Search results for: multiple nonpharmacological interventions

Authors: Carine Platat, Fatima Qshadi, Ghofran Kayed, Nour Hussein, Amjad Jarrar, Habiba Ali

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Nowadays, smartphones are very popular. They are offering a variety of easy-to-use and free applications among which step counters and fitness tests. The number of users is huge making of such applications a potentially efficient new strategy to encourage people to become more active. Nonetheless, data on their reliability and validity are very scarce and when available, they are often negative and contradictory. Besides, weight status, which is likely to introduce a bias in the physical activity assessment, was not often considered. Hence, the use of these applications as motivational tool, assessment tool and in research is questionable. PACER is one of the free step counters application. Even though it is one of the best rated free application by users, it has never been tested for reliability and validity. Prior any use of PACER, this remains to be investigated. The objective of this work is to investigate the reliability and validity of the smartphone application PACER in measuring the number of steps and in assessing the cardiorespiratory fitness by the 6 minutes walking test. 20 overweight or obese students (10 male and 10 female) were recruited at the United Arab Emirate University, aged between 18 and 25 years old. Reliability and validity were tested in real life conditions and in controlled conditions by using a treadmill. Test-retest experiments were done with PACER on 2 days separated by a week in real life conditions (24 hours each time) and in controlled conditions (30 minutes on treadmill, 3km/h). Validity was tested against the pedometer OMRON in the same conditions. During treadmill test, video was recorded and steps numbers were compared between PACER, pedometer and video. The validity of PACER in estimating the cardiorespiratory fitness (VO2max) as part of the 6 minutes walking test (6MWT) was studied against the 20m shuttle running test. Reliability was studied by calculating intraclass correlation coefficients (ICC), 95% confidence interval (95%CI) and by Bland-Altman plots. Validity was studied by calculating Spearman correlation coefficient (rho) and Bland-Altman plots. PACER reliability was good in both male and female in real life conditions (p≤10-3) but only in female in controlled conditions (p=0.01). PACER was valid against OMRON pedometer in male and female in real life conditions (rho=0.94, p≤10-3 ; rho=0.64, p=0.01, in male and female respectively). In controlled conditions, PACER was not valid against pedometer. But, PACER was valid against video in female (rho=0.72, p≤10-3). PACER was valid against the shuttle run test in male and female (rho-=0.66, p=0.01 ; rho=0.51, p=0.04) to estimate VO2max. This study provides data on the reliability and viability of PACER in overweight or obese male and female young adults. Globally, PACER was shown as reliable and valid in real life conditions in overweight or obese male and female to count steps and assess fitness. This supports the use of PACER to assess and promote physical activity in clinical follow-up and community interventions.

Keywords: smartphone application, pacer, reliability, validity, steps, fitness, physical activity

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Authors: Sarah K. Basudan, Ragad I. Al Jazzar, Zeinah Sulaihim, Hanan M. Al-Kadri

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Background: Cesarean section has been increasing in recent years, with a wide range of etiologies contributing to this rise. This study aimed to assess the indications, outcomes, and complications in Riyadh, Saudi Arabia. Methods: A Retrospective Cohort study was conducted at King Abdulaziz medical city. The study includes two cohorts: G1 (2009) and G2 (2020) groups who met the inclusion criteria. The data was transferred to the SPSS (statistical package for social sciences) version 24 for analysis. The initial descriptive statistics were run for all variables, including numerical and categorical data. The numerical data were reported as median, and standard deviation and categorical data were reported as frequencies and percentages. Results: The data were collected from 399 women who were divided into two groups, G1(199) and G2(200). The mean age of all participants is 32+-6​; G1 and G2 had significant differences in age means with 30+-6 and 34+-5, respectively, with a p-value of <0.001, which indicates delayed fertility by four years. Moreover, a breech presentation was less likely to occur in G2 (OR 0.64, CI: 0.21-0.62. P<0.001). Nonetheless, maternal causes such as repeated C-sections and maternal medical conditions were more likely to happen in G2 (OR 1.5, CI: 1.04-2.38, p=0.03) and (OR 5.4, CI: 1.12-23.9, P=0.01), respectively. Furthermore, postpartum hemorrhage showed an increase of 12% in G2 (OR 5.4, CI: 2.2-13.4, p<0.001). G2 was more likely to be admitted to the neonatal intensive care unit (NICU) (OR 16, CI: 7.4-38.7) and to special care baby (SCB) (OR 7.2, CI: 3.9-13.1), both with a p-value<0.001 compared to regular nursery admission. Conclusion: There are multiple factors that are contributing to the increase in c section rate in a Saudi tertiary hospitals. The factors were suggested to be previous c-sections, abnormal fetal heart rate, malpresentation, and maternal or fetal medical conditions.

Keywords: cesarean sections, maternal indications, maternal complications, neonatal condition

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Authors: Yessenia Parrado, Ana Barbosa, Daniela Mahe, Sebastian Toro, Jhon Garcia

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The purpose of this work is to present the identification and characterization of the barriers and enablers to public innovation in the Central Region of Colombia from a mixed methodology in a research carried out in 2020 by the Laboratory of Innovation, Creativity and New Technologies of the National University of Colombia in alliance with the National Planning Department. Based on the research, the index of barriers to regional and departmental public innovation was built, which reflects the level of difficulty of the territorial entities to overcome the barriers present around three dimensions: organizational structure of the entity, generation of public value, and governance processes. The index was built from the item response methodology and the multiple correspondence analysis from the application of an institutional information form for public entities and a perception form for public servants. This investigation had the participation of 36 entities and 1038 servers and servants from the departments of Huila, Meta, Boyacá, Cundinamarca, Tolima, and the Capital District. In this exercise, it was identified that the departmental indices range between 13 and 44 and that the regional index was 30 out of 100. From the analysis of the information, it was possible to establish that the main barriers are the lack of specialized agencies for public innovation exercises, lack of qualified personnel and work methodologies for public innovation, inadequate information management, lack of feedback between the learning from governmental and non-governmental entities, the inability of the initiatives to generate binding participation mechanisms and the lack of qualification of citizens to participate in these processes.

