Search results for: long-term family planning
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6152

Search results for: long-term family planning

1202 Analyzing Land use change and its impacts on the Urban Environment in a Fast Growing Metropolitan City of Pakistan

Authors: Muhammad Nasar-u-Minallah, Dagmar Haase, Salman Qureshi

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In a rapidly growing developing country cities are becoming more urbanized leading to modifications in urban climate. Rapid urbanization, especially unplanned urban land expansion, together with climate change has a profound impact on the urban settlement and urban thermal environment. Cities, particularly Pakistan are facing remarkably environmental issues and uneven development, and thus it is important to strengthen the investigation of urban environmental pressure brought by land-use changes and urbanization. The present study investigated the long term modification of the urban environment by urbanization utilizing Spatio-temporal dynamics of land-use change, urban population data, urban heat islands, monthly maximum, and minimum temperature of thirty years, multi remote sensing imageries, and spectral indices such as Normalized Difference Built-up Index and Normalized Difference Vegetation Index. The results indicate rapid growth in an urban built-up area and a reduction in vegetation cover in the last three decades (1990-2020). A positive correlation between urban heat islands and Normalized Difference Built-up Index, whereas a negative correlation between urban heat islands and the Normalized Difference Vegetation Index clearly shows how urbanization is affecting the local environment. The increase in air and land surface temperature temperatures is dangerous to human comfort. Practical approaches, such as increasing the urban green spaces and proper planning of the cities, have been suggested to help prevent further modification of the urban thermal environment by urbanization. The findings of this work are thus important for multi-sectorial use in the cities of Pakistan. By taking into consideration these results, the urban planners, decision-makers, and local government can make different policies to mitigate the urban land use impacts on the urban thermal environment in Pakistan.

Keywords: land use, urban environment, local climate, Lahore

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1201 LIS Students’ Experience of Online Learning During Covid-19

Authors: Larasati Zuhro, Ida F Priyanto

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Background: In March 2020, Indonesia started to be affected by Covid-19, and the number of victims increased slowly but surely until finally, the highest number of victims reached the highest—about 50,000 persons—for the daily cases in the middle of 2021. Like other institutions, schools and universities were suddenly closed in March 2020, and students had to change their ways of studying from face-to-face to online. This sudden changed affected students and faculty, including LIS students and faculty because they never experienced online classes in Indonesia due to the previous regulation that academic and school activities were all conducted onsite. For almost two years, school and academic activities were held online. This indeed has affected the way students learned and faculty delivered their courses. This raises the question of whether students are now ready for their new learning activities due to the covid-19 disruption. Objectives: this study was conducted to find out the impact of covid-19 pandemic on the LIS learning process and the effectiveness of online classes for students of LIS in Indonesia. Methodology: This was qualitative research conducted among LIS students at UIN Sunan Kalijaga, Yogyakarta, Indonesia. The population are students who were studying for masters’program during covid-19 pandemic. Results: The study showed that students were ready with the online classes because they are familiar with the technology. However, the Internet and technology infrastructure do not always support the process of learning. Students mention slow WIFI is one factor that causes them not being able to study optimally. They usually compensate themselves by visiting a public library, a café, or any other places to get WIFI network. Noises come from the people surrounding them while they are studying online.Some students could not concentrate well when attending the online classes as they studied at home, and their families sometimes talk to other family members, or they asked the students while they are attending the online classes. The noise also came when they studied in a café. Another issue is that the classes were held in shorter time than that in the face-to-face. Students said they still enjoyed the onsite classes instead of online, although they do not mind to have hybrid model of learning. Conclusion: Pandemic of Covid-19 has changed the way students of LIS in Indonesia learn. They have experienced a process of migrating the way they learn from onsite to online. They also adapted their learning with the condition of internet access speed, infrastructure, and the environment. They expect to have hybrid classes in the future.

Keywords: learning, LIS students, pandemic, covid-19

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1200 Planning the Journey of Unifying Medical Record Numbers in Five Facilities and the Expected Challenges: Case Study in Saudi Arabia

Authors: N. Al Khashan, H. Al Shammari, W. Al Bahli

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Patients who are eligible to receive treatment at the National Guard Health Affairs (NGHA), Saudi Arabia will typically have four medical record numbers (MRN), one in each of the geographical areas. More hospitals and primary healthcare facilities in other geographical areas will launch soon which means more MRNs. When patients own four MRNs, this will cause major drawbacks in patients’ quality of care such as creating new medical files in different regions for relocated patients and using referral system among regions. Consequently, the access to a patient’s medical record from other regions and the interoperability of health information between the four hospitals’ information system would be challenging. Thus, there is a need to unify medical records among these five facilities. As part of the effort to increase the quality of care, a new Hospital Information Systems (HIS) was implemented in all NGHA facilities by the end of 2016. NGHA’s plan is put to be aligned with the Saudi Arabian national transformation program 2020; whereby 70% citizens and residents of Saudi Arabia would have a unified medical record number that enables transactions between multiple Electronic Medical Records (EMRs) vendors. The aim of the study is to explore the plan, the challenges and barriers of unifying the 4 MRNs into one Enterprise Patient Identifier (EPI) in NGHA hospitals by December 2018. A descriptive study methodology was used. A journey map and a project plan are created to be followed by the project team to ensure a smooth implementation of the EPI. It includes the following: 1) Approved project charter, 2) Project management plan, 3) Change management plan, 4) Project milestone dates. Currently, the HIS is using the regional MRN. Therefore, the HIS and all integrated health care systems in all regions will need modification to move from MRN to EPI without interfering with patient care. For now, the NGHA have successfully implemented an EPI connected with the 4 MRNs that work in the back end in the systems’ database.

Keywords: consumer health, health informatics, hospital information system, universal medical record number

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1199 Analysis of Access Pattern to School and Travel Risks among School Children in Benin City, Edo State, Nigeria

Authors: Barry Aifesehi Aiworo, Henry Oriakhi

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This paper, examines the analysis of access pattern to school and travel risks among school children in Benin City, Edo State, Nigeria. The risk includes accident, molestation (sexually) and kidnapping. The objective of this paper are to examine the various means (modes) of transport to school; determine the type and incidences of risk experienced by school children in the study area; examine the risk incidences and ages of school children in the study area. Hypothesis which states that the types of risks encountered by school children are independent of means of transport was tested using the chi-square test (X2). A sampling ratio of twelve percent (12%) was taken from 396 schools in Benin City. By implication, 49 schools were randomly selected in Benin City for this research. A total of 42,053 students in the 49 schools constitute the sample frame for the research. Two percent (2%), 841 students were taken as the sample size. The use of stratified sampling method was applied by stratifying the study area (Benin City) into local governments- Egor, Ikpoba-Okha and Oredo. Thereafter, the lists of schools in the various local governments were obtained from the Ministry of Education before the schools for research were randomly chosen from each local government area. The analysis revealed that 6.7% of the total students interviewed have been involved in road accidents. 1.04% of the total respondents said at one time or the other that they have been kidnapped. Finally, the research found that travel is comparatively safe and believes this may be partly attributable to safer route to schools and school children being more familiar with the school journey. The research indicates that children aged between eleven and fifteen are most at risk of hit or knocked down on Benin City’s roads. These findings may help in planning and targeting road safety initiative (education, campaigns) in Benin City.

