Search results for: significant stressed zone

Authors: Mukund Ramchandra Mogarekar, Pankaj Kumar, Shraddha V. More

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Background: Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), Apo B, and lipoprotein(a) was found as atherogenic factors while high-density lipoprotein cholesterol (HDL-C) was anti-atherogenic. Methods and Results: The study group consists of 40 MI subjects as cases and 40 healthy as controls. Monocytic PON 2 Lactonase (LACT) activity was measured by using Dihydrocoumarine (DHC) as substrate. Phenotyping was done by method of Mogarekar MR et al, serum AOPP by modified method of Witko-Sarsat V et al and Apo B by Turbidimetric immunoassay. PON 2 LACT activities were significantly lower (p< 0.05) and AOPPs & Apo B were higher in MI subjects (p> 0.05). Trimodal distribution of QQ, QR & RR phenotypes of study population showed no significant difference among cases and controls (p> 0.05). Univariate binary logistic regression analysis showed independent association of TC, HDL, LDL, AOPP, Apo B, and PON 2 LACT activity with MI and multiple forward binary logistic regression showed PON 2 LACT activity and serum Apo B as an independent predictor of MI. Conclusions- Decrease in PON 2 LACT activity in MI subjects than in controls suggests increased oxidative stress in MI which is reflected by significantly increased AOPP and Apo B. PON 1 polymorphism of QQ, QR and RR showed no significant difference in protection against MI. Univariate and multiple forward binary logistic regression showed PON 2 LACT activity and serum Apo B as an independent predictor of MI.

Keywords: advanced oxidation protein products, apolipoprotein-B, myocardial infarction, paraoxonase 2 lactonase

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Authors: Moustafa Osman Mohammed

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Integration sustainability outcomes give attention to construction ecology in the design review of urban environments to comply with Earth’s System that is composed of integral parts of the (i.e., physical, chemical and biological components). Naturally, exchange patterns of industrial ecology have consistent and periodic cycles to preserve energy flows and materials in Earth’s System. When engineering topology is affecting internal and external processes in system networks, it postulated the valence of the first-level spatial outcome (i.e., project compatibility success). These instrumentalities are dependent on relating the second-level outcome (i.e., participant security satisfaction). Construction ecology approach feedback energy from resources flows between biotic and abiotic in the entire Earth’s ecosystems. These spatial outcomes are providing an innovation, as entails a wide range of interactions to state, regulate and feedback “topology” to flow as “interdisciplinary equilibrium” of ecosystems. The interrelation dynamics of ecosystems are performing a process in a certain location within an appropriate time for characterizing their unique structure in “equilibrium patterns”, such as biosphere and collecting a composite structure of many distributed feedback flows. These interdisciplinary systems regulate their dynamics within complex structures. These dynamic mechanisms of the ecosystem regulate physical and chemical properties to enable a gradual and prolonged incremental pattern to develop a stable structure. The engineering topology of construction ecology for integration sustainability outcomes offers an interesting tool for ecologists and engineers in the simulation paradigm as an initial form of development structure within compatible computer software. This approach argues from ecology, resource savings, static load design, financial other pragmatic reasons, while an artistic/architectural perspective, these are not decisive. The paper described an attempt to unify analytic and analogical spatial modeling in developing urban environments as a relational setting, using optimization software and applied as an example of integrated industrial ecology where the construction process is based on a topology optimization approach.

Keywords: construction ecology, industrial ecology, urban topology, environmental planning

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Authors: Mursal Ibrahim Zada

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Since 2001, the new Government of Afghanistan has put the improvement of transportation in rural area as one of the key issues for the development of the country. Since then, about 17,000 km of rural roads were planned to be constructed in the entire country. This thesis will assess the impact of rural road improvement on the development of rural communities and housing facilities. Specifically, this study aims to show that the improved road has leads to an improvement in the community, which in turn has a positive effect on the lives of rural people. To obtain this goal, a questionnaire survey was conducted in March 2015 to the residents of four different districts of Kabul province, Afghanistan, where the road projects were constructed in recent years. The collected data was analyzed using on a regression analysis considering different factors such as land price, waiting time at the station, travel time to the city, number of employed family members and so on. Three models are developed to demonstrate the relationship between different factors before and after the improvement of rural transportation. The results showed a significant change positively in the value of land price and housing facilities, travel time to the city, waiting time at the station, number of employed family members, fare per trip to the city, and number of trips to the city per month after the pavement of the road. The results indicated that the improvement of transportation has a significant impact on the improvement of the community in different parts, especially on the price of land and housing facility and travel time to the city.

Keywords: accessibility, Afghanistan, housing facility, rural area, land price

Procedia PDF Downloads 263

Authors: Somayeh Sharifi

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The purpose of this study is to investigate the effects of collaborative reflection and class observation on improving the quality of teacher training courses and the students reading comprehension skills. 13 inexperienced English teachers teaching elementary courses that were at the same level of proficiency were chosen. Thirteen participants were allocated in two groups, with 7 teachers in the experimental group and the other 6 teachers in the control group. Since two groups were not selected randomly, this study is a form of quasi-experimental research. In addition to a 3-day teacher training course for both groups, teachers in experimental group recorded and observed 20 sessions of their own classes and 30 sessions of experienced teachers’ class and participated in 12 meetings -3 month once a week- in which teachers shared any event that they found interesting during observations and their own teaching and compare it with strategies that they learned in teacher training courses. In contrast, the control group did not engage in any process of observation and collaboration. In order to test students' performance in English before and after the treatment, a Key English Test (KET) was employed to check students' reading skill. The result of the test shows that there is not a significant difference in mean of scores in KET pretest in and, since they are close to each other. However by considering mean and median of posttest in both classes we perceive that although both control and experimental group students' proficiency in English enhanced, there was a significant difference in experimental group students' final scores before and after treatment.

