Search results for: healthcare access

Authors: Vivian Polak, Lena Verdeli, Wendy Lou, Caroline Lovett

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Postnatal depression (PND) is a common complication of childbirth that increases the risk of future depressive episodes in women, postpartum depression in partners, as well as social, emotional, behavioural, language, and cognitive problems in offspring. Although psychotherapy, and in particular Group Interpersonal Psychotherapy (IPT-G), has been proven effective in treating PND, it remains largely inaccessible. However, research has indicated that online synchronous group therapy can be equally as effective as in-person therapy and is a more affordable and accessible modality of treatment. This study aimed to ascertain whether delivering IPT-G virtually when compared to treatment as usual, could more effectively reduce depressive and anxiety symptoms, enhance mother-infant attachment, improve the couple relationship, augment social support, improve overall functioning, and enhance the quality of life for women in rural and northern Ontario who are suffering from PND. By bridging the gap in access to mental health services during the postpartum period, this study seeks to improve the well-being of mothers and their families in rural and northern Ontario, Canada. A randomized controlled trial was conducted to determine whether virtual IPT-G plus treatment as usual would be more effective than treatment as usual alone in treating women with PND in Ontario, Canada. Preliminary results indicate that women who received virtual IPT-G had a clinically and statistically significant decrease in overall depressive symptoms compared to their counterparts who received only the treatment as usual. As such, providing online synchronous IPT-G in the perinatal period not only has the potential to improve women's outcomes in the present but also to decrease future health costs, reduce the burden on the educational and justice systems, and decrease the number of disability life years lost to postnatal depression.

Keywords: family wellbeing, group psychotherapy, interpersonal psychotherapy, postnatal depression, virtual psychotherapy

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Authors: Azzi Mohammed Amin

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Summary: This note aims to demonstrate the impact that comes out of electronic commerce to improve the quality of banking services and to answer the questions raised in the problem; it also aims to find out the methods applied in the banks to improve the quality of banking. And it identified a conceptual framework for electronic commerce and electronic banking. In addition, the inclusion of case study includes the Algerian Popular Credit Bank to measure the impact of electronic commerce on the quality of banking services. Has been focusing on electronic banking services as a field of modern knowledge, including fields characterized by high module in content and content, where banking management concluded that the service and style of electronic submission is the only area to compete and improve their quality. After studying the exploration of some of the banks operating in Algeria, and concluded that the majority relies sites, especially on the Internet, to introduce themselves and their affiliates as well as the definition of customer coverage for traditional and electronic, which are still at the beginning of the road where only some plastic cards, e-Banking, Bank of cellular, ATM and fast transfers. The establishment of an electronic network that requires the use of an effective banking system overall settlement of all economic sectors also requires the Algerian banks to be ready to receive this technology through the modernization of management and modernization of services (expand the use of credit cards, electronic money, and expansion of the Internet). As well as the development of the banking media to contribute to the dissemination of electronic banking culture in the community. Has been reached that the use of the communications revolution has made e-banking services inevitable impose itself in determining the future of banks and development, has also been reached that there is the impact of electronic commerce on the improvement of banking services through the provision of the information base and extensive refresher on-site research and development, and apply strategies Marketing, all of which help banks to increase the performance of its services, despite the presence of some of the risks of the means of providing electronic service and not the nature of the service itself and clear impact also by changing the shape or location of service from traditional to electronic which works to reduce and the costs of providing high-quality service and thus access to the largest segment.

Keywords: e-commerce, e-banking, impact e-commerce, B2C

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Authors: Bougema Theodore Ntenkeh, Chi-bikom Barbara Kyien

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The reduction of poverty and hunger sits at the heart of the United Nations 2030 Agenda for Sustainable Development, and are the first two of the Sustainable Development Goals. The World Food Day celebrated on the 16th of October every year, highlights the need for people to have physical and economic access at all times to enough nutritious and safe food to live a healthy and active life; while the world poverty day celebrated on the 17th of October is an opportunity to acknowledge the struggle of people living in poverty, a chance for them to make their concerns heard, and for the community to recognize and support poor people in their fight against poverty. The association between household food security and poverty reduction is not only sparse in Cameroon but mostly qualitative. The paper therefore investigates the effect of household food security on poverty reduction in Cameroon quantitatively using data from the Cameroon Household Consumption Survey collected by the Government Statistics Office. The methodology employed five indicators of household food security using the Multiple Correspondence Analysis and poverty is captured as a dummy variable. Using a control function technique, with pre and post estimation test for robustness, the study postulates that household food security has a positive and significant effect on poverty reduction in Cameroon. A unit increase in the food security score reduces the probability of the household being poor by 31.8%, and this effect is statistically significant at 1%. The result further illustrates that the age of the household head and household size increases household poverty while households residing in urban areas are significantly less poor. The paper therefore recommends that households should diversify their food intake to enhance an effective supply of labour in the job market as a strategy to reduce household poverty. Furthermore, family planning methods should be encouraged as a strategy to reduce birth rate for an equitable distribution of household resources including food while the government of Cameroon should also develop the rural areas given that trend in urbanization are associated with the concentration of productive economic activities, leading to increase household income, increased household food security and poverty reduction.

Keywords: food security, poverty reduction, SDGs, Cameroon

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Authors: Mahshid Arabi

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In recent years, remarkable advancements in the fields of artificial intelligence and machine learning have led to the development of facial recognition technologies. These technologies are now employed in a wide range of applications, including security, surveillance, healthcare, and education. In the field of education, the identification of university entrance exam candidates has been one of the fundamental challenges. Traditional methods such as using ID cards and handwritten signatures are not only inefficient and prone to fraud but also susceptible to errors. In this context, utilizing advanced technologies like facial recognition can be an effective and efficient solution to increase the accuracy and reliability of identity verification in entrance exams. This article examines the use of FaceMatch software for recognizing the faces of university entrance exam candidates in Iran. The main objective of this research is to evaluate the efficiency and accuracy of FaceMatch software in identifying university entrance exam candidates to prevent fraud and ensure the authenticity of individuals' identities. Additionally, this research investigates the advantages and challenges of using this technology in Iran's educational systems. This research was conducted using an experimental method and random sampling. In this study, 1000 university entrance exam candidates in Iran were selected as samples. The facial images of these candidates were processed and analyzed using FaceMatch software. The software's accuracy and efficiency were evaluated using various metrics, including accuracy rate, error rate, and processing time. The research results indicated that FaceMatch software could accurately identify candidates with a precision of 98.5%. The software's error rate was less than 1.5%, demonstrating its high efficiency in facial recognition. Additionally, the average processing time for each candidate's image was less than 2 seconds, indicating the software's high efficiency. Statistical evaluation of the results using precise statistical tests, including analysis of variance (ANOVA) and t-test, showed that the observed differences were significant, and the software's accuracy in identity verification is high. The findings of this research suggest that FaceMatch software can be effectively used as a tool for identifying university entrance exam candidates in Iran. This technology not only enhances security and prevents fraud but also simplifies and streamlines the exam administration process. However, challenges such as preserving candidates' privacy and the costs of implementation must also be considered. The use of facial recognition technology with FaceMatch software in Iran's educational systems can be an effective solution for preventing fraud and ensuring the authenticity of university entrance exam candidates' identities. Given the promising results of this research, it is recommended that this technology be more widely implemented and utilized in the country's educational systems.

