Search results for: primary school children
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9411

Search results for: primary school children

5631 Eating Disorders and Eating Behaviors in Morbid Obese Women with and without Type 2 Diabetes

Authors: Azadeh Mottaghi, Zeynab Shakeri

Abstract:

Background: Eating disorders (ED) are group of psychological disorders that significantly impair physical health and psychosocial function. EDconsists wide range of morbidity such as loss of eating control, binge eating disorder(BED), night eating syndrome (NES), and bulimia nervosa. Eating behavior is a wide range term that includes food choices, eating patterns, eating problems. In this study, current knowledge will be discussed aboutcomparison of eating disorders and eating behaviors in morbid obese women with and without type 2 diabetes. Methods: 231 womenwith morbid obesity were included in the study.Loss of eating control, Binge eating disorder and Bulimia nervosa, Night eating syndrome, and eating behaviors and psychosocial factorswere assessed. SPSS version 20 was used for statistical analysis. A p-value of <0.05 was considered significant. Results: There was a significant difference between women with and without diabetes in case of binge eating disorder (76.3% vs. 47.3%, p=0.001). Women with the least Interpersonal support evaluation list (ISEL) scores had a higher risk of eating disorders, and it is more common among diabetics (29.31% vs. 30.45%, p= 0.050). There was no significant difference between depression level and BDI score among women with or without diabetes. Although 38.5% (n=56) of women with diabetes and 50% (n=71) of women without diabetes had minimal depression. The logistic regression model has shown that women without diabetes had lower odds of exhibiting BED (OR=0.28, 95% CI 0.142-0.552).Women with and without diabetes with high school degree (OR=5.54, 95% CI 2.46-9.45, P= 0.0001 & OR=6.52, 95% CI 3.15-10.56, respectively) and moderate depression level (OR=2.03, 95% CI 0.98-3.95 & OR=3.12, 95% CI 2.12-4.56, P= 0.0001) had higher odds of BED. Conclusion: The result of the present study shows that the odds of BED was lower in non-diabetic women with morbid obesity. Women with morbid obesity who had high school degree and moderate depression level had more odds for BED.

Keywords: eating disorders binge eating disorder, night eating syndrome, bulimia nervosa, morbid obesity

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5630 Strengthening Social and Psychological Resources - Project "Herausforderung" as a (Sports-) Pedagogical Concept in Adolescence

Authors: Kristof Grätz

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Background: Coping with crisis situations (e.g., the identity crisis in adolescence) is omnipresent in today's socialization and should be encouraged as a child. For this reason, students should be given the opportunity to create, endure and manage these crisis situations in a sporting context within the project “Herausforderung.” They should prove themselves by working on a self-assigned task, accompanied by ‚coaches’ in a place outside of their hometown. The aim of the project is to observe this process from a resource-oriented perspective. Health promotion, as called for by the WHO in the Ottawa Charter since 1986, includes strengthening psychosocial resources. These include cognitive, emotional, and social potentials that contribute to improving the quality of life, provide favourable conditions for coping with health burdens and enable people to influence their physical performance and well-being self-confidently and actively. A systematic strengthening of psychosocial resources leads to an improvement in mental health and contributes decisively to the regular implementation and long-term maintenance of this health behavior. Previous studies have already shown significant increases in self-concept following experiential educational measures [Fengler, 2007; Eberle & Fengler, 2018] and positive effects of experience-based school trips on the social competence of students [Reuker, 2009]. Method: The research project examines the influence of the project “Herausforderung” on psychosocial resources such as self-efficacy, self-concept, social support, and group cohesion. The students participating in the project will be tested in a pre-post design in the context of the challenge. This test includes specific questions to capture the different psychosocial resources. For the measurement, modifications of existing scales with good item selectivity and reliability are used to a large extent, so that acceptable item and scale values can be expected. If necessary, the scales were adapted or shortened to the specific context in order to ensure a balanced relationship between reliability and test economy. Specifically, these are already tested scales such as FRKJ 8-16, FSKN, GEQ, and F-SozU. The aim is to achieve a sample size of n ≥ 100. Conclusion: The project will be reviewed with regard to its effectiveness, and implications for a resource-enhancing application in sports settings will be given. Conclusions are drawn as to which extent to specific experiential educational content in physical education can have a health-promoting effect on the participants.

Keywords: children, education, health promotion, psychosocial resources

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5629 Symbolic Play and Language: A Developmental Relationship

Authors: Sherri Franklin-Guy

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Play activities have long been utilized to support the development of expressive language in young children. More specifically, stages of symbolic play, or pretend play, have served as indicators of levels of cognitive development, the foundation of language. This presentation will examine the relationship between symbolic play and language development in toddlers and preschoolers. Implications for clinicians and educators will be discussed.

Keywords: cognition, language development, pretend play, symbolic play

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5628 Proposed Organizational Development Interventions in Managing Occupational Stressors for Business Schools in Batangas City

Authors: Marlon P. Perez

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The study intended to determine the level of occupational stress that was experienced by faculty members of private and public business schools in Batangas City with the end in view of proposing organizational development interventions in managing occupational stressors. Stressors such as factors intrinsic to the job, role in the organization, relationships at work, career development and organizational structure and climate were used as determinants of occupational stress level. Descriptive method of research was used as its research design. There were only 64 full-time faculty members coming from private and public business schools in Batangas City – University of Batangas, Lyceum of the Philippines University-Batangas, Golden Gate Colleges, Batangas State University and Colegio ng Lungsod ng Batangas. Survey questionnaire was used as data gathering instrument. It was found out that all occupational stressors were assessed stressful when grouped according to its classification of tertiary schools while response of subject respondents differs on their assessment of occupational stressors. Age variable has become significantly related to respondents’ assessments on factors intrinsic to the job and career development; however, it was not significantly related to role in the organization, relationships at work and organizational structure and climate. On the other hand, gender, marital status, highest educational attainment, employment status, length of service, area of specialization and classification of tertiary school were revealed to be not significantly related to all occupational stressors. Various organizational development interventions have been proposed to manage the occupational stressors that are experienced by business faculty members in the institution.

Keywords: occupational stress, business school, organizational development, intervention, stressors, faculty members, assessment, manage

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5627 Perceptions and Experiences of Students and Their Instructors on Online versus Face-To-Face Classrooms

Authors: Rahime Filiz Kiremit

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This study involves investigating the comparisons of both online and face-to-face classes, along with providing their respective differences. The research project contains information pertaining to the two courses, provided with testimony from students and instructors alike. There were a total of 37 participants involved within the study from San Jacinto College; 35 students and the two instructors of their respective courses. The online instructor has a total of four years of teaching experience, while the face-to-face instructor has accrued 11 years of instructional education. The both instructors were interviewed and the samples were collected from three different classes - TECA 1311-702 (Educating Young Children 13 week distance learning), TECA 1311-705 (Educating Young Children 13 week distance learning) and TECA 1354 (Child Growth and Development). Among all three classes, 13 of the 29 students enrolled in either of the online courses considered participation within the survey, while 22 of the 28 students enrolled in the face-to-face course elected to do the same thing. With regards to the students’ prior class enrollment, 25 students had taken online classes previously, 9 students had taken early-childhood courses, 4 students had taken general classes, 11 students had taken both types of classes, 10 students had not yet taken online classes, and only 1 of them had taken a hybrid course. 10 of the participants professed that they like face-to-face classes, because they find that they can interact with their classmates and teachers. They find that online classes have more work to do, because they need to read the chapters and instructions on their own time. They said that during the face-to-face instruction, they could take notes and converse concerns with professors and fellow peers. They can have hands-on activities during face-to-face classes, and, as a result, improve their abilities to retain what they have learned within that particular time. Some of the students even mentioned that they are supposed to discipline themselves, because the online classes require more work. According to the remaining six students, online classes are easier than face-to-face classes. Most of them believe that the easiness of a course is dependent on the types of classes, the instructors, and the respective subjects of which they teach. With considerations of all 35 students, almost 63% of the students agreed that they interact more with their classmates in face-to-face classes.

