Search results for: place identity
333 Adaptability in Older People: A Mixed Methods Approach
Authors: V. Moser-Siegmeth, M. C. Gambal, M. Jelovcak, B. Prytek, I. Swietalsky, D. Würzl, C. Fida, V. Mühlegger
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Adaptability is the capacity to adjust without great difficulty to changing circumstances. Within our project, we aimed to detect whether older people living within a long-term care hospital lose the ability to adapt. Theoretical concepts are contradictory in their statements. There is also lack of evidence in the literature how the adaptability of older people changes over the time. Following research questions were generated: Are older residents of a long-term care facility able to adapt to changes within their daily routine? How long does it take for older people to adapt? The study was designed as a convergent parallel mixed method intervention study, carried out within a four-month period and took place within seven wards of a long-term care hospital. As a planned intervention, a change of meal-times was established. The inhabitants were surveyed with qualitative interviews and quantitative questionnaires and diaries before, during and after the intervention. In addition, a survey of the nursing staff was carried out in order to detect changes of the people they care for and how long it took them to adapt. Quantitative data was analysed with SPSS, qualitative data with a summarizing content analysis. The average age of the involved residents was 82 years, the average length of stay 45 months. The adaptation to new situations does not cause problems for older residents. 47% of the residents state that their everyday life has not changed by changing the meal times. 24% indicate ‘neither nor’ and only 18% respond that their daily life has changed considerably due to the changeover. The diaries of the residents, which were conducted over the entire period of investigation showed no changes with regard to increased or reduced activity. With regard to sleep quality, assessed with the Pittsburgh sleep quality index, there is little change in sleep behaviour compared to the two survey periods (pre-phase to follow-up phase) in the cross-table. The subjective sleep quality of the residents is not affected. The nursing staff points out that, with good information in advance, changes are not a problem. The ability to adapt to changes does not deteriorate with age or by moving into a long-term care facility. It only takes a few days to get used to new situations. This can be confirmed by the nursing staff. Although there are different determinants like the health status that might make an adjustment to new situations more difficult. In connection with the limitations, the small sample size of the quantitative data collection must be emphasized. Furthermore, the extent to which the quantitative and qualitative sample represents the total population, since only residents without cognitive impairments of selected units participated. The majority of the residents has cognitive impairments. It is important to discuss whether and how well the diary method is suitable for older people to examine their daily structure.Keywords: adaptability, intervention study, mixed methods, nursing home residents
Procedia PDF Downloads 149332 Timely Screening for Palliative Needs in Ambulatory Oncology
Authors: Jaci Mastrandrea
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Background: The National Comprehensive Cancer Network (NCCN) recommends that healthcare institutions have established processes for integrating palliative care (PC) into cancer treatment and that all cancer patients be screened for PC needs upon initial diagnosis as well as throughout the entire continuum of care (National Comprehensive Cancer Network, 2021). Early PC screening is directly correlated with improved patient outcomes. The Sky Lakes Cancer Treatment Center (SLCTC) is an institution that has access to PC services yet does not have protocols in place for identifying patients with palliative needs or a standardized referral process. The aim of this quality improvement project is to improve early access to PC services by establishing a standardized screening and referral process for outpatient oncology patients. Method: The sample population included all adult patients with an oncology diagnosis who presented to the SLCTC for treatment during the project timeline from March 15th, 2022, to April 29th, 2022. The “Palliative and Supportive Needs Assessment'' (PSNA) screening tool was developed from validated and evidence-based PC referral criteria. The tool was initially implemented using paper forms and later was integrated into the Epic-Beacon EHR system. Patients were screened by registered nurses on the SLCTC treatment team. Nurses responsible for screening patients received an educational inservice prior to implementation. Patients with a PSNA score of three or higher were considered to be a positive screen. Scores of five or higher triggered a PC referral order in the patient’s EHR for the oncologist to review and approve. All patients with a positive screen received an educational handout on the topic of PC, and the EHR was flagged for follow-up. Results: Prior to implementation of the PSCNA screening tool, the SLCTC had zero referrals to PC in the past year, excluding referrals to hospice. Data was collected from the first 100 patient screenings completed within the eight-week data collection period. Seventy-three percent of patients met criteria for PC referral with a score greater than or equal to three. Of those patients who met referral criteria, 53.4% (39 patients) were referred for a palliative and supportive care consultation. Patients that were not referred to PC upon meeting the criteria were flagged in the EHR for re-screening within one to three months. Patients with lung cancer, chronic hematologic malignancies, breast cancer, and gastrointestinal malignancy most frequently met criteria for PC referral and scored highest overall on the scale of 0-12. Conclusion: The implementation of a standardized PC screening tool at the SLCTC significantly increased awareness of PC needs among cancer patients in the outpatient setting. Additionally, data derived from this quality improvement project supports the national recommendation for PC to be an integral component of cancer treatment across the entire continuum of care.Keywords: oncology, palliative care, symptom management, symptom screening, ambulatory oncology, cancer, supportive care
Procedia PDF Downloads 76331 Conceptualization and Assessment of Key Competencies for Children in Preschools: A Case Study in Southwest China
Authors: Yumei Han, Naiqing Song, Xiaoping Yang, Yuping Han
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This study explores the conceptualization of key competencies that children are expected to develop in three year preschools (age 3-6) and the assessment practices of such key competencies in China. Assessment of children development has been put into the central place of early childhood education quality evaluation system in China. In the context of students key competencies development centered education reform in China, defining and selecting key competencies of children in preschools are of great significance in that they would lay a solid foundation for children’s lifelong learning path, and they would lead to curriculum and instruction reform, teacher development reform as well as quality evaluation reform in the early childhood education area. Based on sense making theory and framework, this study adopted multiple stakeholders’ (early childhood educators, parents, evaluation administrators, scholars in the early childhood education field) perspectives and grass root voices to conceptualize and operationalize key competencies for children in preschools in Southwest China. On the ground of children development theories, Chinese and international literature related to children development and key competencies, and key competencies frameworks by UNESCO, OECD and other nations, the authors designed a two-phase sequential mixed method study to address three main questions: (a) How is early childhood key competency defined or labeled from literature and from different stakeholders’ views? (b) Based on the definitions explicated in the literature and the surveys on different stakeholders, what domains and components are regarded to constitute the key competency framework of children in three-year preschools in China? (c) How have early childhood key competencies been assessed and measured, and how such assessment and measurement contribute to enhancing early childhood development quality? On the first phase, a series of focus group surveys were conducted among different types of stakeholders around the research questions. Moreover, on the second phase, based on the coding of the participants’ answers, together with literature synthesis findings, a questionnaire survey was designed and conducted to select most commonly expected components of preschool children’s key competencies. Semi-structured open questions were also included in the questionnaire for the participants to add on competencies beyond the checklist. Rudimentary findings show agreeable concerns on the significance and necessity of conceptualization and assessment of key competencies for children in preschools, and a key competencies framework composed of 7 domains and 25 indicators was constructed. Meanwhile, the findings also show issues in the current assessment practices of children’s competencies, such as lack of effective assessment tools, lack of teacher capacity in applying the tools to evaluating children and advancing children development accordingly. Finally, the authors put forth suggestions and implications for China and international communities in terms of restructuring early childhood key competencies framework, and promoting child development centered reform in early childhood education quality evaluation and development.Keywords: assessment, conceptualization, early childhood education quality in China, key competencies
Procedia PDF Downloads 251330 ‘Only Amharic or Leave Quick!’: Linguistic Genocide in the Western Tigray Region of Ethiopia
Authors: Merih Welay Welesilassie
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Language is a potent instrument that does not only serve the purpose of communication but also plays a pivotal role in shaping our cultural practices and identities. The right to choose one's language is a fundamental human right that helps to safeguard the integrity of both personal and communal identities. Language holds immense significance in Ethiopia, a nation with a diverse linguistic landscape that extends beyond mere communication to delineate administrative boundaries. Consequently, depriving Ethiopians of their linguistic rights represents a multifaceted punishment, more complex than food embargoes. In the aftermath of the civil war that shook Ethiopia in November 2020, displacing millions and resulting in the loss of hundreds of thousands of lives, concerns have been raised about the preservation of the indigenous Tigrayan language and culture. This is particularly true following the annexation of western Tigray into the Amhara region and the implementation of an Amharic-only language and culture education policy. This scholarly inquiry explores the intricacies surrounding the Amhara regional state's prohibition of Tigrayans' indigenous language and culture and the subsequent adoption of a monolingual and monocultural Amhara language and culture in western Tigray. The study adopts the linguistic genocide conceptual framework as an analytical tool to gain a deeper insight into the factors that contributed to and facilitated this significant linguistic and cultural shift. The research was conducted by interviewing ten teachers selected through a snowball sampling. Additionally, document analysis was performed to support the findings. The findings revealed that the push for linguistic and cultural assimilation was driven by various political and economic factors and the desire to promote a single language and culture policy. This process, often referred to as ‘Amharanization,’ aimed to homogenize the culture and language of the society. The Amhara authorities have enacted several measures in pursuit of their objectives, including the outlawing of the Tigrigna language, punishment for speaking Tigrigna, imposition of the Amhara language and culture, mandatory relocation, and even committing heinous acts that have inflicted immense physical and emotional suffering upon members of the Tigrayan community. Upon conducting a comprehensive analysis of the contextual factors, actions, intentions, and consequences, it has been posited that there may be instances of linguistic genocide taking place in the Western Tigray region. The present study sheds light on the severe consequences that could arise because of implementing monolingual and monocultural policies in multilingual areas. Through thoroughly scrutinizing the implications of such policies, this study provides insightful recommendations and directions for future research in this critical area.Keywords: linguistic genocide, linguistic human right, mother tongue, Western Tigray
