Search results for: shared-decision making

Authors: M. Miljkovic, A. Urakpo, M. Simic-Koumoutsaris

Abstract:

Benefit-risk assessment (BRA) is a valuable tool that takes place in multiple stages during a medicine's lifecycle, and this assessment can be conducted in a variety of ways. The aim was to summarize current BRA methods used during approval decisions and in post-approval settings and to see possible future directions. Relevant reviews, recommendations, and guidelines published in medical literature and through regulatory agencies over the past five years have been examined. BRA implies the review of two dimensions: the dimension of benefits (determined mainly by the therapeutic efficacy) and the dimension of risks (comprises the safety profile of a drug). Regulators, industry, and academia have developed various approaches, ranging from descriptive textual (qualitative) to decision-analytic (quantitative) models, to facilitate the BRA of medicines during the product lifecycle (from Phase I trials, to authorization procedure, post-marketing surveillance and health technology assessment for inclusion in public formularies). These approaches can be classified into the following categories: stepwise structured approaches (frameworks); measures for benefits and risks that are usually endpoint specific (metrics), simulation techniques and meta-analysis (estimation techniques), and utility survey techniques to elicit stakeholders’ preferences (utilities). All these approaches share the following two common goals: to assist this analysis and to improve the communication of decisions, but each is subject to its own specific strengths and limitations. Before using any method, its utility, complexity, the extent to which it is established, and the ease of results interpretation should be considered. Despite widespread and long-time use, BRA is subject to debate, suffers from a number of limitations, and currently is still under development. The use of formal, systematic structured approaches to BRA for regulatory decision-making and quantitative methods to support BRA during the product lifecycle is a standard practice in medicine that is subject to continuous improvement and modernization, not only in methodology but also in cooperation between organizations.

Keywords: benefit-risk assessment, benefit-risk profile, product lifecycle, quantitative methods, structured approaches

Procedia PDF Downloads 155

Authors: A. Kourou, M. Panoutsopoulou

Abstract:

Nowadays, disaster risk reduction requires innovative ways of working collaboratively, monitoring tools, management methods, risk communication, and knowledge, as key factors for decision-making actors. Experience has shown that the assessment of seismic risk and its effective management is still an important challenge. In Greece, Ionian Islands region is characterized as the most seismic area of the country and one of the most active worldwide. It is well known that in case of a disastrous earthquake the local authorities need to assess the situation in the affected area and coordinate the disaster response. In particular, the main outcomes of 'Telemachus' project are the development of an innovative operational system that hosts the needed data of seismic risk management in the Ionian Islands and the implementation of educational actions for the involved target groups. This project is funded in the Priority Axis 'Environmental Protection and Sustainable Development' of Operational Plan 'Ionian Islands 2014-2020'. EPPO is one of the partners of the project and it is responsible, among others, for the development of proper training material. This paper presents the training material of 'Telemachus' and its usage as a helpful, managerial tool in case of earthquake emergency. This material is addressed to different target groups, such as civil protection staff, people that involved with the tourism industry, educators of disabled people, etc. Very positive aspect of the project is the involvement of end-users that should evaluate the training products; test standards; clarify the personnel’s roles and responsibilities; improve interagency coordination; identify gaps in resources; improve individual performance; and identify opportunities for improvement. It is worth mentioning that even though the abovementioned material developed is useful for the training of specific target groups on emergency management issues within Ionian Islands Region, it could be used throughout Greece and other countries too.

Keywords: education of civil protection staff, Ionian Islands Region of Greece, seismic risk, training material

Procedia PDF Downloads 123

Authors: Clara Franch de la Cal, Christopher J Morris, Michael McArthur

Abstract:

Cystic fibrosis (CF) is an autosomal recessive genetic disorder characterized by abnormal transport of chloride and sodium across the lung epithelium, leading to thick and viscous secretions. Within which CF patients suffer from repeated bacterial pulmonary infections, with Pseudomonas aeru-ginosa (PA) eliciting the greatest inflammatory response, causing an irreversible loss of lung func-tion that determines morbidity and mortality. The cell wall of PA is a permeability barrier to many antibacterials and the rise of Mutli-Drug Resistant strains (MDR) is eroding the efficacy of the few remaining clinical options. In addition when PA infection becomes established it forms an antibi-otic-resistant biofilm, embedded in which are slow growing cells that are refractive to drug treat-ment. Making the development of new antibacterials a major challenge. This work describes the development of new type of nanoparticulate oligonucleotide antibacterial capable of tackling PA infections, including MDR strains. It is being developed to both block growth and prevent biofilm formation. These oligonucleotide therapeutics, Transcription Factor Decoys (TFD), act on novel genomic targets by capturing key regulatory proteins to block essential bacterial genes and defeat infection. They have been successfully transfected into a wide range of pathogenic bacteria, both in vitro and in vivo, using a proprietary delivery technology. The surfactant used self-assembles with TFD to form a nanoparticle stable in biological fluids, which protects the TFD from degradation and preferentially transfects prokaryotic membranes. Key challenges are to adapt the nanoparticle so it is active against PA in the context of biofilms and to formulate it for administration by inhalation. This would allow the drug to be delivered to the respiratory tract, thereby achieving drug concentrations sufficient to eradicate the pathogenic organisms at the site of infection.

Keywords: antibacterials, transcriptional factor decoys (TFDs), pseudomonas aeruginosa

Procedia PDF Downloads 284

Authors: S. M. Chabane sari S. Zargou, A.R. Senoudi, F. Benmouna

Abstract:

Immobilization of nano particles (NPs) is the subject of numerous studies pertaining to the design of polymer nano composites, supported catalysts, bioactive colloidal crystals, inverse opals for novel optical materials, latex templated-hollow inorganic capsules, immunodiagnostic assays; “Pickering” emulsion polymerization for making latex particles and film-forming composites or Janus particles; chemo- and biosensors, tunable plasmonic nano structures, hybrid porous monoliths for separation science and technology, biocidal polymer/metal nano particle composite coatings, and so on. Particularly, in the recent years, the literature has witnessed an impressive progress of investigations on polymer coatings, grafts and particles as supports for anchoring nano particles. This is actually due to several factors: polymer chains are flexible and may contain a variety of functional groups that are able to efficiently immobilize nano particles and their precursors by dispersive or van der Waals, electrostatic, hydrogen or covalent bonds. We review methods to prepare polymer-immobilized nano particles through a plethora of strategies in view of developing systems for separation, sensing, extraction and catalysis. The emphasis is on methods to provide (i) polymer brushes and grafts; (ii) monoliths and porous polymer systems; (iii) natural polymers and (iv) conjugated polymers as platforms for anchoring nano particles. The latter range from soft bio macromolecular species (proteins, DNA) to metallic, C60, semiconductor and oxide nano particles; they can be attached through electrostatic interactions or covalent bonding. It is very clear that physicochemical properties of polymers (e.g. sensing and separation) are enhanced by anchored nano particles, while polymers provide excellent platforms for dispersing nano particles for e.g. high catalytic performances. We thus anticipate that the synergetic role of polymeric supports and anchored particles will increasingly be exploited in view of designing unique hybrid systems with unprecedented properties.

