Search results for: community programming

Authors: Alejandro Arnaldo Barroso Martinez

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Unlike sex, which is constituted by anatomic-physiological differences, gender is a social construction. Our thoughts and behaviors as females and males are not etched in stone by our biology but rather from how society expects us to think and behave based on our sex assignment in the womb. Social expectations, values, and roles are taken on by individuals and shape the ways considered acceptable and linked to our bodies, feelings, and interpersonal relationships. Furthermore, these evolve into dire consequences for those who do not meet these disciplinary, economic, and cultural standards. Then, the social learning of gender identity implies the individual’s psychological sense of being, and it might be highly linked to a sense of life and suicide attempts. As a result, suicide has been considered a gender issue with differences in the rates and means used by men and women worldwide. Nevertheless, there has been a misunderstanding of the meaning of being male or female in a particular context and how it becomes a risk process for suicide attempts. For this reason, the general objective of the current research is to explain how this process occurs in Cuba. From a Critical Sociology and Social Psychology, a qualitative methodology was developed through six case studies and qualitative in-depth interviews. The analysis is focused on the sequence and interplay between two dimensions of meaning: signifiers and voices. Findings show that the risk process of suicide attempts in Cuba means some patriarchal beliefs and practices as part of informal educational models and some positivist practices in mental health attention. Findings also show that community relations create a sense of belonging, and it is a protection against suicide attempts in Cuba. Those frames of signifiers and voices explain in both males and females but differently when and how they are suffering from isolation, violence, the normalization of emotional awareness, and emotional distress expression. Suicide prevention programs should take gender learning into account as a cultural process.

Keywords: social constructions, gender identity, meanings, suicide attempt

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Authors: F. Christie, M. Staber

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Malnutrition is a predictor of poor clinical outcome in the elderly. Up to 60% of hip fracture patients are clinically malnourished on admission. This study assessed the perioperative nutritional state of patients admitted with a proximal femoral fracture and examined if adequate nutritional support was achieved. Methods: Prospective, the observational audit of 30 patients, admitted with a proximal femoral fracture, over a one-month period. We recorded: patient demographics; surgical delay; nutritional state on admission; documentation of Malnutrition Universal Screening Tool (MUST) score; dietician input and daily calorie intake through food charts. The nutritional state was re-assessed weekly and at discharge. The outcome was measured by the length of hospital stay and thirty-day mortality. Results: Mean age 87, M:F 1:2 and all patients were ASA three or four. Five patients (17%) had a prolonged ( >24 hours) fasting period. All patients had a MUST score completed on admission, 27% were underweight and 30% were high risk for malnutrition. Twenty-six patients (87%) were appropriately assessed for dietician referral. Thirteen patients had food charts; on average, hospital meals provided 1500kcal daily. No patient achieved > 75% of the provided calories with 69% of patients achieving 50% or less. Only three patients were started on nutritional supplements. Twenty-three patients (77%) lost weight, averaging 6% weight loss during admission. Mean length of stay (LOS) was 23 days and 30-day mortality 9%. Four patients (13%) gained weight, their mean LOS was 17 days and 30-day mortality 0%. Discussion: Malnutrition in the elderly originates in the community. Following major trauma it’s difficult to reverse nutritional deficits in hospitals. It’s therefore concerning that no high-risk patient achieved their recommended calorie intake. Perioperative optimisation needs to include early nutritional intervention, early anaesthetic review and adjusted anaesthetic techniques to support feeding.

Keywords: trauma, nutrition, neck of femur fracture

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Authors: Jiarong Zhang

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Digitizing intangible cultural heritage is a complex and comprehensive process from which sorts of intellectual property rights may be generated. Digitizing may be a repacking process of cultural heritage, which creates copyrights; recording folk songs and indigenous performances can create 'related rights'. At the same time, digitizing intangible cultural heritage may infringe the intellectual property rights of others unintentionally. Recording religious rituals of indigenous communities without authorization can violate the moral right of the ceremony participants of the community; making digital copies of rock paintings may infringe the right of reproduction. In addition, several parties are involved in the digitization process: indigenous peoples, museums, and archives can be holders of cultural heritage; companies and research institutions can be technology providers; internet platforms can be promoters and sellers; the public and groups above can be beneficiaries. When diverse intellectual property rights versus various parties, problems and disputes can arise easily. What are the types of intellectual property rights generated in the digitization process? What is the essence of these rights? Who should these rights belong to? How to use intellectual property to protect the digitalization of cultural heritage? How to avoid infringing on the intellectual property rights of others? While the digitization has been regarded as an effective approach to preserve intangible cultural heritage, related intellectual property issues have not received the attention and full discussion. Thus, parties involving in the digitization process may face intellectual property infringement lawsuits. The article will explore those problems from the intersection perspective of intellectual property law and cultural heritage. From a comparative approach, the paper will analysis related legal documents and cases, and shed some lights of those questions listed. The findings show, although there are no intellectual property laws targeting the cultural heritage in most countries, the involved stakeholders can seek protection from existing intellectual property rights following the suggestions of the article. The research will contribute to the digitization of intangible cultural heritage from a legal and policy aspect.

Keywords: copyright, digitization, intangible cultural heritage, intellectual property, Internet platforms

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Authors: Jaya Bishnu Pradhan

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Weaving mat is one of the common activities performed in different community generally in the rural part of Nepal. Mat weavers’ practice mathematical ideas and concepts implicitly in order to perform their job. This study is intended to uncover the mathematical ideas embedded in mat weaving that can help teachers and students for the teaching and learning of school geometry. The ethnographic methodology was used to uncover and describe the beliefs, values, understanding, perceptions, and attitudes of the mat weavers towards mathematical ideas and concepts in the process of mat weaving. A total of 4 mat weavers, two mathematics teachers and 12 students from grade level 6-8, who are used to participate in weaving, were selected for the study. The whole process of the mat weaving was observed in a natural setting. The classroom observation and in-depth interview were taken with the participants with the help of interview guidelines and observation checklist. The data obtained from the field were categorized according to the themes regarding mathematical ideas embedded in the weaving activities, and its possibilities in teaching learning of school geometry. In this study, the mathematical activities in different sectors of their lives, their ways of understanding the natural phenomena, and their ethnomathematical knowledge were analyzed with the notions of pluralism. From the field data, it was found that the mat weaver exhibited sophisticated geometrical ideas in the process of construction of frame of mat. They used x-test method for confirming if the mat is rectangular. Mat also provides a good opportunity to understand the space geometry. A rectangular form of mat may be rolled up when it is not in use and can be converted to a cylindrical form, which usually can be used as larder so as to reserve food grains. From the observation of the situations, this cultural experience enables students to calculate volume, curved surface area and total surface area of the cylinder. The possibilities of incorporation of these cultural activities and its pedagogical use were observed in mathematics classroom. It is argued that it is possible to use mat weaving activities in the teaching and learning of school geometry.

