Search results for: and worldwide governance indicators
Commenced in January 2007
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Edition: International
Paper Count: 4339

Search results for: and worldwide governance indicators

379 The Influence of Ibuprofen, Diclofenac and Naproxen on Composition and Ultrastructural Characteristics of Atriplex patula and Spinacia oleracea

Authors: Ocsana Opris, Ildiko Lung, Maria L. Soran, Alexandra Ciorita, Lucian Copolovici

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The effects assessment of environmental stress factors on both crop and wild plants of nutritional value are a very important research topic. Continuously worldwide consumption of drugs leads to significant environmental pollution, thus generating environmental stress. Understanding the effects of the important drugs on plant composition and ultrastructural modification is still limited, especially at environmentally relevant concentrations. The aim of the present work was to investigate the influence of three non-steroidal anti-inflammatory drugs (NSAIDs) on chlorophylls content, carotenoids content, total polyphenols content, antioxidant capacity, and ultrastructure of orache (Atriplex patula L.) and spinach (Spinacia oleracea L.). All green leafy vegetables selected for this study were grown in controlled conditions and treated with solutions of different concentrations (0.1‒1 mg L⁻¹) of diclofenac, ibuprofen, and naproxen. After eight weeks of exposure of the plants to NSAIDs, the chlorophylls and carotenoids content were analyzed by high-performance liquid chromatography coupled with photodiode array and mass spectrometer detectors, total polyphenols and antioxidant capacity by ultraviolet-visible spectroscopy. Also, the ultrastructural analyses of the vegetables were performed using transmission electron microscopy in order to assess the influence of the selected NSAIDs on cellular organisms, mainly photosynthetic organisms (chloroplasts), energy supply organisms (mitochondria) and nucleus as a cellular metabolism coordinator. In comparison with the control plants, decreases in the content of chlorophylls were observed in the case of the Atriplex patula L. plants treated with ibuprofen (11-34%) and naproxen (25-52%). Also, the chlorophylls content from Spinacia oleracea L. was affected, the lowest decrease (34%) being obtained in the case of the treatment with naproxen (1 mg L⁻¹). Diclofenac (1 mg L⁻¹) affected the total polyphenols content (a decrease of 45%) of Atriplex patula L. and ibuprofen (1 mg L⁻¹) affected the total polyphenols content (a decrease of 20%) of Spinacia oleracea L. The results obtained also indicate a moderate reduction of carotenoids and antioxidant capacity in the treated plants, in comparison with the controls. The investigations by transmission electron microscopy demonstrated that the green leafy vegetables were affected by the selected NSAIDs. Thus, this research contributes to a better understanding of the adverse effects of these drugs on studied plants. Important to mention is that the dietary intake of these drugs contaminated plants, plants with important nutritional value, may also presume a risk to human health, but currently little is known about the fate of the drugs in plants and their effect on or risk to the ecosystem.

Keywords: abiotic stress, green leafy vegetables, pigments content, ultra structure

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378 Linkages between Innovation Policies and SMEs' Innovation Activities: Empirical Evidence from 15 Transition Countries

Authors: Anita Richter

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Innovation is one of the key foundations of competitive advantage, generating growth and welfare worldwide. Consequently, all firms should innovate to bring new ideas to the market. Innovation is a vital growth driver, particularly for transition countries to move towards knowledge-based, high-income economies. However, numerous barriers, such as financial, regulatory or infrastructural constraints prevent, in particular, new and small firms in transition countries from innovating. Thus SMEs’ innovation output may benefit substantially from government support. This research paper aims to assess the effect of government interventions on innovation activities in SMEs in emerging countries. Until now academic research related to the innovation policies focused either on single country and/or high-income countries assessments and less on cross-country and/or low and middle-income countries. Therefore the paper seeks to close the research gap by providing empirical evidence from 8,500 firms in 15 transition countries (Eastern Europe, South Caucasus, South East Europe, Middle East and North Africa). Using firm-level data from the Business Environment and Enterprise Performance Survey of the World Bank and EBRD and policy data from the SME Policy Index of the OECD, the paper investigates how government interventions affect SME’s likelihood of investing in any technological and non-technological innovation. Using the Standard Linear Regression, the impact of government interventions on SMEs’ innovation output and R&D activities is measured. The empirical analysis suggests that a firm’s decision to invest into innovative activities is sensitive to government interventions. A firm’s likelihood to invest into innovative activities increases by 3% to 8%, if the innovation eco-system noticeably improves (measured by an increase of 1 level in the SME Policy Index). At the same time, a better eco-system encourages SMEs to invest more in R&D. Government reforms in establishing a dedicated policy framework (IP legislation), institutional infrastructure (science and technology parks, incubators) and financial support (public R&D grants, innovation vouchers) are particularly relevant to stimulate innovation performance in SMEs. Particular segments of the SME population, namely micro and manufacturing firms, are more likely to benefit from an increased innovation framework conditions. The marginal effects are particularly strong on product innovation, process innovation, and marketing innovation, but less on management innovation. In conclusion, government interventions supporting innovation will likely lead to higher innovation performance of SMEs. They increase productivity at both firm and country level, which is a vital step in transitioning towards knowledge-based market economies.

Keywords: innovation, research and development, government interventions, economic development, small and medium-sized enterprises, transition countries

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377 Internal Concept of Integrated Health by Agrarian Society in Malagasy Highlands for the Last Century

Authors: O. R. Razanakoto, L. Temple

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Living in a least developed country, the Malagasy society has a weak capacity to internalize progress, including health concerns. Since the arrival in the fifteenth century of Arabic script, called Sorabe, that was mainly dedicated to the aristocracy, until the colonial era beginning at the end of the nineteenth century and that has popularized the current usual script of the occidental civilization, the upcoming manuscripts that deal with apparent scientific or at least academic issue have been slowly established. So that, the Malagasy communities’ way of life is not well documented yet to allow a precise understanding of the major concerns, reason, and purpose of the existence of the farmers that compose them. A question arises, according to literature, how does Malagasy community that is dominated by agrarian society conceive the conservation of its wellbeing? This study aims to emphasize the scope and the limits of the « One Health » concept or of the Health Integrated Approach (HIA) that evolves at global scale, with regard to the specific context of local Malagasy smallholder farms. It is expected to identify how this society represents linked risks and the mechanisms between human health, animal health, plant health, and ecosystem health within the last 100 years. To do so, the framework to conduct systematic review for agricultural research has been deployed to access available literature. This task has been coupled with the reading of articles that are not indexed by online scientific search engine but that mention part of a history of agriculture and of farmers in Madagascar. This literature review has informed the interactions between human illnesses and those affecting animals and plants (breeded or wild) with any unexpected event (ecological or economic) that has modified the equilibrium of the ecosystem, or that has disturbed the livelihoods of agrarian communities. Besides, drivers that may either accentuate or attenuate the devasting effects of these illnesses and changes were revealed. The study has established that the reasons of human worries are not only physiological. Among the factors that regulate global health, food system and contemporary medicine have helped to the improvement of life expectancy from 55 to 63 years in Madagascar during the last 50 years. However, threats to global health are still occurring. New human or animal illnesses and livestock / plant pathology or enemies may also appear, whereas ancient illnesses that are supposed to have disappeared may be back. This study has highlighted how much important are the risks associated to the impact of unmanaged externalities that weaken community’s life. Many risks, and also solutions, come from abroad and have long term effects even though those happen as punctual event. Thus, a constructivist strategy is suggested to the « One Health » global concept throughout the record of local facts. This approach should facilitate the exploration of methodological pathways and the identification of relevant indicators for research related to HIA.

Keywords: agrarian system, health integrated approach, history, madagascar, resilience, risk

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376 Rural Entrepreneurship as a Response to Climate Change and Resource Conservation

Authors: Omar Romero-Hernandez, Federico Castillo, Armando Sanchez, Sergio Romero, Andrea Romero, Michael Mitchell

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Environmental policies for resource conservation in rural areas include subsidies on services and social programs to cover living expenses. Government's expectation is that rural communities who benefit from social programs, such as payment for ecosystem services, are provided with an incentive to conserve natural resources and preserve natural sinks for greenhouse gases. At the same time, global climate change has affected the lives of people worldwide. The capability to adapt to global warming depends on the available resources and the standard of living, putting rural communities at a disadvantage. This paper explores whether rural entrepreneurship can represent a solution to resource conservation and global warming adaptation in rural communities. The research focuses on a sample of two coffee communities in Oaxaca, Mexico. Researchers used geospatial information contained in aerial photographs of the geographical areas of interest. Households were identified in the photos via the roofs of households and georeferenced via coordinates. From the household population, a random selection of roofs was performed and received a visit. A total of 112 surveys were completed, including questions of socio-demographics, perception to climate change and adaptation activities. The population includes two groups of study: entrepreneurs and non-entrepreneurs. Data was sorted, filtered, and validated. Analysis includes descriptive statistics for exploratory purposes and a multi-regression analysis. Outcomes from the surveys indicate that coffee farmers, who demonstrate entrepreneurship skills and hire employees, are more eager to adapt to climate change despite the extreme adverse socioeconomic conditions of the region. We show that farmers with entrepreneurial tendencies are more creative in using innovative farm practices such as the planting of shade trees, the use of live fencing, instead of wires, and watershed protection techniques, among others. This result counters the notion that small farmers are at the mercy of climate change and have no possibility of being able to adapt to a changing climate. The study also points to roadblocks that farmers face when coping with climate change. Among those roadblocks are a lack of extension services, access to credit, and reliable internet, all of which reduces access to vital information needed in today’s constantly changing world. Results indicate that, under some circumstances, funding and supporting entrepreneurship programs may provide more benefit than traditional social programs.