Keywords: collaborative reflection, reading comprehension, teacher training courses, key English test (KET)

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Authors: Okhee Woo, Hye Seon Shin

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Purpose: To investigate the diagnostic power of digital breast tomosynthesis (DBT) in evaluation of breast microcalcifications and usefulness as a pre-procedural study for stereotactic biopsy in comparison with full-field digital mammogram (FFDM) and FFDM plus magnification image (FFDM+MAG). Methods and Materials: An IRB approved retrospective observer performance study on DBT, FFDM, and FFDM+MAG was done. Image quality was rated in 5-point scoring system for lesion clarity (1, very indistinct; 2, indistinct; 3, fair; 4, clear; 5, very clear) and compared by Wilcoxon test. Diagnostic power was compared by diagnostic values and AUC with 95% confidence interval. Additionally, procedural report of biopsy was analysed for patient positioning and adequacy of instruments. Results: DBT showed higher lesion clarity (median 5, interquartile range 4-5) than FFDM (3, 2-4, p-value < 0.0001), and no statistically significant difference to FFDM+MAG (4, 4-5, p-value=0.3345). Diagnostic sensitivity and specificity of DBT were 86.4% and 92.5%; FFDM 70.4% and 66.7%; FFDM+MAG 93.8% and 89.6%. The AUCs of DBT (0.88) and FFDM+MAG (0.89) were larger than FFDM (0.59, p-values < 0.0001) but there was no statistically significant difference between DBT and FFDM+MAG (p-value=0.878). In 2 cases with DBT, petit needle could be appropriately prepared; and other 3 without DBT, patient repositioning was needed. Conclusion: DBT showed better image quality and diagnostic values than FFDM and equivalent to FFDM+MAG in the evaluation of breast microcalcifications. Evaluation with DBT as a pre-procedural study for breast stereotactic biopsy can lead to more accurate localization and successful biopsy and also waive the need for additional magnification images.

Keywords: DBT, breast cancer, stereotactic biopsy, mammography

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Authors: Rui Du

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This paper attempts to assess the impact of a major sporting event —the Super Bowl on the local economies. The identification strategy is to compare the winning and losing cities at the National Football League (NFL) conference finals under the assumption of similar pre-treatment trends. The stock market performances of companies headquartered in these cities are used to capture the sudden changes in local economic activities during a short time span. The exogenous variations in the football game outcome allow a straightforward difference-in-differences approach to identify the effect. This study finds that the post-event trends in winning and losing cities diverge despite the fact that both cities have economically and statistically similar pre-event trends. Empirical analysis provides suggestive evidence of a positive, significant local economic impact of conference final wins, possibly through city image enhancement. Further empirical evidence shows the presence of heterogeneous effects across industrial sectors, suggesting that city image enhancing the effect of the Super Bowl participation is empirically relevant for the changes in the composition of local industries. Also, this study also adopts a similar strategy to examine the local economic impact of Super Bowl successes, however, finds no statistically significant effect.

Keywords: Super Bowl Participation, local economies, city image enhancement, difference-in-differences, industrial sectors

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Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

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Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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Authors: Ramutė Miseikienė, Saulius Tusas

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Somatic cell count and bacteria count are the main indicators of cow milk quality. The aim of this study was to analyze and compare parameters of milk quality in different-sized cows herds. Milk quality of ten dairy cows farms during one year period was analyzed. Dairy farms were divided into five groups according to number of cows in the farm (under 50 cows, 51–100 cows, 101–200 cows, 201–400 cows and more than 400 cows). The averages of somatic cells bacteria count in milk and milk freezing temperature were analyzed. Also, these parameters of milk quality were compared during outdoor (from May to September) and indoor (from October to April) periods. The largest number of SCC was established in the smallest farms, i.e., in farms under 50 cows and 51-100 cows (respectively 264±9,19 and 300±10,24 thousand/ml). Reliable link between the smallest and largest dairy farms and farms with 101-200 and 201-400 cows and count of somatic cells in milk has not been established (P > 0.05). Bacteria count had a low tendency to decrease when the number of cows in farms increased. The highest bacteria number was determined in the farms with 51-100 cows and the the lowest bacteria count was in milk when 201-400 and more than 401 cows were kept. With increasing the number of cows milk maximal freezing temperature decreases (significant negative trend), i. e, indicator is improving. It should be noted that in all farms milk freezing point never exceeded requirements (-0.515 °C). The highest difference between SCC in milk during the indoor and outdoor periods was established in farms with 201-400 cows (respectively 218.49 thousand/ml and 268.84 thousand/ml). However, the count of SC was significantly higher (P < 0.05) during outdoor period in large farms (201-400 and more cows). There was no significant difference between bacteria count in milk during both – outdoor and indoor – periods (P > 0.05).

Keywords: bacteria, cow, farm size, somatic cell count

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Authors: Ani Wilson Uchenna, Ogbonna Chikodi

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This study examined the impact of artificial intelligence driven applications on banks’ performance in West Africa using Nigeria and Ghana as case studies. Specifically, the study examined the extent to which deployment of smart automated teller machine impacts the banks’ net worth within the reference period in Nigeria and Ghana. It ascertained the impact of point of sale on banks’ net worth within the reference period in Nigeria and Ghana. Thirdly, it verified the extent to which webpay services can influence banks’ performance in Nigeria and Ghana and finally, determined the impact of mobile pay services on banks’ performance in Nigeria and Ghana. The study used automated teller machine (ATM), Point of sale services (POS), Mobile pay services (MOP) and Web pay services (WBP) as proxies for explanatory variables while Bank net worth was used as explained variable for the study. The data for this study were sourced from central bank of Nigeria (CBN) Statistical Bulletin as well as Bank of Ghana (BoGH) Statistical Bulletin, Ghana payment systems oversight annual report and world development indicator (WDI). Furthermore, the mixed order of integration observed from the panel unit test result justified the use of autoregressive distributed lag (ARDL) approach to data analysis which the study adopted. While the cointegration test showed the existence of cointegration among the studied variables, bound test result justified the presence of long-run relationship among the series. Again, ARDL error correction estimate established satisfactory (13.92%) speed of adjustment from long run disequilibrium back to short run dynamic relationship. The study found that while Automated teller machine (ATM) had statistically significant impact on bank net worth (BNW) of Nigeria and Ghana, point of sale services application (POS) statistically and significantly impact on bank net worth within the study period, mobile pay services application was statistically significant in impacting the changes in the bank net worth of the countries of study while web pay services (WBP) had no statistically significant impact on bank net worth of the countries of reference. The study concluded that artificial intelligence driven application have significant an positive impact on bank performance with exception of web pay which had negative impact on bank net worth. The study recommended that management of banks both in Nigerian and Ghanaian should encourage more investments in AI-powered smart ATMs aimed towards delivering more secured banking services in order to increase revenue, discourage excessive queuing in the banking hall, reduced fraud and minimize error in processing transaction. Banks within the scope of this study should leverage on modern technologies to checkmate the excesses of the private operators POS in order to build more confidence on potential customers. Government should convert mobile pay services to a counter terrorism tool by ensuring that restrictions on over-the-counter withdrawals to a minimum amount is maintained and place sanctions on withdrawals above that limit.