Keywords: distance education, face-to-face education, online classroom, students' perceptions

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5626 Descriptive Analysis of the Database of Poliomyelitis Surveillance System in Mauritania from 2012-2019

Authors: B. Baba Ahmed, P. Yanogo, B. Djibryl. N. Medas

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Introduction: Polio is a highly contagious viral infection, with children under 5 years of age being the most affected. It is a public health emergency of international concern. Polio surveillance in Mauritania has been ongoing since 1998 and has achieved "polio free" status in 2007. our objective is to analyse a pidemiological surveillance database of poliomyélitis in Mauritania from 2012-2019. Method: A transversal descriptive analysis of poliomyélitis database was carried out in Mauritania from 2012-2019.An exhaustive sampling was done on all suspected polio cases recorded in the database from 2012 -2019. This study used EPI-INFO 7.4 for frequency calculation for qualitative variables, mean and standard deviation for quantitative variables. Results: We found 459 suspected cases of polio over the study period with an average rate of acute non-polio flaccid paralysis of 25.4 cases/100,000 children under 15 years of age. The age group 0-6 years represented 75.2%. Males constituted 50.2%. Females represented 49.78% with a ratio of M/F=1.Among the 422 observations, the average age is 4 years +/- 3.38. The four regions, TIRIS-ZEMMOUR, INCHIRI, TAGANT, NOUACHCHOTT OUEST recorded the lowest percentages of notifications, respectively (3.28%; 3.93%; 4.37%; 4.8%). 99.34% [98.09-99.78] of cases presented acute flaccid paralysis. And 56.77% [52.19-61.23], had limb asymmetry. We showed that 82.93% [79.21-86.10], had fever. we found that 89.5% of suspected polio cases were investigated before 48 hours. And 88.39% of suspected cases had two adequate samples taken 48 hours apart and within 14 days after the onset of symptoms. Only 30.95% of samples arrived at the referral laboratory before 72 hours. Conclusion: This study has shown that Mauritania has achieved the objectives in most of the quantitative performance indicators of polio surveillance. This study has shown a low notification of cases in the northern and central regions of the country. There is a problem with the transport of samples to the laboratory.

Keywords: analysis, data base, Epi-Info, polio

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5625 Behavioral Changes and Gill Histopathological Alterations of Red Hybrid Tilapia (Oreochromis sp.) Exposed to Glyphosate Herbicide

Authors: Abubakar Muhammad Umar, Nur Adeela Yasid, Hassan Mohd Daud, Mohd Yunus Abd Shukor

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Glyphosate [N-(phosphonomethyl) glycine] is among the most broadly and generally recognised broad-spectrum herbicides used in agriculture due to its low cost and effectiveness in weed management. The pollution of glyphosate in the aquatic environment can be via water run-off from agricultural lands, or by spray drift, aerial spraying or due to industrial discharge, which may be seen as a threat to aquatic biota. Fish is one of the best organisms to study the toxicological aspects of glyphosate. A 49 days experiment was conducted under laboratory conditions to ascertain the effects of technical grade glyphosate on behaviour and histopathological conditions in the gills of red hybrid tilapia using a light inverted microscope. Air gasping, erratic swimming, fin movement, mucus secretion, hemorrhages, and loss of scales were observed as behavioural changes in the exposed fish. There was no histopathological complication observed in the gill of the control fish, but various levels of alterations were seen in the gills of the fish exposed to glyphosate herbicide. These include lifting of primary lamella, congestion of secondary lamella, as well as hyperplasia in both primary and secondary gill lamella, and hypertrophy of secondary gill lamella. Based on the findings of this study, glyphosate herbicide exerts behavioural and histopathological changes in the gill of red hybrid tilapia, and therefore, the fish is considered a good bioindicator in aquatic environment monitoring. Excessive usage of glyphosate herbicide near aquatic habitats should be discouraged.

Keywords: behavioural, histopathological, Oreochromis niloticus, glyphosate

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5624 Women Empowerment in Cassava Production: A Case Study of Southwest Nigeria

Authors: Adepoju A. A., Olapade-Ogunwole F., Ganiyu M. O.

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This study examined women's empowerment in cassava production in southwest Nigeria. The contributions of the five domains namely decision about agricultural production, decision-making power over productive resources, control of the use of income, leadership and time allocation to women disempowerment, profiled the women based on their socio-economics features and determined factors influencing women's disempowerment. Primary data were collected from the women farmers and processors through the use of structured questionnaires. Purposive sampling was used to select the LGAs and villages based on a large number of cassava farmers and processors, while cluster sampling was used to select 360 respondents in the study area. Descriptive statistics such as bar charts and percentages, Women Empowerment in Agriculture (WEAI), and the Logit regression model were used to analyze the data collected. The results revealed that 63.88% of the women were disempowered. Lack of decision-making power over productive resources; 36.47% and leadership skills; 33.26% contributed mostly to the disempowerment of the women. About 85% of the married women were disempowered, while 76.92% of the women who participated in social group activities were more empowered than their disempowered counterparts. The findings showed that women with more years of processing experience have the probability of being disempowered while those who engage in farming as a primary livelihood activity, and participate in social groups among others have the tendency to be empowered. In view of this, it was recommended that women should be encouraged to farm and contribute to social group activities.