Keywords: entrepreneurship, global warming, rural communities, climate change adaptation

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375 Assessment of Commercial Antimicrobials Incorporated into Gelatin Coatings and Applied to Conventional Heat-Shrinking Material for the Prevention of Blown Pack Spoilage in Vacuum Packaged Beef Cuts

Authors: Andrey A. Tyuftin, Rachael Reid, Paula Bourke, Patrick J. Cullen, Seamus Fanning, Paul Whyte, Declan Bolton , Joe P. Kerry

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One of the primary spoilage issues associated with vacuum-packed beef products is blown pack spoilage (BPS) caused by the psychrophilic spore-forming strain of Clostridium spp. Spores derived from this organism can be activated after heat-shrinking (eg. 90°C for 3 seconds). To date, research into the control of Clostridium spp in beef packaging is limited. Active packaging in the form of antimicrobially-active coatings may be one approach to its control. Antimicrobial compounds may be incorporated into packaging films or coated onto the internal surfaces of packaging films using a carrier matrix. Three naturally-sourced, commercially-available antimicrobials, namely; Auranta FV (AFV) (bitter oranges extract) from Envirotech Innovative Products Ltd, Ireland; Inbac-MDA (IMDA) from Chemital LLC, Spain, mixture of different organic acids and sodium octanoate (SO) from Sigma-Aldrich, UK, were added into gelatin solutions at 2 concentrations: 2.5 and 3.5 times their minimum inhibition concentration (MIC) against Clostridium estertheticum (DSMZ 8809). These gelatin solutions were coated onto the internal polyethylene layer of cold plasma treated, heat-shrinkable laminates conventionally used for meat packaging applications. Atmospheric plasma was used in order to enhance adhesion between packaging films and gelatin coatings. Pouches were formed from these coated packaging materials, and beef cuts which had been inoculated with C. estertheticum were vacuum packaged. Inoculated beef was vacuum packaged without employing active films and this treatment served as the control. All pouches were heat-sealed and then heat-shrunk at 90°C for 3 seconds and incubated at 2°C for 100 days. During this storage period, packs were monitored for the indicators of blown pack spoilage as follows; gas bubbles in drip, loss of vacuum (onset of BPS), blown, the presence of sufficient gas inside the packs to produce pack distension and tightly stretched, “overblown” packs/ packs leaking. Following storage and assessment of indicator date, it was concluded that AFV- and SO-containing packaging inhibited the growth of C. estertheticum, significantly delaying the blown pack spoilage of beef primals. IMDA did not inhibit the growth of C. estertheticum. This may be attributed to differences in release rates and possible reactions with gelatin. Overall, active films were successfully produced following plasma surface treatment, and experimental data demonstrated clearly that the use of antimicrobially-active films could significantly prolong the storage stability of beef primals through the effective control of BPS.

Keywords: active packaging, blown pack spoilage, Clostridium, antimicrobials, edible coatings, food packaging, gelatin films, meat science

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374 The Different Effects of Mindfulness-Based Relapse Prevention Group Therapy on QEEG Measures in Various Severity Substance Use Disorder Involuntary Clients

Authors: Yu-Chi Liao, Nai-Wen Guo, Chun‑Hung Lee, Yung-Chin Lu, Cheng-Hung Ko

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Objective: The incidence of behavioral addictions, especially substance use disorders (SUDs), is gradually be taken seriously with various physical health problems. Mindfulness-based relapse prevention (MBRP) is a treatment option for promoting long-term health behavior change in recent years. MBRP is a structured protocol that integrates formal meditation practices with the cognitive-behavioral approach of relapse prevention treatment by teaching participants not to engage in reappraisal or savoring techniques. However, considering SUDs as a complex brain disease, questionnaires and symptom evaluation are not sufficient to evaluate the effect of MBRP. Neurophysiological biomarkers such as quantitative electroencephalogram (QEEG) may improve accurately represent the curative effects. This study attempted to find out the neurophysiological indicator of MBRP in various severity SUD involuntary clients. Participants and Methods: Thirteen participants (all males) completed 8-week mindfulness-based treatment provided by trained, licensed clinical psychologists. The behavioral data were from the Severity of Dependence Scale (SDS) and Negative Mood Regulation Scale (NMR) before and afterMBRP treatment. The QEEG data were simultaneously recorded with executive attention tasks, called comprehensive nonverbal attention test(CNAT). The two-way repeated-measures (treatment * severity) ANOVA and independent t-test were used for statistical analysis. Results: Thirteen participants regrouped into high substance dependence (HS) and low substance dependence (LS) by SDS cut-off. The HS group showed more SDS total score and lower gamma wave in the Go/No Go task of CNAT at pretest. Both groups showed the main effect that they had a lower frontal theta/beta ratio (TBR) during the simple reaction time task of CNAT. The main effect showed that the delay errors of CNAT were lower after MBRP. There was no other difference in CNAT between groups. However, after MBRP, compared to LS, the HS group have resonant progress in improving SDS and NMR scores. The neurophysiological index, the frontal TBR of the HS during the Go/No Go task of CNATdecreased than that of the LS group. Otherwise, the LS group’s gamma wave was a significant reduction on the Go/No Go task of CNAT. Conclusion: The QEEG data supports the MBRP can restore the prefrontal function of involuntary addicts and lower their errors in executive attention tasks. However, the improvement of MBRPfor the addict with high addiction severity is significantly more than that with low severity, including QEEG’s indicators and negative emotion regulation. Future directions include investigating the reasons for differences in efficacy among different severity of the addiction.

Keywords: mindfulness, involuntary clients, QEEG, emotion regulation

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373 Preparation of Papers - Developing a Leukemia Diagnostic System Based on Hybrid Deep Learning Architectures in Actual Clinical Environments

Authors: Skyler Kim

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An early diagnosis of leukemia has always been a challenge to doctors and hematologists. On a worldwide basis, it was reported that there were approximately 350,000 new cases in 2012, and diagnosing leukemia was time-consuming and inefficient because of an endemic shortage of flow cytometry equipment in current clinical practice. As the number of medical diagnosis tools increased and a large volume of high-quality data was produced, there was an urgent need for more advanced data analysis methods. One of these methods was the AI approach. This approach has become a major trend in recent years, and several research groups have been working on developing these diagnostic models. However, designing and implementing a leukemia diagnostic system in real clinical environments based on a deep learning approach with larger sets remains complex. Leukemia is a major hematological malignancy that results in mortality and morbidity throughout different ages. We decided to select acute lymphocytic leukemia to develop our diagnostic system since acute lymphocytic leukemia is the most common type of leukemia, accounting for 74% of all children diagnosed with leukemia. The results from this development work can be applied to all other types of leukemia. To develop our model, the Kaggle dataset was used, which consists of 15135 total images, 8491 of these are images of abnormal cells, and 5398 images are normal. In this paper, we design and implement a leukemia diagnostic system in a real clinical environment based on deep learning approaches with larger sets. The proposed diagnostic system has the function of detecting and classifying leukemia. Different from other AI approaches, we explore hybrid architectures to improve the current performance. First, we developed two independent convolutional neural network models: VGG19 and ResNet50. Then, using both VGG19 and ResNet50, we developed a hybrid deep learning architecture employing transfer learning techniques to extract features from each input image. In our approach, fusing the features from specific abstraction layers can be deemed as auxiliary features and lead to further improvement of the classification accuracy. In this approach, features extracted from the lower levels are combined into higher dimension feature maps to help improve the discriminative capability of intermediate features and also overcome the problem of network gradient vanishing or exploding. By comparing VGG19 and ResNet50 and the proposed hybrid model, we concluded that the hybrid model had a significant advantage in accuracy. The detailed results of each model’s performance and their pros and cons will be presented in the conference.

