Search results for: subjective appetite
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 764

Search results for: subjective appetite

284 Prevalence and Factors Associated With Concurrent Use of Herbal Medicine and Anti-retroviral Therapy Among HIV/Aids Patients Attending Selected HIV Clinics in Wakiso District

Authors: Nanteza Rachel

Abstract:

Background: Worldwide, there were 36.7 million people living with Human Immunodeficiency Virus (HIV) in 2015, up from 35 million at the end of 2013. Wakiso district is one of the hotspots for the Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) infection in Uganda, with the prevalence of 8.1 %. Herbal medicine has gained popularity among Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) patients as adjuvant therapy to reduce the adverse effects of ART. Regardless of the subsidized and physical availability of the Anti-Retroviral Therapy (ART), majority of Africans living with Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) resort to adding to their ART traditional medicine. Result found out from a pilot observation made by the PI that indicate 13 out of 30 People Living with AIDS(PLWA) who are attending Human Immunodeficiency Virus (HIV) clinics in Wakiso district reported to be using herbal preparations despite the fact that they were taking Anti Retro Viral (ARVs) this prompted this study to be done. Purpose of the study: To determine the prevalence and factors associated with concurrent use of herbal medicine and anti-retroviral therapy among HIV/AIDS patients attending selected HIV clinics in Wakiso district. Methodology: This was a cross sectional study with both quantitative data collection (use of a questionnaire) and qualitative data collection (key informants’ interviews). A mixed method of sampling was used, that is, purposive and random sampling. Purposive sampling was based on the location in the district and used to select 7 health facilities basing on the 7 health sub districts from Wakiso. Simple random sampling was used to select one HIV clinic from each of the 7 health sub districts. Furthermore, the study units were enrolled in to the study as they entered into the HIV clinics, and 105 respondents were interviewed. Both manual and computer packages (SPSS) were used to analyze the data Results: The prevalence of concurrent use of herbal medicine and ART was 38 (36.2%). Commonly HIV symptom treated with herbs was fever 27(71.1%), diarrhea 3(7.9%) and cough 2(5.3%). Commonly used herbs for fever (Omululuza (Vernonica amydalina), Ekigagi (Aloe sp), Nalongo (Justicia betonica Linn) while for diarrhea was Ntwatwa. The side effects also included; too much pain, itchy pain of HIV, aneamia,felt sick, loss/gain appetite, joint pain and bad dreams. Herbs used to sooth the side effects were; for aneamia was avocado leaves Parea Americana mill The significant factors associated with concurrent use of herbal medicine were being familiar with herbs and conventional medicine for management HIV symptoms being expensive. The other significant factor was exhibiting hostility to patients by health personnel providing HIV care. Conclusion: Herbal medicine is widely used by clients in HIV/AIDS care. Patients being familiar with herbs and conventional medicine being expensive were associated with concurrent use of herbal medicine and ART. The exhibition of hostility to the HIV/AIDS patients by the health care providers was also associated with concurrent use of herbal medicine and ART among HIV/AIDS patients.

Keywords: HIV patients, herbal medicine, antiretroviral therapy, factors associated

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283 An Inspection of Two Layer Model of Agency: An fMRI Study

Authors: Keyvan Kashkouli Nejad, Motoaki Sugiura, Atsushi Sato, Takayuki Nozawa, Hyeonjeong Jeong, Sugiko Hanawa , Yuka Kotozaki, Ryuta Kawashima

Abstract:

The perception of agency/control is altered with presence of discrepancies in the environment or mismatch of predictions (of possible results) and actual results the sense of agency might become altered. Synofzik et al. proposed a two layer model of agency: In the first layer, the Feeling of Agency (FoA) is not directly available to awareness; a slight mismatch in the environment/outcome might cause alterations in FoA, while the agent still feels in control. If the discrepancy passes a threshold, it becomes available to consciousness and alters Judgment of Agency (JoA), which is directly available in the person’s awareness. Most experiments so far only investigate subjects rather conscious JoA, while FoA has been neglected. In this experiment we target FoA by using subliminal discrepancies that can not be consciously detectable by the subjects. Here, we explore whether we can detect this two level model in the subjects behavior and then try to map this in their brain activity. To do this, in a fMRI study, we incorporated both consciously detectable mismatching between action and result and also subliminal discrepancies in the environment. Also, unlike previous experiments where subjective questions from the participants mainly trigger the rather conscious JoA, we also tried to measure the rather implicit FoA by asking participants to rate their performance. We compared behavioral results and also brain activation when there were conscious discrepancies and when there were subliminal discrepancies against trials with no discrepancies and against each other. In line with our expectations, conditions with consciously detectable incongruencies triggered lower JoA ratings than conditions without. Also, conditions with any type of discrepancies had lower FoA ratings compared to conditions without. Additionally, we found out that TPJ and angular gyrus in particular to have a role in coding of JoA and also FoA.

Keywords: agency, fMRI, TPJ, two layer model

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282 Assessment of Sleep Disorders in Moroccan Women with Gynecological Cancer: Cross-Sectional Study

Authors: Amina Aquil, Abdeljalil El Got

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Background: Sleep quality is one of the most important indicators related to the quality of life of patients suffering from cancer. Many factors could affect this quality of sleep and then be considered as associated predictors. Methods: The aim of this study was to assess the prevalence of sleep disorders and the associated factors with impaired sleep quality in Moroccan women with gynecological cancer. A cross-sectional study was carried out within the oncology department of the Ibn Rochd University Hospital, Casablanca, on Moroccan women who had undergone radical surgery for gynecological cancer (n=100). Translated and validated Arabic versions of the following international scales were used: Pittsburgh sleep quality index (PSQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg's self-esteem scale (RSES), and Body image scale (BIS). Results: 78% of participants were considered poor sleepers. Most of the patients exhibited very poor subjective quality, low sleep latency, a short period of sleep, and a low rate of usual sleep efficiency. The vast majority of these patients were in poor shape during the day and did not use sleep medication. Waking up in the middle of the night or early in the morning and getting up to use the bathroom were the main reasons for poor sleep quality. PSQI scores were positively correlated with anxiety, depression, body image dissatisfaction, and lower self-esteem (p < 0.001). Conclusion: Sleep quality and its predictors require a systematic evaluation and adequate management to prevent sleep disturbances and mental distress as well as to improve the quality of life of these patients.