Keywords: ethnography, ethnomathematics, geometry, mat weaving, school pedagogy

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Authors: Arzyana Sunkar, Yanto Santosa, Intan Purnamasari, Yohanna Dalimunthe

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A variety of negative allegations have criticized the Indonesian oil palm plantations as being environmentally unfriendly. One of the important allegations thus must be verified is that expansion of Indonesian oil palm plantation has increased the deforestation rate of primary tropical forest. In relation to this, a research was conducted to study the origin or history of the status and land use of 8 private oil palm plantations (with a total of 46,372.38 ha) located in Riau Province. Several methods were employed: (1) conducting analysis of overlay maps between oil palm plantation studied with the 1986 Forest Map Governance Agreement (TGHK) and the 1994 and 2014 Riau Provincial Spatial Plans(RTRWP); (2) studying the Cultivation Right on Land (HGU) documents including the Forestry Ministerial Decree on the release of forest area and (3) interpretation of lands at imagery of bands 542, covering 3 years before and after the oil palm industries operated. In addition, field cross-checked, and interviews were conducted with National Land Agency, Plantation and Forestry Office and community figures. The results indicated that as much as 1.95% of the oil palm plantations under study were converted from production forest, 30.34% from limited production forest and 67.70% from area for other usage /conversion production forest. One year prior to the establishment of the plantations, the land cover types comprised of rubber plantations (49.96%), secondary forest (35.99%), bare land (10.17%), shrubs (3.03%) and mixed dryland farming-shrubs (0.84%), whereas the land use types comprised of 35.99% forest concession areas, 14.04% migrants dryland farms, and 49.96% Cultivation Right on Land of other companies. These results indicated that most of the private oil palm plantations under study, resulted from the conversion of production forests and the previous land use were not primary forest but rubber plantations and secondary forests.

Keywords: land cover types, land use history, primary forest, private oil palm plantations

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Authors: Francisco Domingos Francisco

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Tropical forests are key providers of many Ecosystem Services (ES), contributing to human wellbeing on a global and local scale. Communities around and within Moribane Forest Reserve (MFR), Manica Province - Mozambique, benefit from ES through the exploitation of non-wood and wood forest products. The objective was to assess the provisioning capacity of the MFR in woody forest products in species and profiles of interest to local communities in the main sources of extraction. Social data relating to the basic needs of local communities for these products were captured through an exploratory study before this one. From that study, it became known about the most collected wood species, the sources of collection, and their availability in the profiles of greatest interest to them. A field survey through 39 rectangular 50mx20m plots was conducted with 13 plots established in each of the three land-use types (LUT), namely Restricted Forest, Unrestricted Forest, and Disturbed areas. The results show that 89 species were identified, of which 28 (31.4%) are assumed to be the most used by the communities. The number of species of local interest does not vary across the LUT (p>0.05). The most used species (MUS) is distributed in 82% in Restricted Forest, 75% in Unrestricted, and also 75% in Disturbed. Most individuals of both general and MUS found in Unrestricted Forest, and Degraded areas have lower end profiles (5-7 cm), representing 0.77 and 0.26%, respectively. The profile of individuals of species of local interest varies by LUT (p<0.05), and their greatest proportion (0.51%) outside the lower end is found in Restricted Forest. There were no similarities between the LUT for the species in general (JCI <0.5) but between the MUS (JCI >0.5). Conclusion, the areas authorized for the exploitation of wood forest products in the MFR tend to reduce their ability to provide local communities with forest products in species and profiles of their interest. This reduction item is a serious threat to the biodiversity of the Restricted Forest. The study can help the academic community in future studies by replicating the methodology used for monitoring purposes or conducting studies in other similar areas, and the results may support decision-makers in designing better strategies for sustainability.

Keywords: ecosystem services, land-use types, local communities, species profile, wellbeing, wood forest product

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Authors: Emile Niringiyimana, LI Ji Qing, Giovanni Dushimimana, Virginie Umwere

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The development and utilization of renewable energy (RE) can not only effectively reduce carbon dioxide (CO2) emissions, but also became a solution to electricity shortage mitigation in rural areas. Hybrid RE systems are promising ways to provide consistent and continuous power for isolated areas. This work investigated the prospect and cost effectiveness of hybrid system complementarity between a 100kW solar PV system and a small-scale 200kW hydropower station in the South of Rwanda. In order to establish the optimal size of a RE system with adequate sizing of system components, electricity demand, solar radiation, hydrology, climate data are utilized as system input. The average daily solar radiation in Rukarara is 5.6 kWh/m2 and average wind speed is 3.5 m/s. The ideal integrated RE system, according to Homer optimization, consists of 91.21kW PV, 146kW hydropower, 12 x 24V li-ion batteries with a 20kW converter. The method of enhancing such hybrid systems control, sizing and choice of components is to reduce the Net present cost (NPC) of the system, unmet load, the cost of energy and reduction of CO2. The power consumption varies according to dominant source of energy in the system by controlling the energy compensation depending on the generation capacity of each power source. The initial investment of the RE system is $977,689.25, and its operation and maintenance expenses is $142,769.39 over a 25-year period. Although the investment is very high, the targeted profits in future are huge, taking into consideration of high investment in rural electrification structure implementations, tied with an increase of electricity cost and the 5 years payback period. The study outcomes suggest that the standalone hybrid PV-Hydropower system is feasible with zero pollution in Rukara community.

Keywords: HOMER optimization, hybrid power system, renewable energy, NPC and solar pv systems

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Authors: Sheriff Folarin, Oluwafunke Folarin, Hadassah Hussaini, Victor Jubril, Olaniyi Ayodele

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Using a famous, unrestrained and fiery United States-based, Nigerian-owned Sahara Reporters as a case study, this paper examined the impact of online-based media on governance in Nigeria. The discourse is premised on the thesis that the internet has changed the face of journalism and that the mainstream but online-based media have made journalism more participatory than ever. Everyone who has something to say finds it easy to say it quickly and conveniently, unhinged or without being censored. This has made online journalism very popular and the number of online-based news platforms to be on the increase. As these platforms have given the citizens a means to interact and added to the content of the news, they have also succeeded in promoting partisanship. It thus becomes necessary to study the impact of the rabid news platform, Sahara Reporters, on governance in Africa’s biggest democracy, Nigeria. Few studies have examined the impact on governance of mainstream-online media platforms and those studies that did, have only focused on social media, such as Facebook and Twitter. This paper is a product of a bigger study, in which the research design entailed semi-structured interviews with participants from different sectors of the society and an analysis of contents from the Sahara Reporters website, from which data were collected. The findings revealed that through uncensored reporting and citizen participation on the platform of Sahara Reporters, there had been a significant people influence on governance in Nigeria, with government at two levels (national and state) sometimes shifting or yielding grounds, particularly from 2011-2016. The study also recognized the presence of counter-forces in the online community who want to discredit the information on the site. Through the lens of media dependency theory, the study concluded that the public now increasingly depends on online news media for information and the more news these media provide, the more the people depend on it, making it easy for them to influence governance.