Keywords: facial recognition, FaceMatch software, Iran, university entrance exam

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Authors: Anita Chhatwal

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Purpose: The purpose of this paper is to evaluate and investigate the scope of usage of Academic Social Networking Websites (ASNs) by the Science faculty members across universities of North India, viz. Panjab University, Punjabi University and University of Delhi, Delhi. Design/Methodology/Approach: The present study is based upon the primary data collected from 81 science faculty participants from three universities of North India. Questionnaire method was used as an instrument for survey. The study is descriptive and research-based to investigate the popular ASNs amongst the participants from three sample universities and the purpose for which they use them along with the problems they encounter while using ASNs. Findings: The findings of the study revealed that majority of the participants were using ASNs for their academic needs. It was observed that majority of the participants (78%) used ASNs to access scientific papers, while 73.8% of the participants used them to share their research publications. ResearchGate (60.5%) and Google Scholar (59.7%) were the top two most preferred and widely used ASNs by the participants. The critical analysis of the data shows that laptops (86.3%) emerged as major tools for accessing ASNs. Shortage of computers was found to be the chief obstacle in accessing ASNs by the participants. Results of the study demonstrate that 56.3% of participants suggested conduct of seminars and training as the most effective method to increase the awareness of ASNs. Research Limitations/Implications: The study in hand absorbed the 81 faculty (Assistant Professors) members from 15 Science teaching departments across three sample universities of North India. The findings of this study will help the Government of India to regulate and simultaneously make effort to develop and enhance ASNs usage among faculty, researchers, and students. The present study will add to the existing library and information science literature and will be advantageous for all the information professionals as well. Originality/Value: This study is original survey based on primary data investigate the usage of ASNs by the academia. This study will be useful for research scholars, academicians and students all over the world.

Keywords: academic social networks, awareness and usage, North India, scholarly communication, web 2.0

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Authors: Ansari Mohammad Reza, Hiroko Ono, Fakhrullah Sarwari

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Our world is fast heading toward being a predominantly urban planet. This can be a double-edged sword reality where it is as much frightening as it seems interesting. Moreover, a look to the current predictions and taking into the consideration the fact that about 90 percent of the coming urbanization is going to be absorbed by the towns and the cities of the developing countries of Asia and Africa, directly provide us the clues to assume a much more tragic ending to this story than to the happy one. Likewise, in a situation wherein most of these countries are still severely struggling to find the proper answer to their very first initial questions of urbanization—e.g. how to provide the essential structure for their cities, define the regulation, or even design the proper pattern on how the cities should be expanded—thus it is not weird to claim that most of the coming urbanization of the world is going to happen informally. This reality could not only bring the feature, landscape or the picture of the cities of the future under the doubt but at the same time provide the ground for the rise of a bunch of other essential questions of how the facilities would be distributed in these cities, or how fair will this pattern of distribution be. Kabul the capital of Afghanistan, as a city located in the developing world that its process of urbanization has been starting since 2001 and currently hold the position to be the fifth fastest growing city in the world, contained to a considerable slum ratio of 0.7—that means about 70 percent of its population is living in the informal areas—subsequently could be a very good case study to put this questions into the research and find out how the informal development of a city can lead to the unfair and unbalanced distribution of its facilities. Likewise, in this study we tried our best to first propose the ideal model for the fair distribution of the facilities in the Kabul city—where all the citizens have the same equal chance of access to the facilities—and then evaluate the situation of the city based on how fair the facilities are currently distributed therein. We subsequently did it by the comparative analysis between the existing facility rate in the formal and informal areas of the city to the one that was proposed as the fair ideal model.

Keywords: Afghanistan, facility distribution, formal settlements, informal settlements, Kabul

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Authors: Yelbek B. Utepov, Assel S. Tulebekova, Alizhan B. Kazkeyev

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Maturity sensors are used to determine concrete strength by the non-destructive method. The method of placement of the maturity sensors determines their number required for a certain frame of a monolithic building. Previous studies weakly describe this aspect, giving only logical assumptions. This paper proposes a cheap prototype of an embedded wireless sensor for monitoring concrete structures, as well as an alternative strategy for placing sensors based on the transitional boundaries of the temperature distribution of concrete curing, which were determined by building a heat map of the temperature distribution, where unknown values are calculated by the method of inverse distance weighing. The developed prototype can simultaneously measure temperature and relative humidity over a smartphone-controlled time interval. It implements a maturity method to assess the in-situ strength of concrete, which is considered an alternative to the traditional shock impulse and compression testing method used in Kazakhstan. The prototype was tested in laboratory and field conditions. The tests were aimed at studying the effect of internal and external temperature and relative humidity on concrete's strength gain. Based on an experimentally poured concrete slab with randomly integrated maturity sensors, it was determined that the transition boundaries form elliptical forms. Temperature distribution over the largest diameter of the ellipses was plotted, resulting in correct and inverted parabolas. As a result, the distance between the closest opposite crossing points of the parabolas is accepted as the maximum permissible step for setting the maturity sensors. The proposed placement strategy can be applied to sensors that measure various continuous phenomena such as relative humidity. Prototype testing has also revealed Bluetooth inconvenience due to weak signal and inability to access multiple prototypes simultaneously. For this reason, further prototype upgrades are planned in future work.

