Search results for: scattering cross sections

Authors: Linta Koka

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Aim: The way people with severe mental disorders deal with self-stigma and how it affects their self-esteem is a problem that has gained much attention in recent years. The primary aim of this study was to empirically explore the link between self-stigma and self-esteem of individuals with the presence of a mental illness, offering a novel perspective by exploring the same variables amongst a sample without a mental illness. Methods: This study utilized a cross-sectional study. Participants with (N=85) and without (N=75) a mental health issue were included from Darlingdon's Mind organization. Participants completed two scales, one of Self-Stigma of Mental Illness Scale and one of Self-Esteem, following some demographics questions. Results: According to the primary hypothesis, self-stigma significantly correlates with self-esteem in the clinical population. Furthermore, gender and ethnicity, above all the demographics, positively correlates to the relationship of self-stigma with self-esteem in people who endure a mental health issue. Limitations: A significant limitation is that of the size of the sample of participants conducted in this study. The clinical population was limited to 85 participants, and the control group consisted of 76 participants. Since the sample was not representative. The small size used did not allow any comparisons between the group with mental illness and the control group. There was a restricted time to approach the participants since the online survey was released by the end of May. Conclusions: Individuals suffering from mental illnesses may internalize stigmatizing stereotypes on an explicit level. Efforts should be made to lessen the harmful impact stigma may have on mentally ill people, such as worsening symptoms or delays in receiving care. Further study is needed within this small research topic to improve awareness and regulate mental health among the general population. Undoubtedly, people with mental disorders are stigmatized; therefore, more research is required to explore all factors contributing to mentally ill patients' devaluation.

Keywords: self-stigma, mental illness, self-esteem, clinical population, non-clinical population

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Authors: Arjun G. Koppad

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The study was conducted in Joida taluk of Uttara Kannada district, Karnataka, India, to assess the land use land cover (LULC) and forest aboveground biomass using L band SAR data. The study area covered has dense, moderately dense, and sparse forests. The sampled area was 0.01 percent of the forest area with 30 sampling plots which were selected randomly. The point center quadrate (PCQ) method was used to select the tree and collected the tree growth parameters viz., tree height, diameter at breast height (DBH), and diameter at the tree base. The tree crown density was measured with a densitometer. Each sample plot biomass was estimated using the standard formula. In this study, the LULC classification was done using Freeman-Durden, Yamaghuchi and Pauli polarimetric decompositions. It was observed that the Freeman-Durden decomposition showed better LULC classification with an accuracy of 88 percent. An attempt was made to estimate the aboveground biomass using SAR backscatter. The ALOS-2 PALSAR-2 L-band data (HH, HV, VV &VH) fully polarimetric quad-pol SAR data was used. SAR backscatter-based regression model was implemented to retrieve forest aboveground biomass of the study area. Cross-polarization (HV) has shown a good correlation with forest above-ground biomass. The Multi Linear Regression analysis was done to estimate aboveground biomass of the natural forest areas of the Joida taluk. The different polarizations (HH &HV, VV &HH, HV & VH, VV&VH) combination of HH and HV polarization shows a good correlation with field and predicted biomass. The RMSE and value for HH & HV and HH & VV were 78 t/ha and 0.861, 81 t/ha and 0.853, respectively. Hence the model can be recommended for estimating AGB for the dense, moderately dense, and sparse forest.

Keywords: forest, biomass, LULC, back scatter, SAR, regression

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Authors: Aminah Muchdar

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To increase the genetic diversity of soybean in order to adapt to agroecology in Indonesia conducted ways including introduction, cross, mutation and genetic transformation. The purpose of this research is to obtain early maturity soybean mutant lines, large seed tolerant to drought with high yield potential. This study consisted of two stages: the first is sensitivity of gamma rays carried out in the Laboratory BATAN. The genetic variety used is Anjasmoro. The method seeds irradiated with gamma rays at a rate of activity with the old ci 1046.16976 irradiation 0-71 minutes. Irradiation doses of 0, 100, 200, 300, 400, 500, 600, 700, 800, 900 and 1000gy. The results indicated all seeds irradiated with doses of 0 - 1000gy, just a dose of 200 and 300gy are able to show the percentage of germination, plant height, number of leaves, number of normal sprouts and green leaves of the best and can be continued for a second trial in order to assemble and to get mutants which is expected. The result of second stage of soybean M2 Population irradiated with diversity Gamma Irradiation performed that in the form of soybean planting, the seed planted is the first derivative of the M2 irradiated seeds. The result after the age of 30ADP has already showing growth and development of plants that vary when compared to its parent, both in terms of plant height, number of leaves, leaf shape and leaf forage level. In the generative phase, a plant that has been irradiated 200 and 300 gy seen some plants flower form packs, but not formed pods, there is also a form packs of flowers, but few pods produce soybean morphological characters such as plant height, number of branches, pods, days to flowering, harvesting, seed weight and seed number.

Keywords: gamma ray, genetic mutation, irradiation, soybean

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Authors: Alan Walsh, Peter Walker, Michael Ellis

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There is a real danger that both practitioners and researchers considering risks associated with megaprojects ignore or underestimate the impacts of cultural risk. The paper investigates the potential impacts of a failure to achieve cultural unity between the principal actors executing a megaproject. The principle relationships include the relationships between the principle Contractors and the project stakeholders or the project stakeholders and their principle advisors, Western Consultants. This study confirms that cultural dissonance between these parties can delay or disrupt the megaproject execution and examines why cultural issues should be prioritized as a significant risk factor in megaproject delivery. This paper addresses the practical impacts and potential mitigation measures, which may reduce cultural dissonance for a megaproject's delivery. This information is retrieved from on-going case studies in live infrastructure megaprojects in Europe and the Middle East's GCC states, from Western Consultants' perspective. The collaborating researchers each have at least 30 years of construction experience and are engaged in architecture, project management and contracts management, dealing with megaprojects in Europe or the GCC. After examining the cultural interfaces they have observed during the execution of megaprojects, they conclude that globally, culture significantly influences their efficient delivery. The study finds that cultural risk is ever-present, where different nationalities co-manage megaprojects and that cultural conflict poses a real threat to the timely delivery of megaprojects. The study indicates that the higher the cultural distance between the principal actors, the more pronounced the risk, with the risk of cultural dissonance more prominent in GCC megaprojects. The findings support a more culturally aware and cohesive team approach and recommend cross-cultural training to mitigate the effects of cultural disparity.

