Search results for: mental health rehabilitation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10071

Search results for: mental health rehabilitation

6231 Correlation between Early Government Interventions in the Northeastern United States and COVID-19 Outcomes

Authors: Joel Mintz, Kyle Huntley, Waseem Wahood, Samuel Raine, Farzanna Haffizulla

Abstract:

The effect of different state government interventions on COVID-19 health outcomes is currently unknown. Stay at home (SAH) orders, all non-essential business closures and school closures in the Northeastern US were examined. A linear correlation between the peak number of new daily COVID-19 positive tests, hospitalizations and deaths per capita and the elapsed time between government issued guidance and a fixed number of COVID-19 deaths in each state was performed. Earlier government interventions were correlated with lower peak healthcare burden. Statewide closures of schools and non-essential businesses showed significantly greater (p<.001) correlation to peak COVID-19 disease burden as compared to a statewide SAH. The implications of these findings require further study to determine the effectiveness of these interventions.

Keywords: Coronavirus, epidemiology, government intervention, public health, social distancing

Procedia PDF Downloads 181
6230 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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6229 Physical Activity Patterns and Status of Adolescent Learners from Low and Middle Socio-Economic Status Communities in Kwazulu-Natal Province

Authors: Patrick Mkhanyiseli Zimu

Abstract:

A sedentary lifestyle and insufficient physical activity (PA) increases the risk of developing chronic non-communicable diseases (NCDs). Knowing the PA levels and patterns of adolescents from different socio-economic backgrounds is important to direct programs at schools and in communities to prevent NCDs risk factors, which can have long-term effects on the health of the adolescents. The study aimed to investigate adolescent PA levels, patterns, and influencing factors (age, gender, socio-economic status). The 353 participants (203 females and 150 males) from eight low socio-economic (LSES) and middle socio-economic (MSES) public secondary schools completed a Physical Activity Questionnaire for Adolescents (PAQ-A). The PAQ-A is a seven day recall instrument that assesses general estimates of PA levels and patterns for high school learners in Grades 9-12 and provides a summary of physical activity scores derived from seven items, each scored on a 5-point Likert scale. The seven items were PA during spare time and five domains (during physical education, lunch break, after school, in the evenings, on the weekend) and selecting one statement that described participant’s physical activity behaviour. The PA Levels (x̄=2.61, SD=.74) were below the international PA cut-off points of x̄=2.75. Physical education (PE) showed the highest PA score (x̄=3.05, SD=1.21) and lunch break showed the lowest PA score (x̄=2.09, SD=1.14). Positive correlations occurred between PA levels and SES (r=.122, p=0.022), and PA and gender (r=.223, p= 0.0001). LSES participant’s PA score was significantly lower (x̄=2.52; SD=.73) than those from MSES (x̄=2.70; SD=.74, p=0.022). Adolescents from low and middle socio-economic status communities are not sufficiently active. Their average PA score of 2.61 is below the PAQ-A global criterion referenced cut-off points of 2.75, which is considered sufficiently physically active for adolescents to ensure both short- and long-term health benefits. As adolescents are not sufficiently active, collaborative school and community PA programs need to be implemented to supplement physical education in order to prevent short- and long-term health problems.

Keywords: adolescents, health promotion, physical activity, physical education

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6228 Levels and Determinants of Experiencing Violence during Pregnancy among Adolescent Women - The Case of Southern Africa

Authors: Sibusiso Mkwananzi

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The health of mother and child remain at risk among pregnant adolescents. Nevertheless, these are placed in even greater jeopardy when an expectant adolescent experiences violence. This paper sought to explore the levels and determinants of expecting adolescents in five Southern African countries. The study used the most recent (2010/2015) nationally representative demographic health survey (DHS) data from Malawi, Mozambique, Namibia, Zambia, and Zimbabwe. The highest levels of violence during pregnancy occurred amongst adolescent females living in Zimbabwe at 11.4%, followed by Zambia (8.3%) and Namibia (7.7%). Lowest levels were seen in Mozambique at 3.6%. Additionally, the determinants of experiencing violence during pregnancy included educational attainment, marital status, wealth and place of residence. Expectant adolescents that had a higher likelihood of experiencing violence were married and lived predominantly in rural settings. Higher risk was also associated with lower acquisition of education and poverty. These results show a very similar pattern to the risk factors associated with early pregnancy in the region. The predictors point to issues of possible lowered empowerment amongst younger women in their relationships and the structural challenges faced by this fledgling group. Nevertheless, addressing these dynamics could go a long way in not only decreasing the likelihood of unwanted motherhood at this early stage of the life course, but indeed even ensuring the prevention of violence during wanted early pregnancy. This would lead to improved levels of maternal and child health despite younger maternal age and aid in achieving a number of sustainable development goals.

Keywords: adolescents, determinants, Southern Africa, violence during pregnancy

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6227 The Use of Five Times Sit-To-Stand Test in Ambulatory People with Spinal Cord Injury When Tested with or without Hands

Authors: Lalita Khuna, Sugalya Amatachaya, Pipatana Amatachaya, Thiwabhorn Thaweewannakij, Pattra Wattanapan

Abstract:

The five times sit-to-stand test (FTSST) has been widely used to quantify lower extremity motor strength (LEMS), dynamic balance ability, and risk of falls in many individuals. Recently, it has been used in ambulatory patients with spinal cord injury (SCI) but variously using with or without hands according to patients’ ability. This difference might affect the validity of the test in these individuals. Thus, this study assessed the concurrent validity of the FTSST in ambulatory individuals with SCI, separately for those who could complete the test with or without hands using LEMS and standard functional measures as gold standards. Moreover, the data of the tests from those who completed the FTSST with and without hands were compared. A total of 56 ambulatory participants with SCI who could complete sit-to-stand with or without hands were assessed for the time to complete the FTSST according to their ability. Then they were assessed for their LEMS scores and functional abilities, including the 10-meter walk test (10MWT), the walking index for spinal cord injury II (WISCI II), the timed up and go test (TUGT), and the 6-minute walk test (6MWT). The Mann-Whitney U test was used to compare the different findings between the participants who performed the FTSST with and without hands. The Spearman rank correlation coefficient (ρ) was applied to analyze the levels of correlation between the FTSST and standard tests (LEMS scores and functional measures). There were significant differences in the data between the participants who performed the test with and without hands (p < 0.01). The time to complete the FTSST of the participants who performed the test without hands showed moderate to strong correlation with total LEMS scores and all functional measures (ρ = -0.71 to 0.69, p < 0.001). On the contrary, the FTSST data of those who performed the test with hands were significantly correlated only with the 10MWT, TUGT, and 6MWT (ρ = -0.47 to 0.57, p < 0.01). The present findings confirm the concurrent validity of the FTSST when performed without hands for LEMS and functional mobility necessary for the ability of independence and safety of ambulatory individuals with SCI. However, the test using hands distort the ability of the outcomes to reflect LEMS and WISCI II that reflect lower limb functions. By contrast, the 10MWT, TUGT, and 6MWT allowed upper limb contribution in the tests. Therefore, outcomes of these tests showed a significant correlation to the outcomes of FTSST when assessed using hands. Consequently, the use of FTSST with or without hands needs to consider the clinical application of the outcomes, i.e., to reflect lower limb functions or mobility of the patients.