Keywords: governance, media, online news, Sahara reporters

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Authors: Tebikew Yeneabat, Tefera Belachew, Muluneh Haile

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Background: Exclusive breast-feeding (EBF) is the practice of feeding only breast milk (including expressed breast milk) during the first six months and no other liquids and solid foods except medications. The time to cessation of exclusive breast-feeding, however, is different in different countries depending on different factors. Studies showed the risk of diarrhea morbidity and mortality is higher among none exclusive breast-feeding infants, common during starting other foods. However, there is no study that evaluated the time to cessation of exclusive breast-feeding in the study area. The aim of this study was to show time to cessation of EBF and its predictors among mothers of index infants less than twelve months old. Methods: We conducted a community-based cross-sectional study from February 13 to March 3, 2012 using both quantitative and qualitative methods. This study included a total of 592 mothers of index infant using multi-stage sampling method. Data were collected by using interviewer administered structured questionnaire. Bivariate and multivariate Cox regression analyses were performed. Results: Cessation of exclusive breast-feeding occurred in 392 (69.63%) cases. Among these, 224 (57.1%) happened before six months, while 145 (37.0%) and 23 (5.9%) occurred at six months and after six months of age of the index infant respectively. The median time for infants to stay on exclusive breast-feeding was 6.36 months in rural and 5.13 months in urban, and this difference was statistically significant on a Log rank (Cox-mantel) test. Maternal and paternal occupation, place of residence, postnatal counseling on exclusive breast-feeding, mode of delivery, and birth order of the index infant were significant predictors of cessation of exclusive breast-feeding. Conclusion: Providing postnatal care counseling on EBF, routine follow-up and support of those mothers having infants stressing for working mothers can bring about implementation of national strategy on infant and young child feeding.

Keywords: exclusive breastfeeding, cessation, median duration, Ankesha Guagusa Woreda

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Authors: Hui Tag, Jambey Tsering, Pallabi Kalita Hui, Baikuntha Jyoti Gogoi, Vijay Veer

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The food security issues and its relevance in High Mountain regions of the world have been often neglected. Wild edible plants have been playing a major role in livelihood security among the tribal Communities of East Himalayan Region of the world since time immemorial. The Eastern Himalayan Region of India is one of the mega diverse regions of world and rated as top 12th Global Biodiversity Hotspots by IUCN and recognized as one of the 200 significant eco-regions of the Globe. The region supports one of the world’s richest alpine floras and about one-third of them are endemic to the region. There are at least 7,500 flowering plants, 700 orchids, 58 bamboo species, 64 citrus species, 28 conifers, 500 mosses, 700 ferns and 728 lichens. The region is the home of more than three hundred different ethnic communities having diverse knowledge on traditional uses of flora and fauna as food, medicine and beverages. Monpa, Memba and Khamba are among the local communities residing in high altitude region of Eastern Himalaya with rich traditional knowledge related to utilization of wild edible plants. The Monpas, Memba and Khamba are the followers Mahayana sect of Himalayan Buddhism and they are mostly agrarian by primary occupation and also heavily relaying on wild edible plants for their livelihood security during famine since millennia. In the present study, we have reported traditional uses of 40 wild edible plant species and out of which 6 species were analysed at biochemical level for nutrients contents and free radical scavenging activities. The results have shown significant free radical scavenging (antioxidant) activity and nutritional potential of the selected 6 wild edible plants used by the local communities of Eastern Himalayan Region of India.

Keywords: East Himalaya, local community, wild edible plants, nutrition, food security

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Authors: Ngoc-Nguyen Nguyen, Hsiu-Ling Chen, Thanh-Truc Lai Huynh

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In foreign language learning, vocabulary acquisition has consistently posed challenges to learners, especially for those at lower levels. Conventional approaches often fail to promote vocabulary learning and ensure engaging experiences alike. The emergence of mobile learning, particularly the integration of chatbot systems, has offered alternative ways to facilitate this practice. Chatbots have proven effective in educational contexts by offering interactive learning experiences in a constructivist manner. These tools have caught attention in the field of mobile-assisted language learning (MALL) in recent years. This research is conducted in an English for Specific Purposes (ESP) course at the A2 level of the CEFR, designed for non-English majors. Participants are first-year Vietnamese students aged 18 to 20 at a university. This quasi-experimental study follows a pretest-posttest control group design over five weeks, with two classes randomly assigned as the experimental and control groups. The experimental group engages in chatbot-assisted spaced practice with SRL components, while the control group uses the same spaced practice without SRL. The two classes are taught by the same lecturer. Data are collected through pre- and post-tests, cognitive load surveys, and semi-structured interviews. The combination of self-regulated learning (SRL) and distributed practice, grounded in the spacing effect, forms the basis of the present study. SRL elements, which concern goal setting and strategy planning, are integrated into the system. The spaced practice method, similar to those used in widely recognized learning platforms like Duolingo and Anki flashcards, spreads out learning over multiple sessions. This study’s design features quizzes progressively increasing in difficulty. These quizzes are aimed at targeting both the Recognition-Recall and Comprehension-Use dimensions for a comprehensive acquisition of vocabulary. The mobile-based chatbot system is built using Golang, an open-source programming language developed by Google. It follows a structured flow that guides learners through a series of 4 quizzes in each week of teacher-led learning. The quizzes start with less cognitively demanding tasks, such as multiple-choice questions, before moving on to more complex exercises. The integration of SRL elements allows students to self-evaluate the difficulty level of vocabulary items, predict scores achieved, and choose appropriate strategy. This research is part one of a two-part project. The initial findings will determine the development of an upgraded chatbot system in part two, where adaptive features in response to the integration of SRL components will be introduced. The research objectives are to assess the effectiveness of the chatbot-assisted approach, based on the combination of spaced practice and SRL, in improving vocabulary acquisition and managing cognitive load, as well as to understand students' perceptions of this learning tool. The insights from this study will contribute to the growing body of research on mobile-assisted language learning and offer practical implications for integrating chatbot systems with spaced practice into educational settings to enhance vocabulary learning.