Keywords: cultural risk underestimation, cultural distance, megaproject characteristics, megaproject execution

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Authors: William Cheng, Rini Sekartini

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Background: Sleep is essential for children because it provides enhancement for the neural system activities that give physiologic effects for the body to support growth and development. One of the modifiable factors that relates with sleep is nutrition, which includes nutritional status, iron intake, and magnesium intake. Nutritional status represents the balance between nutritional intake and expenditure, while iron and magnesium are micronutrients that are related to sleep regulation. The aim of this study is to identify prevalence of sleep disturbance among Indonesian children and to evaluate its relation with aspect to nutrition. Methods : A cross-sectional study involving children aged 5 to 7-years-old in an urban primary health care between 2012 and 2013 was carried out. Related data includes anthropometric status, iron intake, and magnesium intake. Iron and magnesium intake was obtained by 24-hours food recall procedure. Sleep Disturbance Scale for Children (SDSC) was used as the diagnostic tool for sleep disturbance, with score under 39 indicating presence of problem. Results: Out of 128 school-aged children included in this study, 28 (23,1%) of them were found to have sleep disturbance. The majority of children had good nutritional status, with only 15,7% that were severely underweight or underweight, and 12,4% that were identified as stunted. On the contrary, 99 children (81,8%) were identified to have inadequate magnesium intake and 56 children (46,3%) with inadequate iron intake. Our analysis showed there was no significant relation between all of the nutritional status indicators and sleep disturbance (p>0,05%). Moreover, inadequate iron and magnesium intake also failed to prove significant relation with sleep disturbance in this population. Conclusion: Almost fourth of school-aged children in Indonesia were found to have sleep disturbance and further study are needed to overcome this problem. According to our finding, there is no correlation between nutritional status, iron intake, magnesium intake, and sleep disturbance.

Keywords: iron intake, magnesium intake, nutritional status, school-aged children, sleep disturbance

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Authors: Marcelus U. Ajonina, Deodata B. Ngonga, Kenric B. Ware, Carine K. Nfor

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Background: Lack of knowledge of rational use of antimalarial drugs among dispensers is a serious problem, especially in areas of intense transmission, thus increasing the risk of resistance and adverse drug reactions. This study was aimed at assessing the knowledge of malaria as well as perception and dispensing practices of antimalarials among vendors in Buea community. Methods: A community-based cross-sectional survey of a random sample of 140 drug vendors living within the Buea community was conducted between March and June 2017. A questionnaire was designed to obtain information from drug vendors on the general knowledge of malaria as well as dispensing practices. Data were analyzed using SPSS Statistics 20.0 and were considered significant at p ≤ 0.05. Results: Knowledge of malaria symptoms, transmission, and prevention was reasonable among 55.8% (77) of the respondents. Only 33.6% (47) of the respondents could attribute the cause of malaria to protozoan of genus Plasmodium species. Of the 140 vendors, 115 (82.7%) prescribe antimalarial drugs. The knowledge of the national protocol was malaria case management among dispensers was 35.0%. Vendors in hospital/community pharmacies were 2.4 times (OR = 3.14, 95% CI: 4.14 - 8.74, p < 0.001) more knowledgeable about malaria treatment protocol than those of in drugstores. The prevalence of self-prescription of antimalarials was 39.3%. Self-prescription was significantly higher in drugstores than hospital/community pharmacies (p=0.004). In all, 56 (40.6%) of vendors showed good practices regarding antimalarial drug dispensing with the majority (51.7%) from community pharmacies (OR=2.27,95% CI: 1.13-4.56). Conclusion: Findings reveal moderate knowledge of malaria but poor prescription and dispensing practices of antimalarial drugs among vendors, thus indicating a need for routine monitoring and evaluation to prevent the emergence of resistant strains to current efficacious antimalarials.

Keywords: antimalarials, drug retail outlets, dispensing, drug resistance, prescription

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Authors: Rosy Chaudhary, Pushpa Parajuli

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Background and Objectives: Informational support to family members has a significant potential for reducing this distress related to hospitalization of their patient into the critical care unit, enabling them to cope better and support the patient. The objective of the study is to assess family members’ perception of informational support, anxiety, satisfaction with care and to reveal the association with selected socio-demographic variables and to investigate the correlation between informational support, anxiety and satisfaction with care. Materials and Methods: A descriptive cross-sectional study was conducted in 39 family caregivers of patients admitted in critical care unit of BPKIHS(B.P. Koirala Institute of Health Sciences). Consecutive sampling technique was used wherein data was collected over duration of one month using interview schedule. Descriptive and inferential statistics were used. Results: The mean age of the respondents was 34.97 ± 10.64 and two third (66.70%) were male. Mean score for informational support was 25.72(SD = 5.66; theoretical range of 10 - 40). Mean anxiety was 10.41 (SD = 5.02; theoretical range of 7 - 21). Mean score for satisfaction with care was 40.77 (SD = 6.77; theoretical range of 14 - 64). A moderate positive correlation was found between informational support and satisfaction with care (r = 0.551, p < .001) and a moderate negative correlation was found between anxiety and satisfaction with care (r = -0.590; p = 0.000). No relationship was noted between informational support and anxiety. Conclusion: The informational support and satisfaction of the family caregivers with the care provided to their patients was satisfactory. More than three fourth of the family caregivers had anxiety; the factors associated being educational status of the caregivers, the family income and duration of visiting hours. There was positive correlation between informational support and satisfaction with care provided justifying the need for comprehensive information to the family caregivers by the health personnel. There was negative correlation between anxiety and satisfaction with care.

Keywords: anxiety, caregivers, critical care unit, informational support, family

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Authors: Pavan K. Emani, Shashank Kothari, V. S. Phanikanth

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The ultimate load analysis of RC pile groups has assumed a lot of significance under liquefying soil conditions, especially due to post-earthquake studies of 1964 Niigata, 1995 Kobe and 2001 Bhuj earthquakes. The present study reports the results of numerical simulations on pile groups subjected to monotonically increasing lateral loads under design amounts of pile axial loading. The soil liquefaction has been considered through the non-linear p-y relationship of the soil springs, which can vary along the depth/length of the pile. This variation again is related to the liquefaction potential of the site and the magnitude of the seismic shaking. As the piles in the group can reach their extreme deflections and rotations during increased amounts of lateral loading, a precise modeling of the inelastic behavior of the pile cross-section is done, considering the complete stress-strain behavior of concrete, with and without confinement, and reinforcing steel, including the strain-hardening portion. The possibility of the inelastic buckling of the individual piles is considered in the overall collapse modes. The model is analysed using Riks analysis in finite element software to check the post buckling behavior and plastic collapse of piles. The results confirm the kinds of failure modes predicted by centrifuge test results reported by researchers on pile group, although the pile material used is significantly different from that of the simulation model. The extension of the present work promises an important contribution to the design codes for pile groups in liquefying soils.