Keywords: mobility, lower limb muscle strength, clinical test, rehabilitation

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6226 Predictors of Sexually Transmitted Infection of Korean Adolescent Females: Analysis of Pooled Data from Korean Nationwide Survey

Authors: Jaeyoung Lee, Minji Je

Abstract:

Objectives: In adolescence, adolescents are curious about sex, but sexual experience before becoming an adult can cause the risk of high probability of sexually transmitted infection. Therefore, it is very important to prevent sexually transmitted infections so that adolescents can grow in healthy and upright way. Adolescent females, especially, have sexual behavior distinguished from that of male adolescents. Protecting female adolescents’ reproductive health is even more important since it is directly related to the childbirth of the next generation. This study, thus, investigated the predictors of sexually transmitted infection in adolescent females with sexual experiences based on the National Health Statistics in Korea. Methods: This study was conducted based on the National Health Statistics in Korea. The 11th Korea Youth Behavior Web-based Survey in 2016 was conducted in the type of anonymous self-reported survey in order to find out the health behavior of adolescents. The target recruitment group was middle and high school students nationwide as of April 2016, and 65,528 students from a total of 800 middle and high schools participated. The study was conducted in 537 female high school students (Grades 10–12) among them. The collected data were analyzed as complex sampling design using SPSS statistics 22. The strata, cluster, weight, and finite population correction provided by Korea Center for Disease Control & Prevention (KCDC) were reflected to constitute complex sample design files, which were used in the statistical analysis. The analysis methods included Rao-Scott chi-square test, complex samples general linear model, and complex samples multiple logistic regression analysis. Results: Out of 537 female adolescents, 11.9% (53 adolescents) had experiences of venereal infection. The predictors for venereal infection of the subjects were ‘age at first intercourse’ and ‘sexual intercourse after drinking’. The sexually transmitted infection of the subjects was decreased by 0.31 times (p=.006, 95%CI=0.13-0.71) for middle school students and 0.13 times (p<.001, 95%CI=0.05-0.32) for high school students whereas the age of the first sexual experience was under elementary school age. In addition, the sexually transmitted infection of the subjects was 3.54 times (p < .001, 95%CI=1.76-7.14) increased when they have experience of sexual relation after drinking alcohol, compared to those without the experience of sexual relation after drinking alcohol. Conclusions: The female adolescents had high probability of sexually transmitted infection if their age for the first sexual experience was low. Therefore, the female adolescents who start sexual experience earlier shall have practical sex education appropriate for their developmental stage. In addition, since the sexually transmitted infection increases, if they have sexual relations after drinking alcohol, the consideration for prevention of alcohol use or intervention of sex education shall be required. When health education intervention is conducted for health promotion for female adolescents in the future, it is necessary to reflect the result of this study.

Keywords: adolescent, coitus, female, sexually transmitted diseases

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6225 Too Well to Die; Too Ill to Live

Authors: Deepak Jugran

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The last century has witnessed rapid scientific growth, and social policies mainly targeted to increase the “life expectancy” of the people. As a result of these developments, the aging as well as ailing population, is increasing by every day. Despite an increase in “life expectancy”, we have not recorded compression in morbidity numbers as the age of onset of the majority of health issues has not increased substantially. In recent years, the prevalence of chronic diseases along with the improved treatment has also resulted in the increase of people living with chronic diseases. The last decade has also focused on social policies to increase the life expectancy in the population; however, in recent decades, social policies and biomedical research are gradually shifting on the potential of increasing healthy life or healthspan. In this article, we review the existing framework of lifespan and healthspan and wish to ignite a discussion among social scientists and public health experts to propose a wholistic framework to balance the trade-offs on social policies for “lifespan” and “healthspan”.

Keywords: lifespan, healthspan, chronic diseases, social policies

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6224 Social Integration of Visually Impaired Persons in Georgia

Authors: Vakhtang Nozadze, Luiza Arutinova, Khatuna Martskvishvili

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The social empowerment of most needed individuals is a challenging issue, especially for developing countries. The current study explores the effects of visual impairment on individuals’ satisfaction with different aspects of life (i.e. education, job, income, family) and coping strategies. Furthermore, the difference between groups according to health status is revealed. Other demographic variables (education, employment, and marital status) is also considered. The cross-sectional design and self-reported questionnaires were adopted. Seventy-two visually impaired males and females (age range 13-66) and seventy healthy individuals participated in the study. The results reveal the importance of health status on the accessibility of social amenities, individuals’ satisfaction with life, and a diversity of coping strategies, irrespective of the age. The research has an important implication for social integration research and policy.

Keywords: coping strategies, life satisfaction, social integration, visual impairment

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6223 Combined Treatment of Aged Rats with Donepezil and the Gingko Extract EGb 761® Enhances Learning and Memory Superiorly to Monotherapy

Authors: Linda Blümel, Bettina Bert, Jan Brosda, Heidrun Fink, Melanie Hamann

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Age-related cognitive decline can eventually lead to dementia, the most common mental illness in elderly people and an immense challenge for patients, their families and caregivers. Cholinesterase inhibitors constitute the most commonly used antidementia prescription medication. The standardized Ginkgo biloba leaf extract EGb 761® is approved for treating age-associated cognitive impairment and has been shown to improve the quality of life in patients suffering from mild dementia. A clinical trial with 96 Alzheimer´s disease patients indicated that the combined treatment with donepezil and EGb 761® had fewer side effects than donepezil alone. In an animal model of cognitive aging, we compared the effect of combined treatment with EGb 761® or donepezil monotherapy and vehicle. We compared the effect of chronic treatment (15 days of pretreatment) with donepezil (1.5 mg/kg p. o.), EGb 761® (100 mg/kg p. o.), or the combination of the two drugs, or vehicle in 18 – 20 month old male OFA rats. Learning and memory performance were assessed by Morris water maze testing, motor behavior in an open field paradigm. In addition to chronic treatment, the substances were administered orally 30 minutes before testing. Compared to the first day and to the control group, only the combination group showed a significant reduction in latency to reach the hidden platform on the second day of testing. Moreover, from the second day of testing onwards, the donepezil, the EGb 761® and the combination group required less time to reach the hidden platform compared to the first day. The control group did not reach the same latency reduction until day three. There were no effects on motor behavior. These results suggest a superiority of the combined treatment of donepezil with EGb 761® compared to monotherapy.