Procedia PDF Downloads 65329 Co-Designing Health as a Social Community Centre: The Case of a 'Doctors of the World Project' in Brussels
Authors: Marco Ranzato, Maguelone Vignes
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The co-design process recently run by the trans-disciplinary urban laboratory Metrolab Brussels for outlining the architecture of a future integrated health centre in Brussels (Belgium) has highlighted that a buffer place open to the local community is the appropriate cornerstone around which organizing a space where diverse professionals and patients are together. In the context of the migrants 'crisis' in Europe, the growing number of vulnerable people in Brussels and the increasing complexity of the health and welfare systems, the NGO Doctors of the World (DoW) has launched a project funded by The European Regional Development Fund, and aiming to create a new community centre combining social and health services in a poor but changing neighborhood of Brussels. Willing not to make a 'ghetto' of this new integrated service, the NGO looks at hosting different publics in order to make the poorest, marginal and most vulnerable people access to a regular kind of service. As a trans-disciplinary urban research group, Metrolab has been involved in the process of co-designing the architecture of the future centre with a set of various health professionals, social workers, and patients’ representatives. Metrolab drawn on the participants’ practice experiences and knowledge of hosting different kinds of publics and professions in a same structure in order to imagine what rooms should fit into the centre, what atmosphere they should convey, how should they be interrelated and organized, and, concurrently, how the building should fit into the urban frame of its neighborhood. The result is that, in order for an integrated health centre framed in the landscape of a disadvantaged neighborhood to function, it has to work as social community centre offering accessibility and conviviality to diverse social groups. This paper outlines the methodology that Metrolab used to design and conduct, in close collaboration with DoW, a series of 3 workshops. Through sketching and paper modeling, the methodology made participants talk about their experience by projecting them into a situation. It included a combination of individual and collective work in order to sharp participants’ eyes on architectural forms, explicit their thoughts and experience through inter-subjectivity and imagine solutions to the challenges they raised. Such a collaborative method encompasses several challenges about patients’ participation and representation, replicability of the conditions of success and the plurality of the research findings communication formats. This paper underlines how this participatory process has contributed to build knowledge on the few-documented topic of the architecture of community health centres. More importantly, the contribution builds on this participatory process to discuss the importance of adapting the architecture of the new integrated health centre to the changing population of Brussels and to the issues of its specific neighborhood.Keywords: co-design, health, social innovation, urban lab
Procedia PDF Downloads 173328 Lifespan Assessment of the Fish Crossing System of Itaipu Power Plant (Brazil/Paraguay) Based on the Reaching of Its Sedimentological Equilibrium Computed by 3D Modeling and Churchill Trapping Efficiency
Authors: Anderson Braga Mendes, Wallington Felipe de Almeida, Cicero Medeiros da Silva
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This study aimed to assess the lifespan of the fish transposition system of the Itaipu Power Plant (Brazil/Paraguay) by using 3D hydrodynamic modeling and Churchill trapping effiency in order to identify the sedimentological equilibrium configuration in the main pond of the Piracema Channel, which is part of a 10 km hydraulic circuit that enables fish migration from downstream to upstream (and vice-versa) the Itaipu Dam, overcoming a 120 m water drop. For that, bottom data from 2002 (its opening year) and 2015 were collected and analyzed, besides bed material at 12 stations to the purpose of identifying their granulometric profiles. The Shields and Yalin and Karahan diagrams for initiation of motion of bed material were used to determine the critical bed shear stress for the sedimentological equilibrium state based on the sort of sediment (grain size) to be found at the bottom once the balance is reached. Such granulometry was inferred by analyzing the grosser material (fine and medium sands) which inflows the pond and deposits in its backwater zone, being adopted a range of diameters within the upper and lower limits of that sand stratification. The software Delft 3D was used in an attempt to compute the bed shear stress at every station under analysis. By modifying the input bathymetry of the main pond of the Piracema Channel so as to the computed bed shear stress at each station fell within the intervals of acceptable critical stresses simultaneously, it was possible to foresee the bed configuration of the main pond when the sedimentological equilibrium is reached. Under such condition, 97% of the whole pond capacity will be silted, and a shallow water course with depths ranging from 0.2 m to 1.5 m will be formed; in 2002, depths ranged from 2 m to 10 m. Out of that water path, the new bottom will be practically flat and covered by a layer of water 0.05 m thick. Thus, in the future the main pond of the Piracema Channel will lack its purpose of providing a resting place for migrating fish species, added to the fact that it may become an insurmountable barrier for medium and large sized specimens. Everything considered, it was estimated that its lifespan, from the year of its opening to the moment of the sedimentological equilibrium configuration, will be approximately 95 years–almost half of the computed lifespan of Itaipu Power Plant itself. However, it is worth mentioning that drawbacks concerning the silting in the main pond will start being noticed much earlier than such time interval owing to the reasons previously mentioned.Keywords: 3D hydrodynamic modeling, Churchill trapping efficiency, fish crossing system, Itaipu power plant, lifespan, sedimentological equilibrium
Procedia PDF Downloads 234327 Young People’s Perceptions of Disability: The New Generation’s View of a Public Seen as Vulnerable and Marginalized
Authors: Ulysse Lecomte, Maryline Thenot
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For a long time, disabled people lived in isolation within the family environment, with little interaction with the outside world and a high risk of social exclusion. However, in a number of countries, progress has been made thanks to changes in legislation on the social integration of disabled people, a significant change in attitudes, and the development of CSR. But the problem of their social, economic, and professional exclusion persists and has been further exacerbated by the COVID-19 pandemic. This societal phenomenon is sufficiently important to be the subject of management science research. We have therefore focused our work on society's current perception of people with disabilities and their possible integration. Our aim is to find out what levers could be put in place to bring about positive change in the situation. We have chosen to focus on the perception of young people in France, who are the new generation responsible for the future of our society and from whom tomorrow's decisionmakers, future employers, and stakeholders who can influence the living conditions of disabled people will be drawn. Our study sample corresponds to the 18-30 age group, which is the population of young adults likely to have sufficient experience and maturity. The aim of this study is not only to find out how this population currently perceives disability but also to identify the factors influencing this perception and the most effective levers for action to act positively on this phenomenon and thus promote better social integration of people with disabilities in the future. The methodology is based on theoretical and empirical research. The literature review includes a historical and etymological approach to disability, a definition of the different concepts of disability, an approach to disability as a vector of social exclusion, and the role of perception and representations in defining the social image of disability. This literature review is followed by an empirical part carried out by means of a questionnaire administered to 110 young people aged 18 to 30. Analysis of our results suggests that, despite a recent improvement, disabled people are still perceived as vulnerable and socially marginalised. The following factors stand out as having a significant influence (positive or negative) on the perception of disability: the individual's familiarity with the 'world of disability', cultural factors, the degree of 'visibility' of the disability and the empathy level of the disabled person him/herself. Others, on the other hand, such as socio-political and economic factors, have little impact on this perception. In addition, it is possible to classify the various levers of action likely to improve the social perception of disability according to their degree of effectiveness. Our study population prioritised training initiatives for the various players and stakeholders (teachers, students, disabled people themselves, companies, sports clubs, etc.). This was followed by communication, ecommunication and media campaigns in favour of disability. Lastly, the sample was judged as 'less effective' positive discrimination actions such as setting a minimum percentage for the representation of disabled people in various fields (studies, employment, politics ...).Keywords: disability, perception, social image, young people, influencing factors, levers for action
Procedia PDF Downloads 35326 Gender Differences in the Impact and Subjective Interpretation of Childhood Sexual Abuse Survivors
Authors: T. Borja-Alvarez, V. Jiménez-Borja, M. Jiménez Borja, C. J. Jiménez-Mosquera
