Search results for: female migrant entrepreneurship experiences
Commenced in January 2007
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Edition: International
Paper Count: 5748

Search results for: female migrant entrepreneurship experiences

498 Analysis and Quantification of Historical Drought for Basin Wide Drought Preparedness

Authors: Joo-Heon Lee, Ho-Won Jang, Hyung-Won Cho, Tae-Woong Kim

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Drought is a recurrent climatic feature that occurs in virtually every climatic zone around the world. Korea experiences the drought almost every year at the regional scale mainly during in the winter and spring seasons. Moreover, extremely severe droughts at a national scale also occurred at a frequency of six to seven years. Various drought indices had developed as tools to quantitatively monitor different types of droughts and are utilized in the field of drought analysis. Since drought is closely related with climatological and topographic characteristics of the drought prone areas, the basins where droughts are frequently occurred need separate drought preparedness and contingency plans. In this study, an analysis using statistical methods was carried out for the historical droughts occurred in the five major river basins in Korea so that drought characteristics can be quantitatively investigated. It was also aimed to provide information with which differentiated and customized drought preparedness plans can be established based on the basin level analysis results. Conventional methods which quantifies drought execute an evaluation by applying a various drought indices. However, the evaluation results for same drought event are different according to different analysis technique. Especially, evaluation of drought event differs depend on how we view the severity or duration of drought in the evaluation process. Therefore, it was intended to draw a drought history for the most severely affected five major river basins of Korea by investigating a magnitude of drought that can simultaneously consider severity, duration, and the damaged areas by applying drought run theory with the use of SPI (Standardized Precipitation Index) that can efficiently quantifies meteorological drought. Further, quantitative analysis for the historical extreme drought at various viewpoints such as average severity, duration, and magnitude of drought was attempted. At the same time, it was intended to quantitatively analyze the historical drought events by estimating the return period by derived SDF (severity-duration-frequency) curve for the five major river basins through parametric regional drought frequency analysis. Analysis results showed that the extremely severe drought years were in the years of 1962, 1988, 1994, and 2014 in the Han River basin. While, the extreme droughts were occurred in 1982 and 1988 in the Nakdong river basin, 1994 in the Geumg basin, 1988 and 1994 in Youngsan river basin, 1988, 1994, 1995, and 2000 in the Seomjin river basin. While, the extremely severe drought years at national level in the Korean Peninsula were occurred in 1988 and 1994. The most damaged drought were in 1981~1982 and 1994~1995 which lasted for longer than two years. The return period of the most severe drought at each river basin was turned out to be at a frequency of 50~100 years.

Keywords: drought magnitude, regional frequency analysis, SPI, SDF(severity-duration-frequency) curve

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497 Effect of E-Governance and E-Learning Platform on Access to University Education by Public Servants in Nigeria

Authors: Nwamaka Patricia Ibeme, Musa Zakari

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E-learning is made more effective because; it is enable student to students to easily interact, share, and collaborate across time and space with the help of e-governance platform. Zoom and the Microsoft classroom team can invite students from all around the world to join a conversation on a certain subject simultaneously. E-governance may be able to work on problem solving skills, as well as brainstorming and developing ideas. As a result of the shared experiences and knowledge, students are able to express themselves and reflect on their own learning." For students, e-governance facilities provide greater opportunity for students to build critical (higher order) thinking abilities through constructive learning methods. Students' critical thinking abilities may improve with more time spent in an online classroom. Students' inventiveness can be enhanced through the use of computer-based instruction. Discover multimedia tools and produce products in the styles that are easily available through games, Compact Disks, and television. The use of e-learning has increased both teaching and learning quality by combining student autonomy, capacity, and creativity over time in developed countries." Teachers are catalysts for the integration of technology through Information and Communication Technology, and e-learning supports teaching by simplifying access to course content." Creating an Information and Communication Technology class will be much easier if educational institutions provide teachers with the assistance, equipment, and resources they need. The study adopted survey research design. The populations of the study are Students and staff. The study adopted a simple random sampling technique to select a representative population. Both primary and secondary method of data collection was used to obtain the data. A chi-square statistical technique was used to analyze. Finding from the study revealed that e-learning has increase accesses to universities educational by public servants in Nigeria. Public servants in Nigeria have utilized e-learning and Online Distance Learning (ODL) programme to into various degree programmes. Finding also shows that E-learning plays an important role in teaching because it is oriented toward the use of information and communication technologies that have become a part of the everyday life and day-to-day business. E-learning contributes to traditional teaching methods and provides many advantages to society and citizens. The study recommends that the e-learning tools and internet facilities should be upgrade to foster any network challenges in the online facilitation and lecture delivery system.

Keywords: E-governance, E-learning, online distance learning, university education public servants, Nigeria

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496 Necessity for a Standardized Occupational Health and Safety Management System: An Exploratory Study from the Danish Offshore Wind Sector

Authors: Dewan Ahsan

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Denmark is well ahead in generating electricity from renewable sources. The offshore wind sector is playing the pivotal role to achieve this target. Though there is a rapid growth of offshore wind sector in Denmark, still there is a dearth of synchronization in OHS (occupational health and safety) regulation and standards. Therefore, this paper attempts to ascertain: i) what are the major challenges of the company specific OHS standards? ii) why does the offshore wind industry need a standardized OHS management system? and iii) who can play the key role in this process? To achieve these objectives, this research applies the interview and survey techniques. This study has identified several key challenges in OHS management system which are; gaps in coordination and communication among the stakeholders, gaps in incident reporting systems, absence of a harmonized OHS standard and blame culture. Furthermore, this research has identified eleven key stakeholders who are actively involve with the offshore wind business in Denmark. As noticed, the relationships among these stakeholders are very complex specially between operators and sub-contractors. The respondent technicians are concerned with the compliance of various third-party OHS standards (e.g. ISO 31000, ISO 29400, Good practice guidelines by G+) which are applying by various offshore companies. On top of these standards, operators also impose their own OHS standards. From the technicians point of angle, many of these standards are not even specific for the offshore wind sector. So, it is a big challenge for the technicians and sub-contractors to comply with different company specific standards which also elevate the price of their services offer to the operators. For instance, when a sub-contractor is competing for a bidding, it must fulfill a number of OHS requirements (which demands many extra documantions) set by the individual operator and/the turbine supplier. According to sub-contractors’ point of view these extra works consume too much time to prepare the bidding documents and they also need to train their employees to pass the specific OHS certification courses to accomplish the demand for individual clients and individual project. The sub-contractors argued that in many cases these extra documentations and OHS certificates are inessential to ensure the quality service. So, a standardized OHS management procedure (which could be applicable for all the clients) can easily solve this problem. In conclusion, this study highlights that i) development of a harmonized OHS standard applicable for all the operators and turbine suppliers, ii) encouragement of technicians’ active participation in the OHS management, iii) development of a good safety leadership, and, iv) sharing of experiences among the stakeholders (specially operators-operators-sub contractors) are the most vital strategies to overcome the existing challenges and to achieve the goal of 'zero accident/harm' in the offshore wind industry.

Keywords: green energy, offshore, safety, Denmark

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495 Measuring the Impact of Implementing an Effective Practice Skills Training Model in Youth Detention

Authors: Phillipa Evans, Christopher Trotter

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Aims: This study aims to examine the effectiveness of a practice skills framework implemented in three youth detention centres in Juvenile Justice in New South Wales (NSW), Australia. The study is supported by a grant from and Australian Research Council and NSW Juvenile Justice. Recent years have seen a number of incidents in youth detention centres in Australia and other places. These have led to inquiries and reviews with some suggesting that detention centres often do not even meet basic human rights and do little in terms of providing opportunities for rehabilitation of residents. While there is an increasing body of research suggesting that community based supervision can be effective in reducing recidivism if appropriate skills are used by supervisors, there has been less work considering worker skills in youth detention settings. The research that has been done, however, suggest that teaching interpersonal skills to youth officers may be effective in enhancing the rehabilitation culture of centres. Positive outcomes have been seen in a UK detention centre for example, from teaching staff to do five-minute problem-solving interventions. The aim of this project is to examine the effectiveness of training and coaching youth detention staff in three NSW detention centres in interpersonal practice skills. Effectiveness is defined in terms of reductions in the frequency of critical incidents and improvements in the well-being of staff and young people. The research is important as the results may lead to the development of more humane and rehabilitative experiences for young people. Method: The study involves training staff in core effective practice skills and supporting staff in the use of those skills through supervision and de-briefing. The core effective practice skills include role clarification, pro-social modelling, brief problem solving, and relationship skills. The training also addresses some of the background to criminal behaviour including trauma. Data regarding critical incidents and well-being before and after the program implementation are being collected. This involves interviews with staff and young people, the completion of well-being scales, and examination of departmental records regarding critical incidents. In addition to the before and after comparison a matched control group which is not offered the intervention is also being used. The study includes more than 400 young people and 100 youth officers across 6 centres including the control sites. Data collection includes interviews with workers and young people, critical incident data such as assaults, use of lock ups and confinement and school attendance. Data collection also includes analysing video-tapes of centre activities for changes in the use of staff skills. Results: The project is currently underway with ongoing training and supervision. Early results will be available for the conference.