Keywords: cassava, production, empowerment, southwest, Nigeria

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5623 The Lighthouse Project: Recent Initiatives to Navigate Australian Families Safely Through Parental Separation

Authors: Kathryn McMillan

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A recent study of 8500 adult Australians aged 16 and over revealed 62% had experienced childhood maltreatment. In response to multiple recommendations by bodies such as the Australian Law Reform Commission, parliamentary reports and stakeholder input, a number of key initiatives have been developed to grapple with the difficulties of a federal-state system and to screen and triage high-risk families navigating their way through the court system. The Lighthouse Project (LHP) is a world-first initiative of the Federal Circuit and Family Courts in Australia (FCFOCA) to screen family law litigants for major risk factors, including family violence, child abuse, alcohol or substance abuse and mental ill-health at the point of filing in all applications that seek parenting orders. It commenced on 7 December 2020 on a pilot basis but has now been expanded to 15 registries across the country. A specialist risk screen, Family DOORS, Triage has been developed – focused on improving the safety and wellbeing of families involved in the family law system safety planning and service referral, and ¬ differentiated case management based on risk level, with the Evatt List specifically designed to manage the highest risk cases. Early signs are that this approach is meeting the needs of families with multiple risks moving through the Court system. Before the LHP, there was no data available about the prevalence of risk factors experienced by litigants entering the family courts and it was often assumed that it was the litigation process that was fueling family violence and other risks such as suicidality. Data from the 2022 FCFCOA annual report indicated that in parenting proceedings, 70% alleged a child had been or was at risk of abuse, 80% alleged a party had experienced Family Violence, 74 % of children had been exposed to Family Violence, 53% alleged through substance misuse by party children had caused or was at risk of causing harm to children and 58% of matters allege mental health issues of a party had caused or placed a child at risk of harm. Those figures reveal the significant overlap between child protection and family violence, both of which are under the responsibility of state and territory governments. Since 2020, a further key initiative has been the co-location of child protection and police officials amongst a number of registries of the FCFOCA. The ability to access in a time-effective way details of family violence or child protection orders, weapons licenses, criminal convictions or proceedings is key to managing issues across the state and federal divide. It ensures a more cohesive and effective response to family law, family violence and child protection systems.

Keywords: child protection, family violence, parenting, risk screening, triage.

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5622 Erosion Wear of Cast Al-Si Alloys

Authors: Pooja Verma, Rajnesh Tyagi, Sunil Mohan

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Al-Si alloys are widely used in various components such as liner-less engine blocks, piston, compressor bodies and pumps for automobile sector and aerospace industries due to their excellent combination of properties like low thermal expansion coefficient, low density, excellent wear resistance, high corrosion resistance, excellent cast ability, and high hardness. The low density and high hardness of primary Si phase results in significant reduction in density and improvement in wear resistance of hypereutectic Al-Si alloys. Keeping in view of the industrial importance of the alloys, hypereutectic Al-Si alloys containing 14, 16, 18 and 20 wt. % of Si were prepared in a resistance furnace using adequate amount of deoxidizer and degasser and their erosion behavior was evaluated by conducting tests at impingement angles of 30°, 60°, and 90° with an erodent discharge rate of 7.5 Hz, pressure 1 bar using erosion test rig. Microstructures of the cast alloys were examined using Optical microscopy (OM) and scanning electron microscopy (SEM) and the presence of Si particles was confirmed by x-ray diffractometer (XRD). The mechanical properties and hardness were measured using uniaxial tension tests at a strain rate of 10-3/s and Vickers hardness tester. Microstructures of the alloys and X-ray examination revealed the presence of primary and eutectic Si particles in the shape of cuboids or polyhedral and finer needles. Yield strength (YS), ultimate tensile strength (UTS), and uniform elongation of the hypereutectic Al-Si alloys were observed to increase with increasing content of Si. The optimal strength and ductility was observed for Al-20 wt. % Si alloy which is significantly higher than the Al-14 wt. % Si alloy. The increased hardness and the strength of the alloys with increasing amount of Si has been attributed presence of Si in the solid solution which creates strain, and this strain interacts with dislocations resulting in solid-solution strengthening. The interactions between distributed primary Si particles and dislocations also provide Orowan strengthening leading to increased strength. The steady state erosion rate was found to decrease with increasing angle of impact as well as Si content for all the alloys except at 900 where it was observed to increase with the increase in the Si content. The minimum erosion rate is observed in Al-20 wt. % Si alloy at 300 and 600 impingement angles because of its higher hardness in comparison to other alloys. However, at 90° impingement angle the wear rate for Al-20 wt. % Si alloy is found to be the minimum due to deformation, subsequent cracking and chipping off material.

Keywords: Al-Si alloy, erosion wear, cast alloys, dislocation, strengthening

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5621 Mitigation Measures for the Acid Mine Drainage Emanating from the Sabie Goldfield: Case Study of the Nestor Mine

Authors: Rudzani Lusunzi, Frans Waanders, Elvis Fosso-Kankeu, Robert Khashane Netshitungulwana

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The Sabie Goldfield has a history of gold mining dating back more than a century. Acid mine drainage (AMD) from the Nestor mine tailings storage facility (MTSF) poses a serious threat to the nearby ecosystem, specifically the Sabie River system. This study aims at developing mitigation measures for the AMD emanating from the Nestor MTSF using materials from the Glynns Lydenburg MTSF. The Nestor MTSF (NM) and the Glynns Lydenburg MTSF (GM) each provided about 20 kg of bulk composite samples. Using samples from the Nestor MTSF and the Glynns Lydenburg MTSF, two mixtures were created. MIX-A is a mixture that contains 25% weight percent (GM) and 75% weight percent (NM). MIX-B is the name given to the second mixture, which contains 50% AN and 50% AG. The same static test, i.e., acid–base accounting (ABA), net acid generation (NAG), and acid buffering characteristics curve (ABCC) was used to estimate the acid-generating probabilities of samples NM and GM for MIX-A and MIX-B. Furthermore, the mineralogy of the Nestor MTSF samples consists of the primary acid-producing mineral pyrite as well as the secondary minerals ferricopiapite and jarosite, which are common in acidic conditions. The Glynns Lydenburg MTSF samples, on the other hand, contain primary acid-neutralizing minerals calcite and dolomite. Based on the assessment conducted, materials from the Glynns Lydenburg are capable of neutralizing AMD from Nestor MTSF. Therefore, the alkaline tailings materials from the Glynns Lydenburg MTSF can be used to rehabilitate the acidic Nestor MTSF.

Keywords: Nestor Mine, acid mine drainage, mitigation, Sabie River system

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5620 School Funding Methods and Egalitarianism

Authors: Mathew Hoyes

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This paper is a collation of data, studies and anecdotes on the way education is funded in New Zealand, the ideals which have lead to this method, as well as the issues it has created when combined with other factors and government policy on education over the last two decades. The purpose of this paper is to provide a historical perspective of this situation and to contribute to the global discussion of how to fund schools in an equitable manner, given that the world has become increasingly more globalised and the perception of widening gaps between the rich and the poor in the western world.