Keywords: age-related cognitive decline, dementia, ginkgo biloba leaf extract EGb 761®, learning and memory, old rats

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6222 A False Introduction: Teaching in a Pandemic

Authors: Robert Michael, Kayla Tobin, William Foster, Rachel Fairchild

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The COVID-19 pandemic has caused significant disruptions in education, particularly in the teaching of health and physical education (HPE). This study examined a cohort of teachers that experienced being a preservice and first-year teacher during various stages of the pandemic. Qualitative data collection was conducted by interviewing six teachers from different schools in the Eastern U.S. over a series of structured interviews. Thematic analysis was employed to analyze the data. The pandemic significantly impacted the way HPE was taught as schools shifted to virtual and hybrid models. Findings revealed five major themes: (a) You want me to teach HOW?, (b) PE without equipment and six feet apart, (c) Behind the Scenes, (d) They’re back…I became a behavior management guru, and (e) The Pandemic Crater. Overall, this study highlights the significant challenges faced by preservice and first-year teachers in teaching physical education during the pandemic and underscores the need for ongoing support and resources to help them adapt and succeed in these challenging circumstances.

Keywords: teacher education, preservice teachers, first year teachers, health and physical education

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6221 Rural Nurses as a Consistent Resource

Authors: Meirav Eshkol, Miri Blaufeld, Rinat Basal

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Aim: The working environment in rural clinics is often isolated and distant from major health centers. In these circumstances, rural health care faces numerous challenges. The hope is that, in the immediate future and in the medium and long range, the rural nursing staff will realize their full professional and personal potential to their own satisfaction and to the health and welfare of their patients. Background: Rural nurses work mostly alone or with very few colleagues, and have the authority to make professional decisions, a fact which often requires them to make critical decisions in pressure situations. In addition, the expectations set for these nurses are extremely high, a fact which requires them to be extremely skilled and to fulfill their professional potential. They are required to provide high-quality and comprehensive care to the individual, the family, and the community and to maintain close interaction with the community. Work in a rural setting requires the flexibility to perform multiple tasks in an isolated setting, often far removed from major health centers. In order to maintain professional satisfaction for the rural nurse, expanded direction and training are required in professional know-how, and in the development of new and existing skills, toward the goal of treating a diverse population and to obtain a comprehensive view of the components of a diagnosis for treatment and to develop an understanding appropriate to the presented reality. Objective: To provide knowledge and to expand and develop professional skills in the prevention and advancement of health in the care of a diverse patient population. The development of strategies and skills for work under pressure alone instills expertise in performing multiple tasks in diverse disciplines. To reduce feelings of stress and burnout. Methodology: This course is the first and one of a kind in Clalit - the biggest health organisation in Israel. Observing and identifying the needs of the nurses in the field relating to the development of professional and personal skills defining goals and objectives, and determining the content of a course designed for rural nurses and kibbutz nurses who are not Clalit employees. Results: 43 nurses participated and 30 answered the feedback questionnaire. The rating of their experience was 4.33 (on a scale of 1-5, with 5 being the highest ranking). 92% indicated the importance of meeting with additional nurses to teach their colleagues. 83% of the nurses indicated an increased sense of organizational belonging. 60% indicated that the course helped to reduce feelings of stress and burnout in becoming a better rural nurse. 80% indicated that the course helped them establish intra-organizational professional cooperation and initiating processes. Conclusion: The course is an instrument which aids in increasing the feeling of organizational belonging, reducing feelings of stress and burnout, creation of relationships and cooperation both within and outside of the organization, increased the realization of the potential of the village nurse.

Keywords: rural nurse, alone, burnout, multiple tasks

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6220 Critical Approach to Define the Architectural Structure of a Health Prototype in a Rural Area of Brazil

Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Luca Preis

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A primary healthcare facility in developing countries should be a multifunctional space able to respond to different requirements: Flexibility, modularity, aggregation and reversibility. These basic features could be better satisfied if applied to an architectural artifact that complies with the typological, figurative and constructive aspects of the context in which it is located. Therefore, the purpose of this paper is to identify a procedure that can define the figurative aspects of the architectural structure of the health prototype for the marginal areas of developing countries through a critical approach. The application context is the rural areas of the Northeast of Bahia in Brazil. The prototype should be located in the rural district of Quingoma, in the municipality of Lauro de Freitas, a particular place where there is still a cultural fusion of black and indigenous populations. Based on the historical analysis of settlement strategies and architectural structures in spaces of public interest or collective use, this paper aims to provide a procedure able to identify the categories and rules underlying typological and figurative aspects, in order to detect significant and generalizable elements, as well as materials and constructive techniques typically adopted in the rural areas of Brazil. The object of this work is therefore not only the recovery of certain constructive approaches but also the development of a procedure that integrates the requirements of the primary healthcare prototype with its surrounding economic, social, cultural, settlement and figurative conditions.

Keywords: architectural typology, developing countries, local construction techniques, primary health care.

