Search results for: infrastructure intervention
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4278

Search results for: infrastructure intervention

738 A Method to Evaluate and Compare Web Information Extractors

Authors: Patricia Jiménez, Rafael Corchuelo, Hassan A. Sleiman

Abstract:

Web mining is gaining importance at an increasing pace. Currently, there are many complementary research topics under this umbrella. Their common theme is that they all focus on applying knowledge discovery techniques to data that is gathered from the Web. Sometimes, these data are relatively easy to gather, chiefly when it comes from server logs. Unfortunately, there are cases in which the data to be mined is the data that is displayed on a web document. In such cases, it is necessary to apply a pre-processing step to first extract the information of interest from the web documents. Such pre-processing steps are performed using so-called information extractors, which are software components that are typically configured by means of rules that are tailored to extracting the information of interest from a web page and structuring it according to a pre-defined schema. Paramount to getting good mining results is that the technique used to extract the source information is exact, which requires to evaluate and compare the different proposals in the literature from an empirical point of view. According to Google Scholar, about 4 200 papers on information extraction have been published during the last decade. Unfortunately, they were not evaluated within a homogeneous framework, which leads to difficulties to compare them empirically. In this paper, we report on an original information extraction evaluation method. Our contribution is three-fold: a) this is the first attempt to provide an evaluation method for proposals that work on semi-structured documents; the little existing work on this topic focuses on proposals that work on free text, which has little to do with extracting information from semi-structured documents. b) It provides a method that relies on statistically sound tests to support the conclusions drawn; the previous work does not provide clear guidelines or recommend statistically sound tests, but rather a survey that collects many features to take into account as well as related work; c) We provide a novel method to compute the performance measures regarding unsupervised proposals; otherwise they would require the intervention of a user to compute them by using the annotations on the evaluation sets and the information extracted. Our contributions will definitely help researchers in this area make sure that they have advanced the state of the art not only conceptually, but from an empirical point of view; it will also help practitioners make informed decisions on which proposal is the most adequate for a particular problem. This conference is a good forum to discuss on our ideas so that we can spread them to help improve the evaluation of information extraction proposals and gather valuable feedback from other researchers.

Keywords: web information extractors, information extraction evaluation method, Google scholar, web

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737 Socio-Spatial Transformations in Obsolete Port Regions: A Case for Istanbul-Karaköy District

Authors: Umut Tuğlu Karslı

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While, port function had a major role during the antiquity and medieval times, it has started to lose its significance in 19th century. In many port cities, while heavy industrial functions and ports have been moved out of the former port districts, the resulting derelict spaces have been transformed to new waterfront quarters to accommodate commercial, tourism, cultural, residential and public uses. Primary aim of these operations is to revitalize abandoned spaces of historical potential and re-establish a relationship between the city and the coast. Karakoy Port, field of this study, located in the Bosphorus, was surrounded by the city centre in time due to the transformation of urban functions, and as a result it has lost its former significance. While Karakoy has 24 hours lively residential and commercial uses in old times; in early 1980s, became a district of mechanical, plumbing and electronic parts suppliers during the day and a place for homeless at night. Today, activities for revitalization of this region continue in two forms and scales. First of these activities is the "planned transformation projects," which also includes the most important one “Galataport project”, and the second one is "spontaneous transformation," which consists of individual interventions. Galataport project that based on the idea of arranging the area specifically for tourists was prepared in 2005 and became a topic of tremendous public debate. On the other hand, the "spontaneous transformation" that is observed in the Karakoy District starts in 2004 with the foundation of “Istanbul Modern Museum”. Istanbul Modern, the first contemporary arts museum of the city, allowed the cultural integration of old naval warehouses of the port to the daily life. Following this adaptive reuse intervention, the district started to accommodate numerous art galleries, studios, café-workshops and design stores. In this context, this paper briefly examines revitalization studies in obsolete port regions, analyzes the planned and ongoing socio-spatial transformations in the specific case of Karakoy under the subjects of "planned transformation projects" and "spontaneous transformation", and realizes a critical review of the sustainability of the proposals on how to reinstate the district in the active life of Istanbul.

Keywords: port cities, socio-spatial transformation, urban regeneration, urban revitalization

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736 The Impact of Floods and Typhoons on Housing Welfare: Case Study of Thua Thien Hue Province, Vietnam

Authors: Seyeon Lee, Suyeon Lee, Julia Rogers

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This research investigates and records post-flood and typhoon conditions of low income housing in the Thua Thien Hue Province, Vietnam; area prone to extreme flooding in Central Vietnam. The cost of rebuilding houses after flood and typhoon has been always a burden for low income households. These costs often lead to the elimination of essential construction practices for disaster resistance. Despite relief efforts from international non-profit organizations and Vietnam government, the impacts of flood and typhoon damages to residential construction has been reoccurring to the same neighborhood annually. Notwithstanding its importance, this topic has not been systematically investigated. The study is limited to assistance provided to low income households documenting existing conditions of low income homes impacted by post flood and typhoon conditions in the Thua Thien Hue Province. The research identifies leading causes of the building failure from the natural disasters. Relief efforts and progress made since the last typhoon is documented. The quality of construction and repairs are assessed based on Home Builders Guide to Coastal Construction by Federal Emergency Management Agency. Focus group discussions and individual interviews with local residents from four different communities were conducted to get incites on repair effort by the non-profit organizations and Vietnam government, and their needs post flood and typhoon. The findings from the field study informed that many of the local people are now aware of the importance of improving housing conditions as one of the key coping strategies to withstand flood and typhoon events as it makes housing and community more resilient to future events. While there has been a remarkable improvement of housing and infrastructure with the support from the local government as well as the non-profit organizations, many households in the study areas are found to still live in weak and fragile housing conditions without gaining access to the aid to repair and strengthen the houses. Given that the major immediate recovery action taken by the local people tends to focus on repairing damaged houses, and on this ground, low-income households spend a considerable amount of their income on housing repair, providing proper and applicable construction practices will not only improve the housing condition, but also contribute to reducing poverty in Vietnam.

Keywords: disaster coping mechanism, housing welfare, low-income housing, recovery reduction

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735 Tommy: Communication in Education about Disability

Authors: Karen V. Lee

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The background and significance of this study involve communication in education by a faculty advisor exploring story and music that informs others about a disabled teacher. Social issues draw deep reflection about the emotional turmoil. As a musician becoming a teacher is a passionate yet complex endeavor, the faculty advisor shares a poetic but painful story about a disabled teacher being inducted into the teaching profession. The qualitative research method as theoretical framework draws on autoethnography of music and story where the faculty advisor approaches a professor for advice. His musicianship shifts her forward, backward, and sideways through feelings that evoke and provoke curriculum to remove communication barriers in education. They discover they do not transfer knowledge from educational method classes. Instead, the autoethnography embeds musical language as a metaphorical conduit for removing communication barriers in teacher education. Sub-themes involve communication barriers and educational technologies to ensure teachers receive social, emotional, physical, spiritual, and intervention disability resources that evoke visceral, emotional responses from the audience. Major findings of the study discover how autoethnography of music and story bring the authors to understand wider political issues of the practicum internship for teachers with disabilities. An epiphany reveals the irony of living in a culture of both uniformity and diversity. They explore the constructs of secrecy, ideology, abnormality, and marginalization by evoking visceral and emotional responses from the audience. As the voices harmonize plot, climax, characterization, and denouement, they dramatize meaning that is episodic yet incomplete to highlight the circumstances surrounding the disabled protagonist’s life. In conclusion, the qualitative research method argues for embracing storied experiences that depict communication in education. Scholarly significance embraces personal thoughts and feelings as a way of understanding social phenomena while highlighting the importance of removing communication barriers in education. The circumstance about a teacher with a disability is not uncommon in society. Thus, the authors resolve to removing barriers in education by using stories to transform the personal and cultural influences that provoke new ways of thinking about the curriculum for a disabled teacher.