Keywords: body image, gynecological cancer, self esteem, sleep quality

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281 Improvement of Sleep Quality Through Manual and Non-Pharmacological Treatment

Authors: Andreas Aceranti, Sergio Romanò, Simonetta Vernocchi, Silvia Arnaboldi, Emilio Mazza

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As a result of the Sars-Cov2 pandemic, the incidence of thymism disorders has significantly increased and, often, patients are reluctant to want to take drugs aimed at stabilizing mood. In order to provide an alternative approach to drug therapies, we have prepared a study in order to evaluate the possibility of improving the quality of life of these subjects through osteopathic treatment. Patients were divided into visceral and fascial manual treatment with the aim of increasing serotonin levels and stimulating the vagus nerve through validated techniques. The results were evaluated through the administration of targeted questionnaires in order to assess quality of life, mood, sleep and intestinal functioning. At a first endpoint we found, in patients undergoing fascial treatment, an increase in quality of life and sleep: in fact, they report a decrease in the number of nocturnal awakenings; a reduction in falling asleep times and greater rest upon waking. In contrast, patients undergoing visceral treatment, as well as those included in the control group, did not show significant improvements. Patients in the fascial group have, in fact, reported an improvement in thymism and subjective quality of life with a generalized improvement in function. Although the study is still ongoing, based on the results of the first endpoint we can hypothesize that fascial stimulation of the vagus nerve with manual and osteopathic techniques may be a valid alternative to pharmacological treatments in mood and sleep disorders.

Keywords: ostheopathy, insomnia, noctural awakening, thymism

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280 An Information-Based Approach for Preference Method in Multi-Attribute Decision Making

Authors: Serhat Tuzun, Tufan Demirel

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Multi-Criteria Decision Making (MCDM) is the modelling of real-life to solve problems we encounter. It is a discipline that aids decision makers who are faced with conflicting alternatives to make an optimal decision. MCDM problems can be classified into two main categories: Multi-Attribute Decision Making (MADM) and Multi-Objective Decision Making (MODM), based on the different purposes and different data types. Although various MADM techniques were developed for the problems encountered, their methodology is limited in modelling real-life. Moreover, objective results are hard to obtain, and the findings are generally derived from subjective data. Although, new and modified techniques are developed by presenting new approaches such as fuzzy logic; comprehensive techniques, even though they are better in modelling real-life, could not find a place in real world applications for being hard to apply due to its complex structure. These constraints restrict the development of MADM. This study aims to conduct a comprehensive analysis of preference methods in MADM and propose an approach based on information. For this purpose, a detailed literature review has been conducted, current approaches with their advantages and disadvantages have been analyzed. Then, the approach has been introduced. In this approach, performance values of the criteria are calculated in two steps: first by determining the distribution of each attribute and standardizing them, then calculating the information of each attribute as informational energy.

Keywords: literature review, multi-attribute decision making, operations research, preference method, informational energy

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279 Misconception of the Idea ‘Oshinowoism’ and the Later Development in the ‘Yaba Painting School'

Authors: Irokanulo I. Emmanuel

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The idea of ‘Oshinowoism’ is a representational school, which is a concept based on pure and rustic energy in painting. It is described as any painting that depicts the actions of significant through simple illusions. The idea is never to replicate a photographic resemblance with paint but to create an affinity between what one sees and what one artistically intends to create as a representation of that which one beholds in society as an illusion of reality, not as a reality in itself, but as subjective analysis of reality. The disciples of ‘Oshinowoism’ pursue their art from a representational point of view, creating material realities within feels of colours, forms and space, not trying to confuse the art as a substitute for reality nor reality as a substitute for art, but giving each its space and materialism to exist. The depictions of Oshinowo are the constant reminders or perhaps interpretations of those developments that emerged in contemporary African societies because of neocolonialism. This essay has three objectives. First, it examines the misconception around the development of this thought. Secondly, it contextualizes the later contemporary development of painting as art and craft in present-day Lagos, and third, it constructs the misconception and misconstruction of the concept of ‘Oshinowoism’ and offers a correct ideology of this thought with the body of Oshinowo’s work to give the existence to this philosophy. This study looks at the students of Kolade Oshinowo, especially those students who share similar elements and an affinity with the master painting skills, as a way of reconstructing and addressing the misconception in his style. The early works of Olaku, Edosa, and Lara Ige Jacks are plausible evidence of the existential essence of Oshinowo’s artistic philosophy. To this end, therefore, this study would explore the quality of their pictorial techniques and skills in painting as a way of preserving their master’s philosophy.

Keywords: Oshinowoism, colour scheme, drawing, philosophy, representations

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278 Determination of Fatigue Limit in Post Impacted Carbon Fiber Reinforced Epoxy Polymer (CFRP) Specimens Using Self Heating Methodology

Authors: Deepika Sudevan, Patrick Rozycki, Laurent Gornet

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This paper presents the experimental identification of the fatigue limit for pristine and impacted Carbon Fiber Reinforced Epoxy polymer (CFRP) woven composites based on the relatively new self-heating methodology for composites. CFRP composites of [0/90]8 and quasi isotropic configurations prepared using hand-layup technique are subjected to low energy impacts (20 J energy) simulating a barely visible impact damage (BVID). Runway debris strike, tool drop or hailstone impact can cause a BVID on an aircraft fuselage made of carbon composites and hence understanding the post-impact fatigue response of CFRP laminates is of immense importance to the aerospace community. The BVID zone on the specimens is characterized using X-ray Tomography technique. Both pristine and impacted specimens are subjected to several blocks of constant amplitude (CA) fatigue loading keeping R-ratio a constant but with increments in the mean loading stress after each block. The number of loading cycles in each block is a subjective parameter and it varies for pristine and impacted CFRP specimens. To monitor the temperature evolution during fatigue loading, thermocouples are pasted on the CFRP specimens at specific locations. The fatigue limit is determined by two strategies, first is by considering the stabilized temperature in every block and second is by considering the change in the temperature slope per block. The results show that both strategies can be adopted to determine the fatigue limit in both pristine and impacted CFRP composites.