Keywords: collapse load analysis, inelastic buckling, liquefaction, pile group

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Authors: Flavio Cannavo

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Continuous evaluation of the status of potentially hazardous volcanos plays a key role for civil protection purposes. The importance of monitoring volcanic activity, especially for energetic paroxysms that usually come with tephra emissions, is crucial not only for exposures to the local population but also for airline traffic. Presently, real-time surveillance of most volcanoes worldwide is essentially delegated to one or more human experts in volcanology, who interpret data coming from different kind of monitoring networks. Unfavorably, the high nonlinearity of the complex and coupled volcanic dynamics leads to a large variety of different volcanic behaviors. Moreover, continuously measured parameters (e.g. seismic, deformation, infrasonic and geochemical signals) are often not able to fully explain the ongoing phenomenon, thus making the fast volcano state assessment a very puzzling task for the personnel on duty at the control rooms. With the aim of aiding the personnel on duty in volcano surveillance, here we introduce a system based on an ensemble of data-driven classifiers to infer automatically the ongoing volcano status from all the available different kind of measurements. The system consists of a heterogeneous set of independent classifiers, each one built with its own data and algorithm. Each classifier gives an output about the volcanic status. The ensemble technique allows weighting the single classifier output to combine all the classifications into a single status that maximizes the performance. We tested the model on the Mt. Etna (Italy) case study by considering a long record of multivariate data from 2011 to 2015 and cross-validated it. Results indicate that the proposed model is effective and of great power for decision-making purposes.

Keywords: Bayesian networks, expert system, mount Etna, volcano monitoring

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Authors: Natalie Hoyer

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Usually, steel structures are designed for the upper region of the steel toughness-temperature curve. To address the reduced toughness properties in the temperature transition range, additional safety assessments based on fracture mechanics are necessary. These assessments enable the appropriate selection of steel materials to prevent brittle fracture. In this context, recommendations were established in 2011 to regulate the appropriate selection of steel grades for bridge bearing components. However, these recommendations are no longer fully aligned with more recent insights: Designing bridge bearings and their components in accordance with DIN EN 1337 and the relevant sections of DIN EN 1993 has led to an increasing trend of using large plate thicknesses, especially for long-span bridges. However, these plate thicknesses surpass the application limits specified in the national appendix of DIN EN 1993-2. Furthermore, compliance with the regulations outlined in DIN EN 1993-1-10 regarding material toughness and through-thickness properties requires some further modifications. Therefore, these standards cannot be directly applied to the material selection for bearings without additional information. In addition, recent findings indicate that certain bridge bearing components are subjected to high fatigue loads, necessitating consideration in structural design, material selection, and calculations. To address this issue, the German Center for Rail Traffic Research initiated a research project aimed at developing a proposal to enhance the existing standards. This proposal seeks to establish guidelines for the selection of steel materials for bridge bearings to prevent brittle fracture, particularly for thick plates and components exposed to specific fatigue loads. The results derived from theoretical analyses, including finite element simulations and analytical calculations, are verified through component testing on a large-scale. During these large-scale tests, where a brittle failure is deliberately induced in a bearing component, an artificially generated defect is introduced into the specimen at the predetermined hotspot. Subsequently, a dynamic load is imposed until the crack initiation process transpires, replicating realistic conditions akin to a sharp notch resembling a fatigue crack. To stop the action of the dynamic load in time, it is important to precisely determine the point at which the crack size transitions from stable crack growth to unstable crack growth. To achieve this, the potential drop measurement method is employed. The proposed paper informs about the choice of measurement method (alternating current potential drop (ACPD) or direct current potential drop (DCPD)), presents results from correlations with created FE models, and may proposes a new approach to introduce beach marks into the fracture surface within the framework of potential drop measurement.

Keywords: beach marking, bridge bearing design, brittle fracture, design for fatigue, potential drop

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Authors: Rachel Barker

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The exponential velocity in the truly knowledge-intensive world today has increasingly bombarded organizations with unfathomable challenges. Hence organizations are introduced to strange lexicons of descriptors belonging to a new paradigm of who, what and how knowledge at individual and organizational levels should be managed. Although organizational knowledge has been recognized as a valuable intangible resource that holds the key to competitive advantage, little progress has been made in understanding how knowledge sharing at individual level could benefit knowledge use at collective level to ensure added value. The research problem is that a lack of research exists to measure knowledge sharing through a multi-layered structure of ideas with at its foundation, philosophical assumptions to support presuppositions and commitment which requires actual findings from measured variables to confirm observed and expected events. The purpose of this paper is to address this problem by presenting a theoretical approach to measure knowledge sharing in emerging knowledge organizations. The research question is that despite the competitive necessity of becoming a knowledge-based organization, leaders have found it difficult to transform their organizations due to a lack of knowledge on who, what and how it should be done. The main premise of this research is based on the challenge for knowledge leaders to develop an organizational culture conducive to the sharing of knowledge and where learning becomes the norm. The theoretical constructs were derived and based on the three components of the knowledge management theory, namely technical, communication and human components where it is suggested that this knowledge infrastructure could ensure effective management. While it is realised that it might be a little problematic to implement and measure all relevant concepts, this paper presents effect of eight critical success factors (CSFs) namely: organizational strategy, organizational culture, systems and infrastructure, intellectual capital, knowledge integration, organizational learning, motivation/performance measures and innovation. These CSFs have been identified based on a comprehensive literature review of existing research and tested in a new framework adapted from four perspectives of the balanced score card (BSC). Based on these CSFs and their items, an instrument was designed and tested among managers and employees of a purposefully selected engineering company in South Africa who relies on knowledge sharing to ensure their competitive advantage. Rigorous pretesting through personal interviews with executives and a number of academics took place to validate the instrument and to improve the quality of items and correct wording of issues. Through analysis of surveys collected, this research empirically models and uncovers key aspects of these dimensions based on the CSFs. Reliability of the instrument was calculated by Cronbach’s a for the two sections of the instrument on organizational and individual levels.The construct validity was confirmed by using factor analysis. The impact of the results was tested using structural equation modelling and proved to be a basis for implementing and understanding the competitive predisposition of the organization as it enters the process of knowledge management. In addition, they realised the importance to consolidate their knowledge assets to create value that is sustainable over time.