Keywords: communication in education, communication barriers, autoethnography, teaching

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734 Adopting New Knowledge and Approaches to Sustainable Urban Drainage in Saudi Arabia

Authors: Ali Alahmari

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Urban drainage in Saudi Arabia is an increasingly challenging issue due to factors such as climate change and rapid urban expansion. The existing infrastructure, based on traditional drainage systems, is not always able to cope with the increased precipitation, sometimes leading to rainwater runoff and floods causing disturbances and damage to property. Therefore, there is a need to find new ways of managing drainage, such as Sustainable Urban Drainage Systems (SUDS). The research has highlighted the main driving forces behind the need for change, revealed by the participants, to the need to adopt new ideas and approaches for urban drainage. However, while moving towards this, certain factors that may hinder the aim of using the experiences of other countries and taking advantage of innovative solutions. The research illustrates an initial conceptual model for these factors emerging from the analysis. It identifies some of the fundamental issues affecting the resistance to change towards the adoption of the concept of sustainability in Saudi Arabia, with Riyadh city as a case study. This was by using a qualitative approach, whereby, through two phases of fieldwork during 2013 and 2014, twenty-six semi-structured interviews were conducted with a number of representative officials and professionals from key government departments and organisations related to urban drainage management. Grounded Theory approach was followed to analyse the qualitative data obtained. Resistance to change was classified to: firstly: individual inertia (e.g. familiarity with the conventional solutions and approaches, lack of awareness, and considering sustainability as a marginal matter in urban planning). This resulted in not paying the desired attention, and impact on planning and setting priorities for development. Secondly: institutionalised inertia (e.g. lack of technical and design specifications for other unconventional drainage solutions, lack of consideration by decision makers in other disciplines such as contributions from environmental and geographical studies, and routine work and bureaucracy). This contributes to the weakness of decision-making, weakness in the role of research, and a lack of human resources. It seems that attitudes towards change may have reduced the ability to move forward towards sustainable development, in addition to contributing towards difficulties in some aspects of the decision-making process. Thus, the chapter provides insights into the current situation in Saudi Arabia and contributes to understanding the decisions that are made regarding change.

Keywords: climate change, new knowledge and approaches, resistance to change, Saudi Arabia, SUDS, urban drainage, urban expansion

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733 Case Report on Sepsis by Alpha-Hemolytic Streptococcus and Mannheimia haemolytica in Neonate Dogs

Authors: Maria L. G. Lourenco, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

Neonatal sepsis is a systemic response of acute infection by bacteria that may lead to high mortality in a litter. This study aims to report a case of sepsis by alpha-hemolytic Streptococcus and Mannheimia haemolytica in neonate dogs. A pregnant, mixed-breed bitch at approximately the 60th day of pregnancy was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, and subjected to a c-section due to uterine atony and fetuses no heartbeats on the ultrasound examination. The mother presented leukopenia of 1.6 thousand leukocytes, and there was no other information regarding previous clinical history. Among the offspring, four were stillborn, and five were born alive. On clinical examination, neonates weighed between 312 and 384 grams. Reflexes were present, and the newborn's body temperature was between 89.9 ºF and 96.4 ºF. Neonates also presented clinical signs of neonatal infection: omphalitis, abdomen, and extremities with cyanotic color, hematuria, and diarrhea (meconium). Complementary tests revealed leukopenia. The presence of alpha hemolytic streptococcus and Mannheimia haemolytica was revealed in the bacterial culture. The bacteria were sensitive to cephalosporins and penicillin on the antibiogram. Treatment for sepsis was instituted with the drug ceftriaxone, at a dose of 50 mg per kilogram, administered intravenous (jugular vein). Subsequently administered subcutaneous, every 12 hours, for seven days. Heated fluid therapy was performed, with Ringer lactate, at a dose of 4 ml per 100 grams of weight, intravenous. Heating measures were instituted. Blood plasma was also administered, at a dose of 2 mL per 100 grams of weight, administered subcutaneous, as a source of passive immunity. A maternal milk substitute was instituted, and lactation was discontinued since the mother was unable to nurse due to the infection. The mother was neutered during the c-section and treated with ceftriaxone (50 mg/kg). After seven days, the newborns presented normal clinical signs and no alterations in the hemogram. Early diagnosis and intervention were essential for the survival of these patients.

Keywords: neonatal infection, puppies, bacteria, newborn

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732 Integrated Information Approach to Inbound Logistics in Indian Steel Sector

Authors: N. Jena, Nitin Seth

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Globalization and free trade has forced the organizations to continuously rethink and rework on the increasing cost of logistics. World wide, it is visualized that on one side the steel sector is witnessing rapid growth and on the other side it is facing huge challenges in terms of availability of raw materials for uninterrupted production. Inbound logistics also gains significant importance for ensuring the timely availability of raw materials. It is seen that in Indian steel sector logistic cost is still very large and challenging. Effectively managing the inbound logistics in steel decides the profitability and serviceability of the organization. Effective management of inbound logistics also has a major role on the inventory of the organization. Since, the logistics for the steel industry in India is evolving rapidly and it is the interplay of infrastructure, technology and new types of service providers that will define whether the industry is able to help its customers to reduce their logistics costs. Integration of Logistics has been treated as one of the most potential area for the companies to provide a base for cost reduction. In spite of the proven area for benefits for the industry, it is very surprising that none of the researchers have explored this area. Although, many researchers explored the subject of logistics in steel industry, but their perspective varied from exploring and understanding the associated cost and finding out the relations between them. Visualizing a potential gap, the present research is under taken to explore the integration opportunities in inbound logistics for steel sector. Typically in Indian steel sector where in most of the manufacturers depend on imported materials for processing the logistics is very challenging and accounts for transactions at supplier – who is situated in different country, shipper- who is transporting the material to the host country, regulators in both countries-that include customs and various clearing agents, local logistics service providers and local transporters/handlers. It is seen that In bound logistics cost in the steel sector is very high and accounts for about 15-16% of the turn over, integration of information across different channels provides and opportunity for improvements and growth of the organization. In the present paper, a case of leading steel manufacturer has been taken and the potentials for integration of information across various partners have been identified. The paper provides the identification of grey area in steel sector for major improvements in cycle time and lowering the inventories by integration of information. Finally, based on integration of information, the paper presents a business information framework for steel sector.

Keywords: integration, steel sectors, suppliers, shippers, customs and cargo agents, transporters

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731 A 10 Year Review of the Complications of Ingested and Aspirated Dentures

Authors: Rory Brown, Jessica Daniels, Babatunde Oremule, William Tsang, Sadie Khwaja

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Introduction: Dentures are common and are an intervention for both physical and psychological symptoms associated with tooth loss. However, the humble denture can cause morbidity and mortality if swallowed or aspirated. Numerous case reports document complications including hollow viscus perforation, fistula formation and airway compromise. The purpose of this review was to examine the literature documenting cases of swallowed or aspirated dentures over the past ten years to investigate factors that contribute to developing complications. Methods: A Medline literature search was performed to identify cases of denture ingestion or aspiration for over ten years. Data was collected to include patient, appliance and temporal factors that may contribute to developing complications including hollow viscus perforation, fistula formation, abscess, bowel obstruction, necrosis, hemorrhage and airway obstruction. The data was analyzed using observational and inferential statistics in the form of Chi-Squared and Pearson correlation tests. Results: Eighty-five cases of ingested or aspirated dentures were identified from 77 articles published between 1/10/2009 and 31/10/2019. Fourteen articles were excluded because they did not provide sufficient information on individual cases. Complications were documented in 37.6% of patients, and 2 cases resulted in death. There was no significant difference in complication risk based on patient age, hooked appliance, level of impaction, or radiolucency. However, symptoms of greater than 1-day duration are associated with an increased risk of complication (p=0.005). Increased time from ingestion or aspiration to removal is associated with an increased risk of complications, and the p-value remains significant up to and including day 4 (p=0.017). Conclusions: With denture use predicted to rise complications from the denture, ingestion and aspiration may become more frequent. We have demonstrated that increased symptom duration significantly increases the risk of developing complications. Additionally, we established the risk of developing complications is significantly reduced if the denture is removed with four days of aspiration or ingestion. By actively intervening early when presented with a case of swallowed or aspirated dentures, we may be able to reduce the morbidity associated with this unassuming device.