Keywords: acute lymphoblastic leukemia, hybrid model, leukemia diagnostic system, machine learning

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372 Acceptability of ‘Fish Surimi Peptide’ in Under Five Children Suffering from Moderate Acute Malnutrition in Bangladesh

Authors: M. Iqbal Hossain, Azharul Islam Khan, S. M. Rafiqul Islam, Tahmeed Ahmed

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Objective: Moderate acute malnutrition (MAM) is a major cause of morbidity and mortality in under-5 children of low-income countries. Approximately 14.6% of all under-5 mortality worldwide is attributed to MAM with >3 times increased risk of death compared to well-nourished peers. Prevalence of MAM among under-5 children in Bangladesh is ~12% (~1.7 million). Providing a diet containing adequate nutrients is the mainstay of treatment of children with MAM. It is now possible to process fish into fish peptides with longer shelf-life without refrigerator, known as ‘Fish Surimi peptide’ and this could be an attractive alternative to supply fish protein in the diet of children in low-income countries like Bangladesh. We conducted this study to assess the acceptability of Fish Surimi peptide given with various foods/meals in 2-5 years old children with MAM. Design/methods: Fish Surimi peptide is broken down from white fish meat using plant-derived enzyme and the ingredient is just fish meat consisted of 20 different kinds of amino acids including nine essential amino acids. In a convenience sample of 34 children we completed the study ward of Dhaka Hospital of icddr,b in Bangladesh during November 2014 through February 2015. For each child the study was for two consecutive days: i.e. direct observation of food intake of two lunches and two suppers. In a randomly and blinded manner and cross over design an individual child received Fish Surimi peptide (5g at lunch and 5g at supper) mixed meal [e.g. 30g rice and 30g dahl (thick lentil soup) or 60g of a vegetables-lentil-rice mixed local dish known as khichuri in one day and the same meal on other day without any Fish Surimi peptide. We observed the completeness and eagerness of eating and any possible side effect (e.g. allergy, vomiting, diarrhea etc.) over these two days. Results: The mean±SD age of the enrolled children was 38.4±9.4 months, weight 11.22±1.41 kg, height 91.0±6.3 cm, and WHZ was -2.13±0.76. Their mean±SD total feeding time (minutes) for lunch was 25.4±13.6 vs. 20.6±11.1 (p=0.130) and supper was 22.3±9.7 vs. 19.7±11.2 (p=0.297), and total amount (g) of food eaten in lunch and supper was found similar 116.1±7.0 vs. 117.7±8.0 (p=3.01) in A (Fish Surimi) and B group respectively. Score in Hedonic scale by mother on test of food given to children at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) and on overall acceptance (including the texture, smell, and appearance) of food at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) for A and B group respectively. No adverse event was observed in any food group during the study period. Conclusions: Fish Surimi peptide may be a cost effective supplementary food, which should be tested by appropriately designed randomized community level intervention trial both in wasted children and stunted children.

Keywords: protein-energy malnutrition, moderate acute malnutrition, weight-for-height z-score, mid upper arm circumference, acceptability, fish surimi peptide, under-5 children

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371 Simulation-based Decision Making on Intra-hospital Patient Referral in a Collaborative Medical Alliance

Authors: Yuguang Gao, Mingtao Deng

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The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

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370 The Lack of Female Representation in Senior Positions: An Exploratory Study between South Africa and India

Authors: Dina Maria Smit

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Worldwide, it seems as if women are adequately represented in government and parliament but are almost absent from governing boards of private enterprises. The reasons for this seem to be embedded in perceptions of inadequacy, remnants of patriarchy, glass ceilings and even female choice. Direct or indirect discrimination against females have been found to be one of the reasons that female employees are found in traditionally “softer” roles, whilst the old “Boy’s Club” is still operational to keep women out of senior managerial positions, especially in the private sector. The cultural construct of Indian society, focusing on male preference, patriarchy, divorce laws and low educational levels of females as opposed to men, is indicative of a society wherein high gender inequality still exists. The position in South Africa is similar in that substantive gender equality has not been reached despite a progressive constitution and anti-discrimination laws. There is a strong push to propel women to senior positions in South Africa, but these efforts have not yet translated into females taking up senior positions in private companies. In South Africa, females still earn less than their male counterparts whilst performing doing the same jobs, are overrepresented in parliament, but do not captain the ships in the private sector. The lack of female parity in employment leads to a lack of autonomy and authority in both South Africa and India. The divide between formal and informal work, unpaid work, mainly being done by women, need to be investigated to ensure substantive gender parity. The findings will show that females are still not equal to men in employment, especially in senior private positions; mainly due to the remnants of patriarchy and glass ceilings that still need to be shattered. This article aims to set out the reasons why gender disparity still exists in India and South Africa, seen through a legal lense. Both countries are signatories to the CEDAW Convention and have constitutions that advocate for the right of equality. Although equal rights have been implemented in both countries, equality may not be well implemented. This investigation is comparative in nature and aims to contribute to the growing body of evidence on how to ensure gender parity in all occupational levels and categories. The study is in quantitative in nature. If substantive gender equality, as opposed to formative gender equality, is a key motivator to ensure gender equality, an investigation into the reasons for this disparity is warranted before suggestions can be tendered to effect lasting change. The aim of this comparative study is not to plug the legal system of one country into the other, but to take into account of the autonomy of choice, set against cultural differences and similarities in an effort to shatter the glass ceilings for women who aspire to climb the corporate ladders.

Keywords: gender inequality, glass ceilings, patriarchy, female disparity

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369 Digital Twins: Towards an Overarching Framework for the Built Environment

Authors: Astrid Bagireanu, Julio Bros-Williamson, Mila Duncheva, John Currie

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Digital Twins (DTs) have entered the built environment from more established industries like aviation and manufacturing, although there has never been a common goal for utilising DTs at scale. Defined as the cyber-physical integration of data between an asset and its virtual counterpart, DT has been identified in literature from an operational standpoint – in addition to monitoring the performance of a built asset. However, this has never been translated into how DTs should be implemented into a project and what responsibilities each project stakeholder holds in the realisation of a DT. What is needed is an approach to translate these requirements into actionable DT dimensions. This paper presents a foundation for an overarching framework specific to the built environment. For the purposes of this research, the UK widely used the Royal Institute of British Architects (RIBA) Plan of Work from 2020 is used as a basis for itemising project stages. The RIBA Plan of Work consists of eight stages designed to inform on the definition, briefing, design, coordination, construction, handover, and use of a built asset. Similar project stages are utilised in other countries; therefore, the recommendations from the interviews presented in this paper are applicable internationally. Simultaneously, there is not a single mainstream software resource that leverages DT abilities. This ambiguity meets an unparalleled ambition from governments and industries worldwide to achieve a national grid of interconnected DTs. For the construction industry to access these benefits, it necessitates a defined starting point. This research aims to provide a comprehensive understanding of the potential applications and ramifications of DT in the context of the built environment. This paper is an integral part of a larger research aimed at developing a conceptual framework for the Architecture, Engineering, and Construction (AEC) sector following a conventional project timeline. Therefore, this paper plays a pivotal role in providing practical insights and a tangible foundation for developing a stage-by-stage approach to assimilate the potential of DT within the built environment. First, the research focuses on a review of relevant literature, albeit acknowledging the inherent constraint of limited sources available. Secondly, a qualitative study compiling the views of 14 DT experts is presented, concluding with an inductive analysis of the interview findings - ultimately highlighting the barriers and strengths of DT in the context of framework development. As parallel developments aim to progress net-zero-centred design and improve project efficiencies across the built environment, the limited resources available to support DTs should be leveraged to propel the industry to reach its digitalisation era, in which AEC stakeholders have a fundamental role in understanding this, from the earliest stages of a project.

Keywords: digital twins, decision-making, design, net-zero, built environment

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368 User Experience Evaluation on the Usage of Commuter Line Train Ticket Vending Machine

Authors: Faishal Muhammad, Erlinda Muslim, Nadia Faradilla, Sayidul Fikri

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To deal with the increase of mass transportation needs problem, PT. Kereta Commuter Jabodetabek (KCJ) implements Commuter Vending Machine (C-VIM) as the solution. For that background, C-VIM is implemented as a substitute to the conventional ticket windows with the purposes to make transaction process more efficient and to introduce self-service technology to the commuter line user. However, this implementation causing problems and long queues when the user is not accustomed to using the machine. The objective of this research is to evaluate user experience after using the commuter vending machine. The goal is to analyze the existing user experience problem and to achieve a better user experience design. The evaluation method is done by giving task scenario according to the features offered by the machine. The features are daily insured ticket sales, ticket refund, and multi-trip card top up. There 20 peoples that separated into two groups of respondents involved in this research, which consist of 5 males and 5 females each group. The experienced and inexperienced user to prove that there is a significant difference between both groups in the measurement. The user experience is measured by both quantitative and qualitative measurement. The quantitative measurement includes the user performance metrics such as task success, time on task, error, efficiency, and learnability. The qualitative measurement includes system usability scale questionnaire (SUS), questionnaire for user interface satisfaction (QUIS), and retrospective think aloud (RTA). Usability performance metrics shows that 4 out of 5 indicators are significantly different in both group. This shows that the inexperienced group is having a problem when using the C-VIM. Conventional ticket windows also show a better usability performance metrics compared to the C-VIM. From the data processing, the experienced group give the SUS score of 62 with the acceptability scale of 'marginal low', grade scale of “D”, and the adjective ratings of 'good' while the inexperienced group gives the SUS score of 51 with the acceptability scale of 'marginal low', grade scale of 'F', and the adjective ratings of 'ok'. This shows that both groups give a low score on the system usability scale. The QUIS score of the experienced group is 69,18 and the inexperienced group is 64,20. This shows the average QUIS score below 70 which indicate a problem with the user interface. RTA was done to obtain user experience issue when using C-VIM through interview protocols. The issue obtained then sorted using pareto concept and diagram. The solution of this research is interface redesign using activity relationship chart. This method resulted in a better interface with an average SUS score of 72,25, with the acceptable scale of 'acceptable', grade scale of 'B', and the adjective ratings of 'excellent'. From the time on task indicator of performance metrics also shows a significant better time by using the new interface design. Result in this study shows that C-VIM not yet have a good performance and user experience.