Keywords: innovation, intellectual capital, knowledge sharing, performance measures

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Authors: Seyed Saeid Nabavi

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Background: Many infants with intrauterine growth disorder are screened for TORCH infections. This action has no economic justification in terms of the imposed costs. In this regard, due to the research gap in this field, this study aimed to investigate the relationship between intrauterine growth disorder and TORCH infection in neonates referred to Milad hospital in 2019 and 2020. Materials and Methods: In this cross-sectional study, 41IUGR newborns were selected and evaluated based on diagnostic and clinical studies in Milad Hospital in 2019 and 2020. TORCH results found in IgG and IgM antibody titer assay were tested in mother and infant. Antibody titers of toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis were determined in cases, and other variables were compared. The collected data were entered in SPSS software 25 and analyzed at a significant level of 0.05 using the statistical tests of Kolmogorov–Smirnov, Shapiro–Wilk, chi-square, and Mann–Whitney. Results: Most of the IUGR infants studied were girls (68.3%), Gravida and Parity were reported to be 68.3% and 80%, respectively, in the study. Mean weight, APGAR score, and neonatal gestational age are reported as 1710.62±334.43 g, 7.71±1.47, and 35.7+ 1.98 weeks, respectively. Most of the newborns were born by cesarean section (92.7%). TORCH infection was reported in three patients, 7.3%. The mean gestational age of IUGR infants with TORCH infection was reported to be less than other babies with IUGR. Therefore, the mean gestational age of subjects with TORCH infection was 33±1.4 weeks and in others 35.94±1.91 weeks (p-value = 0.038). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found (p-value > 0.05). Conclusion: TORCH infection was reported in 3 patients( 7.3%). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found. p-value > 0.05

Keywords: congenital infection, intrauterine growth restriction, TORCH infections, neonates

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Authors: Man Wai Leung, Margaret O’Donoghue, Lorna K. P. Suen

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Personal and household hygiene measures are important to prevent upper respiratory tract infections (URTIs) and other infectious diseases, including coronavirus disease 2019 (COVID-19). An online survey recruited 414 eligible parents in Hong Kong to study their hygiene knowledge, attitudes, and practices (KAP) in the prevention of URTIs among their children. The average knowledge score was high (10.2/12.0), but some misconceptions were identified. The majority of participants agreed that good personal hygiene (93.5%) and good environmental hygiene (92.8%) can prevent URTIs. The average score for hand hygiene practices was high (3.78/4.00), but only 56.8% of parents always perform hand hygiene before touching their mouth, nose, or eyes. For environmental hygiene, only some household items were disinfected with disinfectants (69.8%: door handles, 60.4%: toilet seats, 42.8%: floor, 24.2%: dining chairs, 20.5%: dining tables). Higher knowledge score was associated with parents having a tertiary educational level or above, working as healthcare professionals, living at private residential flat or staff quarter, and having a household income of $70,000 or above. Hand hygiene practices varied significantly with parents’ age and income. During the 5th wave of the COVID-19 epidemic, misconceptions about hygiene knowledge were found among parents. Health promotion programs should target parents, especially those who are in old age, obtain lower educational levels, live in public housing, or have a lower income. Hand hygiene moments and proper use of disinfectants could be one of the targeted educational topics.

Keywords: hygiene, upper respiratory tract infection, parents, children, COVID-19

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Authors: K. M. Yoo, M. H. Kang

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Conventional commercial wind turbine design software is limited to large wind turbines due to not incorporating with low Reynold’s Number aerodynamic characteristics typically for small wind turbines. To extract maximum annual energy product from an intermediately designed small wind turbine associated with measured wind data, numerous simulation is highly recommended to have a best fitting planform design with proper airfoil configuration. Since depending upon wind distribution with average wind speed, an optimal wind turbine planform design changes accordingly. It is theoretically not difficult, though, it is very inconveniently time-consuming design procedure to finalize conceptual layout of a desired small wind turbine. Thus, to help simulations easier and faster, a GUI software is developed to conveniently iterate and change airfoil types, wind data, and geometric blade data as well. With magnetic generator torque curve, peak power tracking simulation is also available to better match with the magnetic generator. Small wind turbine often lacks starting torque due to blade optimization. Thus this simulation is also embedded along with yaw design. This software provides various blade cross section details at user’s design convenience such as skin thickness control with fiber direction option, spar shape, and their material properties. Since small wind turbine is under international safety regulations with fatigue damage during normal operations and safety load analyses with ultimate excessive loads, load analyses are provided with each category mandated in the safety regulations.

Keywords: GUI software, Low Reynold’s number aerodynamics, peak power tracking, safety regulations, wind turbine performance optimization

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Authors: Andrew Nowlan

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During the Coronavirus pandemic, collaborative online international learning (COIL) emerged as an alternative to overseas sojourns. However, now that face-to-face classes have resumed and students are studying abroad, the rationale for doing COIL is not always clear amongst educators and students. Also, the logistics of COIL become increasingly complicated when participants involved in a potential collaboration have different second language (L2) learning goals. In this paper, the researcher will report on a study involving two bilingual, cross-cultural COIL courses between students at a university in Japan and those studying in North America, from April to December, 2022. The students in Japan were enrolled in an intercultural communication class in their L2 of English, while the students in Canada and the United States were studying intermediate Japanese as their L2. Based on a qualitative survey and journaling data received from 31 students in Japan, and employing a transcendental phenomenological research design, the researcher will highlight the students’ essence of experience during COIL. Essentially, students benefited from the experience through improved communicative competences and increased knowledge of the target culture, even when the L2 learning goals between institutions differed. Students also reported that the COIL experience was effective in preparation for actual study abroad, as opposed to a replacement for it, which challenges the existing literature. Both educators and administrators will be exposed to the perceptions of Japanese university students towards COIL, which could be generalized to other higher education contexts, including those in Southeast Asia. Readers will also be exposed to ideas for developing more effective pre-departure study abroad programs and domestic intercultural curriculum through COIL, even when L2 learning goals may differ between participants.