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6219 Cosmic Radiation Hazards and Protective Strategies in Space Exploration

Authors: Mehrnaz Mostafavi, Alireza Azani, Mahtab Shabani, Fatemeh Ghafari

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While filled with promise and wonder, space exploration also presents significant challenges, one of the foremost being the threat of cosmic radiation to astronaut health. Recent advancements in assessing these risks and developing protective strategies have shed new light on this issue. Cosmic radiation encompasses a variety of high-energy particles originating from sources like solar particle events, galactic cosmic rays, and cosmic rays from beyond the solar system. These particles, composed of protons, electrons, and heavy ions, pose a substantial threat to human health in space due to the lack of Earth's protective atmosphere and magnetic field. Researchers have made significant progress in assessing the risks associated with cosmic radiation exposure. By employing advanced dosimetry techniques and conducting biological studies, they have gained insights into how cosmic radiation affects astronauts' health, including increasing the risk of cancer and radiation sickness. This research has led to personalized risk assessment methods tailored to individual astronaut profiles. Distinctive protection strategies have been proposed to combat the dangers of cosmic radiation. These include developing spacecraft shielding materials and designs to enhance radiation protection. Additionally, researchers are exploring pharmacological interventions such as radioprotective drugs and antioxidant therapies to mitigate the biological effects of radiation exposure and preserve astronaut well-being. The findings from recent research have significant implications for the future of space exploration. By advancing our understanding of cosmic radiation risks and developing effective protection strategies, we pave the way for safer and more sustainable human missions beyond Earth's orbit. This is especially crucial for long-duration missions to destinations like Mars, where astronauts will face prolonged exposure to cosmic radiation. In conclusion, recent research has marked a milestone in addressing the challenges posed by cosmic radiation in space exploration. By delving into the complexities of cosmic radiation exposure and developing innovative protection strategies, scientists are ensuring the health and resilience of astronauts as they venture into the vast expanse of the cosmos. Continued research and collaboration in this area are essential for overcoming the cosmic radiation challenge and enabling humanity to embark on new frontiers of exploration and discovery in space.

Keywords: Space exploration, cosmic radiation, astronaut health, risk assessment, protective strategies

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6218 A Systematic Review of Pedometer-or Accelerometer-Based Interventions for Increasing Physical Activity in Low Socioeconomic Groups

Authors: Shaun G. Abbott, Rebecca C. Reynolds, James B. Etter, John B. F. de Wit

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The benefits of physical activity (PA) on health are well documented. Low socioeconomic status (SES) is associated with poor health, with PA a suggested mediator. Pedometers and accelerometers offer an effective behavior change tool to increase PA levels. While the role of pedometer and accelerometer use in increasing PA is recognized in many populations, little is known in low-SES groups. We are aiming to assess the effectiveness of pedometer- and accelerometer-based interventions for increasing PA step count and improving subsequent health outcomes among low-SES groups of high-income countries. Medline, Embase, PsycINFO, CENTRAL and SportDiscus databases were searched to identify articles published before 10th July, 2015; using search terms developed from previous systematic reviews. Inclusion criteria are: low-SES participants classified by income, geography, education, occupation or ethnicity; study duration minimum 4 weeks; an intervention and control group; wearing of an unsealed pedometer or accelerometer to objectively measure PA as step counts per day for the duration of the study. We retrieved 2,142 articles from our database searches, after removal of duplicates. Two investigators independently reviewed titles and abstracts of these articles (50% each) and a combined 20% sample were reviewed to account for inter-assessor variation. We are currently verifying the full texts of 430 articles. Included studies will be critically appraised for risk of bias using guidelines suggested by the Cochrane Public Health Group. Two investigators will extract data concerning the intervention; study design; comparators; steps per day; participants; context and presence or absence of obesity and/or chronic disease. Heterogeneity amongst studies is anticipated, thus a narrative synthesis of data will be conducted with the simplification of selected results into percentage increases from baseline to allow for between-study comparison. Results will be presented at the conference in December if selected.

Keywords: accelerometer, pedometer, physical activity, socioeconomic, step count

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6217 Implication of Woman’s Status on Child Health in India

Authors: Rakesh Mishra

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India’s Demography has always amazed the world because of its unprecedented outcomes in the presence of multifaceted socioeconomic and geographical characteristics. Being the first one to implement family panning in 1952, it occupies 2nd largest population of the world, with some of its state like Uttar Pradesh contributing 5th largest population to the world population surpassing Brazil. Being the one with higher in number it is more prone to the demographic disparity persisting into its territories brought upon by the inequalities in availability, accessibility and attainability of socioeconomic and various other resources. Fifth goal of Millennium Development Goal emphasis to improve maternal and child health across the world as Children’s development is very important for the overall development of society and the best way to develop national human resources is to take care of children. The target is to reduce the infant deaths by three quarters between 1990 and 2015. Child health status depends on the care and delivery by trained personnel, particularly through institutional facilities which is further associated with the status of the mother. However, delivery in institutional facilities and delivery by skilled personnel are rising slowly in India. The main objective of the present study is to measure the child health status on based on the educational and occupational background of the women in India. Study indicates that women education plays a very crucial role in deciding the health of the new born care and access to family planning, but the women autonomy indicates to have mixed results in different states of India. It is observed that rural women are 1.61 times more likely to exclusive breastfed their children compared to urban women. With respect to Hindu category, women belonging to other religious community were 21 percent less likely to exclusive breastfed their child. Taking scheduled caste as reference category, the odds of exclusive breastfeeding is found to be decreasing in comparison to other castes, and it is found to be significant among general category. Women of high education status have higher odds of using family planning methods in most of the southern states of India. By and large, girls and boys are about equally undernourished. Under nutrition is generally lower for first births than for subsequent births and consistently increases with increasing birth order for all measures of nutritional status. It is to be noted that at age 12-23 months, when many children are being weaned from breast milk, 30 percent of children are severely stunted and around 21 percent are severely underweight. So, this paper presents the evidence on the patterns of prevailing child health status in India and its states with reference to the mother socioeconomics and biological characteristics and examines trends in these, and discusses plausible explanations.

Keywords: immunization, exclusive breastfeeding, under five mortality, binary logistic regression, ordinal regression and life table

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6216 The Predictive Implication of Executive Function and Language in Theory of Mind Development in Preschool Age Children

Authors: Michael Luc Andre, Célia Maintenant

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Theory of mind is a milestone in child development which allows children to understand that others could have different mental states than theirs. Understanding the developmental stages of theory of mind in children leaded researchers on two Connected research problems. In one hand, the link between executive function and theory of mind, and on the other hand, the relationship of theory of mind and syntax processing. These two lines of research involved a great literature, full of important results, despite certain level of disagreement between researchers. For a long time, these two research perspectives continue to grow up separately despite research conclusion suggesting that the three variables should implicate same developmental period. Indeed, our goal was to study the relation between theory of mind, executive function, and language via a unique research question. It supposed that between executive function and language, one of the two variables could play a critical role in the relationship between theory of mind and the other variable. Thus, 112 children aged between three and six years old were recruited for completing a receptive and an expressive vocabulary task, a syntax understanding task, a theory of mind task, and three executive function tasks (inhibition, cognitive flexibility and working memory). The results showed significant correlations between performance on theory of mind task and performance on executive function domain tasks, except for cognitive flexibility task. We also found significant correlations between success on theory of mind task and performance in all language tasks. Multiple regression analysis justified only syntax and general abilities of language as possible predictors of theory of mind performance in our preschool age children sample. The results were discussed in the perspective of a great role of language abilities in theory of mind development. We also discussed possible reasons that could explain the non-significance of executive domains in predicting theory of mind performance, and the meaning of our results for the literature.