Keywords: education funding equity, egalitarianism, socio-economic, New Zealand colonialism

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5619 Cognitive Radio in Aeronautic: Comparison of Some Spectrum Sensing Technics

Authors: Abdelkhalek Bouchikhi, Elyes Benmokhtar, Sebastien Saletzki

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The aeronautical field is experiencing issues with RF spectrum congestion due to the constant increase in the number of flights, aircrafts and telecom systems on board. In addition, these systems are bulky in size, weight and energy consumption. The cognitive radio helps particularly solving the spectrum congestion issue by its capacity to detect idle frequency channels then, allowing an opportunistic exploitation of the RF spectrum. The present work aims to propose a new use case for aeronautical spectrum sharing and to study the performances of three different detection techniques: energy detector, matched filter and cyclostationary detector within the aeronautical use case. The spectrum in the proposed cognitive radio is allocated dynamically where each cognitive radio follows a cognitive cycle. The spectrum sensing is a crucial step. The goal of the sensing is gathering data about the surrounding environment. Cognitive radio can use different sensors: antennas, cameras, accelerometer, thermometer, etc. In IEEE 802.22 standard, for example, a primary user (PU) has always the priority to communicate. When a frequency channel witch used by the primary user is idle, the secondary user (SU) is allowed to transmit in this channel. The Distance Measuring Equipment (DME) is composed of a UHF transmitter/receiver (interrogator) in the aircraft and a UHF receiver/transmitter on the ground. While the future cognitive radio will be used jointly to alleviate the spectrum congestion issue in the aeronautical field. LDACS, for example, is a good candidate; it provides two isolated data-links: ground-to-air and air-to-ground data-links. The first contribution of the present work is a strategy allowing sharing the L-band. The adopted spectrum sharing strategy is as follow: the DME will play the role of PU which is the licensed user and the LDACS1 systems will be the SUs. The SUs could use the L-band channels opportunely as long as they do not causing harmful interference signals which affect the QoS of the DME system. Although the spectrum sensing is a key step, it helps detecting holes by determining whether the primary signal is present or not in a given frequency channel. A missing detection on primary user presence creates interference between PU and SU and will affect seriously the QoS of the legacy radio. In this study, first brief definitions, concepts and the state of the art of cognitive radio will be presented. Then, a study of three communication channel detection algorithms in a cognitive radio context is carried out. The study is made from the point of view of functions, material requirements and signal detection capability in the aeronautical field. Then, we presented a modeling of the detection problem by three different methods (energy, adapted filter, and cyclostationary) as well as an algorithmic description of these detectors is done. Then, we study and compare the performance of the algorithms. Simulations were carried out using MATLAB software. We analyzed the results based on ROCs curves for SNR between -10dB and 20dB. The three detectors have been tested with a synthetics and real world signals.

Keywords: aeronautic, communication, navigation, surveillance systems, cognitive radio, spectrum sensing, software defined radio

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5618 Improving the Training for Civil Engineers by Introducing Virtual Reality Technique

Authors: Manar Al-Ateeq

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The building construction industry plays a major role in the economy of the word and the state of Kuwait. This paper evaluates existing new civil site engineers, describes a new system for improvement and insures the importance of prequalifying and developing for new engineers. In order to have a strong base in engineering, educational institutes and workplaces should be responsible to continuously train engineers and update them with new methods and techniques in engineering. As to achieve that, school of engineering should constantly update computational resources to be used in the professions. A survey was prepared for graduated Engineers based on stated objectives to understand the status of graduate engineers in both the public and private sector. Interviews were made with different sectors in Kuwait, and several visits were made to different training centers within different workplaces in Kuwait to evaluate training process and try to improve it. Virtual Reality (VR) technology could be applied as a complement to three-dimensional (3D) modeling, leading to better communication whether in job training, in education or in professional practice. Techniques of 3D modeling and VR can be applied to develop the models related to the construction process. The 3D models can support rehabilitation design as it can be considered as a great tool for monitoring failure and defaults in structures; also it can support decisions based on the visual analyses of alternative solutions. Therefore, teaching computer-aided design (CAD) and VR techniques in school will help engineering students in order to prepare them to site work and also will assist them to consider these technologies as important supports in their later professional practice. This teaching technique will show how the construction works developed, allow the visual simulation of progression of each type of work and help them to know more about the necessary equipment needed for tasks and how it works on site.

Keywords: three dimensional modeling (3DM), civil engineers (CE), professional practice (PP), virtual reality (VR)

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5617 Cost and Non-affordability of a Nutritious Diet in Ethiopia: The Fill the Nutrient Gap Approach

Authors: Andinet Abera Hailu, Claudia Damu, Aregash Samuel, Saskia de Pee

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Introduction: Ethiopia has made considerable progress in reducing stunting, yet 39% of children under five remain affected. Child wasting, micronutrient deficiencies, and poor quality of diets for children and adults are the main challenges faced by Ethiopians. Availability and access to nutritious foods and potential scenarios to improve affordability were assessed. Methodology: The Fill the Nutrient Gap (FNG) methodology was used. Cost of the diet software was used to optimize the cost and affordability of nutritious diets for a typical household. Monthly food price data (November 2018 to October 2019) was used to calculate the cost of the diet. Modeling of interventions was performed to identify potential entry points for policy implementers. Non-affordability of the modeled diets was estimated. Average per capita diet-related greenhouse gas (GHG) footprints for current diets and modeled diet scenarios were also evaluated. Result: Almost all households would be able to afford energy-only diets. However, only 25% of households could afford a nutritious diet. Diets containing multiple nutrients would cost four times more than energy-sufficient diets. Nutritious diets tended to cost more in areas where fewer foods were found on local markets (correlation coefficient =-0.62). A modeling scenario performed on multiple interventions showed a reduced monthly cost of a nutritious diet. The GHG emissions of optimized diets that meet nutrient needs were below the country’s emission target. Conclusion: Adolescent girls and women were at risk of inadequate diets as the cost of meeting their nutrient requirements was highest. Diet costs were predominantly driven by requirements for vitamin B12, iron, and calcium. Improving access to nutrition can have implications for climate outcomes as well as nutrition.

Keywords: diet cost, affordability, modelling, environment

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5616 Effect of Rural Entrepreneurship in Rural Development in Nigeria: A Study of Selected Entrepreneurs in Ikwuano Local Government Area, Abia State, Nigeria

Authors: Ifeanyi Charles Otuokere, Victoria Nneoma Nnochiri

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Entrepreneurship generally and specifically within the rural communities in Nigeria is a fast means of bringing development within the communities. This is made possible by utmost maximization and management of available local resources to develop rural areas through good management of these local resources. This study anchors on the rural development paradigm and the integrated rural development theories to understudy the knowledge of rural entrepreneurs on rural economic development. The research study made use of surveys and descriptive analysis. The assessable population for the study, which was randomly selected, is 100 rural entrepreneurs from ten rural communities within the Ikwuano Local Government Area of Abia State. The study made use of both primary and secondary as a source of data collection with much emphasis on a primary source, although secondary data such as journals, textbooks electronic sources were also utilised. A carefully structured questionnaire drafted to extract raw data was administered to selected entrepreneurs. The findings of the study showed that developments within rural communities can only be achieved through rural entrepreneurship. This is evidenced in increased output, job creation, and most importantly, reduction of rural to urban migration, among other things. Recommendations were also made based on these findings; the researchers recommended that infrastructural developments should be made available in the rural communities and government policies should create enabling environments along with other assistance to help these rural entrepreneurs achieve their sole aim.