Keywords: artificial intelligence (ai), bank performance, automated teller machines (atm), point of sale (pos)

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Authors: H. Arzani, Z. Arzani

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Every piece of rangeland has a different set of physical and biological characteristics. This requires the manager to synthesis various information for regular monitoring to define changes trend to get wright decision for sustainable management. So range managers need to use computerized technologies to monitor rangeland, and select. The best management practices. There are four examples of computerized technologies that can benefit sustainable management: (1) Photographic method for cover measurement: The method was tested in different vegetation communities in semi humid and arid regions. Interpretation of pictures of quadrats was done using Arc View software. Data analysis was done by SPSS software using paired t test. Based on the results, generally, photographic method can be used to measure ground cover in most vegetation communities. (2) GPS application for corresponding ground samples and satellite pixels: In two provinces of Tehran and Markazi, six reference points were selected and in each point, eight GPS models were tested. Significant relation among GPS model, time and location with accuracy of estimated coordinates was found. After selection of suitable method, in Markazi province coordinates of plots along four transects in each 6 sites of rangelands was recorded. The best time of GPS application was in the morning hours, Etrex Vista had less error than other models, and a significant relation among GPS model, time and location with accuracy of estimated coordinates was found. (3) Application of satellite data for rangeland monitoring: Focusing on the long term variation of vegetation parameters such as vegetation cover and production is essential. Our study in grass and shrub lands showed that there were significant correlations between quantitative vegetation characteristics and satellite data. So it is possible to monitor rangeland vegetation using digital data for sustainable utilization. (4) Rangeland suitability classification with GIS: Range suitability assessment can facilitate sustainable management planning. Three sub-models of sensitivity to erosion, water suitability and forage production out puts were entered to final range suitability classification model. GIS was facilitate classification of range suitability and produced suitability maps for sheep grazing. Generally digital computers assist range managers to interpret, modify, calibrate or integrating information for correct management.

Keywords: computer, GPS, GIS, remote sensing, photographic method, monitoring, rangeland ecosystem, management, suitability, sheep grazing

Procedia PDF Downloads 367

Authors: Rachel Hasan

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Kingdom of Saudi Arabia has witnessed various significant social and political developments in 2018. Crown Prince of Kingdom of Saudi Arabia, Muhammad bin Salman, also serving as Deputy Prime Minister of Saudi Arabia, has made several social, cultural, and political changes in the country under his grand National Transformation Program. Program provides a vision of more economically viable, culturally liberal, and politically pleasant Saudi Arabia. One of the most significant and ground breaking changes that has been made under this program is awarding women the long awaited rights. Legislative changes are made to allow woman to drive. Seemingly basic on surface but driving rights to women represent much deeper meaning to the culture of Saudi Arabia and to the world outside. Ever since this right is awarded to the women, world media is interpreting this change in various colors. This paper aims to investigate the portrayal of gender rights in various online media publications and websites. The methodology applied has been quantitative content analysis method to analyze the various aspects of media's coverage of various social and cultural changes with reference to women's rights. For the purpose of research, convenience sampling was done for eight international online articles from media websites. The articles discussed the lifting of ban for females on driving cars in Saudi Arabia as well as gender development for these women. These articles were analyzed for media frames, and various categories of analysis were developed, which highlighted the stance that was observed. Certain terms were conceptualized and operationalized and were also explained for better understanding of the context.

Keywords: gender rights, media coverage, political change, women's liberation

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Authors: Odunjo Oluronke Omolola, Okanlawon Simon Ayorinde

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This study examines the relationship between house characteristics and socio-economic characteristics of developers in Ibadan, southwest, Nigeria. The research is borne out of the fact that social housing has not done much as a result of finance and housing poverty is on the increase in the country. Multistage random sampling was used in selecting 2,646 respondents in the area. The questionnaire forms the basic instrument for data collection and was administered to heads of households to collect information on socio-economic and demographic characteristics as well as characteristics of development. Both descriptive and inferential statistical analyses were employed in the presentation of the findings; MANOVA was used to analyse the relationship between house characteristics measured by wall materials (Y1-Yn) and socio-economic characteristics of developers measured by gender (X1), religion (X2), educational background (X3) and employment status (X4).The study found out that the bulk of the respondents (65.7%) were male, while 51.7% practiced Christianity. Also, 35.9% had HND/1st/Postgraduate degree, while 43.9% were self employed; Most households however, had membership size of 5 (26.9%). The significant wall material in the area was sandcrete block (71.2%) as opposed to mud (19.1%) and brick (0.6%). Multiple Analysis of Variance shows that there is a significant relationship between sandcrete block and each of gender (X1) and employment status (X3). The factor adduced to this is accessibility to cooperative societies which serve as the gravitational force of attraction for housing finance. The study suggests among others that, there should be re-invigoration of existing cooperative societies, while more should be established for the provision of housing finance.

Keywords: relationship, house development, developers, sandcrete block, cooperative societies

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Authors: Gulnur Arabaci

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Heavy metals are one of the major groups of contaminants in the environment and many of them are toxic even at very low concentration in plants and animals. However, some metals play important roles in the biological function of many enzymes in living organisms. Metals such as zinc, iron, and cooper are important for survival and activity of enzymes in plants, however heavy metals can inhibit enzyme which is responsible for defense system of plants. Polyphenol oxidase (PPO) is a copper-containing metalloenzyme which is responsible for enzymatic browning reaction of plants. Enzymatic browning is a major problem for the handling of vegetables and fruits in food industry. It can be increased and effected with many different futures such as metals in the nature and ground. In the present work, PPO was isolated and characterized from green leaves of red poppy plant (Papaver rhoeas). Then, the effect of some known antibrowning agents which can form complexes with metals and metals were investigated on the red poppy PPO activity. The results showed that glutathione was the most potent inhibitory effect on PPO activity. Cu(II) and Fe(II) metals increased the enzyme activities however, Sn(II) had the maximum inhibitory effect and Zn(II) and Pb(II) had no significant effect on the enzyme activity. In order to reduce the effect of heavy metals, the effects of metal-antibrowning agent complexes on the PPO activity were determined. EDTA and metal complexes had no significant effect on the enzyme. L-ascorbic acid and metal complexes decreased but L-ascorbic acid-Cu(II)-complex had no effect. Glutathione–metal complexes had the best inhibitory effect on Red poppy leaf PPO activity.