Keywords: heat map, placement strategy, temperature and relative humidity, wireless embedded sensor

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Authors: Wesley Too, Christine Chesiror

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Hypertension is a public health challenge that globally, with the World Health Organization estimating that by 2025, more than 1.5 billion people would have been diagnosed with it. Kenya’s prevalence of hypertension is estimated at 24.6 percent; however, 55% of the affected have uncontrolled blood pressure, which is worst in some parts of the country with different lifestyle: nomads and migratory communities. Kenyan pastoralists comprise 20% of the nation's population and are constantly on the move for search of water, pasture for their herd, and desertification have driven nomadic populations to the brink, given their unique and dynamic challenges. Nomads face myriad of challenges and barriers towards the management of their health care problems. Nomadic area is predominantly rural, with a low population density and a nomadic population. Health care access and quality are further hampered by poor telecommunications, infrastructure, and security. In Kenya, nomadic communities experience the worst health outcomes, disproportionate health disparities, and inequalities due to unresponsive, culturally sensitive health care system to nomad’s lifestyle and their health care needs. Marsabit covering a surface area of 66,923.1 km2, is the second largest county in Kenya, constituting about 2.3 million people of North-Eastern region, with only 2.3 percent and 1.9 percent of Kenya's total number of doctors and nurses in the country. In Kenya, there are scanty research on hypertension managementin this region and, at best, non-existent study on hypertension among nomads-migratory communities of Northern Kenya. Therefore, the purpose seeks to determine the prevalence of hypertension among nomads and document nomads' practices regarding early detections, management, and levels of control of hypertension in one of the Counties in Kenya with high- hypertensive case load per year. Methods: A cross-sectional study design was used to collect data from multiple sites and health facilities. A total of 260 participants were enrolled into the study. The study is currently ongoing. It is anticipated that by September, we will have initial findings & recommendations to share for conference

Keywords: pastoralists, hypertension, health, kenya

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Authors: Anna S. Tolkacheva, Sergey N. Shkerin, Kirill G. Zemlyanoi, Olga G. Reznitskikh, Pavel D. Khavlyuk

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Calcium oxovanadates with garnet related structure are multifunctional oxides in various fields like photoluminescence, microwave dielectrics, and magneto-dielectrics. For example, vanadate garnets are self-luminescent compounds. They attract attention as RE-free broadband excitation and emission phosphors and are candidate materials for UV-based white light-emitting diodes (WLEDs). Ca₅M₄(VO₄)₆ (M = Mg, Zn, Co, Ni, Mn) compounds are also considered promising for application in microwave devices as substrate materials. However, the relation between their structure, composition and physical/chemical properties remains unclear. Given the above-listed observations, goals of this study are to synthesise Ca₅M₄(VO₄)₆ (M = Mg, Zn, Ni) and to study their thermal and electrical properties. Solid solutions Ca₅Mg₄₋ₓMₓ(VO₄)₆ (0 ≤ x ≤ 4) where M is Zn and Ni have been synthesized by sol-gel method. The single-phase character of the final products was checked by powder X-ray diffraction on a Rigaku D/MAX-2200 X-ray diffractometer using Cu Kα radiation in the 2θ range from 15° to 70°. The dependence of thermal properties on chemical composition of solid solutions was studied using simultaneous thermal analyses (DSC and TG). Thermal analyses were conducted in a Netzch simultaneous analyser STA 449C Jupiter, in Ar atmosphere, in temperature range from 25 to 1100°C heat rate was 10 K·min⁻¹. Coefficients of thermal expansion (CTE) were obtained by dilatometry measurements in air up to 800°C using a Netzsch 402PC dilatometer; heat rate was 1 K·min⁻¹. Impedance spectra were obtained via the two-probe technique with an impedance meter Parstat 2273 in air up to 700°C with the variation of pH₂O from 0.04 to 3.35 kPa. Cation deficiency in Ca and Mg sublattice under the substitution of MgO with ZnO up to 1/6 was observed using Rietveld refinement of the crystal structure. Melting point was found to decrease with x changing from 0 to 4 in Ca₅Mg₄₋ₓMₓ(VO₄)₆ where M is Zn and Ni. It was observed that electrical conductivity does not depend on air humidity. The reported study was funded by the RFBR Grant No. 17–03–01280. Sample attestation was carried out in the Shared Access Centers at the IHTE UB RAS.

Keywords: garnet structure, electrical conductivity, thermal expansion, thermal properties

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Authors: Kaleb Shiferaw, Berhanu Geberemedhin

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Ethiopian farmers have a long tradition of beekeeping and the country has huge potential for honey production. However traditional mode of production still dominates the sub sector which negatively affect the total production and productivity. A number of studies have been conducted to better understand the working honey production, however, none of them systematically investigate the extent of technical efficiency of the sub-sector. This paper uses Stochastic Frontier production model to quantifying the extent of technical efficiency and identify exogenous determinant of inefficiency. The result showed that consistent with other studies traditional practice dominate small scale honey production in Ethiopia. The finding also revealed that use of purchased inputs such as bee forage and other supplement is very limited among honey producers indicating that natural bee forage is the primary source of bee forage. The immediate consequence of all these is low production and productivity. The number of hives the household owns, whether the household used improved apiculture technologies, availability of natural forest which is the primary sources of nectar for bees and amount of land owned by the households were found to have a significant influence on the amount of honey produced by beekeeper. Our result further showed that the mean technical efficiency of honey producers is 0.79 implying that, on average honey producer produce 80 percent of the maximum output. The implication is that 20 percent of the potential output is lost due to technical inefficiency. Number of hives owned by a honey produces, distance to district town-a proxy to market access, household wealth, and whether the household head has a leadership role in the PA affect the technical efficiency of honey producers. The finding suggest that policies that aim to expand the use of improved hives is expected to increase the honey production at household level. The result also suggest that investment on rural infrastructure would be instrumental in improving technical efficiency of honey producer.

Keywords: small-scale honey producer, Ethiopia, technical efficiency in apiculture, stochastic frontier analysis

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Authors: Sakeena Naikwadi, K. Jagaluraiah Sannapapamma

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Vetiveria zizanioides is an aromatic grass and traditionally been used in aromatherapy and ayurvedic medicine. Vetiver root is multi-functional biopolymer and has highly aromatic, antimicrobial, UV blocking, antioxidant properties suitable for textile finishing. The vetiver root (Gulabi) powder of different concentration (2, 4, 6,8 percent) were extracted by aqueous and solvent methods subjected to bioassay for antimicrobial efficiency and GCMS spectral analysis. The organic cotton fabric was finished with vetiver root extract (8 percent) by exhaust and pad dry cure methods. The finished fabric was assessed for functional properties viz., UV protective factor, antimicrobial efficiency and aroma intensity. The results revealed that Ethanol extraction showed a greater zone of inhibition compared to aqueous extract in root powder. Among the concentrations, 8 percent root extract in ethanol showed a greater zone of inhibition against gram-positive organism S. aureus and gram-negative organism E. coli. The major compounds present in vetiver root extracts were diethyl pathalate with greater percentage (87.73 %) followed by 7- Isopropyl dimethyl carboxylic acid (4.05 %), 2-butanone 4-trimethyle cyclohexen (1.21 %), phenanthrene carboxylic acid (1.03 %), naphthalene pentanoic acid (0.99 %), 1-phenanthrene carboxylic acid and 1 cyclohexenone 2-methyl oxobuty (0.89 %). The sample finished by pad dry cure method exhibited better UV protection even after 10th wash as compared to exhaust method. Vetiver extract treated samples exhibited maximum zone of inhibition against S. aureus than the E. coli organism. The vetiver root extract treated organic cotton fabric through pad dry cure method possessed good antimicrobial activity against S. aureus and E. coli even after 20th washes compared to vetiver root extract treated by exhaust method. The olfactory analysis was carried out by 30 panels of members and opined that vetiver root extract treated fabric has very good and pleasant aroma with better tactile properties that provide cooling, soothing effect and enhances the mood of the wearer. Vetiver root extract finished organic cotton fabric possessed aroma, antimicrobial and UV properties which are aptly suitable for medical and healthcare textiles viz., wound dressing, bandage gauze, surgical cloths, baby diapers and sanitary napkins. It can be used as after finishing agent for variegated garments and made-ups and can be replaced with commercial after finishing agents.

