Search results for: key population
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5812

Search results for: key population

412 The Causes and Potential Solutions for Foodborne Illness, Food Security, and Food Safety: In the Case of the East Harerghe Region of Oromia, Ethiopia

Authors: Tuji Jemal Ahmed, Abdi Mohammed, Geremew Geidare Kailo

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Food security, foodborne illness, and food safety are critical issues that affect the East Harerghe region of Oromia, Ethiopia. Despite the region's potential for agriculture, food insecurity remains a significant problem, with many households experiencing chronic hunger and malnutrition. The region also experiences high rates of foodborne illnesses, including cholera, typhoid, and diarrhea, which are caused by poor hygiene and sanitation practices. Additionally, food safety is a significant challenge, particularly in rural areas, where there is a lack of infrastructure, inadequate food storage facilities, and limited access to information about food safety. There are several factors that contribute to the current situation in the East Harerghe region; firstly, the region is susceptible to natural disasters, for instance, drought, which affects crop yields and livestock production. Secondly, the region also experiences poor infrastructure, which affects the storage and transportation of food, particularly in rural areas. Thirdly, there is a lack of awareness and knowledge on good hygiene and sanitation practices, specifically during food handling, processing, and storage. Fourthly, unitability due to conflict and other forms of land degradation exacerbates food insecurity and malnutrition. Finally, limited access to financial resources and markets commonly affects smallholder farmers by their ability to produce and sell food. To address the current situation in that area, several potential solutions can be implemented; investment in infrastructure is necessary, especially in rural areas, to improve the storage and transportation of food. Education and awareness programs on good hygiene and sanitation practices should target local communities, smallholder farmers, and food vendors. Financial resources and markets should be made more accessible to smallholder farmers, particularly through the provision of credit and improved access to markets. Addressing the underlying causes of conflict and promoting peaceful coexistence can help to reduce displacement and loss of livelihoods. Finally, the enforcement of food safety regulations and the implementation of standards for food processing and storage facilities are necessary to ensure food safety. In conclusion, addressing the challenges of food security, foodborne illness, and food safety in the East Harerghe region requires a coordinated effort from various stakeholders, including the government, non-governmental organizations, and local communities. By implementing the solutions outlined above, the region can improve its food security, prevent foodborne illnesses, and keep food safe for its population. Eventually, building the resilience of communities to shocks such as droughts, floods, and conflict is necessary to ensure long-term food security in the region.

Keywords: foodborne illness, food handling, food safety, food security

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411 Maternal Risk Factors Associated with Low Birth Weight Neonates in Pokhara, Nepal: A Hospital Based Case Control Study