Keywords: gold, layer, polymer, macromolecular

Procedia PDF Downloads 391

Authors: Nuri Onat, Omer Tatari, Gokhan Egilmez

Abstract:

The U.S. buildings consume significant amount of energy and natural resources and they are responsible for approximately 40 % of the greenhouse gases emitted in the United States. Awareness of these environmental impacts paved the way for the adoption of green building movement. The green building movement is a rapidly increasing trend. Green Construction market has generated $173 billion dollars in GDP, supported over 2.4 million jobs, and provided $123 billion dollars in labor earnings. The number of LEED certified buildings is projected to be almost half of the all new, nonresidential buildings by 2015. National Science and Technology Council (NSTC) aims to increase number of net-zero energy buildings (NZB). The ultimate goal is to have all commercial NZB by 2050 in the US (NSTC 2008). Green Building Initiative (GBI) became the first green building organization that is accredited by American National Standards Institute (ANSI), which will also boost number of green buildings certified by Green Globes. However, there is much less focus on greening the residential buildings, although the environmental impacts of existing residential buildings are more than that of commercial buildings. In this regard, current research aims to model the residential green building movement with a dynamic model approach and assess the possible strategies to stabilize the carbon footprint of the U.S. residential building stock. Three aspects of sustainable development are considered in policy making, namely: high performance green building (HPGB) construction, NZB construction and building retrofitting. 19 different policy options are proposed and analyzed. Results of this study explored that increasing the construction rate of HPGBs or NZBs is not a sufficient policy to stabilize the carbon footprint of the residential buildings. Energy efficient building retrofitting options are found to be more effective strategies then increasing HPGBs and NZBs construction. Also, significance of shifting to renewable energy sources for electricity generation is stressed.

Keywords: green building movement, residential buildings, carbon footprint, system dynamics

Procedia PDF Downloads 428

Authors: Gertrude Yidanpoa Grumah

Abstract:

Ghana boasts of a rich linguistic diversity, with around eighty-seven indigenous languages coexisting with English, the official language. Within this multilingual environment, speech communities adopt bilingual code choices as a common practice, as people seamlessly switch between Ghanaian languages and English. Extensive research has delved into this phenomenon from various perspectives, including the role of bilingual code choices in teaching, its implications for language policy, and its significance in multilingual communities. Yet, a noticeable gap in the literature persists, with most studies focusing on codeswitching between English and the major southern Ghanaian languages like Twi, Ga, and Ewe. The intricate dynamics of codeswitching with minority indigenous languages, such as Mampruli spoken in northern Ghana, remain largely unexplored. This thesis embarks on an investigation into Mampruli-English codeswitching, delving into the linguistic practices of educated Mampruli speakers. The data collection methods encompass interviews, recorded radio programs, and ethnographic observation. The analytical framework employed draws upon the Ethnography of Communication, with observation notes and transcribed interviews thoughtfully classified into discernible themes. The research findings suggest that a bilingual's tendency to switch from Mampruli to English is significantly influenced by factors such as the level of education, age, gender, perceptions of language prestige, and religious beliefs. In essence, this study represents a pioneering endeavor, marking the first comprehensive study on codeswitching practices within the Mampruli-English context and making a significant contribution to our understanding of Mampruli linguistics, covering the social language codes reflecting the speech community. In a region where such research has been scarce for the past four decades, this study addresses a critical knowledge gap, shedding light on the intricate dynamics of language use in northern Ghana.

Keywords: codeswitching, English, ethnography of communication, Mampruli, sociolinguistics

Procedia PDF Downloads 63

Authors: Nanche Billa Robert

Abstract:

More and more youth are doubtful of making a satisfactory labour market transition because of the present global economic instability and this is more so in Africa of the Sahara and metropolis like Douala. We use the explanatory sequential mixed method: in the first phase we randomly administered 610 questionnaires in the Douala metropolis respecting the population size of each division and its gender composition. We constructed the questionnaire using the desired values for living a comfortable life in Douala. In the second phase, we purposefully selected and interviewed 50 poor youth in order to explain in detail the initial quantitative results. We obtain the following result: The modal income class is 24,000-74,000 frs Central Africa Franc (CFA) and about 67% of the youth of the Douala metropolis earn below 75,000 frs CFA. They earn only 31.02% of the total income. About 85.7% earn below 126,000 frs CFA and about 92.14% earn below 177,000 frs CFA. The poverty-line is estimated at 177,000 frs CFA per month based on the desired predominant values in Douala and only about 9% of youth earn this sum, therefore, 91% of the youth are poor. We discovered that the salary a youth earns influences his level of poverty. Low income earners eat once or twice per day, rent low-standard houses of below 20,000 frs, are dependent and possess very limited durable goods, consult traditional doctors when they are sick, sleep and gamble during their leisure time. Intermediate income earners feed themselves either twice or thrice per day, eat healthy meals weekly, possess more durable goods, are independent, gamble and drink during their leisure time. High income earners feed themselves at least thrice per day, eat healthy food daily, inhabit high quality and expensive houses, are more stable by living longer in their neighbourhoods, like travelling and drinking during their leisure time. Unsalaried youth, are students, housewives or unemployed youth, they eat four times per day, take healthy meals daily, weekly, fortnightly or occasionally, are dependent or homeless depending on whether they are students or unemployed youth. The situation of the youth can be ameliorated through investing in the productive sector and promoting entrepreneurship as well as formalizing the informal sector.