Keywords: item response, public innovation, quantitative analysis, compared analysis

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Authors: Janell Jayamohan

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A pilot project based on the Theory of Planned Behavior was completed at a single sex female international high school in order to improve the quality of comprehensive sex education in a 12th grade classroom. The student sample is representative of a growing phenomenon of “Third Culture Kids” or global nomads; often in today’s world, culture transcends any one dominant influence and blends values from multiple sources. The Objective was to improve intentions of condom use during the students’ first or next intercourse. A peer-education session which focused on condom attitudes, social norms, and self-efficacy - central tenets of the Theory of Planned Behavior - was added to an existing curriculum in order to achieve this objective. Peer educators were given liberty of creating and executing the lesson to their homeroom, a sample of 23 senior students, with minimal intervention from faculty, the desired outcome being that the students themselves would be the best judge of what is culturally relevant and important to their peers. The school nurse and school counselor acted as faculty facilitators but did not assist in the creation or delivery of the lesson, only checked for medical accuracy. The participating sample of students completed a pre and post-test with validated questions assessing changes in attitudes and overall satisfaction with the peer education lesson. As this intervention was completed during the Covid-19 pandemic, the peer education session was completed in a virtual classroom environment, limiting the modes of information delivery available to the peer educators, but is planned to be replicated in an in-person environment in subsequent cycles.

Keywords: adolescents, condoms, peer education, sex education, theory of planned behavior, third culture kids

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Authors: Zelalem Markos Borko

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Work-related stress is a reaction that occurs when the work weight progress toward becoming excessive. Therefore, unless properly managed, stress leads to high employee turnover, decreased performance, illness and absenteeism. Yet, little has been addressed regarding work-related stress and its predictors in the study area. Therefore, the objective of this study was to assess stress prevalence and its predictors in the study area. To that effect, a cross-sectional study design was conducted on 281 employees from the Ethiopian Federal Bureau of Investigation by using stratified random sampling techniques. Survey questionnaire scales were employed to collect data. Data were analyzed by percentage, Pearson correlation coefficients, simple linear regression, multiple linear regressions, independent t-test and one-way ANOVA statistical techniques. In the present study13.9% of participants faced high stress, whereas 13.5% of participants faced low stress and the rest 72.6% of officers experienced moderate stress. There is no significant group difference among workers due to age, gender, marital status, educational level, years of service and police rank. This study concludes that factors such as role conflict, performance over-utilization, role ambiguity, and qualitative and quantitative role overload together predict 39.6% of work-related stress. This indicates that 60.4% of the variation in stress is explained by other factors, so other additional research should be done to identify additional factors predicting stress. To prevent occupational stress among police, the Ethiopian Federal Bureau of Investigation should develop strategies based on factors that will help to develop stress reduction management.

Keywords: work-related stress, Ethiopian federal bureau of investigation, predictors, Addis Ababa

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Authors: Bediru Abamecha

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Background: Domestic violence is a global problem that occurs regardless of culture, ethnicity or socio-economic class. It is known to be responsible for numerous hospital visits undertaken by women. Violence on pregnant women is a health and social problem that poses particular risks to the woman and her unborn child. Objective: The Objective of this study will be to assess prevalence of domestic violence and its correalates among pregnant women in Manna Woreda of Jimma Zone. Methods: Simple Random Sampling technique will be used to select 12 kebeles (48% of the study area) and Systematic Sampling will be used to reach to the house hold in selected kebeles in manna woreda of Jimma zone, south west Ethiopia from february 15-25, 2011. An in-depth interview will be conducted on Women affairs, police office and Nurses working and minimum of 4FGD with 6-8 members on pregnant women and selected male from the community. SPSS version 16.0 will be used to enter, clean and analyze the data. Descriptive statistics such as mean or median for continuous variables and percent for categorical variables will be made. Bivariate analysis will be used to check the association between independent variables and domestic violence. Variables found to have association with domestic violence will be entered to multiple logistic regressions for controlling the possible effect of confounders and finally the variables which had significance association will be identified on basis of OR, with 95% CI. All statistical significance will be considered at p<0.05. The qualitative data will be summarized manually and thematic analysis will be performed and finally both will be triangulated.

Keywords: ante natal care, ethiopian demographic and health survey, domestic violence, statistical package for social science

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Authors: M. Imran Hamid, Muzammil Hussain, Yunpeng Wu, Meichun Xiang, Xingzhong Liu

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The rhizosphere microbiome elucidate multiple functioning in the soil suppressiveness against plant pathogens. Soybean rhizosphere microbial communities may involve in the natural suppression of soybean cyst nematode (SCN) populations in disease suppressive soils. To explore these ecological mechanisms of microbes, a long term monoculture suppressive soil were taken into account for further investigation to test the disease suppressive ability by using different treatments. The designed treatments are as, i) suppressive soil (S), ii) conducive soil (C), iii) conducive soil mixed with 10% (w/w) suppressive soil (CS), iv) suppressive soil treated at 80°C for 1 hr (S80), and v) suppressive soil treated with formalin (SF). By using an ultra-high-throughput sequencing approach, we identified the key bacterial and fungal taxa involved in SCN suppression. The Phylum-level investigation of bacteria revealed that Actinobacteria, Bacteroidetes, and Proteobacteria in the rhizosphere soil of soybean seedlings were more abundant in the suppressive soil than in the conducive soil. The phylum-level analysis of fungi in rhizosphere soil indicated that relative abundance of Ascomycota was higher in suppressive soil than in the conducive soil, where Basidiomycota was more abundant. Transferring suppressive soil to conducive soil increased the population of Ascomycota in the conducive soil by lowering the populations of Basidiomycota. The genera, such as, Pochonia, Purpureocillium, Fusarium, Stachybotrys that have been well documented as bio-control agents of plant nematodes were far more in the disease suppressive soils. Our results suggested that the plants engage a subset of functional microbial groups in the rhizosphere for initial defense upon nematode attack and protect the plant roots later on by nematodes to response for suppression of SCN in disease-suppressive soils.