Keywords: inhibition, metal, red poppy, poly phenol oxidase (PPO)

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Authors: M. Azharul Islam, M. Russel Sarker, M. Shahadat Hossen

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Air pollution is one of the major environmental problems that have gained importance in all over the world. Air pollution is a problem for all of us. The present study was conducted to explore the people’s perception level and awareness of air pollution in selected areas of Mymensingh in Bangladesh. Health impacts of air pollution also studied through personal interview and structured questionnaire. The relationship of independent variables (age, educational qualification, family size, residence and communication exposure) with the respondent’s perception level and awareness of air pollution (dependent variable) was studied to achieve the objectives of the study. About 600 respondents were selected randomly from six sites for collecting data during the period of July 2016 to June 2017. Pearson’s product-moment correlation coefficients were computed to examine the relationship between the concerned variables. The results revealed that about half (46.67%) of the respondents had a medium level of perception and awareness about air pollution in their areas where 31.67 percent had low, and 21.67 percent had a high level. In rural areas of the study sites, 43.33 percent respondents had low, 50 percent had medium, and only 6.67 percent had high perception and awareness on air pollution. In case of urban areas, 20 percent respondents had low, 43.33 percent had medium, and 36.67 percent had a high level of awareness and perception on air pollution. The majority of the respondents (93.33 percent) were lacking of proper awareness about air pollution in rural areas while 63.33 percent in urban areas. Out of five independent variables, three variables such as- educational qualification, residence status and communication exposure had positive and significant relationship. Age of respondents had negative and significant relationship with their awareness of air pollution where family size of the respondents had no significant relationship with their perception and awareness of air pollution. Thousands of people live in urban areas where urban smog, particle pollution, and toxic pollutants pose serious health concerns. But most of the respondents of the urban sites are not familiarize about the real causes of air pollution. Respondents exposed higher level of experience for air pollutants, such as- irritation of the eyes, coughing, tightness of chest and many health difficulties. But respondents of both rural and urban area hugely suffered such health problems and the tendency of certain difficulties increased day by day. In this study, most of the respondents had lack of knowledge on the causes of such health difficulties due to their lower perception level. Proper attempts should be taken to raise literacy level, communication exposure to increase the perception and awareness of air pollution among the respondents of the study areas. Extra care with above concerned fields should be taken to increase perception and awareness of air pollution in rural areas.

Keywords: air pollution, awareness, health impacts, perception of people

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Authors: Chris Schoborg, Morgan C. Wang

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In the realm of the National Football League (NFL), substantial dedication of time and effort is invested by both players and coaches in meticulously analyzing the game footage of their opponents. The primary aim is to anticipate the actions of the opposing team. Defensive players and coaches are especially focused on deciphering their adversaries' intentions to effectively counter their strategies. Acquiring insights into the specific play type and its intended direction on the field would confer a significant competitive advantage. This study establishes pre-snap information as the cornerstone for predicting both the play type (e.g., deep pass, short pass, or run) and its spatial trajectory (right, left, or center). The dataset for this research spans the regular NFL season data for all 32 teams from 2013 to 2022. This dataset is acquired using the nflreadr package, which conveniently extracts play-by-play data from NFL games and imports it into the R environment as structured datasets. In this study, we employ a recently developed machine learning algorithm, XGBoost. The final predictive model achieves an impressive lift of 2.61. This signifies that the presented model is 2.61 times more effective than random guessing—a significant improvement. Such a model has the potential to markedly enhance defensive coaches' ability to formulate game plans and adequately prepare their players, thus mitigating the opposing offense's yardage and point gains.

Keywords: lift, NFL, sports analytics, XGBoost

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Authors: Mohd A. Azizan, Mohd Z. Zali

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It is well established that exposure to vibration has an adverse effect on human health, comfort, and performance. However, there is little quantitative knowledge on performance combined with drowsiness level during vibration exposure. This paper reports a study investigating the influence of vibration amplitude on seated occupant reaction time and drowsiness level. Eighteen male volunteers were recruited for this experiment. Before commencing the experiment, total transmitted acceleration measured at interfaces between the seat pan and seatback to human body was adjusted to become 0.2 ms-2 r.m.s and 0.4 ms-2 r.m.s for each volunteer. Seated volunteers were exposed to Gaussian random vibration with frequency band 1-15 Hz at two level of amplitude (low vibration amplitude and medium vibration amplitude) for 20-minutes in separate days. For the purpose of drowsiness measurement, volunteers were asked to complete 10-minutes PVT test before and after vibration exposure and rate their subjective drowsiness by giving score using Karolinska Sleepiness Scale (KSS) before vibration, every 5-minutes interval and following 20-minutes of vibration exposure. Strong evidence of drowsiness was found as there was a significant increase in reaction time and number of lapse following exposure to vibration in both conditions. However, the effect is more apparent in medium vibration amplitude. A steady increase of drowsiness level can also be observed in KSS in all volunteers. However, no significant differences were found in KSS between low vibration amplitude and medium vibration amplitude. It is concluded that exposure to vibration has an adverse effect on human alertness level and more pronounced at higher vibration amplitude. Taken together, these findings suggest a role of vibration in promoting drowsiness, especially at higher vibration amplitude.