Keywords: income, inequality, poverty, metropolis

Procedia PDF Downloads 95

Authors: Silvia Alaimo

Abstract:

This lecture brings to our attention the theme of spirituality within Gestalt therapy’s theoretical and clinical perspectives and which is closely connected to the fertile emptiness and creative indifference’ experiences. First of all, the premise that must be done is the overcoming traditional western culture’s philosophical and religious misunderstandings, such as the dicotomy between spirituality and pratical/material daily life, as well as the widespread secular perspective of classic psychology. Even fullness and emptiness have traditionally been associated with the concepts of being and not being. "There is only one way through which we can contact the deepest layers of our existence, rejuvenate our thinking and reach intuition (the harmony of thought and being): inner silence" (Perls) *. Therefore, "fertile void" doesn't mean empty in itself, but rather an useful condition of every creative and responsible act, making room for a deeper dimension close to spirituality. Spirituality concerns questions about the meaning of existence, which lays beyond the concrete and literal dimension, looking for the essence of things, and looking at the value of personal experience. Looking at fundamentals of Gestalt epistemology, phenomenology, aesthetics, and the relationship, we can reach the heart of a therapeutic work that takes spiritual contours and which are based on an embodied (incarnate size), through the relational aesthetic knowledge (Spagnuolo Lobb ), the deep contact with each other, the role of compassion and responsibility, as the patient's recognition criteria (Orange, 2013) rooted in the body. The aesthetic dimension, like the spiritual dimension to which it is often associated, is a subtle dimension: it is the dimension of the essence of things, of their "soul." In clinical practice, it implies that the relationship between therapist and patient is "in the absence of judgment," also called "zero point of creative indifference," expressed by ‘therapeutic mentality’. It consists in following with interest and authentic curiosity where the patient wants to go and support him in his intentionality of contact. It’s a condition of pure and simple awareness, of the full acceptance of "what is," a moment of detachment from one's own life in which one does not take oneself too seriously, a starting point for finding a center of balance and integration that brings to the creative act, to growth, and, as Perls would say, to the excitement and adventure of living.

Keywords: spirituality, bodily, embodied aesthetics, phenomenology, relationship

Procedia PDF Downloads 137

Authors: Hanan Fayez Hussein

Abstract:

‘Due to increasing environmental challenges and security problems in the world such as global warming, storms, and terrorism’, humans have discovered new technologies and new materials in order to program daily life. As providing physical and psychological security is one of the primary functions of architecture, so in order to provide security, building must prevents unauthorized entry and harm to occupant and reduce the threat of attack by making building less attractive targets by new technologies such as; Nanotechnology, which has emerged as a major science and technology focus of the 21st century and will be the next industrial revolution. Nanotechnology is control of the properties of matter, and it deals with structures of the size 100 nanometers or smaller in at least one dimension and has wide application in various fields. The construction and architecture sectors were among the first to be identified as a promising application area for nanotechnology. The advantages of using nanomaterials in construction are enormous, and promises heighten building security by utilizing the strength of building materials to make our buildings more secure and get smart home. Access barriers such as wall and windows could incorporate stronger materials benefiting from nano-reinforcement utilizing nanotubes and nano composites to act as protective cover. Carbon nanotubes, as one of nanotechnology application, can be designed up to 250 times stronger than steel. Nano-enabled devices and materials offer both enhanced and, in some cases, completely new defence systems. In the addition, the small amount of carbon nanoparticles to the construction materials such as; cement, concrete, wood, glass, gypson, and steel can make these materials act as defence elements. This paper highlights the fact that nanotechnology can impact the future global security and how building’s envelop can act as a defensive cover for the building and can be resistance to any threats can attack it. Then focus on its effect on construction materials such as; Concrete can obtain by nanoadditives excellent mechanical, chemical, and physical properties with less material, which can acts as a precautionary shield to the building.

Keywords: nanomaterial, global warming, building security, smart homes

Procedia PDF Downloads 82

Authors: Ben Khayut, Lina Fabri, Maya Avikhana

Abstract:

The models of the modern Artificial Narrow Intelligence (ANI) cannot: a) independently and continuously function without of human intelligence, used for retraining and reprogramming the ANI’s models, and b) think, understand, be conscious, cognize, infer, and more in state of Uncertainty, and changes in situations, and environmental objects. To eliminate these shortcomings and build a new generation of Artificial Intelligence systems, the paper proposes a Conception, Model, and Method of Computational Psycholinguistic Cognitive Situational-Fuzzy Self-Controlled Brain and Mind System (CPCSFSCBMSUU) using a neural network as its computational memory, operating under uncertainty, and activating its functions by perception, identification of real objects, fuzzy situational control, forming images of these objects, modeling their psychological, linguistic, cognitive, and neural values of properties and features, the meanings of which are identified, interpreted, generated, and formed taking into account the identified subject area, using the data, information, knowledge, and images, accumulated in the Memory. The functioning of the CPCSFSCBMSUU is carried out by its subsystems of the: fuzzy situational control of all processes, computational perception, identifying of reactions and actions, Psycholinguistic Cognitive Fuzzy Logical Inference, Decision making, Reasoning, Systems Thinking, Planning, Awareness, Consciousness, Cognition, Intuition, Wisdom, analysis and processing of the psycholinguistic, subject, visual, signal, sound and other objects, accumulation and using the data, information and knowledge in the Memory, communication, and interaction with other computing systems, robots and humans in order of solving the joint tasks. To investigate the functional processes of the proposed system, the principles of Situational Control, Fuzzy Logic, Psycholinguistics, Informatics, and modern possibilities of Data Science were applied. The proposed self-controlled System of Brain and Mind is oriented on use as a plug-in in multilingual subject Applications.

Keywords: computational brain, mind, psycholinguistic, system, under uncertainty

Procedia PDF Downloads 177

Authors: Nathenal Thomas

Abstract:

In the food chain and in many other agricultural products, corn, also known as maize, which goes by the scientific name Zea mays subsp, is a widely produced agricultural product. Corn has the highest adaptability. It comes in many different types, is employed in many different industrial processes, and is more adaptable to different agro-climatic situations. In Ethiopia, maize is among the most widely grown crop. Small-scale corn farming may be a household's only source of food in developing nations like Ethiopia. The aforementioned data demonstrates that the country's requirement for this crop is excessively high, and conversely, the crop's productivity is very low for a variety of reasons. The most damaging disease that greatly contributes to this imbalance between the crop's supply and demand is the corn disease. The failure to diagnose diseases in maize plant until they are too late is one of the most important factors influencing crop output in Ethiopia. This study will aid in the early detection of such diseases and support farmers during the cultivation process, directly affecting the amount of maize produced. The diseases in maize plants, such as northern leaf blight and cercospora leaf spot, have distinct symptoms that are visible. This study aims to detect the most frequent and degrading maize diseases using the most efficiently used subset of machine learning technology, deep learning so, called Image Processing. Deep learning uses networks that can be trained from unlabeled data without supervision (unsupervised). It is a feature that simulates the exercises the human brain goes through when digesting data. Its applications include speech recognition, language translation, object classification, and decision-making. Convolutional Neural Network (CNN) for Image Processing, also known as convent, is a deep learning class that is widely used for image classification, image detection, face recognition, and other problems. it will also use this algorithm as the state-of-the-art for my research to detect maize diseases by photographing maize leaves using a mobile phone.