Keywords: disease suppressive soil, high-throughput sequencing, rhizosphere microbiome, soybean cyst nematode

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Authors: B. Ashraf, A. M. Malik

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The study was accomplished at the Department of Economics and Agriculture Economics, Pir Mahar Ali Shah ARID Agriculture University, Punjab, Pakistan during 2013-16 with a purpose to discover the effect of Islamic finance/banking on employment in Punjab, Pakistan. Islamic banking system is sub-component of conventional banking system in various countries of the world; however, in Pakistan, it has been established as a separate Islamic banking system. The Islamic banking operates under the doctrine of Shariah. It is claimed that the referred banking is free of interest (Riba) and addresses the philosophy and basic values of Islam in finance that reduces the factors of uncertainty, risk and others speculative activities. Two Islamic bank’s; Meezan Bank Limited (Pakistan) and Al-Baraka Bank Limited (Pakistan) from North Punjab (Bahawalnagar) and central Punjab (Lahore) west Punjab (Gujrat), Pakistan were randomly selected for the conduct of research. A total of 206 samples were collected from the define areas and banks through questionnaire. The data was analyzed by using the Statistical Package for Social Sciences (SPSS) version 21.0. Multiple linear regressions were applied to prove the hypothesis. The results revealed that the assets formation had significant positive; whereas, the technology, length of business (experience) and bossiness size had significant negative impact with employment generation in Islamic finance/banking in Punjab, Pakistan. This concludes that the employment opportunities may be created in the country by extending the finance to business/firms to start new business and increase the Public awareness by the Islamic banks through intensive publicity. However; Islamic financial institutions may be encouraged by Government as it enhances the employment in the country.

Keywords: assets formation, borrowers, employment generation, Islamic banks, Islamic finance

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Authors: Anne Giles

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Trauma is generally defined as an experience, or multiple experiences, overwhelming a person's ability to cope. Over time, many people recover from the neurobiological, physical, and emotional effects of trauma on their own. For some people, however, troubling symptoms develop over time that can result in distress and disability. This cluster of symptoms is classified as Post-traumatic Stress Disorder (PTSD). People who meet the criteria for PTSD and other trauma-related disorder diagnoses often hold a set of understandable but unfounded beliefs about traumatic events that cause undue suffering. Becoming aware of unhelpful beliefs—termed "cognitive distortions"—and challenging them is the realm of Cognitive Behavior Therapy (CBT). A form of CBT found by researchers to be especially effective for PTSD is Cognitive Processing Therapy (CPT). Through the compassionate use of CPT, people identify, examine, challenge, and relinquish unhelpful beliefs, thereby reducing symptoms and suffering. Widely-held cultural beliefs can interfere with the progress of recovery from trauma-related disorders. Although highly revered, largely unquestioned, and often stabilizing, cultural beliefs can be founded in simplistic, dichotomous thinking, i.e., things are all right, or all wrong, all good, or all bad. The reality, however, is nuanced and complex. After studying examples of cultural beliefs from China and the United States and how these might interfere with trauma recovery, trauma counselors can help clients derive criteria for preserving helpful beliefs, discover, examine, and jettison unhelpful beliefs, reduce trauma symptoms, and live their lives more freely and fully.

Keywords: cognitive processing therapy (CPT), cultural beliefs, post-traumatic stress disorder (PTSD), trauma recovery

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Authors: Yuriy A. Knirel

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Enteric bacteria Escherichia coli is the predominant facultative anaerobe of the colonic flora, and some specific serotypes are associated with enteritis, hemorrhagic colitis, and hemolytic uremic syndrome. Shigella spp. are human pathogens that cause diarrhea and bacillary dysentery (shigellosis). They are in effect E. coli with a specific mode of pathogenicity. Strains of Salmonella enterica are responsible for a food-borne infection (salmonellosis), and specific serotypes cause typhoid fever and paratyphoid fever. All these bacteria are closely related in respect to structure and genetics of the lipopolysaccharide, including the O-polysaccharide part (O‑antigen). Being exposed to the bacterial cell surface, the O antigen is subject to intense selection by the host immune system and bacteriophages giving rise to diverse O‑antigen forms and providing the basis for typing of bacteria. The O-antigen forms of many bacteria are unique, but some are structurally and genetically related to others. The sequenced O-antigen gene clusters between conserved galF and gnd genes were analyzed taking into account the O-antigen structures established by us and others for all S. enterica and Shigella and most E. coli O-serogroups. Multiple genetic mechanisms of diversification of the O-antigen forms, such as lateral gene transfer and mutations, were elucidated and are summarized in the present paper. They include acquisition or inactivation of genes for sugar synthesis or transfer or recombination of O-antigen gene clusters or their parts. The data obtained contribute to our understanding of the origins of the O‑antigen diversity, shed light on molecular evolutionary relationships between the O-antigens of enteric bacteria, and open a way for studies of the role of gene polymorphism in pathogenicity.

Keywords: enteric bacteria, O-antigen gene cluster, polysaccharide biosynthesis, polysaccharide structure

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Authors: Alicia Carranza, Hildemar Dos Santos, W. Lawrence Beeson, R. Patti Herring, Kimberly R. Freeman, Adam Arechiga

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Early exposure to trauma can impact health-related behaviors later in life, which poses a considerable challenge for young adults transitioning into independence when they are lacking the necessary skills and support to live a healthy life. The study will be a non-experimental, mixed methods pre- and post-test (where subjects will serve as their own controls) to determine the impact of an eight-week trauma-informed healthy lifestyle program on self-efficacy for adopting health-promoting behaviors and health outcomes among young adults. Forty-two adults, ages 18-24 who are living in Orange County, CA will be recruited to participate in the eight-week trauma-informed healthy living program. Baseline and post-intervention assessments will be conducted to assess changes in self-efficacy for nutrition and physical exercise, sleep quality and quantity, body mass index (kg/m2), and coping skills used by comparing pre- to post-intervention. Some of the planned activities include cooking demonstrations, mindful eating activities and media literacy using Instagram. Frequencies analyses, paired t-test, and multiple regression will be used to determine if there was a change in coping skills. The results of this study can serve to assess the potential for mitigating the effects of Adverse Childhood Experiences (ACEs), or other toxic stress, experienced during adolescence across the lifespan. Young adults who learn how to cope with stress in a healthy way and engage in a healthy lifestyle can be better prepared to role model that behavior to their children.