Keywords: economic developments, rural communities, rural development, rural entrepreneurship

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5615 Assessment of Chromium Concentration and Human Health Risk in the Steelpoort River Sub-Catchment of the Olifants River Basin, South Africa

Authors: Abraham Addo-Bediako

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Many freshwater ecosystems are facing immense pressure from anthropogenic activities, such as agricultural, industrial and mining. Trace metal pollution in freshwater ecosystems has become an issue of public health concern due to its toxicity and persistence in the environment. Trace elements pose a serious risk not only to the environment and aquatic biota but also humans. Chromium is one of such trace elements and its pollution in surface waters and groundwaters represents a serious environmental problem. In South Africa, agriculture, mining, industrial and domestic wastes are the main contributors to chromium discharge in rivers. The common forms of chromium are chromium (III) and chromium (VI). The latter is the most toxic because it can cause damage to human health. The aim of the study was to assess the contamination of chromium in the water and sediments of two rivers in the Steelpoort River sub-catchment of the Olifants River Basin, South Africa and human health risk. The concentration of Cr was analyzed using inductively coupled plasma–optical emission spectrometry (ICP-OES). The concentration of the metal was found to exceed the threshold limit, mainly in areas of high human activities. The hazard quotient through ingestion exposure did not exceed the threshold limit of 1 for adults and children and cancer risk for adults and children computed did not exceed the threshold limit of 10-4. Thus, there is no potential health risk from chromium through ingestion of drinking water for now. However, with increasing human activities, especially mining, the concentration could increase and become harmful to humans who depend on rivers for drinking water. It is recommended that proper management strategies should be taken to minimize the impact of chromium on the rivers and water from the rivers should properly be treated before domestic use.

Keywords: land use, health risk, metal pollution, water quality

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5614 The Impact of Model Specification Decisions on the Teacher ValuE-added Effectiveness: Choosing the Correct Predictors

Authors: Ismail Aslantas

Abstract:

Value-Added Models (VAMs), the statistical methods for evaluating the effectiveness of teachers and schools based on student achievement growth, has attracted decision-makers’ and researchers’ attention over the last decades. As a result of this attention, many studies have conducted in recent years to discuss these statistical models from different aspects. This research focused on the importance of conceptual variables in VAM estimations; therefor, this research was undertaken to examine the extent to which value-added effectiveness estimates for teachers can be affected by using context predictions. Using longitudinal data over three years from the international school context, value-added teacher effectiveness was estimated by ordinary least-square value-added models, and the effectiveness of the teachers was examined. The longitudinal dataset in this study consisted of three major sources: students’ attainment scores up to three years and their characteristics, teacher background information, and school characteristics. A total of 1,027 teachers and their 35,355 students who were in eighth grade were examined for understanding the impact of model specifications on the value-added teacher effectiveness evaluation. Models were created using selection methods that adding a predictor on each step, then removing it and adding another one on a subsequent step and evaluating changes in model fit was checked by reviewing changes in R² values. Cohen’s effect size statistics were also employed in order to find out the degree of the relationship between teacher characteristics and their effectiveness. Overall, the results indicated that prior attainment score is the most powerful predictor of the current attainment score. 47.1 percent of the variation in grade 8 math score can be explained by the prior attainment score in grade 7. The research findings raise issues to be considered in VAM implementations for teacher evaluations and make suggestions to researchers and practitioners.

Keywords: model specification, teacher effectiveness, teacher performance evaluation, value-added model

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5613 Operative versus Non-Operative Treatment of Scaphoid Non-Union in Children: A Case Presentation and Review of the Literature

Authors: Ilja Käch, Abdul R. Jandali, Nadja Zechmann-Müller

Abstract:

Introduction: We discuss the treatment of two young male patients suffering from scaphoid non-union after a traumatic scaphoid fracture. The currently propagated techniques for treating a scaphoid non-union in children are either the operative reconstruction of the scaphoid or the conservative treatment with splinting in a scaphoid cast. Cases: In the first case, we operated on a 13 years old male patient with a posttraumatic scaphoid non-union in the middle third with a humpback deformity. We resected the middle third of the scaphoid and grafted the defect with an iliac crest bone, and the DISI-Deformity was reduced. Fixation was performed with K-Wires and immobilisation in a scaphoid cast. In the second case a 13 years old male patient also with a posttraumatic scaphoid non-union in the middle third and humpback deformity, DISI-deformity, was treated conservatively. Immobilisation in a scaphoid cast for four months was performed. Results: Operative: One year postoperatively the patient achieved a painless free arc of motion. Flexion/Extension 70/0/60°, Radial-/Ulnarduction 30/0/30° and Pro-/Supination 90/0/90°. The computer tomogram showed complete consolidation and bony fusion of the iliac crest bone. Conservative: Six to eight months after conservative treatment the patient demonstrated painless motion and AROM Flexion/Extension 80/0/80°, Radial-/Ulnarduction and Pro-/Supination in maximum range. Complete consolidation in the computer tomogram with persistent humpback- and DISI deformity. Conclusion: In the literature, both techniques are described, either the operative scaphoid reconstruction or the conservative treatment with splinting. In our cases, both the operative and conservative treatments showed comparable good results. However, the humpback- and DISI deformity can only be addressed with a surgical approach.

Keywords: scaphoid, non-union, trauma, operative vs. non operative

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5612 Role of Total Neoadjuvant Therapy in Sphincter Preservation in Locally Advanced Rectal Cancer: A Case Series

Authors: Arpit Gite

Abstract:

Purpose: We have evaluated the role of Total Neoadjuvant Therapy in patients with Locally Advanced Rectal cancer by giving Chemoradiotherapy followed by consolidation chemotherapy (CRT-CNCT) and, after that, the strategy of wait and watch. Methods: In this prospective case series, we evaluated the results of three locally advanced Rectal cancers, two cases Stage II (cT3N0) and one case Stage III ( cT4aN2). All three patients' growth was 4-6 cm from the anal verge. We have treated with Chemoradiotherapy to dose of 45Gy/25 Fractions to elective nodal regions (Inguinal node in anal canal Involvement)and Primary and mesorectum (Phase I) followed by 14.4Gy/8 Fractions to Primary and Mesorectum(Phase II) to a total dose of 59.4Gy/33 Fractions with concurrent chemotherapy Tab Capecitabine 825mg/m2 PO BD with Radiation therapy. After 6 weeks of completion of Chemoradiotherapy, advised six cycles of consolidative chemotherapy, CAPEOX regimen, Oxaliplatin 130mg/m2 on day 1 and Capecitabine 1000mg/m2 PO BD on days 1-14 repeated on a 21-day cycle for a total of six cycles. The primary endpoint is Disease-free survival (DFS); the secondary endpoint is adverse events related to chemoradiotherapy. Radiation toxicity is assessed by RTOG criteria, and chemotherapy toxicity is assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Results: After 6 weeks of completion of Chemoradiotherapy, we did PET-CT of all three patients; all three patients had a clinically complete response and we advised 6 cycles of consolidative chemotherapy. After completion of consolidative chemotherapy, again PET-CT and sigmoidoscopy, all three patients had complete response on PET-CT and no lesions on sigmoidoscopy and kept all three patients on wait and watch.2 patients had Grade 2 skin toxicities,1 patient had Grade 1 skin toxicity, .2 patients had Grade 2 lower GI toxicities, and 1 patient had Grade lower GI toxicity, both according to RTOG criteria. 3 patients had Grade 2 diarrhea due to capecitabine, and 1 patient had Grade 1 thrombocytopenia due to oxaliplatin assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Conclusion: Sphincter Preservation is possible with this regimen in those who don’t want to opt for surgery or in case of low-lying rectal cancer.