Keywords: custody, practice skills, training, youth workers

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494 Self-Care and Emotional Wellbeing of Nurses Using Playback Theatre and Expressive Arts

Authors: Radhika Jain

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The nursing community in India face unique challenges ranging from lack of adequate career progression, low social status attached to the profession, poor nurse-to-patient ratio leading to heavy workload resulting in stress and burnout, lack of general recognition and the responsibility of often having to deal with the ire of the patients and their families. This study explores how a combination of Playback Theatre and Expressive Arts could be used as a very powerful tool to understand the concerns, and consequently as a self-care tool to bring about the sense of well-being and emotional awareness for the nurses. For the purpose of this study, Playback Theatre was used as an entry tool to understand the thoughts, feelings and concerns. Playback theatre is a unique improvisational form of theatre developed by Jonathan Fox and Jo Salas in 1975, in which audience share their own stories from their lives and the performers play them back through a range of improv techniques such as metaphor, poetry, music and movement. Playback Theatre helped in first warming them up to the idea of sharing and then gave them the confidence of a safe space to collectively go deeper into their emotional experiences. As the next step, structured sessions of Expressive Arts were conducted with the same set of nurses, for them to work on the issues and concerns they have (and which they shared during the Playback performance). These sessions were to enable longer engagements as many of the concerns expressed were related to perceptions and beliefs that have been ingrained over a period of time and hence it needs a longer engagement to be worked on in detail. The Expressive Art sessions helped in this regard. Expressive arts therapy combines psychology and the creative process to promote emotional growth and healing. The study was conducted at two places: one a geriatric centre and the other, a palliative care centre. The study revealed that concerns and challenges would not be identical across the nursing community or across similar types of health care organizations but would be specific to each organization or centre as the circumstances and set-up at each place would be different. At the geriatric centre, stress and burnout emerged as the main concerns while at the palliative care centre, the main concern that came up was around the difficulty the nurses faced in expressing emotions and in communicating their feelings. The objective analysis of the results of the study indicated how longer-term engagements using Expressive Arts as the modality helped the nurses have better awareness of their emotions and helped them develop tools of self-care tools while also tapping into their emotions to express and experience. The process of eliciting the main concerns from the nurses using a Playback Theatre performance and then following that with subsequent sessions of expressive arts helped the nurses in the way nurses approached their job and the reduced level of overwhelm that they felt.

Keywords: palliative care, nurses, self-care, expressive arts, playback theatre

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493 Examining Historically Defined Periods in Autobiographical Memories for Transitional Events

Authors: Khadeeja Munawar, Shamsul Haque

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We examined the plausibility of transition theory suggesting that memories of transitional events, which give rise to a significant and persistent change in the fabric of daily life, are organized around the historically defined autobiographical periods (H-DAPs). 141 Pakistani older adults retrieved 10 autobiographical memories (AMs) each to 10 cue words. As the history of Pakistan is dominated by various political and nationwide transitional events, it was expected that the participants would recall memories with H-DAPs references. The content analysis revealed that 0.7% of memories had H-DAP references and 0.4% memories mentioned major transitional events such as War/Natural Disaster. There was a vivid reminiscence bump between 10 - 20 years of age in lifespan distribution of AMs. There were 67.9% social-focused AMs. Significantly more self-focused memories were reported by individuals who endorsed themselves as conservatives. Only a few H-DAPs were reported, although the history of Pakistan was dominated by numerous political, historical and nationwide transitional events. Memories within and outside of the bump period were mostly positive. The participants rarely used historical/political or nationwide significant events or periods to date the memories elicited. The intense and nationwide (as well as region-wise) significant historical/political events spawned across decades in the lives of participants of the present study but these events did not produce H-DAPs. The findings contradicted the previous studies on H-DAPs and transition theory. The dominance of social-focused AMs in the present study is in line with the past studies comparing the memories of collectivist and individualist cultures (i.e., European Americans vs. Asian, African and Latin-American cultures). The past empirical evidence shows that conservative values and beliefs are adopted as a coping strategy to feel secure in the face of danger when future is dominated with uncertainty and to connect to likeminded others. In the present study, conservative political ideology is somehow assisting the participants in living a stable life midst of their complex social worlds. The reminiscence bump, as well as dominance of positive memories within and outside the bump period, are in line with the narrative/identity account which states that the events and experiences during adolescence and early adulthood assimilate into a person’s lifelong narratives. Hence these events are used as identity markers and are more easily recalled later in life. Also, according to socioemotional theory and the positivity effect, the participants evaluated past events more positively as they grow up and the intensity of negative emotions decreased with time.

Keywords: autobiographical memory, historically defined autobiographical periods, narrative/identity account, Pakistan, reminiscence bump, SMS framework, transition theory

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492 Household Socioeconomic Factors Associated with Teenage Pregnancies in Kigali City, Rwanda

Authors: Dieudonne Uwizeye, Reuben Muhayiteto

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Teenage pregnancy is a challenging problem for sustainable development due to restrictions it poses to socioeconomic opportunities for young mothers, their children and families. Being unable to take appropriate economic and social responsibilities, teen mothers get trapped into poverty and become economic burden to their family and country. Besides, teenage pregnancy is also a health problem because children born to very young mothers are vulnerable with greater risk of illnesses and deaths, and teenage mothers are more likely to be exposed to greater risk of maternal mortality and to other health and psychological problems. In Kigali city, in Rwanda, teenage pregnancy rate is currently high and its increase in recent years is worrisome. However, only individual factors influencing the teenage pregnancy tend to be the basis of interventions. It is important to understand the important socioeconomic factors at the household level that are associated with teenage pregnancy to help government, parents, and other stakeholders to appropriately address the problem with sustainable measures. This study analyzed secondary data from the Fifth Rwanda Demographic and Health Survey (RDHS-V 2014-2015) conducted by the National Institute of Statistics of Rwanda (NISR). The aim was to examine household socio-economic factors that are associated with incidence of teenage pregnancies in Kigali city. In addition to descriptive analysis, Pearson’s Chi Square and Binary Logistic Regression were used in the analysis. Findings indicate that marital status and age of household head, number of members in a household, number of rooms used for sleeping, educational level of the household head and household's wealth are significantly associated with teenage pregnancy in Rwanda ( p< 0.05). It was found that teenagers living with parents, those having parents with higher education and those from richer families are less likely to become pregnant. Age of household head was pinpointed as factor to teenage pregnancy, with teenage-headed households being more vulnerable. The findings also revealed that household composition correlates with the probability of teenage pregnancy (p < 0.05) with teenagers from households with less number of members being more vulnerable. Regarding the size of the house, the study suggested that the more rooms available in households, the less incidences of teenage pregnancy are likely to be observed (p < 0.05). However, teenage pregnancy was not significantly associated with physical violence among parents (p = 0.65) and sex of household heads (p = 0.52), except in teen-headed households of which female are predominantly heads. The study concludes that teenage pregnancy remains a serious social, economic and health problem in Rwanda. The study informs government officials, parents and other stakeholders to take interventions and preventive measures through community sex education, policies and strategies to foster effective parental guidance, care and control of young girls through meeting their necessary social and financial needs within households.