Keywords: mobile learning, mobile-assisted language learning, MALL, chatbots, vocabulary learning, spaced practice, spacing effect, self-regulated learning, SRL, self-regulation, EFL, cognitive load

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Authors: Eric D. Olson

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The lesbian/gay/bisexual/transgender/queer/questioning tourist (LGBTQ+) travels more frequently, spends more money on travel, and is more likely to travel internationally compared to their straight/heterosexual counterparts. For Vietnam, this represents a huge opportunity to increase international tourism, considering social advancements and recognition of the LGBTQ+ have greatly increased in the past few years in Vietnam. For example, Vietnam’s Health Ministry confirmed in 2022 that same-sex attraction and being transgender is not a mental health condition. A robust hospitality ecosystem of LGBTQ+ tourism suppliers already exists in Vietnam catering to LGBTQ+ tourists (e.g., Gay Hanoi Tours, VietPride). Vietnam is a safe and welcoming destination with incredible nature, cosmopolitan cities, and friendly people; however, there is a dearth of academic and industry research that has examined how LGBTQ+ international tourists perceive Vietnam as an LGBTQ+ friendly destination. To rectify this gap, this research examines Vietnam as an LGBTQ+ destination in order to provide government officials, destination marketers, and industry practitioners with insight into this increasingly visible tourist market segment. A self-administered survey instrument was administered to n=375 international LGBTQ+ tourists to examine their perceptions of Vietnam. A factor analysis found three categories of LGBTQ+ factors of visitation to Vietnam: safety and security (Eigenvalue = 4.12, variance = 32.45, α = .82); LGBTQ+ attractions (Eigenvalue = 3.65 variance = 24.23, α = .75); and friendly interactions (Eigenvalue = 3.71, variance = 10.45, α = .96). Multiple regression was used to examine LGBTQ+ visitation factors and intention to visit Vietnam, F=12.20 (2, 127), p < .001, R2 = .56. Safety and security (β = 0.42, p < .001), LGBTQ+ attractions (β = 0.61, p < .001) and friendly interactions (β = 0.42, p < .001) are predictors to visit Vietnam. Results are consistent with previous research that highlight safety/security is of utmost importance to the community when traveling. Attractions, such as LGBTQ+ tours, suppliers, and festivals can also be used as a pull factor in encouraging tourism. Implications/limitations will be discussed.

Keywords: tourism, LGBTQ, vietnam, regression

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Authors: Anželika Teresė

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In order to solve issues in sign language linguistics, address matters pertaining to maintaining high quality of sign language (SL) translation, contribute to dispelling misconceptions about SL and deaf people, and raise awareness and understanding of the deaf community heritage, this presentation discusses literature in Lithuanian Sign Language (LSL) and inherent metaphors that are created by using the phonological parameter –handshape, location, movement, palm orientation and nonmanual features. The study covered in this presentation is twofold, involving both the micro-level analysis of metaphors in terms of phonological parameters as a sub-lexical feature and the macro-level analysis of the poetic context. Cognitive theories underlie research of metaphors in sign language literature in a range of SL. The study follows this practice. The presentation covers the qualitative analysis of 34 pieces of LSL literature. The analysis employs ELAN software widely used in SL research. The target is to examine how specific types of each phonological parameter are used for the creation of metaphors in LSL literature and what metaphors are created. The results of the study show that LSL literature employs a range of metaphors created by using classifier signs and by modifying the established signs. The study also reveals that LSL literature tends to create reference metaphors indicating status and power. As the study shows, LSL poets metaphorically encode status by encoding another meaning in the same sign, which results in creating double metaphors. The metaphor of identity has been determined. Notably, the poetic context has revealed that the latter metaphor can also be identified as a metaphor for life. The study goes on to note that deaf poets create metaphors related to the importance of various phenomena significance of the lyrical subject. Notably, the study has allowed detecting locations, nonmanual features and etc., never mentioned in previous SL research as used for the creation of metaphors.

Keywords: Lithuanian sign language, sign language literature, sign language metaphor, metaphor at the phonological level, cognitive linguistics

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Authors: Mariem Saied, Jens Gustedt, Gilles Muller

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We present Dido, a source-to-source auto-generation and optimization framework for multi-dimensional stencil computations. It enables a large programmer community to easily and safely implement stencil codes on distributed-memory parallel architectures with Ordered Read-Write Locks (ORWL) as an execution and communication back-end. ORWL provides inter-task synchronization for data-oriented parallel and distributed computations. It has been proven to guarantee equity, liveness, and efficiency for a wide range of applications, particularly for iterative computations. Dido consists mainly of an implicitly parallel domain-specific language (DSL) implemented as a source-level transformer. It captures domain semantics at a high level of abstraction and generates parallel stencil code that leverages all ORWL features. The generated code is well-structured and lends itself to different possible optimizations. In this paper, we enhance Dido to handle both Jacobi and Gauss-Seidel grid traversals. We integrate temporal blocking to the Dido code generator in order to reduce the communication overhead and minimize data transfers. To increase data locality and improve intra-node data reuse, we coupled the code generation technique with the polyhedral parallelizer Pluto. The accuracy and portability of the generated code are guaranteed thanks to a parametrized solution. The combination of ORWL features, the code generation pattern and the suggested optimizations, make of Dido a powerful code generation framework for stencil computations in general, and for distributed-memory architectures in particular. We present a wide range of experiments over a number of stencil benchmarks.

Keywords: stencil computations, ordered read-write locks, domain-specific language, polyhedral model, experiments

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Authors: Abhishek Soti, Aditya Sharma, Akhilendra Bhushan Gupta

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Fouled reverse osmosis membranes are primarily characterized by Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Spectrometer (EDS) for a detailed investigation of foulants; however, this has severe limitations on several accounts. Apart from inaccuracy in spectral properties and inevitable interferences and interactions between sample and instrument, misidentification of elements due to overlapping peaks is a significant drawback of EDS. This paper discusses this limitation by analyzing fouled polyamide RO membranes derived from community RO plants of Rajasthan treating brackish water via a combination of results obtained from EDS and Raman spectroscopy and cross corroborating with ICP-MS analysis of water samples prepared by dissolving the deposited salts. The anomalous behavior of different morphic forms of CaCO₃ in aqueous suspensions tends to introduce false reporting of the presence of certain heavy metals and rare earth metals in the scales of the fouled RO membranes used for treating brackish groundwater when analyzed using the commonly adopted techniques like SEM-EDS or Raman spectrometry. Peaks of CaCO₃ reflected in EDS spectra of the membrane were found to be misinterpreted as Scandium due to the automatic assignment of elements by the software. Similarly, the morphic forms merged with the dominant peak of CaCO₃ might be reflected as a single peak of Molybdenum in the Raman spectrum. A subsequent ICP-MS analysis of the deposited salts showed that both Sc and Mo were below detectable levels. It is always essential to cross-confirm the results through a destructive analysis method to avoid such interferences. It is further recommended to study different morphic forms of CaCO₃ scales, as they exhibit anomalous properties like reverse solubility with temperature and hence altered precipitation tendencies, for an accurate description of the composition of scales, which is vital for the smooth functioning of RO systems.