Authors: Dipendra Kumar Yadav, Nabaraj Paudel, Anjana Yadav

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Background: Low Birth weight (LBW) is defined as the weight at birth less than 2500 grams, irrespective of the period of their gestation. LBW is an important indicator of general health status of population and is considered as the single most important predictors of infant mortality especially of deaths within the first month of life that is birth weight determines the chances of newborn survival. Objective of this study was to identify the maternal risk factors associated with low birth weight neonates. Materials and Methods: A hospital based case-control study was conducted in maternity ward of Manipal Teaching Hospital, Pokhara, Nepal from 23 September 2014 to 12 November 2014. During study period 59 cases were obtained and twice number of control group were selected with frequency matching of the mother`s age with ± 3 years and total controls were 118. Interview schedule was used for data collection along with record review. Data were entered in Epi-data program and analysis was done with help of SPSS software program. Results: From bivariate logistic regression analysis, eighteen variables were found significantly associated with LBW and these were place of residence, family monthly income, education, previous still birth, previous LBW, history of STD, history of vaginal bleeding, anemia, ANC visits, less than four ANC visits, de-worming status, counseling during pregnancy, CVD, physical workload, stress, extra meal during pregnancy, smoking and alcohol consumption status. However after adjusting confounding variables, only six variables were found significantly associated with LBW. Mothers who had family monthly income up to ten thousand rupees were 4.83 times more likely to deliver LBW with CI (1.5-40.645) and p value 0.014 compared to mothers whose family income NRs.20,001-60,000. Mothers who had previous still birth were 2.01 times more likely to deliver LBW with CI (0.69-5.87) and p value 0.02 compared to mothers who did not has previous still birth. Mothers who had previous LBW were 5.472 times more likely to deliver LBW with CI (1.2-24.93) and p value 0.028 compared to mothers who did not has previous LBW. Mothers who had anemia during pregnancy were 3.36 times more likely to deliver LBW with CI (0.77-14.57) and p value 0.014 compared to mothers who did not has anemia. Mothers who delivered female newborn were 2.96 times more likely to have LBW with 95% CI (1.27-7.28) and p value 0.01 compared to mothers who deliver male newborn. Mothers who did not get extra meal during pregnancy were 6.04 times more likely to deliver LBW with CI (1.11-32.7) and p value 0.037 compared to mothers who getting the extra meal during pregnancy. Mothers who consumed alcohol during pregnancy were 4.83 times more likely to deliver LBW with CI (1.57-14.83) and p value 0.006 compared to mothers who did not consumed alcohol during pregnancy. Conclusions: To reduce low birth weight baby through economic empowerment of family and individual women. Prevention and control of anemia during pregnancy is one of the another strategy to control the LBW baby and mothers should take full dose of iron supplements with screening of haemoglobin level. Extra nutritional food should be provided to women during pregnancy. Health promotion program will be focused on avoidance of alcohol and strengthen of health services that leads increasing use of maternity services.

Keywords: low birth weight, case-control, risk factors, hospital based study

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410 Impact of Fluoride Contamination on Soil and Water at North 24 Parganas, West Bengal, India

Authors: Rajkumar Ghosh

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Fluoride contamination is a growing concern in various regions across the globe, including North 24 Parganas in West Bengal, India. The presence of excessive fluoride in the environment can have detrimental effects on crops, soil quality, and water resources. This note aims to shed light on the implications of fluoride contamination and its impact on the agricultural sector in North 24 Parganas. The agricultural lands in North 24 Parganas have been significantly affected by fluoride contamination, leading to adverse consequences for crop production. Excessive fluoride uptake by plants can hinder their growth, reduce crop yields, and impact the quality of agricultural produce. Certain crops, such as paddy, vegetables, and fruits, are more susceptible to fluoride toxicity, resulting in stunted growth, leaf discoloration, and reduced nutritional value. Fluoride-contaminated water, often used for irrigation, contributes to the accumulation of fluoride in the soil. Over time, this can lead to soil degradation and reduced fertility. High fluoride levels can alter soil pH, disrupt the availability of essential nutrients, and impair microbial activity critical for nutrient cycling. Consequently, the overall health and productivity of the soil are compromised, making it increasingly challenging for farmers to sustain agricultural practices. Fluoride contamination in North 24 Parganas extends beyond the soil and affects water resources as well. The excess fluoride seeps into groundwater, making it unsafe for consumption. Long-term consumption of fluoride-contaminated water can lead to various health issues, including dental and skeletal fluorosis. These health concerns pose significant risks to the local population, especially those reliant on contaminated water sources for their daily needs. Addressing fluoride contamination requires concerted efforts from various stakeholders, including government authorities, researchers, and farmers. Implementing appropriate water treatment technologies, such as defluoridation units, can help reduce fluoride levels in drinking water sources. Additionally, promoting alternative irrigation methods and crop diversification strategies can aid in mitigating the impact of fluoride on agricultural productivity. Furthermore, creating awareness among farmers about the adverse effects of fluoride contamination and providing access to alternative water sources are crucial steps toward safeguarding the health of the community and sustaining agricultural activities in the region. Fluoride contamination poses significant challenges to crop production, soil health, and water resources in North 24 Parganas, West Bengal. It is imperative to prioritize efforts to address this issue effectively and implement appropriate measures to mitigate fluoride contamination. By adopting sustainable practices and promoting awareness, the community can work towards restoring the agricultural productivity, soil quality and ensuring access to safe drinking water in the region.