Keywords: CFRP, fatigue limit, low energy impact, self-heating, WRM

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277 Surgical Skills in Mulanje

Authors: Nick Toossi, Joseph Hartland

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Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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276 Continuous FAQ Updating for Service Incident Ticket Resolution

Authors: Kohtaroh Miyamoto

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As enterprise computing becomes more and more complex, the costs and technical challenges of IT system maintenance and support are increasing rapidly. One popular approach to managing IT system maintenance is to prepare and use an FAQ (Frequently Asked Questions) system to manage and reuse systems knowledge. Such an FAQ system can help reduce the resolution time for each service incident ticket. However, there is a major problem where over time the knowledge in such FAQs tends to become outdated. Much of the knowledge captured in the FAQ requires periodic updates in response to new insights or new trends in the problems addressed in order to maintain its usefulness for problem resolution. These updates require a systematic approach to define the exact portion of the FAQ and its content. Therefore, we are working on a novel method to hierarchically structure the FAQ and automate the updates of its structure and content. We use structured information and the unstructured text information with the timelines of the information in the service incident tickets. We cluster the tickets by structured category information, by keywords, and by keyword modifiers for the unstructured text information. We also calculate an urgency score based on trends, resolution times, and priorities. We carefully studied the tickets of one of our projects over a 2.5-year time period. After the first 6 months, we started to create FAQs and confirmed they improved the resolution times. We continued observing over the next 2 years to assess the ongoing effectiveness of our method for the automatic FAQ updates. We improved the ratio of tickets covered by the FAQ from 32.3% to 68.9% during this time. Also, the average time reduction of ticket resolution was between 31.6% and 43.9%. Subjective analysis showed more than 75% reported that the FAQ system was useful in reducing ticket resolution times.

Keywords: FAQ system, resolution time, service incident tickets, IT system maintenance

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275 Quality of Life and Self-Assessed Health of Methadone – Maintained Opiate Addicts

Authors: Brajevic-gizdic Igna, Vuletic Gorka

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Introduction: Research in opiate addiction is increasingly indicating the importance of substitution therapy in opiate addicts. Opiate addiction is a chronic relapsing disease that includes craving as a criterion. Craving has been considered a predictor of a relapse, which is defined as a strong desire with an excessive need to take a substance. The study aimed to measure the intensity of craving using the VAS (visual analog scale) in opioid addicts taking the Opioid Substitution Therapy (OST). Method: The total sample compromised of 30 participants in outpatient treatment. Two groups of opiate addicts were considered: Methadone-maintenance and buprenorphine-maintenance addicts. The participants completed the survey questionnaire during the outpatient treatment. Results: The results indicated high levels of cravings in patients during the treatment on OST, which is considered an important destabilization factor in abstinence. Thus, the use of methadone/buprenorphine dose should be considered. Conclusion: These findings provided an objective measurement of methadone /buprenorphine dosage and therapy options. The underdoes of OST can put patients at high risk of relapse, resulting in high levels of craving. Thus, when determining the therapeutic dose of OST, it is crucial to consider patients´ craving. This would achieve stabilization more quickly and avoid relapse in abstinence. Subjective physician assessment and patient’s statement are the main criteria to determine OST dosage. Future studies should use larger sample sizes and focus on the importance of intensity craving measurement on OST to objectify methadone /buprenorphine dosage.

Keywords: abstinence, addicts, methadone, OST, quality of life

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274 Exploring Influence Range of Tainan City Using Electronic Toll Collection Big Data

Authors: Chen Chou, Feng-Tyan Lin

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Big Data has been attracted a lot of attentions in many fields for analyzing research issues based on a large number of maternal data. Electronic Toll Collection (ETC) is one of Intelligent Transportation System (ITS) applications in Taiwan, used to record starting point, end point, distance and travel time of vehicle on the national freeway. This study, taking advantage of ETC big data, combined with urban planning theory, attempts to explore various phenomena of inter-city transportation activities. ETC, one of government's open data, is numerous, complete and quick-update. One may recall that living area has been delimited with location, population, area and subjective consciousness. However, these factors cannot appropriately reflect what people’s movement path is in daily life. In this study, the concept of "Living Area" is replaced by "Influence Range" to show dynamic and variation with time and purposes of activities. This study uses data mining with Python and Excel, and visualizes the number of trips with GIS to explore influence range of Tainan city and the purpose of trips, and discuss living area delimited in current. It dialogues between the concepts of "Central Place Theory" and "Living Area", presents the new point of view, integrates the application of big data, urban planning and transportation. The finding will be valuable for resource allocation and land apportionment of spatial planning.

Keywords: Big Data, ITS, influence range, living area, central place theory, visualization

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273 Developing an Exhaustive and Objective Definition of Social Enterprise through Computer Aided Text Analysis

Authors: Deepika Verma, Runa Sarkar

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One of the prominent debates in the social entrepreneurship literature has been to establish whether entrepreneurial work for social well-being by for-profit organizations can be classified as social entrepreneurship or not. Of late, the scholarship has reached a consensus. It concludes that there seems little sense in confining social entrepreneurship to just non-profit organizations. Boosted by this research, increasingly a lot of businesses engaged in filling the social infrastructure gaps in developing countries are calling themselves social enterprise. These organizations are diverse in their ownership, size, objectives, operations and business models. The lack of a comprehensive definition of social enterprise leads to three issues. Firstly, researchers may face difficulty in creating a database for social enterprises because the choice of an entity as a social enterprise becomes subjective or based on some pre-defined parameters by the researcher which is not replicable. Secondly, practitioners who use ‘social enterprise’ in their vision/mission statement(s) may find it difficult to adjust their business models accordingly especially during the times when they face the dilemma of choosing social well-being over business viability. Thirdly, social enterprise and social entrepreneurship attract a lot of donor funding and venture capital. In the paucity of a comprehensive definitional guide, the donors or investors may find assigning grants and investments difficult. It becomes necessary to develop an exhaustive and objective definition of social enterprise and examine whether the understanding of the academicians and practitioners about social enterprise match. This paper develops a dictionary of words often associated with social enterprise or (and) social entrepreneurship. It further compares two lexicographic definitions of social enterprise imputed from the abstracts of academic journal papers and trade publications extracted from the EBSCO database using the ‘tm’ package in R software.