Keywords: CNN, zea mays subsp, leaf blight, cercospora leaf spot

Procedia PDF Downloads 74

Authors: Ziaullah, Shah Wahab Ali

Abstract:

Micro-grid equipped with heterogeneous energy resources present the idea of small scale distributed energy management (DEM). DEM helps in minimizing the transmission and operation costs, power management and peak load demands. Micro-grids are collections of small, independent controllable power-generating units and renewable energy resources. Micro-grids also motivate to enable active customer participation by giving accessibility of real-time information and control to the customer. The capability of fast restoration against faulty situation, integration of renewable energy resources and Information and Communication Technologies (ICT) make micro-grid as an ideal system for distributed power systems. Micro-grids can have a bank of energy storage devices. The energy management system of micro-grid can perform real-time energy forecasting of renewable resources, energy storage elements and controllable loads in making proper short-term scheduling to minimize total operating costs. We present a review of existing micro-grids optimization objectives/goals, constraints, solution approaches and tools used in micro-grids for energy management. Cost-benefit analysis of micro-grid reveals that cooperation among different micro-grids can play a vital role in the reduction of import energy cost and system stability. Cooperative micro-grids energy trading is an approach to electrical distribution energy resources that allows local energy demands more control over the optimization of power resources and uses. Cooperation among different micro-grids brings the interconnectivity and power trading issues. According to the literature, it shows that open area of research is available for cooperative micro-grids energy trading. In this paper, we proposed and formulated the efficient energy management/trading module for interconnected micro-grids. It is believed that this research will open new directions in future for energy trading in cooperative micro-grids/interconnected micro-grids.

Keywords: distributed energy management, information and communication technologies, microgrid, energy management

Procedia PDF Downloads 375

Authors: Tonghua Li

Abstract:

Under the neoliberal corporate food regime, biofuels are a double-edged sword that exacerbates tensions between national food security and trade in green agricultural products. Biofuels have the potential to help achieve green sustainable development goals, but they threaten food security by exacerbating competition for land and changing global food trade patterns. The U.S.-China trade war complicates this debate. Under the influence of different political and corporate coordination mechanisms in China and the US, trade disputes can have different impacts on sustainable agricultural practices. This paper develops an actor-centred ‘network governance framework’ focusing on trade in soybean and corn-based biofuels to explain how trade wars can change the actions of governmental and non-governmental actors in the context of oligopolistic competition and market concentration in agricultural trade. There is evidence that the US-China trade decoupling exacerbates the conflict between national security, free trade in agriculture, and the realities and needs of green and sustainable energy development. The US government's trade policies reflect concerns about China's relative gains, leading to a loss of trade profits, making it impossible for the parties involved to find a balance between the three objectives and, consequently, to get into a biofuels and soybean industry dilemma. Within the setting of prioritizing national security and strategic interests, the government has replaced the dominant position of large agribusiness in the neoliberal food system, and the goal of environmental sustainability has been marginalized by high politics. In contrast, China faces tensions in the trade war between food security self-sufficiency policy and liberal sustainable trade, but the state-capitalist model ensures policy coordination and coherence in trade diversion and supply chain adjustment. Despite ongoing raw material shortages and technological challenges, China remains committed to playing a role in global environmental governance and promoting green trade objectives.

Keywords: food security, green trade, biofuels, soybeans, US-China trade war

Procedia PDF Downloads 7

Authors: Slah Eddine Ben Fadhel

Abstract:

Despite the development of new pedagogic methods, current teaching practices put more emphasis on the learning products than on the processes learners deploy. In school syllabi, for instance, very little time is devoted to both the explanation and analysis of strategies aimed at resolving problems by means of targeting students’ metacognitive procedures. Within a cognitive framework, teaching/learning contexts are conceived of in terms of cognitive, metacognitive and affective activities intended for the treatment of information. During these activities, learners come to develop an array of knowledge and strategies which can be subsumed within an active and constructive process. Through the investigation of strategies and metacognition concepts, the purpose is to reflect upon the modalities at the heart of the learning process and to demonstrate, similarly, the inherent significance of a cognitive approach to learning. The scope of this paper is predicated on a study where the population is a group of 76 primary school pupils who experienced difficulty with learning French. The population was divided into two groups: the first group was submitted during three months to a strategy-based training to learn French. All through this phase, the teachers centred class activities round making learners aware of the strategies the latter deployed and geared them towards appraising the steps these learners had themselves taken by means of a variety of tools, most prominent among which is the logbook. The second group was submitted to the usual learning context with no recourse whatsoever to any strategy-oriented tasks. The results of both groups point out the improvement of linguistic competences in the French language in the case of those pupils who were trained by means of strategic procedures. Furthermore, this improvement was noted in relation with the native language (Arabic), a fact that tends to highlight the importance of the interdisciplinary investigation of (meta-)cognitive strategies. These results show that strategic learning promotes in pupils the development of a better awareness of their own processes, which contributes to improving their general linguistic competences.

Keywords: constructive approach, cognitive strategies, metacognition, learning

Procedia PDF Downloads 211

Authors: Jessica Achebe, Susan Tighe

Abstract:

The recent Canadian infrastructure report card reveals the unhealthy state of municipal infrastructure intensified challenged faced by municipalities to maintain adequate infrastructure performance thresholds and meet user’s required service levels. For a road agency, huge funding gap issue is inflated by growing concerns of the environmental repercussion of road construction, operation and maintenance activities. As the reduction of material consumption and greenhouse gas emission when maintain and rehabilitating road networks can achieve added benefits including improved life cycle performance of pavements, reduced climate change impacts and human health effect due to less air pollution, improved productivity due to optimal allocation of resources and reduced road user cost. Incorporating environmental sustainability measure into pavement management is solution widely cited and studied. However measuring the environmental performance of road network is still a far-fetched practice in road network management, more so an ostensive agency-wide environmental sustainability or sustainable maintenance specifications is missing. To address this challenge, this present research focuses on the environmental sustainability performance of network-level pavement management. The ultimate goal is to develop a framework to incorporate environmental sustainability in pavement management systems for network-level maintenance programming. In order to achieve this goal, this study reviewed previous studies that employed environmental performance measures, as well as the suitability of environmental performance indicators for the evaluation of the sustainability of network-level pavement maintenance strategies. Through an industry practice survey, this paper provides a brief forward regarding the pavement manager motivations and barriers to making more sustainable decisions, and data needed to support the network-level environmental sustainability. The trends in network-level sustainable pavement management are also presented, existing gaps are highlighted, and ideas are proposed for sustainable network-level pavement management.