Keywords: locally advanced rectal cancer, sphincter preservation, chemoradiotherapy, consolidative chemotherapy

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5611 Comparison of Gestational Diabetes Influence on the Ultrastructure of Rectus Abdominis Muscle in Women and Rats

Authors: Giovana Vesentini, Fernanda Piculo, Gabriela Marini, Debora Damasceno, Angelica Barbosa, Selma Martheus, Marilza Rudge

Abstract:

Problem statement: Skeletal muscle is highly adaptable, muscle fiber composition and size can respond to a variety of stimuli, such physiologic, as pregnancy, and metabolic abnormalities, as Diabetes mellitus. This study aimed to analyze the effects of pregnancy-associated diabetes on the rectus abdominis muscle (RA), and to compare this changes in rats and women. Methods: Female Wistar rats were maintained under controlled conditions and distributed in Pregnant (P) and Long-term mild pregnant diabetic (LTMd) (n=3 r/group). Diabetes in rats was induced by streptozotocin (100mg/Kg, sc) on the first day of life, for a hyperglycemic state between 120-300 mg/dL in adult life. Female rats were mated overnight, at day 21 of pregnancy were anesthetized, and killed for the harvesting of maternal RA. Pregnant women who attended the Diabetes Prenatal Care Clinic of Botucatu Medical School were distributed in Pregnant non-diabetic (Pnd) and Gestational Diabetic (GDM) (n=3 w/group). The diagnosis of GDM was established according to ADA’s criteria (2016). The harvesting of RA was during the cesarean section. Transversal cross-sections of the RA of both women and rats were analyzed by transmission electron microscopy. All procedures were approved by the Ethics Committee on Animal Experiments of the Botucatu Medical School (Protocol Number 1003/2013) and by the Botucatu Medical School Ethical Committee for Human Research in Medical Sciences (CAAE: 41570815.0.0000.5411). Results: The photomicrographs of the RA of rats revealed disorganized Z lines, thinning sarcomeres, and a usual quantity of intermyofibrillar mitochondria in the P group. The LTMd group showed swollen sarcoplasmic reticulum, dilated T tubes and areas with sarcomere disruption. The ultrastructural analysis of Pnd non-diabetic women in the RA showed well-organized myofibrils forming intact sarcomeres, organized Z lines and a normal distribution of intermyofibrillar mitochondria. The GDM group revealed increase in intermyofibrillar mitochondria, areas with sarcomere disruption and increased lipid droplets. Conclusion: Pregnancy and diabetes induce adaptations in the ultrastructure of the rectus abdominis muscle for both women and rats, changing the architectural design of these tissues. However, in rats these changes are more severe maybe because, besides the high blood glucose levels, the quadrupedal animal may suffer an excessive mechanical tension during pregnancy by gravity. Probably, these findings may suggest that these alterations are a risk factor that contributes to the development of muscle dysfunction in women with GDM and may motivate treatment strategies in these patients.

Keywords: gestational diabetes, muscle dysfunction, pregnancy, rectus abdominis

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5610 Management of Urinary Tract Infections by Nurse Practitioners in a Canadian Pediatric Emergency Department: A Rretrospective Cohort Study

Authors: T. Mcgraw, F. N. Morin, N. Desai

Abstract:

Background: Antimicrobial resistance is a critical issue in global health care and a significant contributor to increased patient morbidity and mortality. Suspected urinary tract infection (UTI) is a key area of inappropriate antibiotic prescription in pediatrics. Management patterns of infectious diseases have been shown to vary by provider type within a single setting. The aim of this study was to assess compliance with national UTI management guidelines by nurse practitioners in a pediatric emergency department (ED). Methods: This was a post-hoc analysis of a retrospective cohort study to review and evaluate visits to a tertiary care freestanding pediatric emergency department. Patients were included if they were 60 days to 36 months old and discharged with a diagnosis of UTI or ‘rule-out UTI’ between July 2015 and July 2020. Primary outcome measure was proportion of visits seen by Nurse Practitioners (NP) which were associated with national guideline compliance in the diagnosis and treatment of suspected UTI. We performed descriptive statistics and comparative analyses to determine differences in practice patterns between NPs, and physicians. Results: A total of 636 charts were reviewed, of which 402 patients met inclusion criteria. 17 patients were treated by NPs, 385 were treated by either Pediatric Emergency Medicine physicians (PEM) or non-PEM physicians. Overall, the proportion of infants receiving guideline-compliant care was 25.9% (21.8-30.4%). Of those who were prescribed antibiotics, 79.6% (74.7-83.8%) received first line guideline recommended therapy and 58.9% (53.8-63.8%) received fully compliant therapy with respect to age, dose, duration, and frequency. In patients treated by NPs, 16/17 (94%(95% CI:73.0-99.0)) required antibiotics, 15/16 (93%(95% CI: 71.7-98.9)) were treated with first line agent (cephalexin), 8/16 (50%(95% CI:28-72)) were guideline compliant of dose and duration. 5/8 (63%(95% CI:30.6-86.3)) were noncompliant for dose being too high. There was no difference in receiving guideline compliant empiric antibiotic therapy between physicians and nurse practitioners (OR: 0.837 CI: 0.302-2.69). Conclusion: In this post-hoc analysis, guideline noncompliance by nurse practitioners is common in children tested and treated for UTIs in a pediatric emergency department. Care by a Nurse Practitioner was not associated with greater rate of noncompliance than care by a Pediatric Emergency Medicine physician. Future appropriately powered studies may focus on confirming these results.

Keywords: antibiotic stewardship, infectious disease, nurse practitioner, urinary tract infection

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5609 Case Report on ‘Primary Adenocarcinoma of Aberrant HER2+ Anogenital Mammary-like Glands in a Male'

Authors: Shivani Kuttuva, James Sampson, Timothy Simmons, Vinayak Thattaruparambil, Holly Burton, Peter Coyne

Abstract:

Anogenital mammary-like glands were established to be embryological remnants of breast tissue due to failed resolution of the ectodermal mammary ridge. However, recent studies are now considering this to represent normal constituents of the anogenital area with histological resemblance to the orthotopic breast tissue with multiple benign and malignant lesions arising from it. The incidence of the above has been predominant in females in the vulval region. Due to the paucity of cases reported in men, this poses a diagnostic and therapeutic challenge resulting in a delay in treatment and, thereby, poor outcomes. Our patient presented to the dermatology clinic with an itchy, purplish lesion in the peri-anal region which, on punch biopsy, was diagnosed to be Extra-mammary Paget’s disease and taken up for Wide local excision. Immunochemically, staining was positive for HER2, ER and Cytokeratin 7, keeping with the presence of actual breast tissue with no primary breast carcinoma. Due to the invasive nature of the disease, he required Abdominoperineal resection with flap reconstruction. Despite complete surgical clearance and adjuvant radiotherapy, the disease progressed to adjacent inguinal and obturator lymph nodes with origin resembling anogenital type mammary glands but histology negative for hormonal receptors of the breast.