Keywords: activity relationship chart, commuter line vending machine, system usability scale, usability performance metrics, user experience evaluation

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367 Governance of Climate Adaptation Through Artificial Glacier Technology: Lessons Learnt from Leh (Ladakh, India) In North-West Himalaya

Authors: Ishita Singh

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Social-dimension of Climate Change is no longer peripheral to Science, Technology and Innovation (STI). Indeed, STI is being mobilized to address small farmers’ vulnerability and adaptation to Climate Change. The experiences from the cold desert of Leh (Ladakh) in North-West Himalaya illustrate the potential of STI to address the challenges of Climate Change and the needs of small farmers through the use of Artificial Glacier Techniques. Small farmers have a unique technique of water harvesting to augment irrigation, called “Artificial Glaciers” - an intricate network of water channels and dams along the upper slope of a valley that are located closer to villages and at lower altitudes than natural glaciers. It starts to melt much earlier and supplements additional irrigation to small farmers’ improving their livelihoods. Therefore, the issue of vulnerability, adaptive capacity and adaptation strategy needs to be analyzed in a local context and the communities as well as regions where people live. Leh (Ladakh) in North-West Himalaya provides a Case Study for exploring the ways in which adaptation to Climate Change is taking place at a community scale using Artificial Glacier Technology. With the above backdrop, an attempt has been made to analyze the rural poor households' vulnerability and adaptation practices to Climate Change using this technology, thereby drawing lessons on vulnerability-livelihood interactions in the cold desert of Leh (Ladakh) in North-West Himalaya, India. The study is based on primary data and information collected from 675 households confined to 27 villages of Leh (Ladakh) in North-West Himalaya, India. It reveals that 61.18% of the population is driving livelihoods from agriculture and allied activities. With increased irrigation potential due to the use of Artificial Glaciers, food security has been assured to 77.56% of households and health vulnerability has been reduced in 31% of households. Seasonal migration as a livelihood diversification mechanism has declined in nearly two-thirds of households, thereby improving livelihood strategies. Use of tactical adaptations by small farmers in response to persistent droughts, such as selling livestock, expanding agriculture lands, and use of relief cash and foods, have declined to 20.44%, 24.74% and 63% of households. However, these measures are unsustainable on a long-term basis. The role of policymakers and societal stakeholders becomes important in this context. To address livelihood challenges, the role of technology is critical in a multidisciplinary approach involving multilateral collaboration among different stakeholders. The presence of social entrepreneurs and new actors on the adaptation scene is necessary to bring forth adaptation measures. Better linkage between Science and Technology policies, together with other policies, should be encouraged. Better health care, access to safe drinking water, better sanitary conditions, and improved standards of education and infrastructure are effective measures to enhance a community’s adaptive capacity. However, social transfers for supporting climate adaptive capacity require significant amounts of additional investment. Developing institutional mechanisms for specific adaptation interventions can be one of the most effective ways of implementing a plan to enhance adaptation and build resilience.

Keywords: climate change, adaptation, livelihood, stakeholders

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366 The Intensity of Root and Soil Respiration Is Significantly Determined by the Organic Matter and Moisture Content of the Soil

Authors: Zsolt Kotroczó, Katalin Juhos, Áron Béni, Gábor Várbíró, Tamás Kocsis, István Fekete

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Soil organic matter plays an extremely important role in the functioning and regulation processes of ecosystems. It follows that the C content of organic matter in soil is one of the most important indicators of soil fertility. Part of the carbon stored in them is returned to the atmosphere during soil respiration. Climate change and inappropriate land use can accelerate these processes. Our work aimed to determine how soil CO2 emissions change over ten years as a result of organic matter manipulation treatments. With the help of this, we were able to examine not only the effects of the different organic matter intake but also the effects of the different microclimates that occur as a result of the treatments. We carried out our investigations in the area of the Síkfőkút DIRT (Detritus Input and Removal Treatment) Project. The research area is located in the southern, hilly landscape of the Bükk Mountains, northeast of Eger (Hungary). GPS coordinates of the project: 47°55′34′′ N and 20°26′ 29′′ E, altitude 320-340 m. The soil of the area is Luvisols. The 27-hectare protected forest area is now under the supervision of the Bükki National Park. The experimental plots in Síkfőkút were established in 2000. We established six litter manipulation treatments each with three 7×7 m replicate plots established under complete canopy cover. There were two types of detritus addition treatments (Double Wood and Double Litter). In three treatments, detritus inputs were removed: No Litter No Roots plots, No Inputs, and the Controls. After the establishment of the plots, during the drier periods, the NR and NI treatments showed the highest CO2 emissions. In the first few years, the effect of this process was evident, because due to the lack of living vegetation, the amount of evapotranspiration on the NR and NI plots was much lower, and transpiration practically ceased on these plots. In the wetter periods, the NL and NI treatments showed the lowest soil respiration values, which were significantly lower compared to the Co, DW, and DL treatments. Due to the lower organic matter content and the lack of surface litter cover, the water storage capacity of these soils was significantly limited, therefore we measured the lowest average moisture content among the treatments after ten years. Soil respiration is significantly influenced by temperature values. Furthermore, the supply of nutrients to the soil microorganisms is also a determining factor, which in this case is influenced by the litter production dictated by the treatments. In the case of dry soils with a moisture content of less than 20% in the initial period, litter removal treatments showed a strong correlation with soil moisture (r=0.74). In very dry soils, a smaller increase in moisture does not cause a significant increase in soil respiration, while it does in a slightly higher moisture range. In wet soils, the temperature is the main regulating factor, above a certain moisture limit, water displaces soil air from the soil pores, which inhibits aerobic decomposition processes, and so heterotrophic soil respiration also declines.

Keywords: soil biology, organic matter, nutrition, DIRT, soil respiration

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365 Lake Water Surface Variations and Its Influencing Factors in Tibetan Plateau in Recent 10 Years

Authors: Shanlong Lu, Jiming Jin, Xiaochun Wang

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The Tibetan Plateau has the largest number of inland lakes with the highest elevation on the planet. These massive and large lakes are mostly in natural state and are less affected by human activities. Their shrinking or expansion can truly reflect regional climate and environmental changes and are sensitive indicators of global climate change. However, due to the sparsely populated nature of the plateau and the poor natural conditions, it is difficult to effectively obtain the change data of the lake, which has affected people's understanding of the temporal and spatial processes of lake water changes and their influencing factors. By using the MODIS (Moderate Resolution Imaging Spectroradiometer) MOD09Q1 surface reflectance images as basic data, this study produced the 8-day lake water surface data set of the Tibetan Plateau from 2000 to 2012 at 250 m spatial resolution, with a lake water surface extraction method of combined with lake water surface boundary buffer analyzing and lake by lake segmentation threshold determining. Then based on the dataset, the lake water surface variations and their influencing factors were analyzed, by using 4 typical natural geographical zones of Eastern Qinghai and Qilian, Southern Qinghai, Qiangtang, and Southern Tibet, and the watersheds of the top 10 lakes of Qinghai, Siling Co, Namco, Zhari NamCo, Tangra Yumco, Ngoring, UlanUla, Yamdrok Tso, Har and Gyaring as the analysis units. The accuracy analysis indicate that compared with water surface data of the 134 sample lakes extracted from the 30 m Landsat TM (Thematic Mapper ) images, the average overall accuracy of the lake water surface data set is 91.81% with average commission and omission error of 3.26% and 5.38%; the results also show strong linear (R2=0.9991) correlation with the global MODIS water mask dataset with overall accuracy of 86.30%; and the lake area difference between the Second National Lake Survey and this study is only 4.74%, respectively. This study provides reliable dataset for the lake change research of the plateau in the recent decade. The change trends and influencing factors analysis indicate that the total water surface area of lakes in the plateau showed overall increases, but only lakes with areas larger than 10 km2 had statistically significant increases. Furthermore, lakes with area larger than 100 km2 experienced an abrupt change in 2005. In addition, the annual average precipitation of Southern Tibet and Southern Qinghai experienced significant increasing and decreasing trends, and corresponding abrupt changes in 2004 and 2006, respectively. The annual average temperature of Southern Tibet and Qiangtang showed a significant increasing trend with an abrupt change in 2004. The major reason for the lake water surface variation in Eastern Qinghai and Qilian, Southern Qinghai and Southern Tibet is the changes of precipitation, and that for Qiangtang is the temperature variations.