Keywords: household socio-economic factors, Rwanda, Rwanda demographic and health survey, teenage pregnancy

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491 Evaluating the Benefits of Intelligent Acoustic Technology in Classrooms: A Case Study

Authors: Megan Burfoot, Ali GhaffarianHoseini, Nicola Naismith, Amirhosein GhaffarianHoseini

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Intelligent Acoustic Technology (IAT) is a novel architectural device used in buildings to automatically vary the acoustic conditions of space. IAT is realized by integrating two components: Variable Acoustic Technology (VAT) and an intelligent system. The VAT passively alters the RT by changing the total sound absorption in a room. In doing so, the Reverberation Time (RT) is changed and thus, the sound strength and clarity are altered. The intelligent system detects sound waves in real-time to identify the aural situation, and the RT is adjusted accordingly based on pre-programmed algorithms. IAT - the synthesis of these two components - can dramatically improve acoustic comfort, as the acoustic condition is automatically optimized for any detected aural situation. This paper presents an evaluation of the improvements of acoustic comfort in an existing tertiary classroom located at Auckland University of Technology in New Zealand. This is a pilot case study, the first of its’ kind attempting to quantify the benefits of IAT. Naturally, the potential acoustic improvements from IAT can be actualized by only installing the VAT component of IAT and by manually adjusting it rather than utilizing an intelligent system. Such a simplified methodology is adopted for this case study to understand the potential significance of IAT without adopting a time and cost-intensive strategy. For this study, the VAT is built by overlaying reflective, rotating louvers over sound absorption panels. RT's are measured according to international standards before and after installing VAT in the classroom. The louvers are manually rotated in increments by the experimenter and further RT measurements are recorded. The results are compared with recommended guidelines and reference values from national standards for spaces intended for speech and communication. The results obtained from the measurements are used to quantify the potential improvements in classroom acoustic comfort, where IAT to be used. This evaluation reveals the current existence of poor acoustic conditions in the classroom caused by high RT's. The poor acoustics are also largely attributed to the classrooms’ inability to vary acoustic parameters for changing aural situations. The classroom experiences one static acoustic state, neglecting to recognize the nature of classrooms as flexible, dynamic spaces. Evidently, when using VAT the classroom is prescribed with a wide range of RTs it can achieve. Namely, acoustic requirements for varying teaching approaches are satisfied, and acoustic comfort is improved. By quantifying the benefits of using VAT, it can confidently suggest these same benefits are achieved with IAT. Nevertheless, it is encouraged that future studies continue this line of research toward the eventual development of IAT and its’ acceptance into mainstream architecture.

Keywords: acoustic comfort, classroom acoustics, intelligent acoustics, variable acoustics

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490 Teen Insights into Drugs, Alcohol, and Nicotine: A National Survey of Adolescent Attitudes toward Addictive Substances

Authors: Linda Richter

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Background and Significance: The influence of parents on their children’s attitudes and behaviors is immense, even as children grow out of what one might assume to be their most impressionable years and into teenagers. This study specifically examines the potential that parents have to prevent or reduce the risk of adolescent substance use, even in the face of considerable environmental influences to use nicotine, alcohol, or drugs. Methodology: The findings presented are based on a nationally representative survey of 1,014 teens aged 12-17 living in the United States. Data were collected using an online platform in early 2018. About half the sample was female (51%), 49% was aged 12-14, and 51% was aged 15-17. The margin of error was +/- 3.5%. Demographic data on the teens and their families were available through the survey platform. Survey items explored adolescent respondents’ exposure to addictive substances; the extent to which their sources of information about these substances are reliable or credible; friends’ and peers’ substance use; their own intentions to try substances in the future; and their relationship with their parents. Key Findings: Exposure to nicotine, alcohol, or other drugs and misinformation about these substances were associated with a greater likelihood that adolescents have friends who use drugs and that they have intentions to try substances in the future, which are known to directly predict actual teen substance use. In addition, teens who reported a positive relationship with their parents and having parents who are involved in their lives had a lower likelihood of having friends who use drugs and of having intentions to try substances in the future. This relationship appears to be mediated by parents’ ability to reduce the extent to which their children are exposed to substances in their environment and to misinformation about them. Indeed, the findings indicated that teens who reported a good relationship with their parents and those who reported higher levels of parental monitoring had significantly higher odds of reporting a lower number of risk factors than teens with a less positive relationship with parents or less monitoring. There also were significantly greater risk factors associated with substance use among older teens relative to younger teens. This shift appears to coincide directly with the tendency of parents to pull back in their monitoring and their involvement in their adolescent children’s lives. Conclusion: The survey findings underscore the importance of resisting the urge to completely pull back as teens age and demand more independence since that is exactly when the risks for teen substance use spike and young people need their parents and other trusted adults to be involved more than ever. Particularly through the cultivation of a healthy, positive, and open relationship, parents can help teens receive accurate and credible information about substance use and also monitor their whereabouts and exposure to addictive substances. These findings, which come directly from teens themselves, demonstrate the importance of continued parental engagement throughout children’s lives, regardless of their age and the disincentives to remaining involved and connected.

Keywords: adolescent, parental monitoring, prevention, substance use

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489 Land Transfer for New Township and Its Impact from Dwellers' Point of View: A Case Study of New Town Kolkata

Authors: Subhra Chattopadhyay

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New Towns are usually built up at city-periphery with an eye to accommodate overspill population and functions of the city. ‘New towns are self-sufficient planned towns having a full range of urban economic and social activities, so it can provide employments for all of its inhabitants as well as a balanced self-content social community could be maintained’. In 3rd world countries New towns often emerge from scratch i.e on the area having no urban background and therefore, it needs a massive land conversion from rural to urban. This paper aims to study the implication of such land title transfer into rural sustainability with a case study at Jatragachi, New Town Kolkata. Broad objectives of this study are to understand 1. new changes in this area like i)changes in land use, ii) demographic changes, iii) occupational changes of the local people and 2.their view about new town planning. Major observations are stated below. The studied area was completely rural till recent years and is now at the heart of New Town Kolkata. Though this area is now under the jurisdiction of New Town Kolkata Development Authority (NKDA), it is still administrated by rural self-government.It creates administrative confusion and misuse of public capital. It is observed in this study that cultivation was the mainstay of livelihood for the majority of residents till recent past. There was a dramatic rise in irrigated area in the decade of 90’s pointing out agricultural prosperity.The area achieved the highest productivity of rice in the District. Percentage of marginal workers dropped significantly.In addition to it, ascending women’s literacy rate as found in this rural Mouza obviously indicates a constant social progress .Through land conversion, this flourishing agricultural land has been transformed into urban area with highly sophisticated uses. Such development may satisfy educated urban elite but the dwellers of the area suffer a lot. They bear the cost of new town planning through loss of their assured food and income as well as their place identity. The number of marginal workers increases abruptly. The growth of female literacy drops down. The area loses its functional linkages with its surroundings and fails to prove its actual growth potentiality. The physical linkages( like past roads and irrigation infrastructure) which had developed through time to support the economy become defunct. The ecological services which were provided by the agricultural field are denied. The historicity of this original site is demolished. Losses of the inhabitants of the area who have been evicted are also immense and cannot be materially compensated. Therefore, the ethos of such new town planning in stake of rural sustainability is under question. Need for an integrated approach for rural and urban development planning is felt in this study.

Keywords: new town, sustainable development, growth potentiality, land transfer

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488 Yoga for Holistic Health Wellbeing

Authors: Pothula Madhusudhan Reddy

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Introduction: Yoga is a way of life. of uniting the mind, body and soul. It is also an art of living the right way. The techniques of Yoga are very practical, so they can always be applied. This is the reason why Yoga has been practiced for thousands of years and is still valid today. Importance of Yoga: Yoga that helps to inculcate healthy habits and adopt a healthy lifestyle to achieve good health Research Aim: The aim of this study is to explore the potential benefits of yoga for holistic health and wellbeing, both at an individual and societal level The ultimate goal of human being is to attain the state of perfect freedom from the shackles of ignorance, which is the generator of all the pangs and miseries of life. Methodology: This research follows a thematic and practical experience approach. Yoga includes body postures and movements (stretching), breathing practices, imagery, meditation, and progressive relaxation techniques. Data Collection: The data for this research is collected through a combination of literature review, expert interviews, and practical yoga sessions. The literature review provides a comprehensive understanding of the principles and practices of yoga, while expert interviews offer insights from experienced practitioners. Practical yoga sessions allow for first hand experiences and observations, facilitating a deeper understanding of the subject matter. Analysis Procedures: The collected data is analyzed thematically, where key themes and patterns related to the benefits and effects of yoga on holistic health and wellbeing are identified. The findings are then interpreted and synthesized to draw meaningful conclusions. Questions Addressed: This research addresses the following questions: What are the potential benefits of yoga for holistic health and wellbeing? How does yoga promote rejuvenate the body, mind, and senses? What are the implications of a society embracing yoga for overall societal wellbeing and happiness? Findings: The research highlights that practicing yoga can lead to increased awareness of the body, mind, and senses. It promotes overall physical and mental health, helping individuals achieve a state of happiness and contentment. Moreover, the study emphasizes that a society embracing yoga can contribute to the development of a healthy and happy community. Theoretical Importance: The study of yoga for holistic health and wellbeing holds theoretical importance as it provides insights into the science of yoga and its impact on individuals and society. It contributes to the existing body of knowledge on the subject and further establishes yoga as a potential tool for enhancing overall wellness. Conclusion: The study concludes that yoga is a powerful practice for achieving holistic health and wellbeing. This research provides valuable insights into the science of yoga and its potential as a tool for promoting overall wellness.