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Research on child sexual abuse has predominantly focused on female survivors. This has resulted in less research looking at the particular context in which this abuse takes place for boys and the impact this abuse may have on male survivors. The aim of this study is to examine the sex and age of the perpetrators of child sexual abuse and explore gender differences in the impact along with the subjective interpretation that survivors attribute to these experiences. The data for this study was obtained from Ecuadorian university students (M = 230, F = 293) who reported sexual abuse using the ISPCAN Child Abuse Screening Tool Retrospective version (ICAST-R). Participants completed Horowitz's Impact of Event Scale (IES) and were also requested to choose among neutral, positive, and negative adjectives to describe these experiences. The results indicate that in the case of males, perpetrators were both males (adults =27%, peers =20%, relatives =10.3%, cousins =7.4%) and young females (girlfriends or ex-girlfriends =25.6%, neighborhood =20.7%, school =16.7%, cousins =15.3%, strangers =12.8%). In contrast, almost all females reported that adult males were the perpetrators (relatives =29.6%, neighborhood =11.9%, strangers =19.9%, family friends =9.7%). Regarding the impact of these events, significant gender differences emerged. More females (50%) than males (20%) presented symptoms of post-traumatic stress disorder (PTSD). Gender differences also surfaced in the way survivors interpret their experiences. Almost half of the male participants selected the word “consensual” followed by the words “normal”, “helped me to mature”, “shameful”, “confusing”, and “traumatic”. In contrast, almost all females chose the word “non-consensual” followed by the words “shameful”, “traumatic”, “scary”, and “confusing”. In conclusion, the findings of this study suggest that young females and adult males were the most common perpetrators of sexually abused boys whereas adult males were the most common perpetrators of sexually abused girls. The impact and the subjective interpretation of these experiences were more negative for girls than for boys. The factors that account for the gender differences in the impact and the interpretation of these experiences need further exploration. It is likely that the cultural expectations of sexual behaviors for boys and girls in Latin American societies may partially explain the differential impact in the way these childhood sexual abuse experiences are interpreted in adulthood. In Ecuador, as is the case in other Latin American countries, the machismo culture not only accepts but encourages early sexual behaviors in boys and negatively judges premature sexual behavior in females. The result of these different sexual expectations may be that sexually abused boys may re-define these experiences as “consensual” and “normal” in adulthood, even though these were not consensual at the time of occurrence. Future studies are needed to more deeply understand the different contexts of sexual abuse for boys and girls in order to analyze the long-term impact of these experiences.Keywords: abuse, child, gender differences, sexual
Procedia PDF Downloads 104325 Frailty and Quality of Life among Older Adults: A Study of Six LMICs Using SAGE Data
Authors: Mamta Jat
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Background: The increased longevity has resulted in the increase in the percentage of the global population aged 60 years or over. With this “demographic transition” towards ageing, “epidemiologic transition” is also taking place characterised by growing share of non-communicable diseases in the overall disease burden. So, many of the older adults are ageing with chronic disease and high levels of frailty which often results in lower levels of quality of life. Although frailty may be increasingly common in older adults, prevention or, at least, delay the onset of late-life adverse health outcomes and disability is necessary to maintain the health and functional status of the ageing population. This is an effort using SAGE data to assess levels of frailty and its socio-demographic correlates and its relation with quality of life in LMICs of India, China, Ghana, Mexico, Russia and South Africa in a comparative perspective. Methods: The data comes from multi-country Study on Global AGEing and Adult Health (SAGE), consists of nationally representative samples of older adults in six low and middle-income countries (LMICs): China, Ghana, India, Mexico, the Russian Federation and South Africa. For our study purpose, we will consider only 50+ year’s respondents. The logistic regression model has been used to assess the correlates of frailty. Multinomial logistic regression has been used to study the effect of frailty on QOL (quality of life), controlling for the effect of socio-economic and demographic correlates. Results: Among all the countries India is having highest mean frailty in males (0.22) and females (0.26) and China with the lowest mean frailty in males (0.12) and females (0.14). The odds of being frail are more likely with the increase in age across all the countries. In India, China and Russia the chances of frailty are more among rural older adults; whereas, in Ghana, South Africa and Mexico rural residence is protecting against frailty. Among all countries china has high percentage (71.46) of frail people in low QOL; whereas Mexico has lowest percentage (36.13) of frail people in low QOL.s The risk of having low and middle QOL is significantly (p<0.001) higher among frail elderly as compared to non–frail elderly across all countries with controlling socio-demographic correlates. Conclusion: Women and older age groups are having higher frailty levels than men and younger aged adults in LMICs. The mean frailty scores demonstrated a strong inverse relationship with education and income gradients, while lower levels of education and wealth are showing higher levels of frailty. These patterns are consistent across all LMICs. These data support a significant role of frailty with all other influences controlled, in having low QOL as measured by WHOQOL index. Future research needs to be built on this evolving concept of frailty in an effort to improve quality of life for frail elderly population, in LMICs setting.Keywords: Keywords: Ageing, elderly, frailty, quality of life
Procedia PDF Downloads 289324 The Participation of Experts in the Criminal Policy on Drugs: The Proposal of a Cannabis Regulation Model in Spain by the Cannabis Policy Studies Group
Authors: Antonio Martín-Pardo
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With regard to the context in which this paper is inserted, it is noteworthy that the current criminal policy model in which we find immersed, denominated by some doctrine sector as the citizen security model, is characterized by a marked tendency towards the discredit of expert knowledge. This type of technic knowledge has been displaced by the common sense and by the daily experience of the people at the time of legislative drafting, as well as by excessive attention to the short-term political effects of the law. Despite this criminal-political adverse scene, we still find valuable efforts in the side of experts to bring some rationality to the legislative development. This is the case of the proposal for a new cannabis regulation model in Spain carried out by the Cannabis Policy Studies Group (hereinafter referred as ‘GEPCA’). The GEPCA is a multidisciplinary group composed by authors with multiple/different orientations, trajectories and interests, but with a common minimum objective: the conviction that the current situation regarding cannabis is unsustainable and, that a rational legislative solution must be given to the growing social pressure for the regulation of their consumption and production. This paper details the main lines through which this technical proposal is developed with the purpose of its dissemination and discussion in the Congress. The basic methodology of the proposal is inductive-expository. In that way, firstly, we will offer a brief, but solid contextualization of the situation of cannabis in Spain. This contextualization will touch on issues such as the national regulatory situation and its relationship with the international context; the criminal, judicial and penitentiary impact of the offer and consumption of cannabis, or the therapeutic use of the substance, among others. In second place, we will get down to the business properly by detailing the minutia of the three main cannabis access channels that are proposed. Namely: the regulated market, the associations of cannabis users and personal self-cultivation. In each of these options, especially in the first two, special attention will be paid to both, the production and processing of the substance and the necessary administrative control of the activity. Finally, in a third block, some notes will be given on a series of subjects that surround the different access options just mentioned above and that give fullness and coherence to the proposal outlined. Among those related issues we find some such as consumption and tenure of the substance; the issue of advertising and promotion of cannabis; consumption in areas of special risk (work or driving v. g.); the tax regime; the need to articulate evaluation instruments for the entire process; etc. The main conclusion drawn from the analysis of the proposal is the unsustainability of the current repressive system, clearly unsuccessful, and the need to develop new access routes to cannabis that guarantee both public health and the rights of people who have freely chosen to consume it.Keywords: cannabis regulation proposal, cannabis policies studies group, criminal policy, expertise participation
Procedia PDF Downloads 120323 COVID-19 Laws and Policy: The Use of Policy Surveillance For Better Legal Preparedness
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
Procedia PDF Downloads 142322 Study of Elastic-Plastic Fatigue Crack in Functionally Graded Materials
Authors: Somnath Bhattacharya, Kamal Sharma, Vaibhav Sonkar
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Composite materials emerged in the middle of the 20th century as a promising class of engineering materials providing new prospects for modern technology. Recently, a new class of composite materials known as functionally graded materials (FGMs) has drawn considerable attention of the scientific community. In general, FGMs are defined as composite materials in which the composition or microstructure or both are locally varied so that a certain variation of the local material properties is achieved. This gradual change in composition and microstructure of material is suitable to get gradient of properties and performances. FGMs are synthesized in such a way that they possess continuous spatial variations in volume fractions of their constituents to yield a predetermined composition. These variations lead to the formation of a non-homogeneous macrostructure with continuously varying mechanical and / or thermal properties in one or more than one direction. Lightweight functionally graded composites with high strength to weight and stiffness to weight ratios have been used successfully in aircraft industry and other engineering applications like in electronics industry and in thermal barrier coatings. In the present work, elastic-plastic crack growth problems (using Ramberg-Osgood Model) in an FGM plate under cyclic load has been explored by extended finite element method. Both edge and centre crack problems have been solved by taking additionally holes, inclusions and minor cracks under plane stress conditions. Both soft and hard inclusions have been implemented in the problems. The validity of linear elastic fracture mechanics theory is limited to the brittle materials. A rectangular plate of functionally graded material of length 100 mm and height 200 mm with 100% copper-nickel alloy on left side and 100% ceramic (alumina) on right side is considered in the problem. Exponential gradation in property is imparted in x-direction. A uniform traction of 100 MPa is applied to the top edge of the rectangular domain along y direction. In some problems, domain contains major crack along with minor cracks or / and holes or / and inclusions. Major crack is located the centre of the left edge or the centre of the domain. The discontinuities, such as minor cracks, holes, and inclusions are added either singly or in combination with each other. On the basis of this study, it is found that effect of minor crack in the domain’s failure crack length is minimum whereas soft inclusions have moderate effect and the effect of holes have maximum effect. It is observed that the crack growth is more before the failure in each case when hard inclusions are present in place of soft inclusions.Keywords: elastic-plastic, fatigue crack, functionally graded materials, extended finite element method (XFEM)