Keywords: collaborative online international learning, study abroad, phenomenology, EdTech, intercultural communication

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Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

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Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

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Authors: Pil Kyoo Jo, Jee Young Kim, Yu Jin Oh, Sohyun Park, Young Ha Joo, Hye Suk Kim, Semi Kang

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When convenience drives daily food choices, the increased consumption of processed foods may be associated with the increased intakes of sodium and fat and further with the onset of chronic diseases. The purpose of this study was to investigate the levels of sodium, saturated fat, and calories intakes through processed foods and the dietary patterns among adult populations in South Korea. We used the nationally representative data from the 5th Korea National Health and Nutrition Examination Survey (KNHANES, 2010-2012) and a cross-sectional survey on the eating behaviors among university students(N=893, 380 men, 513 women) aged from 20 to 24 years. Results showed that South Koreans consumed 43.5% of their total food consumption from processed foods. The 24-hour recalls data showed that 77% of sodium, 60% of fats, 59% of saturated fat, and 44% of calories were consumed from processed food. The intake of processed foods increased by 1.7% in average since 2008 annually. Only 33% of processed food that respondents consumed had nutrition labeling. The data from university students showed that students selected processed foods in convenience store when eating alone compared to eating with someone else. Given the convenience and lack of time, more people will consume processed foods and it may impact their overall dietary intake and further their health. In order to help people to make healthier food choices, regulations and policies to reduce the potentially unhealthy nutrients of processed foods should be strengthened. This research was supported by the National Research Foundation of Korea for 2011 Korea-Japan Basic Scientific Cooperation Program. This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2015S1A5B6037369).

Keywords: sodium, fat, processed foods, diet trends

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Authors: Ni Luh Putu Harta Wedari

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Background: Clostridium difficile has two main virulence factors, namely TcdA and TcdB. TcdA encoded by the tcdA gene acts as an enterotoxin, pro-inflammatory and fluid accumulation, while TcdB encoded by the tcdB gene is cytotoxic, causes disruption of the actin cytoskeleton, and causes disruption of tight junctions in colon cells. This study aims to explore the relationship between the tcdA and tcdB genes and the duration of diarrhea in elderly patients. Method: This research was an observational analytic with a prospective cross-sectional with samples of elderly diarrhea patients who met the inclusion criteria in Denpasar City health service facilities from 1 December 2022 until 30 June 2023, and then their feces were analyzed using the real-time PCR method. Results: In this study, 40 elderly diarrhea patients met the inclusion criteria and in accordance with the minimum sample size, 28 (70%) men and 12 (30%) women. 5 patients (12.5%) had a history of azithromycin, 4 (10%) levofloxacin, 17 (42.5%) ciprofloxacin, 8 (20%) metronidazole, 1 (2.5%) cefoperazone, 5 (12, 5%) doxycycline. Comorbids, namely 13 (32.5%) type II diabetes mellitus, 4 (10%) chronic kidney disease, 10 (25%) malignancies, 7 (17.5%) urinary tract infections, 3 (7.5%) %) immunocompromised, 2 (5%) cardiac heart failure, and 1 (2.5%) acute on chronic kidney disease. The overall diarrhea duration average was 5 days. 8 samples (20%) were positive for 16s rRNA, and there was no significant difference in diarrhea duration with negative samples (p=0.166). The relationship between the tcdA gene and the duration of diarrhea could not be performed because all samples were negative. Likewise, relationship analysis between the coexistence of tcdA and tcdB could not be performed. There was no significant difference between tcdB positive 3 (7.5%) and negative with diarrhea duration (p=0.739). Conclusion: There is no significant relationship between the presence of the 16s rRNA and tcdB C. difficile genes with the duration of diarrhea in elderly patients.

Keywords: clostridium, difficile, diarrhea, elderly, tcdA, tcdB

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Authors: E. Loffi Borghese

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In this comprehensive study, we delve into the intricate dynamics of the big tech oligopoly, focusing particularly on Apple as a case study. The core objective is to scrutinize the evolving relationship between a firm's commitment to positive social impact as its primary purpose and its resilience in the face of disruptive innovations within the big tech market. Our exploration begins with a theoretical framework, emphasizing the significance of distinguishing between corporate social responsibility and social impact as a primary purpose. Drawing on insights from Drumwright and Bartkus and Glassman, we underscore the transformative potential when a firm aligns its core business with a social mission, transcending mere side activities. Examining successful firms, such as Apple, we adopt Sinek's perspective on inspirational leadership and the "golden circle." This framework sheds light on why some organizations, like Apple, succeed in making positive social impact their primary purpose. Apple's early-stage life cycle is dissected, revealing a profound commitment to challenging the status quo and promoting simpler alternatives that resonate with its users' lives. The study then navigates through industry life cycles, drawing on Klepper's stages and Christensen's disruptive innovations. Apple's dominance in the big tech oligopoly is contrasted with companies like Harley Davidson and Polaroid, illustrating the consequences of failing to adapt to disruptive innovations. The data and methods employed encompass a qualitative approach, leveraging sources like ECB, Forbes, World in Data, and scientific articles. A secondary data analysis probes Apple's market evolution within the big tech oligopoly, emphasizing the shifts in market context and innovation trends that demand strategic adaptations. The subsequent sections scrutinize Apple's present innovation strategies, highlighting its diversified product portfolio and intensified focus on big data. We examine the implications of these shifts on Apple's capacity to maintain positive social impact as its primary purpose, pondering potential consequences on its brand perception. The study culminates in a reflection on the broader implications of the big tech oligopoly's dominance. It contemplates the diminishing competitiveness in the market and the potential sidelining of positive social impact as a competitive advantage. The expansion of tech firms into diverse sectors raises concerns about negative societal impacts, prompting a call for increased regulatory attention and awareness. In conclusion, this research serves as a catalyst for heightened awareness and discussion on the intricate interplay between firms' social impact goals, disruptive innovations, and the broader societal implications within the evolving landscape of the big tech oligopoly. Despite limitations, this study aims to stimulate further research, urging a conscious and responsible approach to shaping the future economic system.