Keywords: yoga, asana, pranayama, meditation

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487 Pathogenic Escherichia Coli Strains and Their Antibiotic Susceptibility Profiles in Cases of Child Diarrhea at Addis Ababa University, College of Health Sciences, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Authors: Benyam Zenebe, Tesfaye Sisay, Gurja Belay, Workabeba Abebe

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Background: The prevalence and antibiogram of pathogenic E. coli strains, which cause diarrhea vary from region to region, and even within countries in the same geographical area. In Ethiopia, diagnostic approaches to E. coli induced diarrhea in children less than five years of age are not standardized. The aim of this study was to determine the involvement of pathogenic E. coli strains in child diarrhea and determine the antibiograms of the isolates in children less than 5 years of age with diarrhea at Addis Ababa University College of Health Sciences TikurAnbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A purposive study that included 98 diarrheic children less than five years of age was conducted at Addis Ababa University College of Health Sciences, TikurAnbessa Specialized Hospital, Addis Ababa, Ethiopia to detect pathogenic E. coli biotypes. Stool culture was used to identify presumptive E. coliisolates. Presumptive isolates were confirmed by biochemical tests, and antimicrobial susceptibility tests were performed on confirmed E. coli isolates by the disk diffusion method. DNA was extracted from confirmed isolates by a heating method and subjected to Polymerase Chain Reaction or the presence of virulence genes. Amplified PCR products were analyzed by agarose gel electrophoresis. Data were collected on child demographics and clinical conditions using administered questionnaires. The prevalence of E. coli strains from the total diarrheic children, and the prevalence of pathogenic strains from total E. coli isolates along with their susceptibility profiles; the distribution of pathogenic E.coli biotypes among different age groups and between the sexes were determined by using descriptive statistics. Result: Out of 98 stool specimens collected from diarrheic children less than 5 years of age, 75 presumptive E. coli isolates were identified by culture; further confirmation by biochemical tests showed that only 56 of the isolates were E. coli; 29 of the isolates were found in male children and 27 of them in female children. Out of the 58 isolates of E. coli, 25 pathotypes belonging to different classes of pathogenic strains: STEC, EPEC, EHEC, EAEC were detected by using the PCR technique. Pathogenic E. coli exhibited high rates of antibiotic resistance to many of the antibiotics tested. Moreover, they exhibited multiple drug resistance. Conclusion: This study found that the isolation rate of E. coli and the involvement of antibiotic-resistant pathogenic E. coli in diarrheic children is prominent, and hence focus should be given on the diagnosis and antimicrobial sensitivity testing of pathogenic E. coli at Addis Ababa University College of Health Sciences TikurAnbessa Specialized Hospital. Among antibiotics tested, Cefotitan could be a drug of choice to treat E. coli.

Keywords: antibiotic susceptibility profile, children, diarrhea, E. coli, pathogenic

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486 Effect of Maternal Factors and C-Peptide and Insulin Levels in Cord Blood on the Birth Weight of Newborns: A Preliminary Study from Southern Sri Lanka

Authors: M. H. A. D. de Silva, R. P. Hewawasam, M. A. G. Iresha

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Macrosomia is common in infants born to not only women diagnosed with gestational diabetes mellitus but also non-diabetic obese women. Maternal Body Mass Index (BMI) correlates with the incidence of large for gestational age infants. Obesity has reached epidemic levels in modern societies. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. It is also established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given BMI indicating a genetic predisposition in the occurrence of obesity. The objective of this study is to determine the effect of maternal weight, weight gain during pregnancy, c-peptide and insulin concentrations in the cord blood on the birth of appropriate for and large for gestational age infants in a tertiary care center in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of insulin and C-peptide were measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured, and characteristics of the mother were collected. The relationship between insulin, C-peptide and anthropometrics were assessed by Spearman correlation. The multiple logistic regression analysis examined influences of maternal weight, weight gain during pregnancy, C-peptide and insulin concentrations in cord blood as covariates on the birth of large for gestational age infants. A significant difference (P<0.001) was observed between the insulin levels of infants born large for gestational age (18.73 ± 0.52 µlU/ml) and appropriate for gestational age (13.08 ± 0.56 µlU/ml). Consistently, A significant decrease in concentration (41.68%, P<0.001) was observed between C-peptide levels of infants born large for gestational age and appropriate for gestational age. Cord blood insulin and C-peptide levels had a significant correlation with birth weight (r=0.35, P<0.05) of the newborn at delivery. Maternal weight and BMI which are indicators of maternal nutrition were proven to be directly correlated with birth weight and length. To our knowledge, this relationship was investigated for the first time in a Sri Lankan setting and was also evident in our results. This study confirmed the fact that insulin and C-peptide play a major role in regulating fetal growth. According to the results obtained in this study, we can suggest that the increased BMI of the mother has a direct influence on increased maternal insulin secretion, which may subsequently affect cord insulin and C-peptide levels and also birth weight of the infant.

Keywords: C-peptide, insulin, large for gestational age, maternal weight

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485 Civilian and Military Responses to Domestic Security Threats: A Cross-Case Analysis of Belgium, France, and the United Kingdom

Authors: John Hardy

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The domestic security environment in Europe has changed dramatically in recent years. Since January 2015, a significant number of domestic security threats that emerged in Europe were located in Belgium, France and the United Kingdom. While some threats were detected in the planning phase, many also resulted in terrorist attacks. Authorities in all three countries instituted special or emergency measures to provide additional security to their populations. Each country combined an additional policing presence with a specific military operation to contribute to a comprehensive security response to domestic threats. This study presents a cross-case analysis of three countries’ civilian and military responses to domestic security threats in Europe. Each case study features a unique approach to combining civilian and military capabilities in similar domestic security operations during the same time period and threat environment. The research design focuses on five variables relevant to the relationship between civilian and military roles in each security response. These are the distinction between policing and military roles, the legal framework for the domestic deployment of military forces, prior experience in civil-military coordination, the institutional framework for threat assessments, and the level of public support for the domestic use of military forces. These variables examine the influence of domestic social, political, and legal factors on the design of combined civil-military operations in response to domestic security threats. Each case study focuses on a specific operation: Operation Vigilant Guard in Belgium, Operation Sentinel in France, and Operation Temperer in the United Kingdom. The results demonstrate that the level of distinction between policing and military roles and the existence of a clear and robust legal framework for the domestic use force by military personnel significantly influence the design and implementation of civilian and military roles in domestic security operations. The findings of this study indicate that Belgium, France and the United Kingdom experienced different design and implementation challenges for their domestic security operations. Belgium and France initially had less-developed legal frameworks for deploying the military in domestic security operations than the United Kingdom. This was offset by public support for enacting emergency measures and the strength of existing civil-military coordination mechanisms. The United Kingdom had a well-developed legal framework for integrating civilian and military capabilities in domestic security operations. However, its experiences in Ireland also made the government more sensitive to public perceptions regarding the domestic deployment of military forces.