Keywords: EBSCO database, lexicographic definition, social enterprise, text mining

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272 Chinese Speakers’ Language Attitudes Towards English Accents: Comparing Mainland and Hong Kong English Major Students’ Accent Preferences in ELF Communication

Authors: Jiaqi XU, Qingru Sun

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Accent plays a crucial role in second language (L2) learners’ performance in the schooling context in the era of globalization, where English is adopted as a lingua franca (ELF). Previous studies found that Chinese mainland students prefer American English accents, whereas the young generations in Hong Kong prefer British accents. However, these studies neglect the non-native accents of English and fail to elaborate much about why the L2 learners differ in accent preferences between the two regions. Therefore, this research aims to bridge the research gap by 1) including both native and non-native varieties of English accents: American accent, British accent, Chinese Mandarin English accent, and Hong Kong English accent; and 2) uncovering and comparing the deeper reasons for the similar or/and different accent preferences between the Chinese mainland and Hong Kong speakers. This research designed a questionnaire including objective and subjective questions to investigate the students’ accent inclinations and the attitudes and reasons behind their linguistic choices. The questionnaire was distributed to eight participants (4 Chinese mainland students and 4 Hong Kong students) who were postgraduate students at a Hong Kong university. Based on the data collection, this research finds out one similarity and two differences between the Chinese mainland and Hong Kong students’ attitudes. The theories of identity construction and standard language ideology are further applied to analyze the reasons behind the similarities and differences and to evaluate how language attitudes intertwine with their identity construction and language ideology.

Keywords: accent, language attitudes, identity construction, language ideology, ELF communication

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271 House Facades and Emotions: Exploring the Psychological Impact of Architectural Features

Authors: Nour Tawil, Sandra Weber, Kirsten K. Roessler, Martin Mau, Simone Kuhn

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The link between “quality” residential environments and human health and well-being has long been proposed. While the physical properties of a sound environment have been fairly defined, little focus has been given to the psychological impact of architectural elements. Recently, studies have investigated the response to architectural parameters, using measures of physiology, brain activity, and emotion. Results showed different aspects of interest: detailed and open versus blank and closed facades, patterns in perceiving different elements, and a visual bias for capturing faces in buildings. However, in the absence of a consensus on methodologies, the available studies remain unsystematic and face many limitations regarding the underpinning psychological mechanisms. To bridge some of these gaps, an online study was launched to investigate design features that influence the aesthetic judgement and emotional evaluation of house facades, using a well-controlled stimulus set of Canadian houses. A methodical modelling of design features will be performed to extract both high and low level image properties, in addition to segmentation of layout-related features. 300 participants from Canada, Denmark, and Germany will rate the images on twelve psychological dimensions representing appealing aspects of a house. Subjective ratings are expected to correlate with specific architectural elements while controlling for typicality and familiarity, and other individual differences. With the lack of relevant studies, this research aims to identify architectural elements of beneficial qualities that can inform design strategies for optimized residential spaces.

Keywords: architectural elements, emotions, psychological response, residential facades.

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270 Needs for Primary Prevention in Families with Mentally Ill Parents

Authors: Patricia Wahl, Dirk Bruland, Albert Lenz

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Children of mentally ill parents are a large high risk group for mental disorders which is hardly reached by preventive programs. The children inherit a heightened risk to develop a mental disorder themselves during their lifetime, but they and their parents are often rejecting to seek help. To elicit the factors determining this prevention dilemma, an explorative qualitative interview study is conducted in 25 families with mentally ill parents and yet unaffected children. Inclusion criteria are the children’s age (7 to 14 years old) and that these children live together with the affected parent. With regard to the concept of Mental Health Literacy the following research questions are leading the Qualitative Content Analysis: What are the needs of families with mentally ill parents? How can their help-seeking behaviour be described? What are their subjective illness theories? And which influences do gender, ethnicity and socio-economic status have on needs, help-seeking and illness theories? Mental Health Literacy relates to the knowledge and attitudes towards mental disorders influencing the recognition, management or prevention of these disorders. The concept seems to be an interesting starting point for our analysis with the aim to understand antecedences and processes in the families more deeply. Results of an extensive literature review serve as deductive framework for our analysis, first findings from the interviews will be available up to the time of the conference and can be presented. They hopefully will give inside in the families’ living environment and help to adapt/develop interventions and in the long term reduce health inequalities. The project at hand is part of the Health Literacy in Childhood and Adolescence (HLCA) Research Consortium financed by the German Federal Ministry of Education and Research (BMBF).

Keywords: children of mentally ill parents, help-seeking behaviour, mental health literacy, prevention dilemma

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269 Qualitative Profiling Model and Competencies Evaluation to Fighting Unemployment

Authors: Francesca Carta, Giovanna Linfante, Laura Agneni, Debora Radicchia, Camilla Micheletta, Angelo Del Cimmuto

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Overtaking competence mismatches and fostering career pathways congruent with the individual skills profile would significantly contribute to fighting unemployment. The aim of this paper is to examine the usefulness and efficiency of qualitative tools in supporting and improving the quality of caseworkers’ activities during the jobseekers’ profile analysis and career guidance process. The selected target groups are long-term and middle term unemployed, job seekers, young people at the end of the vocational training pathway and unemployed woman with social disadvantages. The experimentation is conducted in Italy at public employment services in 2017. In the framework of Italian labour market reform, the experimentation represents the first step to develop a customized qualitative model profiling; the final general object is to improve the public employment services quality. The experimentation tests the transferability of an OECD self-assessment competences tool in the Italian public employment services. On one hand, the first analysis results will indicate the user’s perception concerning the tool’s application and their different competence levels (literacy, numeracy, problem solving, career interest, subjective well-being and health, behavioural competencies) with reference to the specific target. On the other hand, the experimentation outcomes will show caseworkers understanding regarding the tool’s usability and efficiency for career guidance and reskilling and upskilling programs.