Keywords: aspiration, denture, ingestion, endoscopic foreign, body removal, foreign body impaction

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730 Technical Option Brought Solution for Safe Waste Water Management in Urban Public Toilet and Improved Ground Water Table

Authors: Chandan Kumar

Abstract:

Background and Context: Population growth and rapid urbanization resulted nearly 2 Lacs migrants along with families moving to Delhi each year in search of jobs. Most of these poor migrant families end up living in slums and constitute an estimated population of 1.87 lacs every year. Further, more than half (52 per cent) of Delhi’s population resides in places such as unauthorized and resettled colonies. Slum population is fully dependent on public toilet to defecate. In Public toilets, manholes either connected with Sewer line or septic tank. Septic tank connected public toilet faces major challenges to dispose of waste water. They have to dispose of waste water in outside open drain and waste water struck out side of public toilet complex and near to the slum area. As a result, outbreak diseases such as Malaria, Dengue and Chikungunya in slum area due to stagnated waste water. Intervention and Innovation took place by Save the Children in 21 Public Toilet Complexes of South Delhi and North Delhi. These public toilet complexes were facing same waste water disposal problem. They were disposing of minimum 1800 liters waste water every day in open drain. Which caused stagnated water-borne diseases among the nearest community. Construction of Soak Well: Construction of soak well in urban context was an innovative approach to minimizing the problem of waste water management and increased water table of existing borewell in toilet complex. This technique made solution in Ground water recharging system, and additional water was utilized in vegetable gardening within the complex premises. Soak well had constructed with multiple filter media with inlet and safeguarding bed on surrounding surface. After construction, soak well started exhausting 2000 liters of waste water to raise ground water level through different filter media. Finally, we brought a change in the communities by constructing soak well and with zero maintenance system. These Public Toilet Complexes were empowered by safe disposing waste water mechanism and reduced stagnated water-borne diseases.

Keywords: diseases, ground water recharging system, soak well, toilet complex, waste water

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729 Effect of Locally Injected Mesenchymal Stem Cells on Bone Regeneration of Rat Calvaria Defects

Authors: Gileade P. Freitas, Helena B. Lopes, Alann T. P. Souza, Paula G. F. P. Oliveira, Adriana L. G. Almeida, Paulo G. Coelho, Marcio M. Beloti, Adalberto L. Rosa

Abstract:

Bone tissue presents great capacity to regenerate when injured by trauma, infectious processes, or neoplasia. However, the extent of injury may exceed the inherent tissue regeneration capability demanding some kind of additional intervention. In this scenario, cell therapy has emerged as a promising alternative to treat challenging bone defects. This study aimed at evaluating the effect of local injection of bone marrow-derived mesenchymal stem cells (BM-MSCs) and adipose tissue-derived mesenchymal stem cells (AT-MSCs) on bone regeneration of rat calvaria defects. BM-MSCs and AT-MSCs were isolated and characterized by expression of surface markers; cell viability was evaluated after injection through a 21G needle. Defects of 5 mm in diameter were created in calvaria and after two weeks a single injection of BM-MSCs, AT-MSCs or vehicle-PBS without cells (Control) was carried out. Cells were tracked by bioluminescence and at 4 weeks post-injection bone formation was evaluated by micro-computed tomography (μCT) and histology, nanoindentation, and through gene expression of bone remodeling markers. The data were evaluated by one-way analysis of variance (p≤0.05). BM-MSCs and AT-MSCs presented characteristics of mesenchymal stem cells, kept viability after passing through a 21G needle and remained in the defects until day 14. In general, injection of both BM-MSCs and AT-MSCs resulted in higher bone formation compared to Control. Additionally, this bone tissue displayed elastic modulus and hardness similar to the pristine calvaria bone. The expression of all evaluated genes involved in bone formation was upregulated in bone tissue formed by BM-MSCs compared to AT-MSCs while genes involved in bone resorption were upregulated in AT-MSCs-formed bone. We show that cell therapy based on the local injection of BM-MSCs or AT-MSCs is effective in delivering viable cells that displayed local engraftment and induced a significant improvement in bone healing. Despite differences in the molecular cues observed between BM-MSCs and AT-MSCs, both cells were capable of forming bone tissue at comparable amounts and properties. These findings may drive cell therapy approaches toward the complete bone regeneration of challenging sites.

Keywords: cell therapy, mesenchymal stem cells, bone repair, cell culture

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728 Possibilities and Prospects for the Development of the Agricultural Insurance Market (The Example of Georgia)

Authors: Nino Damenia

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The agricultural sector plays an important role in the development of Georgia's economy, it contributes to employment and food security. It faces various types of risks that may lead to heavy financial losses. Agricultural insurance is one of the means of combating agricultural risks. The paper discusses the agricultural insurance experience of those countries (European countries and the USA) that have successfully implemented the agricultural insurance program. Analysis of international cases shows that a well-designed and implemented agri-insurance system can bring significant benefits to farmers, insurance companies and the economy as a whole. In the background of all this, the Government of Georgia recognized the importance of agro-insurance and took important steps for its development. In 2014, in cooperation with insurance companies, an agro-insurance program was introduced, the purpose of which is to increase the availability of insurance for farmers and stimulate the agro-insurance market. Despite such a step forward, challenges remain such as awareness of farmers, insufficient infrastructure for data collection and risk assessment, involvement of insurance companies and other important factors. With the support of the government and stakeholders, it is possible to overcome the existing challenges and establish a strong and effective agro-insurance system. Objectives. The purpose of the research is to analyze the development trends of the agricultural insurance market, to identify the main factors affecting its growth, and to further develop recommendations for development prospects for Georgia. Methodologies. The research uses mixed methods, which combine qualitative and quantitative research techniques. The qualitative method includes the study of the literature of Georgian and foreign economists, which allows us to get acquainted with the challenges, opportunities, legislative and regulatory frameworks of agricultural insurance. Quantitative analysis involves collecting data from stakeholders and then analyzing it. The paper also uses the methods of synthesis, comparison and statistical analysis of the agricultural insurance market in Georgia, Europe and the USA. Conclusions. As the main results of the research, we can consider that the analysis of the insurance market has been made and its main functions have been identified; The essence, features and functions of agricultural insurance are analyzed; European and US agricultural insurance market is researched; The stages of formation and development of the agricultural insurance market of Georgia are studied, its importance for the agricultural sector of Georgia is determined; The role of the state for the development of agro-insurance is analyzed and development prospects are established based on the study of the current trends of the agro-insurance market of Georgia.