Keywords: child development, executive function, general language, syntax, theory of mind

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6215 Exploring Management of the Fuzzy Front End of Innovation in a Product Driven Startup Company

Authors: Dmitry K. Shaytan, Georgy D. Laptev

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In our research we aimed to test a managerial approach for the fuzzy front end (FFE) of innovation by creating controlled experiment/ business case in a breakthrough innovation development. The experiment was in the sport industry and covered all aspects of the customer discovery stage from ideation to prototyping followed by patent application. In the paper we describe and analyze mile stones, tasks, management challenges, decisions made to create the break through innovation, evaluate overall managerial efficiency that was at the considered FFE stage. We set managerial outcome of the FFE stage as a valid product concept in hand. In our paper we introduce hypothetical construct “Q-factor” that helps us in the experiment to distinguish quality of FFE outcomes. The experiment simulated for entrepreneur the FFE of innovation and put on his shoulders responsibility for the outcome of valid product concept. While developing managerial approach to reach the outcome there was a decision to look on product concept from the cognitive psychology and cognitive science point of view. This view helped us to develop the profile of a person whose projection (mental representation) of a new product could optimize for a manager or entrepreneur FFE activities. In the experiment this profile was tested to develop breakthrough innovation for swimmers. Following the managerial approach the product concept was created to help swimmers to feel/sense water. The working prototype was developed to estimate the product concept validity and value added effect for customers. Based on feedback from coachers and swimmers there were strong positive effect that gave high value for customers, and for the experiment – the valid product concept being developed by proposed managerial approach for the FFE. In conclusions there is a suggestion of managerial approach that was derived from experiment.

Keywords: concept development, concept testing, customer discovery, entrepreneurship, entrepreneurial management, idea generation, idea screening, startup management

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6214 A Seven Year Single-Centre Study of Dental Implant Survival in Head and Neck Oncology Patients

Authors: Sidra Suleman, Maliha Suleman, Stephen Brindley

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Oral rehabilitation of head and neck cancer patients plays a crucial role in the quality of life for such individuals post-treatment. Placement of dental implants or implant-retained prostheses can help restore oral function and aesthetics, which is often compromised following surgery. Conventional prosthodontic techniques can be insufficient in rehabilitating such patients due to their altered anatomy and reduced oral competence. Hence, there is a strong clinical need for the placement of dental implants. With an increasing incidence of head and neck cancer patients, the demand for such treatment is rising. Aim: The aim of the study was to determine the survival rate of dental implants in head and neck cancer patients placed at the Restorative and Maxillofacial Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: All patients who received dental implants between January 1, 2013 to December 31, 2020 were identified. Patients were excluded based on three criteria: 1) non-head and neck cancer patients, 2) no outpatient follow-up post-implant placement 3) provision of non-dental implants. Scanned paper notes and electronic records were extracted and analyzed. Implant survival was defined as fixtures that had remained in-situ / not required removal. Sample: Overall, 61 individuals were recruited from the 143 patients identified. The mean age was 64.9 years, with a range of 35 – 89 years. The sample included 37 (60.7%) males and 24 (39.3%) females. In total, 211 implants were placed, of which 40 (19.0%) were in the maxilla, 152 (72.0%) in the mandible and 19 (9.0%) in autogenous bone graft sites. Histologically 57 (93.4%) patients had squamous cell carcinoma, with 43 (70.5%) patients having either stage IVA or IVB disease. As part of treatment, 42 (68.9%) patients received radiotherapy, which was carried out post-operatively for 29 (69.0%) cases. Whereas 21 (34.4%) patients underwent chemotherapy, 13 (61.9%) of which were post-operative. The Median follow-up period was 21.9 months with a range from 0.9 – 91.4 months. During the study, 23 (37.7%) patients died and their data was censored beyond the date of death. Results: In total, four patients who had received radiotherapy had one implant failure each. Two mandibular implants failed secondary to osteoradionecrosis, and two maxillary implants did not survive as a result of failure to osseointegrate. The overall implant survival rates were 99.1% at three years and 98.1% at both 5 and 7 years. Conclusions: Although this data shows that implant failure rates are low, it highlights the difficulty in predicting which patients will be affected. Future studies involving larger cohorts are warranted to further analyze factors affecting outcomes.

Keywords: oncology, dental implants, survival, restorative

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6213 Analyzing Factors Impacting COVID-19 Vaccination Rates

Authors: Dongseok Cho, Mitchell Driedger, Sera Han, Noman Khan, Mohammed Elmorsy, Mohamad El-Hajj

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Since the approval of the COVID-19 vaccine in late 2020, vaccination rates have varied around the globe. Access to a vaccine supply, mandated vaccination policy, and vaccine hesitancy contribute to these rates. This study used COVID-19 vaccination data from Our World in Data and the Multilateral Leaders Task Force on COVID-19 to create two COVID-19 vaccination indices. The first index is the Vaccine Utilization Index (VUI), which measures how effectively each country has utilized its vaccine supply to doubly vaccinate its population. The second index is the Vaccination Acceleration Index (VAI), which evaluates how efficiently each country vaccinated its population within its first 150 days. Pearson correlations were created between these indices and country indicators obtained from the World Bank. The results of these correlations identify countries with stronger health indicators, such as lower mortality rates, lower age dependency ratios, and higher rates of immunization to other diseases, displaying higher VUI and VAI scores than countries with lesser values. VAI scores are also positively correlated to Governance and Economic indicators, such as regulatory quality, control of corruption, and GDP per capita. As represented by the VUI, proper utilization of the COVID-19 vaccine supply by country is observed in countries that display excellence in health practices. A country’s motivation to accelerate its vaccination rates within the first 150 days of vaccinating, as represented by the VAI, was largely a product of the governing body’s effectiveness and economic status, as well as overall excellence in health practises.