Keywords: career guidance, evaluation competences, reskilling pathway, unemployment

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268 Intelligent Control of Bioprocesses: A Software Application

Authors: Mihai Caramihai, Dan Vasilescu

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The main research objective of the experimental bioprocess analyzed in this paper was to obtain large biomass quantities. The bioprocess is performed in 100 L Bioengineering bioreactor with 42 L cultivation medium made of peptone, meat extract and sodium chloride. The reactor was equipped with pH, temperature, dissolved oxygen, and agitation controllers. The operating parameters were 37 oC, 1.2 atm, 250 rpm and air flow rate of 15 L/min. The main objective of this paper is to present a case study to demonstrate that intelligent control, describing the complexity of the biological process in a qualitative and subjective manner as perceived by human operator, is an efficient control strategy for this kind of bioprocesses. In order to simulate the bioprocess evolution, an intelligent control structure, based on fuzzy logic has been designed. The specific objective is to present a fuzzy control approach, based on human expert’ rules vs. a modeling approach of the cells growth based on bioprocess experimental data. The kinetic modeling may represent only a small number of bioprocesses for overall biosystem behavior while fuzzy control system (FCS) can manipulate incomplete and uncertain information about the process assuring high control performance and provides an alternative solution to non-linear control as it is closer to the real world. Due to the high degree of non-linearity and time variance of bioprocesses, the need of control mechanism arises. BIOSIM, an original developed software package, implements such a control structure. The simulation study has showed that the fuzzy technique is quite appropriate for this non-linear, time-varying system vs. the classical control method based on a priori model.

Keywords: intelligent, control, fuzzy model, bioprocess optimization

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267 Influence of Loudness Compression on Hearing with Bone Anchored Hearing Implants

Authors: Anja Kurz, Marc Flynn, Tobias Good, Marco Caversaccio, Martin Kompis

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Bone Anchored Hearing Implants (BAHI) are routinely used in patients with conductive or mixed hearing loss, e.g. if conventional air conduction hearing aids cannot be used. New sound processors and new fitting software now allow the adjustment of parameters such as loudness compression ratios or maximum power output separately. Today it is unclear, how the choice of these parameters influences aided speech understanding in BAHI users. In this prospective experimental study, the effect of varying the compression ratio and lowering the maximum power output in a BAHI were investigated. Twelve experienced adult subjects with a mixed hearing loss participated in this study. Four different compression ratios (1.0; 1.3; 1.6; 2.0) were tested along with two different maximum power output settings, resulting in a total of eight different programs. Each participant tested each program during two weeks. A blinded Latin square design was used to minimize bias. For each of the eight programs, speech understanding in quiet and in noise was assessed. For speech in quiet, the Freiburg number test and the Freiburg monosyllabic word test at 50, 65, and 80 dB SPL were used. For speech in noise, the Oldenburg sentence test was administered. Speech understanding in quiet and in noise was improved significantly in the aided condition in any program, when compared to the unaided condition. However, no significant differences were found between any of the eight programs. In contrast, on a subjective level there was a significant preference for medium compression ratios of 1.3 to 1.6 and higher maximum power output.

Keywords: Bone Anchored Hearing Implant, baha, compression, maximum power output, speech understanding

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266 Nutritional Status of People Living with Human Immuno Virus/Acquired Immune Deficiency Syndrome Attending Anti-Retro Viral Treatment Clinic of BP Koirala Institute of Health Sciences, Nepal

Authors: Ghimire K., Mehta R. S., Parajuli P., Chettri R.

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Background: Malnutrition is a common hallmark of Human Immuno Virus (HIV) disease. It plays a synergistic role in immunosuppression which is initiated by Human Immuno Virus itself, and malnutrition forms an independent risk factor for disease progression. Objectives: The objective of the study is to assess the nutritional status of the people living with Human Immuno Virus/Acquired Immune Deficiency Syndrome attending the Anti-Retro viral Treatment Clinic and find the association of nutritional status with different socio-demographic variables. Methods: A total of 101 people living with HIV/AIDS (PLWHA) were selected by convenient sampling technique. The study was conducted at the ART clinic of BPKIHS. A subjective global assessment tool was used for data collection. Descriptive and inferential statistics were used for data analysis. Results: The study demonstrated that the mean age of the respondents was 40.97+8.650 years. 65.3% were well-nourished, and 34.7% of the participants were mildly/moderately malnourished, whereas none of them were severely malnourished. BMI was statistically significant with education status, family income, and duration of illness of the participants, and nutritional status was statistically significant with gender, marital status, education status, and family history of HIV. Conclusion: On the basis of the result, it can be concluded that more than half of the respondents were well nourished. Gender, marital status, and education are associated with nutritional status.

Keywords: nutritional status, people living with HIV/AIDS, ART treatment, Nepal

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265 Portable Palpation Probe for Diabetic Foot Ulceration Monitoring

Authors: Bummo Ahn

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Palpation is widely used to measure soft tissue firmness or stiffness in the living condition in order to apply detection, diagnosis, and treatment of tumors, scar tissue, abnormal muscle tone, or muscle spasticity. Since these methods are subjective and depend on the proficiency level, it is concluded that there are other diagnoses depending on the condition of the experts and the results are not objective. The mechanical property obtained by using the elasticity of the tissue is important to calculate a predictive variable for monitoring abnormal tissues. If the mechanical load such as reaction force on the foot increases in the same region under the same conditions, the mechanical property of the tissue is changed. Therefore, objective diagnosis is possible not only for experts but also for patients using this quantitative information. Furthermore, the portable system also allows non-experts to easily diagnose at home, not in hospitals or institutions. In this paper, we introduce a portable palpation system that can be used to measure the mechanical properties of human tissue, which can be applied to monitor diabetic foot ulceration patients with measuring the mechanical property change of foot tissue. The system was designed to be smaller and portable in comparison with the conventional palpation systems. It is consists of the probe, the force sensor, linear actuator, micro control unit, the display module, battery, and housing. Using this system, we performed validation experiments by applying different palpations (3 and 5 mm) to soft tissue (silicone rubber) and measured reaction forces. In addition, we estimated the elastic moduli of the soft tissue against different palpations and compare the estimated elastic moduli that show similar value even if the palpation depths are different.