Keywords: pavement management, sustainability, network-level evaluation, environment measures

Procedia PDF Downloads 211

Authors: Aisling De Paor

Abstract:

Scientific and technological developments are driving genetics and genetic technologies into the public sphere. Scientists are making genetic discoveries as to the make up of the human body and the cause and effect of disease, diversity and disability amongst individuals. Technological innovation in the field of genetics is also advancing, with the development of genetic testing, and other emerging genetic technologies, including gene editing (which offers the potential for genetic modification). In addition to the benefits for medicine, health care and humanity, these genetic advances raise a range of ethical, legal and societal concerns. From an ethical perspective, such advances may, for example, change the concept of humans and what it means to be human. Science may take over in conceptualising human beings, which may push the boundaries of existing human rights. New genetic technologies, particularly gene editing techniques create the potential to stigmatise disability, by highlighting disability or genetic difference as something that should be eliminated or anticipated. From a disability perspective, use (and misuse) of genetic technologies raise concerns about discrimination and violations to the dignity and integrity of the individual. With an acknowledgement of the likely future orientation of genetic science, and in consideration of the intersection of genetics and disability, this paper highlights the main concerns raised as genetic science and technology advances (particularly with gene editing developments), and the consequences for disability and human rights. Through the use of traditional doctrinal legal methodologies, it investigates the use (and potential misuse) of gene editing as creating the potential for a unique form of discrimination and stigmatization to develop, as well as a potential gateway to a form of new, subtle eugenics. This article highlights the need to maintain caution as to the use, application and the consequences of genetic technologies. With a focus on the law and policy position in Europe, it examines the need to control and regulate these new technologies, particularly gene editing. In addition to considering the need for regulation, this paper highlights non-normative approaches to address this area, including awareness raising and education, public discussion and engagement with key stakeholders in the field and the development of a multifaceted genetics advisory network.

Keywords: disability, gene-editing, genetics, law, regulation

Procedia PDF Downloads 360

Authors: Ismaila Olabisi Ogundiji, Hakeem Mayowa Olujide, Qasim Usamot

Abstract:

The main reasons for site-specific management for agricultural inputs are to increase the profitability of crop production, to protect the environment and to improve products’ quality. Information about the variability of different soil attributes within a field is highly essential for the decision-making process. Lack of fast and accurate acquisition of soil characteristics remains one of the biggest limitations of precision agriculture due to being expensive and time-consuming. Adaptive sampling has been proven as an accurate and affordable sampling technique for planning within a field for site-specific management of agricultural inputs. This study employed spatial uncertainty of soil apparent electrical conductivity (ECa) estimates to identify adaptive re-survey areas in the field. The original dataset was grouped into validation and calibration groups where the calibration group was sub-grouped into three sets of different measurements pass intervals. A conditional simulation was performed on the field ECa to evaluate the ECa spatial uncertainty estimates by the use of the geostatistical technique. The grouping of high-uncertainty areas for each set was done using image segmentation in MATLAB, then, high and low area value-separate was identified. Finally, an adaptive re-survey was carried out on those areas of high-uncertainty. Adding adaptive re-surveying significantly minimized the time required for resampling whole field and resulted in ECa with minimal error. For the most spacious transect, the root mean square error (RMSE) yielded from an initial crude sampling survey was minimized after an adaptive re-survey, which was close to that value of the ECa yielded with an all-field re-survey. The estimated sampling time for the adaptive re-survey was found to be 45% lesser than that of all-field re-survey. The results indicate that designing adaptive sampling through spatial uncertainty models significantly mitigates sampling cost, and there was still conformity in the accuracy of the observations.

Keywords: soil electrical conductivity, adaptive sampling, conditional simulation, spatial uncertainty, site-specific management

Procedia PDF Downloads 132

Authors: Daeung Jung

Abstract:

Background: In case of patients with missing teeth, multiple implant restoration has been widely used and is inevitable. To increase its survival rate, it is important to understand the influence of different implant designs on inter-implant crestal bone resorption. There are several implant systems designed to minimize loss of crestal bone, and the Astra Tech and Brånemark Implant are two of them. Aim/Hypothesis: The aim of this 10-year study was to compare the height of inter-implant bone crest in two implant systems; the Astra Tech and the Brånemark implant system. Material and Methods: In this retrospective study, 40 consecutively treated patients were utilized; 23 patients with 30 sites for Astra Tech system and 17 patients with 20 sites for Brånemark system. The implant restoration was comprised of splinted crown in partially edentulous patients. Radiographs were taken immediately after 1st surgery, at impression making, at prosthetics setting, and annually after loading. Lateral distance from implant to bone crest, inter-implant distance was gauged, and crestal bone height was measured from the implant shoulder to the first bone contact. Calibrations were performed with known length of thread pitch distance for vertical measurement, and known diameter of abutment or fixture for horizontal measurement using ImageJ. Results: After 10 years, patients treated with Astra Tech implant system demonstrated less inter-implant crestal bone resorption when implants had a distance of 3mm or less between them. In cases of implants that had a greater than 3 mm distance between them, however, there appeared to be no statistically significant difference in crestal bone loss between two systems. Conclusion and clinical implications: In the situation of partially edentulous patients planning to have more than two implants, the inter-implant distance is one of the most important factors to be considered. If it is impossible to make sure of having sufficient inter-implant distance, the implants with less micro gap in the fixture-abutment junction, less traumatic 2nd surgery approach, and the adequate surface topography would be choice of appropriate options to minimize inter-implant crestal bone resorption.

Keywords: implant design, crestal bone loss, inter-implant distance, 10-year retrospective study

Procedia PDF Downloads 166

Authors: Theophilus O. Odunlami, Hasan Haroglu, Nader Saleh-Matter

Abstract:

The challenges facing the construction industry are often worsened by the compounded nature of projects coupled with the complexity of key stakeholders involved at different stages of the project. Projects are planned to achieve outlined benefits in line with the business case; however, a lack of effective management of key stakeholders can result in unrealistic delivery aspirations, unnecessary re-works, and overruns. The aim of this study is to examine the early stages of a project lifecycle and investigate the stakeholder management and involvement processes and their impact on the successful delivery of the project. The research engaged with conventional construction organisations and project personnel and stakeholders on diverse projects, using a research strategy to analyse existing project case studies, narrative enquiries, interviews, and surveys using a combined qualitative, quantitative, and mixed method of analysis. Research findings have shown that the involvement of stakeholders at different levels during the early stages has pronounced effects on project delivery; it helps to forge synergy and promotes a clear understanding of individual responsibilities, strengths, and weaknesses. This has often fostered a positive sense of productive collaboration right through the early stages of the project. These research findings intend to contribute to the development of a process framework for stakeholder and project team involvement in the early stages of a project. This framework will align with the selection criteria for stakeholders, contractors, and resources, ultimately contributing to the successful completion of projects. The primary question addressed in this study is stakeholder involvement and management of the early stages of a building project life cycle impacts project delivery. Findings showed that early-stage stakeholder involvement and collaboration between project teams and contractors significantly contribute to project success. However, a strong and healthy communication strategy would be required to maintain the flow of value-added ideas among stakeholders at the early stages to benefit the project at the execution stage.