Keywords: accident, molestation (sexually), kidnapping, pedophile, pedestrian

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1198 A Preliminary Survey on Butterfly Fauna at Rajagala Archaeological Site, Ampara, Sri Lanka

Authors: D. Eranda N. Mandawala, P. A. D. Mokshi V. Perera

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The RajagalaArchaeological site (RAS) is located 26 km from Ampara town (7º29'25.22" N, 81º36'59.05" E) accessible through the Ampara-Uhana-MahaOya highway of the Eastern province of Sri Lanka. This site has recently been added to the tentative list of UNESCO world heritage site and is also a forest reserve. This dry zone forest consists of tropical mixed evergreen vegetation and scrublands on a rocky outcrop of elevation of about 350 meters above mean sea level. It is also scattered with several ponds of differing sizes on rocky outcrops, rocky cliffs, and about 50 cave dwellings. No comprehensive biodiversity survey of any sorts has been conducted at the RAS so far. Therefore, a preliminary survey was conducted to determine its butterfly fauna diversity. An opportunistic Visual Encounter Survey method was used to observe various butterfly species during the morning between 8:00am-12:00noon and in the evening between 2:00-6:00pm on 3 site visits in October 2017, February 2018, and November 2019. All encountered species were photographed using a Nikon D750 camera with Sigma 105mm f/2.8 EX DG OS HSM macro lens, and field guide books were used to identify them. Sri Lanka is home to 248 species of butterflies, of which are 26 are endemic. At RAS, we observed a total of 39 species (15%) of butterflies belonging to 5 Lepidoptera families. Out of these, one endemic species(4%) and 9 endemic subspecieswere also identified. The former was Troidesdarsius, also known as the Sri Lanka birdwing which is the national butterfly and the largest butterfly in Sri Lanka, and the latter were Plains cupid (Chiladespandavalanka), Yamfly (Loxuraatymnus arcuate), Common Cerulean (Jamidescelenotissama), Tawny Rajah(Charaxespsaphonpsaphon), Tamil Yeoman(Cirrochroathaislanka), Angled Castor(Ariadne ariadneminorata), GladeyeBushbrown(Mycalesispatnia patina), Common Crow (Euploea core asela)and Blue Mormon (Papiliopolymnestorparinda). The endemic subspecies belonged to 3 Lepidoptera families (3from Lycaenidae, 5 from Nymphalidae, and 1 from Papilionidae family). Anthropogenic activities such as unauthorized cattle farming, forest clearance, and man-made forest fires currently threaten this site. If such trends continue, it may lead to the reduction of butterfly fauna diversity within this area in the future.

Keywords: lepidoptera, rajagala, Sri Lanka birdwing, endemic

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1197 A Method for Precise Vertical Position of the Implant When Using Computerized Surgical Guides and Bone Reduction

Authors: Abraham Finkelman

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Computerized Surgical Guides have been proven to be a predictable way to perform dental implants, with a relatively high accuracy in comparison to a treatment plan. When using the CSG Bone supported, it allows us to make the necessary changes of the hard tissue prior to the implant placement and after the implant placement. The CSG gives us an accurate position for the drilling, and during the implant placement it allows us to alter the vertical position of the implant altering the final position of the abutment and avoiding any risk of any damage to the adjacent anatomical structures. Any Changes required to the bone level can be done prior to the fixation of the CSG using a reduction guide, which incur extra surgical fees and the need of a second surgical guide. Any changes of the bone level after the implant placement are at the risk of damaging the implant neck surface. The technique consists of a universal system that allows us to remove the excess bone around the implant sockets prior to the implant placement which then enables us to place the implant in the vertical position with accuracy as planned with the CSG. The systems consist of a hollow pin of different sizes and diameters. Depending on the implant system that we are using. Length sizes are from 6mm-16mm and a diameter of 2.6mm-4.8mm. Upon the completion of the drilling, the pin is then inserted into the implant socket-using the insertion tool. Once the insertion tool has unscrewed the pin, we can continue with the bone reduction. The bone reduction can be done using conventional methods upon the removal of all the excess bone around the pin. The insertion tool is then screwed into the pin and the pin is then removed. We now, have the new bone level at the crest of the implant socket which is our mark for the vertical position of the implant. In some cases, when we are locating the implant very close to anatomical structures, any form of deviation to the vertical position of the implant during the surgery, can cause damage to such anatomical structures, creating irreversible damages such as paresthesia or dysesthesia of the mandibular nerve. If we are planning for immediate loading and we have done our temporary restauration in base of our computerized plan, deviation in the vertical position of the implant will affect the position of the abutment, affecting the accuracy of the temporary prosthesis, extending the working time till we adapt the prosthesis to the new position.

Keywords: bone reduction, computer aided navigation, dental implant placement, surgical guides

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1196 Correlates of Modes of Transportation to Work among Working Adults in Ernakulam District, Kerala

Authors: Anjaly Joseph, Elezebeth Mathews

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Transportation and urban planning is the least recognised area for physical activity promotion in India, unlike developed regions. Identifying the preferred transportation modalities and factors associated with it is essential to address these lacunae. The objective of the study was to assess the prevalence of modes of transportation to work, and its correlates among working adults in Ernakulam District, Kerala. A cross sectional study was conducted among 350 working individuals in the age group of 18-60 years, selected through multi-staged stratified random sampling in Ernakulam district of Kerala. The inclusion criteria were working individuals 18-60 years, workplace at a distance of more than 1 km from the home and who worked five or more days a week. Pregnant women/women on maternity leave and drivers (taxi drivers, autorickshaw drivers, and lorry drivers) were excluded. An interview schedule was used to capture the modes of transportation namely, public, private and active transportation, socio demographic details, travel behaviour, anthropometric measurements and health status. Nearly two-thirds (64 percent) of them used private transportation to work, while active commuters were only 6.6 percent. The correlates identified for active commuting compared to other modes were low socio-economic status (OR=0.22, CI=0.5-0.85) and presence of a driving license (OR=4.95, CI= 1.59-15.45). The correlates identified for public transportation compared to private transportation were female gender (OR= 17.79, CI= 6.26-50.31), low income (OR=0.33, CI= 0.11-0.93), being unmarried (OR=5.19, CI=1.46-8.37), presence of no or only one private vehicle in the house (OR=4.23, CI=1.24-20.54) and presence of convenient public transportation facility to workplace (OR=3.97, CI= 1.66-9.47). The association between body mass index (BMI) and public transportation were explored and found that public transport users had lesser BMI than private commuters (OR=2.30, CI=1.23-4.29). Policies that encourage active and public transportation needs to be introduced such as discouraging private vehicle through taxes, introduction of convenient and safe public transportation facility, walking/cycling paths, and paid parking facility.