Keywords: innovation trends, market dynamics, social impact, tech oligopoly

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Authors: Amare Nigatu, Mågne Bratveit, Bente E. Moen

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Background: Pesticide exposure is an important public health concern in Ethiopia, but there is limited information on pesticide intoxications. Residents may have an increased risk of pesticide exposure through proximity of their homes to farms using pesticides. Also the pesticide exposure might be related to employment at these farms. This study investigated the prevalence of acute pesticide intoxications (API) by residence proximity to a nearby flower farm and assessed if intoxications are related to working there or not. Methods: A cross-sectional survey involving 516 persons was conducted. Participants were grouped according to their residence proximity from a large flower farm; living within 5 kilometers and 5-12 kilometers away, respectively. In a structured interview, participants were asked if they had health symptoms within 48 hours of pesticide exposure in the past year. Those, who had experienced this and reported two or more typical pesticide intoxication symptoms, were considered as having had API. Chi-square and independent t-tests were used to compare categorical and continuous variables, respectively. Confounding variables were adjusted by using binomial regression model. Results: The prevalence of API in the past year among the residents in the study area was 26%, and it was higher in the population living close to the flower farm (42%) compared to those living far away (11%), prevalence ratio (PR) = 3.2, 95% CI: 2.2-4.8, adjusted for age, gender & education. A subgroup living close to the farm & working there had significantly more API (56%) than those living close & did not work there (16%), adjusted PR = 3.0, 95% CI: 1.8-4.9. Flower farm workers reported more API (56%) than those not working there (13%,), adjusted PR = 4.0, 95% CI: 2.9-5.6. Conclusion: The residents living closer than 5 kilometers to the flower farm reported significantly higher prevalence of API than those living 5-12 kilometers away. This increased risk of API was associated with work at the flower farm.

Keywords: acute pesticide intoxications, self-reported symptoms, flower farm workers, living proximity

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Authors: Nik Kamariah Nikmat, Noor Hasmini Abdghani

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The Malaysian government had consistently revived its campaign for “Buy Malaysian Goods” from time to time. The purpose of the campaign is to remind consumers to be ethnocentric and patriotic when purchasing product and services. This is necessary to ensure high demand for local products and services compared to foreign products. However, the decline of domestic investment in 2012 has triggered concern for the Malaysian economy. Hence, this study attempts to determine the drivers of actual purchasing behavior, intention to purchase domestic products and ethnocentrism. The study employs the cross-sectional primary data, self-administered on household, selected using stratified random sampling in four Malaysian regions. A nine factor driver of actual domestic purchasing behavior (culture openness, conservatism, collectivism, patriotism, control belief, interest in foreign travel, attitude, ethnocentrism and intention) were measured utilizing 60 items, using 7-point Likert-scale. From 1000 questionnaires distributed, a sample of 486 were returned representing 48.6 percent response rate. From the fit generated structural model (SEM analysis), it was found that the drivers of actual purchase behavior are collectivism, cultural openness and patriotism; the drivers of intention to purchase domestic product are attitude, control belief, collectivism and conservativeness; and drivers of ethnocentrism are cultural openness, control belief, foreign travel and patriotism. It also shows that Malaysian consumers scored high in ethnocentrism and patriotism. The findings are discussed in the perspective of its implication to Malaysian National Agenda.

Keywords: actual purchase, ethnocentrism, patriotism, culture openness, conservatism

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Authors: Dwi Endarti, Susi a Kristina, Rizki Noorizzati, Akbar E Nugraha, Fera Maharani, Kika a Putri, Asninda H Azizah, Sausanzahra Angganisaputri, Yunisa Yustikarini

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Cost utility analysis is the most recommended pharmacoeconomic method since it allows widely comparison of cost-effectiveness results from different interventions. The method uses outcome of quality-adjusted life year (QALY) or disability-adjusted life year (DALY). Measurement of QALY requires the data of utility dan life years gained. Utility is measured with the instrument for quality of life measurement such as EQ-5D. Recently, the EQ-5D is available in two versions which are EQ-5D-3L and EQ-5D-5L. This study aimed to compare the EQ-5D-3L and EQ-5D-5L to examine the most suitable version for Indonesian population. This study was an observational study employing cross sectional approach. Data of quality of life measured with EQ-5D-3L and EQ-5D-5L were collected from several groups of population which were respondent with chronic diseases, respondent with acute diseases, and respondent from general population (without illness) in Yogyakarta Municipality, Indonesia. Convenience samples of hypertension patients (83), diabetes mellitus patients (80), and osteoarthritis patients (47), acute respiratory tract infection (81), cephalgia (43), dyspepsia (42), and respondent from general population (293) were recruited in this study. Responses on the 3L and 5L versions of EQ-5D were compared by examining the psychometric properties including agreement, internal consistency, ceiling effect, and convergent validity. Based on psychometric properties tests of EQ-5D-3L dan EQ-5D-5L, EQ-5D-5L tended to have better psychometric properties compared to EQ-5D-3L. Future studies for health related quality of life (HRQOL) measurements for pharmacoeconomic studies in Indonesia should apply EQ-5D-5L.

Keywords: EQ-5D, Health Related Quality of Life, Indonesian Population, Psychometric Properties

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Authors: Adrian Priceputu, Elena Mihaela Stan

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Our research addresses a critical challenge in renewable energy: improving efficiency and reducing the costs associated with the installation of ground-mounted photovoltaic (PV) panels. The most commonly used foundation solution is metal piles - with various sections adapted to soil conditions and the structural model of the panels. However, direct foundation systems are also sometimes used, especially in brownfield sites. Although metal micropiles are generally the first design option, understanding and predicting their bearing capacity, particularly under varied soil conditions, remains an open research topic. CPT Method and Current Challenges: Metal piles are favored for PV panel foundations due to their adaptability, but existing design methods rely heavily on costly and time-consuming in situ tests. The Cone Penetration Test (CPT) offers a more efficient alternative by providing valuable data on soil strength, stratification, and other key characteristics with reduced resources. During the test, a cone-shaped probe is pushed into the ground at a constant rate. Sensors within the probe measure the resistance of the soil to penetration, divided into cone penetration resistance and shaft friction resistance. Despite some existing CPT-based design approaches for metal piles, these methods are often cumbersome and difficult to apply. They vary significantly due to soil type and foundation method, and traditional approaches like the LCPC method involve complex calculations and extensive empirical data. The method was developed by testing 197 piles on a wide range of ground conditions, but the tested piles were very different from the ones used for PV pile foundations, making the method less accurate and practical for steel micropiles. Project Objectives and Methodology: Our research aims to develop a calculation method for metal micropile foundations using CPT data, simplifying the complex relationships involved. The goal is to estimate the pullout bearing capacity of piles without additional laboratory tests, streamlining the design process. To achieve this, a case study was selected which will serve for the development of an 80ha solar power station. Four testing locations were chosen spread throughout the site. At each location, two types of steel profiles (H160 and C100) were embedded into the ground at various depths (1.5m and 2.0m). The piles were tested for pullout capacity under natural and inundated soil conditions. CPT tests conducted nearby served as calibration points. The results served for the development of a preliminary equation for estimating pullout capacity. Future Work: The next phase involves validating and refining the proposed equation on additional sites by comparing CPT-based forecasts with in situ pullout tests. This validation will enhance the accuracy and reliability of the method, potentially transforming the foundation design process for PV panels.