Keywords: fluoride contamination, drinking water, toxicity, soil health

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409 In vitro Antimicrobial Resistance Pattern of Bovine Mastitis Bacteria in Ethiopia

Authors: Befekadu Urga Wakayo

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Introduction: Bacterial infections represent major human and animal health problems in Ethiopia. In the face of poor antibiotic regulatory mechanisms, development of antimicrobial resistance (AMR) to commonly used drugs has become a growing health and livelihood threat in the country. Monitoring and control of AMR demand close coloration between human and veterinary services as well as other relevant stakeholders. However, risk of AMR transfer from animal to human population’s remains poorly explored in Ethiopia. This systematic research literature review attempted to give an overview on AMR challenges of bovine mastitis bacteria in Ethiopia. Methodology: A web based research literature search and analysis strategy was used. Databases are considered including; PubMed, Google Scholar, Ethiopian Veterinary Association (EVA) and Ethiopian Society of Animal Production (ESAP). The key search terms and phrases were; Ethiopia, dairy, cattle, mastitis, bacteria isolation, antibiotic sensitivity and antimicrobial resistance. Ultimately, 15 research reports were used for the current analysis. Data extraction was performed using a structured Microsoft Excel format. Frequency AMR prevalence (%) was registered directly or calculated from reported values. Statistical analysis was performed on SPSS – 16. Variables were summarized by giving frequencies (n or %), Mean ± SE and demonstrative box plots. One way ANOVA and independent t test were used to evaluate variations in AMR prevalence estimates (Ln transformed). Statistical significance was determined at p < 0.050). Results: AMR in bovine mastitis bacteria was investigated in a total of 592 in vitro antibiotic sensitivity trials involving 12 different mastitis bacteria (including 1126 Gram positive and 77 Gram negative isolates) and 14 antibiotics. Bovine mastitis bacteria exhibited AMR to most of the antibiotics tested. Gentamycin had the lowest average AMR in both Gram positive (2%) and negative (1.8%) bacteria. Gram negative mastitis bacteria showed higher mean in vitro resistance levels to; Erythromycin (72.6%), Tetracycline (56.65%), Amoxicillin (49.6%), Ampicillin (47.6%), Clindamycin (47.2%) and Penicillin (40.6%). Among Gram positive mastitis bacteria higher mean in vitro resistance was observed in; Ampicillin (32.8%), Amoxicillin (32.6%), Penicillin (24.9%), Streptomycin (20.2%), Penicillinase Resistant Penicillin’s (15.4%) and Tetracycline (14.9%). More specifically, S. aurues exhibited high mean AMR against Penicillin (76.3%) and Ampicillin (70.3%) followed by Amoxicillin (45%), Streptomycin (40.6%), Tetracycline (24.5%) and Clindamycin (23.5%). E. coli showed high mean AMR to Erythromycin (78.7%), Tetracycline (51.5%), Ampicillin (49.25%), Amoxicillin (43.3%), Clindamycin (38.4%) and Penicillin (33.8%). Streptococcus spp. demonstrated higher (p =0.005) mean AMR against Kanamycin (> 20%) and full sensitivity (100%) to Clindamycin. Overall, mean Tetracycline (p = 0.013), Gentamycin (p = 0.001), Polymixin (p = 0.034), Erythromycin (p = 0.011) and Ampicillin (p = 0.009) resistance increased from the 2010’s than the 2000’s. Conclusion; the review indicated a rising AMR challenge among bovine mastitis bacteria in Ethiopia. Corresponding, public health implications demand a deeper, integrated investigation.