Keywords: nutrition, healthy lifestyle, trauma-informed, stress management

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Authors: Yunfan Jiang

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In response to an identified gap in available treatment programmes for high-risk offenders with multiple criminogenic needs and guided by emerging literature in the field of correctional rehabilitation, Singapore Prison Service (SPS) developed the Integrated Criminogenic Programme (ICP) in 2012. This evidence-informed psychological programme was designed to address all seven dynamic criminogenic needs (from the Central 8) of high-risk offenders by applying concepts from rehabilitation and psychological theories such as Risk-Need-Responsivity, Good Lives Model, narrative identity, and motivational interviewing. This programme also encompasses a 6-month community maintenance component for the purpose of providing structured step-down support in the aftercare setting. These sessions provide participants the opportunity for knowledge reinforcement and application of skills attained in-care. A quantitative evaluation of the ICP showed that the intervention group had statistically significant improvements across time in most self-report measures of criminal attitudes, substance use attitudes, and psychosocial functioning. This was congruent with qualitative data from participants saying that the ICP had the most impact on their criminal thinking patterns and management of behaviours in high-risk situations. Results from the comparison group showed no difference in their criminal attitudes, even though they reported statistically significant improvements across time in their substance use attitudes and some self-report measures of psychosocial functioning. The programme’s efficacy was also apparent in the lower rates of recidivism and relapse within 12 months for the intervention group. The management of staff issues arising from the development and implementation of an innovative high-intensity psychological programme such as the ICP will also be discussed.

Keywords: evaluation, forensic psychology, intervention programme, offender rehabilitation

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Authors: Armin Eilaghi, Ahmad Sedaghat, Hayder Abdurazzak, Fadi Alkhatib, Shiva Sadeghi, Martin Jaeger

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A summary of experiences, recommendations, and lessons learnt in the application of PBL in the course of “Engineering Skills” in the School of Engineering at Australian College of Kuwait in Kuwait is presented. Four projects were introduced as part of the PBL course “Engineering Skills” to 24 students in School of Engineering. These students were grouped in 6 teams to develop their skills in 10 learning outcomes. The learning outcomes targeted skills such as drawing, design, modeling, manufacturing and analysis at a preliminary level; and also some life line learning and teamwork skills as these students were exposed for the first time to the PBL (project based learning). The students were assessed for 10 learning outcomes of the course and students’ feedback was collected using an anonymous survey at the end of the course. Analyzing the students’ feedbacks, it is observed that 67% of students preferred multiple smaller projects than a single big project because it provided them with more time and attention focus to improve their “soft skills” including project management, risk assessment, and failure analysis. Moreover, it is found that 63% of students preferred to work with different team members during the course to improve their professional communication skills. Among all, 62% of students believed that working with team members from other departments helped them to increase the innovative aspect of projects and improved their overall performance. However, 70% of students counted extra time needed to regenerate momentum with the new teams as the major challenge. Project based learning provided a suitable platform for introducing students to professional engineering practice and meeting the needs of students, employers and educators. It was found that students achieved their 10 learning outcomes and gained new skills developed in this PBL unit. This was reflected in their portfolios and assessment survey.

Keywords: project-based learning, engineering skills, undergraduate engineering, problem-based learning

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Authors: Joanna Maj

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Body machine interfaces (BMIs) afford users a non-invasive way coordinate movement. Vibrotactile stimulation has been incorporated into BMIs to allow feedback in real-time and guide movement control to benefit patients with cognitive deficits, such as stroke survivors. To advance research in this area, we examined vibrational discrimination thresholds at four body locations to determine suitable application sites for future multi-channel BMIs using vibration cues to guide movement planning and control. Twelve healthy adults had a pair of small vibrators (tactors) affixed to the skin at each location: forearm, shoulders, torso, and knee. A "standard" stimulus (186 Hz; 750 ms) and "probe" stimuli (11 levels ranging from 100 Hz to 235 Hz; 750 ms) were delivered. Probe and test stimulus pairs could occur sequentially or simultaneously (timing). Participants verbally indicated which stimulus felt more intense. Stimulus order was counterbalanced across tactors and body locations. Probabilities that probe stimuli felt more intense than the standard stimulus were computed and fit with a cumulative Gaussian function; the discrimination threshold was defined as one standard deviation of the underlying distribution. Threshold magnitudes depended on stimulus timing and location. Discrimination thresholds were better for stimuli applied sequentially vs. simultaneously at the torso as well as the knee. Thresholds were small (better) and relatively insensitive to timing differences for vibrations applied at the shoulder. BMI applications requiring multiple channels of simultaneous vibrotactile stimulation should therefore consider the shoulder as a deployment site for a vibrotactile BMI interface.

Keywords: electromyography, electromyogram, neuromuscular disorders, biomedical instrumentation, controls engineering

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Authors: Ramin Mansouri

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Due to the contrast of rivers discharge regime with water demands, one of the best ways to use water resources is to regulate the natural flow of the rivers and supplying water needs to construct dams. Optimal utilization of reservoirs, consideration of multiple important goals together at the same is of very high importance. To study about analyzing this method, statistical data of Bakhtiari and Roudbar dam over 46 years (1955 until 2001) is used. Initially an appropriate objective function was specified and using DE algorithm, the rule curve was developed. In continue, operation policy using rule curves was compared to standard comparative operation policy. The proposed method distributed the lack to the whole year and lowest damage was inflicted to the system. The standard deviation of monthly shortfall of each year with the proposed algorithm was less deviated than the other two methods. The Results show that median values for the coefficients of F and Cr provide the optimum situation and cause DE algorithm not to be trapped in local optimum. The most optimal answer for coefficients are 0.6 and 0.5 for F and Cr coefficients, respectively. After finding the best combination of coefficients values F and CR, algorithms for solving the independent populations were examined. For this purpose, the population of 4, 25, 50, 100, 500 and 1000 members were studied in two generations (G=50 and 100). result indicates that the generation number 200 is suitable for optimizing. The increase in time per the number of population has almost a linear trend, which indicates the effect of population in the runtime algorithm. Hence specifying suitable population to obtain an optimal results is very important. Standard operation policy had better reversibility percentage, but inflicts severe vulnerability to the system. The results obtained in years of low rainfall had very good results compared to other comparative methods.

Keywords: reservoirs, differential evolution, dam, Optimal operation

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Authors: Gulelat Gatew

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Bamboo Woven Strand Board (WSB) products are manufactured from Ethiopia highland bamboo (Yushania alpina) as a multiple layer mat structure for enhanced mechanical performance. Hence, it shows similar mechanical properties as tropical hardwood products. WSB, therefore, constitutes a sustainable alternative to tropical hardwood products. The resin and wax ratio had a great influence on the determinants properties of the product quality such as internal bonding, water absorption, thickness swelling, bending and stiffness properties. Among these properties, because of the hygroscopic nature of the bamboo, thickness swelling and water absorption are important performances of WSB for using in construction and outdoor facilities. When WSB is exposed to water or moist environment, they tend to swell and absorb water in all directions. The degree of swelling and water absorption depends on the type of resin used, resin formulation, resin ratio, wax type and ratio. The objective of this research is investigating effects of phenol formaldehyde and wax on thickness swelling and water absorption behavior on bamboo WSB for construction and outdoor facilities. The experiments were conducted to measure the effects of wax and phenol-formaldehyde resin content on WSB thickness swelling and water absorption which leads to investigate its effect on dimension stability and mechanical properties. Both experiments were performed with 2–hour and 24-hour water immersion test and a significant set of data regarding the influence of such method parameters is also presented. The addition of up to 2% wax with 10% of phenol formaldehyde significantly reduced thickness swelling and water absorption of WSB which resulted in making it more hydrophobic and less susceptible to the influences of moisture in high humidity conditions compared to the panels without wax.