Keywords: reverse osmosis, foulant analysis, groundwater, EDS, artifacts

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Authors: Susan Ka Yee Chow

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The Coronavirus disease (COVID-19) reached Hong Kong in 2019 resulting in epidemic in late January 2020. Considering the epidemic development, tertiary institutions made announcements that all on-campus classes were suspended since 01/29/2020. In Tung Wah College, e-learning was adopted in all courses for all programmes. For the undergraduate nursing students, the contact hours and curriculum are bounded by the Nursing Council of Hong Kong to ensure core competence after graduation. Unlike the usual e-learning where students are allowed having flexibility of time and place in their learning, real time learning mode using Blackboard was used to mimic the actual classroom learning environment. Students were required to attend classes according to the timetable using online platform. For lectures, voice over PowerPoint file was the initial step for mass lecturing. Real time lecture was then adopted to improve interactions between teacher and students. Post-lecture quizzes were developed to monitor the effectiveness of lecture delivery. The seminars and tutorials were conducted using real time mode where students were separated into small groups with interactive discussions with teacher within the group. Live time demonstrations were conducted during laboratory sessions. All teaching sessions were audio/video recorded for students’ referral. The assessments including seminar presentation and debate were retained. The learning mode creates an atmosphere for students to display the visual, audio and written works in a non-threatening atmosphere. Other students could comment using text or direct voice as they desired. Real time online learning is the pedagogy to replace classroom contacts in the emergent and unforeseeable circumstances. The learning pace and interaction between students and students with teacher are maintained. The learning mode has the advantage of creating an effective and beneficial learning experience.

Keywords: e-learning, nursing curriculum, real time mode, teaching and learning

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Authors: E. Kotrotsiou, A. S. Topsioti, S. Mantzoukas, E. Dragioti, M. Gouva

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Introduction: The literature has demonstrated that individual and psychological factors have a direct effect on the perceptions and attitudes of women with cancer. Objectives: To investigate the relationship between the fear of cancer and anxiety. Aim: To examine the impact of the fear of cancer in women with state and trait anxiety of women. Methods: A community sample of 286 women (mean age 39.6 years, SD = 9.5 ranged 20-60) participated in the current study. The women completed a) State - Trait Anxiety Inventory (STAI) and b) questionnaire concerning socio-demographic information and questions for fear of cancer. Results: The perception of fear in women with cancer is statistically independent from their age (t–test, p = 0.58), their family status (χ2, p = 0.519), their place of residency (χ2, p = 0.148), the manifestation of gynecological cancer (χ2, p = 0.979) or the manifestation of any type of cancer in the family (χ2, p = 0.277). In contrast, it was observed that there was a dependence in relation to a total of phobias (χ2, p = 0.003), the fear of illness (χ2, p< 0.001) and the fear of heights (χ2, p = 0.004). Furthermore, the participants that responded that they feared cancer displayed greater level of stress both as situation (t=-3.462; p=0.001) and as a trait of their personality (t=-4.377; p<0.001), and at the same time they displayed greater levels of depression in comparisons with the other participants. Furthermore, following multiple linear regression analysis it was observed that the participants that responded positively to the question if they feared cancer had 8, 3 units greater stress level as a personality trait in comparison to women that responded negatively to the question if they feared cancer (B=8.3; p=0.016; R2=0.506). Conclusion: Women’s fear of cancer is statistically independent from their age, family status, place of residency, the manifestation of gynaecological cancer and with the manifestation of cancer any type in the family. In contrast, there is a dependency with the total of phobias, fear of illness and fear of heights. Women that state that they have a fear of cancer manifest greater levels of stress from the rest of the participants both as situation and as a trait of their personality (p = 0.001 and p< 0.001 accordingly). In specific, the study demonstrated that the participants that positively to the question if they feared cancer had 8,3 units greater stress level as a personality trait in comparison to women that responded negatively.

Keywords: fear, women health, anxiety, psychology, cancer

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Authors: Daniele Calvi, Loris Franchi, Sabrina Corpino

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Thanks to the latest Mars mission, the planetary exploration has made enormous strides over the past ten years increasing the interest of the scientific community and beyond. These missions aim to fulfill many complex operations which are of paramount importance to mission success. Among these, a special mention goes to the Entry, Descent and Landing (EDL) functions which require a dedicated system to overcome all the obstacles of these critical phases. The general objective of the system is to safely bring the spacecraft from orbital conditions to rest on the planet surface, following the designed mission profile. For this reason, this work aims to develop a simulation tool integrating the re-entry trajectory algorithm in order to support the EDL design during the preliminary phase of the mission. This tool was used on a reference unmanned mission, whose objective is finding bio-evidence and bio-hazards on Martian (sub)surface in order to support the future manned mission. Regarding the concept of operations (CONOPS) of the mission, it concerns the use of Space Penetrator Systems (SPS) that will descend on Mars surface following a ballistic fall and will penetrate the ground after the impact with the surface (around 50 and 300 cm of depth). Each SPS shall contain all the instrumentation required to sample and make the required analyses. Respecting the low-cost and low-mass requirements, as result of the tool, an Entry Descent and Impact (EDI) system based on inflatable structure has been designed. Hence, a solution could be the one chosen by Finnish Meteorological Institute in the Mars Met-Net mission, using an inflatable Thermal Protection System (TPS) called Inflatable Braking Unit (IBU) and an additional inflatable decelerator. Consequently, there are three configurations during the EDI: at altitude of 125 km the IBU is inflated at speed 5.5 km/s; at altitude of 16 km the IBU is jettisoned and an Additional Inflatable Braking Unit (AIBU) is inflated; Lastly at about 13 km, the SPS is ejected from AIBU and it impacts on the Martian surface. Since all parameters are evaluated, it is possible to confirm that the chosen EDI system and strategy verify the requirements of the mission.