Keywords: antimicrobial, olfactory analysis, UV protection factor, vetiver root extract

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Authors: Valeria Aman

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The presented study examines the impact of international mobility on knowledge production among mobile scientists and within the sending and receiving research groups. Scientists are relevant to the dynamics of knowledge production because scientific knowledge is mainly characterized by embeddedness and tacitness. International mobility enables the dissemination of scientific knowledge to other places and encourages new combinations of knowledge. It can also increase the interdisciplinarity of research by forming synergetic combinations of knowledge. Particularly innovative ideas can have their roots in related research domains and are sometimes transferred only through the physical mobility of scientists. Diversity among scientists with respect to their knowledge base can act as an engine for the creation of knowledge. It is therefore relevant to study how knowledge acquired through international mobility affects the knowledge production process. In certain research domains, international mobility may be essential to contextualize knowledge and to gain access to knowledge located at distant places. The knowledge production process contingent on the type of international mobility and the epistemic culture of a research field is examined. The production of scientific knowledge is a multi-faceted process, the output of which is mainly published in scholarly journals. Therefore, the study builds upon publication and citation data covered in Elsevier’s Scopus database for the period of 1996 to 2015. To analyse these data, bibliometric and social network analysis techniques are used. A basic analysis of scientific output using publication data, citation data and data on co-authored publications is combined with a content map analysis. Abstracts of publications indicate whether a research stay abroad makes an original contribution methodologically, theoretically or empirically. Moreover, co-citations are analysed to map linkages among scientists and emerging research domains. Finally, acknowledgements are studied that can function as channels of formal and informal communication between the actors involved in the process of knowledge production. The results provide better understanding of how the international mobility of scientists contributes to the production of knowledge, by contrasting the knowledge production dynamics of internationally mobile scientists with those being nationally mobile or immobile. Findings also allow indicating whether international mobility accelerates the production of knowledge and the emergence of new research fields.

Keywords: bibliometrics, diversity, interdisciplinarity, international mobility, knowledge production

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Authors: Alene Toulany, Elizabeth Dettmer, Seena Grewal, Kaley Roosen, Andrea Regina, Cathleen Steinegger, Kate Stadelman, Melissa Chambers, Lindsay Lochhead, Kelsey Gallagher, Alissa Steinberg, Andrea Leyser, Allison Lougheed, Jill Hamilton

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Obesity and psychiatric disorders occur together so frequently that the combination has been coined an epidemic within an epidemic. Youth living with obesity are at increased risk for trauma, depression, anxiety and disordered eating. Although symptoms of binge eating disorder are common in paediatric obesity management programs, they are often not identified or addressed within treatment. At The Hospital for Sick Children (SickKids), a tertiary care paediatric hospital in Toronto, Canada, adolescents with obesity are treated in an interdisciplinary outpatient clinic (1-2 hours/week). This intensity of care is simply not enough to help these extremely complex patients. Existing day treatment programs for eating, and psychiatric disorders are not well suited for patients with obesity. In order to address this identified care gap, a unique collaboration was formed between the obesity, psychiatry, and eating disorder programs at SickKids in 2015. The aim of this collaboration was to provide an enhanced treatment arm to our general psychiatry day hospital program that addresses both the mental health issues and the lifestyle challenges common to youth with obesity and binge eating. The program is currently in year-one of a two-year pilot project and is designed for a length of stay of approximately 6 months. All youth participate in daily group therapy, academics, and structured mealtimes. The groups are primarily skills-based and are informed by cognitive/dialectical behavioural therapies. Weekly family therapy and individual therapy, as well as weekly medical appointments with a psychiatrist and a nurse, are provided. Youth in the enhanced treatment arm also receive regular sessions with a dietitian to establish normalized eating behaviours and monthly multifamily meal sessions to address challenges related to behaviour change and mealtimes in the home. Outcomes that will be evaluated include measures of mental health, anthropometrics, metabolic status, and healthcare satisfaction. At the end of the two years, it is expected that we will have had about 16 youth participants. This model of care delivery will be the first of its kind in Canada and is expected to inform future paediatric treatment practices.

Keywords: adolescent, binge eating, mental illness, obesity

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Authors: Alex Rodriguez, Adam Guerrero

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Purpose: This study is designed to examine the institutions that comprise the Online Consortium of Independent Colleges and Universities (OCICU) to understand better the types of higher education institutions that comprise their membership. The literature on this topic is extensive in analyzing the current economic environment around higher education, which is largely considered to be negative for independent, tuition-driven institutions, and is forcing colleges and universities to reexamine how the college-attending population defines value and how institutions can best utilize their existing resources (and those of other institutions) to meet that value expectation. The results from this analysis are intended to give OCICU the ability to target their current customer base better, based on their most notable differences, and other institutions to see how to best approach consolidation within higher education. Design/Methodology: This study utilized k-means cluster analysis in order to explore the possibility that different segments exist within the seventy-one colleges and universities that have comprised OCICU. It analyzed fifty different variables, whose selection was based on the previous literature, collected by the Integrated Postsecondary Education Data System (IPEDS), whose data is self-reported by individual institutions. Findings: OCICU member institutions are partitioned into two clusters: "access institutions" and "conventional institutions” based largely on the student profile they target. Value: The methodology of the study is relatively unique as there are not many studies within the field of higher education marketing that have employed cluster analysis, and this type of analysis has never been conducted on OCICU members, specifically, or that of any higher education consolidated offering. OCICU can use the findings of this study to obtain a better grasp as to the specific needs of the two market segments OCICU currently serves and develop measurable marketing programs around how those segments are defined that communicate the value sought by current and potential OCICU members or those of similar institutions. Other consolidation efforts within higher education can also employ the same methodology to determine their own market segments.