Keywords: early stages, project lifecycle, stakeholders, decision-making strategy, project framework

Procedia PDF Downloads 100

Authors: Ali Liaghat, Navid Tavanpour, Nima Tavanpour

Abstract:

An increase in population and prevalence of urbanity have led plan makers and decision makers put effort into sustainable development of cities at national and local levels. One of the important issues in urban development is compliance with safety issues in cities. Despite natural disasters and unexpected events such as floods, earthquakes, hurricanes, fires, etc., urban development should be regarded as an axiom, or else any form of construction and development is not safe, because it will greatly harm economic growth and development and pose an obstacle to achieving sustainable development, plus a loss to lives and finances of people. Therefore, in line with urban development, it is necessary to identify particular environmental and local issues as determinants and pay attention to them at the top of everything, in that we can call it a good action and factor in urban sustainable developments. Physical structure of each city represents how it has developed or its development shaped and what incidents, changes, natural disasters it has undergone over time. Since any form of development plan should be in accordance with the previous situations of cities, disregarding it, unfortunately, can escalate into uncontrolled urban development, non-resistant and unstable construction against earthquake or invasion of river areas, destruction of agricultural lands or vegetation, periodic floods over time. It has been viewed as serious threats to developing cities, and typically caused destruction of bed and other urban facilities as well as damages to lives and finances. In addition, uncontrolled development has caused cities to look ugly in terms of urban façade, and off and on such unplanned measures caused the country to face countless losses, and it not only vitiates expenses incurred, but it will also impose additional costs of reconstruction, i.e. it is unsustainable development. Thus, in this paper, in addition to a discussion about necessity for a profound attitude toward this subject and making long-term plans, programs for organizing river and its surrounding area, creating open and green urban spaces, retrofitting and flood preventing are presented for sustainable safety and development of cities along with a critique of successful countries.

Keywords: flood, sustainable development, urbanisation, urban management

Procedia PDF Downloads 268

Authors: Kristina Sutiene, Lina Dapkute

Abstract:

The paper investigates the current demographic trends that exert the sustainability of pension systems in most EU regions. Several drivers usually compose the demographic challenge, coming from the structure and trends of population in the country. As the case of research, three main variables of demographic risk in Lithuania have been singled out and have been used in making up the analysis. Over the last two decades, the country has presented a peculiar demographic situation characterized by pessimistic fertility trends, negative net migration rate and rising life expectancy that make the significant changes in labor-age population. This study, therefore, sets out to assess the relative impact of these risk factors both individually and in aggregate, while assuming economic trends to evolve historically. The evidence is presented using data of pension funds that operate in Lithuania and are financed by defined-contribution plans. To achieve this goal, the discrete-time pension fund’s value model is developed that reflects main operational modalities: contribution income from current participants and new entrants, pension disbursement and administrative expenses; it also fluctuates based on returns from investment activity. Age-structured Leslie population dynamics model has been integrated into the main model to describe the dynamics of fertility, migration and mortality rates upon age. Validation has concluded that Leslie model adequately fits the current population trends in Lithuania. The elasticity of pension system is examined using Loimaranta efficiency as a measure for comparison of plausible long-term developments of demographic risks. With respect to the research question, it was found that demographic risks have different levels of influence on future value of aggregated pension funds: The fertility rates have the highest importance, while mortality rates give only a minor impact. Further studies regarding the role of trying out different economic scenarios in the integrated model would be worthwhile.

Keywords: asset liability modelling, Leslie model, pension funds, population dynamics

Procedia PDF Downloads 269

Authors: Rick Denley

Abstract:

Urban planning today faces unprecedented challenges as cities strive for sustainability in response to climate change, rapid population growth, and the increasing demand for green infrastructure. In this context, effective leadership becomes as essential as innovative design and technology. Rick Denley’s keynote, Resilient Leadership in Sustainable Urban Planning: Embracing Change to Shape Future Cities, focuses on equipping urban planners, academics, and industry leaders with the leadership tools necessary to guide their teams and projects through complex transitions. His session addresses the essential role of leadership in driving sustainable urban transformations, adapting to changing environmental demands, and fostering collaborative approaches to green infrastructure initiatives. Rick’s keynote is grounded in his Change Growth Formula, a practical framework he has developed over years of leading corporate transformations and advising on resilience and growth. His talk will focus on how urban planning professionals can cultivate adaptability, inspire innovative thinking, and lead their teams to achieve impactful urban projects that prioritize sustainable landscapes, water management, and green spaces. Attendees will gain actionable insights on building a resilient mindset, leveraging collaborative partnerships, and aligning urban planning initiatives with environmental goals. This session is aligned with the conference’s objectives to share interdisciplinary knowledge, explore innovative solutions, and address critical challenges in urban landscape and urban planning. Rick’s approach combines insights from leadership theory with real-world applications in urban planning, making his talk relevant for professionals seeking both inspiration and practical tools to lead sustainable transformations.

Keywords: resilient leadership, change management, collaborative planning, adaptive leadership, community engagement, leadership in urban design

Procedia PDF Downloads 7

Authors: Katarzyna Olejko

Abstract:

The need to redefine the goals and adapt the operational activities carried out in accordance with the concept of sustainable management to these goals results in the increasing importance of information on the company's activities perceived from the perspective of the effectiveness and efficiency of environmental goals implementation. The narrow scope of reporting data on a company's impact on the environment is not adequate to meet the information needs of modern investors. Reporting obligations are therefore imposed on companies in order to increase the effectiveness of corporate governance and to improve the process of assessing the achievement of environmental goals. The non-financial reporting obligations introduced in Polish legislation increased the scope of reported information. However, the lack of detailed guidelines on the method of reporting resulted in a large diversification of the scope of non-financial information, making it impossible to compare the data presented by companies. The source of information regarding the level of the implementation of standards in Environmental, social and corporate governance (ESG) is the report on compliance with best practices published by the Warsaw Stock Exchange. The document Best Practices of Warsaw Stock Exchange (WSE) Listed Companies (2021), amended by the WSE in 2021, includes the rules applicable to this area (ESG). The aim of this article is to present the level of compliance with good practices in the area of ESG by selected companies listed on the Warsaw Stock Exchange The research carried out as part of this study, which was based on information from reports on the compliance with good practices of companies listed on the Warsaw Stock Exchange that was made available in the good practice scanner, have revealed that good practices in the ESG area are implemented by companies to a limited extent. The level of their application in comparison with other rules is definitely lower. The lack of experience and clear guidelines on ESG reporting may cause some confusion, which is why conscious investors and reporting companies themselves are pinning their hopes on the Corporate Sustainability Reporting Directive (CSRD) adopted by European Parliament.