Keywords: EDL, Mars, mission, SPS, TPS

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Authors: Rishabh Nagpal, Riya Uchagaonkar, Venkata Naga Narasimha Ashish Mernedi, Ahmed Hambaba

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The rapid evolution of technology in the communication sector continually seeks to bridge the gap between different communities, notably between the deaf community and the hearing world. This project develops a comprehensive American Sign Language (ASL) recognition system, leveraging the advanced capabilities of convolutional neural networks (CNNs) and vision transformers (ViTs) to interpret and translate ASL in real-time. The primary objective of this system is to provide an effective communication tool that enables seamless interaction through accurate sign language interpretation. The architecture of the proposed system integrates dual networks -VGG16 for precise spatial feature extraction and vision transformers for contextual understanding of the sign language gestures. The system processes live input, extracting critical features through these sophisticated neural network models, and combines them to enhance gesture recognition accuracy. This integration facilitates a robust understanding of ASL by capturing detailed nuances and broader gesture dynamics. The system is evaluated through a series of tests that measure its efficiency and accuracy in real-world scenarios. Results indicate a high level of precision in recognizing diverse ASL signs, substantiating the potential of this technology in practical applications. Challenges such as enhancing the system’s ability to operate in varied environmental conditions and further expanding the dataset for training were identified and discussed. Future work will refine the model’s adaptability and incorporate haptic feedback to enhance the interactivity and richness of the user experience. This project demonstrates the feasibility of an advanced ASL recognition system and lays the groundwork for future innovations in assistive communication technologies.

Keywords: sign language, computer vision, vision transformer, VGG16, CNN

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Authors: Muntanavadee Maytapattana

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This research aims to study the effects of the Parent Training Program for Obesity Reduction (PTPOR) on child waist circumference and health behaviors of pre-school children at the Samut-Songkhram kindergarten school, Samut-Songkhram province, Thailand. The objective of this research is to evaluate the effectiveness of the PTPOR on child waist circumference and health behaviors of the pre-school children. The conceptual framework of this study is developed on the basis of the Ecological Systems Theory (EST), not only do the individual factors such as child characteristics and child risk factors contribute to the child’s weight status, but also other factors such as parenting style and family characteristics, as well as community and demographic factors. This research is a quasi-experimental study. Participants were pre-school overweight and obese children and their parents. Forty-one parent-child dyads were recruited into the program. Parents participated in two sessions including an educational session and a group discussion session. Research methodology uses Paired-Samples t-test to determine the difference between groups in the mean scores of the outcome variables of the children and parents. The research results show that there was significant difference between child waist circumferences mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child waist circumference was decrease after finishing the program. And there was no significant difference between child exercise health behaviors mean score at the baseline and finishing the program at the 0.05 level; however, mean score of the child exercise behavior was increase after finishing the program. Meanwhile, there was significant difference between child dietary health behavior mean score at the baseline and finishing the program at the 0.01 level (p = 0.001), mean score of the child dietary was increase after finishing the program.

Keywords: PTPOR, child waist circumference, child health behaviors, pre-school children

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Authors: Meilisha Putri Pertiwi, Mufti Petala Patria

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Mangrove forest often categorized as a productive ecosystem in trophic water and the highest carbon storage among all the forest types. Mangrove-derived organic matter determines the food web of fish and invertebrates. In Indonesia trophic water ecosystem, 80% commersial fish caught in coastal area are high related to food web in mangrove forest ecosystem. Based on the previous research in Panjang Island, Bojonegara, Banten, Indonesia, removed mangrove litterfall to the sea water were 9,023 g/m³/s for two stations (west station–5,169 g/m³/s and north station-3,854 g/m³/s). The vegetation were dominated from Rhizophora apiculata and Rhizopora stylosa. C element is the highest content (27,303% and 30,373%) than N element (0,427% and 0,35%) and P element (0,19% and 0,143%). The aim of research also to know the diversity of fish inhabit in mangrove forest. Fish sampling is by push net. Fish caught are collected into plastics, total length measured, weigh measured, and individual and total counted. Meanwhile, the 3 modified pipes (1 m long, 5 inches diameter, and a closed one hole part facing the river by using a nylon cloth) set in the water channel connecting mangrove forest and sea water for each stasiun. They placed for 1 hour at low tide. Then calculate the speed of water flow and volume of modified pipes. The fish and mangrove litter will be weigh for wet weight, dry weight, and analyze the C, N, and P element content. The sampling data will be conduct 3 times of month in full moon. The salinity, temperature, turbidity, pH, DO, and the sediment of mangrove forest will be measure too. This research will give information about the fish diversity in mangrove forest, the removed mangrove litterfall to the sea water, the composition of sediment, the total element content (C, N, P) of fish and mangrove litter, and the correlation of element content absorption between fish and mangrove litter. The data will be use for the fish and mangrove ecosystem conservation.

Keywords: fish diversity, mangrove forest, mangrove litter, carbon element, nitrogen element, P element, conservation

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Authors: Giulia Cardoni, Francesca Fabbrii

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Living archives perform a function of social memory sharing, which contributes to building social bonds, communities, and identities. This potential lies in the ability to live archives to put together an archival function, which allows the conservation and transmission of memory with an artistic, performative and creative function linked to the present. As part of the DARE-UIA (Digital environment for collaborative alliances to regenerate urban ecosystems in middle-sized cities) project the creation of a living digital archive made it possible to create a narrative that would consolidate the cultural memory of the Darsena district of the city of Ravenna. The aim of the project is to stimulate the urban regeneration of a suburban area of a city, enhancing its cultural memory and identity heritage through digital heritage tools. The methodology used involves various digital storytelling actions necessary for the overall narrative using georeferencing systems (GIS), storymaps and 3D reconstructions for a transversal narration of historical content such as personal and institutional historical photos and to enhance the industrial archeology heritage of the neighborhood. The aim is the creation of an interactive and replicable narrative in similar contexts to the Darsena district in Ravenna. The living archive, in which all the digital contents are inserted, finds its manifestation towards the outside in the form of a museum spread throughout the neighborhood, making the contents usable on smartphones via QR codes and totems inserted on-site, creating thematic itineraries spread around the neighborhood. The construction of an interactive and engaging digital narrative has made it possible to enhance the material and immaterial heritage of the neighborhood by recreating the community that has historically always distinguished it.