Keywords: lake water surface variation, MODIS MOD09Q1, remote sensing, Tibetan Plateau

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364 Tourism Management of the Heritage and Archaeological Sites in Egypt

Authors: Sabry A. El Azazy

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The archaeological heritage sites are one of the most important touristic attractions worldwide. Egypt has various archaeological sites and historical locations that are classified within the list of the archaeological heritage destinations in the world, such as Cairo, Luxor, Aswan, Alexandria, and Sinai. This study focuses on how to manage the archaeological sites and provide them with all services according to the traveler's needs. Tourism management depends on strategic planning for supporting the national economy and sustainable development. Additionally, tourism management has to utilize highly effective standards of security, promotion, advertisement, sales, and marketing while taking into consideration the preservation of monuments. In Egypt, the archaeological heritage sites must be well-managed and protected, which would assist tourism management, especially in times of crisis. Recently, the monumental places and archeological heritage sites were affected by unstable conditions and were threatened. It is essential to focus on preserving our heritage. Moreover, more efforts and cooperation between the tourism organizations and ministry of archaeology have to be done in order to protect the archaeology and promote the tourism industry. Methodology: Qualitative methods have been used as the overall approach to this study. Interviews and observations have provided the researcher with the required in-depth insight to the research subject. The researcher was a lecturer of tourist guidance that allows visiting all historical sites in Egypt. Additionally, the researcher had the privilege to communicate with tourism specialists and attend meetings, conferences, and events that were focused on the research subject. Objectives: The main purpose of the research was gaining information in order to develop theoretical research on how to effectively benefit out of those historical sights both economically and culturally, and pursue further researches and scientific studies to be well-suited for tourism and hospitality sector. The researcher works hard to present further studies in a field related to tourism and archaeological heritage using previous experience. Pursing this course of study enables the researcher to acquire the necessary abilities and competencies to achieve the set goal successfully. Results: The professional tourism management focus on making Egypt one of the most important destinations in the world, and provide the heritage and archaeological sites with all services that will place those locations into the international map of tourism. Tourists interested in visiting Egypt and making tourism flourish supports and strengths Egypt's national economy and the local community, taking into consideration preserving our heritage and archaeology. Conclusions: Egypt has many tourism attractions represented in the heritage, archaeological sites, and touristic places. These places need more attention and efforts to be included in tourism programs and be opened for visitors from all over the world. These efforts will encourage both local and international tourism to see our great civilization and provide different touristic activities.

Keywords: archaeology, archaeological sites, heritage, ministry of archaeology, national economy, touristic attractions, tourism management, tourism organizations

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363 Theoretical-Methodological Model to Study Vulnerability of Death in the Past from a Bioarchaeological Approach

Authors: Geraldine G. Granados Vazquez

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Every human being is exposed to the risk of dying; wherein some of them are more susceptible than others depending on the cause. Therefore, the cause could be the hazard to die that a group or individual has, making this irreversible damage the condition of vulnerability. Risk is a dynamic concept; which means that it depends on the environmental, social, economic and political conditions. Thus vulnerability may only be evaluated in terms of relative parameters. This research is focusing specifically on building a model that evaluate the risk or propensity of death in past urban societies in connection with the everyday life of individuals, considering that death can be a consequence of two coexisting issues: hazard and the deterioration of the resistance to destruction. One of the most important discussions in bioarchaeology refers to health and life conditions in ancient groups; the researchers are looking for more flexible models that evaluate these topics. In that way, this research proposes a theoretical-methodological model that assess the vulnerability of death in past urban groups. This model pretends to be useful to evaluate the risk of death, considering their sociohistorical context, and their intrinsic biological features. This theoretical and methodological model, propose four areas to assess vulnerability. The first three areas use statistical methods or quantitative analysis. While the last and fourth area, which corresponds to the embodiment, is based on qualitative analysis. The four areas and their techniques proposed are a) Demographic dynamics. From the distribution of age at the time of death, the analysis of mortality will be performed using life tables. From here, four aspects may be inferred: population structure, fertility, mortality-survival, and productivity-migration, b) Frailty. Selective mortality and heterogeneity in frailty can be assessed through the relationship between characteristics and the age at death. There are two indicators used in contemporary populations to evaluate stress: height and linear enamel hypoplasias. Height estimates may account for the individual’s nutrition and health history in specific groups; while enamel hypoplasias are an account of the individual’s first years of life, c) Inequality. Space reflects various sectors of society, also in ancient cities. In general terms, the spatial analysis uses measures of association to show the relationship between frail variables and space, d) Embodiment. The story of everyone leaves some evidence on the body, even in the bones. That led us to think about the dynamic individual's relations in terms of time and space; consequently, the micro analysis of persons will assess vulnerability from the everyday life, where the symbolic meaning also plays a major role. In sum, using some Mesoamerica examples, as study cases, this research demonstrates that not only the intrinsic characteristics related to the age and sex of individuals are conducive to vulnerability, but also the social and historical context that determines their state of frailty before death. An attenuating factor for past groups is that some basic aspects –such as the role they played in everyday life– escape our comprehension, and are still under discussion.

Keywords: bioarchaeology, frailty, Mesoamerica, vulnerability

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362 Monitoring the Responses to Nociceptive Stimuli During General Anesthesia Based on Electroencephalographic Signals in Surgical Patients Undergoing General Anesthesia with Laryngeal Mask Airway (LMA)

Authors: Ofelia Loani Elvir Lazo, Roya Yumul, Sevan Komshian, Ruby Wang, Jun Tang

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Background: Monitoring the anti-nociceptive drug effect is useful because a sudden and strong nociceptive stimulus may result in untoward autonomic responses and muscular reflex movements. Monitoring the anti-nociceptive effects of perioperative medications has long been desiredas a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively.To this end, electroencephalogram (EEG) based tools includingBIS and qCON were designed to provide information about the depth of sedation whileqNOXwas produced to informon the degree of antinociception.The goal of this study was to compare the reliability of qCON/qNOX to BIS asspecific indicators of response to nociceptive stimulation. Methods: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board(IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed o62n all patientsprior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. Results: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from74±13 mm Hg at baseline to 84± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76±12 BPM at baseline to 80±13BPM during noxious stimuli[p=0.078] respectively). Conclusion: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices.

Keywords: antinociception, bispectral index (BIS), general anesthesia, laryngeal mask airway, qCON/qNOX

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361 Epidemiological Data of Schistosoma haematobium Bilharzia in Rural and Urban Localities in the Republic of Congo

Authors: Jean Akiana, Digne Merveille Nganga Bouanga, Nardiouf Sjelin Nsana, Wilfrid Sapromet Ngoubili, Chyvanelle Ndous Akiridzo, Vishnou Reize Ampiri, Henri-Joseph Parra, Florence Fenollar, Didier Raoult, Oleg Mediannikov, Cheikh Sadhibou Sokhna

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Schistosoma haematobium schistosomiasis is an endemic disease in which the level of human exposure, incidence, and fatality attributed to it remains, unfortunately, high worldwide. The erection of hydroelectric infrastructures constitute a major factor in the emergence of this disease. In the context of the Republic of the Congo, which considers industrialization and modernization as two essential pillars of development, building the hydroelectric dams of Liouesso (19 Mw) and the feasibility studies of the dams of Chollet (600MW) in the Sangha, of Sounda (1000MW) in Kouilou and Kouembali (150MW) on Lefini is necessary to increase the country's energy capacities. Likewise, the urbanization of former endemic localities should take into account the maintenance of contamination points. However, health impact studies on schistosomiasis epidemiology in general and urinary bilharzia, in particular, have never been carried out in these areas, neither before nor after the erection of those dams. Participants benefited from an investigative questionnaire, urinalysis both by dipstick and urine filtrate examined under a microscope. Assessment of the genetic diversity of schistosoma species populations was considered as well as PCR analysis to confirm the test strip and microscopy tests. 405 participants were registered in five localities. The sampling was made up of a balanced population in terms of male/female ratio, which is around 1. The prevalence rate was 45% (55/123) in Nkayi, 10.40% (11/106) in Loudima, 1 case in Mbomo (West Cuvette), which would probably be imported, zero in Liouesso and Kabo. The highest oviuria (number of eggs per volume of urine) is 150 S. haematobium eggs/10ml in Nkayi, apart from the case of imported Mbomo, imported from Gabon, which has 160 S. haematobium eggs/10ml. The lowest oviuria was 2 S. haematobium eggs/10ml. Prevalence rates are still high in semi-urban areas (Nkayi). As praziquantel treatments are available and effective, it is important to step up mass treatment campaigns in high risk areas already largely initiated by the National Schistosomiasis Control Program. Prevalence rates are still high in semi-urban areas (Nkayi). As praziquantel treatments are available and effective, it is important to step up mass treatment campaigns in high risk areas already largely initiated by the National Schistosomiasis Control Program.