Keywords: antimicrobial resistance, dairy cattle, Ethiopia, Mastitis bacteria

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408 A Cross Cultural Study of Jewish and Arab Listeners: Perception of Harmonic Sequences

Authors: Roni Granot

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Musical intervals are the building blocks of melody and harmony. Intervals differ in terms of their size, direction, or quality as consonants or dissonants. In Western music, perceptual dissonance is mostly associated with the sensation of beats or periodicity, whereas cognitive dissonance is associated with rules of harmony and voice leading. These two perceptions can be studied separately in musical cultures which include melodic with little or no harmonic structures. In the Arab musical system, there is a number of different quarter- tone intervals creating various combinations of consonant and dissonant intervals. While traditional Arab music includes only melody, today’s Arab pop music includes harmonization of songs, often using typical Western harmonic sequences. Therefore, the Arab population in Israel presents an interesting case which enables us to examine the distinction between perceptual and cognitive dissonance. In the current study, we compared the responses of 34 Jewish Western listeners and 56 Arab listeners to two types of stimuli and their relationships: Harmonic sequences and isolated harmonic intervals (dyads). Harmonic sequences were presented in synthesized piano tones and represented five levels of Harmonic prototypicality (Tonic ending; Tonic ending with half flattened third; Deceptive cadence; Half cadence; and Dissonant unrelated ending) and were rated on 5-point scales of closure and surprise. Here we report only findings related to the harmonic sequences. One-way repeated measures ANOVA with one within subjects factor with five levels (Type of sequence) and one between- subjects factor (Musical background) indicates a main effect of Type of sequence for surprise ratings F (4, 85) = 51 p<.001, and for closure ratings F (4, 78) 9.54 p < .001, no main effect of Background on either surprise or closure ratings, and a marginally significant Type X Background interaction for surprise F (4, 352) = 6.05 p = .069 and closure ratings F (4, 324) 3.89 p < .01). Planned comparisons show that the interaction of Type of sequence X Background center around surprise and closure ratings of the regular versus the half- flattened third tonic and the deceptive versus the half cadence. The half- flattened third tonic is rated as less surprising and as demanding less continuation than the regular tonic by the Arab listeners as compared to the Western listeners. In addition, the half cadence is rated as more surprising but demanding less continuation than the deceptive cadence in the Arab listeners as compared to the Western listeners. Together, our results suggest that despite the vast exposure of Arab listeners to Western harmony, sensitivity to harmonic rules seems to be partial with preference to oriental sonorities such as half flattened third. In addition, the percept of directionality which demands sensitivity to the level on which closure is obtained and which is strongly entrenched in Western harmony, may not be fully integrated into the Arab listeners’ mental harmonic scheme. Results will be discussed in terms of broad differences between Western and Eastern aesthetic ideals.

Keywords: harmony, cross cultural, Arab music, closure

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407 Medical Dressing Induced Digital Ischemia in Patient with Congenital Insensitivity to Pain and Anhidrosis

Authors: Abdulwhab Alotaibi, Abdullah Alzahrani, Ziyad Bokhari, Abdulelah Alghamdi

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First described in 1975 by Dr. Miller, Medical dressings are uncommon but possible cause of hand digital ischemia due the tourniquet-like effect. The incident of this complication has been reported across wide range of age-groups, yet it seems like that the pediatric population are specifically vulnerable. Multiple dressing types were reported to have caused ischemic injury, such as elastic wrap, tubular gauze, and self-adherent dressings. We present a case of medical dressing induced digital ischemia in patient with Congenital insensitivity to pain and anhidrosis (CIPA), which further challenge the discovery of the condition. An 8-year-old girl known case of CIPA. Brought by her mother to the ER after nail bed injury, which she managed by application of elastic wrap that was left for 24 hours. When the mother found out she immediately removed the elastic band, and noticed the fingertip was black and cold with tense bullae. The color then changed later when she arrived to the ER to dark purple with bluish discoloration on the tip. On examination there was well demarcated tense bullae on the distal right fifth finger. Neurovascular intact, pulse oximetry on distal digit 100%, capillary refill time was delayed. She was seen under Plastic surgery and conservative management recommended, and patient was discharged with safety netting. Two days later the patient came as follow-up visit at which her condition demonstrated significant improvement, the bullae has since ruptured leaving behind sloughed skin, capillary refill and pulse oximetry were both within normal limits, sensory function couldn’t be assessed but her motor function and ROM were normal, topical bacitracin and bandage dressings were applied for the eroded skin. Patient was scheduled for a follow-up in 2 weeks. Preventatively it’s advisable to avoid the commonly implicated dressings such as elastic, tubular gauze or self-adherent wraps in hand or digital injuries when possible, but in cases where the use of these dressings is of necessity the appropriate precautions must be taken, Dr. Makarewich proposed the following 5 measures to help minimize the incidence of the injury: 1-Unwrapping 12 inches of the dressing before rolling the injured finger. 2-Wrapping from distal to proximal with minimal tension to avoid vascular embarrassment. 3-The use of 5-25 inch to overlap the entire wrap. 4-Maintaining light pressure over the wrap to allow adherence of the dressing. 5-Minimization of the number of layers used to wrap the affected digit. Also assessing the capillary refill after the application can help in determining the patency of the supplying blood vessels. It’s also important to selectively determine if the patient is a candidate for conservative management, as tailored approach can help in maximizing the positive outcomes for our patients.