Keywords: palpation probe, portable, diabetic foot ulceration, monitoring, mechanical property

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264 A Sense of Home: Study of Walk-up Apartment Housing Units In Yangon, Myanmar

Authors: Phyo Kyaw Kyaw

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In the Yangon urban landscape, one could not help, but notice old buildings from the colonial period along with condominium developments recently, and many walk-up apartment buildings to accommodate the urbanization, growing population and social-economic status of Myanmar people. Walk-up apartments were built and popular after the British colonial period (around 1950s) and are still built up to today due to its cost-effectiveness and to accommodate low to mid-income residents in the metropolitan Yangon. Approximately 90% of apartment buildings are walk-up apartments. The common impression of walk-up apartments in Yangon appears to be old rectangular box shape, homogenous envelope and limited square feet dull interior small space. In other words, the buildings are full of constraints, lack of good user experiences, and they are not well-fitted in the modern days. Therefore, the resident suffers consequently many years, some may live in the apartment their entire lives. Thousands of people living in the walk-up apartment on a daily basis are being shaped by the space and its inadequate quality of living. Can it be called “Home” by the dwellers or is the place a temporary shelter?. Online semi-structured interviews of 15 apartments’ residents and online questionnaire surveys of 70 apartment residents are conducted. This research aims to explore what makes “Home” “A sense of Home” for walk-up apartment users in Yangon, Myanmar by studying subjective responses shaped by the interior and experience of the spaces in apartment to understand the perception of the residents and improve the quality of living. The result reflects the priority level of important factors in relation to the sense of home framework.

Keywords: home, living quality, space, perception, residents, walk-up apartment, Yangon

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263 Craving Intensity Measurements in Opiate Addicts to Objectify the Opioid Substitution Therapy Dose and Reduce the Relapse Risk

Authors: Igna Brajevic-Gizdic, Magda Pletikosa Pavić

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Introduction: Research in opiate addiction is increasingly indicating the importance of substitution therapy in opiate addicts. Opiate addiction is a chronic relapsing disease that includes craving as a criterion. Craving has been considered a predictor of a relapse, which is defined as a strong desire with an excessive need to take a substance. The study aimed to measure the intensity of craving using the VAS (visual analog scale) in opioid addicts taking Opioid Substitution Therapy (OST). Method: The total sample compromised of 30 participants in outpatient treatment. Two groups of opiate addicts were considered: Methadone-maintenance and buprenorphine-maintenance addicts. The participants completed the survey questionnaire during the outpatient treatment. Results: The results indicated high levels of cravings in patients during the treatment of OST, which is considered an important destabilization factor in abstinence. Thus, the use of methadone/buprenorphine dose should be considered. Conclusion: These findings provided an objective measurement of methadone /buprenorphine dosage and therapy options. The underdoes of OST can put patients at high risk of relapse, resulting in high levels of craving. Thus, when determining the therapeutic dose of OST, it is crucial to consider patients' cravings. This would achieve stabilization more quickly and avoid relapse in abstinence. Subjective physician assessment and patients' statement are the main criteria to determine OST dosage. Future studies should use larger sample sizes and focus on the importance of intensity craving measurement on OST to objectify methadone /buprenorphine dosage.

Keywords: buprenorphine, craving, heroin addicts, methadone, OST

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262 Agency Beyond Metaphysics of Subjectivity

Authors: Erik Kuravsky

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One of the problems with a post-structuralist account of agency is that it appears to reject the freedom of an acting subject, thus seeming to deny the very phenomenon of agency. However, this is only a problem if we think that human beings can be agents exclusively in terms of being subjects, that is, if we think agency subjectively. Indeed, we tend to understand traditional theories of human freedom (e.g., Plato’s or Kant’s) in terms of a peculiar ability of the subject. The paper suggests to de-subjectivize agency with the help of Heidegger’s later thought. To do it, ir argues that classical theories of agency may indeed be interpreted as subject-oriented (sometimes even by their authors), but do not have to be read as such. Namely, the claim is that what makes agency what it is, what is essential in agency, is not its belonginess to a subject, but its ontological configuration. We may say that agency “happens,” and that there is a very specific ontological characteristics to this happening. The argument of the paper is that we can find these characteristic in the classical accounts of agency and that these characteristics are sufficient to distinguish human freedom from other natural phenomena. In particular, it offers to think agency not as one of human characteristics, but as an ontological event in which human beings take part. Namely, agency is a (non-human) characteristic of the different modes in which the experienceable existence of beings is determined by Being. To be an agent then is to participate in such ontological determination. What enables this participation is the ways human beings non-thematically understand the ontological difference. For example, for Plato, one acts freely only if one is led by an idea of the good, while for Kant the imperative for free action is categorial. The agency of an agent is thus dependent on the differentiation between ideas/categories and beings met in experience – one is “free” from contingent sensibility in terms of what is different from it ontologically. In this light, modern dependence on subjectivity is evident in the fact that the ontological difference is thought as belonging to one’s thinking, consciousness etc. That is, it is taken subjectively. A non-subjective account of agency, on the other hand, requires thinking this difference as belonging to Being itself, and thinking human beings as a medium within which occurs the non-human force of ontological differentiation.