Keywords: drowsiness, human vibration, karolinska sleepiness scale, psychomotor vigilance test

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Authors: G. R. Constantine, M.C.K. Thilakasiri, V.S. Mohottala, T.V. Soundaram, D.S. Rathnayake, E.G.H.E. De Silva, A.L.S. Mohamed, V.R. Weerasekara

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Orthostatic hypotension is prevalent in the elderly population, and it is an important risk factor contributing to falls in the elderly. This study aims to evaluate the prevalence of orthostatic hypotension in hospitalized elderly patients, changes in blood pressure during the hospital stay, morbidities associated with it and its association with falls in the elderly. A cross-sectional descriptive study was conducted in the National Hospital of Sri Lanka (NHSL) in a sample of 120 patients of age 65 years or above who were admitted to the medical wards. The demographic, clinical data was obtained by an interviewer-administered questionnaire. Two validated questionnaires were used to assess symptoms and effects of orthostatic hypotension and risk factors associated with falls. Orthostatic hypotension on admission and after 3 days of hospital stay was measured by bed-side mercury sphygmomanometer. Prevalence of orthostatic hypotension among the study population was 63.3%(76 patients). But no significant change in the orthostatic hypotension noted after 3 days of hospital admission (SND 0.61, SE= 5.59, p=0.27). There was no significant association found between orthostatic hypotension and its symptoms (dizziness and vertigo, vision problems, malaise, fatigue, poor concentration, neck stiffness), impact on standing or walking and non-communicable diseases. Falls were experienced by 27.5 % (33 patients) of the study population and prevalence of patients with orthostatic hypotension who had experienced falls was 25.9% (28 patients). In conclusions, orthostatic hypotension is more prevalent among elderly patients, but It wasn’t associated with symptoms, and non-communicable diseases, or as a risk factor for falls in elderly.

Keywords: orthostatic hypotension, elderly falls, emergency geriatric, Sri Lanka

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Authors: Reza Dehghani Bidgoli

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Information on different rangeland plants’ nutritive values at various phonological stages is important in rangelands management. This information helps rangeland managers to choose proper grazing times to achieve higher animal performance without detrimental effects on the rangeland vegetations. Effects of various plant parts’ phonological stages and vegetation types on reserve carbohydrates and forage quality indicators were investigated during the 2009 and 2010. Plant samples were collected in a completely randomized block (CRB) design. The species included, grasses (Secale montanum and Festuco ovina), forbs (Lotus corniculatus and Sanguisorba minor), and shrubs (Kochia prosterata and Salsola rigida). Aerial plant parts’ samples were oven-dried at 80oC for 24 hours, then analyzed for soluble carbohydrates, crude protein (CP), acid detergent fiber (ADF), dry matter digestible (DMD), and metabolizable energy (ME). Results showed that plants at the seedling stage had more reserve carbohydrates and from the three vegetation types (grass, forbs, and shrub), forbs contained more soluble carbohydrates compared to the other two (grasses and shrubs). Differences in soluble carbohydrate contents of different species at various phonological stages in 2 years were statistically significant. The forage quality indicators (CP, ADF, DMD, and ME) in different species, in different vegetation types, in the 2 years were statistically significant, except for the CP.

Keywords: grazing, soluble carbohydrate, protein, fiber, metabolizeable energy

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Authors: Yi Jen Wang, Yu Ju Chen

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Background: Heart rate variability (HRV) biofeedback can promote autonomic nervous function, sleep quality and reduce psychological stress. In HRV biofeedback training, it is hoped that through the guidance of machine video or audio, the patient can breathe slowly according to his own heart rate changes so that the heart and lungs can achieve resonance, thereby promoting the related effects of autonomic nerve function; while, it is also pointed out that if slow breathing of 6 times per minute can also guide the case to achieve the effect of cardiopulmonary resonance. However, there is no relevant research to explore the comparison of the effectiveness of cardiopulmonary resonance by using video or audio HRV biofeedback training and metronome-guided slow breathing. Purpose: To compare the promotion of autonomic nervous function performance between using HRV biofeedback and slow breathing guided by a metronome. Method: This research is a kind of experimental design with convenient sampling; the cases are randomly divided into the heart rate variability biofeedback training group and the slow breathing training group. The HRV biofeedback training group will conduct HRV biofeedback training in a four-week laboratory and use the home training device for autonomous training; while the slow breathing training group will conduct slow breathing training in the four-week laboratory using the mobile phone APP breathing metronome to guide the slow breathing training, and use the mobile phone APP for autonomous training at home. After two groups were enrolled and four weeks after the intervention, the autonomic nervous function-related performance was repeatedly measured. Using the chi-square test, student’s t-test and other statistical methods to analyze the results, and use p <0.05 as the basis for statistical significance. Results: A total of 27 subjects were included in the analysis. After four weeks of training, the HRV biofeedback training group showed significant improvement in the HRV indexes (SDNN, RMSSD, HF, TP) and sleep quality. Although the stress index also decreased, it did not reach statistical significance; the slow breathing training group was not statistically significant after four weeks of training, only sleep quality improved significantly, while the HRV indexes (SDNN, RMSSD, TP) all increased. Although HF and stress indexes decreased, they were not statistically significant. Comparing the difference between the two groups after training, it was found that the HF index improved significantly and reached statistical significance in the HRV biofeedback training group. Although the sleep quality of the two groups improved, it did not reach that level in a statistically significant difference. Conclusion: HRV biofeedback training is more effective in promoting autonomic nervous function than slow breathing training, but the effects of reducing stress and promoting sleep quality need to be explored after increasing the number of samples. The results of this study can provide a reference for clinical or community health promotion. In the future, it can also be further designed to integrate heart rate variability biological feedback training into the development of AI artificial intelligence wearable devices, which can make it more convenient for people to train independently and get effective feedback in time.

Keywords: autonomic nervous function, HRV biofeedback, heart rate variability, slow breathing

Procedia PDF Downloads 175

Authors: Amritee Bora, B. S. Mipun

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Land degradation is often used to describe the land environmental phenomena that reduce land’s original productivity both qualitatively and quantitatively. The study of land degradation vulnerability primarily deals with “Environmentally Sensitive Areas” (ESA) and the amount of topsoil loss due to erosion. In many studies, it is observed that the assessment of the existing status of land degradation is used to represent the vulnerability. Moreover, it is also noticed that in most studies, the primary emphasis of land degradation vulnerability is to assess its sensitivity to soil erosion only. However, the concept of land degradation vulnerability can have different objectives depending upon the perspective of the study. It shows the extent to which changes in land use land cover can imprint their effect on the land. In other words, it represents the susceptibility of a piece of land to degrade its productive quality permanently or in the long run. It is also important to mention that the vulnerability of land degradation is not a single factor outcome. It is a probability assessment to evaluate the status of land degradation and needs to consider both biophysical and human induce parameters. To avoid the complexity of the previous models in this regard, the present study has emphasized on to generate a simplified model to assess the land degradation vulnerability in terms of its current human population pressure, land use practices, and existing biophysical conditions. It is a “Mixed-Method” termed as the land degradation vulnerability index (LDVi). It was originally inspired by the MEDALUS model (Mediterranean Desertification and Land Use), 1999, and Farazadeh’s 2007 revised version of it. It has followed the guidelines of Space Application Center, Ahmedabad / Indian Space Research Organization for land degradation vulnerability. The model integrates the climatic index (Ci), vegetation index (Vi), erosion index (Ei), land utilization index (Li), population pressure index (Pi), and cover management index (CMi) by giving equal weightage to each parameter. The final result shows that the very high vulnerable zone primarily indicates three (3) prominent circumstances; land under continuous population pressure, high concentration of human settlement, and high amount of topsoil loss due to surface runoff within the study sites. As all the parameters of the model are amalgamated with equal weightage further with the help of regression analysis, the LDVi model also provides a strong grasp of each parameter and how far they are competent to trigger the land degradation process.