Procedia PDF Downloads 390321 Cognitive Behaviour Hypnotherapy as an Effective Intervention for Nonsuicidal Self Injury Disorder
Authors: Halima Sadia Qureshi, Urooj Sadiq, Noshi Eram Zaman
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The goal of this study was to see how cognitive behavior hypnotherapy affected nonsuicidal self-injury. DSM 5 invites the researchers to explore the newly added condition under the chapter of conditions under further study named Nonsuicidal self-injury disorder. To date, no empirical sound intervention has been proven effective for NSSI as given in DSM 5. Nonsuicidal self-injury is defined by DSM 5 as harming one's self physically, without suicidal intention. Around 7.6% of teenagers are expected to fulfill the NSSI disorder criteria. 3 Adolescents, particularly university students, account for around 87 percent of self-harm studies. Furthermore, one of the risks associated with NSSI is an increased chance of suicide attempts, and in most cases, the cycle repeats again. 6 The emotional and psychological components of the illness might lead to suicide, either intentionally or unintentionally. 7 According to a research done at a Pakistani military hospital, over 80% of participants had no intention of committing suicide. Furthermore, it has been determined that improvements in NSSI prevention and intervention are necessary as a stand-alone strategy. The quasi-experimental study took place in Islamabad and Rawalpindi, Pakistan, from May 2019 to April 2020 and included students aged 18 to 25 years old from several institutions and colleges in the twin cities. According to the Diagnostic and Statistical Manual of Mental Disorders 5th edition, the individuals were assessed for >2 episodes without suicidal intent using the intentional self-harm questionnaire. The Clinician Administered Nonsuicidal Self-Injury Disorder Index (CANDI) was used to assess the individual for NSSI condition. Symptom checklist-90 (SCL-90) was used to screen the participants for differential diagnosis. Mclean Screening Instrument for Borderline Personality Disorder (MSI-BPD) was used to rule out the BPD cases. The selected participants, n=106 from the screening sample of 600, were selected. They were further screened to meet the inclusion and exclusion criteria, and the total of n=71 were split into two groups: intervention and control. The intervention group received cognitive behavior hypnotherapy for the next three months, whereas the control group received no treatment. After the period of three months, both the groups went through the post assessment, and after the three months’ period, follow-up assessment was conducted. The groups were evaluated, and SPSS 25 was used to analyse the data. The results showed that each of the two groups had 30 (50 percent) of the 60 participants. There were 41 males (68 percent) and 19 girls (32 percent) in all. The bulk of the participants were between the ages of 21 and 23. (48 percent). Self-harm events were reported by 48 (80 percent) of the pupils, and suicide ideation was found in 6 (ten percent). In terms of pre- and post-intervention values (d=4.90), post-intervention and follow-up assessment values (d=0.32), and pre-intervention and follow-up values (d=5.42), the study's effect size was good. The comparison of treatment and no-treatment groups revealed that treatment was more successful than no-treatment, F (1, 58) = 53.16, p.001. The results reveal that the treatment manual of CBH is effective for Nonsuicidal self-injury disorder.Keywords: NSSI, nonsuicidal self injury disorder, self-harm, self-injury, Cognitive behaviour hypnotherapy, CBH
Procedia PDF Downloads 184320 Monitoring of Indoor Air Quality in Museums
Authors: Olympia Nisiforou
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The cultural heritage of each country represents a unique and irreplaceable witness of the past. Nevertheless, on many occasions, such heritage is extremely vulnerable to natural disasters and reckless behaviors. Even if such exhibits are now located in Museums, they still receive insufficient protection due to improper environmental conditions. These external changes can negatively affect the conditions of the exhibits and contribute to inefficient maintenance in time. Hence, it is imperative to develop an innovative, low-cost system, to monitor indoor air quality systematically, since conventional methods are quite expensive and time-consuming. The present study gives an insight into the indoor air quality of the National Byzantine Museum of Cyprus. In particular, systematic measurements of particulate matter, bio-aerosols, the concentration of targeted chemical pollutants (including Volatile organic compounds (VOCs), temperature, relative humidity, and lighting conditions as well as microbial counts have been performed using conventional techniques. Measurements showed that most of the monitored physiochemical parameters did not vary significantly within the various sampling locations. Seasonal fluctuations of ammonia were observed, showing higher concentrations in the summer and lower in winter. It was found that the outdoor environment does not significantly affect indoor air quality in terms of VOC and Nitrogen oxides (NOX). A cutting-edge portable Gas Chromatography-Mass Spectrometry (GC-MS) system (TORION T-9) was used to identify and measure the concentrations of specific Volatile and Semi-volatile Organic Compounds. A large number of different VOCs and SVOCs found such as Benzene, Toluene, Xylene, Ethanol, Hexadecane, and Acetic acid, as well as some more complex compounds such as 3-ethyl-2,4-dimethyl-Isopropyl alcohol, 4,4'-biphenylene-bis-(3-aminobenzoate) and trifluoro-2,2-dimethylpropyl ester. Apart from the permanent indoor/outdoor sources (i.e., wooden frames, painted exhibits, carpets, ventilation system and outdoor air) of the above organic compounds, the concentration of some of them within the areas of the museum were found to increase when large groups of visitors were simultaneously present at a specific place within the museum. The high presence of Particulate Matter (PM), fungi and bacteria were found in the museum’s areas where carpets were present but low colonial counts were found in rooms where artworks are exhibited. Measurements mentioned above were used to validate an innovative low-cost air-quality monitoring system that has been developed within the present work. The developed system is able to monitor the average concentrations (on a bidaily basis) of several pollutants and presents several innovative features, including the prompt alerting in case of increased average concentrations of monitored pollutants, i.e., exceeding the limit values defined by the user.Keywords: exibitions, indoor air quality , VOCs, pollution
Procedia PDF Downloads 124319 Effect of Low to Moderate Altitude on Football Performance: An Analysis of Thirteen Seasons in the South African Premier Soccer League
Authors: Khatija Bahdur, Duane Dell’Oca
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There is limited information on how altitude impacts performance in a team sport. Most altitude research in football has been conducted at high elevation ( > 2500m), resulting in a chasm of understanding whether low to moderate altitude affects performance. The South African Premier Soccer League (PSL) fixtures entail matches played at altitudes from sea level to 1700m above mean sea level. Despite coaches highlighting the effect of altitude on performance outcomes in matches, further research is needed to establish whether altitude does impact match results. Greater insight into if and how altitude impacts performance in the PSL will assist coaches in deciding if and how to incorporate altitude in their planning. The purpose of this study is to fill in this gap through the use of a retrospective analysis of PSL matches. This quantitative study is based on a descriptive analysis of 181 PSL matches involving one team based at sea-level, taking place over a period of thirteen seasons. The following data were obtained: altitude at which the match was played, match result, the timing of goals, and timing of substitutions. The altitude was classified in 2 ways: inland ( > 500m) and coastal ( < 500m) and also further subdivided into narrower categories ( < 500m, 500-1000m, 1000-1300m; 1300-1500m, > 1500m). The analysis included a 2-sample t-test to determine differences in total goals scored and timing of goals for inland and coastal matches and the chi-square test to identify the significance of altitude on match results. The level of significance was set at the alpha level of 0.05. Match results are significantly affected by the altitude and level of altitude within inland teams most likely to win when playing at inland venues (p=0.000). The proportion of draws was slightly higher at the coast. At altitudes between 500-1000m, 1300-1500m, and 1500-1700m, a greater percentage of matches were won by coastal teams as opposed to draws. The timing of goals varied based on the team’s base altitude and the match elevation. The most significant differences were between 36-40 minutes (p=0.023), 41-45 minutes (p=0.000) and 50-65 minutes (p=0.000). When breaking down inland team’s matches to different altitude categories, greater differences were highlighted. Inland teams scored more goals per minute between 10-20 minute (p=0.009), 41-45 minutes (p=0.003) and 50-65 minutes (p=0.015). The total number of goals scored per match at different altitudes by a) inland teams (p=0.000), b) coastal teams (p=0.006). Coastal teams made significantly more substitutions when playing at altitude (p=0.034), although there were no significant differences when comparing the different altitude categories. The timing of all three changes, however, did vary significantly at the different altitudes. There were no significant differences in timing or number of substitutions for inland teams. Match results and timing of goals are influenced by altitude, with differences between the level of altitude also playing a role. The trends indicate that inland teams win more matches when playing at altitude against coastal teams, and they score more goals just prior to half-time and in the first quarter of the second half.Keywords: coastal teams, inland teams, timing of goals, results, substitutions
Procedia PDF Downloads 132318 Anti-Graft Instruments and Their Role in Curbing Corruption: Integrity Pact and Its Impact on Indian Procurement
Authors: Jot Prakash Kaur