Keywords: agricultural insurance, agriculture, agricultural insurance program, risk

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727 Selecting the Best Risk Exposure to Assess Collision Risks in Container Terminals

Authors: Mohammad Ali Hasanzadeh, Thierry Van Elslander, Eddy Van De Voorde

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About 90 percent of world merchandise trade by volume being carried by sea. Maritime transport remains as back bone behind the international trade and globalization meanwhile all seaborne goods need using at least two ports as origin and destination. Amid seaborne traded cargos, container traffic is a prosperous market with about 16% in terms of volume. Albeit containerized cargos are less in terms of tonnage but, containers carry the highest value cargos amongst all. That is why efficient handling of containers in ports is very important. Accidents are the foremost causes that lead to port inefficiency and a surge in total transport cost. Having different port safety management systems (PSMS) in place, statistics on port accidents show that numerous accidents occur in ports. Some of them claim peoples’ life; others damage goods, vessels, port equipment and/or the environment. Several accident investigation illustrate that the most common accidents take place throughout transport operation, it sometimes accounts for 68.6% of all events, therefore providing a safer workplace depends on reducing collision risk. In order to quantify risks at the port area different variables can be used as exposure measurement. One of the main motives for defining and using exposure in studies related to infrastructure is to account for the differences in intensity of use, so as to make comparisons meaningful. In various researches related to handling containers in ports and intermodal terminals, different risk exposures and also the likelihood of each event have been selected. Vehicle collision within the port area (10-7 per kilometer of vehicle distance travelled) and dropping containers from cranes, forklift trucks, or rail mounted gantries (1 x 10-5 per lift) are some examples. According to the objective of the current research, three categories of accidents selected for collision risk assessment; fall of container during ship to shore operation, dropping container during transfer operation and collision between vehicles and objects within terminal area. Later on various consequences, exposure and probability identified for each accident. Hence, reducing collision risks profoundly rely on picking the right risk exposures and probability of selected accidents, to prevent collision accidents in container terminals and in the framework of risk calculations, such risk exposures and probabilities can be useful in assessing the effectiveness of safety programs in ports.

Keywords: container terminal, collision, seaborne trade, risk exposure, risk probability

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726 The Incidence of Maxillary Canine Ankylosis: A Single-Centre Analysis of 206 Canines Following Surgical Exposure and Orthodontic Alignment

Authors: Sidra Suleman, Maliha Suleman, Jinesh Shah

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Maxillary canines play a crucial role in occlusion and aesthetics. Successful management of impacted canines requires early identification and intervention to prevent complications such as resorption of adjacent teeth and cystic changes. Although removal of the deciduous canine can encourage normal eruption of its successor, this is not always successful. Some patients may require surgical exposure and bonding of a gold chain to mobilise and align the canine, which can take up to 3 years. As this procedure has various risks, patients need to be appropriately consented to. Failure of such treatment commonly occurs due to inadequate anchorage or failure of the gold chain attachment, but in some cases, this is due to ankylosis. Aim: The aim of this study was to determine the incidence of ankylosis of unerupted maxillary ectopic canines following surgical exposure and orthodontic alignment at the Maxillofacial and Orthodontic Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: Patients treated from January 1, 2017, to December 31, 2019, were retrospectively studied. Electronic records with post-treatment follow-up at 3-6 months and 12-15 months were extracted and analysed. Patients were excluded based on three criteria, non-compliance with orthodontic treatment post-surgery, presence of canine transposition, and external orthodontic treatment. Sample: Overall, 159 suitable patients were selected from the 171 patients identified. Surgical exposure and gold chain bonding was carried out for a total of 206 maxillary canines, with the pattern of impaction being 159 (77.2 %) palatal, 46 (22.3%) buccal, and 1 (0.49%) in line of the arch. The sample consisted of 57 (35.8%) males and 102 (64.2%) females between the age range of 10 to 32 years, with the mean age being 15 years. The procedures were carried out under general anaesthesia for all but three patients, with two cases being repeats. Closed exposure was carried out for 189 (91.7%) canines. Results: The incidence of ankylosis from this study was 0.97%. In total, two patients had upper left canine ankylosis, which was identified at their 12-15 months orthodontic follow-up. Both patients were males, one having closed exposure at age 15 and the other having open exposure at age 19. Conclusions: Although this data shows that there is a low risk of ankylosis (0.97%), it highlights the difficulty in predicting which patients may be affected, and thus, a thorough pre-treatment assessment and careful observation during treatment is necessary. Future studies involving larger cohorts are warranted to further analyse factors affecting outcomes.

Keywords: ankylosis, ectopic, maxillary canines, orthodontics

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725 Carbapenem Usage in Medical Wards: An Antibiotic Stewardship Feedback Project

Authors: Choon Seong Ng, P. Petrick, C. L. Lau

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Background: Carbapenem-resistant isolates have been increasingly reported recently. Carbapenem stewardship is designed to optimize its usage particularly among medical wards with high prevalence of carbapenem prescriptions to combat such emerging resistance. Carbapenem stewardship programmes (CSP) can reduce antibiotic use but clinical outcome of such measures needs further evaluation. We examined this in a prospective manner using feedback mechanism. Methods: Our single-center prospective cohort study involved all carbapenem prescriptions across the medical wards (including medical patients admitted to intensive care unit) in a tertiary university hospital setting. The impact of such stewardship was analysed according to the accepted and the rejected groups. The primary endpoint was safety. Safety measure applied in this study was the death at 1 month. Secondary endpoints included length of hospitalisation and readmission. Results: Over the 19 months’ period, input from 144 carbapenem prescriptions was analysed on the basis of acceptance of our CSP recommendations on the use of carbapenems. Recommendations made were as follows : de-escalation of carbapenem; stopping the carbapenem; use for a short duration of 5-7 days; required prolonged duration in the case of carbapenem-sensitive Extended Spectrum Beta-Lactamases bacteremia; dose adjustment; and surgical intervention for removal of septic foci. De-escalation, shorten duration of carbapenem and carbapenem cessation comprised 79% of the recommendations. Acceptance rate was 57%. Those who accepted CSP recommendations had no increase in mortality (p = 0.92), had a shorter length of hospital stay (LOS) and had cost-saving. Infection-related deaths were found to be higher among those in the rejected group. Moreover, three rejected cases (6%) among all non-indicated cases (n = 50) were found to have developed carbapenem-resistant isolates. Lastly, Pitt’s bacteremia score appeared to be a key element affecting the carbapenem prescription’s behaviour in this trial. Conclusions: Carbapenem stewardship program in the medical wards not only saves money, but most importantly it is safe and does not harm the patients with added benefits of reducing the length of hospital stay. However, more time is needed to engage the primary clinical teams by formal clinical presentation and immediate personal feedback by senior Infectious Disease (ID) personnel to increase its acceptance.

Keywords: audit and feedback, carbapenem stewardship, medical wards, university hospital

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724 Value Generation of Construction and Demolition Waste Originated in the Building Rehabilitation to Improve Energy Efficiency; From Waste to Resources

Authors: Mercedes Del Rio Merino, Jaime Santacruz Astorqui, Paola Villoria Saez, Carmen Viñas Arrebola

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The lack of treatment of the waste from construction and demolition waste (CDW) is a problem that must be solved immediately. It is estimated that in the world not to use CDW generates an increase in the use of new materials close to 20% of the total value of the materials used. The problem is even greater in case these wastes are considered hazardous because the final deposition of them may also generate significant contamination. Therefore, the possibility of including CDW in the manufacturing of building materials, represents an interesting alternative to ensure their use and to reduce their possible risk. In this context and in the last years, many researches are being carried out in order to analyze the viability of using CDW as a substitute for the traditional raw material of high environmental impact. Even though it is true, much remains to be done, because these works generally characterize materials but not specific applications that allow the agents of the construction to have the guarantees required by the projects. Therefore, it is necessary the involvement of all the actors included in the life cycle of these new construction materials, and also to promote its use for, for example, definition of standards, tax advantages or market intervention is necessary. This paper presents the main findings reached in "Waste to resources (W2R)" project since it began in October 2014. The main goal of the project is to develop new materials, elements and construction systems, manufactured from CDW, to be used in improving the energy efficiency of buildings. Other objectives of the project are: to quantify the CDW generated in the energy rehabilitation works, specifically wastes from the building envelope; and to study the traceability of CDW generated and promote CDW reuse and recycle in order to get close to the life cycle of buildings, generating zero waste and reducing the ecological footprint of the construction sector. This paper determines the most important aspects to consider during the design of new constructive solutions, which improve the energy efficiency of buildings and what materials made with CDW would be the most suitable for that. Also, a survey to select best practices for reducing "close to zero waste" in refurbishment was done. Finally, several pilot rehabilitation works conform the parameters analyzed in the project were selected, in order to apply the results and thus compare the theoretical with reality. Acknowledgements: This research was supported by the Spanish State Secretariat for Research, Development and Innovation of the Ministry of Economy and Competitiveness under "Waste 2 Resources" Project (BIA2013-43061-R).