Keywords: population pressure, land utilization, soil erosion, land degradation vulnerability

Procedia PDF Downloads 166

Authors: Lubaina Soni, Claire Farrell, Christopher Szota, Tim D. Fletcher

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Green roofs are a promising engineered ecosystem for reducing stormwater runoff and restoring vegetation cover in cities. Plants can contribute to rainfall retention by rapidly depleting water in the substrate; however, this increases the risk of plant drought stress. Green roof configurations, therefore, need to provide plants the opportunity to efficiently deplete the substrate but also avoid severe drought stress. This study used green roof modules placed in a rainout shelter during a six-month rainfall regime simulated in Melbourne, Australia. Rainfall was applied equally with an overhead irrigation system on each module. Aside from rainfall, modules were under natural climatic conditions, including temperature, wind, and radiation. A single species, Ficinia nodosa, was planted with five different treatments and three replicates of each treatment. In this experiment, we tested the impact of three plant cover treatments (0%, 50% and 100%) on rainfall retention and plant drought stress. We also installed two runoff zone treatments covering 50% of the substrate surface for additional modules with 0% and 50% plant cover to determine whether directing rainfall resources towards plant roots would reduce drought stress without impacting rainfall retention. The retention performance for the simulated rainfall events was measured, quantifying all components for hydrological performance and survival on green roofs. We found that evapotranspiration and rainfall retention were similar for modules with 50% and 100% plant cover. However, modules with 100% plant cover showed significantly higher plant drought stress. Therefore, planting at a lower cover/density reduced plant drought stress without jeopardizing rainfall retention performance. Installing runoff zones marginally reduced evapotranspiration and rainfall retention, but by approximately the same amount for modules with 0% and 50% plant cover. This indicates that reduced evaporation due to the installation of the runoff zones likely contributed to reduced evapotranspiration and rainfall retention. Further, runoff occurred from modules with runoff zones faster than those without, indicating that we created a faster pathway for water to enter and leave the substrate, which also likely contributed to lower overall evapotranspiration and retention. However, despite some loss in retention performance, modules with 50% plant cover installed with runoff zones showed significantly lower drought stress in plants compared to those without runoff zones. Overall, we suggest that reducing plant cover represents a simple means of optimizing green roof performance but creating runoff zones may reduce plant drought stress at the cost of reduced rainfall retention.

Keywords: green roof, plant cover, plant drought stress, rainfall retention

Procedia PDF Downloads 115

Authors: Marzieh Yassin, Fereshteh Navaee, Javad Sarrafzadeh, Reza Salehi

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Introduction: Myofascial trigger point (MTrP) is one of the most common sources of musculoskeletal pain. Approximately 30-85% of the patients with musculoskeletal pains would experience MTrP in their life. The prevalence of MTrP has reported in the patients seen in a general orthopedic clinic, general medical clinic and specialty pain management centers, 21%, 30% and 93% respectively. Nowadays, dry needling is suggested as a standard treatment for MTrPs. The purpose of the present study was to examine the effectiveness of dry needling with stretching upper trapezius muscle on pain and pain pressure threshold in participants with active myofascial trigger point. Methods: Thirty participants with an active myofascial trigger point of the upper trapezius muscle were randomly divided into two groups: dry needling with passive stretch (n=15) and passive stretch alone (n=15). They received 5 sessions of the treatments for three weeks. The outcomes were pain intensity and pain pressure threshold that were assessed with visual analogue scale and algometer respectively. Results: Significant improvement in pain and pain pressure threshold was observed in both groups (P=0.0001) after the treatment. Also, the results showed a significant difference in measurements between two groups (P<0.05). Conclusion: Dry needling with passive stretch can be more effective on pain and pain pressure threshold than passive stretching alone in short term in participants with active myofascial trigger points.

Keywords: dry needling, myofascial pain syndrome, myofascial trigger point, stretching

Procedia PDF Downloads 67

Authors: Orkide Donma, Mustafa M. Donma

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Basal metabolic rate (BMR) is widely used and an accepted measure of energy expenditure. Its principal determinant is body mass. However, this parameter is also correlated with a variety of other factors. The objective of this study is to measure BMR and compare it with the values obtained from predictive equations in adults classified according to their body mass index (BMI) values. 276 adults were included into the scope of this study. Their age, height and weight values were recorded. Five groups were designed based on their BMI values. First group (n = 85) was composed of individuals with BMI values varying between 18.5 and 24.9 kg/m². Those with BMI values varying from 25.0 to 29.9 kg/m² constituted Group 2 (n = 90). Individuals with 30.0-34.9 kg/m², 35.0-39.9 kg/m², > 40.0 kg/m² were included in Group 3 (n = 53), 4 (n = 28) and 5 (n = 20), respectively. The most commonly used equations to be compared with the measured BMR values were selected. For this purpose, the values were calculated by the use of four equations to predict BMR values, by name, introduced by Food and Agriculture Organization (FAO)/World Health Organization (WHO)/United Nations University (UNU), Harris and Benedict, Owen and Mifflin. Descriptive statistics, ANOVA, post-Hoc Tukey and Pearson’s correlation tests were performed by a statistical program designed for Windows (SPSS, version 16.0). p values smaller than 0.05 were accepted as statistically significant. Mean ± SD of groups 1, 2, 3, 4 and 5 for measured BMR in kcal were 1440.3 ± 210.0, 1618.8 ± 268.6, 1741.1 ± 345.2, 1853.1 ± 351.2 and 2028.0 ± 412.1, respectively. Upon evaluation of the comparison of means among groups, differences were highly significant between Group 1 and each of the remaining four groups. The values were increasing from Group 2 to Group 5. However, differences between Group 2 and Group 3, Group 3 and Group 4, Group 4 and Group 5 were not statistically significant. These insignificances were lost in predictive equations proposed by Harris and Benedict, FAO/WHO/UNU and Owen. For Mifflin, the insignificance was limited only to Group 4 and Group 5. Upon evaluation of the correlations of measured BMR and the estimated values computed from prediction equations, the lowest correlations between measured BMR and estimated BMR values were observed among the individuals within normal BMI range. The highest correlations were detected in individuals with BMI values varying between 30.0 and 34.9 kg/m². Correlations between measured BMR values and BMR values calculated by FAO/WHO/UNU as well as Owen were the same and the highest. In all groups, the highest correlations were observed between BMR values calculated from Mifflin and Harris and Benedict equations using age as an additional parameter. In conclusion, the unique resemblance of the FAO/WHO/UNU and Owen equations were pointed out. However, mean values obtained from FAO/WHO/UNU were much closer to the measured BMR values. Besides, the highest correlations were found between BMR calculated from FAO/WHO/UNU and measured BMR. These findings suggested that FAO/WHO/UNU was the most reliable equation, which may be used in conditions when the measured BMR values are not available.