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The paper aims to showcase that with the introduction of anti-graft instruments and willingness of the governments towards their implementation, a significant change can be witnessed in the anti-corruption landscape of any country. Since the past decade anti-graft instruments have been introduced by several international non-governmental organizations with the vision of curbing corruption. Transparency International’s ‘Integrity Pact’ has been one such initiative. Integrity Pact has been described as a tool for preventing corruption in public contracting. Integrity Pact has found its relevance in a developing country like India where public procurement constitutes 25-30 percent of Gross Domestic Product. Corruption in public procurement has been a cause of concern even though India has in place a whole architecture of rules and regulations governing public procurement. Integrity Pact was first adopted by a leading Oil and Gas government company in 2006. Till May 2015, over ninety organizations had adopted Integrity Pact, of which majority of them are central government units. The methodology undertaken to understand impact of Integrity Pact on Public procurement is through analyzing information received from important stakeholders of the instrument. Government, information was sought through Right to Information Act 2005 about the details of adoption of this instrument by various government organizations and departments. Contractor, Company websites and annual reports were used to find out the steps taken towards implementation of Integrity Pact. Civil Society, Transparency International India’s resource materials which include publications and reports on Integrity Pact were also used to understand the impact of Integrity Pact. Some of the findings of the study include organizations adopting Integrity pacts in all kinds of contracts such that 90% of their procurements fall under Integrity Pact. Indian State governments have found merit in Integrity Pact and have adopted it in their procurement contracts. Integrity Pact has been instrumental in creating a brand image of companies. External Monitors, an essential feature of Integrity Pact have emerged as arbitrators for the bidders and are the first line of procurement auditors for the organizations. India has cancelled two defense contracts finding it conflicting with the provisions of Integrity Pact. Some of the clauses of Integrity Pact have been included in the proposed Public Procurement legislation. Integrity Pact has slowly but steadily grown to become an integral part of big ticket procurement in India. Government’s commitment to implement Integrity Pact has changed the way in which public procurement is conducted in India. Public Procurement was a segment infested with corruption but with the adoption of Integrity Pact a number of clean up acts have been performed to make procurement transparent. The paper is divided in five sections. First section elaborates on Integrity Pact. Second section talks about stakeholders of the instrument and the role it plays in its implementation. Third section talks about the efforts taken by the government to implement Integrity Pact in India. Fourth section talks about the role of External Monitor as Arbitrator. The final section puts forth suggestions to strengthen the existing form of Integrity Pact and increase its reach.Keywords: corruption, integrity pact, procurement, vigilance
Procedia PDF Downloads 342317 Effect of Ti, Nb, and Zr Additives on Biocompatibility of Injection Molded 316L Stainless Steel for Biomedical Applications
Authors: Busra Gundede, Ozal Mutlu, Nagihan Gulsoy
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Background: Over the years, material research has led to the development of numerous metals and alloys for using in biomedical applications. One of the major tasks of biomaterial research is the functionalization of the material surface to improve the biocompatibility according to a specific application. 316L and 316L alloys are excellent for various bio-applications. This research was investigated the effect of titanium (Ti), niobium (Nb), and zirconium (Zr) additives on injection molded austenitic grade 316L stainless steels in vitro biocompatibility. For this purpose, cytotoxic tests were performed to evaluate the potential biocompatibility of the specimens. Materials and Methods: 3T3 fibroblast were cultivated in DMEM supplemented with 10% fetal bovine serum and %1 penicillin-streptomycin at 37°C with 5% CO2 and 95%humidity. Trypsin/EDTA solution was used to remove cells from the culture flask. Cells were reseeded at a density of 1×105cell in 25T flasks. The medium change took place every 3 days. The trypan blue assay was used to determine cell viability. Cell viability is calculated as the number of viable cells divided by the total number of cells within the grids on the cell counter machine counted the number of blue staining cells and the number of total cells. Cell viability should be at least 95% for healthy log-phase cultures. MTT assay was assessed for 96-hours. Cells were cultivated in 6-well flask within 5 ml DMEM and incubated as same conditions. 0,5mg/ml MTT was added for 4-hours and then acid-isoprohanol was added for solubilize to formazan crystals. Cell morphology after 96h was investigated by SEM. The medium was removed, samples were washed with 0.15 M PBS buffer and fixed for 12h at 4- 8°C with %2,5 gluteraldehyte. Samples were treated with 1% osmium tetroxide. Samples were then dehydrated and dried, mounted on appropriate stubs with colloidal silver and sputter-coated with gold. Images were collected using a scanning electron microscope. ROS assay is a cell viability test for in vitro studies. Cells were grown for 96h, ROS solution added on cells in 6 well plate flask and incubated for 1h. Fluorescence signal indicates ROS generation by cells. Results: Trypan Blue exclusion assay results were 96%, 92%, 95%, 90%, 91% for negative control group, 316L, 316L-Ti, 316L-Nb and 316L-Zr, respectively. Results were found nearly similar to each other when compared with control group. Cell viability from MTT analysis was found to be 100%, 108%, 103%, 107%, and 105% for the control group, 316L, 316L-Ti, 316L-Nb and 316L-Zr, respectively. Fluorescence microscopy analysis indicated that all test groups were same as the control group in ROS assay. SEM images demonstrated that the attachment of 3T3 cells on biomaterials. Conclusion: We, therefore, concluded that Ti, Nb and Zr additives improved physical properties of 316L stainless. In our in vitro experiments showed that these new additives did not modify the cytocompatibility of stainless steel and these additives on 316L might be useful for biomedical applications.Keywords: 316L stainles steel, biocompatibility, cell culture, Ti, Nb, Zr
Procedia PDF Downloads 513316 The Sustained Utility of Japan's Human Security Policy
Authors: Maria Thaemar Tana
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The paper examines the policy and practice of Japan’s human security. Specifically, it asks the question: How does Japan’s shift towards a more proactive defence posture affect the place of human security in its foreign policy agenda? Corollary to this, how is Japan sustaining its human security policy? The objective of this research is to understand how Japan, chiefly through the Ministry of Foreign Affairs (MOFA) and JICA (Japan International Cooperation Agency), sustains the concept of human security as a policy framework. In addition, the paper also aims to show how and why Japan continues to include the concept in its overall foreign policy agenda. In light of the recent developments in Japan’s security policy, which essentially result from the changing security environment, human security appears to be gradually losing relevance. The paper, however, argues that despite the strategic challenges Japan faced and is facing, as well as the apparent decline of its economic diplomacy, human security remains to be an area of critical importance for Japanese foreign policy. In fact, as Japan becomes more proactive in its international affairs, the strategic value of human security also increases. Human security was initially envisioned to help Japan compensate for its weaknesses in the areas of traditional security, but as Japan moves closer to a more activist foreign policy, the soft policy of human security complements its hard security policies. Using the framework of neoclassical realism (NCR), the paper recognizes that policy-making is essentially a convergence of incentives and constraints at the international and domestic levels. The theory posits that there is no perfect 'transmission belt' linking material power on the one hand, and actual foreign policy on the other. State behavior is influenced by both international- and domestic-level variables, but while systemic pressures and incentives determine the general direction of foreign policy, they are not strong enough to affect the exact details of state conduct. Internal factors such as leaders’ perceptions, domestic institutions, and domestic norms, serve as intervening variables between the international system and foreign policy. Thus, applied to this study, Japan’s sustained utilization of human security as a foreign policy instrument (dependent variable) is essentially a result of systemic pressures (indirectly) (independent variables) and domestic processes (directly) (intervening variables). Two cases of Japan’s human security practice in two regions are examined in two time periods: Iraq in the Middle East (2001-2010) and South Sudan in Africa (2011-2017). The cases show that despite the different motives behind Japan’s decision to participate in these international peacekeepings ad peace-building operations, human security continues to be incorporated in both rhetoric and practice, thus demonstrating that it was and remains to be an important diplomatic tool. Different variables at the international and domestic levels will be examined to understand how the interaction among them results in changes and continuities in Japan’s human security policy.Keywords: human security, foreign policy, neoclassical realism, peace-building
Procedia PDF Downloads 135315 Sentiment Analysis on University Students’ Evaluation of Teaching and Their Emotional Engagement
Authors: Elisa Santana-Monagas, Juan L. Núñez, Jaime León, Samuel Falcón, Celia Fernández, Rocío P. Solís
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Teaching practices have been widely studied in relation to students' outcomes, positioning themselves as one of their strongest catalysts and influencing students' emotional experiences. In the higher education context, teachers become even more crucial as many students ground their decisions on which courses to enroll in based on opinions and ratings of teachers from other students. Unfortunately, sometimes universities do not provide the personal, social, and academic stimulation students demand to be actively engaged. To evaluate their teachers, universities often rely on students' evaluations of teaching (SET) collected via Likert scale surveys. Despite its usefulness, such a method has been questioned in terms of validity and reliability. Alternatively, researchers can rely on qualitative answers to open-ended questions. However, the unstructured nature of the answers and a large amount of information obtained requires an overwhelming amount of work. The present work presents an alternative approach to analyse such data: sentiment analysis. To the best of our knowledge, no research before has included results from SA into an explanatory model to test how students' sentiments affect their emotional engagement in class. The sample of the present study included a total of 225 university students (Mean age = 26.16, SD = 7.4, 78.7 % women) from the Educational Sciences faculty of a public university in Spain. Data collection took place during the academic year 2021-2022. Students accessed an online questionnaire using a QR code. They were asked to answer the following open-ended question: "If you had to explain to a peer who doesn't know your teacher how he or she communicates in class, what would you tell them?". Sentiment analysis was performed using Microsoft's pre-trained model. The reliability of the measure was estimated between the tool and one of the researchers who coded all answers independently. The Cohen's kappa and the average pairwise percent agreement were estimated with ReCal2. Cohen's kappa was .68, and the agreement reached was 90.8%, both considered satisfactory. To test the hypothesis relations among SA and students' emotional engagement, a structural equation model (SEM) was estimated. Results demonstrated a good fit of the data: RMSEA = .04, SRMR = .03, TLI = .99, CFI = .99. Specifically, the results showed that student’s sentiment regarding their teachers’ teaching positively predicted their emotional engagement (β == .16 [.02, -.30]). In other words, when students' opinion toward their instructors' teaching practices is positive, it is more likely for students to engage emotionally in the subject. Altogether, the results show a promising future for sentiment analysis techniques in the field of education. They suggest the usefulness of this tool when evaluating relations among teaching practices and student outcomes.Keywords: sentiment analysis, students' evaluation of teaching, structural-equation modelling, emotional engagement
Procedia PDF Downloads 87314 Training During Emergency Response to Build Resiliency in Water, Sanitation, and Hygiene
Authors: Lee Boudreau, Ash Kumar Khaitu, Laura A. S. MacDonald