Keywords: woven strand board (WSB), water absorption, thickness swelling, phenol formaldehyde resin

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Authors: Rita Bagheri, Javed Ahmed, Humayra Bashir, M. Irfan Qureshi

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Agriculture lands suffer from a combination of stresses such as salinity and metal contamination including cadmium at the same time. Under such condition of multiple stresses, plant may exhibit unique responses different from the stress occurring individually. Thus, it would be interesting to investigate that how plant respond to combined stress at level of antioxidants and proteome expression, and identifying the proteins which are involved in imparting stress tolerance. With an approach of comparative proteomics and antioxidant analysis, present study investigates the response of Spinacia oleracea to salt (NaCl), cadmium (Cd), and their combination (NaCl+Cd) stress. Two-dimensional gel electrophoresis was used for resolving leaf proteome, and proteins of interest were identified using PDQuest software. A number of proteins expressed differentially, those indicated towards their roles in imparting stress tolerance, were digested by trypsin and analyzed on mass spectrometer for peptide mass fingerprinting (PMF). Data signals were then matched with protein databases using MASCOT. Results show that NaCl, Cd and both together (NaCl+Cd) induce oxidative stress which was highest in combined stress of Cd+NaCl. Correspondingly, the activities of enzymatic antioxidants viz., SOD, APX, GR and CAT, and non-enzymatic antioxidants had highest changes under combined stress compares to single stress over their respective controls. Among the identified proteins, several interesting proteins were identified that may be have role in Spinacia oleracia tolerance in individual and combinatorial stress of salt and cadmium. The functional classification of identified proteins indicates the importance and necessity of keeping higher ratio of defence and disease responsive proteins.

Keywords: Spinacia oleracea, Cd, salinity, proteomics, antioxidants, combinatorial stress

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Authors: Faseluka Olamide Tope

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Giving quality education to students with special needs requires that all necessary resources should be harnessed and digital devices has become important part of resources used as instructional materials in educating students with special needs. Teachers who will make use of these technologies are considered as a part of the most important elements in any educational programme and the effective usage of these technologies largely depends on them. Out of numerous determinants of the effective use of these digital devices, this study examines teachers’ attitude and knowledge as predictors of effective use of digital technology for education of special needs student in Oyo state, Nigeria. The descriptive survey research design of the expo-facto type was adopted for the study, using simple random sampling technique. The study was carried out among sixty (60) participants. Two research questions and two research hypotheses were formulated and used. The data collected through the research instruments for the study were analysedusing frequency, percentage, mean and standard deviation, Pearson, Product, Moment Correlation (PPMC) and Multiple Regression Analysis. The study revealed a significant relationship between teachers attitude (50, < 0.05) and effective use of digital technologies for special needs students. Furthermore, there was a significant contribution F (F=4.289; R=0.876 and R2 =0.758) in the joint contribution of the independent variable  (teacher’s attitude and teacher’s knowledge) and dependent variable (effective use of digital technologies) while teachers knowledge have the highest contribution(b=7.926, t=4.376), the study therefore revealed that teachers attitude and knowledge are potent factors that predicts the effective usage of digital technologies for the education of special needs student. The study recommended that due to the ever-changing nature of technology which comes with new features, teachers should be equipped with appropriate knowledge in order to effectively make use of them and teachers should also develop right attitude toward the use of digital technologies

Keywords: teachers’ knowledge, teachers’ attitude, digital devices, special needs students

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Authors: Francesca Nardi, Kashish Aneja, Katherine Ginsbach

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The COVID-19 pandemic has demonstrated both a need for evidence-based and rights-based public health policy and how challenging it can be to make effective decisions with limited information, evidence, and data. The O’Neill Institute, in conjunction with several partners, has been working since the beginning of the pandemic to collect, analyze, and distribute critical data on public health policies enacted in response to COVID-19 around the world in the COVID-19 Law Lab. Well-designed laws and policies can help build strong health systems, implement necessary measures to combat viral transmission, enforce actions that promote public health and safety for everyone, and on the individual level have a direct impact on health outcomes. Poorly designed laws and policies, on the other hand, can fail to achieve the intended results and/or obstruct the realization of fundamental human rights, further disease spread, or cause unintended collateral harms. When done properly, laws can provide the foundation that brings clarity to complexity, embrace nuance, and identifies gaps of uncertainty. However, laws can also shape the societal factors that make disease possible. Law is inseparable from the rest of society, and COVID-19 has exposed just how much laws and policies intersects all facets of society. In the COVID-19 context, evidence-based and well-informed law and policy decisions—made at the right time and in the right place—can and have meant the difference between life or death for many. Having a solid evidentiary base of legal information can promote the understanding of what works well and where, and it can drive resources and action to where they are needed most. We know that legal mechanisms can enable nations to reduce inequities and prepare for emerging threats, like novel pathogens that result in deadly disease outbreaks or antibiotic resistance. The collection and analysis of data on these legal mechanisms is a critical step towards ensuring that legal interventions and legal landscapes are effectively incorporated into more traditional kinds of health science data analyses. The COVID-19 Law Labs see a unique opportunity to collect and analyze this kind of non-traditional data to inform policy using laws and policies from across the globe and across diseases. This global view is critical to assessing the efficacy of policies in a wide range of cultural, economic, and demographic circumstances. The COVID-19 Law Lab is not just a collection of legal texts relating to COVID-19; it is a dataset of concise and actionable legal information that can be used by health researchers, social scientists, academics, human rights advocates, law and policymakers, government decision-makers, and others for cross-disciplinary quantitative and qualitative analysis to identify best practices from this outbreak, and previous ones, to be better prepared for potential future public health events.