Keywords: active transportation, correlates, India, public transportation, transportation modes

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1195 Navigating Rough Seas: A Qualitative Exploration of National Sociotechnical Imaginaries of Myanmar’s Future Marine Fisheries

Authors: Hannes Groeneweg

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Myanmar is considered one of the largest fishing nations in the world. The country’s rapid economic and political reform process since 2011 entails both challenges and opportunities for its marine fishing sector. The development pathway of the sector remains unclear. Which future will eventually materialize is shaped and determined by the various visions and actions of the stakeholders engaging in political debates and decision-making. These visions can be conceptualized through the Science and Technology Studies (STS) concept of sociotechnical imaginaries. The research of this article is guided by the question of which imaginaries are currently relevant, who is propagating these imaginaries, and how are these imaginaries produced and contested. Using qualitative documentary analysis of policy documents, reports, and media articles as well as in-depth interviews with key stakeholders, three archetypical national sociotechnical imaginaries of Myanmar’s future marine fisheries were identified: The industrial scale extractivism imaginary views marine fishing sector as a driver for national economic growth and focuses on the industrial and technological development of the production chain, increasing yield and exports. Sustainable fishing management encompasses the vulnerability of marine ecosystems and views increasing efficient sustainability governance, planning, and management into existing fishing practices. In the traditional sufficiency fishing imaginary, small-scale fishing practices are viewed as an important livelihood practice for millions of coastal dwellers. The need to conserve them through strengthening the self-reliance, autonomy, and resilience of these communities is stressed. In national debates, the first two imaginaries are currently dominant. The imaginaries, as well as their contestations, are also linked to other critical political issues. The paper suggests that participatory decision-making processes are needed to create an inclusive imaginary of the future marine fishing sector.

Keywords: science and technology studies, sociotechnical imaginaries, marine fishing, knowledge coproduction, Myanmar

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1194 Design of Traffic Counting Android Application with Database Management System and Its Comparative Analysis with Traditional Counting Methods

Authors: Muhammad Nouman, Fahad Tiwana, Muhammad Irfan, Mohsin Tiwana

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Traffic congestion has been increasing significantly in major metropolitan areas as a result of increased motorization, urbanization, population growth and changes in the urban density. Traffic congestion compromises efficiency of transport infrastructure and causes multiple traffic concerns; including but not limited to increase of travel time, safety hazards, air pollution, and fuel consumption. Traffic management has become a serious challenge for federal and provincial governments, as well as exasperated commuters. Effective, flexible, efficient and user-friendly traffic information/database management systems characterize traffic conditions by making use of traffic counts for storage, processing, and visualization. While, the emerging data collection technologies continue to proliferate, its accuracy can be guaranteed through the comparison of observed data with the manual handheld counters. This paper presents the design of tablet based manual traffic counting application and framework for development of traffic database management system for Pakistan. The database management system comprises of three components including traffic counting android application; establishing online database and its visualization using Google maps. Oracle relational database was chosen to develop the data structure whereas structured query language (SQL) was adopted to program the system architecture. The GIS application links the data from the database and projects it onto a dynamic map for traffic conditions visualization. The traffic counting device and example of a database application in the real-world problem provided a creative outlet to visualize the uses and advantages of a database management system in real time. Also, traffic data counts by means of handheld tablet/ mobile application can be used for transportation planning and forecasting.

Keywords: manual count, emerging data sources, traffic information quality, traffic surveillance, traffic counting device, android; data visualization, traffic management

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1193 Effect of the Community Chair-Based Exercise Programme on the Balance of the Elderly in Hong Kong

Authors: Wai Sang Wu, Florence Pik Sze Mok

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Introduction: Ageing population is one of the hot topics nowadays in the world and this phenomenon is believed to exacerbate continuously in the future. According to the latest information from World Health Organization (WHO) in 2016, the proportion of people aged more than 60 years is projected to be doubled from 12% in 2015 to 22% in 2050 of the world's population. Similarly, according to figures released by the Census and Statistic Department of Hong Kong in 2015, the contribution of elderly aged more than 65 years olds is projected to increase from 15% in 2014 to 34% in 2064 in local community. On the other hand, falls in elderly is a common problem, and it can bring along many negative consequences among elders, such as reducing their mobility level as well as their quality of life. In addition, it can also increase the caring stress of their family caregivers and as well increase the reliance and burden on the medical care system of Hong Kong. Therefore, appropriate measures should be implemented in order to minimize the risk of fall among elders. The objective of this study is to evaluate the effectiveness of the chair-based exercise programme in affecting the balance of the elderly in Hong Kong. Methods: Thirteen healthy subjects (males = 2; females = 11; mean age: 76.2 ± 7.8 years old) were recruited from an elderly social centre in the community to participate in a structural chair-based exercise programme for 6 weeks (1 session per week; 60-minutes per session). Subjects were being assessed on their balance ability using three commonly used clinical assessments, namely, 1) single leg stance (SLS) test, 2) functional reach test, and 3) 360-degree turn test, before and after their participation in the chair-based exercise programme. Pre and post within-subject comparison was adopted to assess the effectiveness of the programme. Results: There was significant improvement (p < 0.05) in all balance parameters of the subjects after their participation in the exercise programme. Elderly demonstrated significant improvement in SLS (p < 0.012), functional reach (p < 0.030) and 360 degree turn (p < 0.043). Conclusions: This study showed that a community chair-based exercise programme is effective in improving the balance ability of the elders. It seems to be another exercise regime that should be promoted among the elders in order to minimize their risk of falls and its negative consequence.

Keywords: balance, chair-based exercise programme, community, elderly

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1192 Reliability and Maintainability Optimization for Aircraft’s Repairable Components Based on Cost Modeling Approach

Authors: Adel A. Ghobbar

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The airline industry is continuously challenging how to safely increase the service life of the aircraft with limited maintenance budgets. Operators are looking for the most qualified maintenance providers of aircraft components, offering the finest customer service. Component owner and maintenance provider is offering an Abacus agreement (Aircraft Component Leasing) to increase the efficiency and productivity of the customer service. To increase the customer service, the current focus on No Fault Found (NFF) units must change into the focus on Early Failure (EF) units. Since the effect of EF units has a significant impact on customer satisfaction, this needs to increase the reliability of EF units at minimal cost, which leads to the goal of this paper. By identifying the reliability of early failure (EF) units with regards to No Fault Found (NFF) units, in particular, the root cause analysis with an integrated cost analysis of EF units with the use of a failure mode analysis tool and a cost model, there will be a set of EF maintenance improvements. The data used for the investigation of the EF units will be obtained from the Pentagon system, an Enterprise Resource Planning (ERP) system used by Fokker Services. The Pentagon system monitors components, which needs to be repaired from Fokker aircraft owners, Abacus exchange pool, and commercial customers. The data will be selected on several criteria’s: time span, failure rate, and cost driver. When the selected data has been acquired, the failure mode and root cause analysis of EF units are initiated. The failure analysis approach tool was implemented, resulting in the proposed failure solution of EF. This will lead to specific EF maintenance improvements, which can be set-up to decrease the EF units and, as a result of this, increasing the reliability. The investigated EFs, between the time period over ten years, showed to have a significant reliability impact of 32% on the total of 23339 unscheduled failures. Since the EFs encloses almost one-third of the entire population.