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In April 2015, a magnitude 7.8 earthquake struck Nepal, killing, injuring, and displacing thousands of people. The earthquake also damaged water and sanitation service networks, leading to a high risk of diarrheal disease and the associated negative health impacts. In response to the disaster, the Environment and Public Health Organization (ENPHO), a Kathmandu-based non-governmental organization, worked with the Centre for Affordable Water and Sanitation Technology (CAWST), a Canadian education, training and consulting organization, to develop two training programs to educate volunteers on water, sanitation, and hygiene (WASH) needs. The first training program was intended for acute response, with the second focusing on longer term recovery. A key focus was to equip the volunteers with the knowledge and skills to formulate useful WASH advice in the unanticipated circumstances they would encounter when working in affected areas. Within the first two weeks of the disaster, a two-day acute response training was developed, which focused on enabling volunteers to educate those affected by the disaster about local WASH issues, their link to health, and their increased importance immediately following emergency situations. Between March and October 2015, a total of 19 training events took place, with over 470 volunteers trained. The trained volunteers distributed hygiene kits and liquid chlorine for household water treatment. They also facilitated health messaging and WASH awareness activities in affected communities. A three-day recovery phase training was also developed and has been delivered to volunteers in Nepal since October 2015. This training focused on WASH issues during the recovery and reconstruction phases. The interventions and recommendations in the recovery phase training focus on long-term WASH solutions, and so form a link between emergency relief strategies and long-term development goals. ENPHO has trained 226 volunteers during the recovery phase, with training ongoing as of April 2016. In the aftermath of the earthquake, ENPHO found that its existing pool of volunteers were more than willing to help those in their communities who were more in need. By training these and new volunteers, ENPHO was able to reach many more communities in the immediate aftermath of the disaster; together they reached 11 of the 14 earthquake-affected districts. The collaboration between ENPHO and CAWST in developing the training materials was a highly collaborative and iterative process, which enabled the training materials to be developed within a short response time. By training volunteers on basic WASH topics during both the immediate response and the recovery phase, ENPHO and CAWST have been able to link immediate emergency relief to long-term developmental goals. While the recovery phase training continues in Nepal, CAWST is planning to decontextualize the training used in both phases so that it can be applied to other emergency situations in the future. The training materials will become part of the open content materials available on CAWST’s WASH Resources website.Keywords: water and sanitation, emergency response, education and training, building resilience
Procedia PDF Downloads 307313 A Generation Outside: Afghan Refugees in Greece 2003-2016
Authors: Kristina Colovic, Mari Janikian, Nikolaos Takis, Fotini-Sonia Apergi
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A considerable number of Afghan asylum seekers in Greece are still waiting for answers about their future and status for personal, social and societal advancement. Most have been trapped in a stalemate of continuously postponed or temporarily progressed levels of integration into the EU/Greek process of asylum. Limited quantitative research exists investigating the psychological effects of long-term displacement among Afghans refugees in Greece. The purpose of this study is to investigate factors that are associated with and predict psychological distress symptoms among this population. Data from a sample of native Afghan nationals (N > 70) living in Greece for approximately the last ten years will be collected from May to July 2016. Criteria for participation include the following: being 18 years of age or older, and emigration from Afghanistan to Greece from 2003 onwards (i.e., long-term refugees or part of the 'old system of asylum'). Snowball sampling will be used to recruit participants, as this is considered the most effective option when attempting to study refugee populations. Participants will complete self-report questionnaires, consisting of the Afghan Symptom Checklist (ASCL), a culturally validated measure of psychological distress, the World Health Organization Quality of Life scale (WHOQOL-BREF), an adapted version of the Comprehensive Trauma Inventory-104 (CTI-104), and a modified Psychological Acculturation Scale. All instruments will be translated in Greek, through the use of forward- and back-translations by bilingual speakers of English and Greek, following WHO guidelines. A pilot study with 5 Afghan participants will take place to check for discrepancies in understanding and for further adapting the instruments as needed. Demographic data, including age, gender, year of arrival to Greece and current asylum status will be explored. Three different types of analyses (descriptive statistics, bivariate correlations, and multivariate linear regression) will be used in this study. Descriptive findings for respondent demographics, psychological distress symptoms, traumatic life events and quality of life will be reported. Zero-order correlations will assess the interrelationships among demographic, traumatic life events, psychological distress, and quality of life variables. Lastly, a multivariate linear regression model will be estimated. The findings from the study will contribute to understanding the determinants of acculturation, distress and trauma on daily functioning for Afghans in Greece. The main implications of the current study will be to advocate for capacity building and empower communities through effective program evaluation and design for mental health services for all refugee populations in Greece.Keywords: Afghan refugees, evaluation, Greece, mental health, quality of life
Procedia PDF Downloads 289312 Statistical Optimization of Adsorption of a Harmful Dye from Aqueous Solution
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Textile industries cater to varied customer preferences and contribute substantially to the economy. However, these textile industries also produce a considerable amount of effluents. Prominent among these are the azo dyes which impart considerable color and toxicity even at low concentrations. Azo dyes are also used as coloring agents in food and pharmaceutical industry. Despite their applications, azo dyes are also notorious pollutants and carcinogens. Popular techniques like photo-degradation, biodegradation and the use of oxidizing agents are not applicable for all kinds of dyes, as most of them are stable to these techniques. Chemical coagulation produces a large amount of toxic sludge which is undesirable and is also ineffective towards a number of dyes. Most of the azo dyes are stable to UV-visible light irradiation and may even resist aerobic degradation. Adsorption has been the most preferred technique owing to its less cost, high capacity and process efficiency and the possibility of regenerating and recycling the adsorbent. Adsorption is also most preferred because it may produce high quality of the treated effluent and it is able to remove different kinds of dyes. However, the adsorption process is influenced by many variables whose inter-dependence makes it difficult to identify optimum conditions. The variables include stirring speed, temperature, initial concentration and adsorbent dosage. Further, the internal diffusional resistance inside the adsorbent particle leads to slow uptake of the solute within the adsorbent. Hence, it is necessary to identify optimum conditions that lead to high capacity and uptake rate of these pollutants. In this work, commercially available activated carbon was chosen as the adsorbent owing to its high surface area. A typical azo dye found in textile effluent waters, viz. the monoazo Acid Orange 10 dye (CAS: 1936-15-8) has been chosen as the representative pollutant. Adsorption studies were mainly focused at obtaining equilibrium and kinetic data for the batch adsorption process at different process conditions. Studies were conducted at different stirring speed, temperature, adsorbent dosage and initial dye concentration settings. The Full Factorial Design was the chosen statistical design framework for carrying out the experiments and identifying the important factors and their interactions. The optimum conditions identified from the experimental model were validated with actual experiments at the recommended settings. The equilibrium and kinetic data obtained were fitted to different models and the model parameters were estimated. This gives more details about the nature of adsorption taking place. Critical data required to design batch adsorption systems for removal of Acid Orange 10 dye and identification of factors that critically influence the separation efficiency are the key outcomes from this research.Keywords: acid orange 10, activated carbon, optimum adsorption conditions, statistical design
Procedia PDF Downloads 171311 Application of Combined Cluster and Discriminant Analysis to Make the Operation of Monitoring Networks More Economical
Authors: Norbert Magyar, Jozsef Kovacs, Peter Tanos, Balazs Trasy, Tamas Garamhegyi, Istvan Gabor Hatvani
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Water is one of the most important common resources, and as a result of urbanization, agriculture, and industry it is becoming more and more exposed to potential pollutants. The prevention of the deterioration of water quality is a crucial role for environmental scientist. To achieve this aim, the operation of monitoring networks is necessary. In general, these networks have to meet many important requirements, such as representativeness and cost efficiency. However, existing monitoring networks often include sampling sites which are unnecessary. With the elimination of these sites the monitoring network can be optimized, and it can operate more economically. The aim of this study is to illustrate the applicability of the CCDA (Combined Cluster and Discriminant Analysis) to the field of water quality monitoring and optimize the monitoring networks of a river (the Danube), a wetland-lake system (Kis-Balaton & Lake Balaton), and two surface-subsurface water systems on the watershed of Lake Neusiedl/Lake Fertő and on the Szigetköz area over a period of approximately two decades. CCDA combines two multivariate data analysis methods: hierarchical cluster analysis and linear discriminant analysis. Its goal is to determine homogeneous groups of observations, in our case sampling sites, by comparing the goodness of preconceived classifications obtained from hierarchical cluster analysis with random classifications. The main idea behind CCDA is that if the ratio of correctly classified cases for a grouping is higher than at least 95% of the ratios for the random classifications, then at the level of significance (α=0.05) the given sampling sites don’t form a homogeneous group. Due to the fact that the sampling on the Lake Neusiedl/Lake Fertő was conducted at the same time at all sampling sites, it was possible to visualize the differences between the sampling sites belonging to the same or different groups on scatterplots. Based on the results, the monitoring network of the Danube yields redundant information over certain sections, so that of 12 sampling sites, 3 could be eliminated without loss of information. In the case of the wetland (Kis-Balaton) one pair of sampling sites out of 12, and in the case of Lake Balaton, 5 out of 10 could be discarded. For the groundwater system of the catchment area of Lake Neusiedl/Lake Fertő all 50 monitoring wells are necessary, there is no redundant information in the system. The number of the sampling sites on the Lake Neusiedl/Lake Fertő can decrease to approximately the half of the original number of the sites. Furthermore, neighbouring sampling sites were compared pairwise using CCDA and the results were plotted on diagrams or isoline maps showing the location of the greatest differences. These results can help researchers decide where to place new sampling sites. The application of CCDA proved to be a useful tool in the optimization of the monitoring networks regarding different types of water bodies. Based on the results obtained, the monitoring networks can be operated more economically.Keywords: combined cluster and discriminant analysis, cost efficiency, monitoring network optimization, water quality