Keywords: Consolidation, Colleges, Enrollment, Higher Education, Marketing, Strategy, Universities

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Authors: Mariana Damova, Stanko Stankov, Emil Stoyanov, Hristo Hristov, Hermand Pessek, Plamen Chernev

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We will present one of the first use cases on the DestinE platform, a joint initiative of the European Commission, European Space Agency and EUMETSAT, providing access to global earth observation, meteorological and statistical data, and emphasize the good practice of intergovernmental agencies acting in concert. Further, we will discuss the importance of space-bound disruptive solutions for improving the balance between the ever-increasing water-related disasters coming from climate change and minimizing their economic and societal impact. The use case focuses on forecasting floods and estimating the impact of flood events on the urban environment and the ecosystems in the affected areas with the purpose of helping municipal decision-makers to analyze and plan resource needs and to forge human-environment relationships by providing farmers with insightful information for improving their agricultural productivity. For the forecast, we will adopt an EO4AI method of our platform ISME-HYDRO, in which we employ a pipeline of neural networks applied to in-situ measurements and satellite data of meteorological factors influencing the hydrological and hydrodynamic status of rivers and dams, such as precipitations, soil moisture, vegetation index, snow cover to model flood events and their span. ISME-HYDRO platform is an e-infrastructure for water resources management based on linked data, extended with further intelligence that generates forecasts with the method described above, throws alerts, formulates queries, provides superior interactivity and drives communication with the users. It provides synchronized visualization of table views, graphviews and interactive maps. It will be federated with the DestinE platform.

Keywords: flood simulation, AI, Earth observation, e-Infrastructure, flood forecasting, flood areas localization, response planning, resource estimation

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Authors: Molnar Catalina, Lexi Frankel, Amalia Ardeljan, Enoch Kim, Marissa Dallara, Omar Rashid

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Introduction: Clostridium difficile (C. diff) is a toxin-producing bacteria that can cause diarrhea and colitis. U.S. Center for Disease Control and Prevention revealed that C. difficile infection (CDI) has increased from 31 cases per 100,000 persons per year in 1996 to 61 per 100,000 in 2003. Approximately 500,000 cases per year occur in the United States. After exposure, the bacteria colonize the colon, where it adheres to the intestinal epithelium where it produces two toxins: TcdA and TcdB. TcdA affects the intestinal epithelium, causing fluid secretion, inflammation, and tissue necrosis, while TcdB acts as a cytotoxin purpose of this study was to evaluate the association between C diff infection and bronchial lung cancer development. Methods: Using ICD- 9 and ICD-10 codes, the data was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to assess the patients infected with C diff as opposed to the non-infected patients. The Holy Cross Health, Fort Lauderdale, granted access to the database for the purpose of academic research. Patients were matched for age and Charlson Comorbidity Index (CCI). Standard statistical methods were used. Results: Bronchial lung cancer occurrence in the population not infected with C diff infection was 4741, as opposed to the population infected with C. diff, where 2039 cases of lung cancer were observed. The difference was statistically significant (p-value < 2.2x10^e-16), which reveals that C diff might be protective against bronchial lung cancer. The data was then matched by treatment to create to minimize the effect of treatment bias. Bronchial cancer incidence was 422 and 861 in infected vs. non-infected (p-value of < 2.2x10^e-16), which once more indicates that C diff infection could be beneficial in diminishing bronchial cancer development. Conclusion: This retrospective study conveys a statistical correlation between C diff infection and decreased incidence of lung bronchial cancer. Further studies are needed to comprehend the protective mechanisms of C. Diff infection on lung cancer.

Keywords: C. diff, lung cancer, protective, microbiology

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Authors: Manchari Paranthahan

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Higher education has often presented barriers to many communities as a result of its colonial roots. While higher education was initially created for white cis-males, student populations have become more diverse in the past few decades. Despite this increase in diversity, barriers like rising costs and hostile education settings continue to make higher education hard to access for certain demographics. These barriers and limitations are compounded for students who are intersectionality marginalized, such as Queer and Trans Black, Indigenous and People of Colour (QTBIPOC) Disabled students. As of 2021-2022, only 57.5% of the Canadian population between the ages of 25 - 64 held a college or university credential, with only 32.9% holding a bachelor’s degree or higher. In that same time frame, only 0.64% of the students who successfully completed a higher education program identified as transgender or nonbinary. QTBIPOC Disabled students experience diverse forms of oppression while navigating education systems, often preventing them from completing their education successfully. This research project will investigate the complex experiences of intersectional marginalization of QTBIPOC Disabled students in Canadian post-secondary education systems. Through this investigation, this research seeks to reimagine more inclusive and accessible education systems in Canada and beyond. The social and academic experiences of QTBIPOC Disabled students in education systems are largely absent from scholarly literature, speaking to their continued marginalization and erasure from academic discourses. The lack of representation for this community in academia reinforces the idea that there is no space for marginalized bodies in further education, a discriminatory belief that this research project aims to investigate and reframe with this project. This research study will be informed by Critical Race theory, Queer Theory and Critical Disability Theories. Through a blend of critical narrative ethnography and ethnodrama for my methodological framing. Using these methodologies will speak to the intersecting factors that impact the experiences that QTBIPOC Disabled students have in education systems while offering space to analyze and create new systems of learning that benefits all students.

Keywords: QTBIPOC, queer, disability, pedagogy

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Authors: Myriam Roy

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The perspectives of the Togolese public towards mental illness were assessed, looking at religious affiliation, personal knowledge of someone with a mental illness, and education level as influencers. The goal was to observe which factors influenced most strongly the general public’s attitudes towards mental illness. The Togolese population was surveyed within the context of mental health awareness workshops and involved college and university students, rural community members, and company employees. Taylor and Dear’s Community Attitudes towards the Mentally Ill (CAMI) questionnaire was used to assess these influencers and includes four dimensions of community attitudes towards mental illness: authoritarianism, benevolence, social restrictiveness, and community mental health ideology (CMHI). Demographic questions were also included, tailored to the various realities of the Togolese population. These questions looked, among others, at religious, ethnical (region of origin within Togo), and educational background. It was found that religious affiliation and personal knowledge did not correlate significantly with changes in the four dimensions of the CAMI scale. It suggests that public perspectives towards mental illness might not be as associated with these variables as was previously thought. The dimensions, however, did correlate with themselves as was expected. Authoritarianism was associated positively with social restrictiveness, benevolence was associated negatively with social restrictiveness and positively with CMHI, and CMHI was associated negatively with social restrictiveness, indicating the CAMI did not suffer from reliability and validity issues when used with this population. Interestingly, level of education significantly impacted authoritarianism level, with higher education associated with a decrease in authoritarianism. This finding would support the notion that education is likely to provide access to a wide array of information as well as interaction with people from various backgrounds and situations. Providing increased awareness regarding mental health and illness in schools could be beneficial to favor the impact that education appears to have on public perspectives towards mental illness in Togo. Future studies could assess which mental health interventions in schools would be the most useful in Togo.