Keywords: supportability, no fault found, FMEA, early failure, availability, operational reliability, predictive model

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1191 Determination of the Vaccine Induced Immunodominant Regions of Nucleoprotein Crimean-Congo Hemorrhagic Fever Virus

Authors: Engin Berber, Nurettin Canakoglu, Ibrahim Sozdutmaz, Merve Caliskan, Shaikh Terkis Islam Pavel, Hazel Yetiskin, Aykut Ozdarendeli

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Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne virus in the family Bunyaviridae, genus Nairovirus. The CCHFV genome consists of three molecules of negative-sense single-stranded RNA, each encapsulated separately. The virion particle contains viral RNA polymerase (L segment), surface glycoproteins Gn and Gc (Msegment), and a nucleocapsid protein NP (S segment). CCHF is characterized by high case mortality, occurring in Asia, Africa, the Middle East and Eastern Europe. Clinical CCHF was first recognized in Turkey in 2002. The numbers of CCHF cases have gradually increased in Turkey making the virus a public health concern. Between 2002 and 2014, more than 8000 the CCHF cases have been reported in Turkey and mortality rate is around 5%. So, Turkey is one of the countries where the epidemy has become spread to the wider geography and the biggest outbreaks of CCHF have occurred in the world. We have recently developed an inactivated cell-culture based vaccine against CCHF. We have showed that the Balb/c mice immunized with the CCHF vaccine induced the high level of neutralizing antibodies. In this study, we aimed to determine the immunodominant regions of nucleoprotein (NP) CCHFV Kelkit06 strain which stimulate T cells. For this purpose, pools of overlapping NP were used for an IFN- γ ELISPOT assay. Balb/c mice were divided into two groups for the experiment. Two groups (n = 10 each) were immunized via the intraperitoneal route with 5, or 10μg of the cell culture-based vaccine. The control group (n = 6) was mock immunized with PBS. Booster injections with the same formulation were given on days 21 and 42 after the first immunization. The higher reactivity against the CCHFV NP pools 31-40 and 80-90 was determined in the two dose groups. In order to analyze the vaccine-induced T cell responses in Balb/c mice immunized with varying doses of the vaccine, we have been also currently working on CD4+, CD8+ and CD3 + T cells by flow cytometry.

Keywords: Crimean-Congo hemorrhagic fever virus, immunodominant regions of NP, T cell response, vaccine

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1190 SARS-CoV-2: Prediction of Critical Charged Amino Acid Mutations

Authors: Atlal El-Assaad

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Viruses change with time through mutations and result in new variants that may persist or disappear. A Mutation refers to an actual change in the virus genetic sequence, and a variant is a viral genome that may contain one or more mutations. Critical mutations may cause the virus to be more transmissible, with high disease severity, and more vulnerable to diagnostics, therapeutics, and vaccines. Thus, variants carrying such mutations may increase the risk to human health and are considered variants of concern (VOC). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - the contagious in humans, positive-sense single-stranded RNA virus that caused coronavirus disease 2019 (COVID-19) - has been studied thoroughly, and several variants were revealed across the world with their corresponding mutations. SARS-CoV-2 has four structural proteins, known as the S (spike), E (envelope), M (membrane), and N (nucleocapsid) proteins, but prior study and vaccines development focused on genetic mutations in the S protein due to its vital role in allowing the virus to attach and fuse with the membrane of a host cell. Specifically, subunit S1 catalyzes attachment, whereas subunit S2 mediates fusion. In this perspective, we studied all charged amino acid mutations of the SARS-CoV-2 viral spike protein S1 when bound to Antibody CC12.1 in a crystal structure and assessed the effect of different mutations. We generated all missense mutants of SARS-CoV-2 protein amino acids (AAs) within the SARS-CoV-2:CC12.1 complex model. To generate the family of mutants in each complex, we mutated every charged amino acid with all other charged amino acids (Lysine (K), Arginine (R), Glutamic Acid (E), and Aspartic Acid (D)) and studied the new binding of the complex after each mutation. We applied Poisson-Boltzmann electrostatic calculations feeding into free energy calculations to determine the effect of each mutation on binding. After analyzing our data, we identified charged amino acids keys for binding. Furthermore, we validated those findings against published experimental genetic data. Our results are the first to propose in silico potential life-threatening mutations of SARS-CoV-2 beyond the present mutations found in the five common variants found worldwide.

Keywords: SARS-CoV-2, variant, ionic amino acid, protein-protein interactions, missense mutation, AESOP

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1189 Tracing the Courtyard Typology from the Past: Highlighting a Need for Conservation in Case of Historic Settlement in Historic Town of Gwalior

Authors: Shivani Dolas, A. Richa Mishra

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The existence of Courtyards in India can be traced back to ‘Indus valley civilization’ and various layers of history bearing implications like socio-cultural, traditional, religious, climatic, etc., moreover serving as a breathing space in case of historical core areas. Over time, with the overlay of various historic layers within the historic urban cores and the present high density populace, the cores are getting congested day by day. In this case, courtyards may emerge out as an efficient medium to provide quality of life through livable spaces. Presently, with the growing population of the historic town of Gwalior, town in Madhya Pradesh holds remarkable essence of courtyards with its multiple concepts over time. Its scale and function varies from an imposing grand appearance in palatial form, up to functional practices as residential. Its privilege can also be drawn in urban forms, in sharing single space by multiple dwellings and in temples which can be sketched specifically in the region. Moreover, the effectiveness of courtyards has proven balance and control of micro-climate in such composite climate region. The research paper aims to underline the concept of courtyards in case of a mixed use neighborhood, Naya bazar, in Lashkar area of Gwalior, which developed during 19th century, highlighting the need of its preservation. The paper also elaborates its various implications on user-space relationship as in the present context, and growing congestion in the area, user and space relationship is seen lost. The noticeable change in the behavioral context in buildings and users can be noticed with the downfall of courtyards, isolating users with land. Also, a concern has been expressed on negligence of courtyard planning in future development, suggesting recommendations on preserving the courtyard typology as heritage.

Keywords: courtyards, Gwalior, historic settlement, heritage

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1188 Exploring Strategies Used by Victims of Intimate Partner Violence to Increase Sense of Safety: A Systematic Review and Quantitative Study

Authors: Thomas Nally, Jane Ireland, Roxanne Khan, Philip Birch

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Intimate Partner Violence (IPV), a significant societal problem, affects individuals worldwide. However, the strategies victims use to keep safe are under-researched. IPV is significantly under-reported, and services often are not able to be accessed by all victims. Thus they are likely to use their own strategies to manage their victimization before being able to seek support. Two studies were completed to understand these strategies. A systematic review of the literature and study completed with professionals who work with victims was undertaken to understand this area. In study one, a systematic review of the literature (n=61 papers), were analyzed using Thematic Analysis. The results indicated that victims use a large array of behaviors to increase their sense of safety and coping with emotions but also experience significant barriers to help-seeking. In study 2, sixty-nine professionals completed a measure exploring the likelihood and effectiveness of various victim strategies regarding increasing their sense of safety. Strategies included in the measure were obtained from those identified in study 1. Findings indicated that professionals perceived victims of IPV to be more likely to employ safety strategies and coping behaviors that may be ineffective but not help-seeking behaviors. Further, the responses were analyzed using Cluster Analysis. Safety strategies resulted in five clusters; perpetrator-directed strategies, prevention strategies, cognitive reappraisal, safety planning and avoidance strategies. Help-Seeking resulted in six clusters; information or practical support, abuse-related support, emotional support, secondary support and informal support. Finally, coping resulted in four clusters; emotional coping, self-directed coping, thought recording/change and cognitive coping. Both studies indicate that victims may use a variety of strategies to manage their safety besides seeking help. Professionals working with victims, using a strength-based approach, should understand what is used and is effective for victims who are unable to leave the relationships or access external support.