Procedia PDF Downloads 351310 Exploring the Neural Correlates of Different Interaction Types: A Hyperscanning Investigation Using the Pattern Game
Authors: Beata Spilakova, Daniel J. Shaw, Radek Marecek, Milan Brazdil
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Hyperscanning affords a unique insight into the brain dynamics underlying human interaction by simultaneously scanning two or more individuals’ brain responses while they engage in dyadic exchange. This provides an opportunity to observe dynamic brain activations in all individuals participating in interaction, and possible interbrain effects among them. The present research aims to provide an experimental paradigm for hyperscanning research capable of delineating among different forms of interaction. Specifically, the goal was to distinguish between two dimensions: (1) interaction structure (concurrent vs. turn-based) and (2) goal structure (competition vs cooperation). Dual-fMRI was used to scan 22 pairs of participants - each pair matched on gender, age, education and handedness - as they played the Pattern Game. In this simple interactive task, one player attempts to recreate a pattern of tokens while the second player must either help (cooperation) or prevent the first achieving the pattern (competition). Each pair played the game iteratively, alternating their roles every round. The game was played in two consecutive sessions: first the players took sequential turns (turn-based), but in the second session they placed their tokens concurrently (concurrent). Conventional general linear model (GLM) analyses revealed activations throughout a diffuse collection of brain regions: The cooperative condition engaged medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC); in the competitive condition, significant activations were observed in frontal and prefrontal areas, insula cortices and the thalamus. Comparisons between the turn-based and concurrent conditions revealed greater precuneus engagement in the former. Interestingly, mPFC, PCC and insulae are linked repeatedly to social cognitive processes. Similarly, the thalamus is often associated with a cognitive empathy, thus its activation may reflect the need to predict the opponent’s upcoming moves. Frontal and prefrontal activation most likely represent the higher attentional and executive demands of the concurrent condition, whereby subjects must simultaneously observe their co-player and place his own tokens accordingly. The activation of precuneus in the turn-based condition may be linked to self-other distinction processes. Finally, by performing intra-pair correlations of brain responses we demonstrate condition-specific patterns of brain-to-brain coupling in mPFC and PCC. Moreover, the degree of synchronicity in these neural signals related to performance on the game. The present results, then, show that different types of interaction recruit different brain systems implicated in social cognition, and the degree of inter-player synchrony within these brain systems is related to nature of the social interaction.Keywords: brain-to-brain coupling, hyperscanning, pattern game, social interaction
Procedia PDF Downloads 341309 Insights into Particle Dispersion, Agglomeration and Deposition in Turbulent Channel Flow
Authors: Mohammad Afkhami, Ali Hassanpour, Michael Fairweather
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The work described in this paper was undertaken to gain insight into fundamental aspects of turbulent gas-particle flows with relevance to processes employed in a wide range of applications, such as oil and gas flow assurance in pipes, powder dispersion from dry powder inhalers, and particle resuspension in nuclear waste ponds, to name but a few. In particular, the influence of particle interaction and fluid phase behavior in turbulent flow on particle dispersion in a horizontal channel is investigated. The mathematical modeling technique used is based on the large eddy simulation (LES) methodology embodied in the commercial CFD code FLUENT, with flow solutions provided by this approach coupled to a second commercial code, EDEM, based on the discrete element method (DEM) which is used for the prediction of particle motion and interaction. The results generated by LES for the fluid phase have been validated against direct numerical simulations (DNS) for three different channel flows with shear Reynolds numbers, Reτ = 150, 300 and 590. Overall, the LES shows good agreement, with mean velocities and normal and shear stresses matching those of the DNS in both magnitude and position. The research work has focused on the prediction of those conditions favoring particle aggregation and deposition within turbulent flows. Simulations have been carried out to investigate the effects of particle size, density and concentration on particle agglomeration. Furthermore, particles with different surface properties have been simulated in three channel flows with different levels of flow turbulence, achieved by increasing the Reynolds number of the flow. The simulations mimic the conditions of two-phase, fluid-solid flows frequently encountered in domestic, commercial and industrial applications, for example, air conditioning and refrigeration units, heat exchangers, oil and gas suction and pressure lines. The particle size, density, surface energy and volume fractions selected are 45.6, 102 and 150 µm, 250, 1000 and 2159 kg m-3, 50, 500, and 5000 mJ m-2 and 7.84 × 10-6, 2.8 × 10-5, and 1 × 10-4, respectively; such particle properties are associated with particles found in soil, as well as metals and oxides prevalent in turbulent bounded fluid-solid flows due to erosion and corrosion of inner pipe walls. It has been found that the turbulence structure of the flow dominates the motion of the particles, creating particle-particle interactions, with most of these interactions taking place at locations close to the channel walls and in regions of high turbulence where their agglomeration is aided both by the high levels of turbulence and the high concentration of particles. A positive relationship between particle surface energy, concentration, size and density, and agglomeration was observed. Moreover, the results derived for the three Reynolds numbers considered show that the rate of agglomeration is strongly influenced for high surface energy particles by, and increases with, the intensity of the flow turbulence. In contrast, for lower surface energy particles, the rate of agglomeration diminishes with an increase in flow turbulence intensity.Keywords: agglomeration, channel flow, DEM, LES, turbulence
Procedia PDF Downloads 318308 Strategies for Implementing Climate-Resilient Urban Public Spaces: Key Principles of Public Space Design based on People-Centred and Climate-Responsive
Authors: Abimanyu S. Aji, Ima Yusmanita, R. A .Retno Hastijanti, Yudha Utama
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The impacts of climate change are increasingly affecting major cities around the world. In April 2024, floods paralyzed Dubai, while in May of the same year, the city of Sao Leopoldo in southern Brazil, Rio Grande do Sul, experienced significant flooding that resulted in hundreds of casualties. In Europe, extreme weather along the Czech-Polish border caused rivers to overflow, carrying debris that destroyed historic cities and bridges and damaged homes. By the end of October 2024, further torrential flooding in Valencia, Spain, led to fatalities. Meanwhile, Southeast Asian cities, particularly Jakarta, are also highly vulnerable to the impacts of climate change and face the threat of being submerged due to rising sea levels. In response, the Indonesian government plans to relocate the capital to East Kalimantan, as Jakarta is no longer suitable as the capital city due to major urban problems and the impact of climate change. Given these circumstances, urgent action is needed to develop climate-resilient urban mitigation and adaptation strategies. One promising approach involves developing public space infrastructure that serves multiple functions, enhances resilience, and improves community welfare. Current urban design trends that adapt to climate change can create a new typology of spaces that respond to present or future climatic conditions. Small-scale interventions, such as designing and developing climate-resilient public spaces strategically located within spatial planning, can drive large-scale changes by transforming the urban context and enhancing the city's resilience to climate change. Public spaces represent the identity of a city, and functional public spaces that consider natural elements foster a harmonious interaction between the city and its environment. Additionally, the environmental design of these public spaces can help reduce hot temperatures in densely populated urban areas. The objective of this research is to identify suitable public spaces for transformation that can address climate adaptation challenges. Strategies for creating climate-resilient urban public spaces are categorized into two main aspects: tangible and intangible. Intangible strategies focus on community engagement and incorporate the ‘Penta Helix’ model, which includes five key elements: government, community, academia, business, and media. Tangible strategies encompass infrastructure design that adapts to climate change and adheres to several key principles: community co-creation, community health and welfare, learning through local themes, encouraging behavior change and new habits, fostering green entrepreneurship, enhancing environmental resilience, and promoting ecosystem integration. The outcome of these strategies is to create distinctive and inclusive public space architecture, including biophilic design elements. The methodologies employed in this study include both quantitative and qualitative approaches. The result of this study is a strategic concept that outlines key principles for designing community-centered and climate-responsive public spaces. By identifying the vital role of public spaces, this strategy can serve as a foundation for city-level climate adaptation efforts and raise awareness about the urgency of urban resilience, leveraging existing infrastructure opportunities. Furthermore, this research contributes to the global understanding of resilient urban design, offering valuable insights for other regions facing similar challenges.Keywords: climate adaptation, city resilience, urban public space, community engagement
Procedia PDF Downloads 7307 In Search of Innovation: Exploring the Dynamics of Innovation
Authors: Michal Lysek, Mike Danilovic, Jasmine Lihua Liu