Keywords: counter-terrorism, democracy, homeland security, intelligence, militarization, policing

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484 Transforming the Education System for the Innovative Society: A Case Study

Authors: Mario Chiasson, Monique Boudreau

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Problem statement: Innovation in education has become a central topic of discussion at various levels, including schools and scholarly literature, driven by the global technological advancements of Industry 4.0. This study aims to contribute to the ongoing dialogue by examining the role of innovation in transforming school culture through the reimagination of traditional structures. The study argues that such a transformation necessitates an understanding and experience of systems leadership. This paper presents the case of the Francophone South School District, where a transformative initiative created an innovative learning environment by engaging students, teachers, and community members collaboratively through eco-communities. Traditional barriers and structures in education were dismantled to facilitate this process. The research component of this paper focuses on the Intr’Appreneur project, a unique initiative launched by the district team in the New Brunswick, Canada to support a system-wide transformation towards progressive and innovative organizational models. Methods This study is part of a larger research project that focuses on the transformation of educational systems in six pilot schools involved in the Intr’Appreneur project. Due to COVID-19 restrictions, the project was downscaled to three schools, and virtual qualitative interviews were conducted with volunteer teachers and administrators. Data was collected from students, teachers, and principals regarding their perceptions of the new learning environment and experiences. The analysis process involved developing categories, establishing codes for emerging themes, and validating the findings. The study emphasizes the importance of system leadership in achieving successful transformation. Results: The findings demonstrate that school principals played a vital role in enabling system-wide change by fostering a dynamic, collaborative, and inclusive culture, coordinating and mobilizing community members, and serving as educational role models who facilitated active and personalized pedagogy among the teaching staff. These qualities align with the characteristics of Leadership 4.0 and are crucial for successful school system transformations. Conclusion: This paper emphasizes the importance of systems leadership in driving educational transformations that extend beyond pedagogical and technological advancements. The research underscores the potential impact of such a leadership approach on teaching, learning, and leading processes in Education 4.0.

Keywords: leadership, system transformation, innovation, innovative learning environment, Education 4.0, system leadership

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483 Civic E-Participation in Central and Eastern Europe: A Comparative Analysis

Authors: Izabela Kapsa

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Civic participation is an important aspect of democracy. The contemporary model of democracy is based on citizens' participation in political decision-making (deliberative democracy, participatory democracy). This participation takes many forms of activities like display of slogans and symbols, voting, social consultations, political demonstrations, membership in political parties or organizing civil disobedience. The countries of Central and Eastern Europe after 1989 are characterized by great social, economic and political diversity. Civil society is also part of the process of democratization. Civil society, funded by the rule of law, civil rights, such as freedom of speech and association and private ownership, was to play a central role in the development of liberal democracy. Among the many interpretations of concepts, defining the concept of contemporary democracy, one can assume that the terms civil society and democracy, although different in meaning, nowadays overlap. In the post-communist countries, the process of shaping and maturing societies took place in the context of a struggle with a state governed by undemocratic power. State fraud or repudiation of the institution is a representative state, which in the past was the only way to manifest and defend its identity, but after the breakthrough became one of the main obstacles to the development of civil society. In Central and Eastern Europe, there are many obstacles to the development of civil society, for example, the elimination of economic poverty, the implementation of educational campaigns, consciousness-related obstacles, the formation of social capital and the deficit of social activity. Obviously, civil society does not only entail an electoral turnout but a broader participation in the decision-making process, which is impossible without direct and participative democratic institutions. This article considers such broad forms of civic participation and their characteristics in Central and Eastern Europe. The paper is attempts to analyze the functioning of electronic forms of civic participation in Central and Eastern European states. This is not accompanied by a referendum or a referendum initiative, and other forms of political participation, such as public consultations, participative budgets, or e-Government. However, this paper will broadly present electronic administration tools, the application of which results from both legal regulations and increasingly common practice in state and city management. In the comparative analysis, the experiences of post-communist bloc countries will be summed up to indicate the challenges and possible goals for further development of this form of citizen participation in the political process. The author argues that for to function efficiently and effectively, states need to involve their citizens in the political decision-making process, especially with the use of electronic tools.

Keywords: Central and Eastern Europe, e-participation, e-government, post-communism

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482 Multimodal Ophthalmologic Evaluation Can Detect Retinal Injuries in Asymptomatic Patients With Primary Antiphospholipid Syndrome

Authors: Taurino S. R. Neto, Epitácio D. S. Neto, Flávio Signorelli, Gustavo G. M. Balbi, Alex H. Higashi, Mário Luiz R. Monteiro, Eloisa Bonfá, Danieli C. O. Andrade, Leandro C. Zacharias

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Purpose: To perform a multimodal evaluation, including the use of Optical Coherence Angiotomography (OCTA), in patients with primary antiphospholipid syndrome (PAPS) without ocular complaints and to compare them with healthy individuals. Methods: A complete structural and functional ophthalmological evaluation using OCTA and microperimetry (MP) exam in patients with PAPS, followed at a tertiary rheumatology outpatient clinic, was performed. All ophthalmologic manifestations were recorded and then statistical analysis was performed for comparative purposes; p <0.05 was considered statistically significant. Results: 104 eyes of 52 subjects (26 patients with PAPS without ocular complaints and 26 healthy individuals) were included. Among PAPS patients, 21 were female (80.8%) and 21 (80.8%) were Caucasians. Thrombotic PAPS was the main clinical criteria manifestation (100%); 65.4% had venous and 34.6% had arterial thrombosis. Obstetrical criteria were present in 34.6% of all thrombotic PAPS patients. Lupus anticoagulant was present in all patients. 19.2% of PAPS patients presented ophthalmologic findings against none of the healthy individuals. The most common retinal change was paracentral acute middle maculopathy (PAMM) (3 patients, 5 eyes), followed by drusen-like deposits (1 patient, 2 eyes) and pachychoroid pigment epitheliopathy (1 patient, 1 eye). Systemic hypertension and hyperlipidaemia were present in 100% of the PAPS patients with PAMM, while only six patients (26.1%) with PAPS without PAMM presented these two risk factors together. In the quantitative OCTA evaluation, we found significant differences between PAPS patients and controls in both the superficial vascular complex (SVC) and deep vascular complex (DVC) in the high-speed protocol, as well as in the SVC in the high-resolution protocol. In the analysis of the foveal avascular zone (FAZ) parameters, the PAPS group had a larger area of FAZ in the DVC using the high-speed method compared to the control group (p=0.047). In the quantitative analysis of the MP, the PAPS group had lower central (p=0.041) and global (p<0.001) retinal sensitivity compared to the control group, as well as in the sector analysis, with the exception of the inferior sector. In the quantitative evaluation of fixation stability, there was a trend towards worse stability in the PAPS subgroup with PAMM in both studied methods. Conclusions: PAMM was observed in 11.5% of PAPS patients with no previous ocular complaints. Systemic hypertension concomitant with hyperlipidemia was the most commonly associated risk factor for PAMM in patients with PAPS. PAPS patients present lower vascular density and retinal sensitivity compared to the control group, even in patients without PAMM.

Keywords: antiphospholipid syndrome, optical coherence angio tomography, optical coherence tomography, retina

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481 The Medical Student Perspective on the Role of Doubt in Medical Education

Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

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Introduction: An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavored to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learners. Aim: Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Methods: Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Results: Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. Discussion: After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Conclusion: Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: ethics, medical student, doubt, medical education, faith

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480 The Report of Co-Construction into a Trans-National Education Teaching Team

Authors: Juliette MacDonald, Jun Li, Wenji Xiang, Mingwei Zhao

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Shanghai International College of Fashion and Innovation (SCF) was created as a result of a collaborative partnership agreement between the University of Edinburgh and Donghua University. The College provides two programmes: Fashion Innovation and Fashion Interior Design and the overarching curriculum has the intention of developing innovation and creativity within an international learning, teaching, knowledge exchange and research context. The research problem presented here focuses on the multi-national/cultural faculty in the team, the challenges arising from difficulties in communication and the associated limitations of management frameworks. The teaching faculty at SCF are drawn from China, Finland, Korea, Singapore and the UK with input from Flying Faculty from Fashion and Interior Design, Edinburgh College of Art (ECA), for 5 weeks each semester. Rather than fully replicating the administrative and pedagogical style of one or other of the institutions within this joint partnership the aim from the outset was to create a third way which acknowledges the quality assurance requirements of both Donghua and Edinburgh, the academic and technical needs of the students and provides relevant development and support for all the SCF-based staff and Flying Academics. It has been well acknowledged by those who are involved in teaching across cultures that there is often a culture shock associated with transnational education but that the experience of being involved in the delivery of a curriculum at a Joint Institution can also be very rewarding for staff and students. It became clear at SCF that if a third way might be achieved which encourages innovative approaches to fashion education whilst balancing the expectations of Chinese and western concepts of education and the aims of two institutions, then it was going to be necessary to construct a framework which developed close working relationships for the entire teaching team, so not only between academics and students but also between technicians and administrators at ECA and SCF. The attempts at co-construction and integration are built on the sharing of cultural and educational experiences and knowledge as well as provision of opportunities for reflection on the pedagogical purpose of the curriculum and its delivery. Methods on evaluating the effectiveness of these aims include a series of surveys and interviews and analysis of data drawn from teaching projects delivered to the students along with graduate successes from the last five years, since SCF first opened its doors. This paper will provide examples of best practice developed by SCF which have helped guide the faculty and embed common core values and aims of co-construction regulations and management, whilst building a pro-active TNE (Trans-National Education) team which enhances the learning experience for staff and students alike.