Keywords: building waste, construction and demolition waste, recycling, resources

Procedia PDF Downloads 232
723 Domestic Violence against Women and the Nutritional Status of Their Under-5 Children: A Cross Sectional Survey in Urban Slums of Chittagong, Bangladesh

Authors: Mohiuddin Ahsanul Kabir Chowdhury, Ahmed Ehsanur Rahman, Nazia Binte Ali, Abdullah Nurus Salam Khan, Afrin Iqbal, Mohammad Mehedi Hasan, Salma Morium, Afsana Bhuiyan, Shams El Arifeen

Abstract:

Violence against women has been treated as a global epidemic which is as fatal as any serious disease or accidents. Like many other low-income countries it is also common in Bangladesh. In spite of existence of a few documented evidences in some other countries, in Bangladesh, domestic violence against women (DVAW) is not considered as a factor for malnutrition in children yet. Hence, the aim of the study was to investigate the association between DVAW and the nutritional status of their under-5 children in the context of slum areas of Chittagong, Bangladesh. A Cross-sectional survey was conducted among 87 women of reproductive age having at least one child under-5 years of age and staying with husband for at least last 1 year in selected slums under Chittagong City Corporation area. Data collection tools were structured questionnaire for the study participants and mid-upper arm circumference (MUAC) to measure the nutritional status of the under-5 children. The data underwent descriptive and regression analysis. Out of 87 respondents, 50 (57.5%) reported to suffer from domestic violence by their husband during last one year. Physical violence was found to be significantly associated with age (p=0.02), age at marriage (p=0.043), wealth score (p=0.000), and with knowledge regarding law (p=0.017). According to the measurement of mid-upper arm circumference (MUAC) 21% children were suffering from severe acute malnutrition (SAM) and the same percentage of children were suffering from moderate acute malnutrition (MAM). However, unadjusted odds ratio suggested that there was negative association with domestic violence and nutritional status. But, the logistic regression confounding for other variable showed significant association with total family income (p=0.006), wealth score (p=0.031), age at marriage (p=0.029) and number of child (p=0.006). Domestic violence against women and under nutrition of the children, both are highly prevalent in Bangladesh. More extensive research should be performed to identify the factors contributing to the high prevalence of domestic violence and malnutrition in urban slums of Bangladesh. Household-based intervention is needed to limit this burning problem. In a nutshell, effective community participation, education and counseling are essential to create awareness among the community.

Keywords: Bangladesh, cross sectional survey, domestic violence against women, nutritional status, under-5 children, urban slums

Procedia PDF Downloads 172
722 The Influence of Destination Image on Tourists' Experience at Osun Osogbo World Heritage Site

Authors: Bola Adeleke, Kayode Ogunsusi

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Heritage sites have evolved to preserve culture and heritage and also to educate and entertain tourists. Tourist travel decisions and behavior are influenced by destination image and value of the experience of tourists. Perceived value is one of the important tools for securing a competitive edge in tourism destinations. The model of Ritchie and Crouch distinguished 36 attributes of competitiveness which are classified into five factors which are quality of experience, touristic attractiveness, environment and infrastructure, entertainment/outdoor activities and cultural traditions. The study extended this model with a different grouping of the determinants of destination competitiveness. The theoretical framework used for this study assumes that apart from attractions already situated in the grove, satisfaction with destination common service, and entertainment and events, can all be used in creating a positive image for/and in attracting customers (destination selection) to visit Osun Sacred Osogbo Grove during and after annual celebrations. All these will impact positively on travel experience of customers as well as their spiritual fulfillment. Destination image has a direct impact on tourists’ satisfaction which consequently impacts on tourists’ likely future behavior on whether to revisit a cultural destination or not. The study investigated the variables responsible for destination image competitiveness of the Heritage Site; assessed the factors enhancing the destination image; and evaluated the perceived value realized by tourists from their cultural experience at the grove. A complete enumeration of tourists above 18 years of age who visited the Heritage Site within the month of March and April 2017 was taken. 240 respondents, therefore, were used for the study. The structured questionnaire with 5 Likert scales was administered. Five factors comprising 63 variables were used to determine the destination image competitiveness through principal component analysis, while multiple regressions were used to evaluate perceived value of tourists at the grove. Results revealed that 11 out of the 12 variables determining the destination image competitiveness were significant in attracting tourists to the grove. From the R-value, all factors predicted tourists’ value of experience strongly (R= 0.936). The percentage variance of customer value was explained by 87.70% of the variance of destination common service, entertainment and event satisfaction, travel environment satisfaction and spiritual satisfaction, with F-value being significant at 0.00. Factors with high alpha value contributed greatly to adding value to enhancing destination and tourists’ experience. 11 variables positively predicted tourist value with significance. Managers of Osun World Heritage Site should improve on variables critical to adding values to tourists’ experience.

Keywords: competitiveness, destination image, Osun Osogbo world heritage site, tourists

Procedia PDF Downloads 168
721 Public Procurement and Innovation: A Municipal Approach

Authors: M. Moso-Diez, J. L. Moragues-Oregi, K. Simon-Elorz

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Innovation procurement is designed to steer the development of solutions towards concrete public sector needs as a driver for innovation from the demand side (in public services as well as in market opportunities for companies), is horizontally emerging as a new policy instrument. In 2014 the new EU public procurement directives 2014/24/EC and 2014/25/EC reinforced the support for Public Procurement for Innovation, dedicating funding instruments that can be used across all areas supported by Horizon 2020, and targeting potential buyers of innovative solutions: groups of public procurers with similar needs. Under this programme, new policy adapters and networks emerge, aiming to embed innovation criteria into new procurement processes. As these initiatives are in process, research related to is scarce. We argue that Innovation Public Procurement can arise as an innovative policy instrument to public procurement in different policy domains, in spite of existing institutional and cultural barriers (legal guarantee versus innovation). The presentation combines insights from public procurement to supply management chain management in a sustainability and innovation policy arena, as a means of providing understanding of: (1) the circumstances that emerge; (2) the relationship between public and private actors; and (3) the emerging capacities in the definition of the agenda. The policy adopters are the contracting authorities that mainly are at municipal level where they interact with the supply management chain, interconnecting sustainability and climate measures with other policy priorities such as innovation and urban planning; and through the Competitive Dialogue procedure. We found that geography and territory affect both the level of municipal budget (due to municipal income per capita) and its institutional competencies (due to demographic reasons). In spite of the relevance of institutional determinants for public procurement, other factors play an important role such as human factors as well as both public policy and private intervention. The experience is a ‘city project’ (Bilbao) in the field of brownfield decontamination. Brownfield sites typically refer to abandoned or underused industrial and commercial properties—such as old process plants, mining sites, and landfills—that are available but contain low levels of environmental contaminants that may complicate reuse or redevelopment of the land. This article concludes that Innovation Public Procurement in sustainability and climate issues should be further developed both as a policy instrument and as a policy research line that could enable further relevant changes in public procurement as well as in climate innovation.