Keywords: public health law, surveillance, policy, legal, data

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Authors: Modi M. Ahmed, Noor Al-Dousari, Ali M. Al-Dousari

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Cornulaca aucheri is an annual herb consider as disturbance indicator currently visible and widely distributed in disturbed lands in Liyah area. Such area is suffered from severe land degradation due to multiple interacting factors such as, overgrazing, gravel and sand quarrying, military activities and natural process. The restoration program is applied after refilled quarries sites and levelled the surface irregularities in order to rehabilitate the natural vegetation and wildlife to its original shape. During the past 10 years of rehabilitation, noticeable greenery healthy cover of Cornulaca sp. are shown specially around artificial lake and playas. The existence of such species in high density it means that restoration program has succeeded and transit from bare ground state to Cornulaca and annual forb state. This state is lower state of Range State Transition Succession model, but it is better than bare soil. Cornulaca spp is native desert plant grows in arid conditions on sandy, stony ground, near oasis, on sand dunes and in sandy depressions. The sheep and goats are repulsive of it. Despite its spiny leaves, it provides good grazing for camels and is said to increase the milk supply produced by lactating females. It is about 80 cm tall and has stems that branched from the base with new faster greenery growth in the summer. It shows good environmental potential to be managed as natural types used for the restoration of degraded lands in desert areas.

Keywords: land degradation, range state transition succession model, rehabilitation, restoration program

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Authors: Ruoyang Tang, Jianguo Nie

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Lateral-torsional bracing members are critical to the stability of girder systems during the construction phase of steel-concrete composite bridges, and the interaction effect of multiple girders plays an essential role in the determination of buckling load. In this paper, an investigation is conducted on the lateral-torsional buckling behavior of the steel girder system which is composed of three or four I-shaped girders and braced by solid web crossbeams. The buckling load for such girder system is comprehensively analyzed and an analytical solution is developed for uniform pressure loading conditions. Furthermore, post-buckling analysis including initial geometric imperfections is performed and parametric studies in terms of bracing density, stiffness ratio as well as the number and spacing of girders are presented in order to find the optimal bracing plans for an arbitrary girder layout. The theoretical solution of critical load on account of local buckling mode shows good agreement with the numerical results in eigenvalue analysis. In addition, parametric analysis results show that both bracing density and stiffness ratio have a significant impact on the initial stiffness, global stability and failure mode of such girder system. Taking into consideration the effect of initial geometric imperfections, an increase in bracing density between adjacent girders can effectively improve the bearing capacity of the structure, and higher beam-girder stiffness ratio can result in a more ductile failure mode.

Keywords: bracing member, construction stage, lateral-torsional buckling, steel girder system

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Authors: Ahmed M. Kabel, Maaly A. Abd Elmaaboud

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Scleroderma is one of the connective tissue disorders characterized by skin and systemic fibrosis. Its pathogenesis involves multiple interrelated processes of autoimmunity, vasculopathy, inflammation, and oxidative stress. This study was a trial to explore the possible ameliorative effects of sodium valproate on an experimental model of skin fibrosis induced by bleomycin. Forty male BALB/c mice were divided into four equal groups as follows: control group; bleomycin group; bleomycin + sodium valproate group, and sodium valproate group. Mice were assessed for their body weight every four days throughout the whole study. Skin tissues were used to evaluate the oxidative stress parameters, transforming growth factor beta 1 (TGF-β1), tumor necrosis factor alpha (TNF-α), interleukin 15, and mammalian target of rapamycin (mTOR). Skin fibrosis was evaluated by measuring dermal thickness and staining the skin tissues with Masson trichrome stain. Also, the skin tissues were immunostained with alpha smooth muscle actin (α-SMA). Administration of sodium valproate to bleomycin-treated mice resulted in the restoration of the body weight with a significant decrease in the dermal thickness, amelioration of oxidative stress, suppression of TGF-β1 and mTOR expression, and significant reduction of the percentage of α-SMA immunostaining and the proinflammatory cytokine levels compared to mice treated with bleomycin alone. In conclusion, sodium valproate has an antifibrotic effect on skin fibrosis which may represent a beneficial therapeutic modality for the management of scleroderma.

Keywords: scleroderma, bleomycin, sodium valproate, skin fibrosis

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Authors: Bassant M. M. Ibrahim, Doha H. Abou Baker, Ahmed Abd Elghafour

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Excessive exposure to heavy metals contributes to the occurrence of deleterious health problems that affect vital organs like the brain, liver, kidneys, and heart. The use of natural products that have antioxidant capabilities may contribute to the protection of these organs. In the present study, the essential oil of summer savory (Satureja hortensis) was used to evaluate its protective effects against lead acetate induced damaging effect on rats’ vital organs, due to its high contents of carvacrol, y-terpinene, and p-cymene. Forty female Wister Albino rats were classified into five equal groups, the 1st served as normal group, the 2nd served as positive control group was given lead acetate (60 mg/kg) intra-peritoneal (IP), the third to fifth groups were treated with calcium disodium (EDTA) as chelating agent and summer savory essential oil in doses of (50 and 100mg/kg) respectively. All treatments were given IP concomitant with lead acetate for ten successive days. At the end of the experiment duration electrocardiogram (ECG), an open field test for the evaluation of psychological state, rotarod test as for the evaluation of locomotor coordination ability as well as anti-inflammatory and oxidative stress biomarkers in serum and histopathology of vital organs were performed. The investigations in this study show that the protective effect of high dose of summer savory essential oil is more than the low dose and that the essential oil of summer savory is a promising agent that can contribute to the protection of vital organs against the hazardous damaging effects of lead acetate.