Keywords: digital living archive, digital storytelling, GIS, 3D, open-air museum, urban regeneration, cultural memory

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Authors: John Olav Bjornestad, Bjorn Tore Johansen

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The number of people suffering from mental illnesses is increasing, and such illness is currently one of the major causes of disability and poor health. The reason for this is most likely a lack of physical activity. The purpose of this study was to discover if physical activity was an effective mode of treatment for psychiatric patients at an out-patient treatment facility. The study included an exploration of whether or not patients having physical activity included as an integral part of their treatment (to a greater degree than do patients who are physically inactive) would achieve 1) an improvement in their physical condition 2) a reduction in symptomatic pressure and 3) an increase in their health-related quality of life. The intervention period lasted a total of 12 weeks. The training group completed a minimum of 2 training sessions per week with an intensity of 60-75% of maximum heart rate. The participants’ health-related quality of life (SF-36), symptomatic pressure (SCL-90-R) and physical condition (UKK-walking test) were measured before and after intervention. Twenty participants were pre-tested, and out of this initial group, nine patients completed the intervention program and participated thereafter in post-testing. The results showed that participants on average improved their physical condition, reduced their symptomatic pressure and increased their health-related quality of life over the course of the intervention period. The training group experienced significant changes in their symptomatic pressure (the anxiety dimension) and health-related quality of life (the mental health dimension) from the pre-testing stage to the post-testing one. Furthermore, there was a significant connection between symptomatic pressure and health-related quality of life. The patients who were admitted to the psychiatric out-patient clinic were in a physical condition that was significantly poorer than that of persons of the same age in the remainder of the population. Experiences from the study and the relatively large defection from it demonstrate that there is a great need for close follow-up of psychiatric patients’ physical activity levels when physical activity and lifestyle changes are included as part of their treatment program.

Keywords: health-related quality, mental health, physical activity, physical condition

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Authors: Angela Maria Sarmiento

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Since the end of the 19th century, the Bora people struggled to survive two stages of colonial domination, which resulted in situations of forced contact with the Western world. Their inclusion in global designs altered the configuration of their local spaces and social practices; thus the Bora language was affected and prone to transformation. This descriptive, interpretive study, within the indigenous and minoritized groups’ research field, aimed at analysing the linguistic attitudes as well as the contextual situation of the Bora language in Providencia, an ancestral territory and a speech community contained in the midst of the Colombian Amazon rainforest. Through the inquiry of their sociolinguistic practices, this study also considered the effects of the course of events derived from the rubber exploitation in the late 19th century, and the arrival of the Capuchin’s mission in the early 20th century. The methodology used in this study had an ethnographic approach, which allowed the researcher to study the social phenomena from the perspective of the participants. Fieldwork, diary, field notes, and semi-structured interviews were conducted and then triangulated with participant observations. The findings of this study suggest that there is a transition from current individual bilingualism towards Spanish monolingualism; this is enhanced by the absence of a functional distribution of the three varieties (Bora, Huitoto, and Spanish). Also, the positive attitudes towards the Spanish language are based on its functionality while positive attitudes towards the Bora language mostly refer to pride and identity. Negative attitudes are only directed towards the Bora language. In the search for the roots of these negative attitudes, appeared the traumatic experiences of the rubber exploitation and the indigenous experiences at the capuchin’s boarding school. Finally, the situation of the Bora language can be configured as a social fact strongly connected to previous years of colonial dominations and to the current and continuous incursion of new global-colonial designs.

Keywords: Bora language, language contact, linguistic attitudes, speech communities

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Authors: Clare Cunningham

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Whilst there is a strong global research base on the benefits of structured writing retreats and similar provisions, such as Shut Up and Write events, for academic staff and postgraduate researchers, very little has been published about the worth of such events for undergraduate students. This is despite the fact that, internationally, undergraduate student researchers experience similar pressures, distractions and feelings towards writing as those who are at more senior levels within the academy. This paper reports on a mixed-methods study with cohorts of third-year undergraduate students over the course of four academic years. This involved a range of research instruments adopted over the four years of the study. They include the administration of four questionnaires across three academic years, a collection of ethnographic recordings in the second year, and the collation of reflective journal entries and evaluations from all four years. The final two years of data collection took place during the period of Covid-19 restrictions when writing retreats moved to the virtual space which adds an additional dimension of interest to the analysis. The analysis involved the collation of quantitative questionnaire data to observe patterns in expressions of attitudes towards writing. Qualitative data were analysed thematically and used to corroborate and support the quantitative data when appropriate. The resulting data confirmed that one of the biggest challenges for undergraduate students mirrors those reported in the findings of studies focused on more experienced researchers. This is not surprising, especially given the number of undergraduate students who now work alongside their studies, as well as the increasing number who have caring responsibilities, but it has, as yet, been under-reported. The data showed that the groups of writing retreat participants all had very positive experiences, with accountability, a sense of community and procrastination avoidance some of the key aspects. The analysis revealed the sometimes transformative power of these events for a number of these students in terms of changing the way they viewed writing and themselves as writers. The data presented in this talk will support the proposal that retreats should much more widely be offered to undergraduate students across the world.

Keywords: academic writing, students, undergraduates, writing retreat

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Authors: Su Yin Chiam, Qing Xin Zhang, Jaehoon Chung

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Complementary metal-oxide-semiconductor (CMOS) integrated circuits (ICs) have obtained increased attention in the biosensor community because CMOS technology provides cost-effective and high-performance signal processing at a mass-production level. In order to supply biological samples and reagents effectively to the sensing elements, there are increasing demands for seamless integration of microfluidic components on the fabricated CMOS wafers by post-processing. Although the PDMS microfluidic channels replicated from separately prepared silicon mold can be typically aligned and bonded onto the CMOS wafers, it remains challenging owing the inherently limited aligning accuracy ( > ± 10 μm) between the two layers. Here we present a new post-processing method to create three-dimensional microfluidic components using two different polarities of photoresists, an epoxy-based negative SU-8 photoresist and positive SPR220-7 photoresist. The positive photoresist serves as a sacrificial layer and the negative photoresist was utilized as a structural material to generate three-dimensional structures. Because both photoresists are patterned using a standard photolithography technology, the dimensions of the structures can be effectively controlled as well as the alignment accuracy, moreover, is dramatically improved (< ± 2 μm) and appropriately can be adopted as an alternative post-processing method. To validate the proposed processing method, we applied this technique to build cell-trapping structures. The SU8 photoresist was mainly used to generate structures and the SPR photoresist was used as a sacrificial layer to generate sub-channel in the SU8, allowing fluid to pass through. The sub-channel generated by etching the sacrificial layer works as a cell-capturing site. The well-controlled dimensions enabled single-cell capturing on each site and high-accuracy alignment made cells trapped exactly on the sensing units of CMOS biosensors.

