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by Fitbit for two weeks. In the 8-week intervention phase of the study, participants received each of the four BCTs, in random order, for a two-week period. Text message prompts were delivered daily each morning at a consistent time. All prompts required participant engagement to acknowledge receipt of the BCT message. Engagement is dependent upon the BCT message and may have included recording that a detailed plan for walking has been made or confirmed a daily step goal (action planning, goal setting). Additionally, participants may have been directed to a study dashboard to view their step counts or compare themselves to their baseline average step count (self-monitoring, feedback). At the end of each two-week testing interval, participants were asked to complete the Self-Efficacy for Walking Scale (SEW_Dur), a validated measure that assesses the participant’s confidence in walking incremental distances, and a survey measuring their satisfaction with the individual BCT that they tested. At the end of their trial, participants received a personalized summary of their step data in response to each individual BCT. The analysis will examine the novel individual-level heterogeneity of treatment effect made possible by N-of-1 design and pool results across participants to efficiently estimate the overall efficacy of the selected behavioral change techniques in increasing low-intensity walking by 2,000 steps, five days per week. Self-efficacy will be explored as the likely mechanism of action prompting behavior change. This study will inform the providers and demonstrate the feasibility of an N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

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Authors: Panagiotis Gkekas, Christos Sougles, Dionysios Kehagias, Dimitrios Tzovaras

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This paper presents the architecture of the “Intelligent cooperative integrated system for road safety and road infrastructure maintenance towards 2020” (ODOS2020) advanced infrastructure, which implements a number of cooperative ITS applications based on Internet of Things and Infrastructure-to-Vehicle (V2I) technologies with the purpose to enhance the active road safety level of vehicles through the provision of a fully automated V2I environment. The primary objective of the ODOS2020 project is to contribute to increased road safety but also to the optimization of time for maintenance of road infrastructure. The integrated technological solution presented in this paper addresses all types of vehicles and requires minimum vehicle equipment. Thus, the ODOS2020 comprises a low-cost solution, which is one of its main benefits. The system architecture includes an integrated notification system to transmit personalized information on road, traffic, and environmental conditions, in order for the drivers to receive real-time and reliable alerts concerning upcoming critical situations. The latter include potential dangers on the road, such as obstacles or road works ahead, extreme environmental conditions, etc., but also informative messages, such as information on upcoming tolls and their charging policies. At the core of the system architecture lies an integrated sensorial network embedded in special road infrastructures (strips) that constantly collect and transmit wirelessly information about passing vehicles’ identification, type, speed, moving direction and other traffic information in combination with environmental conditions and road wear monitoring and predictive maintenance data. Data collected from sensors is transmitted by roadside infrastructure, which supports a variety of communication technologies such as ITS-G5 (IEEE-802.11p) wireless network and Internet connectivity through cellular networks (3G, LTE). All information could be forwarded to both vehicles and Traffic Management Centers (TMC) operators, either directly through the ITS-G5 network, or to smart devices with Internet connectivity, through cloud-based services. Therefore, through its functionality, the system could send personalized notifications/information/warnings and recommendations for upcoming events to both road users and TMC operators. In the course of the ODOS2020 project pilot operation has been conducted to allow drivers of both C-ITS equipped and non-equipped vehicles to experience the provided added value services. For non-equipped vehicles, the provided information is transmitted to a smartphone application. Finally, the ODOS2020 system and infrastructure is appropriate for installation on both urban, rural, and highway environments. The paper presents the various parts of the system architecture and concludes by outlining the various challenges that had to be overcome during its design, development, and deployment in a real operational environment. Acknowledgments: Work presented in this paper was co-financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation (call RESEARCH–CREATE–INNOVATE) under contract no. Τ1EDK-03081 (project ODOS2020).

Keywords: infrastructure to vehicle, intelligent transportation systems, internet of things, road safety

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Authors: Chamaraja Parulli

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Family is an important social institution devoted to the growth of a child, and parents are the important agents of socialization. Mentally challenged children are those who are affected by intellectual disability, which is manifested by limitation in intellectual functioning and adoptive behavior. Intellectual disability affects about 3-4 percentage of the general population. Intellectual disability is caused by genetic condition, problems during pregnancy, problems during childbirth, or illness. Mental retardation is the world’s most complex and challenging issue. The stigmatization of disability results in social and economic marginalization. Parents of the mentally challenged children will have a very high level of parenting stress, which is significantly more than the stress perceived by the parents of the children without disability. The prevalence of severe mental disorder called Schizophrenia is among 1.1 percent of the total population in India. On the other hand, 11 to 12 percent is the overall lifetime occurrence rate of mental disorders. While the government has a separate program for mental health, the segment is marred by lack of adequate doctors and infrastructure. Mentally retarded children have certain limitations in mental functioning and skills, which makes them slow learners in speaking, walking, and taking care of their personal needs such as dressing and eating. Accepting a child with mental handicap becomes difficult for parents and to the whole family, as they have to face many problems, including those of management, finance, deprivation of rest, and leisure. Also, the problems faced by the parents can be seen in different areas like – educational, psychological, social, emotional, financial and family related issues. The study brought out various difficulties and problems faced by the parents as well as family members. The findings revealed that the mental retardation is not only a medico-psychological problem but also a socio-cultural problem. The study results, however, indicate that the quality of life of the family having children with mental retardation can be improved to a greater extent by building up a child-friendly ambience at home. The main aim of the present study is to assess the problems faced by the parents of mentally challenged children, with the help of personal interview data collected from the parents of mentally challenged children, residing in Shimoga District of Karnataka State, India. These individuals were selected using stratified random sampling method. Organizing effective intervention programs for parents, family, society, and educational institutions towards reduction of family stress, augmenting the family’s strengths, increasing child’s competence and enhancing the positive attitudes and values of the society will go a long way for the peaceful existence of the mentally challenged children.

Keywords: mentally challenged children, intellectual disability, special children, social infrastructure, differently abled, psychological stress, marginalization

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