Keywords: adult, basal metabolic rate, fao/who/unu, obesity, prediction equations

Procedia PDF Downloads 133

Authors: Bryan Clark B. Hernandez, Eugene C. Herrera, Kazuo Nadaoka

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Mangrove forests thriving in intertidal zones in tropical and subtropical regions of the world offer a range of ecosystem services including carbon storage and sequestration. They can regulate the detrimental effects of climate change due to carbon releases two to four times greater than that of mature tropical rainforests. Moreover, they are effective natural defenses against storm surges and tsunamis. However, their proliferation depends significantly on the prevailing hydroperiod at the coast. In the Philippines, these coastal ecosystems have been severely threatened with a 50% decline in areal extent observed from 1918 to 2010. The highest decline occurred in 1950 - 1972 when national policies encouraged the development of fisheries and aquaculture. With the intensive land use conversion upstream, changes in the freshwater-saltwater envelope at the coast may considerably impact mangrove growth conditions. This study investigates a developing urban watershed in Kalibo, Aklan province with a 220-hectare mangrove forest replanted for over 30 years from coastal mudflats. Since then, the mangrove forest was sustainably conserved and declared as protected areas. Hybrid land cover classification technique was used to classify Landsat images for years, 1990, 2010, and 2017. Digital elevation model utilized was Interferometric Synthetic Aperture Radar (IFSAR) with a 5-meter resolution to delineate the watersheds. Using numerical modelling techniques, the hydrologic and hydraulic analysis of the influence of land cover change to flow and sediment dynamics was simulated. While significant land cover change occurred upland, thereby increasing runoff and sediment loads, the mangrove forests abundance adjacent to the coasts for the urban watershed, was somehow sustained. However, significant alteration of the coastline was observed in Kalibo through the years, probably due to the massive land-use conversion upstream and significant replanting of mangroves downstream. Understanding the hydrologic-hydraulic response of these watersheds to change land cover is essential to helping local government and stakeholders facilitate better management of these mangrove ecosystems.

Keywords: coastal mangroves, hydrologic model, land cover change, Philippines

Procedia PDF Downloads 122

Authors: Raz Flieshman, Adam Michael Altenbuchner, Jörg Krüger

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This paper presents an approach to optimizing the Fused Deposition Modeling (FDM) 3D printing process through a preprocess calibration routine of printing parameters. The core of this method involves the use of a low-cost thermal sensor capable of measuring tempera-tures within the range of -20 to 500 degrees Celsius for detailed process observation. The calibration process is conducted by printing a predetermined path while varying the process parameters through machine instructions (g-code). This enables the extraction of critical thermal, dimensional, and surface properties along the printed path. The calibration routine utilizes computer vision models to extract features and metrics from the thermal images, in-cluding temperature distribution, layer adhesion quality, surface roughness, and dimension-al accuracy and consistency. These extracted properties are then analyzed to optimize the process parameters to achieve the desired qualities of the printed material. A significant benefit of this calibration method is its potential to create printing parameter profiles for new polymer and composite materials, thereby enhancing the versatility and application range of FDM 3D printing. The proposed method demonstrates significant potential in enhancing the precision and reliability of FDM 3D printing, making it a valuable contribution to the field of additive manufacturing.

Keywords: FDM 3D printing, preprocess calibration, thermal sensor, process optimization, additive manufacturing, computer vision, material profiles

Procedia PDF Downloads 40

Authors: Ahsan Ullah

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The aim of this study is to measure the relationship between sedentary behaviour and metabolic rate among adult professionals. An intervention (e-mobile) approach was used for gathered the information from the participants. A total of 40 participants (men = 30, and women = 10) with an average age of (36.53 years ± 8.85) were randomly assigned to an intervention group (n= 20) and control group (n= 20). All the participants completed the Sedentary Behaviour Questionnaire (SBQ) and The International Physical Activity Questionnaire (IPAQ) at baseline and at the end of eight weeks. The participants in the intervention group were given physical activity guidelines targeted at increasing physical activity levels during daily activities. On the other side, the control group was advised to continue with their routine daily physical activity. Statistical analyses, including descriptive statistics and inferential analysis like mean, SD, T-tests, and ANOVA, were used to analyze the data and determine relationships between variables. After analyzing the data, the results showed that significant difference in pre and post metabolic rate scores (1488.31 ± 179.13 to 1468.44 ± 128.19) (f = 10.83, p < 0.000) were noted in the experimental group after eight week. The experimental group increased their walking (863.78 METs per week to 1625.55 METs per week), moderate activity (295 METs per week to 743 METs per week) and vigorous activity (362 METs per week to 1366 METs per week) physical activity (all p<0.001). There were no significant differences observed in any outcome measured before and after eight weeks in the control group. These findings suggest that engaging in physical activity can effectively improve metabolic rate and reduce sedentary behavior among physically active adults.