Keywords: Bilharzia, Schistosoma haematobium, oviuria, urbanization, Congo

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360 Understanding the Diversity of Antimicrobial Resistance among Wild Animals, Livestock and Associated Environment in a Rural Ecosystem in Sri Lanka

Authors: B. M. Y. I. Basnayake, G. G. T. Nisansala, P. I. J. B. Wijewickrama, U. S. Weerathunga, K. W. M. Y. D. Gunasekara, N. K. Jayasekera, A. W. Kalupahana, R. S. Kalupahana, A. Silva- Fletcher, K. S. A. Kottawatta

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Antimicrobial resistance (AMR) has attracted significant attention worldwide as an emerging threat to public health. Understanding the role of livestock and wildlife with the shared environment in the maintenance and transmission of AMR is of utmost importance due to its interactions with humans for combating the issue in one health approach. This study aims to investigate the extent of AMR distribution among wild animals, livestock, and environment cohabiting in a rural ecosystem in Sri Lanka: Hambegamuwa. One square km area at Hambegamuwa was mapped using GPS as the sampling area. The study was conducted for a period of five months from November 2020. Voided fecal samples were collected from 130 wild animals, 123 livestock: buffalo, cattle, chicken, and turkey, with 36 soil and 30 water samples associated with livestock and wildlife. From the samples, Escherichia coli (E. coli) was isolated, and their AMR profiles were investigated for 12 antimicrobials using the disk diffusion method following the CLSI standard. Seventy percent (91/130) of wild animals, 93% (115/123) of livestock, 89% (32/36) of soil, and 63% (19/30) of water samples were positive for E. coli. Maximum of two E. coli from each sample to a total of 467 were tested for the sensitivity of which 157, 208, 62, and 40 were from wild animals, livestock, soil, and water, respectively. The highest resistance in E. coli from livestock (13.9%) and wild animals (13.3%) was for ampicillin, followed by streptomycin. Apart from that, E. coli from livestock and wild animals revealed resistance mainly against tetracycline, cefotaxime, trimethoprim/ sulfamethoxazole, and nalidixic acid at levels less than 10%. Ten cefotaxime resistant E. coli were reported from wild animals, including four elephants, two land monitors, a pigeon, a spotted dove, and a monkey which was a significant finding. E. coli from soil samples reflected resistance primarily against ampicillin, streptomycin, and tetracycline at levels less than in livestock/wildlife. Two water samples had cefotaxime resistant E. coli as the only resistant isolates out of 30 water samples tested. Of the total E. coli isolates, 6.4% (30/467) was multi-drug resistant (MDR) which included 18, 9, and 3 isolates from livestock, wild animals, and soil, respectively. Among 18 livestock MDRs, the highest (13/ 18) was from poultry. Nine wild animal MDRs were from spotted dove, pigeon, land monitor, and elephant. Based on CLSI standard criteria, 60 E. coli isolates, of which 40, 16, and 4 from livestock, wild animal, and environment, respectively, were screened for Extended Spectrum β-Lactamase (ESBL) producers. Despite being a rural ecosystem, AMR and MDR are prevalent even at low levels. E. coli from livestock, wild animals, and the environment reflected a similar spectrum of AMR where ampicillin, streptomycin, tetracycline, and cefotaxime being the predominant antimicrobials of resistance. Wild animals may have acquired AMR via direct contact with livestock or via the environment, as antimicrobials are rarely used in wild animals. A source attribution study including the effects of the natural environment to study AMR can be proposed as this less contaminated rural ecosystem alarms the presence of AMR.

Keywords: AMR, Escherichia coli, livestock, wildlife

Procedia PDF Downloads 184
359 Analysis of Digital Transformation in Banking: The Hungarian Case

Authors: Éva Pintér, Péter Bagó, Nikolett Deutsch, Miklós Hetényi

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The process of digital transformation has a profound influence on all sectors of the worldwide economy and the business environment. The influence of blockchain technology can be observed in the digital economy and e-government, rendering it an essential element of a nation's growth strategy. The banking industry is experiencing significant expansion and development of financial technology firms. Utilizing developing technologies such as artificial intelligence (AI), machine learning (ML), and big data (BD), these entrants are offering more streamlined financial solutions, promptly addressing client demands, and presenting a challenge to incumbent institutions. The advantages of digital transformation are evident in the corporate realm, and firms that resist its adoption put their survival at risk. The advent of digital technologies has revolutionized the business environment, streamlining processes and creating opportunities for enhanced communication and collaboration. Thanks to the aid of digital technologies, businesses can now swiftly and effortlessly retrieve vast quantities of information, all the while accelerating the process of creating new and improved products and services. Big data analytics is generally recognized as a transformative force in business, considered the fourth paradigm of science, and seen as the next frontier for innovation, competition, and productivity. Big data, an emerging technology that is shaping the future of the banking sector, offers numerous advantages to banks. It enables them to effectively track consumer behavior and make informed decisions, thereby enhancing their operational efficiency. Banks may embrace big data technologies to promptly and efficiently identify fraud, as well as gain insights into client preferences, which can then be leveraged to create better-tailored products and services. Moreover, the utilization of big data technology empowers banks to develop more intelligent and streamlined models for accurately recognizing and focusing on the suitable clientele with pertinent offers. There is a scarcity of research on big data analytics in the banking industry, with the majority of existing studies only examining the advantages and prospects associated with big data. Although big data technologies are crucial, there is a dearth of empirical evidence about the role of big data analytics (BDA) capabilities in bank performance. This research addresses a gap in the existing literature by introducing a model that combines the resource-based view (RBV), the technical organization environment framework (TOE), and dynamic capability theory (DC). This study investigates the influence of Big Data Analytics (BDA) utilization on the performance of market and risk management. This is supported by a comparative examination of Hungarian mobile banking services.

Keywords: big data, digital transformation, dynamic capabilities, mobile banking

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358 Analysis of Complex Business Negotiations: Contributions from Agency-Theory

Authors: Jan Van Uden

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The paper reviews classical agency-theory and its contributions to the analysis of complex business negotiations and gives an approach for the modification of the basic agency-model in order to examine the negotiation specific dimensions of agency-problems. By illustrating fundamental potentials for the modification of agency-theory in context of business negotiations the paper highlights recent empirical research that investigates agent-based negotiations and inter-team constellations. A general theoretical analysis of complex negotiation would be based on a two-level approach. First, the modification of the basic agency-model in order to illustrate the organizational context of business negotiations (i.e., multi-agent issues, common-agencies, multi-period models and the concept of bounded rationality). Second, the application of the modified agency-model on complex business negotiations to identify agency-problems and relating areas of risk in the negotiation process. The paper is placed on the first level of analysis – the modification. The method builds on the one hand on insights from behavior decision research (BRD) and on the other hand on findings from agency-theory as normative directives to the modification of the basic model. Through neoclassical assumptions concerning the fundamental aspects of agency-relationships in business negotiations (i.e., asymmetric information, self-interest, risk preferences and conflict of interests), agency-theory helps to draw solutions on stated worst-case-scenarios taken from the daily negotiation routine. As agency-theory is the only universal approach able to identify trade-offs between certain aspects of economic cooperation, insights obtained provide a deeper understanding of the forces that shape business negotiation complexity. The need for a modification of the basic model is illustrated by highlighting selected issues of business negotiations from agency-theory perspective: Negotiation Teams require a multi-agent approach under the condition that often decision-makers as superior-agents are part of the team. The diversity of competences and decision-making authority is a phenomenon that overrides the assumptions of classical agency-theory and varies greatly in context of certain forms of business negotiations. Further, the basic model is bound to dyadic relationships preceded by the delegation of decision-making authority and builds on a contractual created (vertical) hierarchy. As a result, horizontal dynamics within the negotiation team playing an important role for negotiation success are therefore not considered in the investigation of agency-problems. Also, the trade-off between short-term relationships within the negotiation sphere and the long-term relationships of the corporate sphere calls for a multi-period perspective taking into account the sphere-specific governance-mechanisms already established (i.e., reward and monitoring systems). Within the analysis, the implementation of bounded rationality is closely related to findings from BRD to assess the impact of negotiation behavior on underlying principal-agent-relationships. As empirical findings show, the disclosure and reservation of information to the agent affect his negotiation behavior as well as final negotiation outcomes. Last, in context of business negotiations, asymmetric information is often intended by decision-makers acting as superior-agents or principals which calls for a bilateral risk-approach to agency-relations.

Keywords: business negotiations, agency-theory, negotiation analysis, interteam negotiations

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357 A Comparative Study of the Impact of the Total Fertility Rate (TFR) on Trends in the Second Demographic Transition in Rwanda

Authors: Etienne Gatera

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Many studies have been conducted on SDT. Most of them focus on developed countries because of influencing factors such as; education, health, labor force, female labor force participation, industrialization, urbanization and migration. However, this thesis project paper aims to assess the impact of the total fertility rate (TFR) on the trends of the SDR in Rwanda. We will mainly be based in Rwanda after the 1994 genocide. Rwanda is located in East Africa, with approximately 13 million inhabitants. Thus, after the 1994 Tutsi genocide. The population growth rate exploded out of control with 6.17 children per woman in 1995. However, it's declined to 4.2 in 2014-2015 and declining to 4.1% in 2019-2020. Respectively with 3.4 children per woman in urban areas and 4.3 in rural areas. According to the National Institute of Statistics of Rwanda. Rwanda's population is expected to continue to grow for the rest of the century and reach 33.35 million people in 2099, with 2.1 children per woman in 2050. However, this project document aims to demonstrate the impact of the TFR on SDT trends in Rwanda. Thus, the decline in the TFR in Rwanda began with the introduction of family planning practices, which now account for 47.5% in 2019. Childbearing with three children for rural women compared to two children in the city, the increase in Divorce and separation caused by the behavior called "Kuza n'ijoro" or "coming at night" similar to cohabitation in developed countries. The decline in remarriage is caused by single mothers behavior who prefer to raise their children rather than remarry. Therefore, the study used probability sampling with (Stratified random sampling) method with a survey questionnaire of 1067 respondents in the 5 Districts (3 in rural areas and two in urban areas), with the target group of women Age between 15-49. The study demonstrated that the age of marriage in rural areas is two years higher than in urban areas. Divorce is more common in urban is with 6.2% with 5.2% in rural areas. However, separation is more common in rural areas than in urban areas, with a lower rate of 3%, due to the higher system called "Kuza n'ijoro" or "come at night", similar to cohabitation in developed countries. The study revealed that more than 85% of divorced people prefer to remain single, which confirms the low remarriage rate. Childbearing has started to decrease, especially for young singles in urban areas, due to the economic situation, with national statistics showing that unemployment in the youth community is still 16% higher. Therefore, the study concluded by confirming the hypothesis based on the results of the TFR indicators such as marriage, remarriage, divorce, separation, divorce, Kuza n'ijoro, childbearing] and abortion. The study consists of four sections, an introduction and background, a review of the literature, a description of the data and methodology, an analysis of the data, discussion results and a conclusion.