Keywords: cone penetration test, foundation optimization, solar power stations, steel pile foundations

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Authors: Barbara Torres Rives

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Uveitis. Non-infectious anterior uveitis is a polygenic inflammatory eye disease, and it is suggested that mediated processes by the immune system (autoimmune or not) are the main mechanisms proposed in the pathogenesis of this type of uveitis. A relationship between infectious processes, digestive disorders, and a dysbiosis of the microbiome was recently described. In addition, alterations in the immune response associated with the initiation and progression of the disease have been described. Objective: The aim of this study was to identify factors related to the immune system associated with complicated non-infectious anterior uveitis. Methods: A cross-sectional observational analytical study was carried out. The universe consisted of all patients attending the ocular inflammation service of the Cuban Institute of Ophthalmology Ramón Pando Ferrer. The sample consisted of 213 patients diagnosed with non-infectious anterior uveitis. Results: Of the 213 patients with non-infectious anterior uveitis, the development of ophthalmologic complications predominated 56.3% (p=0.0094). In patients with complications was more frequent the presence of human leukocyte antigen-B27 allele (49.2%) (p<0.0001), decreased immunoglobulin G (24.2%, p=0.0124), increased immunoglobulin A (14.2%, p=0.0024), history of recurrent sepsis (59.2%, p=0.0018), recurrent respiratory infections (44.2%, p=0.0003), digestive alterations (40%, p=0.0013) and spondyloarthropathies (30%, p=0.0314). By logistic regression, it was observed that, for each completed year, the elevated risk for developing complicated non-infectious anterior uveitis in human leukocyte antigen-B27 allele positive patients (OR: 4.22, p=0.000), Conclusions: The control of recurrent sepsis at mucosal level and immunomodulation could prevent complications in non-infectious anterior uveitis. Therefore, the microbiome becomes the target of treatment and prevention of complications in non-infectious anterior uveitis.

Keywords: non-infectious anterior uveitis, immune system disorders, recurrent mucosal infections, microbiome

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Authors: Margaret Denise P. Del Rosario, Geraldine Alcantara

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Background: The declaration of the COVID-19 pandemic has impacted hospital visits of child abuse cases with less consults but more severe injuries. Objective: The study aims to identify the clinical profiles of patients seen in the hospital ng Makati Women and Children Protection Unit before and during the pandemic. Design: A cross-sectional analytic study design through review of records that underwent quantitative analysis. Results: 264 cases pre-pandemic and 208 cases during the pandemic were reviewed. Most reported cases were neglect comprising of 47% of the pre-pandemic cases and 68% of cases during the pandemic. Supervisory neglect was most commonly reported. An equal distribution between males and females were seen among victims and alleged perpetrators. The age group of both victims and alleged perpetrators during the pandemic was significantly younger compared to the pre-pandemic period. Children belonging to larger family groups were commonly encountered with most of them being the eldest amongst siblings. Alleged perpetrators were mostly secondary graduates for both time periods. A significant increase of cases during the pandemic occurred at home. More patients required hospitalization during the pandemic period with 37% compared to the 23% of admissions prior to the pandemic. Furthermore, a three-fold increase of injuries sustained during the pandemic required intensive care. Conclusion: The study reflects increased severity of injuries related to abuse during the pandemic compared to pre-pandemic times. A significant increase in injuries requiring intensive care were also seen despite less reported cases.

Keywords: child abuse, COVID-19, violence against children, WCPU, neglect

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Authors: Beruk Berhanu Desalegn, Kebede Awgechew, Addisalem Mesfin

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Introduction: This study aimed to investigate and compare the energy and selected nutrient intakes of sport science and non-sport science University students of Southern Ethiopia. Method: Multiple-day dietary data were collected from 166 university students (76 sport science and 90 non-sport sciences). Average daily energy and nutrient intake, and inadequate intakes were calculated using NutriSurvey (NS). Results: There were significant differences (p < 0.05) in the median intakes of energy, total carbohydrate, and vitamin B1 between female students from the sport science and non-sport science groups, but only the median intake of iron was significantly different (p < 0.05) between the male sport and non-sport science students’ group. The prevalence of inadequate intake of vitamin B1 were significantly (p<0.05) higher in the male and female from the non-sport science groups compared to the male and female students’ groups in the sport science, respectively. Whereas, the prevalence of inadequate iron intake by the male sport science students’ group was significantly (p<0.05) higher compared to their counterparts. Similarly, the prevalence of inadequate energy among the females from the sport science group was significantly (p<0.05) higher compared to the female students from the non-sport science department group. The prevalence of inadequate intakes of dietary energy, and the majority of the nutrients (protein, fat, vitamin A, B1, B2, and magnesium) were high (>50%) in selected University students. Conclusion: The energy and majority of nutrient intakes by the students in the selected universities of southern Ethiopia were sub-optimal. Therefore, activities that will improve the dietary intake of University students should include weekly meal plan revision considering their average recommended nutrient intake (RNI).

Keywords: dietary intake, sport science, University students, Ethiopia

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Authors: Mohammad Reza Dousti, Yaman Boluk, Vivek Bindiganavile

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During the past few decades, oil and natural gas consumption have increased significantly. The limited amount of hydrocarbon resources on earth has led to a stronger desire towards efficient drilling, well completion and extracting, with the least time, energy and money wasted. Well cementing is one of the most crucial and important steps in any well completion, to fill the annulus between the casing string and the well bore. However, since it takes place at the end of the drilling process, a satisfying and acceptable job is rarely done. Hence, a large and significant amount of time and energy is then spent in order to do the required corrections or retrofitting the well in some cases. Oil well cement paste needs to be pumped during the cementing process, therefore the rheological and flow behavior of the paste is of great importance. This study examines the use of innovative cellulose-based nanomaterials on the flow properties of the resulting cementitious system. The cementitious paste developed in this research is composed of water, class G oil well cement, bentonite and cellulose nanocrystals (CNC). Bentonite is used as a cross contamination component. Initially, the influence of CNC on the flow and rheological behavior of CNC and bentonite suspensions was assessed. Furthermore, the rheological behavior of oil well cement pastes dosed with CNC was studied using a steady shear parallel-plate rheometer and the results were compared to the rheological behavior of a neat oil well cement paste with no CNC. The parameters assessed were the yield shear stress and the viscosity. Significant changes in yield shear stress and viscosity were observed due to the addition of the CNC. Based on the findings in this study, the addition of a very small dosage of CNC to the oil well cement paste results in a more viscous cement slurry with a higher yield stress, demonstrating a shear thinning behavior.