Keywords: brain, heart, kidneys, lead acetate, liver, protective, summer savory

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Authors: Rajeev Manhas, M. A. Bhat, A. K. Taku, Dalip Singh, Deep Shikha, Gulzar Bader

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The study was aimed to understand the distribution of various serogroups of Pasteurella multocida in bovines, small ruminants, pig, rabbit, and poultry from Jammu, Jammu and Kashmir and to characterize the isolates with respect to LPS synthesizing genes, dermonecrotic toxin gene (toxA) gene and antibiotic resistance. For isolation, the nasopharyngeal swab procedure appeared to be better than nasal swab procedure, particularly in ovine and swine. Out of 200 samples from different animals, isolation of P. multocida could be achieved from pig and sheep (5 each) and from poultry and buffalo (2 each) samples only, which accounted for 14 isolates. Upon molecular serogrouping, 3 isolates from sheep and 2 isolates from poultry were found as serogroup A, 2 isolates from buffalo were confirmed as serogroup B and 5 isolates from pig were found to belong to serogroup D. However, 2 isolates from sheep could not be typed, hence, untypable. All the 14 isolates were subjected to mPCR genotyping. A total of 10 isolates, 5 each from pig and sheep, generated an amplicon specific to genotype L6 and L6 indicates Heddleston serovars 10, 11, 12 and 15. Similarly, 2 isolates from bovines generated an amplicon of genotype L2 which indicates Heddleston serovar 2/5. However, 2 isolates from poultry generated specific amplicon with L1 signifying Heddleston serovar 1, but these isolates also produced multiple bands with primer L5. Only, one isolate of capsular type A from sheep possessed the structural gene, toxA for dermonecrotoxin. There was variability in the antimicrobial susceptibility pattern in sheep isolates, but overall the rate of tetracycline resistance was relatively high (64.28%) in our strains while all the isolates were sensitive to streptomycin. Except for the swine isolates and one toxigenic sheep isolate, the P. multocida isolates from this study were sensitive to quinolones. Although the level of resistance to commercial antibiotics was generally low, the use of tetracycline and erythromycin was not recommended.

Keywords: antibiogram, genotyping, Pasteurella multocida, serogrouping, toxA

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Authors: Tiera Tanksley, Amanda M. McLeroy

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The advent of technology and social media has ushered in a new era of communication, providing platforms for news dissemination and cause advocacy. However, this digital landscape has also exposed a distressing phenomenon termed "Black death," or trauma porn. This paper delves into the profound effects of repeated exposure to traumatic content on Black youth via social media, exploring the psychological impacts and potential reinforcing of stereotypes. Employing Critical Race Technology Theory (CRTT), the study sheds light on algorithmic anti-blackness and its influence on Black youth's lives and educational experiences. Through ethnographic content analysis, the research investigates common manifestations of Black death encountered online by Black adolescents. Findings unveil distressing viral videos, traumatic images, racial slurs, and hate speech, perpetuating stereotypes. However, amidst the distress, the study identifies narratives of activism and social justice on social media platforms, empowering Black youth to engage in positive change. Coping mechanisms and community support emerge as significant factors in navigating the digital landscape. The study underscores the need for comprehensive interventions and policies informed by evidence-based research. By addressing algorithmic anti-blackness and promoting digital resilience, the paper advocates for a more empathetic and inclusive online environment. Understanding coping mechanisms and community support becomes imperative for fostering mental well-being among Black adolescents navigating social media. In education, the implications are substantial. Acknowledging the impact of Black death content, educators play a pivotal role in promoting media literacy and digital resilience. Creating inclusive and safe online spaces, educators can mitigate negative effects and encourage open discussions about traumatic content. The application of CRTT in educational technology emphasizes dismantling systemic biases and promoting equity. In conclusion, this study calls for educators to be cognizant of the impact of Black death content on social media. By prioritizing media literacy, fostering digital resilience, and advocating for unbiased technologies, educators contribute to an inclusive and just educational environment for all students, irrespective of their race or background. Addressing challenges related to Black death content proactively ensures the well-being and mental health of Black adolescents, fostering an empathetic and inclusive digital space.

Keywords: algorithmic anti-Blackness, digital resilience, media literacy, traumatic content

Procedia PDF Downloads 41

Authors: F. Farzan Nasab, H. J. M. Geijselaers, I. Baran, A. De Boer

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A method is introduced for the coupled skin-rib optimization of a wing box where mass minimization is the objective and local buckling is the constraint. The structure is made of composite materials where continuity of plies in multiple adjacent panels (blending) has to be satisfied. Blending guarantees the manufacturability of the structure; however, it is a highly challenging constraint to treat and has been under debate in recent research in the same area. To fulfill design guidelines with respect to symmetry, balance, contiguity, disorientation and percentage rule of the layup, a reference for the stacking sequences (stacking sequence table or SST) is generated first. Then, an innovative fully gradient-based optimization approach in relation to a specific SST is introduced to obtain the optimum thickness distribution all over the structure while blending is fulfilled. The proposed optimization approach aims to turn the discrete optimization problem associated with the integer number of plies into a continuous one. As a result of a wing box deflection, a rib is subjected to load values which vary nonlinearly with the amount of deflection. The bending stiffness of a skin affects the wing box deflection and thus affects the load applied to a rib. This indicates the necessity of a coupled skin-rib optimization approach for a more realistic optimized design. The proposed method is examined with the optimization of the layup of a composite stiffened skin and rib of a wing torsion box subjected to in-plane normal and shear loads. Results show that the method can successfully prescribe a valid design with a significantly cheap computation cost.

Keywords: blending, buckling optimization, composite panels, wing torsion box

Procedia PDF Downloads 390

Authors: Caroline Lavratti, Pedro Dal Lago, Gustavo Reinaldo, Gilson Dorneles, Andreia Bard, Laira Fuhr, Daniela Pochmann, Alessandra Peres, Luciane Wagner, Viviane Elsner

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Approximately 1% of the world's population is affected by schizophrenia (SZ), a chronic and debilitating neurodevelopmental disorder. Among possible factors, reduced levels of Brain-derived neurotrophic factor (BDNF) has been recognized in physiopathogenesis and course of SZ. In this context, peripheral BDNF levels have been used as a biomarker in several clinical studies, since this neurotrophin is able to cross the blood-brain barrier in a bi-directional manner and seems to present a strong correlation with the central nervous system fluid levels. The patients with SZ usually adopts a sedentary lifestyle, which has been partly associated with the increase in obesity incidence rates, metabolic syndrome, type 2 diabetes and coronary heart disease. On the other hand, exercise, a non-invasive and low cost intervention, has been considered an important additional therapeutic option for this population, promoting benefits to physical and mental health. To our knowledge, few studies have been pointed out that the positive effects of exercise in SZ patients are mediated, at least in part, to enhanced levels of BDNF after training. However, these studies are focused on evaluating the effect of single bouts of exercise of chronic interventions, data concerning the short- and long-term exercise outcomes on BDNF are scarce. Therefore, this study aimed to evaluate the effect of a concurrent exercise protocol (CEP) on plasma BDNF levels of SZ patients in different time-points. Material and Methods: This study was approved by the Research Ethics Committee of the Centro Universitário Metodista do IPA (no 1.243.680/2015). The participants (n=15) were subbmited to the CEP during 90 days, 3 times a week for 60 minutes each session. In order to evaluate the short and long-term effects of exercise, blood samples were collected pre, 30, 60 and 90 days after the intervention began. Plasma BDNF levels were determined with the ELISA method, from Sigma-Aldrich commercial kit (catalog number RAB0026) according to manufacturer's instructions. Results: A remarkable increase on plasma BDNF levels at 90 days after training compared to baseline (p=0.006) and 30 days (p=0.007) values were observed. Conclusion: Our data are in agreement with several studies that show significant enhancement on BDNF levels in response to different exercise protocols in SZ individuals. We might suggest that BDNF upregulation after training in SZ patients acts in a dose-dependent manner, being more pronounced in response to chronic exposure. Acknowledgments: This work was supported by Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS)/Brazil.