Keywords: data mining, Pearson correlation, COVID-19, vaccination rates and hesitancy

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6212 A Feminist/Queer Global Bioethics’Perspective on Reproduction: Abortion, MAR and Surrogacy

Authors: Tamara Roma, Emma Capulli

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Pregnancy and fertility, in other words, reproduction, has become, in the last half of the century, increasingly and globally controlled, medicalized, and regulated. The reflection proposed starts from the consequences of the inscription of reproduction into the neoliberal economic paradigm. The new biotechnologies developments have raised a new patriarchal justification for State’s control of uterus bodies and a new construction of knowledge about reproductive health. Moral discussion and juridification remove reproduction and non-reproduction from their personal and intimate context and frame them under words like “duties”, “rights”, “family planning”, “demography”, and “population policy”, reinvent them as “States business” and ultimately help to re/confirm a specific construct of fertility, motherhood, and family. Moreover, the interaction between the neoliberal economy and medical biotechnologies brought about a new formulation of the connection between feminine generative potential and value production. The widespread and contemporary debates on Medically Assisted Reproduction (MAR), surrogacy and abortion suggest the need for a “feminist/queer global bioethical discourse” capable of inserting itself into the official bioethical debate characterized by the traditional dichotomy of laic bioethics/Catholic bioethics. The contribution moves from a feminist bioethics perspective on reproductive technologies to introduce a feminist/queer global bioethics point of view on reproductive health. The comparison between reproduction and non-reproduction debates is useful to analyze and demonstrate how restrictive legislations, dichotomic bioethical discussion and medical control confirm and strengthens gender injustice in reproductive life. In fact, MAR, surrogacy, and abortion restrictions stem from a shared social and legal paradigm that depends on traditional gender roles revealing how the stratification of reproduction is based on multiple discrimination along the lines of gender, race, and class. In conclusion, the perspective of feminist/queer global bioethics tries to read the concept of universal reproductive justice, introducing an original point of view on reproductive health access.

Keywords: queer bioethics, reproductive health, reproductive justice, reproductive technologies

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6211 Executive Function Assessment with Aboriginal Australians

Authors: T. Keiller, E. Hindman, P. Hassmen, K. Radford, L. Lavrencic

Abstract:

Background: Psychosocial disadvantage is associated with impaired cognitive abilities, with executive functioning (EF) abilities particularly vulnerable. EF abilities strongly predict general daily functioning, educational and career prospects, and health choices. A reliable and valid assessment of EF is important to support appropriate care and intervention strategies. However, evidence-based EF assessment tools for use with Aboriginal Australians are limited. Aim and Method: This research aims to develop and validate a culturally appropriate EF tool for use with indigenous Australians. To this end, Study One aims to review current literature examining the benefits and disadvantages of current EF assessment tools for use with Indigenous Australians. Study Two aims to collate expert opinion on the strengths and weaknesses of various current EF assessment tools for use with Indigenous Australians using Delphi methodology with experienced psychologists (n = 10). The initial two studies will inform the development of a culturally appropriate assessment tool. Study Three aims to evaluate the psychometric properties of the tool with an Indigenous sample living in the New South Wales Mid-North Coast. The study aims to quantify the predictive validity of this tool via comparison to functionality predictors and neuropsychological assessment scores. Study Four aims to collect qualitative data surrounding the feasibility and acceptability of the tool among indigenous Australians and health professionals. Expected Results: Findings from this research are likely to inform cognitive assessment practices and tool selection for health professionals conducting cognitive assessments with Indigenous Australians. Improved assessment of EF will inform appropriate care and intervention strategies for individuals with EF deficits.

Keywords: aboriginal Australians, assessment tool, cognition, executive functioning

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6210 Response of Caldeira De Tróia Saltmarsh to Sea Level Rise, Sado Estuary, Portugal

Authors: A. G. Cunha, M. Inácio, M. C. Freitas, C. Antunes, T. Silva, C. Andrade, V. Lopes

Abstract:

Saltmarshes are essential ecosystems both from an ecological and biological point of view. Furthermore, they constitute an important social niche, providing valuable economic and protection functions. Thus, understanding their rates and patterns of sedimentation is critical for functional management and rehabilitation, especially in an SLR scenario. The Sado estuary is located 40 km south of Lisbon. It is a bar built estuary, separated from the sea by a large sand spit: the Tróia barrier. Caldeira de Tróia is located on the free edge of this barrier, and encompasses a salt marsh with ca. 21,000 m². Sediment cores were collected in the high and low marshes and in the mudflat area of the North bank of Caldeira de Tróia. From the low marsh core, fifteen samples were chosen for ²¹⁰Pb and ¹³⁷Cs determination at University of Geneva. The cores from the high marsh and the mudflat are still being analyzed. A sedimentation rate of 2.96 mm/year was derived from ²¹⁰Pb using the Constant Flux Constant Sedimentation model. The ¹³⁷Cs profile shows a peak in activity (1963) between 15.50 and 18.50 cm, giving a 3.1 mm/year sedimentation rate for the past 53 years. The adopted sea level rise scenario was based on a model built with the initial rate of SLR of 2.1 mm/year in 2000 and an acceleration of 0.08 mm/year². Based on the harmonic analysis of Setubal-Tróia tide gauge of 2005 data, the tide model was estimated and used to build the tidal tables to the period 2000-2016. With these tables, the average mean water levels were determined for the same time span. A digital terrain model was created from LIDAR scanning with 2m horizontal resolution (APA-DGT, 2011) and validated with altimetric data obtained with a DGPS-RTK. The response model calculates a new elevation for each pixel of the DTM for 2050 and 2100 based on the sedimentation rates specific of each environment. At this stage, theoretical values were chosen for the high marsh and the mudflat (respectively, equal and double the low marsh rate – 2.92 mm/year). These values will be rectified once sedimentation rates are determined for the other environments. For both projections, the total surface of the marsh decreases: 2% in 2050 and 61% in 2100. Additionally, the high marsh coverage diminishes significantly, indicating a regression in terms of maturity.