Keywords: CAMI questionnaire, cross-cultural psychology, stigma towards mental illness, West African psychology

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Authors: Komala Arsi, Terrel Spencer, Casey M. Owens, Dan J. Donoghue, Ann M. Donoghue

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Organic poultry production is becoming increasingly popular in the United States with approximately 17% increase in the sales of organic meat and poultry in 2016. As per the National Organic Program (NOP), organic poultry production system should operate according to specific standards, including access to outdoors. In the United States, organic poultry farmers are raising both fast growing and slow growing genotypes for alternative productive systems. Even though heritage breed birds grow much slower compared to commercial breeds, many free range producers believe that they are better suited for outdoor production systems. We conducted an on-farm trial on a working pasture poultry farm to compare the performance and meat quality characteristics of a slow-growing heritage breed (Freedom Rangers, FR), and two commonly used fast growing types of chickens (Cornish cross, CC and Naked Neck, NN), raised on pasture, in side by side pens segregated by breed (n=70/breed). CC and NN group birds were reared for eight weeks whereas FR group birds were reared for 10 weeks and all the birds were commercially processed. By the end of the rearing period, the final body weight of FR group birds was significantly lower than both the fast growing genotypes (CC and NN). Both CC and NN birds showed significantly higher live weight, carcass weight as well as fillet, tender and leg yield (P < 0.05). There was no difference in the wing and rack yield among the different groups. Color of the meat was measured using CEILAB method and expressed as lightness (L), redness (a*) and yellowness (b*). The breast meat from FR birds was much redder (higher a* values) and less yellow (lesser b* values) compared to both the fast growing type of chickens (P < 0.05). Overall, fast growing genotypes produced higher carcass weight and meat yield compared to slow growing genotypes and appear to be an economical option for alternative production systems.

Keywords: fast growing chickens, meat quality, pasture, slow growing chickens

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Authors: Jérémie Ochin

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Soccer analytics are built on two data sources: the frame-by-frame position of each player on the terrain and the sequences of events, such as ball drive, pass, cross, shot, throw-in... With more than 2000 ball-events per soccer game, their precise and exhaustive annotation, based on a monocular video stream such as a TV broadcast, remains a tedious and costly manual task. State-of-the-art methods for spatio-temporal action detection from a monocular video stream, often based on 3D convolutional neural networks, are close to reach levels of performances in mean Average Precision (mAP) compatibles with the automation of such task. Nevertheless, to meet their expectation of exhaustiveness in the context of data analytics, such methods must be applied in a regime of high recall – low precision, using low confidence score thresholds. This setting unavoidably leads to the detection of false positives that are the product of the well documented overconfidence behaviour of neural networks and, in this case, their limited access to contextual information and understanding of the game: their predictions are highly unstructured. Based on the assumption that professional soccer players’ behaviour, pose, positions and velocity are highly interrelated and locally driven by the player performing a ball-action, it is hypothesized that the addition of information regarding surrounding player’s appearance, positions and velocity in the prediction methods can improve their metrics. Several methods are compared to build a proper representation of the game surrounding a player, from handcrafted features of the local graph, based on domain knowledge, to the use of Graph Neural Networks trained in an end-to-end fashion with existing state-of-the-art 3D convolutional neural networks. It is shown that the inclusion of information regarding surrounding players helps reaching higher metrics.

Keywords: fine-grained action recognition, human action recognition, convolutional neural networks, graph neural networks, spatio-temporal action recognition

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Authors: Priyatma Singh, Manpreet Kaur

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Climate change is progressively being identified as a global crisis and this has immediate repercussions for Fiji Islands due to its geographical location being prone to natural disasters. In the Pacific, it is common to find significant differences between men and women, in terms of their roles and responsibilities. In the pursuit of prudent preparedness before disasters, Fijian women’s engagement is constrained due to socially constructed roles and expectation of women here in Fiji. This vulnerability is aggravated by viewing women as victims, rather than as key people who have vital information of their society, economy, and environment, as well as useful skills, which, when recognized and used, can be effective in disaster risk reduction. The focus of this study on disaster management is to outline ways in which Fijian women can be actively engaged in disaster risk management, articulating in decision-making, negating the perceived ideology of women’s constricted roles in Fiji and unveiling social constraints that limit women’s access to practical disaster management strategic plan. This paper outlines the importance of gender mainstreaming in disaster risk reduction and the ways of mainstreaming gender based on a literature review. It analyses theoretical study of academic literature as well as papers and reports produced by various national and international institutions and explores ways to better inform and engage women for climate change per ser disaster management in Fiji. The empowerment of women is believed to be a critical element in constructing disaster resilience as women are often considered to be the designers of community resilience at the local level. Gender mainstreaming as a way of bringing a gender perspective into climate related disasters can be applied to distinguish the varying needs and capacities of women, and integrate them into climate change adaptation strategies. This study will advocate women articulation in disaster risk management, thus giving equal standing to females in Fiji and also identify the gaps and inform national and local Disaster Risk Management authorities to implement processes that enhance gender equality and women’s empowerment towards a more equitable and effective disaster practice.

Keywords: disaster risk management, climate change, gender mainstreaming, women empowerment

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Authors: Niloofar Yousefi, Marie Alaghband, Ivan Garibay

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With the increase of credit card usage, the volume of credit card misuse also has significantly increased, which may cause appreciable financial losses for both credit card holders and financial organizations issuing credit cards. As a result, financial organizations are working hard on developing and deploying credit card fraud detection methods, in order to adapt to ever-evolving, increasingly sophisticated defrauding strategies and identifying illicit transactions as quickly as possible to protect themselves and their customers. Compounding on the complex nature of such adverse strategies, credit card fraudulent activities are rare events compared to the number of legitimate transactions. Hence, the challenge to develop fraud detection that are accurate and efficient is substantially intensified and, as a consequence, credit card fraud detection has lately become a very active area of research. In this work, we provide a survey of current techniques most relevant to the problem of credit card fraud detection. We carry out our survey in two main parts. In the first part, we focus on studies utilizing classical machine learning models, which mostly employ traditional transnational features to make fraud predictions. These models typically rely on some static physical characteristics, such as what the user knows (knowledge-based method), or what he/she has access to (object-based method). In the second part of our survey, we review more advanced techniques of user authentication, which use behavioral biometrics to identify an individual based on his/her unique behavior while he/she is interacting with his/her electronic devices. These approaches rely on how people behave (instead of what they do), which cannot be easily forged. By providing an overview of current approaches and the results reported in the literature, this survey aims to drive the future research agenda for the community in order to develop more accurate, reliable and scalable models of credit card fraud detection.