Keywords: anogenital mammary-like glands, abdominoperineal resection, ectopic breast tissue, ectopic male breast carcinoma, peri-anal skin lesion

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5608 E-Learning Approach for Improving Classroom Teaching to Enhance Students' Learning in Secondary Schools in Nigeria

Authors: Chika Ethel Esege

Abstract:

Electronic learning is learning facilitated by technology which has basically altered approaches globally, including the field of education. This trend is compelling educators to focus on approaches that improve classroom practices in order to enhance students’ learning and participation in a global digital society. However, e-learning is not fully utilized across subject disciplines particularly in the field of humanities, in the context of Nigerian secondary education. This study focused on the use of e-learning to enhance the development of digital skills, particularly, collaboration and communication in secondary school students in Nigeria. The study adopted an ‘action research’ involving 210 students and 7 teachers, who utilised the e-learning platform designed by the researcher for the survey. Mixed methods- qualitative and quantitative- were used for data collection including questionnaire, observation, interview, and analysis of statutory documents. The data were presented using frequency counts for questionnaire responses and figures of screenshots for learning tasks. The VOD Burner software was also used to analyse interviews and video recordings. The study showed that the students acquired collaboration and communication skills through e-learning intervention lesson, and demonstrated satisfaction with this approach. However, the study further revealed that the traditional teaching approach could not provide digital education or develop the digital skills of the students. Based on these findings, recommendations were made that the Nigerian Government should incorporate digital content across subject disciplines into secondary school education curricular and provide adequate infrastructure in order to enable educators to adopt relevant approaches necessary for the enhancement of students’ learning especially in a technologically evolving and advancing world.

Keywords: developing collaboration and communication skills, electronic learning, improving classroom teaching, secondary schools in Nigeria

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5607 The Impact of Social Emotional Learning and Conflict Resolution Skills

Authors: Paula Smith

Abstract:

During adolescence, many students engage in maladaptive behaviors that may reflect a lack of knowledge in social-emotional skills. Oftentimes these behaviors lead to conflicts and school-related disciplinary actions. Therefore, conflict resolution skills are vital for academic and social success. Conflict resolution is one component of a social-emotional learning (SEL) pedagogy that can effectively reduce discipline referrals and build students' social-emotional capacity. This action research study utilized a researcher-developed virtual SEL curriculum to provide instruction to eight adolescent students in an urban school in New York City with the goal of fostering their emotional intelligence (EI), reducing aggressive behaviors, and supporting instruction beyond the core academic content areas. Adolescent development, EI, and SEL frameworks were used to formulate this curriculum. Using a qualitative approach, this study inquired into how effectively participants responded to SEL instruction offered in virtual, Zoom-based workshops. Data included recorded workshop sessions, researcher field notes, and Zoom transcripts. Descriptive analysis involved manual coding/re-coding of transcripts to understand participants’ lived experience with conflict and the ideas presented in the workshops. Findings highlighted several themes and cultural norms that provided insight into adolescents' lived experiences and helped explain their past ideas about conflict. Findings also revealed participants' perspectives about the importance of SEL skills. This study illustrates one example of how evidence-based SEL programs might offer adolescents an opportunity to share their lived experiences. Programs such as this also address both individual and group needs, enabling practitioners to help students develop practical conflict resolution skills.

Keywords: social, emotional, learning, conflict, resolution

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5606 Attitude and Practice of Family Physicians in Giving Smoking Cessation Advice at King Abdul-Aziz Medical City for National Guard, Riyadh

Authors: Mohammed Alateeq, Abdulaziz Alrshoud

Abstract:

Objectives: To examine the attitude and practice of family physicians in giving smoking cessation advice at King Abdul-Aziz Medical City for National Guard, Riyadh. Methods: Cross sectional study using validated self-reported questionnaire that distributed to all family physicians and primary health care doctors at the four main family medicine and primary health care centers, KAMC, Riyadh. Results: 73 physicians are contributed in this study. 28 (38.4%) physicians were from (KASHM ALAN) clinic, 26 (35.6%) physicians were from (UM ALHAMAM) Clinic. 13 (17.8%) physicians were from (ISKAN) clinic. 6 (8.2%) physicians were from the Employee Health Clinic. 73 (100%) of the target population agreed that giving brief smoking cessation advice is part of their duties. 67 (91.7%) agreed that Presence of hospital guidelines and special clinics for smoking cessation will encourage them to provide advice. Only 5 (6.84%) received training courses (1-4 weeks) in smoking cessation interventions. Conclusion: Most of the target population agreed that brief smoking cessation advice is part of their duties. Also, they agreed that Presence of hospital guidelines and special clinics for smoking cessation will encourage them to provide advice although most of them did not received a formal training in smoking cessation advice.

Keywords: advice, attitude, cessation, family physicians, smoking

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5605 Mike Hat: Coloured-Tape-in-Hat as a Head Circumference Measuring Instrument for Early Detection of Hydrocephalus in an Infant

Authors: Nyimas Annissa Mutiara Andini

Abstract:

Every year, children develop hydrocephalus during the first year of life. If it is not treated, hydrocephalus can lead to brain damage, a loss in mental and physical abilities, and even death. To be treated, first, we have to do a proper diagnosis using some examinations especially to detect hydrocephalus earlier. One of the examination that could be done is using a head circumference measurement. Increased head circumference is a first and main sign of hydrocephalus, especially in infant (0-1 year age). Head circumference is a measurement of a child's head largest area. In this measurement, we want to get the distance from above the eyebrows and ears and around the back of the head using a measurement tape. If the head circumference of an infant is larger than normal, this infant might potentially suffer hydrocephalus. If early diagnosis and timely treatment of hydrocephalus could be done most children can recover successfully. There are some problems with early detection of hydrocephalus using regular tape for head circumference measurement. One of the problem is the infant’s comfort. We need to make the infant feel comfort along the head circumference measurement to get a proper result of the examination. For that, we can use a helpful stuff, like a hat. This paper is aimed to describe the possibility of using a head circumference measuring instrument for early detection of hydrocephalus in an infant with a mike hat, coloured-tape-in-hat. In the first life, infants’ head size is about 35 centimeters. First three months after that infants will gain 2 centimeters each month. The second three months, infant’s head circumference will increase 1 cm each month. And for the six months later, the rate is 0.5 cm per month, and end up with an average of 47 centimeters. This formula is compared to the WHO’s head circumference growth chart. The shape of this tape-in-hat is alike an upper arm measurement. This tape-in-hat diameter is about 47 centimeters. It contains twelve different colours range by age. If it is out of the normal colour, the infant potentially suffers hydrocephalus. This examination should be done monthly. If in two times of measurement there still in the same range abnormal of head circumference, or a rapid growth of the head circumference size, the infant should be referred to a pediatrician. There are the pink hat for girls and blue hat for boys. Based on this paper, we know that this measurement can be used to help early detection of hydrocephalus in an infant.