Keywords: SU-8, microfluidic, MEMS, microfabrication

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Authors: Sufian Abdo Jilo

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Veterinary services conserve and maintain animal life and improve the living conditions of human beings through improving rural livelihoods and feeding; veterinary services also address global health crises by preventing risks such as emerging pandemic diseases, antimicrobial resistance, contamination of foods, and environmental health problems at their origin. The purpose of this policy brief is to analyze the way veterinary organizations provide services and to propose an optimal organization for veterinary services in developing countries. The current situation of veterinary institutions in developing countries can't counter the challenge related to animal health and productivity. As a result, reorganization, amalgamation, merging, and consolidation of veterinary health services (veterinary clinics, slaughterhouses, quarantine, and veterinary markets) together with the construction of closer veterinary service facilities and the construction of common areas will help institutions to strengthen cooperation among different veterinarians, which is the first steps for the implementation of a One Health platform and multidisciplinary activities. The improvement and reorganization of the veterinary services institutions will also help the veterinary clinics easily obtain various medical chemicals such as blood and rumen from abattoirs, enhance the surveillance of livestock diseases, enable the community to buy healthy animals from the animal market, and help to reduce economic waste. The services can be performed by a small number of veterinarians through a model of specific areas common to all veterinary services. This model improves the skills and knowledge of veterinarians in all aspects of veterinary medicine and saves students and researchers time. Communities or customers can save time by getting all veterinary services at once. It saves the budget on purchasing medical equipment and medicines at each location and avoids expiration dates on medicines. This model is the latest solution to the global health crisis and should be implemented in the near future to combat the emergence and reemergence of new pathogenic microorganisms.

Keywords: abattoir, developing countries, reform, service, veterinary

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Authors: Laleh Golamrej Eliasi

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Finland is the second most violent country for women in the European Union (EU). 47% of women in Finland claimed to have experienced domestic violence against women (DVAW), compared to an average of 33% in the EU. Although the statistics in Finland are transparent, to the author’s best knowledge, there are no statisticsonDV by nationality in Finland. On the other hand, being a Muslim woman in a non-Muslim-majority country represents a position of double vulnerability to violence. There are 10404 Afghan refugees in Finland who are Muslim. Barriers such as unfamiliarity with support services, fear of the police, racism, language, economic and practical dependence, social isolation, and family commitments all lead to a lack of reporting of DVAW among migrants. Although witnessing and experiencing DV have devastating effects on women’s and children’s health and well-being, there is a lack of studies about DVAW among Afghan families in Finland. To fill this knowledge gap, Afghan women living in Finland are selected as the target group to assess their views on DVAW and child protection. This study is implemented in the socio-ecological approach framework to assess the impacts of individual characteristics, interpersonal relationships, community, and society components on DVAW in Afghan families. Interviews with Afghan women and content analysis are used to find out participants' views on DVAW, its risk factors, and approaches and methods to improve protection for women and children. Main purpose is to obtain information about participants' views on the subject. The findings can be used to improve culturally safe social work knowledge and practices with a bottom-up approach to reduce DV and increase child protection. Therefore, this research can have important effects on the sustainable development of services and supports the welfare and inclusion of immigrant families. The expected results will contribute to sustainable gender equality, which is in line with the fifth goal of the Sustainable Development Goals.

Keywords: domestic violence, immigrant women, immigrant child protection, social work

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Authors: Mahmoud F. Mohamadin, Ahmed Abdel Malek, Wessam Said

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Achieving energy efficient architecture in general, and in emerging countries in particular, is a challenging process that requires the contribution of various governmental, institutional, and individual entities. The rule of architectural design is essential in this process as it is considered as one of the earliest steps on the road to sustainability. Architectural firms have a moral and professional responsibility to respond to these challenges and deliver buildings that consume less energy. This study aims to evaluate the design processes and tools in practice of Egyptian architectural firms based on a limited survey to investigate if their processes and methods can lead to projects that meet the Egyptian Code of Energy Efficiency Improvement. A case study of twenty architectural firms in Cairo was selected and categorized according to their scale; large-scale, medium-scale, and small-scale. A questionnaire was designed and distributed to the firms, and personal meetings with the firms’ representatives took place. The questionnaire answered three main points; the design processes adopted, the usage of performance-based simulation tools, and the usage of BIM tools for energy efficiency purposes. The results of the study revealed that only little percentage of the large-scale firms have clear strategies for building energy efficiency in their building design, however the application is limited to certain project types, or according to the client request. On the other hand, the percentage of medium-scale firms is much less, and it is almost absent in the small-scale ones. This demonstrates the urgent need of enhancing the awareness of the Egyptian architectural design community of the great importance of implementing these methods starting from the early stages of the building design. Finally, the study proposed recommendations for such firms to be able to create a healthy built environment and improve the quality of life in emerging countries.

Keywords: architectural firms, emerging countries, energy efficiency, performance-based simulation tools

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Authors: Khachen Kongpakwattana, Charungthai Dejthevaporn, Orapitchaya Krairit, Piyameth Dilokthornsakul, Devi Mohan, Nathorn Chaiyakunapruk

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Background: Although an increase in the burden of Alzheimer’s disease (AD) is evident worldwide, knowledge of costs and health-related quality of life (HR-QoL) associated with AD in Low- and Middle-Income Countries (LMICs) is still lacking. We, therefore, aimed to collect real-world cost and HR-QoL data, and investigate their associations with multiple disease-severity indicators among AD patients in Thailand. Methods: We recruited AD patients aged ≥ 60 years accompanied by their caregivers at a university-affiliated tertiary hospital. A one-time structured interview was conducted to collect disease-severity indicators, HR-QoL and caregiving information using standardized tools. The hospital’s database was used to retrieve healthcare resource utilization occurred over 6 months preceding the interview date. Costs were annualized and stratified based on cognitive status. Generalized linear models were employed to evaluate determinants of costs and HR-QoL. Results: Among 148 community-dwelling patients, average annual total societal costs of AD care were 8,014 US$ [95% Confidence Interval (95% CI): 7,295 US$ - 8,844 US$] per patient. Total costs of patients with severe stage (9,860 US$; 95% CI: 8,785 US$ - 11,328 US$) were almost twice as high as those of mild stage (5,524 US$; 95% CI: 4,649 US$ - 6,593 US$). The major cost driver was direct medical costs, particularly those incurred by AD prescriptions. Functional status was the strongest determinant for both total costs and patient’s HR-QoL (p-value < 0.001). Conclusions: Our real-world findings suggest the distinct major cost driver which results from expensive AD treatment, emphasizing the demand for country-specific cost evidence. Increases in cognitive and functional status are significantly associated with decreases in total costs of AD care and improvement on patient’s HR-QoL.

Keywords: Alzheimer's disease, associations, costs, disease-severity indicators, health-related quality of life

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