Keywords: Credit Card Fraud Detection, User Authentication, Behavioral Biometrics, Machine Learning, Literature Survey

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Authors: Anna Curtin, Matthew Thibodeau, Heather Buckley

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Water scarcity is characterized by a lack of access to clean and affordable drinking water, as well as water for hygienic and economic needs. The amount of people effected by water scarcity is expected to increase in the coming years due to climate change, population growth, and pollution, amongst other things. In response, scientists are pursuing cost effective drinking water treatment methods, often with a focus on alternative water sources. Desalination of seawater via reverse osmosis is one promising alternative method. Desalination of seawater via reverse osmosis, however, is limited significantly by biofouling of the filtration membrane. Biofouling is the buildup of microorganisms in a biofilm at the water-membrane interface. It clogs the membrane, decreasing the efficiency of filtration, consequently increasing operational and maintenance costs. Although effective, existing chemical treatment methods can damage the membrane, decreasing the lifespan of the membrane; create antibiotic resistance; and cause harm to humans and the environment if they pass through the membrane into the permeate. The current project focuses on applying safer preservatives used in home and personal care products to RO membranes to investigate the biofouling treatment efficacy. Currently, many of these safer preservatives have only been tested on cells in planktonic phase in suspension cultures, not on cells in biofilms. The results of suspension culture tests are not applicable to biofouling scenarios because organisms in planktonic phase in suspension cultures exhibit different morphological, chemical, and metabolic characteristics than those in a biofilm. Testing antifoulant efficacy of safer preservatives on biofilms will provide more applicable results to biofouling on RO membranes. To do this, biofilms will be grown on 96-well-plates and minimum inhibitory concentrations (MIC90) and log-reductions will be calculated for various safer preservatives. Results from these tests will be used to guide doses for tests of safer preservatives in a bench-scale RO system.

Keywords: reverse osmosis, biofouling, preservatives, antimicrobial, safer alternative, green chemistry

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Authors: Helen Nelly Naiga, Jane Frances Zalwango, Saudah N. Kizito, Brian Agaba, Brenda N Simbwa, Maria Goretti Zalwango, Richard Migisha, Benon Kwesiga, Daniel Kadobera, Alex Ario Riolexus, Sarah Paige, Julie R. Harris

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Background: Traditional community beliefs and practices can facilitate the spread of Ebola virus during outbreaks. On September 20, 2022, Uganda declared a Sudan Virus Disease (SVD) outbreak after a case was confirmed in Mubende District. During September–November 2022, the outbreak spread to eight additional districts. We investigated the role of community beliefs and practices in the spread of SUDV in Uganda in 2022. Methods: A qualitative study was conducted in Mubende, Kassanda, and Kyegegwa districts in February 2023. We conducted nine focus group discussions (FGDs) and six key informant interviews (KIIs). FGDs included SVD survivors, household members of SVD patients, traditional healers, religious leaders, and community leaders. Key informants included community, political, and religious leaders, traditional healers, and health workers. We asked about community beliefs and practices to understand if and how they contributed to the spread of SUDV. Interviews were recorded, translated, transcribed, and analyzed thematically. Results: Frequently-reported themes included beliefs that the community deaths, later found to be due to SVD, were the result of witchcraft or poisoning. Key informants reported that SVD patients frequently first consulted traditional healers or spiritual leaders before seeking formal healthcare, and noted that traditional healers treated patients with signs and symptoms of SVD without protective measures. Additional themes included religious leaders conducting laying-on-of-hands prayers for SVD patients and symptomatic contacts, SVD patients and their symptomatic contacts hiding in friends’ homes, and exhumation of SVD patients originally buried in safe and dignified burials, to enable traditional burials. Conclusion: Multiple community beliefs and practices likely promoted SVD outbreak spread during the 2022 outbreak in Uganda. Engaging traditional and spiritual healers early during similar outbreaks through risk communication and community engagement efforts could facilitate outbreak control. Targeted community messaging, including clear biological explanations for clusters of deaths and information on the dangers of exhuming bodies of SVD patients, could similarly facilitate improved control in future outbreaks in Uganda.

Keywords: Ebola, Sudan virus, outbreak, beliefs, traditional

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Authors: Mohammed H. Karim, Bestoon M. Faraj

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Introduction: instrument separation is a common challenge in the endodontic field. Various techniques and technologies have been developed to improve the retrieval success rate. This study aimed to compare the effectiveness of a Dynamic Navigation System (DNS) and a three-dimensional microscope in retrieving broken rotary NiTi files when using trepan burs and the extractor system. Materials and Methods: Thirty maxillary first bicuspids with sixty separate roots were split into two comparable groups based on a comprehensive Cone-Beam Computed Tomography (CBCT) analysis of the root length and curvature. After standardised access opening, glide paths, and patency attainment with the K file (sizes 10 and 15), the teeth were arranged on 3D models (three per quadrant, six per model). Subsequently, controlled-memory heat-treated NiTi rotary files (#25/0.04) were notched 4 mm from the tips and fractured at the apical third of the roots. The C-FR1 Endo file removal system was employed under both guidance to retrieve the fragments, and the success rate, canal aberration, treatment time and volumetric changes were measured. The statistical analysis was performed using IBM SPSS software at a significance level of 0.05. Results: The microscope-guided group had a higher success rate than the DNS guidance, but the difference was insignificant (p > 0.05). In addition, the microscope-guided drills resulted in a substantially lower proportion of canal aberration, required less time to retrieve the fragments and caused a minor change in the root canal volume (p < 0.05). Conclusion: Although dynamically guided trephining with the extractor can retrieve separated instruments, it is inferior to three-dimensional microscope guidance regarding treatment time, procedural errors, and volume change.

Keywords: dynamic navigation system, separated instruments retrieval, trephine burs and extractor system, three-dimensional video microscope

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Authors: Edmaritz Hernandez-Pagan, Kanjana Laosuntisuk, Alex Harris, Allison Haynes, David Buitrago, Michael Kudenov, Colleen Doherty

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Rare Earth Elements (REEs) are critical metals for modern electronics, green technologies, and defense systems. However, due to their dispersed nature in the Earth’s crust, frequent co-occurrence with radioactive materials, and similar chemical properties, acquiring and purifying REEs is costly and environmentally damaging, restricting access to these metals. Plants could serve as resources for bioengineering REE mining systems. Although there is limited information on how REEs affect plants at a cellular and molecular level, plants with high REE tolerance and hyperaccumulation have been identified. This dissertation aims to develop a plant-based system for harvesting REEs from industrial waste material with a focus on Acid Mine Drainage (AMD), a toxic coal mining product. The objectives are 1) to develop a non-destructive, in vivo detection method for REE detection in Phytolacca plants (REE hyperaccumulator) plants utilizing fluorescence spectroscopy and with a primary focus on dysprosium, 2) to characterize the uptake of REE and Heavy Metals in Phytolacca americana and Phytolacca acinosa (REE hyperaccumulator) in AMD for potential implementation in the plant-based system, 3) to implement the REE detection method to identify REE-binding proteins and peptides for potential enhancement of uptake and selectivity for targeted REEs in the plants implemented in the plant-based system. The candidates are known REE-binding peptides or proteins, orthologs of known metal-binding proteins from REE hyperaccumulator plants, and novel proteins and peptides identified by comparative plant transcriptomics. Lanmodulin, a high-affinity REE-binding protein from methylotrophic bacteria, is used as a benchmark for the REE-protein binding fluorescence assays and expression in A. thaliana to test for changes in REE plant tolerance and uptake.