Keywords: cultural co-construction, educational team management, multi-cultural challenges, TNE integration for teaching teams

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479 Germline Mutations of Mitogen-Activated Protein Kinases Pathway Signaling Pathway Genes in Children

Authors: Nouha Bouayed Abdelmoula, Rim Louati, Nawel Abdellaoui, Balkiss Abdelmoula, Oldez Kaabi, Walid Smaoui, Samir Aloulou

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Background and Aims: Cardiofaciocutaneous syndrome (CFC) is an autosomal dominant disorder with the vast majority of cases arising by a new mutation of BRAF, MEK1, MEK2, or rarely, KRAS genes. Here, we report a rare Tunisian case of CFC syndrome for whom we identify SOS1 mutation. Methods: Genomic DNA was obtained from peripheral blood collected in an EDTA tube and extracted from leukocytes using the phenol/chloroform method according to standard protocols. High resolution melting (HRM) analysis for screening of mutations in the entire coding sequence of PTPN11 was conducted first. Then, HRM assays to look for hot spot mutations coding regions of the other genes of the RAS-MAPK pathway (RAt Sarcoma viral oncogene homolog Mitogen-Activated Protein Kinases Pathway): SOS1, SHOC2, KRAS, RAF1, KRAS, NRAS, CBL, BRAF, MEK1, MEK2, HRAS, and RIT1, were applied. Results: Heterozygous SOS1 point mutation clustered in exon 10, which encodes for the PH domain of SOS1, was identified: c.1655 G > A. The patient was a 9-year-old female born from a consanguineous couple. She exhibited pulmonic valvular stenosis as congenital heart disease. She had facial features and other malformations of Noonan syndrome, including macrocephaly, hypertelorism, ptosis, downslanting palpebral fissures, sparse eyebrows, a short and broad nose with upturned tip, low-set ears, high forehead commonly associated with bitemporal narrowing and prominent supraorbital ridges, short and/or webbed neck and short stature. However, the phenotype is also suggestive of CFC syndrome with the presence of more severe ectodermal abnormalities, including curly hair, keloid scars, hyperkeratotic skin, deep plantar creases, and delayed permanent dentition with agenesis of the right maxillary first molar. Moreover, the familial history of the patient revealed recurrent brain malignancies in the paternal family and epileptic disease in the maternal family. Conclusions: This case report of an overlapping RASopathy associated with SOS1 mutation and familial history of brain tumorigenesis is exceptional. The evidence suggests that RASopathies are truly cancer-prone syndromes, but the magnitude of the cancer risk and the types of cancer partially overlap.

Keywords: cardiofaciocutaneous syndrome, CFC, SOS1, brain cancer, germline mutation

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478 ePA-Coach: Design of the Intelligent Virtual Learning Coach for Senior Learners in Support of Digital Literacy in the Context of Electronic Patient Record

Authors: Ilona Buchem, Carolin Gellner

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Over the last few years, the call for the support of senior learners in the development of their digital literacy has become prevalent, mainly due to the progression towards ageing societies paired with advances in digitalisation in all spheres of life, including e-health and electronic patient record (EPA). While major research efforts in supporting senior learners in developing digital literacy have been invested so far in e-learning focusing on knowledge acquisition and cognitive tasks, little research exists in learning models which target virtual mentoring and coaching with the help of pedagogical agents and address the social dimensions of learning. Research from studies with students in the context of formal education has already provided methods for designing intelligent virtual agents in support of personalised learning. However, this research has mostly focused on cognitive skills and has not yet been applied to the context of mentoring/coaching of senior learners, who have different characteristics and learn in different contexts. In this paper, we describe how insights from previous research can be used to develop an intelligent virtual learning coach (agent) for senior learners with a focus on building the social relationship between the agent and the learner and the key task of the agent to socialize learners to the larger context of digital literacy with a focus on electronic health records. Following current approaches to mentoring and coaching, the agent is designed not to enhance and monitor the cognitive performance of the learner but to serve as a trusted friend and advisor, whose role is to provide one-to-one guidance and support sharing of experiences among learners (peers). Based on literature review and synopsis of research on virtual agents and current coaching/mentoring models under consideration of the specific characteristics and requirements of senior learners, we describe the design framework which was applied to design an intelligent virtual learning coach as part of the e-learning system for digital literacy of senior learners in the ePA-Coach project founded by the German Ministry of Education and Research. This paper also presents the results from the evaluation study, which compared the use of the first prototype of the virtual learning coach designed according to the design framework with a voice narration in a multimedia learning environment with senior learners. The focus of the study was to validate the agent design in the context of the persona effect (Lester et al., 1997). Since the persona effect is related to the hypothesis that animated agents are perceived as more socially engaging, the study evaluated possible impacts of agent coaching in comparison with voice coaching on motivation, engagement, experience, and digital literacy.

Keywords: virtual learning coach, virtual mentor, pedagogical agent, senior learners, digital literacy, electronic health records

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477 Physical Function and Physical Activity Preferences of Elderly Individuals Admitted for Elective Abdominal Surgery: A Pilot Study.

Authors: Rozelle Labuschagne, Ronel Roos

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Individuals often experience a reduction in physical function, quality of life and basic activities of daily living after surgery. This is exponentially true for high-risk patients, especially the elderly and frail individuals. Not much is known about the physical function, physical activity preferences and factors associated with the six-minute walk test of elderly individuals who would undergo elective abdominal surgery in South Africa. Such information is important to design effective prehabilitation physiotherapy programs prior to elective surgery. The purpose of the study was to describe the demographic profile and physical function of elderly patients who would undergo elective surgery and to determine factors associated with their six-minute walk test distance findings. A cross-sectional descriptive study in elderly patients older than 60 years of age who would undergo elective abdominal surgery were consecutively sampled at a private hospital in Pretoria, South Africa. Participants’ demographics were collected and physical function assessed with the Functional Comorbidity Index (FCI), DeMorton Mobility Index (DEMMI), Lawton-Brody Instrumental Activities of Daily Living Scale (IADL) and six-minute walk test (6MWT). Descriptive and inferential statistics were used for data analysis with IBM SPSS 25. A p-value ≤ 0.05 were deemed statistically significant. The pilot study consisted of 12 participants (female (n=11, 91.7%), male (n=1, 8.3%) with a mean age of 65.8 (±4.5) years, body mass index of 28 (±4.2) kg.m2 with one (8.3%) participant being a current smoker and four (33.3%) participants having a smoking history. Nine (75%) participants lived independently at home and three (25%) had caregivers. Participants reported walking (n=6, 50%), stretching exercises (n=1, 8.3%), household chores & gardening (n=2, 16.7%), biking/swimming/running (n=1, 8.3%) as physical activity preferences. Physical function findings of the sample were: mean FCI score 3 (±1.1), DEMMI score 81.1 (±14.9), IADL 95 (±17.3), 6MWT 435.50 (IQR 364.75-458.50) with percentage 6MWT distance achieved 81.8% (IQR 64.4%-87.5%). A strong negative correlation was observed between 6MWT distance walked and FCI (r = -0.729, p=0.007). The majority of study participants reported incorporating some form of physical activity into their daily life as form of exercise. Most participants did not achieve their predicted 6MWT distance indicating less than optimal levels of physical function capacity. The number of comorbidities as determined by the FCI was associated with the distance that participants could walk with the 6MWT. The results of this pilot study could be used to indicate which elderly individuals would benefit most from a pre-surgical rehabilitation program. The main goal of such a program would be to improve physical function capacity as measured by the 6MWT. Surgeons could refer patients based on age and number of comorbidities, as determined by the FCI, to potentially improve surgical outcomes.