Keywords: reporting, ESG, corporate governance, best practices

Procedia PDF Downloads 73

Authors: Rodrigo T. Lourenço, Margarida Mano

Abstract:

Higher Education Institutions (HEI), and other levels of Education, face important challenges. One of the most relevant one is the ability to adapt to a society that is changing over time, whilst guarantying levels of training that do not merely react to such changes. Thus, interacting with society, particularly with surrounding communities and key stakeholders, has become an essential requirement for the sustainability of these institutions. One of the formal mechanisms implemented in European educational institutions has been the design of organizational structures that include a top governance body sharing its constitution with both internal members, students and external members. Such frame holds the core mission of involving communities in the governance of educational institutions, assuming, both strategic decision-making functions, with the approval of the institutions’ strategic plans, and a supervision function, approved by activity reports. It also plays an essential role in the life of institutions by holding the responsibility of electing its top executives. In Portugal, it has been almost a decade since the publication of RJIES, the legal framework of Higher Education, such bodies being designated by General Councils. Thus, one may highlight that there has been a better understanding of the operative process of these bodies, as well as their added value to the education system. It has also been possible to analyse the extent to which their core mission has been fulfilled and to understand its growing relevance, particularly regarding the autonomy of institutions. This article aims to contribute to this theme by presenting the results of a study on the role of these bodies in the governance of Public Portuguese HEI, with a special focus on the supervisory competence of organizational performance. Through questionnaires made to board members and interviews with chairpersons of the bodies and top managers of the institutions, it was possible to conclude that there is a high concern with the connections to the external environment. However, regarding organizational performance and the role of the Council as a supervisor of that performance, the activity of the bodies has fallen short of what would be expected. Several reasons may be identified. It is important to emphasize the importance of the profile of the external members and the relationship between the organ’s standard functioning and the election of the head of the institution.

Keywords: governance, stakeholders, supervision, performance

Procedia PDF Downloads 174

Authors: Eliane Ferreira da Silva

Abstract:

This paper aims to mobilize and sensitize public administration leaders to good practices and encourage investment in the PV system in Brazil. It presents a case study methodology for dimensioning the PV system in the roofs of the public buildings of the Esplanade of the Ministries, Brasilia, capital of the country, with predefined resources, starting with the Sustainable Esplanade Project (SEP), of the exponential growth of photovoltaic solar energy in the world and making a comparison with the solar power plant of the Ministry of Mines and Energy (MME), active since: 6/10/2016. In order to do so, it was necessary to evaluate the energy efficiency of the buildings in the period from January 2016 to April 2017, (16 months) identifying the opportunities to reduce electric energy expenses, through the adjustment of contracted demand, the tariff framework and correction of existing active energy. The instrument used to collect data on electric bills was the e-SIC citizen information system. The study considered in addition to the technical and operational aspects, the historical, cultural, architectural and climatic aspects, involved by several actors. Identifying the reductions of expenses, the study directed to the following aspects: Case 1) economic feasibility for exchanges of common lamps, for LED lamps, and, Case 2) economic feasibility for the implementation of photovoltaic solar system connected to the grid. For the case 2, PV*SOL Premium Software was used to simulate several possibilities of photovoltaic panels, analyzing the best performance, according to local characteristics, such as solar orientation, latitude, annual average solar radiation. A simulation of an ideal photovoltaic solar system was made, with due calculations of its yield, to provide a compensation of the energy expenditure of the building - or part of it - through the use of the alternative source in question. The study develops a methodology for public administration, as a major consumer of electricity, to act in a responsible, fiscalizing and incentive way in reducing energy waste, and consequently reducing greenhouse gases.

Keywords: energy efficiency, esplanade of ministries, photovoltaic solar energy, public buildings, sustainable building

Procedia PDF Downloads 132

Authors: Joanna Kufel-Orlowska

Abstract:

Domestic violence is a social threat to public safety and order. It poses a threat not only to the family members of the perpetrator but also disturbs the functioning of society and even the state. In a situation of danger, an individual either defends himself or/and calls for help by contacting an appropriate institution whose aim is to ensure civil security. Most often, such contact takes place through a telephone conversation, which is aimed at diagnosing the problem and prompt intervention. People in different situations and in different ways, despite the general reporting standards, try to inform about the need for help. The article aims to present the results of research on non-standard forms of reporting domestic violence in the opinion of the Polish society and operators of the Polish emergency number 112 (911). The research was conducted in the form of a survey technique on a sample of 160 operators (purposeful selection) and 300 people living in Poland (random selection). The research was conducted in the form of online surveys. The study found that in Poland: 1. emergency number operators often receive reports of domestic violence although they are not always able to diagnose whether the case is strictly about violence; 2. non-standard reports of domestic violence are received by about 30% of emergency number operators. Non-standard should be understood as reports of violence that deviate from the norm, are unusual, or are reported by a non-victim. 3. The most common forms of reporting violence not directly are: pretending to talk to a friend, calling a cab, making an appointment with a dentist/doctor, calling a store and helping with the selection of goods, asking about the bank's hotline, not speaking (in order for the emergency number operator to hear what is going on). 4. Emergency number operators in Poland are properly trained and are able to recognize the threatening situation of the reporting party and conduct the conversation in a safe manner for the reporting party. On the other hand, Polish people support the ability to report violence in a non-standard way and would do so themselves in the event of a threat to their own life, health, or property, thus expecting the emergency number operator to recognize a report and help us.

Keywords: domestic violence, operator of the emergency number 112 (911), emergency call center, reporting domestic violence

Procedia PDF Downloads 105

Authors: Minhal Abidi, Moinuddin

Abstract:

Diabetes mellitus (DM) induced metabolic abnormalities causes oxidative stress which leads to the pathogenesis of complications associated with diabetes like retinopathy, nephropathy periodontitis etc. Combination of glycation and oxidation 'glycoxidation' occurs when oxidative reactions affect the early state of glycation products. Low density lipoprotein (LDL) is prone to glycoxidative attack by sugars and methylglyoxal (MGO) being a strong glycating agent may have severe impact on its structure and consequent role in diabetes. Pro-inflammatory cytokines like IL1β and TNFα produced by the action of gram negative bacteria in periodontits (PD) can in turn lead to insulin resistance. This work discusses modifications to LDL as a result of glycoxidation. The changes in the protein molecule have been characterized by various physicochemical techniques and the immunogenicity of the modified molecules was also evaluated as they presented neo-epitopes. Binding of antibodies present in diabetes patients to the native and glycated LDL has been evaluated. Role of modified epitopes in the generation of antibodies in diabetes and periodontitis has been discussed. The structural perturbations induced in LDL were analyzed by UV–Vis, fluorescence, circular dichroism and FTIR spectroscopy, molecular docking studies, thermal denaturation studies, Thioflavin T assay, isothermal titration calorimetry, comet assay. MALDI-TOF, ketoamine moieties, carbonyl content and HMF content were also quantitated in native and glycated LDL. IL1β and TNFα levels were also measured in the type 2 DM and PD patients. We report increased carbonyl content, ketoamine moieties and HMF content in glycated LDL as compared to native analogue. The results substantiate that in hyperglycemic state MGO modification of LDL causes structural perturbations making the protein antigenic which could obstruct normal physiological functions and might contribute in the development of secondary complications in diabetic patients like periodontitis.