Keywords: ¹³⁷Cs, ²¹⁰Pb, saltmarsh, sea level rise, response model

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6209 Area Exclosure as a Government Strategy to Restore Woody Plant Species Diversity: Case Study in Southern Ethiopia

Authors: Tsegaw Abebe, Temesgen Abebe

Abstract:

Land degradation is one of a serious environmental challenge in Ethiopia and is one of the major underlying causes for declining agricultural productivity. The Ethiopia government realized the significance of environmental restoration specifically on deforested and degraded land after the 1973 and 1984/85 major famines that struck the country. Among the various conservation strategies, the establishment of area exclosures have been regarded as an effective response to halt and reverse the problems of land degradation. There are limited studies in Ethiopia dealing how the conversion of free grazing lands and degraded lands by closures increase biomass accumulation. However, these studies are not sufficient to conclude about the strength of area closures to restore degraded vegetations at the diverse agro-ecological condition. The overall objective of this study was, therefore, to assess and evaluate the usefulness of area closure technique in enhancing rehabilitation of degraded ecosystem and thereby increase the natural capital in the study site (southern Ethiopia). Woody plant species were collected from area exclosure for eight year and adjacent degraded land with similar landscape positions using systematic sampling plot design technique. Woody species diversity was determined by Shannon diversity. Comparative assessment result of woody plant species analysis showed that the density of woody species in the exclosure and degraded site were 778 and 222 individuals per hectare, respectively. A total of 16 woody species, representing 12 families were recorded in the study site. Out of the 12 families, all were recorded in the exclosure while 5 were recorded in the degraded site. Out of the 16 species, 15 were recorded in the exclosure while six were in the degraded site. A total of 10 species were recorded in the exclosure, which were absent in the degraded site. Similarly, one species was recorded in the degraded site which was not present in the exclosure. The results showed that protecting of degraded site from human and animal disturbances promotes woody plant species regenerations and productivity Apart from increasing woody plant species, the local communities have benefited from the exclosure in the form of both products (grass harvesting) and services (ecological). Due to this reason the local communities have positive attitudes and contribute a lot for the success of enclosures in the study site. The present study clearly showed that area closure interventions should be oriented towards managing and improving the productivity of the degraded land, in such a way that both the need for conservation of biodiversity and environmental sustainability, and the demands of the local people for biomass resources can be achieved.

Keywords: degraded land, exclosure, land restoration, woody vegetation

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6208 We Have Never Seen a Dermatologist. Prisons Telederma Project Reaching the Unreachable Through Teledermatology

Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa, Annabella Habinka Ejiri

Abstract:

Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to a lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. We aimed at; i) increase awareness and understanding of teledermatology among prison health workers and ii) improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons. Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prison staff with AD. We conducted five days of training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient-Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: We have the very first iconographic atlas of the main dermatoses in pigmented African skin. We increased; i) the proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80%; ii) the proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year; iii) increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year and iv)Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one year. Our study contributes to the use, evaluation, and verification of the use of teledermatology to increase access to specialist dermatology services to the most hard to reach areas and vulnerable populations such as that of prisoners.

Keywords: teledermatology, prisoners, reaching, un-reachable

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6207 Rapid Detection of the Etiology of Infection as Bacterial or Viral Using Infrared Spectroscopy of White Blood Cells

Authors: Uraib Sharaha, Guy Beck, Joseph Kapelushnik, Adam H. Agbaria, Itshak Lapidot, Shaul Mordechai, Ahmad Salman, Mahmoud Huleihel

Abstract:

Infectious diseases cause a significant burden on the public health and the economic stability of societies all over the world for several centuries. A reliable detection of the causative agent of infection is not possible based on clinical features, since some of these infections have similar symptoms, including fever, sneezing, inflammation, vomiting, diarrhea, and fatigue. Moreover, physicians usually encounter difficulties in distinguishing between viral and bacterial infections based on symptoms. Therefore, there is an ongoing need for sensitive, specific, and rapid methods for identification of the etiology of the infection. This intricate issue perplex doctors and researchers since it has serious repercussions. In this study, we evaluated the potential of the mid-infrared spectroscopic method for rapid and reliable identification of bacterial and viral infections based on simple peripheral blood samples. Fourier transform infrared (FTIR) spectroscopy is considered a successful diagnostic method in the biological and medical fields. Many studies confirmed the great potential of the combination of FTIR spectroscopy and machine learning as a powerful diagnostic tool in medicine since it is a very sensitive method, which can detect and monitor the molecular and biochemical changes in biological samples. We believed that this method would play a major role in improving the health situation, raising the level of health in the community, and reducing the economic burdens in the health sector resulting from the indiscriminate use of antibiotics. We collected peripheral blood samples from young 364 patients, of which 93 were controls, 126 had bacterial infections, and 145 had viral infections, with ages lower than18 years old, limited to those who were diagnosed with fever-producing illness. Our preliminary results showed that it is possible to determine the infectious agent with high success rates of 82% for sensitivity and 80% for specificity, based on the WBC data.

Keywords: infectious diseases, (FTIR) spectroscopy, viral infections, bacterial infections.

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6206 Implementing the WHO Air Quality Guideline for PM2.5 Worldwide can Prevent Millions of Premature Deaths Per Year

Authors: Despina Giannadaki, Jos Lelieveld, Andrea Pozzer, John Evans

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Outdoor air pollution by fine particles ranks among the top ten global health risk factors that can lead to premature mortality. Epidemiological cohort studies, mainly conducted in United States and Europe, have shown that the long-term exposure to PM2.5 (particles with an aerodynamic diameter less than 2.5μm) is associated with increased mortality from cardiovascular, respiratory diseases and lung cancer. Fine particulates can cause health impacts even at very low concentrations. Previously, no concentration level has been defined below which health damage can be fully prevented. The World Health Organization ambient air quality guidelines suggest an annual mean PM2.5 concentration limit of 10μg/m3. Populations in large parts of the world, especially in East and Southeast Asia, and in the Middle East, are exposed to high levels of fine particulate pollution that by far exceeds the World Health Organization guidelines. The aim of this work is to evaluate the implementation of recent air quality standards for PM2.5 in the EU, the US and other countries worldwide and estimate what measures will be needed to substantially reduce premature mortality. We investigated premature mortality attributed to fine particulate matter (PM2.5) under adults ≥ 30yrs and children < 5yrs, applying a high-resolution global atmospheric chemistry model combined with epidemiological concentration-response functions. The latter are based on the methodology of the Global Burden of Disease for 2010, assuming a ‘safe’ annual mean PM2.5 threshold of 7.3μg/m3. We estimate the global premature mortality by PM2.5 at 3.15 million/year in 2010. China is the leading country with about 1.33 million, followed by India with 575 thousand and Pakistan with 105 thousand. For the European Union (EU) we estimate 173 thousand and the United States (US) 52 thousand in 2010. Based on sensitivity calculations we tested the gains from PM2.5 control by applying the air quality guidelines (AQG) and standards of the World Health Organization (WHO), the EU, the US and other countries. To estimate potential reductions in mortality rates we take into consideration the deaths that cannot be avoided after the implementation of PM2.5 upper limits, due to the contribution of natural sources to total PM2.5 and therefore to mortality (mainly airborne desert dust). The annual mean EU limit of 25μg/m3 would reduce global premature mortality by 18%, while within the EU the effect is negligible, indicating that the standard is largely met and that stricter limits are needed. The new US standard of 12μg/m3 would reduce premature mortality by 46% worldwide, 4% in the US and 20% in the EU. Implementing the AQG by the WHO of 10μg/m3 would reduce global premature mortality by 54%, 76% in China and 59% in India. In the EU and US, the mortality would be reduced by 36% and 14%, respectively. Hence, following the WHO guideline will prevent 1.7 million premature deaths per year. Sensitivity calculations indicate that even small changes at the lower PM2.5 standards can have major impacts on global mortality rates.