Keywords: abdominal surgery, elderly, physical function, six-minute walk test

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476 Fostering Students’ Cultural Intelligence: A Social Media Experiential Project

Authors: Lorena Blasco-Arcas, Francesca Pucciarelli

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Business contexts have become globalised and digitalised, which requires that managers develop a strong sense of cross-cultural intelligence while working in geographically distant teams by means of digital technologies. How to better equip future managers on these kinds of skills has been put forward as a critical issue in Business Schools. In pursuing these goals, higher education is shifting from a passive lecture approach, to more active and experiential learning approaches that are more suitable to learn skills. For example, through the use of case studies, proposing plausible business problem to be solved by students (or teams of students), these institutions have focused for long in fostering learning by doing. Though, case studies are no longer enough as a tool to promote active teamwork and experiential learning. Moreover, digital advancements applied to educational settings have enabled augmented classrooms, expanding the learning experience beyond the class, which increase students’ engagement and experiential learning. Different authors have highlighted the benefits of digital engagement in order to achieve a deeper and longer-lasting learning and comprehension of core marketing concepts. Clickers, computer-based simulations and business games have become fairly popular between instructors, but still are limited by the fact that are fictional experiences. Further exploration of real digital platforms to implement real, live projects in the classroom seem relevant for marketing and business education. Building on this, this paper describes the development of an experiential learning activity in class, in which students developed a communication campaign in teams using the BuzzFeed platform, and subsequently implementing the campaign by using other social media platforms (e.g. Facebook, Instagram, Twitter…). The article details the procedure of using the project for a marketing module in a Bachelor program with students located in France, Italy and Spain campuses working on multi-campus groups. Further, this paper describes the project outcomes in terms of students’ engagement and analytics (i.e. visits achieved). the project included a survey in order to analyze and identify main aspects related to how the learning experience is influenced by the cultural competence developed through working in geographically distant and culturally diverse teamwork. Finally, some recommendations to use project-based social media tools while working with virtual teamwork in the classroom are provided.

Keywords: cultural competences, experiential learning, social media, teamwork, virtual group work

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475 Cognition in Context: Investigating the Impact of Persuasive Outcomes across Face-to-Face, Social Media and Virtual Reality Environments

Authors: Claire Tranter, Coral Dando

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Gathering information from others is a fundamental goal for those concerned with investigating crime, and protecting national and international security. Persuading an individual to move from an opposing to converging viewpoint, and an understanding on the cognitive style behind this change can serve to increase understanding of traditional face-to-face interactions, as well as synthetic environments (SEs) often used for communication across varying geographical locations. SEs are growing in usage, and with this increase comes an increase in crime being undertaken online. Communication technologies can allow people to mask their real identities, supporting anonymous communication which can raise significant challenges for investigators when monitoring and managing these conversations inside SEs. To date, the psychological literature concerning how to maximise information-gain in SEs for real-world interviewing purposes is sparse, and as such this aspect of social cognition is not well understood. Here, we introduce an overview of a novel programme of PhD research which seeks to enhance understanding of cross-cultural and cross-gender communication in SEs for maximising information gain. Utilising a dyadic jury paradigm, participants interacted with a confederate who attempted to persuade them to the opposing verdict across three distinct environments: face-to-face, instant messaging, and a novel virtual reality environment utilising avatars. Participants discussed a criminal scenario, acting as a two-person (male; female) jury. Persuasion was manipulated by the confederate claiming an opposing viewpoint (guilty v. not guilty) to the naïve participants from the outset. Pre and post discussion data, and observational digital recordings (voice and video) of participant’ discussion performance was collected. Information regarding cognitive style was also collected to ascertain participants need for cognitive closure and biases towards jumping to conclusions. Findings revealed that individuals communicating via an avatar in a virtual reality environment reacted in a similar way, and thus equally persuasive, when compared to individuals communicating face-to-face. Anonymous instant messaging however created a resistance to persuasion in participants, with males showing a significant decline in persuasive outcomes compared to face to face. The findings reveal new insights particularly regarding the interplay of persuasion on gender and modality, with anonymous instant messaging enhancing resistance to persuasion attempts. This study illuminates how varying SE can support new theoretical and applied understandings of how judgments are formed and modified in response to advocacy.

Keywords: applied cognition, persuasion, social media, virtual reality

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474 Relationship between the Development of Sepsis, Systemic Inflammatory Response Syndrome and Body Mass Index among Adult Trauma Patients at University Hospital in Cairo

Authors: Mohamed Hendawy Mousa, Warda Youssef Mohamed Morsy

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Background: Sepsis is a major cause of mortality and morbidity in trauma patients. Body mass index as an indicator of nutritional status was reported as a predictor of injury pattern and complications among critically ill injured patients. Aim: The aim of this study is to investigate the relationship between body mass index and the development of sepsis, systemic inflammatory response syndrome among adult trauma patients at emergency hospital - Cairo University. Research design: Descriptive correlational research design was utilized in the current study. Research questions: Q1. What is the body mass index profile of adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, Q2. What is the frequency of systemic inflammatory response syndrome and sepsis among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, and Q3. What is the relationship between the development of sepsis, systemic inflammatory response syndrome and body mass index among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?. Sample: A purposive sample of 52 adult male and female trauma patients with revised trauma score 10 to 12. Setting: The Emergency Hospital affiliated to Cairo University. Tools: Four tools were utilized to collect data pertinent to the study: Socio demographic and medical data tool, Systemic inflammatory response syndrome assessment tool, Revised Trauma Score tool, and Sequential organ failure assessment tool. Results: The current study revealed that, (61.5 %) of the studied subjects had normal body mass index, (25 %) were overweight, and (13.5 %) were underweight. 84.6% of the studied subjects had systemic inflammatory response syndrome and 92.3% were suffering from mild sepsis. No significant statistical relationship was found between body mass index and occurrence of Systemic inflammatory response syndrome (2= 2.89 & P = 0.23). However, Sequential organ failure assessment scores were affected significantly by body mass index was found mean of initial and last Sequential organ failure assessment score for underweight, normal and obese where t= 7.24 at p = 0.000, t= 16.49 at p = 0.000 and t= 9.80 at p = 0.000 respectively. Conclusion: Underweight trauma patients showed significantly higher rate of developing sepsis as compared to patients with normal body weight and obese. Recommendations: based on finding of this study the following are recommended: replication of the study on a larger probability sample from different geographical locations in Egypt; Carrying out of further studies in order to assess the other risk factors influencing trauma outcome and incidence of its complications; Establishment of standardized guidelines for managing underweight traumatized patients with sepsis.

Keywords: body mass index, sepsis, systemic inflammatory response syndrome, adult trauma

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473 Investigation of Unusually High Ultrasonic Signal Attenuation in Water Observed in Various Combinations of Pairs of Lead Zirconate Titanate Pb(ZrxTi1-x)O3 (PZT) Piezoelectric Ceramics Positioned Adjacent to One Another Separated by an Intermediate Gap

Authors: S. M. Mabandla, P. Loveday, C. Gomes, D. T. Maiga, T. T. Phadi

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Lead zirconate titanate (PZT) piezoelectric ceramics are widely used in ultrasonic applications due to their ability to effectively convert electrical energy into mechanical vibrations and vice versa. This paper presents a study on the behaviour of various combinations of pairs of PZT piezoelectric ceramic materials positioned adjacent to each other with an intermediate gap submerged in water, where one piezoelectric ceramic material is excited by a cyclic electric field with constant frequency and amplitude displacement. The transmitted ultrasonic sound propagates through the medium and is received by the PZT ceramic at the other end, the ultrasonic sound signal amplitude displacement experiences attenuation during propagation due to acoustic impedance. The investigation focuses on understanding the causes of extremely high amplitude displacement attenuation that have been observed in various combinations of piezoelectric ceramic pairs that are submerged in water arranged in a manner stipulated earlier. by examining various combinations of pairs of these piezoelectric ceramics, their physical, electrical, and acoustic properties, and behaviour and attributing them to the observed significant signal attenuation. The experimental setup involves exciting one piezoelectric ceramic material at one end with a burst square cyclic electric field signal of constant frequency, which generates a burst of ultrasonic sound that propagates through the water medium to the adjacent piezoelectric ceramic at the other end. Mechanical vibrations of a PZT piezoelectric ceramic are measured using a double-beam laser Doppler vibrometer to mimic the incident ultrasonic waves generated and received ultrasonic waves on the other end due to mechanical vibrations of a PZT. The measured ultrasonic sound wave signals are continuously compared to the applied cyclic electric field at both ends. The impedance matching networks are continuously tuned at both ends to eliminate electromechanical impedance mismatch to improve ultrasonic transmission and reception. The study delves into various physical, electrical, and acoustic properties of the PZT piezoelectric ceramics, such as the electromechanical coupling factor, acoustic coupling, and elasticity, among others. These properties are analyzed to identify potential factors contributing to the unusually high acoustic impedance in the water medium between the ceramics. Additionally, impedance-matching networks are investigated at both ends to offset the high signal attenuation and improve overall system performance. The findings will be reported in this paper.