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HMS Industrial Networks AB has been recognized as one of the most innovative companies in the industrial communication industry worldwide. The creation of their Anybus innovation during the 1990s contributed considerably to the company’s success. From inception, HMS’ employees were innovating for the purpose of creating new business (the creation phase). After the Anybus innovation, they began the process of internationalization (the commercialization phase), which in turn led them to concentrate on cost reduction, product quality, delivery precision, operational efficiency, and increasing growth (the growth phase). As a result of this transformation, performing new radical innovations have become more complicated. The purpose of our research was to explore the dynamics of innovation at HMS from the aspect of key actors, activities, and events, over the three phases, in order to understand what led to the creation of their Anybus innovation, and why it has become increasingly challenging for HMS to create new radical innovations for the future. Our research methodology was based on a longitudinal, retrospective study from the inception of HMS in 1988 to 2014, a single case study inspired by the grounded theory approach. We conducted 47 interviews and collected 1 024 historical documents for our research. Our analysis has revealed that HMS’ success in creating the Anybus, and developing a successful business around the innovation, was based on three main capabilities – cultivating customer relations on different managerial and organizational levels, inspiring business relations, and balancing complementary human assets for the purpose of business creation. The success of HMS has turned the management’s attention away from past activities of key actors, of their behavior, and how they influenced and stimulated the creation of radical innovations. Nowadays, they are rhetorically focusing on creativity and innovation. All the while, their real actions put emphasis on growth, cost reduction, product quality, delivery precision, operational efficiency, and moneymaking. In the process of becoming an international company, HMS gradually refocused. In so doing they became profitable and successful, but they also forgot what made them innovative in the first place. Fortunately, HMS’ management has come to realize that this is the case and they are now in search of recapturing innovation once again. Our analysis indicates that HMS’ management is facing several barriers to innovation related path dependency and other lock-in phenomena. HMS’ management has been captured, trapped in their mindset and actions, by the success of the past. But now their future has to be secured, and they have come to realize that moneymaking is not everything. In recent years, HMS’ management have begun to search for innovation once more, in order to recapture their past capabilities for creating radical innovations. In order to unlock their managerial perceptions of customer needs and their counter-innovation driven activities and events, to utilize the full potential of their employees and capture the innovation opportunity for the future.Keywords: barriers to innovation, dynamics of innovation, in search of excellence and innovation, radical innovation
Procedia PDF Downloads 380306 Motivation and Constraints of Athletes’ Migration: Foreign Players in Korean Volleyball League (V-League)
Authors: Young Ik Suh, Sanghak Lee, Tywan G. Martin
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An increasing number of athletes, across all sports, are moving from their home countries to play in foreign countries. The migration of athletes, coaches, managers, and administrators within and between nations is an important aspect of the social and cultural changes taking place in modern, global sports. It is especially important to understand the context of these migrations as they are critical factors in the successful development of sports policies. In previous decades, efforts have been made to understand the motives of migrating athletes from a variety of sports, including rugby, cricket, baseball, and soccer. These studies focused on the athletes’ motivations, experiences as migrants, and recruit process. However, few studies have been conducted in order to understand athletes’ constraints of migration. The concept of constraints in leisure studies refers to the barriers that exist between an individual’s desire for participation and an individual’s real participation. The study of constraints is not a new topic in the fields of sports and recreation. In addition to understanding the motives that drive athletes to work or play in foreign countries, it is also important to recognize that negative dimensions exist that stop some athletes from migrating. Furthermore, little research has explored what makes athletes consider playing in small and unknown volleyball markets, such as the Korean Volleyball League (V-League). The V-League is a professional men’s and women’s volleyball league, started in 2005. It consists of seven men’s clubs, and six women’s clubs and each team has one foreign player. In addition, several limitations are placed on the foreign players, such as on height, position, and salary to play in the V-League. Thus, the main focus of the present research is to understand why foreign athletes (e.g., European, American, Brazil, etc.) are attracted to the V-League, which has a smaller market compared to its neighbors (i.e., China, Japan, and The Philippines). In addition, the current study seeks to identify the negative factors that prevent athletes from playing in the V-League. The participants for this study will be foreign volleyball players participating in the V-League. The investigators will provide a brief introduction to this study and inform the potential participants that they can choose whether to participate in this study. In terms of theoretical saturation, at least 12 participants are generally an adequate number to reach saturation, if they belong to a relatively homogenous group based on culture and ethnicity. This study utilizes a qualitative approach in order to understand the migration experiences foreign volleyball athletes playing in the V-League. The proposed study represents ongoing research to support work conducted by the investigators to understand the possible motivations and constraints for foreign volleyball players playing in the V-League. In addition, significant contributions to scholarship in the field of sports, psychology, and coaching studies will be an outcome of this study along with additions to the body of knowledge in several disciplines, including psychology, sociology, and social work.Keywords: athletes’ migration, motivation, constraints, volleyball
Procedia PDF Downloads 262305 Integrating Natural Language Processing (NLP) and Machine Learning in Lung Cancer Diagnosis
Authors: Mehrnaz Mostafavi
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The assessment and categorization of incidental lung nodules present a considerable challenge in healthcare, often necessitating resource-intensive multiple computed tomography (CT) scans for growth confirmation. This research addresses this issue by introducing a distinct computational approach leveraging radiomics and deep-learning methods. However, understanding local services is essential before implementing these advancements. With diverse tracking methods in place, there is a need for efficient and accurate identification approaches, especially in the context of managing lung nodules alongside pre-existing cancer scenarios. This study explores the integration of text-based algorithms in medical data curation, indicating their efficacy in conjunction with machine learning and deep-learning models for identifying lung nodules. Combining medical images with text data has demonstrated superior data retrieval compared to using each modality independently. While deep learning and text analysis show potential in detecting previously missed nodules, challenges persist, such as increased false positives. The presented research introduces a Structured-Query-Language (SQL) algorithm designed for identifying pulmonary nodules in a tertiary cancer center, externally validated at another hospital. Leveraging natural language processing (NLP) and machine learning, the algorithm categorizes lung nodule reports based on sentence features, aiming to facilitate research and assess clinical pathways. The hypothesis posits that the algorithm can accurately identify lung nodule CT scans and predict concerning nodule features using machine-learning classifiers. Through a retrospective observational study spanning a decade, CT scan reports were collected, and an algorithm was developed to extract and classify data. Results underscore the complexity of lung nodule cohorts in cancer centers, emphasizing the importance of careful evaluation before assuming a metastatic origin. The SQL and NLP algorithms demonstrated high accuracy in identifying lung nodule sentences, indicating potential for local service evaluation and research dataset creation. Machine-learning models exhibited strong accuracy in predicting concerning changes in lung nodule scan reports. While limitations include variability in disease group attribution, the potential for correlation rather than causality in clinical findings, and the need for further external validation, the algorithm's accuracy and potential to support clinical decision-making and healthcare automation represent a significant stride in lung nodule management and research.Keywords: lung cancer diagnosis, structured-query-language (SQL), natural language processing (NLP), machine learning, CT scans
Procedia PDF Downloads 103304 Spatial Analysis and Determinants of Number of Antenatal Health Care Visit Among Pregnant Women in Ethiopia: Application of Spatial Multilevel Count Regression Models
Authors: Muluwerk Ayele Derebe
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Background: Antenatal care (ANC) is an essential element in the continuum of reproductive health care for preventing preventable pregnancy-related morbidity and mortality. Objective: The aim of this study is to assess the spatial pattern and predictors of ANC visits in Ethiopia. Method: This study was done using Ethiopian Demographic and Health Survey data of 2016 among 7,174 pregnant women aged 15-49 years which was a nationwide community-based cross-sectional survey. Spatial analysis was done using Getis-Ord Gi* statistics to identify hot and cold spot areas of ANC visits. Multilevel glmmTMB packages adjusted for spatial effects were used in R software. Spatial multilevel count regression was conducted to identify predictors of antenatal care visits for pregnant women, and proportional change in variance was done to uncover the effect of individual and community-level factors of ANC visits. Results: The distribution of ANC visits was spatially clustered Moran’s I = 0.271, p<.0.001, ICC = 0.497, p<0.001). The highest spatial outlier areas of ANC visit was found in Amhara (South Wollo, Weast Gojjam, North Shewa), Oromo (west Arsi and East Harariga), Tigray (Central Tigray) and Benishangul-Gumuz (Asosa and Metekel) regions. The data was found with excess zeros (34.6%) and over-dispersed. The expected ANC visit of pregnant women with pregnancy complications was higher at 0.7868 [ARR= 2.1964, 95% CI: 1.8605, 2.5928, p-value <0.0001] compared to pregnant women who had no pregnancy complications. The expected ANC visit of a pregnant woman who lived in a rural area was 1.2254 times higher [ARR=3.4057, 95% CI: 2.1462, 5.4041, p-value <0.0001] as compared to a pregnant woman who lived in an urban. The study found dissimilar clusters with a low number of zero counts for a mean number of ANC visits surrounded by clusters with a higher number of counts of an average number of ANC visits when other variables held constant. Conclusion: This study found that the number of ANC visits in Ethiopia had a spatial pattern associated with socioeconomic, demographic, and geographic risk factors. Spatial clustering of ANC visits exists in all regions of Ethiopia. The predictor age of the mother, religion, mother’s education, husband’s education, mother's occupation, husband's occupation, signs of pregnancy complication, wealth index and marital status had a strong association with the number of ANC visits by each individual. At the community level, place of residence, region, age of the mother, sex of the household head, signs of pregnancy complications and distance to health facility factors had a strong association with the number of ANC visits.Keywords: Ethiopia, ANC, spatial, multilevel, zero inflated Poisson
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