Keywords: exercise, BDNF, schizophrenia, time-points

Procedia PDF Downloads 240

Authors: Natalia Ortega

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Safety Culture (SCU) involves various perceptual, psychological, behavioral, and managerial factors. It has been shown that creating and maintaining an SCU is one way to reduce and prevent accidents and fatalities. In the construction sector, safety attitude, knowledge, and a supportive environment are predictors of safety behavior. The highest possible proportion of safety behavior among employees can be achieved by improving their safety attitude and knowledge. Accordingly, top management's commitment to safety is vital in shaping employees' safety attitude; therefore, the first step to improving employees' safety attitude is the genuine commitment of top management to safety. One of the factors affecting the successful implementation of health and safety promotion programs is the construction industry's subcontracting model. The contractual model's complexity, combined with the need for coordination among diverse stakeholders, makes it challenging to implement, manage, and follow up on health and well-being initiatives. The Systems theoretic accident model and process (STAMP) concept has expanded global consideration in recent years, increasing research attention. STAMP focuses attention on the role of constraints in safety management. The findings discover a growth of the research field from the definition in 2004 by Leveson and is being used across multiple domains. A systematic literature review of this novel model aims to meet the safety goals for human space exploration with a powerful and different approach to safety management, safety-driven design, and decision-making. Around two hundred studies have been published about applying the model. However, every single model for safety requires time to transform into research and practice, be tested and debated, and grow further and mature.

Keywords: stamp, risk management, accident prevention, safety culture, systems thinking, construction industry, safety

Procedia PDF Downloads 65

Authors: Said Belaaouad

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This study aimed to explore the quantitative structure-activity relationship (QSAR) of 1,2,4-Triazine-3(2H)-one derivative as a potential anticancer agent against breast cancer. The electronic descriptors were obtained using the Density Functional Theory (DFT) method, and a multiple linear regression techniques was employed to construct the QSAR model. The model exhibited favorable statistical parameters, including R2=0.849, R2adj=0.656, MSE=0.056, R2test=0.710, and Q2cv=0.542, indicating its reliability. Among the descriptors analyzed, absolute electronegativity (χ), total energy (TE), number of hydrogen bond donors (NHD), water solubility (LogS), and shape coefficient (I) were identified as influential factors. Furthermore, leveraging the validated QSAR model, new derivatives of 1,2,4-Triazine-3(2H)-one were designed, and their activity and pharmacokinetic properties were estimated. Subsequently, molecular docking (MD) and molecular dynamics (MD) simulations were employed to assess the binding affinity of the designed molecules. The Tubulin colchicine binding site, which plays a crucial role in cancer treatment, was chosen as the target protein. Through the simulation trajectory spanning 100 ns, the binding affinity was calculated using the MMPBSA script. As a result, fourteen novel Tubulin-colchicine inhibitors with promising pharmacokinetic characteristics were identified. Overall, this study provides valuable insights into the QSAR of 1,2,4-Triazine-3(2H)-one derivative as potential anticancer agent, along with the design of new compounds and their assessment through molecular docking and dynamics simulations targeting the Tubulin-colchicine binding site.

Keywords: QSAR, molecular docking, ADMET, 1, 2, 4-triazin-3(2H)-ones, breast cancer, anticancer, molecular dynamic simulations, MMPBSA calculation

Procedia PDF Downloads 74

Authors: A. R. Shokoohi, E. A. M. Bulder, C. Th. van Alphen, D. F. den Hertog, E. J. Hin

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The Northern region of the Netherlands has beautiful landscapes, a nice diversity of green and blue areas, and dispersed settlements. However, some recent population changes can become threats to health and wellbeing in these areas. The rural areas in the three northern provinces -Groningen, Friesland, and Drenthe, see youngsters leave the region for which reason they are aging faster than other regions in the Netherlands. As a result, some villages have faced major population decline that is leading to loss of facilities/amenities and a decrease in accessibility and social cohesion. Those who still live in these villages are relatively old, low educated and have low-income. To develop a deeper understanding of the health status of the people living in these areas, and help them to improve their living environment, the GO!-Method is being applied in this study. This method has been developed by the National Institute for Public Health and the Environment (RIVM) of the Netherlands and is inspired by the broad definition of health by Machteld Huber: the ability to adapt and direct control, in terms of the physical, emotional and social challenges of life, while paying extra attention to vulnerable groups. A healthy living environment is defined as an environment that residents find it pleasant and encourages and supports healthy behavior. The GO!-method integrates six domains that constitute a healthy living environment: health and lifestyle, facilities and development, safety and hygiene, social cohesion and active citizens, green areas, and air and noise pollution. First of all, this method will identify opportunities for a healthier living environment using existing information and perceptions of residents and other local stakeholders in order to strengthen social participation and quality of life in these rural areas. Second, this approach will connect identified opportunities with available and effective evidence-based interventions in order to develop an action plan from the residents and local authorities perspective which will help them to design their municipalities healthier and more resilient. This method is being used for the first time in rural areas to our best knowledge, in close collaboration with the residents and local authorities of the three provinces to create a sustainable process and stimulate social participation. Our paper will present the outcomes of the first phase of this project in collaboration with the municipality of Westerkwartier, located in the northwest of the province of Groningen. And will describe the current situation, and identify local assets, opportunities, and policies relating to healthier environment; as well as needs and challenges to achieve goals. The preliminary results show that rural demographic changes in the northern Netherlands have negative impacts on service provisions and social cohesion, and there is a need to understand this complicated situation and improve the quality of life in those areas.

Keywords: population decline, rural areas, healthy environment, Netherlands

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