Keywords: intimate partner violence, help-seeking, professional support, victims, victim coping, victim safety

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1187 Spatiotemporal Variability in Rainfall Trends over Sinai Peninsula Using Nonparametric Methods and Discrete Wavelet Transforms

Authors: Mosaad Khadr

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Knowledge of the temporal and spatial variability of rainfall trends has been of great concern for efficient water resource planning, management. In this study annual, seasonal and monthly rainfall trends over the Sinai Peninsula were analyzed by using absolute homogeneity tests, nonparametric Mann–Kendall (MK) test and Sen’s slope estimator methods. The homogeneity of rainfall time-series was examined using four absolute homogeneity tests namely, the Pettitt test, standard normal homogeneity test, Buishand range test, and von Neumann ratio test. Further, the sequential change in the trend of annual and seasonal rainfalls is conducted using sequential MK (SQMK) method. Then the trend analysis based on discrete wavelet transform technique (DWT) in conjunction with SQMK method is performed. The spatial patterns of the detected rainfall trends were investigated using a geostatistical and deterministic spatial interpolation technique. The results achieved from the Mann–Kendall test to the data series (using the 5% significance level) highlighted that rainfall was generally decreasing in January, February, March, November, December, wet season, and annual rainfall. A significant decreasing trend in the winter and annual rainfall with significant levels were inferred based on the Mann-Kendall rank statistics and linear trend. Further, the discrete wavelet transform (DWT) analysis reveal that in general, intra- and inter-annual events (up to 4 years) are more influential in affecting the observed trends. The nature of the trend captured by both methods is similar for all of the cases. On the basis of spatial trend analysis, significant rainfall decreases were also noted in the investigated stations. Overall, significant downward trends in winter and annual rainfall over the Sinai Peninsula was observed during the study period.

Keywords: trend analysis, rainfall, Mann–Kendall test, discrete wavelet transform, Sinai Peninsula

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1186 Agricultural Organized Areas Approach for Resilience to Droughts, Nutrient Cycle and Rural and Wild Fires

Authors: Diogo Pereira, Maria Moura, Joana Campos, João Nunes

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As the Ukraine war highlights the European Economic Area’s vulnerability and external dependence on feed and food, agriculture gains significant importance. Transformative change is necessary to reach a sustainable and resilient agricultural sector. Agriculture is an important drive for bioeconomy and the equilibrium and survival of society and rural fires resilience. The pressure of (1) water stress, (2) nutrient cycle, and (3) social demographic evolution towards 70% of the population in Urban systems and the aging of the rural population, combined with climate change, exacerbates the problem and paradigm of rural and wildfires, especially in Portugal. The Portuguese territory is characterized by (1) 28% of marginal land, (2) the soil quality of 70% of the territory not being appropriate for agricultural activity, (3) a micro smallholding, with less than 1 ha per proprietor, with mainly familiar and traditional agriculture in the North and Centre regions, and (4) having the most vulnerable areas for rural fires in these same regions. The most important difference between the South, North and Centre of Portugal, referring to rural and wildfires, is the agricultural activity, which has a higher level in the South. In Portugal, rural and wildfires represent an average annual economic loss of around 800 to 1000 million euros. The WinBio model is an agrienvironmental metabolism design, with the capacity to create a new agri-food metabolism through Agricultural Organized Areas, a privatepublic partnership. This partnership seeks to grow agricultural activity in regions with (1) abandoned territory, (2) micro smallholding, (3) water and nutrient management necessities, and (4) low agri-food literacy. It also aims to support planning and monitoring of resource use efficiency and sustainability of territories, using agriculture as a barrier for rural and wildfires in order to protect rural population.

Keywords: agricultural organized areas, residues, climate change, drought, nutrients, rural and wild fires

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1185 Septin 11, Cytoskeletal Protein Involved in the Regulation of Lipid Metabolism in Adipocytes

Authors: Natalia Moreno-Castellanos, Amaia Rodriguez, Gema Frühbeck

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Introduction: In adipocytes, the cytoskeleton undergoes important expression and distribution in adipocytes rearrangements during adipogenesis and in obesity. Indeed, a role for these proteins in the regulation of adipocyte differentiation and response to insulin has been demonstrated. Recently, septins have been considered as new components of the cytoskeletal network that interact with other cytoskeletal elements (actin and tubulin) profoundly modifying their dynamics. However, these proteins have not been characterized as yet in adipose tissue. In this work, were examined the cellular, molecular and functional features of a member of this family, septin 11 (SEPT11), in adipocytes and evaluated the impact of obesity on the expression of this protein in human adipose tissue. Methods: Adipose gene and protein expression levels of SEPT11 were analysed in human samples. SEPT11 distribution was evaluated by immunocytochemistry, electronic microscopy, and subcellular fractionation techniques. GST-pull down, immunoprecipitation and a Yeast-Two Hybrid (Y2H) screening were used to identify the SEPT11 interactome. Gene silencing was employed to assess the role of SEPT11 in the regulation of insulin signaling and lipid metabolism in adipocytes. Results: SEPT11 is expressed in human adipocytes, and its levels increased in both omental and subcutaneous adipose tissue in obesity, with SEPT11 mRNA content positively correlating with parameters of insulin resistance in subcutaneous fat. In non-stimulated adipocytes, SEPT11 immunoreactivity showed a ring-like distribution at the cell surface and associated to caveolae. Biochemical analyses showed that SEPT11 interacted with the main component of caveolae, caveolin-1 (CAV1) as well as with the fatty acid-binding protein, FABP5. Notably, the three proteins redistributed and co-localized at the surface of lipid droplets upon exposure of adipocytes to oleate. In this line, SEPT11 silencing in 3T3-L1 adipocytes impaired insulin signaling and decreased insulin-induced lipogenesis. Conclusions: Those findings demonstrate that SEPT11 is a novel component of the adipocyte cytoskeleton that plays an important role in the regulation of lipid traffic, metabolism and can thus represent a potential biomarker of insulin resistance in obesity in adipocytes through its interaction with both CAV1 and FABP5.