Keywords: acoustic impedance, impedance mismatch, piezoelectric ceramics, ultrasonic sound

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472 Person-Centered Approaches in Face-to-Face Interventions to Support Enrolment in Cardiac Rehabilitation: A Scoping Review Study

Authors: Birgit Rasmussen, Thomas Maribo, Bente S. Toft

Abstract:

BACKGROUND: Cardiac rehabilitation is the standard treatment for ischemic heart disease. Cardiac rehabilitation improves quality of life, reduces mortality and the risk of readmission, and provides patients with valuable knowledge and encouragement from peers and staff. Still, less than half of eligible patients enroll. Face-to-face interventions have the potential to support patients' decision-making and increase enrolment in cardiac rehabilitation. However, we lack knowledge of the content and characteristics of interventions. AIM: The aim was to outline and evaluate the content and characteristics of studies that have reported on face-to-face interventions to encourage enrolment in cardiac rehabilitation in patients with ischemic heart disease. METHOD: This scoping review followed the Joanne Briggs Institute methodology. Based on an a-priori protocol that defined the systematic search criteria, six databases were searched for studies published between 2001 and 2023. Two reviewers independently screened and selected studies. All authors discussed the summarized data prior to the narrative presentation. RESULTS: After screening and full text review of 5583 records, 20 studies of heterogeneous design and content were included. Four studies described the key contents in face-to-face interventions to be education, support of autonomy, addressing reasons for change, and emotional and cognitive support while showing understanding. Two studies used motivational interviewing to target patients' experiences and address worries and anticipated difficulties. Four quantitative studies found associations between enrolment and intention to attend, cardiac rehabilitation barriers, exercise self-efficacy, and perceived control. When patients asked questions, enrolment rates were higher, while providing reassurance and optimism could lead to non-attendance if patients had a high degree of worry. In qualitative studies, support to overcome barriers and knowledge about health benefits from participation in cardiac rehabilitation facilitated enrolment. Feeling reassured that the cardiac condition was good could lead to non-attendance. DISCUSSION AND CONCLUSION: To support patients' enrolment in cardiac rehabilitation, it is recommended that interventions integrate a person-centered dialogue. Individual worries and barriers to cardiac rehabilitation should be jointly explored. When talking with patients for whom worries predominate, the recommendation is to focus on the patients' perspectives and avoid too much focus on reassurance and problem-solving. The patients' perspectives, the mechanisms of change, and the process evaluation of the intervention including person-centeredness are relevant to include in future studies.

Keywords: ischemic heart disease, cardiac rehabilitation, enrolment, person-centered, in-hospital interventions

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471 The GRIT Study: Getting Global Rare Disease Insights Through Technology Study

Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

Abstract:

Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

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470 Laparoscopic Resection Shows Comparable Outcomes to Open Thoracotomy for Thoracoabdominal Neuroblastomas: A Meta-Analysis and Systematic Review

Authors: Peter J. Fusco, Dave M. Mathew, Chris Mathew, Kenneth H. Levy, Kathryn S. Varghese, Stephanie Salazar-Restrepo, Serena M. Mathew, Sofia Khaja, Eamon Vega, Mia Polizzi, Alyssa Mullane, Adham Ahmed

Abstract:

Background: Laparoscopic (LS) removal of neuroblastomas in children has been reported to offer favorable outcomes compared to the conventional open thoracotomy (OT) procedure. Critical perioperative measures such as blood loss, operative time, length of stay, and time to postoperative chemotherapy have all supported laparoscopic use rather than its more invasive counterpart. Herein, a pairwise meta-analysis was performed comparing perioperative outcomes between LS and OT in thoracoabdominal neuroblastoma cases. Methods: A comprehensive literature search was performed on PubMed, Ovid EMBASE, and Scopus databases to identify studies comparing the outcomes of pediatric patients with thoracoabdominal neuroblastomas undergoing resection via OT or LS. After deduplication, 4,227 studies were identified and subjected to initial title screening with exclusion and inclusion criteria to ensure relevance. When studies contained overlapping cohorts, only the larger series were included. Primary outcomes include estimated blood loss (EBL), hospital length of stay (LOS), and mortality, while secondary outcomes were tumor recurrence, post-operative complications, and operation length. The “meta” and “metafor” packages were used in R, version 4.0.2, to pool risk ratios (RR) or standardized mean differences (SMD) in addition to their 95% confidence intervals in the random effects model via the Mantel-Haenszel method. Heterogeneity between studies was assessed using the I² test, while publication bias was assessed via funnel plot. Results: The pooled analysis included 209 patients from 5 studies (141 OT, 68 LS). Of the included studies, 2 originated from the United States, 1 from Toronto, 1 from China, and 1was from a Japanese center. Mean age between study cohorts ranged from 2.4 to 5.3 years old, with female patients occupying between 30.8% to 50% of the study populations. No statistically significant difference was found between the two groups for LOS (SMD -1.02; p=0.083), mortality (RR 0.30; p=0.251), recurrence(RR 0.31; p=0.162), post-operative complications (RR 0.73; p=0.732), or operation length (SMD -0.07; p=0.648). Of note, LS appeared to be protective in the analysis for EBL, although it did not reach statistical significance (SMD -0.4174; p= 0.051). Conclusion: Despite promising literature assessing LS removal of pediatric neuroblastomas, results showed it was non-superior to OT for any explored perioperative outcomes. Given the limited comparative data on the subject, it is evident that randomized trials are necessary to further the efficacy of the conclusions reached.

Keywords: laparoscopy, neuroblastoma, thoracoabdominal, thoracotomy

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469 Epidemiological Data of Schistosoma haematobium Bilharzia in Rural and Urban Localities in the Republic of Congo

Authors: Jean Akiana, Digne Merveille Nganga Bouanga, Nardiouf Sjelin Nsana, Wilfrid Sapromet Ngoubili, Chyvanelle Ndous Akiridzo, Vishnou Reize Ampiri, Henri-Joseph Parra, Florence Fenollar, Didier Raoult, Oleg Mediannikov, Cheikh Sadhibou Sokhna

Abstract:

Schistosoma haematobium schistosomiasis is an endemic disease in which the level of human exposure, incidence, and fatality attributed to it remains, unfortunately, high worldwide. The erection of hydroelectric infrastructures constitute a major factor in the emergence of this disease. In the context of the Republic of the Congo, which considers industrialization and modernization as two essential pillars of development, building the hydroelectric dams of Liouesso (19 Mw) and the feasibility studies of the dams of Chollet (600MW) in the Sangha, of Sounda (1000MW) in Kouilou and Kouembali (150MW) on Lefini is necessary to increase the country's energy capacities. Likewise, the urbanization of former endemic localities should take into account the maintenance of contamination points. However, health impact studies on schistosomiasis epidemiology in general and urinary bilharzia, in particular, have never been carried out in these areas, neither before nor after the erection of those dams. Participants benefited from an investigative questionnaire, urinalysis both by dipstick and urine filtrate examined under a microscope. Assessment of the genetic diversity of schistosoma species populations was considered as well as PCR analysis to confirm the test strip and microscopy tests. 405 participants were registered in five localities. The sampling was made up of a balanced population in terms of male/female ratio, which is around 1. The prevalence rate was 45% (55/123) in Nkayi, 10.40% (11/106) in Loudima, 1 case in Mbomo (West Cuvette), which would probably be imported, zero in Liouesso and Kabo. The highest oviuria (number of eggs per volume of urine) is 150 S. haematobium eggs/10ml in Nkayi, apart from the case of imported Mbomo, imported from Gabon, which has 160 S. haematobium eggs/10ml. The lowest oviuria was 2 S. haematobium eggs/10ml. Prevalence rates are still high in semi-urban areas (Nkayi). As praziquantel treatments are available and effective, it is important to step up mass treatment campaigns in high risk areas already largely initiated by the National Schistosomiasis Control Program. Prevalence rates are still high in semi-urban areas (Nkayi). As praziquantel treatments are available and effective, it is important to step up mass treatment campaigns in high risk areas already largely initiated by the National Schistosomiasis Control Program.

Keywords: Bilharzia, Schistosoma haematobium, oviuria, urbanization, Congo

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