Keywords: innovation, city projects, public policy, public procurement

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720 Human Insecurity and Migration in the Horn of Africa: Causes and Decision Processes

Authors: Belachew Gebrewold

Abstract:

The Horn of Africa is marred by complex and systematic internal and external political, economic and social-cultural causes of conflict that result in internal displacement and migration. This paper engages with them and shows how such a study can help us to understand migration, both in this region and more generally. The conflict has occurred within states, between states, among proxies, between armies. Human insecurities as a result of the state collapse of Somalia, the rise of Islamic fundamentalism in the whole region, recurrent drought affecting the livelihoods of subsistence farmers as well as nomads, exposure to hunger, environmental degradation, youth unemployment, rapid growth of slums around big cities, and political repression (especially in Eritrea) have been driving various segments of the regional population into regional and international migration. Eritrea has been going through a brutal dictatorship which pushes many Eritreans to flee their country and be exposed to human trafficking, torture, detention, and agony on their way to Europe mainly through Egypt, Libya and Israel. Similarly, Somalia has been devastated since 1991 by unending civil war, state collapse, and radical Islamists. There are some important aspects to highlight in the conflict-migration nexus in the Horn of Africa: first, the main push factor for the Somalis and Eritreans to leave their countries and risk their lives is the physical insecurity they have been facing in their countries. Secondly, as a result of the conflict the economic infrastructure is massively destroyed. Investment is rare; job opportunities are out of sight. Thirdly, in such a grim situation the politically and economically induced decision to migrate is a household decision, not only an individual decision. Based on this third point this research study took place in the Horn of Africa between 2014 and 2016 during different occasions. The main objective of the research was to understanding how the increasing migration is affecting the socio-economic and socio-political environment, and conversely how the socio-economic and socio-political environments are increasing migration decisions; and whether and how these decisions are individual or family decisions. The main finding is the higher the human insecurity, the higher the family decision; the lower the human insecurity, the higher the individual decision. These findings apply not only to the Eritrean, Somali migrants but also to Ethiopian migrants. But the general impacts of migration on sending countries’ human security is quite mixed and complex.

Keywords: Eritrea, Ethiopia, Horn of Africa, insecurity, migration, Somalia

Procedia PDF Downloads 260
719 Utilization of Rice Husk Ash with Clay to Produce Lightweight Coarse Aggregates for Concrete

Authors: Shegufta Zahan, Muhammad A. Zahin, Muhammad M. Hossain, Raquib Ahsan

Abstract:

Rice Husk Ash (RHA) is one of the agricultural waste byproducts available widely in the world and contains a large amount of silica. In Bangladesh, stones cannot be used as coarse aggregate in infrastructure works as they are not available and need to be imported from abroad. As a result, bricks are mostly used as coarse aggregates in concrete as they are cheaper and easily produced here. Clay is the raw material for producing brick. Due to rapid urban growth and the industrial revolution, demand for brick is increasing, which led to a decrease in the topsoil. This study aims to produce lightweight block aggregates with sufficient strength utilizing RHA at low cost and use them as an ingredient of concrete. RHA, because of its pozzolanic behavior, can be utilized to produce better quality block aggregates at lower cost, replacing clay content in the bricks. The whole study can be divided into three parts. In the first part, characterization tests on RHA and clay were performed to determine their properties. Six different types of RHA from different mills were characterized by XRD and SEM analysis. Their fineness was determined by conducting a fineness test. The result of XRD confirmed the amorphous state of RHA. The characterization test for clay identifies the sample as “silty clay” with a specific gravity of 2.59 and 14% optimum moisture content. In the second part, blocks were produced with six different types of RHA with different combinations by volume with clay. Then mixtures were manually compacted in molds before subjecting them to oven drying at 120 °C for 7 days. After that, dried blocks were placed in a furnace at 1200 °C to produce ultimate blocks. Loss on ignition test, apparent density test, crushing strength test, efflorescence test, and absorption test were conducted on the blocks to compare their performance with the bricks. For 40% of RHA, the crushing strength result was found 60 MPa, where crushing strength for brick was observed 48.1 MPa. In the third part, the crushed blocks were used as coarse aggregate in concrete cylinders and compared them with brick concrete cylinders. Specimens were cured for 7 days and 28 days. The highest compressive strength of block cylinders for 7 days curing was calculated as 26.1 MPa, whereas, for 28 days curing, it was found 34 MPa. On the other hand, for brick cylinders, the value of compressing strength of 7 days and 28 days curing was observed as 20 MPa and 30 MPa, respectively. These research findings can help with the increasing demand for topsoil of the earth, and also turn a waste product into a valuable one.

Keywords: characterization, furnace, pozzolanic behavior, rice husk ash

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718 Site Suitability of Offshore Wind Energy: A Combination of Geographic Referenced Information and Analytic Hierarchy Process

Authors: Ayat-Allah Bouramdane

Abstract:

Power generation from offshore wind energy does not emit carbon dioxide or other air pollutants and therefore play a role in reducing greenhouse gas emissions from the energy sector. In addition, these systems are considered more efficient than onshore wind farms, as they generate electricity from the wind blowing across the sea, thanks to the higher wind speed and greater consistency in direction due to the lack of physical interference that the land or human-made objects can present. This means offshore installations require fewer turbines to produce the same amount of energy as onshore wind farms. However, offshore wind farms require more complex infrastructure to support them and, as a result, are more expensive to construct. In addition, higher wind speeds, strong seas, and accessibility issues makes offshore wind farms more challenging to maintain. This study uses a combination of Geographic Referenced Information (GRI) and Analytic Hierarchy Process (AHP) to identify the most suitable sites for offshore wind farm development in Morocco, with a particular focus on the Dakhla city. A range of environmental, socio-economic, and technical criteria are taken into account to solve this complex Multi-Criteria Decision-Making (MCDM) problem. Based on experts' knowledge, a pairwise comparison matrix at each level of the hierarchy is performed, and fourteen sub-criteria belong to the main criteria have been weighted to generate the site suitability of offshore wind plants and obtain an in-depth knowledge on unsuitable areas, and areas with low-, moderate-, high- and very high suitability. We find that wind speed is the most decisive criteria in offshore wind farm development, followed by bathymetry, while proximity to facilities, the sediment thickness, and the remaining parameters show much lower weightings rendering technical parameters most decisive in offshore wind farm development projects. We also discuss the potential of other marine renewable energy potential, in Morocco, such as wave and tidal energy. The proposed approach and analysis can help decision-makers and can be applied to other countries in order to support the site selection process of offshore wind farms.

Keywords: analytic hierarchy process, dakhla, geographic referenced information, morocco, multi-criteria decision-making, offshore wind, site suitability

Procedia PDF Downloads 132
717 Evidence-Based Practices in Education: A General Review of the Literature on Elementary Classroom Setting

Authors: Carolina S. Correia, Thalita V. Thomé, Andersen Boniolo, Dhayana I. Veiga

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Evidence-based practices (EBP) in education is a set of principles and practices used to raise educational policy, it involves the integration of professional expertise in education with the best empirical evidence in making decisions about how to deliver instruction. The purpose of this presentation is to describe and characterize studies about EBP in education in elementary classroom setting. Data here presented is part of an ongoing systematic review research. Articles were searched and selected from four academic databases: ProQuest, Scielo, Science Direct and Capes. The search terms were evidence-based practices or program effectiveness, and education or teaching or teaching practices or teaching methods. Articles were included according to the following criteria: The studies were explicitly described as evidence-based or discussed the most effective practices in education, they discussed teaching practices in classroom context in elementary school level. Document excerpts were extracted and recorded in Excel, organized by reference, descriptors, abstract, purpose, setting, participants, type of teaching practice, study design and main results. The total amount of articles selected were 1.185, 569 articles from Proquest Research Library; 216 from CAPES; 251 from ScienceDirect and 149 from Scielo Library. The potentially relevant references were 178, from which duplicates were removed. The final number of articles analyzed was 140. From 140 articles, are 47 theoretical studies and 93 empirical articles. The following research design methods were identified: longitudinal intervention study, cluster-randomized trial, meta-analysis and pretest-posttest studies. From 140 articles, 103 studies were about regular school teaching and 37 were on special education teaching practices. In several studies, used as teaching method: active learning, content acquisition podcast (CAP), precision teaching (PT), mediated reading practice, speech therapist programs and peer-assisted learning strategies (PALS). The countries of origin of the studies were United States of America, United Kingdom, Panama, Sweden, Scotland, South Korea, Argentina, Chile, New Zealand and Brunei. The present study in is an ongoing project, so some representative findings will be discussed, providing further acknowledgment on the best teaching practices in elementary classroom setting.