Keywords: Kuza n'ijoro, Rwanda, second demographic transition (SDT), total fertility rate (TFR)

Procedia PDF Downloads 149
356 Assessing Information Dissemination Of Group B Streptococcus In Antenatal Clinics, and Obstetricians and Midwives’ Opinions on the Importance of Doing so

Authors: Aakriti Chetan Shah, Elle Sein

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Background/purpose: Group B Streptococcus(GBS) is the leading cause of severe early onset infection in newborns, with the incidence of Early Onset Group B Streptococcus (EOGBS) in the UK and Ireland rising from 0.48 to 0.57 per 1000 births from 2000 to 2015. A WHO study conducted in 2017, has shown that 38.5% of cases can result in stillbirth and infant deaths. This is an important problem to consider as 20% of women worldwide have GBS colonisation and can suffer from these detrimental effects. Current Royal College of Obstetricians and Midwives (RCOG) guidelines do not recommend bacteriological screening for pregnant women due to its low sensitivity in antenatal screening correlating with the neonate having GBS but advise a patient information leaflet be given to pregnant women. However, a Healthcare Safety Investigation Branch (HSIB) 2019 learning report found that only 50% of trusts and health boards reported giving GBS information leaflets to all pregnant mothers. Therefore, this audit aimed to assess current practices of information dissemination about GBS at Chelsea & Westminster (C&W) Hospital. Methodology: A quantitative cross-sectional study was carried out using a questionnaire based on the RCOG GBS guidelines and the HSIB Learning report. The study was conducted in antenatal clinics at Chelsea & Westminster Hospital, from 29th January 2021 to 14th February 2021, with twenty-two practicing obstetricians and midwives participating in the survey. The main outcome measure was the proportion of obstetricians and midwives who disseminate information about GBS to pregnant women, and the reasons behind why they do or do not. Results: 22 obstetricians and midwives responded with 18 complete responses. Of which 12 were obstetricians and 6 were midwives. Only 17% of clinical staff routinely inform all pregnant women about GBS, and do so at varying timeframes of the pregnancy, with an equal split in the first, second and third trimester. The primary reason for not informing women about GBS was influenced by three key factors: Deemed relevant only for patients at high risk of GBS, lack of time in clinic appointments and no routine NHS screening available. Interestingly 58% of staff in the antenatal clinic believe it is necessary to inform all women about GBS and its importance. Conclusion: It is vital for obstetricians and midwives to inform all pregnant women about GBS due to the high prevalence of incidental carriers in the population, and the harmful effects it can cause for neonates. Even though most clinicians believe it is important to inform all pregnant women about GBS, most do not. To ensure that RCOG and HSIB recommendations are followed, we recommend that women should be given this information at 28 weeks gestation in the antenatal clinic. Proposed implementations include an information leaflet to be incorporated into the Mum and Baby app, an informative video and end-to-end digital clinic documentation to include this information sharing prompt.

Keywords: group B Streptococcus, early onset sepsis, Antenatal care, Neonatal morbidity, GBS

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355 The Effects of Periostin in a Rat Model of Isoproterenol-Mediated Cardiotoxicity

Authors: Mahmut Sozmen, Alparslan Kadir Devrim, Yonca Betil Kabak, Tuba Devrim

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Acute myocardial infarction is the leading cause of deaths in the worldwide. Mature cardiomyocytes do not have the ability to regenerate instead fibrous tissue proliferate and granulation tissue to fill out. Periostin is an extracellular matrix protein from fasciclin family and it plays an important role in the cell adhesion, migration, and growth of the organism. Periostin prevents apoptosis while stimulating cardiomyocytes. The main objective of this project is to investigate the effects of the recombinant murine periostin peptide administration for the cardiomyocyte regeneration in a rat model of acute myocardial infarction. The experiment was performed on 84 male rats (6 months old) in 4 group each contains 21 rats. Saline applied subcutaneously (1 ml/kg) two times with 24 hours intervals to the rats in control group (Group 1). Recombinant periostin peptide (1 μg/kg) dissolved in saline applied intraperitoneally in group 2 on 1, 3, 7, 14 and 21. days on same dates in group 4. Isoproterenol dissolved in saline applied intraperitoneally (85mg/kg/day) two times with 24 hours intervals to the groups 3 and 4. Rats in group 4 further received recombinant periostin peptide (1 μg/kg) dissolved in saline intraperitoneally starting one day after the final isoproterenol administration on days 1, 3, 7, 14 and 21. Following the final application of periostin rats continued to feed routinely with pelleted chow and water ad libitum for further seven days. At the end of 7th day rats sacrificed, blood and heart tissue samples collected for the immunohistochemical and biochemical analysis. Angiogenesis in response to tissue damage, is a highly dynamic process regulated by signals from the surrounding extracellular matrix and blood serum. In this project, VEGF, ANGPT, bFGF, TGFβ are the key factors that contribute to cardiomyocyte regeneration were investigated. Additionally, the relationship between mitosis and apoptosis (Bcl-2, Bax, PCNA, Ki-67, Phopho-Histone H3), cell cycle activators and inhibitors (Cyclin D1, D2, A2, Cdc2), the origin of regenerating cells (cKit and CD45) were examined. Present results revealed that periostin stimulated cardiomyocye cell-cycle re-entry in both normal and MCA damaged cardiomyocytes and increased angiogenesis. Thus, periostin contributes to cardiomyocyte regeneration during the healing period following myocardial infarction which provides a better understanding of its role of this mechanism, improving recovery rates and it is expected to contribute the lack of literature on this subject. Acknowledgement: This project was financially supported by Turkish Scientific Research Council- Agriculture, Forestry and Veterinary Research Support Group (TUBİTAK-TOVAG; Project No: 114O734), Ankara, TURKEY.

Keywords: cardiotoxicity, immunohistochemistry, isoproterenol, periostin

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354 Concentrations of Leptin, C-Peptide and Insulin in Cord Blood as Fetal Origins of Insulin Resistance and Their Effect on the Birth Weight of the Newborn

Authors: R. P. Hewawasam, M. H. A. D. de Silva, M. A. G. Iresha

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Obesity is associated with an increased risk of developing insulin resistance. Insulin resistance often progresses to type-2 diabetes mellitus and is linked to a wide variety of other pathophysiological features including hypertension, hyperlipidemia, atherosclerosis (metabolic syndrome) and polycystic ovarian syndrome. Macrosomia is common in infants born to not only women with gestational diabetes mellitus but also non-diabetic obese women. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age (LGA) are more likely to be obese in childhood. It is also established from previous studies that Asian populations have higher percentage body fat at a lower body mass index compared to Caucasians. High leptin levels in cord blood have been reported to correlate with fetal adiposity at birth. Previous studies have also shown that cord blood C-peptide and insulin levels are significantly and positively correlated with birth weight. Therefore, the objective of this preliminary study was to determine the relationship between parameters of fetal insulin resistance such as leptin, C-peptide and insulin and the birth weight of the newborn in a study population in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns and the concentration of insulin, leptin, and C-peptide were measured by ELISA technique. Birth weight, length, occipital frontal, chest, hip and calf circumferences of newborns were measured and characteristics of the mother such as age, height, weight before pregnancy and weight gain were collected. The relationship between insulin, leptin, C-peptide, and anthropometrics were assessed by Pearson’s correlation while the Mann-Whitney U test was used to assess the differences in cord blood leptin, C-peptide, and insulin levels between groups. A significant difference (p < 0.001) was observed between the insulin levels of infants born LGA (18.73 ± 0.64 µlU/ml) and AGA (13.08 ± 0.43 µlU/ml). Consistently, A significant increase in concentration (p < 0.001) was observed in C-peptide levels of infants born LGA (9.32 ± 0.77 ng/ml) compared to AGA (5.44 ± 0.19 ng/ml). Cord blood leptin concentration of LGA infants (12.67 ng/mL ± 1.62) was significantly higher (p < 0.001) compared to the AGA infants (7.10 ng/mL ± 0.97). Significant positive correlations (p < 0.05) were observed among cord leptin levels and the birth weight, pre-pregnancy maternal weight and BMI between the infants of AGA and LGA. Consistently, a significant positive correlation (p < 0.05) was observed between the birth weight and the C peptide concentration. Significantly high concentrations of leptin, C-peptide and insulin levels in the cord blood of LGA infants suggest that they may be involved in regulating fetal growth. Although previous studies suggest comparatively high levels of body fat in the Asian population, values obtained in this study are not significantly different from values previously reported from Caucasian populations. According to this preliminary study, maternal pre-pregnancy BMI and weight may contribute as significant indicators of cord blood parameters of insulin resistance and possibly the birth weight of the newborn.