Keywords: caveolae, lipid metabolism, obesity, septins

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1184 Educational Sport and Quality of Life for Children and Teenagers from Brazilian Northeast

Authors: Ricardo Hugo Gonzalez, Amanda Figueiredo Vasconcelos, Francisco Loureiro Neto Monteiro, Yara Luiza Freitas Silva, Ana Cristina Lindsay, Márcia Maria Tavares Machado

Abstract:

The use of sport as an integration mean is a very important tool regarding the social involvement of children and teenagers in a vulnerability situation. This study aims to report the experiences of a multidisciplinary program that intends to improve the quality of life of children and teenagers in Fortaleza, in the Northeast of Brazil. More than 400 children and teenagers aging 11 and 16 years participated in this study. Poor communities experience many particular difficulties in the urban centers such as violence, poor housing conditions, unemployment, lack in health care and deficient physical education in school. Physical education, physiotherapy, odontology, medicine and pharmacy students are responsible for the activities in the project supervised by a general coordinator and a counselor teacher of each academic unit. There are classes about team sports like basketball and soccer. Lectures about sexual behavior and sexually transmitted diseases are ministered beside the ones about oral health education, basic life support education, first aids, use and care with pharmaceuticals and orientations about healthy nutrition. In order to get the children’s family closer, monthly informative lectures are ministered. There is also the concern about reflecting the actions and producing academic paperwork such as graduation final projects and books. The number of participants has oscillated lately, and one of the causes is the lack of practicing physical activities and sports regularly. However, 250 teenagers have participated regularly for at least two years. These teenagers have shown a healthier lifestyle and a better physical fitness profile. The resources for maintaining the project come from the Pro-Reitoria of Extension, Federal University of Ceara, as well as from the PROEXT/MEC, Federal Government. Actions of this nature need to be done thinking for long periods so the effects results can become effective. Public and private investments are needed due to low socioeconomic families who are most vulnerable and have fewer opportunities to enhance to health prevention services.

Keywords: children and teenagers, health, multidisciplinary program, quality of life

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1183 Study of Land Use Changes around an Archaeological Site Using Satellite Imagery Analysis: A Case Study of Hathnora, Madhya Pradesh, India

Authors: Pranita Shivankar, Arun Suryawanshi, Prabodhachandra Deshmukh, S. V. C. Kameswara Rao

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Many undesirable significant changes in landscapes and the regions in the vicinity of historically important structures occur as impacts due to anthropogenic activities over a period of time. A better understanding of such influences using recently developed satellite remote sensing techniques helps in planning the strategies for minimizing the negative impacts on the existing environment. In 1982, a fossilized hominid skull cap was discovered at a site located along the northern bank of the east-west flowing river Narmada in the village Hathnora. Close to the same site, the presence of Late Acheulian and Middle Palaeolithic tools have been discovered in the immediately overlying pebbly gravel, suggesting that the ‘Narmada skull’ may be from the Middle Pleistocene age. The reviews of recently carried out research studies relevant to hominid remains all over the world from Late Acheulian and Middle Palaeolithic sites suggest succession and contemporaneity of cultures there, enhancing the importance of Hathnora as a rare precious site. In this context, the maximum likelihood classification using digital interpretation techniques was carried out for this study area using the satellite imagery from Landsat ETM+ for the year 2006 and Landsat TM (OLI and TIRS) for the year 2016. The overall accuracy of Land Use Land Cover (LULC) classification of 2016 imagery was around 77.27% based on ground truth data. The significant reduction in the main river course and agricultural activities and increase in the built-up area observed in remote sensing data analysis are undoubtedly the outcome of human encroachments in the vicinity of the eminent heritage site.

Keywords: cultural succession, digital interpretation, Hathnora, Homo Sapiens, Late Acheulian, Middle Palaeolithic

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1182 A Case-Control Study on Dietary Heme/Nonheme Iron and Colorectal Cancer Risk

Authors: Alvaro L. Ronco

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Background and purpose: Although our country is a developing one, it has a typical Western meat-rich dietary style. Based on estimates of heme and nonheme iron contents in representative foods, we carried out the present epidemiologic study, with the aim of accurately analyzing dietary iron and its role on CRC risk. Subjects/methods: Patients (611 CRC incident cases and 2394 controls, all belonging to public hospitals of our capital city) were interviewed through a questionnaire including socio-demographic, reproductive and lifestyle variables, and a food frequency questionnaire of 64 items, which asked about food intake 5 years before the interview. The sample included 1937 men and 1068 women. Controls were matched by sex and age (± 5 years) to cases. Food-derived nutrients were calculated from available databases. Total dietary iron was calculated and classified by heme or nonheme source, following data of specific Dutch and Canadian studies, and additionally adjusted by energy. Odds Ratios (OR) and 95% confidence intervals were calculated through unconditional logistic regression, adjusting for relevant potential confounders (education, body mass index, family history of cancer, energy, infusions, and others). A heme/nonheme (H/NH) ratio was created and the interest variables were categorized into tertiles, for analysis purposes. Results: The following risk estimations correspond to the highest tertiles. Total iron intake showed no association with CRC risk neither among men (OR=0.83, ptrend =.18) nor among women (OR=1.48, ptrend =.09). Heme iron was positively associated among men (OR=1.88, ptrend < .001) and for the overall sample (OR=1.44, ptrend =.002), however, it was not associated among women (OR=0.91, ptrend =.83). Nonheme iron showed an inverse association among men (OR=0.53, ptrend < .001) and the overall sample (OR=0.78, ptrend =.04), but was not associated among women (OR=1.46, ptrend =.14). Regarding H/NH ratio, risks increased only among men (OR=2.12, ptrend < .001) but lacked of association among women (OR=0.81, ptrend =.29). Conclusions. We have observed different types of associations between CRC risk and high dietary heme, nonheme and H/NH iron ratio. Therefore, the source of the available iron might be of importance as a link to colorectal carcinogenesis, perhaps pointing to reconsider the animal/plant proportions of this vital mineral within diet. Nevertheless, the different associations observed for each sex, demand further studies in order to clarify these points.

Keywords: chelation, colorectal cancer, heme, iron, nonheme

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1181 Implementing Effective Strategies to Improve Teaching and Learning in Higher Education: Balancing the Engagement Acts between Lecturers And Students

Authors: Jeffrey Siphiwe Mkhize

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Twelve years of schooling for most South African children, particularly those children from disadvantaged past, are confronted with numerous and diverse challenges. These challenges range from infrastructural limitations, language of teaching, poor resources and varying family backgrounds. Likewise, schools are categorized to signify schools’ geographic location, poverty lines, societal class and type of students that the school are likely to enroll. Such categorization perpetuates particular lines of identities that are indirectly reinforced by the same system that seeks to redress. South African universities prefer point systems to determine students’ suitability to gain access to their programmes. Once students are admitted based on the qualifying points there is an assumed equity in the manner in which they receive tuition. They are assumed as equal; noting the widened access to South African universities as means to redress past inequalities. Given the challenges, inequalities, it is necessary to view higher education as a site for knowledge construction that is accessible to all students. Epistemological access is key to all students irrespective of their socio-economic status. This paper seeks to contribute to the discourse of student engagement using lecturer-student relationship as a lens to understand this phenomenon. Data were generated using South African Survey of Student Engagement, focus group interviews, semi-structured one-on-one-interviews as well as document analysis. The focus was on students registered for the first year of a Bachelor of Education degree as well as lecturers that teach high risk modules in this qualification at the same level. The findings suggest that lecturers are challenged by overcrowded classrooms and over-enrolled modules; this challenge hampers their good intentions to become more efficient and innovative in their teaching. Students lack confidence in approaching lecturers for assistance. Collaborative learning has stronger results and students believe in self-support to deal with their challenges based on their individual strengths. Collaborative learning is key to student academic performance.