Keywords: cellulose nanocrystal, flow behavior, oil well cement, rheology

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Authors: Lay Poh Tan, Chor Yong Tay, Haiyang Yu

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Micro-contact printing is a form of soft lithography that uses the relief patterns on a master polydimethylsiloxane (PDMS) stamp to form patterns of self-assembled monolayers (SAMs) of ink on the surface of a substrate through conformal contact technique. Here, we adopt this method to print proteins of different dimensions on our biodegradable polymer substrates. We started off with printing 20-500 μm scale lanes of fibronectin to engineer the shape of bone marrow derived human mesenchymal stem cell (hMSCs). After 8 hours of culture, the hMSCs adopted elongated shapes, and upon analysis of the gene expressions, genes commonly associated with myogenesis (GATA-4, MyoD1, cTnT and β-MHC) and neurogenesis (NeuroD, Nestin, GFAP, and MAP2) were up-regulated but gene expression associated to osteogenesis (ALPL, RUNX2, and SPARC) were either down modulated or remained at the nominal level. This is the first evidence that cellular morphology control via micropatterning could be used to modulate stem cell fate without external biochemical stimuli. We further our studies to modulate the focal adhesion (FA) instead of the macro shape of cells. Micro-contact printed islands of different smaller dimensions were investigated. We successfully regulated the FAs into dense FAs and elongated FAs by micropatterning. Additionally, the combined effects of hard (40.4 kPa), and intermediate (10.6 kPa) PA gel and FAs patterning on hMSCs differentiation were studied. Results showed that FA and matrix compliance plays an important role in hMSCs differentiation, and there is a cross-talk between different physical stimulants and the significance of these stimuli can only be realized if they are combined at the optimum level.

Keywords: micro-contact printing, polymer substrate, cell-material interaction, stem cell differentiation

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Authors: Michael Wright, Tiago Costa

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The construction industry in SE Asia has been relying on S355 MPa “as rolled” H-beams for many years now. It is an easily sourced, metallurgically simple, reliable product that all designers, fabricators and constructors are familiar with. However, as the Global demand to better use our finite resources gets stronger, the need for an as-rolled S460 MPa H-Beam is becoming more apparent. The Financial benefits of an “as-rolled” S460 MPa H-beam are obvious. The S460 MPa beam which is currently available and used is fabricated from rolled strip. However, making H-beam from 3 x 460 MPa strips requires costly equipment, valuable welding skills & production time, all of which can be in short supply or better used for other purposes. The Metallurgical benefits of an “as-rolled” S460 MPa H-beam are consistency in the product. Fabricated H-beams have inhomogeneous areas where the strips have been welded together - parent metal, heat affected zone and weld metal all in the one body. They also rely heavily on the skill of the welder to guarantee a perfect, defect free weld. If this does not occur, the beam is intrinsically flawed and could lead to failure in service. An as-rolled beam is a relatively homogenous product, with the optimum strength and ductility produced by delivering steel with as fine as possible uniform cross sectional grain size. This is done by cost effective alloy design coupled with proper metallurgical process control implemented into an existing mill’s equipment capability and layout. This paper is designed to highlight the benefits of bring an “as-rolled” S460 MPa H-beam to the construction market place in SE Asia, and hopefully encourage the current “as-rolled” H-beam producers to rise to the challenge and produce an innovative high quality product for the local market.

Keywords: fine grained, As-rolled, long products, process control, metallurgy

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Authors: V. Rekha, Rama Pal

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The study examines the degree and magnitude of wealth-based inequalities in child health and its determinants in India. Despite making strides in economic growth, India has failed to secure a better nutritional status for all the children. The country currently faces the double burden of malnutrition as well as the problems of overweight and obesity. Child malnutrition, obesity, unsafe water, sanitation among others are identified as the risk factors for Non-Communicable Diseases (NCDs). Eliminating malnutrition in all its forms will catalyse improved health and economic outcomes. The assessment of the distributive dimension of child health across various segments of the population is essential for effective policy intervention. The study utilises the fourth round of District Level Health Survey for 2012-13 to analyse the inequalities among children in the age group 0-14 years in Maharashtra, a state in the western region of India with a population of 11.24 crores which constitutes 9.3 percent of the total population of India. The study considers the extent of health inequality by state, districts, sector, age-groups, and gender. The z-scores of four child health outcome variables are computed to assess the nutritional status of pre-school and school children using WHO reference. The descriptive statistics, concentration curves, concentration indices, correlation matrix, logistic regression have been used to analyse the data. The results indicate that magnitude of inequality is higher in Maharashtra and child health inequalities manifest primarily among the weaker sections of society. The concentration curves show that there exists a pro-poor inequality in child malnutrition measured by stunting, wasting, underweight, anaemia and a pro-rich overweight inequality. The inequalities in anaemia are observably lower due to the widespread prevalence. Rural areas exhibit a higher incidence of malnutrition, but greater inequality is observed in the urban areas. Overall, the wealth-based inequalities do not vary significantly between age groups. It appears that there is no gender discrimination at the state level. Further, rural-urban differentials in gender show that boys from the rural area and girls living in the urban region experience higher disparities in health. The relative distribution of undernutrition across districts in Maharashtra reveals that malnutrition is rampant and considerable heterogeneity also exists. A negative correlation is established between malnutrition prevalence and human development indicators. The findings of logistic regression analysis reveal that lower economic status of the household is associated with a higher probability of being malnourished. The study recognises household wealth, education of the parent, child gender, and household size as factors significantly related to malnutrition. The results suggest that among the supply-side variables, child-oriented government programmes might be beneficial in tackling nutrition deficit. In order to bridge the health inequality gap, the government needs to target the schemes better and should expand the coverage of services.

Keywords: child health, inequality, malnutrition, obesity

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