Keywords: best practices, children, evidence-based education, elementary school, teaching methods

Procedia PDF Downloads 317
716 Evaluate Existing Mental Health Intervention Programs Tailored for International Students in China

Authors: Nargiza Nuralieva

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This meta-analysis investigates the effectiveness of mental health interventions tailored for international students in China, with a specific focus on Uzbek students and Silk Road scholarship recipients. The comprehensive literature review synthesizes existing studies, papers, and reports, evaluating the outcomes, limitations, and cultural considerations of these programs. Data selection targets mental health programs for international students, honing in on a subset analysis related to Uzbek students and Silk Road scholarship recipients. The analysis encompasses diverse outcome measures, such as reported stress levels, utilization rates of mental health services, academic performance, and more. Results reveal a consistent and statistically significant reduction in reported stress levels, emphasizing the positive impact of these interventions. Utilization rates of mental health services witness a significant increase, highlighting the accessibility and effectiveness of support. Retention rates show marked improvement, though academic performance yields mixed findings, prompting nuanced exploration. Psychological well-being, quality of life, and overall well-being exhibit substantial enhancements, aligning with the overarching goal of holistic student development. Positive outcomes are observed in increased help-seeking behavior, positive correlations with social support, and significant reductions in anxiety levels. Cultural adaptation and satisfaction with interventions both indicate positive outcomes, underscoring the effectiveness of culturally sensitive mental health support. The findings emphasize the importance of tailored mental health interventions for international students, providing novel insights into the specific needs of Uzbek students and Silk Road scholarship recipients. This research contributes to a nuanced understanding of the multifaceted impact of mental health programs on diverse student populations, offering valuable implications for the design and refinement of future interventions. As educational institutions continue to globalize, addressing the mental health needs of international students remains pivotal for fostering inclusive and supportive learning environments.

Keywords: international students, mental health interventions, cross-cultural support, silk road scholarship, meta-analysis

Procedia PDF Downloads 35
715 Six Years Antimicrobial Resistance Trends among Bacterial Isolates in Amhara National Regional State, Ethiopia

Authors: Asrat Agalu Abejew

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Background: Antimicrobial resistance (AMR) is a silent tsunami and one of the top global threats to health care and public health. It is one of the common agendas globally and in Ethiopia. Emerging AMR will be a double burden to Ethiopia, which is facing a series of problems from infectious disease morbidity and mortality. In Ethiopia, although there are attempts to document AMR in healthcare institutions, comprehensive and all-inclusive analysis is still lacking. Thus, this study is aimed to determine trends in AMR from 2016-2021. Methods: A retrospective analysis of secondary data recorded in the Amhara Public Health Institute (APHI) from 2016 to 2021 G.C was conducted. Blood, Urine, Stool, Swabs, Discharge, body effusions, and other Microbiological specimens were collected from each study participants, and Bacteria identification and Resistance tests were done using the standard microbiologic procedure. Data was extracted from excel in August 2022, Trends in AMR were analyzed, and the results were described. In addition, the chi-square (X2) test and binary logistic regression were used, and a P. value < 0.05 was used to determine a significant association. Results: During 6 years period, there were 25143 culture and susceptibility tests. Overall, 265 (46.2%) bacteria were resistant to 2-4 antibiotics, 253 (44.2%) to 5-7 antibiotics, and 56 (9.7%) to >=8 antibiotics. The gram-negative bacteria were 166 (43.9%), 155 (41.5%), and 55 (14.6%) resistant to 2-4, 5-7, and ≥8 antibiotics, respectively, whereas 99(50.8%), 96(49.2% and 1 (0.5%) of gram-positive bacteria were resistant to 2-4, 5-7 and ≥8 antibiotics respectively. K. pneumonia 3783 (15.67%) and E. coli 3199 (13.25%) were the most commonly isolated bacteria, and the overall prevalence of AMR was 2605 (59.9%), where K. pneumonia 743 (80.24%), E. cloacae 196 (74.81%), A. baumannii 213 (66.56%) being the most common resistant bacteria for antibiotics tested. Except for a slight decline during 2020 (6469 (25.4%)), the overall trend of AMR is rising from year to year, with a peak in 2019 (8480 (33.7%)) and in 2021 (7508 (29.9%). If left un-intervened, the trend in AMR will increase by 78% of variation from the study period, as explained by the differences in years (R2=0.7799). Ampicillin, Augmentin, ciprofloxacin, cotrimoxazole, tetracycline, and Tobramycin were almost resistant to common bacteria they were tested. Conclusion: AMR is linearly increasing during the last 6 years. If left as it is without appropriate intervention after 15 years (2030 E.C), AMR will increase by 338.7%. A growing number of multi-drug resistant bacteria is an alarm to awake policymakers and those who do have the concern to intervene before it is too late. This calls for a periodic, integrated, and continuous system to determine the prevalence of AMR in commonly used antibiotics.

Keywords: AMR, trend, pattern, MDR

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714 Impacts of Public Insurance on Health Access and Outcomes: Evidence from India

Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

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713 Evaluation of the Quality of Education Offered to Students with Special Needs in Public Schools in the City of Bauru, Brazil

Authors: V. L. M. F. Capellini, A. P. P. M. Maturana, N. C. M. Brondino, M. B. C. L. B. M. Peixoto, A. J. Broughton

Abstract:

A paradigm shift is a process. The process of implementing inclusive education, a system constructed to support all learners, requires planning, identification, experimentation, and evaluation. In this vein, the purpose of the present study was to evaluate the capacity of one Brazilian state school systems to provide special education students with a quality inclusive education. This study originated at the behest of concerned families of students with special needs who filed complaints with the Municipality of Bauru, São Paulo. These families claimed, 1) children with learning differences and educational needs had not been identified for services, and 2) those who had been identified had not received sufficient specialized educational assistance (SEA) in schools across the City of Bauru. Hence, the Office of Civil Rights for the state of São Paulo (Ministério Público de São Paulo) summoned the local higher education institution, UNESP, to design a research study to investigate these allegations. In this exploratory study, descriptive data were gathered from all elementary and middle schools including 58 state schools and 17 city schools, for a total of 75 schools overall. Data collection consisted of each school's annual strategic action plan, surveys and interviews with all school stakeholders to determine their perceptions of the inclusive education available to students with Special Education Needs (SEN). The data were collected as one of four stages in a larger study which also included field observations of a focal students' experience and a continuing education course for all teachers and administrators in both state and city schools. For the purposes of this study, the researchers were interested in understanding the perceptions of school staff, parents, and students across all schools. Therefore, documents and surveys from 75 schools were analyzed for adherence to federal legislation guaranteeing students with SEN the right to special education assistance within the regular school setting. Results shows that while some schools recognized the legal rights of SEN students to receive special education, the plans to actually deliver services were absent. In conclusion, the results of this study revealed both school staff and families have insufficient planning and accessibility resources, and the schools have inadequate infrastructure for full-time support to SEN students, i.e., structures and systems to support the identification of SEN and delivery of services within schools of Bauru, SP. Having identified the areas of need, the city is now prepared to take next steps in the process toward preparing all schools to be inclusive.