Keywords: collaborative learning, consultations, student engagement, student performance

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1180 Reducing the Incidence Rate of Pressure Sore in a Medical Center in Taiwan

Authors: Chang Yu Chuan

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Background and Aim: Pressure sore is not only the consequence of any gradual damage of the skin leading to tissue defects but also an important indicator of clinical care. If hospitalized patients develop pressure sores without proper care, it would result in delayed healing, wound infection, increase patient physical pain, prolonged hospital stay and even death, which would have a negative impact on the quality of care and also increase nursing manpower and medical costs. This project is aimed at decreasing the incidence of pressure sore in one ward of internal medicine. Our data showed 53 cases (0.61%) of pressure sore in 2015, which exceeded the average (0.5%) of Taiwan Clinical Performance Indicator (TCPI) for medical centers. The purpose of this project is to reduce the incidence rate of pressure sore in the ward. After data collection and analysis from January to December 2016, the reasons of developing pressure sore were found: 1. Lack of knowledge to prevent pressure among nursing staffs; 2. No relevant courses about preventing pressure ulcers and pressure wound care being held in this unit; 3. Low complete rate of pressure sore care education that family members should receive from nursing staffs; 4. Decompression equipment is not enough; 5. Lack of standard procedures for body-turning and positioning care. After team members brainstorming, several strategies were proposed, including holding in-service education, pressure sore care seed training, purchasing decompression mattress and memory pillows, designing more elements of health education tools, such as health education pamphlet, posters and multimedia films of body-turning and positioning demonstration, formulation and promotion of standard operating procedures. In this way, nursing staffs can understand the body-turning and positioning guidelines for pressure sore prevention and enhance the quality of care. After the implementation of this project, the pressure sore density significantly decreased from 0.61%(53 cases) to 0.45%(28 cases) in this ward. The project shows good results and good example for nurses working at the ward and helps to enhance quality of care.

Keywords: body-turning and positioning, incidence density, nursing, pressure sore

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1179 Development of Two Phage Therapy-Based Strategies for the Treatment of American Foulbrood Disease Affecting Apis Mellifera capensis

Authors: Ridwaan N. Milase, Leonardo J. Van Zyl, Marla Trindade

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American foulbrood (AFB) is the world’s most devastating honeybee disease that has drastically reduced the population of Apis mellifera capensis since 2009. The outbreak has jeopardized the South African bee keeping industry as well as the agricultural sector dependent on honeybees for honey production and pollination, leading to significant economic losses. AFB is caused by Paenibacillus larvae, a spore-forming, Gram positive facultative anaerobic and flagellated bacterium. The use of antibiotics within beehives has selected for resistant strains of P. larvae, while the current practice of burning spore contaminated beehives and equipment contributes to the economic losses in the honeybee-keeping industry. Therefore, phage therapy is proposed as a promising alternative to combat P. larvae strains affecting A. mellifera capensis. The genomes of two P. larvae strains isolated from infected combs in the Western Cape have been sequenced and annotated using bioinformatics tools. Genome analyses has revealed that these P. larvae strains are lysogens to more than 6 different prophages and possess different type of clustered regularly interspaced short palindromic repeat (CRISPRs) regions per strain. Active prophages from one of the two P. larvae strains were detected and identified using PCR. Electron microscopy was used to determine the family of the identified active prophages. Lytic bacteriophages that specifically target the two P. larvae strains were purified from sewage wastewater, beehive materials, and soil samples to investigate their potential development as anti-P. larvae agents. Another alternative treatment being investigated is the development of a prophage endolysin cocktail. Endolysin genes of the prophages have been targeted, cloned and expressed in Escherichia coli. The heterologously expressed endolysins have been purified and are currently being assessed for their lytic activity against P. larvae strains and other commensal microorganisms that compose the honeybee larvae microbiota. The study has shown that phage therapy and endolysins have a great potential as alternative control methods for AFB disease affecting A. mellifera capensis.

Keywords: American foulbrood, bacteriophage, honeybee, Paenibacillus larvae

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1178 Development of Power System Stability by Reactive Power Planning in Wind Power Plant With Doubley Fed Induction Generators Generator

Authors: Mohammad Hossein Mohammadi Sanjani, Ashknaz Oraee, Oriol Gomis Bellmunt, Vinicius Albernaz Lacerda Freitas

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The use of distributed and renewable sources in power systems has grown significantly, recently. One the most popular sources are wind farms which have grown massively. However, ¬wind farms are connected to the grid, this can cause problems such as reduced voltage stability, frequency fluctuations and reduced dynamic stability. Variable speed generators (asynchronous) are used due to the uncontrollability of wind speed specially Doubley Fed Induction Generators (DFIG). The most important disadvantage of DFIGs is its sensitivity to voltage drop. In the case of faults, a large volume of reactive power is induced therefore, use of FACTS devices such as SVC and STATCOM are suitable for improving system output performance. They increase the capacity of lines and also passes network fault conditions. In this paper, in addition to modeling the reactive power control system in a DFIG with converter, FACTS devices have been used in a DFIG wind turbine to improve the stability of the power system containing two synchronous sources. In the following paper, recent optimal control systems have been designed to minimize fluctuations caused by system disturbances, for FACTS devices employed. For this purpose, a suitable method for the selection of nine parameters for MPSH-phase-post-phase compensators of reactive power compensators is proposed. The design algorithm is formulated ¬¬as an optimization problem searching for optimal parameters in the controller. Simulation results show that the proposed controller Improves the stability of the network and the fluctuations are at desired speed.

Keywords: renewable energy sources, optimization wind power plant, stability, reactive power compensator, double-feed induction generator, optimal control, genetic algorithm

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1177 Prevalence and Correlates of Mental Disorders in Children and Adolescents in Mendefera Community, Eritrea

Authors: Estifanos H. Zeru

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Introduction: Epidemiological research is important to draw need-based rational public health policy. However, research on child and adolescent mental health in low and middle income countries, where socioeconomic, political, cultural, biological and other mental health hazards are in abundance, is almost nonexistent. To the author's knowledge, there is no published research in this field in Eritrea, whose child and adolescent population constitutes 53% of its total population. Study Aims and Objectives: The objective of this study was to determine the prevalence and patterns of DSM-IV psychiatric disorders and identify their socio-demographic correlates among children and adolescents in Mendefera, Eritrea. The study aims to provide local information to public health policymakers to guide policy in service development. Methodology: In a cross-sectional two stage procedure, both the Parent and Child versions of the SDQ were used to screen 314 children and adolescents aged 4-17 years, recruited by a multi-stage random sampling method. All parents/adult guardians also completed a socio-demographic questionnaire. All children and adolescents who screened positive for any of the SDQ abnormality sub-classes were selected for the second stage interview, which was conducted using the K-SADS-PL 2009 Working Draft version to generate specific DSM-IV diagnoses. All data gathered was entered into CSPro version 6.2 and was then transported in to and analyzed using SPSS version 20 for windows. Results: Prevalence of DSM-IV psychiatric disorders was found to be 13.1%. Adolescents 11-17 years old and males had higher prevalence than children 4-10 years old and females, respectively. Behavioral disorders were the commonest disorders (9.9%), followed by affective disorders (3.2%) and anxiety disorders (2.5). Chronic medical illness in the child, poor academic performance, difficulties with teachers in school, psychopathology in a family member and parental conflict were found to be independently associated with these disorders. Conclusion: Prevalence of child and adolescent psychiatric disorders in Eritrea is high. Promotion, prevention, treatment, and rehabilitation for child and adolescent mental health services need to be made widely available in the country. The socio-demographic correlates identified by this study can be targeted for intervention. The need for further research is emphasized.