Keywords: head circumference, hydrocephalus, infant, mike hat

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5604 Trends of Conservation and Development in Mexican Biosphere Reserves: Spatial Analysis and Linear Mixed Model

Authors: Cecilia Sosa, Fernanda Figueroa, Leonardo Calzada

Abstract:

Biosphere reserves (BR) are considered as the main strategy for biodiversity and ecosystems conservation. Mexican BR are mainly inhabited by rural communities who strongly depend on forests and their resources. Even though the dual objective of conservation and development has been sought in BR, land cover change is a common process in these areas, while most rural communities are highly marginalized, partly as a result of restrictions imposed by conservation to the access and use of resources. Achieving ecosystems conservation and social development face serious challenges. Factors such as financial support for development projects (public/private), environmental conditions, infrastructure and regional economic conditions might influence both land use change and wellbeing. Examining the temporal trends of conservation and development in BR is central for the evaluation of outcomes for these conservation strategies. In this study, we analyzed changes in primary vegetation cover (as a proxy for conservation) and the index of marginalization (as a proxy for development) in Mexican BR (2000-2015); we also explore the influence of various factors affecting these trends, such as conservation-development projects financial support (public or private), geographical distribution in ecoregions (as a proxy for shared environmental conditions) and in economic zones (as a proxy for regional economic conditions). We developed a spatial analysis at the municipal scale (2,458 municipalities nationwide) in ArcGIS, to obtain road densities, geographical distribution in ecoregions and economic zones, the financial support received, and the percent of municipality area under protection by protected areas and, particularly, by BR. Those municipalities with less than 25% of area under protection were regarded as part of the protected area. We obtained marginalization indexes for all municipalities and, using MODIS in Google Earth Engine, the number of pixels covered by primary vegetation. We used a linear mixed model in RStudio for the analysis. We found a positive correlation between the marginalization index and the percent of primary vegetation cover per year (r=0.49-0.5); i.e., municipalities with higher marginalization also show higher percent of primary vegetation cover. Also, those municipalities with higher area under protection have more development projects (r=0.46) and some environmental conditions were relevant for percent of vegetation cover. Time, economic zones and marginalization index were all important. Time was particularly, in 2005, when both marginalization and deforestation decreased. Road densities and financial support for conservation-development projects were irrelevant as factors in the general correlation. Marginalization is still being affected by the conservation strategies applied in BR, even though that this management category considers both conservation and development of local communities as its objectives. Our results suggest that roads densities and support for conservation-development projects have not been a factor of poverty alleviation. As better conservation is being attained in the most impoverished areas, we face the dilemma of how to improve wellbeing in rural communities under conservation, since current strategies have not been able to leave behind the conservation-development contraposition.

Keywords: deforestation, local development, marginalization, protected areas

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5603 Risk of Mortality and Spectrum of Second Primary Malignancies in Mantle Cell Lymphoma before and after Ibrutinib Approval: A Population-Based Study

Authors: Karthik Chamari, Vasudha Rudraraju, Gaurav Chaudhari

Abstract:

Background: Mantle cell lymphoma (MCL) is one of the mature B cell non-Hodgkin lymphomas (NHL). The course of MCL is moderately aggressive and variable, and it has median overall survival of 8 to 10 years. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, was approved by the United States (US) Food and Drug Administration in November of 2013 for the treatment of MCL patients who have received at least one prior therapy. In this study, we aimed to evaluate whether there has been a change in survival and patterns of second primary malignancies (SPMs) among the MCL population in the US after ibrutinib approval. Methods: Using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER)-18, we conducted a retrospective study with patients diagnosed with MCL (ICD-0-3 code 9673/3) between 2007 and 2018. We divided patients into two six-year cohorts, pre-ibrutinib approval (2007-2012) and post-ibrutinib approval (2013-2018), and compared relative survival rates (RSRs) and standardized incidence ratios (SIRs) of SPMs between cohorts. Results: We included 9,257 patients diagnosed with MCL between 2007 and 2018 in the SEER-18 survival and SIR registries. Of these, 4,205 (45%) patients were included in the pre-ibrutinib cohort, and 5052 (55%) patients were included in the post-ibrutinib cohort. The median follow-up duration for the pre-ibrutinib cohort was 54 months (range 0 to 143 months), and the post-ibrutinib cohort was 20 months (range 0 to 71 months). There was a significant difference in the five-year RSRs between pre-ibrutinib and post-ibrutinib cohorts (57.5% vs. 62.6%, p < 0.005). Out of the 9,257 patients diagnosed with MCL, 920 developed SPMs. A higher proportion of SPMs occurred in the post-ibrutinib cohort (63%) when compared with the pre-ibrutinib cohort (37%). Non-hematological malignancies comprised most of all SPMs. A higher incidence of non-hematological malignancies occurred in the post-ibrutinib cohort (SIR 1.42, 95% CI 1.29 to 1.56) when compared with the pre-ibrutinib cohort (SIR 1.14, 95% CI 1 to 1.3). There was a statistically significant increase in the incidence of cancers of the respiratory tract (SIR 1.77, 95% CI 1.43 to 2.18), urinary tract (SIR 1.61, 95% CI 1.23 to 2.06) when compared with other non-hematological malignancies in post-ibrutinib cohort. Conclusions: Our study results suggest the relative survival rates have increased since the approval of ibrutinib for mantle cell lymphoma patients. Additionally, for some unclear reasons, the incidence of SPM’s (non-hematological malignancies), mainly cancers of the respiratory tract, urinary tract, have increased in the six years following the approval of ibrutinib. Further studies should be conducted to determine the cause of these findings.

Keywords: mantle cell lymphoma, Ibrutinib, relative survival analysis, secondary primary cancers

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5602 The Low-Cost Design and 3D Printing of Structural Knee Orthotics for Athletic Knee Injury Patients

Authors: Alexander Hendricks, Sean Nevin, Clayton Wikoff, Melissa Dougherty, Jacob Orlita, Rafiqul Noorani

Abstract:

Knee orthotics play an important role in aiding in the recovery of those with knee injuries, especially athletes. However, structural knee orthotics is often very expensive, ranging between $300 and $800. The primary reason for this project was to answer the question: can 3D printed orthotics represent a viable and cost-effective alternative to present structural knee orthotics? The primary objective for this research project was to design a knee orthotic for athletes with knee injuries for a low-cost under $100 and evaluate its effectiveness. The initial design for the orthotic was done in SolidWorks, a computer-aided design (CAD) software available at Loyola Marymount University. After this design was completed, finite element analysis (FEA) was utilized to understand how normal stresses placed upon the knee affected the orthotic. The knee orthotic was then adjusted and redesigned to meet a specified factor-of-safety of 3.25 based on the data gathered during FEA and literature sources. Once the FEA was completed and the orthotic was redesigned based from the data gathered, the next step was to move on to 3D-printing the first design of the knee brace. Subsequently, physical therapy movement trials were used to evaluate physical performance. Using the data from these movement trials, the CAD design of the brace was refined to accommodate the design requirements. The final goal of this research means to explore the possibility of replacing high-cost, outsourced knee orthotics with a readily available low-cost alternative.

Keywords: 3D printing, knee orthotics, finite element analysis, design for additive manufacturing

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