Keywords: Heidegger, freedom, agency, poststructuralism

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261 Pressure Sensitive v/s Pressure Resistance Institutional Investors towards Socially Responsible Investment Behavior: Evidence from Malaysia

Authors: Mohammad Talha, Abdullah Sallehhuddin Abdullah Salim, Abdul Aziz Abdul Jalil, Norzarina Md Yatim

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The significant contribution of institutional investors across the globe in socially responsible investment (SRI) is well-documented in the literature. Nevertheless, how the SRI behavior of pressure-resistant, pressure-sensitive and pressure-indeterminate institutional investors remain unexplored extensively. This study examines the moderating effect of institutional investors towards socially responsible investment behavior in the context of emerging economies. This study involved 229 institutional investors in Malaysia. A total of 1,145 questionnaires were distributed. Out of these, 308 (130 pressure sensitive institutional investors and 178 pressure resistant institutional investors), representing a usable rate of 26.9 per cent, were found fit for data analysis. Utilizing multi-group analysis via AMOS, this study found evidence for the presence of moderating effect by a type of institutional investor topology in socially responsible investment behavior. At intentional level, it established that type of institutional investor was a significant moderator in the relationship between subjective norms, and caring ethical climate with intention among pressure-resistant institutional investors, as well as between perceived behavioral controls with intention among pressure-sensitive institutional investors. At the behavioral level, the results evidenced that there was only a significant moderating effect between intention and socially responsible investment behavior among pressure-resistant institutional investors. The outcomes are expected to benefit policy makers, regulators, and market participants in order to leap forward SRI growth in developing economies. Nevertheless, the outcomes are limited to a few factors, and it is believed that future studies shall address those limitations.

Keywords: socially responsible investment, behavior, pressure sensitive investors, pressure insensitive investors, Institutional Investment Malaysia

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260 Condition Assessment of Reinforced Concrete Bridge Deck Using Ground Penetrating Radar

Authors: Azin Shakibabarough, Mojtaba Valinejadshoubi, Ashutosh Bagchi

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Catastrophic bridge failure happens due to the lack of inspection, lack of design and extreme events like flooding, an earthquake. Bridge Management System (BMS) is utilized to diminish such an accident with proper design and frequent inspection. Visual inspection cannot detect any subsurface defects, so using Non-Destructive Evaluation (NDE) techniques remove these barriers as far as possible. Among all NDE techniques, Ground Penetrating Radar (GPR) has been proved as a highly effective device for detecting internal defects in a reinforced concrete bridge deck. GPR is used for detecting rebar location and rebar corrosion in the reinforced concrete deck. GPR profile is composed of hyperbola series in which sound hyperbola denotes sound rebar and blur hyperbola or signal attenuation shows corroded rebar. Interpretation of GPR images is implemented by numerical analysis or visualization. Researchers recently found that interpretation through visualization is more precise than interpretation through numerical analysis, but visualization is time-consuming and a highly subjective process. Automating the interpretation of GPR image through visualization can solve these problems. After interpretation of all scans of a bridge, condition assessment is conducted based on the generated corrosion map. However, this such a condition assessment is not objective and precise. Condition assessment based on structural integrity and strength parameters can make it more objective and precise. The main purpose of this study is to present an automated interpretation method of a reinforced concrete bridge deck through a visualization technique. In the end, the combined analysis of the structural condition in a bridge is implemented.

Keywords: bridge condition assessment, ground penetrating radar, GPR, NDE techniques, visualization

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259 Use of a Symptom Scale Based on Degree of Functional Impairment for Acute Concussion

Authors: Matthew T. McCarthy, Sarah Janse, Natalie M. Pizzimenti, Anthony K. Savino, Brian Crosser, Sean C. Rose

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Concussion is diagnosed clinically using a comprehensive history and exam, supported by ancillary testing. Frequently, symptom checklists are used as part of the evaluation of concussion. Existing symptom scales are based on a subjective Likert scale, without relation of symptoms to clinical or functional impairment. This is a retrospective review of 133 patients under age 30 seen in an outpatient neurology practice within 30 days of a probable or definite concussion. Each patient completed 2 symptom checklists at the initial visit – the SCAT-3 symptom evaluation (22 symptoms, 0-6 scale) and a scale based on the degree of clinical impairment for each symptom (22 symptoms, 0-3 scale related to functional impact of the symptom). Final clearance date was determined by the treating physician. 60.9% of patients were male with mean age 15.7 years (SD 2.3). Mean time from concussion to first visit was 6.9 days (SD 6.2), and 101 patients had definite concussions (75.9%), while 32 were diagnosed as probable (24.1%). 94 patients had a known clearance date (70.7%) with mean clearance time of 20.6 days (SD 18.6) and median clearance time of 19 days (95% CI 16-21). Mean total symptom score was 27.2 (SD 22.9) on the SCAT-3 and 14.7 (SD 11.9) for the functional impairment scale. Pearson’s correlation between the two scales was 0.98 (p < 0.001). After adjusting for patient and injury characteristics, an equivalent increase in score on each scale was associated with longer time to clearance (SCAT-3 hazard ratio 0.885, 95%CI 0.835-0.938, p < 0.001; functional impairment scale hazard ratio 0.851, 95%CI 0.802-0.902, p < 0.001). A concussion symptom scale based on degree of functional impairment correlates strongly with the SCAT-3 scale and demonstrates a similar association with time to clearance. By assessing the degree of impact on clinical functioning, this symptom scale reflects a more intuitive approach to rating symptoms and can be used in the management of concussion.