Keywords: air quality guidelines, outdoor air pollution, particulate matter, premature mortality

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6205 Environmental Justice and Citizenship Rights in the Tehran Health Plan

Authors: Mohammad Parvaresh, Mahdi Babaee, Bahareh Arghand, Davood Nourmohammadi

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Environmental degradation is caused by social inequalities and the inappropriate use of nature and a factor in the violation of human rights. Indeed, the right to a safe, healthy and ecologically-balanced environment is an independent human right. Therefore, the relationship between human rights and environmental protection is crucial for the study of social justice and sustainable development, and environmental problems are a result of the failure to realize social and economic justice. In this regard, 'article 50 of the constitution of the Islamic Republic of Iran as a general principle have many of the concepts of sustainable development, including: the growth and improvement of human life, the rights of present and future generations, and the integrity of the inner and outer generation, the prohibition of any environmental degradation'. Also, Charter on Citizen’s Rights, which was conveyed by the President of the Islamic Republic of Iran, Mr. Rouhani refers to the right to a healthy environment and sustainable development. In this regard in 2013, Tehran Province Water and Wastewater Co. defined a plan called 'Tehran’s Health Line' was includes Western and Eastern part by about 26 kilometers of water transferring pipelines varied 1000 to 2000 mm diameters. This project aims to: (1) Transfer water from the northwest water treatment plant to the southwest areas, which suffer from qualitative and quantitative water, in order to mix with the improper wells’ water; (2) Reducing the water consumption provided by harvesting from wells which results in improving the underground water resources, causing the large settlements and stopping the immigrating slums into the center or north side of the city. All of the financial resources accounted for 53,000,000 US$ which is mobilized by Tehran Province Water and Wastewater Co. to expedite the work. The present study examines the Tehran Health Line plan and the purpose of implementation of this plan to achieve environmental protection, environmental justice and citizenship rights for all people who live in Tehran.

Keywords: environmental justice, international environmental law, erga omnes, charter on citizen's rights, Tehran health line

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6204 Enhance Indoor Environment in Buildings and Its Effect on Improving Occupant's Health

Authors: Imad M. Assali

Abstract:

Recently, the world main problem is a global warming and climate change affecting both outdoor and indoor environments, especially the air quality (AQ) as a result of vast migration of people from rural areas to urban areas. Therefore, cities became more crowded and denser from an irregular population increase, along with increasing urbanization caused many problems for the environment such as increasing the land prices, changes in life style, and the new buildings are not adapted to the climate producing uncomfortable and unhealthy indoor building conditions. As interior environments are the places that create the most intimate relationship with the user. Consequently, the indoor environment quality (IEQ) for buildings became uncomfortable and unhealthy for its occupants. The symptoms commonly associated with poor indoor environment such as itchy, headache, fatigue, and respiratory complaints such as cough and congestion, etc. The symptoms tend to improve over time or even disappear when people are away from the building. Therefore, designing a healthy indoor environment to fulfill human needs is the main concern for architects and interior designer. However, this research explores how occupant expectations and environmental attitudes may influence occupant health and satisfaction within the context of the indoor environment. In doing so, it reviews and contributes to the methods and tools used to evaluate only the indoor environment quality (IEQ) components of building performance. Its main aim is to review the literature on indoor human comfort. This is followed by a review of previous papers published related to human comfort. Finally, this paper will provide possible approaches in design level of healthy buildings.

Keywords: sustainable building, indoor environment quality (IEQ), occupant's health, active system, sick building syndrome (SBS)

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6203 Evaluating a Holistic Fitness Program Used by High Performance Athletes and Mass Participants

Authors: Peter Smolianov, Jed Smith, Lisa Chen, Steven Dion, Christopher Schoen, Jaclyn Norberg

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This study evaluated the effectiveness of an experimental training program used to improve performance and health of competitive athletes and recreational sport participants. This holistic program integrated and advanced Eastern and Western methods of prolonging elite sports participation and enjoying lifelong fitness, particularly from China, India, Russia, and the United States. The program included outdoor, gym, and water training approaches focused on strengthening while stretching/decompressing and on full body activation-all in order to improve performance as well as treat and prevent common disorders and pains. The study observed and surveyed over 100 users of the program including recreational fitness and sports enthusiasts as well as elite athletes who competed for national teams of different countries and for Division I teams of National Collegiate Athletic Association in the United States. Different types of sport were studied, including territorial games (e.g., American football, basketball, volleyball), endurance/cyclical (athletics/track and field, swimming), and artistic (e.g., gymnastics and synchronized swimming). Results of the study showed positive effects on the participants’ performance and health, particularly for those who used the program for more than two years and especially in reducing spinal disorders and in enabling to perform new training tasks which previously caused back pain.

Keywords: lifelong fitness, injury prevention, prolonging sport participation, improving performance and health

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6202 Involving Children in Creating a Healthy Environment in Low Socioeconomic Position (SEP) Neighborhoods in the Netherlands: A Participatory Action Research (PAR) Project.

Authors: Lisa Wilderink, Ingrid Bakker, Albertine J. Schuit, Jacob C. Seidell, Carry M. Renders

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To ensure that health behavior interventions for children living in low socioeconomic position (SEP) neighborhoods are in line with children’s wishes and needs, participation of the children in the development, implementation, and evaluation is crucial. In this paper, we show how children living in three low-SEP neighborhoods in the Netherlands can be involved in Participatory Action Research (PAR) and what influences this participation process. The Photovoice method was used and provided comprehensive information from the children’s perspectives. With the help of the community workers, the children identified feasible actions. This paper shows that it is possible to involve children from low SEP neighborhoods in a meaningful way. We found that it is important to constantly discuss the process with participants, start with a concrete question or problem and adapt the project to the local context and skills of participants

Keywords: children, healthy behavior, participatory action research, socioeconomic health inequalities

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