Keywords: inclusion, school, special education, special needs

Procedia PDF Downloads 146
712 Evaluating Social Sustainability in Historical City Center in Turkey: Case Study of Bursa

Authors: Şeyda Akçalı

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This study explores the concept of social sustainability and its characteristics in terms of neighborhood (mahalle) which is a social phenomenon in Turkish urban life. As social sustainability indicators that moving away traditional themes toward multi-dimensional measures, the solutions for urban strategies may be achieved through learning lessons from historical precedents. It considers the inherent values of traditional urban forms contribute to the evolution of the city as well as the social functions of it. The study aims to measure non-tangible issues in order to evaluate social sustainability in historic urban environments and how they could contribute to the current urban planning strategies. The concept of neighborhood (mahalle) refers to a way of living that represents the organization of Turkish social and communal life rather than defining an administrative unit for the city. The distinctive physical and social features of neighborhood illustrate the link between social sustainability and historic urban environment. Instead of having a nostalgic view of past, it identifies both the failures and successes and extract lessons of traditional urban environments and adopt them to modern context. First, the study determines the aspects of social sustainability which are issued as the key themes in the literature. Then, it develops a model by describing the social features of mahalle which show consistency within the social sustainability agenda. The model is used to analyze the performance of traditional housing area in the historical city center of Bursa, Turkey whether it meets the residents’ social needs and contribute collective functioning of the community. Through a questionnaire survey exercised in the historic neighborhoods, the residents are evaluated according to social sustainability criteria of neighborhood. The results derived from the factor analysis indicate that social aspects of neighborhood are social infrastructure, identity, attachment, neighborliness, safety and wellbeing. Qualitative evaluation shows the relationship between key aspects of social sustainability and demographic and socio-economic factors. The outcomes support that inherent values of neighborhood retain its importance for the sustainability of community although there must be some local arrangements for few factors with great attention not to compromise the others. The concept of neighborhood should be considered as a potential tool to support social sustainability in national political agenda and urban policies. The performance of underlying factors in historic urban environment proposes a basis for both examining and improving traditional urban areas and how it may contribute to the overall city.

Keywords: historical city center, mahalle, neighborhood, social sustainability, traditional urban environment, Turkey

Procedia PDF Downloads 269
711 A Cognitive Training Program in Learning Disability: A Program Evaluation and Follow-Up Study

Authors: Krisztina Bohacs, Klaudia Markus

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To author’s best knowledge we are in absence of studies on cognitive program evaluation and we are certainly short of programs that prove to have high effect sizes with strong retention results. The purpose of our study was to investigate the effectiveness of a comprehensive cognitive training program, namely BrainRx. This cognitive rehabilitation program target and remediate seven core cognitive skills and related systems of sub-skills through repeated engagement in game-like mental procedures delivered one-on-one by a clinician, supplemented by digital training. A larger sample of children with learning disability were given pretest and post-test cognitive assessments. The experimental group completed a twenty-week cognitive training program in a BrainRx center. A matched control group received another twenty-week intervention with Feuerstein’s Instrumental Enrichment programs. A second matched control group did not receive training. As for pre- and post-test, we used a general intelligence test to assess IQ and a computer-based test battery for assessing cognition across the lifespan. Multiple regression analyses indicated that the experimental BrainRx treatment group had statistically significant higher outcomes in attention, working memory, processing speed, logic and reasoning, auditory processing, visual processing and long-term memory compared to the non-treatment control group with very large effect sizes. With the exception of logic and reasoning, the BrainRx treatment group realized significantly greater gains in six of the above given seven cognitive measures compared to the Feuerstein control group. Our one-year retention measures showed that all the cognitive training gains were above ninety percent with the greatest retention skills in visual processing, auditory processing, logic, and reasoning. The BrainRx program may be an effective tool to establish long-term cognitive changes in case of students with learning disabilities. Recommendations are made for treatment centers and special education institutions on the cognitive training of students with special needs. The importance of our study is that targeted, systematic, progressively loaded and intensive brain training approach may significantly change learning disabilities.

Keywords: cognitive rehabilitation training, cognitive skills, learning disability, permanent structural cognitive changes

Procedia PDF Downloads 185
710 Feasibility of Online Health Coaching for Canadian Armed Forces Personnel Receiving Treatment for Depression, Anxiety and PTSD

Authors: Noah Wayne, Andrea Tuka, Adrian Norbash, Bryan Garber, Paul Ritvo

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Program/Intervention Description: The Canadian Armed Forces(CAF) Mental Health Clinicstreat a full spectrum of mental disorder, addictions, and psychosocial issues that include Major Depressive Disorder, Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, and other diagnoses. We evaluated the feasibility of an online health coach interventiondelivering mindfulness based cognitive behavioral therapy (M-CBT) and behaviour changesupport for individuals receiving treatment at CAF Clinics. Participants were provided accounts on NexJ Connected Wellness, a digital health platform, and 16 weeks of phone-based health coaching,emphasizingmild to moderate aerobic exercise, a healthy diet, and M-CBT content. The primary objective was to assess the feasibility of the online deliverywith CAF members. Evaluation Methods: Feasibility was evaluated in terms of recruitment, engagement, and program satisfaction. Weadditionallyevaluatedhealth behavior change, program completion, and mental health symptoms (i.e. PHQ-9, GAD-7, PCL-5) at three time points. Results: Service members were referred from Vancouver, Esquimalt, and Edmonton CAF bases between August 2020 and January 2021. N=106 CAF personnel were referred, and n=77 consented.N=66 participated, and n=44 completed 4-month and follow-up measures. The platform received a mean rating of76.5 on the System Usability Scale, and health coaching was judged the most helpful program feature (95.2% endorsement), while reminders (53.7%), secure messaging (51.2%), and notifications (51.2%) were also identified. Improvements in mental health status during active interventions were observed on the PHQ-9 (-5.4, p<0.001), GAD-7 (-4.0, p<0.001), and PCL-5 (-4.1, p<0.05). Conclusion: Online health coaching was well-received amidst the COVID-19 pandemic and related lockdowns. Uptake and engagement were positively reported. Participants valuedcontacts and reported strong therapeutic alliances with coaches. Healthy diet, regular exercise, and mindfulness practice are important for physical and mental health. Engagements in these behaviors are associated with reduced symptoms. An online health coach program appears feasible for assisting Canadian Armed Forces personnel.

Keywords: coaching, CBT, military, depression, mental health, digital

Procedia PDF Downloads 140
709 Technical and Economic Potential of Partial Electrification of Railway Lines

Authors: Rafael Martins Manzano Silva, Jean-Francois Tremong

Abstract:

Electrification of railway lines allows to increase speed, power, capacity and energetic efficiency of rolling stocks. However, this process of electrification is complex and costly. An electrification project is not just about design of catenary. It also includes installation of structures around electrification, as substation installation, electrical isolation, signalling, telecommunication and civil engineering structures. France has more than 30,000 km of railways, whose only 53% are electrified. The others 47% of railways use diesel locomotive and represent only 10% of the circulation (tons.km). For this reason, a new type of electrification, less expensive than the usual, is requested to enable the modernization of these railways. One solution could be the use of hybrids trains. This technology opens up new opportunities for less expensive infrastructure development such as the partial electrification of railway lines. In a partially electrified railway, the power supply of theses hybrid trains could be made either by the catenary or by the on-board energy storage system (ESS). Thus, the on-board ESS would feed the energetic needs of the train along the non-electrified zones while in electrified zones, the catenary would feed the train and recharge the on-board ESS. This paper’s objective deals with the technical and economic potential identification of partial electrification of railway lines. This study provides different scenarios of electrification by replacing the most expensive places to electrify using on-board ESS. The target is to reduce the cost of new electrification projects, i.e. reduce the cost of electrification infrastructures while not increasing the cost of rolling stocks. In this study, scenarios are constructed in function of the electrification’s cost of each structure. The electrification’s cost varies considerably because of the installation of catenary support in tunnels, bridges and viaducts is much more expensive than in others zones of the railway. These scenarios will be used to describe the power supply system and to choose between the catenary and the on-board energy storage depending on the position of the train on the railway. To identify the influence of each partial electrification scenario in the sizing of the on-board ESS, a model of the railway line and of the rolling stock is developed for a real case. This real case concerns a railway line located in the south of France. The energy consumption and the power demanded at each point of the line for each power supply (catenary or on-board ESS) are provided at the end of the simulation. Finally, the cost of a partial electrification is obtained by adding the civil engineering costs of the zones to be electrified plus the cost of the on-board ESS. The study of the technical and economic potential ends with the identification of the most economically interesting scenario of electrification.

Keywords: electrification, hybrid, railway, storage

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