Keywords: adolescents, children, correlates, DSM-IV psychiatric disorders, Eritrea, K-SAD-PL 2009, prevalence and correlates, SDQ

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1176 Split Health System for Diabetes Care in Urban Area: Experience from an Action Research Project in an Urban Poor Neighborhood in Bengaluru

Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna

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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.

Keywords: diabetes care, disintegrated health system, quality of care, urban health

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1175 Rare DCDC2 Mutation Causing Renal-Hepatic Ciliopathy

Authors: Atitallah Sofien, Bouyahia Olfa, Attar Souleima, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Ciliopathies are a spectrum of diseases that have in common a defect in the synthesis of ciliary proteins. It is a rare cause of neonatal cholestasis. Clinical presentation varies extremely, and the main affected organs are the kidneys, liver, and pancreas. Methodology: This is a descriptive case report of a newborn who was admitted for exploration of neonatal cholestasis in the Paediatric Department C at the Children’s Hospital of Tunis, where the investigations concluded with a rare genetic mutation. Results: This is the case of a newborn male with no family history of hepatic and renal diseases, born to consanguineous parents, and from a well-monitored uneventful pregnancy. He developed jaundice on the second day of life, for which he received conventional phototherapy in the neonatal intensive care unit. He was admitted at 15 days for mild bronchiolitis. On clinical examination, intense jaundice was noted with normal stool and urine colour. Initial blood work showed an elevation in conjugated bilirubin and a high gamma-glutamyl transferase level. Transaminases and prothrombin time were normal. Abdominal sonography revealed hepatomegaly, splenomegaly, and undifferentiated renal cortex with bilateral medullar micro-cysts. Kidney function tests were normal. The infant received ursodeoxycholic acid and vitamin therapy. Genetic testing showed a homozygous mutation in the DCDC2 gene that hadn’t been documented before confirming the diagnosis of renal-hepatic ciliopathy. The patient has regular follow-ups, and his conjugated bilirubin and gamma-glutamyl transferase levels have been decreasing. Conclusion: Genetic testing has revolutionized the approach to etiological diagnosis in pediatric cholestasis. It enables personalised treatment strategies to better enhance the quality of life of patients and prevent potential complications following adequate long-term monitoring.

Keywords: cholestasis, newborn, ciliopathy, DCDC2, genetic

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1174 Hybrid Speciation and Morphological Differentiation in Senecio (Senecioneae, Asteraceae) from the Andes

Authors: Luciana Salomon

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The Andes hold one of the highest plant species diversity in the world. How such diversity originated is one of the most intriguing questions in studies addressing the pattern of plant diversity worldwide. Recently, the explosive adaptive radiations found in high Andean groups have been pointed as major triggers of this spectacular diversity. The Andes are one of the most species-rich area for the largest genus from the Asteraceae family, Senecio. There, the genus presents an incredible variation in growth form and ecological niche space. If this diversity of Andean Senecio can be explained by a monophyletic origin and subsequent radiation has not been tested up to now. Previous studies trying to disentangle the evolutionary history of some Andean Senecio struggled with the relatively low resolution and support of the phylogenies, which is indicative of recently radiated groups. Using Hyb-Seq, a powerful approach is available to address phylogenetic questions in groups whose evolutionary histories are recent and rapid. This approach was used for Senecio to build a phylogenetic backbone on which to study the mechanisms shaping its hyper-diversity in the Andes, focusing on Senecio ser. Culcitium, an exclusively Andean and well circumscribed group presenting large morphological variation and which is widely distributed across the Andes. Hyb-Seq data for about 130 accessions of Seneciowas generated. Using standard data analysis work flows and a newly developed tool to utilize paralogs for phylogenetic reconstruction, robustness of the species treewas investigated. Fully resolved and moderately supported species trees were obtained, showing Senecio ser. Culcitium as monophyletic. Within this group, some species formed well-supported clades congruent with morphology, while some species would not have exclusive ancestry, in concordance with previous studies showing a geographic differentiation. Additionally, paralogs were detected for a high number of loci, indicating duplication events and hybridization, known to be common in Senecio ser. Culcitium might have lead to hybrid speciation. The rapid diversification of the group seems to have followed a south-north distribution throughout the Andes, having accelerated in the conquest of new habitats more recently available: i.e., Montane forest, Paramo, and Superparamo.

Keywords: evolutionary radiations, andes, paralogy, hybridization, senecio

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1173 Exploring the Relationship Between Life Experiences and Early Relapse Among Imprisoned Users of Illegal Drugs in Oman: A Focused Ethnography

Authors: Hamida Hamed Said Al Harthi

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Background: Illegal drug use is a rising problem that affects Omani youth. This research aimed to study a group of young Omani men who were imprisoned more than once for illegal drug use, focusing on exploring their lifestyle experiences inside and outside the prison and whether these contributed to their early relapse and re-imprisonment. This is the first study of its kind from Oman conducted in a prison setting. Methods: 19 Omani males aged 18–35 years imprisoned in Oman Central Prison were recruited using purposive sampling. Focused ethnography was conducted over 8 months to explore the drug-related experiences outside the prison and during imprisonment. Face-to-face semi-structured interviews with the participants yielded detailed transcripts and field notes. These were thematically analyzed, and the results were compared with the existing literature. Results: The participants’ voices yielded new insights into the lives of young Omani men imprisoned for illegal drug use, including their sufferings and challenges in prison. These included: entry shock, timing and boredom, drug trafficking in prison, as well as physical and psychological health issues. Overall, imprisonment was reported to have negatively impacted the participants’ health, personality, self-concept, emotions, attitudes, behavior and life expectations. The participants reported how their efforts to reintegrate into the Omani community after release from prison were rebuffed due to stigmatization and rejection from society and family. They also experienced frequent unemployment, police surveillance, accommodation problems and a lack of rehabilitation facilities. The immensity of the accumulated psychophysiological trauma contributed to their early relapse and re-imprisonment. Conclusion: This thesis concludes that imprisonment is largely ineffective in controlling drug use in Oman. Urgent action is required across multiple sectors to improve the lives and prospects of users of illegal drugs within and outside the prison to minimize factors contributing to early relapse. Key Words: illegal drugs, drug users, Oman, addiction, Omani culture, prisoners, relapse, re-imprisonment, qualitative research, ethnography.

Keywords: illigal drugs, Prison, Omani culture lifestyle, post prison life

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