Keywords: large for gestational age, leptin, C-peptide, insulin

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353 A Computational Approach to Screen Antagonist’s Molecule against Mycobacterium tuberculosis Lipoprotein LprG (Rv1411c)

Authors: Syed Asif Hassan, Tabrej Khan

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Tuberculosis (TB) caused by bacillus Mycobacterium tuberculosis (Mtb) continues to take a disturbing toll on human life and healthcare facility worldwide. The global burden of TB remains enormous. The alarming rise of multi-drug resistant strains of Mycobacterium tuberculosis calls for an increase in research efforts towards the development of new target specific therapeutics against diverse strains of M. tuberculosis. Therefore, the discovery of new molecular scaffolds targeting new drug sites should be a priority for a workable plan for fighting resistance in Mycobacterium tuberculosis (Mtb). Mtb non-acylated lipoprotein LprG (Rv1411c) has a Toll-like receptor 2 (TLR2) agonist actions that depend on its association with triacylated glycolipids binding specifically with the hydrophobic pocket of Mtb LprG lipoprotein. The detection of a glycolipid carrier function has important implications for the role of LprG in Mycobacterial physiology and virulence. Therefore, considering the pivotal role of glycolipids in mycobacterial physiology and host-pathogen interactions, designing competitive antagonist (chemotherapeutics) ligands that competitively bind to glycolipid binding domain in LprG lipoprotein, will lead to inhibition of tuberculosis infection in humans. In this study, a unified approach involving ligand-based virtual screening protocol USRCAT (Ultra Shape Recognition) software and molecular docking studies using Auto Dock Vina 1.1.2 using the X-ray crystal structure of Mtb LprG protein was implemented. The docking results were further confirmed by DSX (DrugScore eXtented), a robust program to evaluate the binding energy of ligands bound to the Ligand binding domain of the Mtb LprG lipoprotein. The ligand, which has the higher hypothetical affinity, also has greater negative value. Based on the USRCAT, Lipinski’s values and molecular docking results, [(2R)-2,3-di(hexadecanoyl oxy)propyl][(2S,3S,5S,6R)-3,4,5-trihydroxy-2,6-bis[[(2R,3S,4S,5R,6S)-3,4,5-trihydroxy-6 (hydroxymethyl)tetrahydropyran-2-yl]oxy]cyclohexyl] phosphate (XPX) was confirmed as a promising drug-like lead compound (antagonist) binding specifically to the hydrophobic domain of LprG protein with affinity greater than that of PIM2 (agonist of LprG protein) with a free binding energy of -9.98e+006 Kcal/mol and binding affinity of -132 Kcal/mol, respectively. A further, in vitro assay of this compound is required to establish its potency in inhibiting molecular evasion mechanism of MTB within the infected host macrophages. These results will certainly be helpful in future anti-TB drug discovery efforts against Multidrug-Resistance Tuberculosis (MDR-TB).

Keywords: antagonist, agonist, binding affinity, chemotherapeutics, drug-like, multi drug resistance tuberculosis (MDR-TB), RV1411c protein, toll-like receptor (TLR2)

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352 Destination Nollywood: A Newspaper Analysis of the Connections between Film and Tourism in Nigeria, 2012-2022

Authors: E. S. Martens, E. E. Onwuliri

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Over the past three decades, Nigeria’s film industry has become a global powerhouse, releasing hundreds of films annually and even monthly. Nollywood, a portmanteau of Nigeria and Hollywood as well as Bollywood that was coined by New York Times journalist Norimitsu Onishi in 2002, came to mark the plenitude of filmmaking happening in Lagos from the early 1990s onwards. Following the success of the 1992 straight-to-VHS film Living in Bondage, the Nigerian film industry experienced a popular home video boom that gained a huge following in Nigeria, across Africa, and among the global African diaspora. In fact, with an estimated worth of $6.4 billion as of 2021, Nollywood is nowadays considered the world’s second-largest film industry and even the largest in terms of output and popularity. Producing about 2,500 films annually and reaching an estimated audience of over 200 million people worldwide, Nollywood has not only seemingly surpassed Hollywood but also Bollywood with regard to production and consumption size. Due to its commercial success and cultural impact from the early 2010s, Nollywood has often been heralded as a potential driver of Africa’s tourism industry. In its 2012 Global Trends Report, the World Travel Market forecasted an increase in GDP in Africa due to tourism in Nollywood filming locations. Additionally, it was expected that the rising popularity of Nollywood would significantly contribute to growth in the leisure sector, drawing both film enthusiasts and business travelers intrigued by the expanding significance of the Nigerian film industry. Still, despite much talk about the potential impact of Nollywood on Nigerian tourism in the past 10 years or so, relatively little is known about Nollywood’s association with film tourism and the existing connections between Nigeria’s film and tourism industries more generally. Already well over a decade ago, it was observed that there is still a lack of research examining the extent to which film tourism related to Nollywood in Africa has been generated – and to date, this is still largely the case. This paper, then, seeks to discuss the reported connections between Nollywood and tourism and to review the efforts and opportunities related to Nollywood film tourism as suggested in Nigeria’s public domain. Based on a content analysis of over 50 newspaper articles and other online available materials, such as websites, blogs and forums, this paper explores the practices and discourses surrounding Nollywood connections with tourism in Nigeria and across Africa over the past ten years. The analysis shows that, despite these high expectations, film tourism related to Nollywood has remained limited. Despite growing government attention and support to Nollywood and its potential for tourism, most state initiatives in this direction have not (yet) materialize – and it very much remains to be seen to what extent ‘Destination Nollywood’ is really able to come to fruition as long as the structural issues underlying the development of Nigerian film (and) tourism are not sufficiently addressed.

Keywords: film tourism, Nigerian cinema, Nollywood, tourist destination

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351 Implementing Quality Improvement Projects to Enhance Contraception and Abortion Care Service Provision and Pre-Service Training of Health Care Providers

Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie

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Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.

Keywords: abortion, contraception, quality improvement, service provision

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350 Spatial Variation in Urbanization and Slum Development in India: Issues and Challenges in Urban Planning

Authors: Mala Mukherjee

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Background: India is urbanizing very fast and urbanisation in India is treated as one of the most crucial components of economic growth. Though the pace of urbanisation (31.6 per cent in 2011) is however slower and lower than the average for Asia but the absolute number of people residing in cities and towns has increased substantially. Rapid urbanization leads to urban poverty and it is well represented in slums. Currently India has four metropolises and 53 million plus cities. All of them have significant slum population but the standard of living and success of slum development programmes varies across regions. Objectives: Objectives of the paper are to show how urbanisation and slum development varies across space; to show spatial variation in the standard of living in Indian slums; to analyse how the implementation of slum development policies like JNNURM, Rajiv Awas Yojana varies across cities and bring different results in different regions and what are the factors responsible for such variation. Data Sources and Methodology: Census 2011 data on urban population and slum households and amenities have been used for analysing the regional variation of urbanisation in 53 million plus cities of India. Special focus has been put on Kolkata Metropolitan Area. Statistical techniques like z-score and PCA have been employed to work out Standard of Living Deprivation score for all the slums of 53 metropolises. ARC-GIS software is used for making maps. Standard of living has been measured in terms of access to basic amenities, infrastructure and assets like drinking water, sanitation, housing condition, bank account, and so on. Findings: 1. The first finding reveals that migration and urbanization is very high in Greater Mumbai, Delhi, Bangaluru, Chennai, Hyderabad and Kolkata; but slum population is high in Greater Mumbai (50% population live in slums), Meerut, Faridabad, Ludhiana, Nagpur, Kolkata etc. Though the rate of urbanization is high in southern and western states but the percentage of slum population is high in northern states (except Greater Mumbai). 2. Standard of Living also varies widely. Slums of Greater Mumbai and North Indian Cities score fairly high in the index indicating the fact that standard of living is high in those slums compare to the slums in eastern India (Dhanbad, Jamshedpur, Kolkata). Therefore, though Kolkata have relatively lesser percentage of slum population compare to north and south Indian cities but the standard of living in Kolkata’s slums is deplorable. 3. It is interesting to note that even within Kolkata Metropolitan Area slums located in the southern and eastern municipal towns like Rajpur-Sonarpur, Pujali, Diamond Harbour, Baduria and Dankuni have lower standard of living compare to the slums located in the Hooghly Industrial belt like Titagarh, Rishrah, Srerampore etc. Slums of the Hooghly Industrial Belt are older than the slums located in eastern and southern part of the urban agglomeration. 4. Therefore, urban development and emergence of slums should not be the only issue of urban governance but standard of living should be the main focus. Slums located in the main cities like Delhi, Mumbai, Kolkata get more attention from the urban planners and similarly, older slums in a city receives greater political attention compare to the slums of smaller cities and newly emerged slums of the peripheral parts.

Keywords: urbanisation, slum, spatial variation, India

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