Keywords: sedentary behavior, metabolic rate, adult’s professionals, physical activity

Procedia PDF Downloads 27

Authors: Alimohamad Asghari, Ahmad Daneshi, Mohammad Farhadi, Arash Bayat, Mohammad Ajalloueyan, Marjan Mirsalehi, Mohsen Rajati, Seyed Basir Hashemi, Nader Saki, Ali Omidvari

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Evidence suggests that Cochlear Implantation (CI) is a beneficial approach for auditory and speech skills improvement in children with severe to profound hearing loss. However, it remains controversial if implantation in children <12 months is safe and effective compared to older children. The present study aimed to determine whether children's ages affect surgical complications and auditory and speech development. The current multicenter study enrolled 86 children who underwent CI surgery at <12 months of age (group A) and 362 children who underwent implantation between 12 and 24 months of age (group B). The Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores were determined pre-impanation, and "one-year" and "two-year" post-implantation. Four complications (overall rate: 4.65%; three minor) occurred in group A and 12 complications (overall rate: 4.41%; nine minor) occurred in group B. We found no statistically significant difference in the complication rates between the groups (p>0.05). The mean SIR and CAP scores improved over time following CI activation in both groups. However, we did not find significant differences in CAP and SIR scores between the groups across different time points. Cochlear implantation is a safe and efficient procedure in children younger than 12 months, providing substantial auditory and speech benefits comparable to children undergoing implantation at 12 to 24 months of age. Furthermore, surgical complications in younger children are similar to those of children undergoing the CI at an older age.

Keywords: cochlear implant, Infant, complications, outcome

Procedia PDF Downloads 108

Authors: Nazih Ramadan, Manal Mohy-Eldine, Amani Hanoon, Alaa Shehab

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Background and Aims: The study of fingerprints is widely used in providing a clue regarding identity. Age and gender identification from fingerprints is an important step in forensic anthropology in order to minimize the list of suspects search. The aim of this study was to determine finger ridge density and patterns among Egyptians, and to estimate age and gender using ridge densities. Materials and Methods: This study was conducted on 177 randomly-selected healthy Egyptian subjects (90 males and 87 females). They were divided into three age groups; Group (a): from 6-< 12 years, group (b) from 12-< 18 years and group (c) ≥ 18 years. Bilateral digital prints, from every subject, were obtained by the inking procedure. Ridge count per 25 mm² was determined together with assessment of ridge pattern type. Statistical analysis was done with references to different age and sex groups. Results: There was a statistical significant difference in ridge density between the different age groups; where younger ages had significantly higher ridge density than older ages. Females proved to have significantly higher ridge density than males. Also, there was a statistically significant negative correlation between age and ridge density. Ulnar loops were the most frequent pattern among Egyptians then whorls then arches then radial loops. Finally, different regression models were constructed to estimate age and gender from fingerprints ridge density. Conclusion: fingerprint ridge density can be used to identify both age and sex of subjects. Further studies are recommended on different populations, larger samples or using different methods of fingerprint recording and finger ridge counting.

Keywords: age, sex identification, Egyptian population, fingerprints, ridge density

Procedia PDF Downloads 363

Authors: Siwanit Autthawuttikul, Prakob Koraneekid, Sayamon Insa-ard

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The purposes of this research were to development creatively integrated teaching skills using Information and Communication Technology (ICT) for professional teacher in schools under the education area of the basic education commission, ministry of education both schools under the office of primary education and those under The office of secondary education in eight western region provinces of Thailand. This is useful in defining a vision for the school strategy and restructuring schools in addition, teachers will have developed skills in teaching creative integrated ICT. The research methodology comprises quantitative and qualitative data collection. The Baseline Survey, focus group for discussions and then the model was developed creatively integrated teaching skills using ICT. The findings showed that 7 elements were important: (1) Academy Transformation (2) Information Technology Infrastructure (3) Personal Development (4) Supervision, Monitoring and Evaluation (5) Motivating and Rewarding (6) Important factor affecting the success of teaching integrated with ICT were knowledge, skills, attitudes and (7) The role of the individual concerned. The comparison creatively integrated teaching skills before and after participating in the overall shows that the average creatively integrated teaching skills using ICT after attending the event is 3.27, and standard deviation was 0.56, higher than before which is 2.60 and the standard deviation was 0.56. There are significant differences significant statistically level of .05. The final average score of the evaluation plan design creatively integrated teaching skills using ICT teachers' average score was 26.94 at the high levels.

Keywords: integrated curriculum, information and communications technology, teachers in the western region, schools

Procedia PDF Downloads 445

Authors: Kirsty Biggs, Peter Larsen-Disney

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Background: The UK cervical screening programme significantly reduces cancer mortality through the early detection of abnormal cells. Despite this, over a quarter of eligible women choose not to attend their appointment. Objective: To qualitatively explore patients’ barriers to attending cervical smear appointments and identify key trends of cervical screening behaviour, knowledge, and attitudes in primary and secondary care. Methods: A cross-sectional study was conducted to evaluate smear services in Brighton and Hove using questionnaires in general practice and colposcopy. 226 patients participated in the voluntary questionnaire between 10/11/2017 and 02/02/2018. 118 patients were recruited from general practice surgeries and 108 from the colposcopy department. Women were asked about their smear knowledge, self-perceived risks factors, prior experiences and reasons for non-attendance. Demographic data was also collected. Results: Approximately a third of women did not engage in smear testing services. This was consistent across primary and secondary care groups. Over 90% were aware of the role of the screening process in relation to cervical cancer; however, over two thirds believed the smear was also a tool to screen for other pathologies. The most commonly cited reasons for non-attendance were negative emotions or previous experiences. Inconvenient appointment times were also commonly described. In a comparison of attenders versus non-attenders previous negative experiences (p < 0.01) and number of identified risk factors (p = 0.02) were statistically significant with non-attenders describing more prior negative smears and identifying more risk factors. Smear knowledge, risk perception and perceived importance of screening were not significant. Negative previous experiences were described in relation to poor bedside manner, pain, embarrassment and staff competency. Conclusions: In contrary to the literature, our white Caucasian cohort experienced significant barriers to accessing smear services. Women’s prior negative experiences are overriding their perceived importance to attend the screening programme; therefore, efforts need to focus on improving clinical experiences through auditing tools, training and providing a supportive appointment setting. Positive changes can also be expected by improving appointment availabilities with extended hours and self-booking systems.

Keywords: barriers, cervical, Papanicolaou, screening, smear

Procedia PDF Downloads 149