Keywords: checklist, concussion, neurology, scale, sports, symptoms

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258 Stepping in Sustainability: Walkability an Upcoming Design Parameter for Transit Based Communities in Lahore, Pakistan

Authors: Sadaf Saeed

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The consideration of walkability as an urban design parameter in conjunction with transit-oriented development is an established trend in the developed countries but an upcoming trend in developing countries. In Pakistan, the first Bus Rapid Transit (locally called as Metro Bus) has been introduced in the city of Lahore in 2013 where around 40 percent of the riders access to transit stations by walking. To what extent the aspect of walkability has been considered in the local scenario? To address this question, this paper presents an account of urban design parameters regarding pedestrian provisions and quality of walking environment between Metro Bus stations and users’ destination in the transit neighbourhoods (areas up to 500-meter radius). The primary and secondary data for objective and subjective walkability measurements has been used for neighbourhoods of five selected transit stations ranked against the predefined critical assessed factors (CAF). The multi-criteria approach including visual and geospatially-based parameters at street level, along with walkability index score at selected sites linked with CAF evaluation were the selected methods for this study. The acceptability of walkability as an urban design parameter for transit planning in terms of connectivity and social implications of the concept has also been analysed in the local context. The paper highlights that the aspect of walkability in Lahore is being derelict owing to the focus of government on other initiatives such as park and ride and feeder bus services for mobility of passengers. However, the pedestrian-friendly design parameters as a part of future transit planning can enhance social, liveable and interactive walking environment within transit neighbourhoods.

Keywords: walkability, sustainability, transit neighborhoods, social communities

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257 GIS Model for Sanitary Landfill Site Selection Based on Geotechnical Parameters

Authors: Hecson Christian, Joel Macwan

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Landfill site selection in an urban area is a critical issue in the planning process. With the growth of the urbanization, it has a mammoth impact on the economy, ecology, and environmental health of the region. Outsized amount of wastes are produced and the problem gets soared every day. Hence, selection of ideal site for sanitary landfill is a challenge for urban planners and solid waste managers. Disposal site is a function of many parameters. Among all, Geotechnical parameters are very vital as the same is related to surrounding open land. Moreover, the accessible safe and acceptable land is also scarce. Therefore, in this paper geotechnical parameters are used to develop a GIS model to identify an ideal location for landfill purpose. Metropolitan city of Surat is highly populated and fastest growing urban area in India. The research objectives are to conduct field experiments to collect data and to transfer the facts in GIS platform to evolve a model, to find ideal location. Planners’ preferences were obtained to use analytical hierarchical process (AHP) to find weights of each parameter. Integration of GIS and Multi-Criteria Decision Analysis (MCDA) techniques are applied to improve decision-making. It augments an environment for transformation and combination of geographical data and planners’ preferences. GIS performs deterministic overlay and buffer operations. MCDA methods evaluate alternatives based on the decision makers’ subjective values and priorities. Research results have shown many alternative locations. Economic analysis of selected site from actual operations point of view is not included in this research.

Keywords: GIS, AHP, MCDA, Geo-technical

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256 Neuron Point-of-Care Stem Cell Therapy: Intrathecal Transplant of Autologous Bone Marrow-Derived Stem Cells in Patients with Cerebral Palsy

Authors: F. Ruiz-Navarro, M. Matzner, G. Kobinia

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Background: Cerebral palsy (CP) encompasses the largest group of childhood movement disorders, the patterns and severity varies widely. Today, the management focuses only on a rehabilitation therapy that tries to secure the functions remained and prevents complications. However the treatments are not aimed to cure the disease. Stem cells (SCs) transplant via intrathecal is a new approach to the disease. Method: Our aim was to performed a pilot study under the condition of unproven treatment on clinical practice to assessed the safety and efficacy of Neuron Point-of-care Stem cell Therapy (N-POCST), an ambulatory procedure of autologous bone marrow derived SCs (BM-SCs) harvested from the posterior superior iliac crest undergo an on-site cell separation for intrathecal infusion via lumbar puncture. Results: 82 patients were treated in a period of 28 months, with a follow-up after 6 months. They had a mean age of 6,2 years old and male predominance (65,9%). Our preliminary results show that: A. No patient had any major side effects, B. Only 20% presented mild headache due to LP, C. 53% of the patients had an improvement in spasticity, D. 61% improved the coordination abilities, 23% improved the motor function, 15% improved the speech, 23% reduced the number of convulsive events with the same doses or less doses of anti-convulsive medication and 94% of the patients report a subjective general improvement. Conclusions: These results support previous worldwide publications that described the safety and effectiveness of autologous BM-SCs transplant for patients wit CP.

Keywords: autologous transplant, cerebral palsy, point of care, childhood movement disorders

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255 The Conceptual Exploration of Comfort Zone by Using Content Analysis

Authors: Lilla Szabó Hangya, Szilvia Jambori

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The comfort zone is less studied area in the field of psychology. One of the most important definitions is that comfort zone is a psychological state in which things feel familiar to a person with low level of anxiety and stress. But the validity of comfort zone does not confirm till now. The aim of our pilot research is to test which psychological factors could determine how young adults behave during their decision process to stay in one’s comfort zone or to leave it. Every person has a number of comfort zones, so we are not able to measure it directly, only those personality traits which predict if someone leaves his comfort zone easier or harder. In our study at first we wanted to clarify the meaning of comfort zone. 110 young adults (male: 37, female: 73; ages from 18 to 70, average age: 26,6) took part in the study. Beside their demographic datas we asked them what does the comfort zone mean for them. The results showed that the meaning of the comfort zone can be grouped in five dimensions: comfort (49,6 %), leaving it-change (8,1%), ambivalent feelings (10,6%), related to other people (10,6%), pursuit of self-realization (16,8%). Our results demonstrated age related characteristics. For young people at the age of 19 the comfort zone is related to other people, because during adolescents peer relationships become more important. Subjects at the age 20-30 answered that the comfort zone means comfort and stability for them. Their life becomes stable for a while, they are studying or working. But at the age of 25, when they finish university, most of them answered comfort zone means a changing process for them. On the other hand for subjects at the age of 27 the means of the comfort zone is pursuit of self-realization. After that period at the age of 31 when they have families and stable job the stability will also dominant. We saw that the comfort zone has much more meaning besides a pleasant psychological trait. Further we would like to determine which psychological factors relate to comfort zone, and what kind of personality traits could predict leaving or staying in one’s comfort zone. We want to observe the relationship between comfort zone and subjective well-being, life satisfaction self-efficacy or self-esteem.

Keywords: comfort zone, development, personality trait, young adults

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