Keywords: advanced glycation end products, diabetes mellitus, glycation, glycoxidation, low density lipoprotein, periodontitis

Procedia PDF Downloads 191

Authors: Shafiqul Islam, Cordia Chu

Abstract:

Bangladesh contributes little to global climate change, yet it is one of the countries most vulnerable to climate change. Based on semi-structured in-depth interviews and literature review, focusing public spending distribution process, this paper demonstrates how the processes of political economy- enclosure, exclusion, encroachment, and entrenchment hinder the Climate Change Adaptation (CCA) efforts of Bangladesh Climate Change Trust Fund (BCCTF). Enclosure refers to when CCA projects allocated to less vulnerable areas or expand the roles of influencing actors into the public sphere. Exclusion refers to when CCA projects limit affected people's access to resources or marginalize particular stakeholders in decision-making activities. Encroachment refers to when allocation of CCA projects and selection of location and issues degrade the environmental affect or contribute to other forms of disaster risk. Entrenchment refers to when CCA projects aggravate the disempowerment of common people worsen the concentrations of wealth and income inequality within a community. In the case of Bangladesh, climate change policies implemented under the country’s National Adaptation Program of Action (NAPA) and Bangladesh Climate Change Strategic Action Plan (BCCSAP) have somehow enabled influential-elites to mobilize and distribute resources through bureaucracies. Exclusionary forms of fund distribution of CCA exist at both the national and local scales. CCA related allocations have encroached through the low land areas development project without consulting local needs. Most severely, CCA related unequal allocations have entrenched social class trapping the backward communities vulnerable to climate related disasters. Planners and practitioners of BCCTF need to take necessary steps to eliminate the potential risks from the processes of enclosure, exclusion, encroachment, and entrenchment happens in project fund allocations.

Keywords: Bangladesh, climate change adaptation, political economy, public fund distribution

Procedia PDF Downloads 141

Authors: Thifhuriwi Emmanuel Madzunye, Patricia Harpur, Ephias Ruhode

Abstract:

A review of the pertinent literature identified a gap concerning the hindrances and opportunities accompanying the implementation of real-time online learning systems (RTOLs) in rural areas. Whilst RTOLs present a possible solution to teaching and learning issues in rural areas, little is known about the implementation of digital strategies among schools in isolated communities. This study explores associated guidelines that have the potential to inform decision-making where Internet-based education could improve educational opportunities. A systematic literature review has the potential to consolidate and focus on disparate literature served to collect interlinked data from specific sources in a structured manner. During qualitative data analysis (QDA) of selected publications via the application of a QDA tool - ATLAS.ti, the following overarching themes emerged: digital divide, educational strategy, human factors, and support. Furthermore, findings from data collection and literature review suggest that signiant factors include a lack of digital knowledge, infrastructure shortcomings such as a lack of computers, poor internet connectivity, and handicapped real-time online may limit students’ progress. The study recommends that timeous consideration should be given to the influence of the digital divide. Additionally, the evolution of educational strategy that adopts digital approaches, a focus on training of role-players and stakeholders concerning human factors, and the seeking of governmental funding and support are essential to the implementation and success of RTOLs.

Keywords: communication, digital divide, digital skills, distance, educational strategy, government, ICT, infrastructures, learners, limpopo, lukalo, network, online learning systems, political-unrest, real-time, real-time online learning, real-time online learning system, pass-rate, resources, rural area, school, support, teachers, teaching and learning and training

Procedia PDF Downloads 335

Authors: Joseph L. Mathew, Shourjendra N. Banerjee, R. K. Ratho, Sourabh Dutta, Vanita Suri

Abstract:

Background: In India and many other developing countries, a single dose of measles vaccine is administered to infants at 9 months of age. This is based on the assumption that maternal transplacentally transferred antibodies will protect infants until that age. However, our previous data showed that most infants lose maternal anti-measles antibodies before 6 months of age, making them susceptible to measles before vaccination at 9 months. Objective: This prospective study was designed to compare susceptibility in pre-term vs term infants, at different time points. Material and Methods: Following Institutional Ethics Committee approval and a formal informed consent process, venous blood was drawn from a cohort of 45 consecutive term infants and 45 consecutive pre-term infants (both groups delivered by the vaginal route); at birth, 3 months, 6 months and 9 months (prior to measles vaccination). Serum was separated and anti-measles IgG antibody levels were measured by quantitative ELISA kits (with sensitivity and specificity > 95%). Susceptibility to measles was defined as antibody titre < 200mIU/ml. The mean antibody levels were compared between the two groups at the four time points. Results: The mean gestation of term babies was 38.5±1.2 weeks; and pre-term babies 34.7±2.8 weeks. The respective mean birth weights were 2655±215g and 1985±175g. Reliable maternal vaccination record was available in only 7 of the 90 mothers. Mean anti-measles IgG antibody (±SD) in terms babies was 3165±533 IU/ml at birth, 1074±272 IU/ml at 3 months, 314±153 IU/ml at 6 months, and 68±21 IU/ml at 9 months. The corresponding levels in pre-term babies were 2875±612 IU/ml, 948±377 IU/ml, 265±98 IU/ml, and 72±33 IU/ml at 9 months (p > 0.05 for all inter-group comparisons). The proportion of susceptible term infants at birth, 3months, 6months and 9months was 0%, 16%, 67% and 96%. The corresponding proportions in the pre-term infants were 0%, 29%, 82%, and 100% (p > 0.05 for all inter-group comparisons). Conclusion: Majority of infants are susceptible to measles before 9 months of age suggesting the need to anticipate measles vaccination, but there was no statistically significant difference between the proportion of susceptible term and pre-term infants, at any of the four-time points. A larger study is required to confirm these findings and compare sero-protection if vaccination is anticipated to be administered between 6 and 9 months.

Keywords: measles, preterm, susceptibility, term infant

Procedia PDF Downloads 273