Keywords: phytomining, agromining, rare earth elements, pokeweed, phytolacca

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Authors: Natalie Tyldesley-Marshall, Janette Parr, Anna Brown, Yen-Fu Chen, Amy Grove

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It is widely recognised in policy and research that the provision of services for children and young people (CYP) with Special Educational Needs and Disabilities (SEND) is enhanced when health and social care, and education services collaborate and interact effectively. In the UK, there have been significant changes to policy and provisions which support and improve collaboration. However, professionals responsible for implementing these changes face multiple challenges, including a lack of specific implementation guidance or framework to illustrate how effective multi-agency working could or should work. This systematic review will identify the key components of effective multi-agency working in services for CYP with SEND; and the most effective forms of partnership working in this setting. The review highlights interventions that lead to service improvements; and the conditions in the local area that support and encourage success. A protocol was written and registered with PROSPERO registration: CRD42022352194. Searches were conducted on several health, care, education, and applied social science databases from the year 2012 onwards. Citation chaining has been undertaken, as well as broader grey literature searching to enrich the findings. Qualitative, quantitative, mixed methods studies and systematic reviews were included, assessed independently, and critically appraised or assessed for risk of bias using appropriate tools based on study design. Data were extracted in NVivo software and checked by a more experienced researcher. A convergent segregated approach to synthesis and integration was used in which the quantitative and qualitative data were synthesised independently and then integrated using a joint display integration matrix. Findings demonstrate the key ingredients for effective partnership working for services delivering SEND. Interventions deemed effective are described, and lessons learned across interventions are summarised. Results will be of interest to educators and health and social care professionals that provide services to those with SEND. These will also be used to develop policy recommendations for how UK healthcare, social care, and education services for CYP with SEND aged 0-25 can most effectively collaborate and achieve service improvement. The review will also identify any gaps in the literature to recommend areas for future research. Funding for this review was provided by the Department for Education.

Keywords: collaboration, joint commissioning, service delivery, service improvement

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Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth

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Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.

Keywords: aesthetic, Asian, breast, reconstruction

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Authors: Aschenaki Zerihun Kea, Bernt Lindtjorn, Achamyelesh Gebretsadik, Sven Gudmund Hinderaker

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Introduction: Maternal mortality studies conducted at the national level do not provide the information needed for planning and monitoring health programs at lower administrative levels. The aim of this study was to measure maternal mortality, identify risk factors and district-level variations in Sidama National Regional State, southern Ethiopia. Methods: A cross sectional population-based survey was carried out in households where women reported pregnancy and birth outcomes in the past five years. The study was conducted in the Sidama National Regional State, southern Ethiopia, from July 2019 to May 2020. Multi-stage cluster sampling technique was employed. The outcome variable of the study was maternal mortality. Complex sample logistic regression analysis was applied to assess variables independently associated with maternal mortality. Results: We registered 10602 live births (LB) and 48 maternal deaths, yielding an overall maternal mortality ratio (MMR) of 419; 95% CI: 260-577 per 100,000 LB. Aroresa district had the highest MMR with 1142 (95% CI: 693-1591) per 100,000 LB. Leading causes of death were haemorrhage 21 (41%) and eclampsia 10 (27%). Thirty (59%) mothers died during labour, or within 24 hours after delivery, 25 (47%) died at home and 17 (38%) at a health facility. Mothers who did not have formal education had a higher risk of maternal death (AOR: 4.4; 95% CI: 1.7 – 11.0). The risk of maternal death was higher in districts with a low midwife-to-population ratio (AOR: 2.9; 95% CI: 1.0-8.9). Conclusion: The high maternal mortality with district-level variations in Sidama Region highlights the importance of improving obstetric care and employing targeted interventions in areas with high mortality rates. Due attention should be given to improving access to female education. Additional midwives have to be trained and deployed to improve maternal health services and consequently save the lives of mothers.

Keywords: maternal mortality variation, maternal death, Sidama, Ethiopia

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Authors: Stephanie Zuba-Bates

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Purpose: This qualitative research study explored the lived experience of people with functional movement disorder (FMD) including how it impacts their quality of life and participation in life activities. It aims to educate health care professionals about FMD from the perspective of those living with the disorder. Background: Functional movement disorder is characterized by abnormal motor movements including tremors, abnormal gait, paresis, and dystonia with no known underlying pathophysiological cause. Current research estimates that FMD may account for 2-20% of clients seen by neurologists. Getting a diagnosis of FMD is typically long and difficult. In addition, many healthcare professionals are unfamiliar with the disorder which may delay treatment. People living with FMD face great disruption in major areas of life including activities of daily living (ADLs), work, leisure, and community participation. OT practitioners have expertise in working with people with both physical disabilities as well as mental illness and this expertise has the potential to guide treatment and become part of the standard of care. In order for occupational therapists to provide these services, they must be aware of the disorder and must advocate for clients to be referred to OT services. In addition, referring physicians and other health professionals need to understand how having FMD impacts the daily functioning of people living with the disorder and how OT services can intervene to improve their quality of life. This study aimed to answer the following research questions: 1) What is the lived experience of individuals with FMD?; 2) How has FMD impacted their participation in major areas of life?; and, 3) What treatment have they found to be effective in improving their quality of life? Method: A naturalistic approach was used to collect qualitative data through semi-structured telephone interviews of five individuals living with FMD. Subjects were recruited from social media websites and resources for people with FMD. Data was analyzed for common themes among participants. Results: Common themes including the variability of symptoms of the disorder; challenges to receiving a diagnosis; frustrations with and distrust of health care professionals; the impact of FMD on the participant’s ability to perform daily activities; and, strategies for living with the symptoms of FMD. Conclusion: All of the participants in the study had to modify their daily activities, roles and routines as a result of the disorder. This is an area where occupational therapists may intervene to improve the quality of life of these individuals. Additionally, participants reported frustration with the medical community regarding the awareness of the disorder and how they were treated by medical professionals. Much more research and awareness of the disorder is in order.

Keywords: functional movement disorder, occupational therapy, participation, quality of life

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