Keywords: congenital insensitivity to pain, digital ischemia, medical dressing, conservative management

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406 Spatiotemporal Changes in Drought Sensitivity Captured by Multiple Tree-Ring Parameters of Central European Conifers

Authors: Krešimir Begović, Miloš Rydval, Jan Tumajer, Kristyna Svobodová, Thomas Langbehn, Yumei Jiang, Vojtech Čada, Vaclav Treml, Ryszard Kaczka, Miroslav Svoboda

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Environmental changes have increased the frequency and intensity of climatic extremes, particularly hotter droughts, leading to altered tree growth patterns and multi-year lags in tree recovery. The effects of shifting climatic conditions on tree growth are inhomogeneous across species’ natural distribution ranges, with large spatial heterogeneity and inter-population variability, but generally have significant consequences for contemporary forest dynamics and future ecosystem functioning. Despite numerous studies on the impacts of regional drought effects, large uncertainties remain regarding the mechanistic basis of drought legacy effects on wood formation and the ability of individual species to cope with increasingly drier growing conditions and rising year-to-year climatic variability. To unravel the complexity of climate-growth interactions and assess species-specific responses to severe droughts, we combined forward modeling of tree growth (VS-lite model) with correlation analyses against climate (temperature, precipitation, and the SPEI-3 moisture index) and growth responses to extreme drought events from multiple tree-ring parameters (tree-width and blue intensity parameters). We used an extensive dataset with over 1000 tree-ring samples from 23 nature forest reserves across an altitudinal range in Czechia and Slovakia. Our results revealed substantial spatiotemporal variability in growth responses to summer season temperature and moisture availability across species and tree-ring parameters. However, a general trend of increasing spring moisture-growth sensitivity in recent decades was observed in the Scots pine mountain forests and lowland forests of both species. The VS-lite model effectively captured nonstationary climate-growth relationships and accurately estimated high-frequency growth variability, indicating a significant incidence of regional drought events and growth reductions. Notably, growth reductions during extreme drought years and discrete legacy effects identified in individual wood components were most pronounced in the lowland forests. Together with the observed growth declines in recent decades, these findings suggest an increasing vulnerability of Norway spruce and Scots pine in dry lowlands under intensifying climatic constraints.

Keywords: dendroclimatology, Vaganova–Shashkin lite, conifers, central Europe, drought, blue intensity

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405 Impact of Displacements Durations and Monetary Costs on the Labour Market within a City Consisting on Four Areas a Theoretical Approach

Authors: Aboulkacem El Mehdi

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We develop a theoretical model at the crossroads of labour and urban economics, used for explaining the mechanism through which the duration of home-workplace trips and their monetary costs impact the labour demand and supply in a spatially scattered labour market and how they are impacted by a change in passenger transport infrastructures and services. The spatial disconnection between home and job opportunities is referred to as the spatial mismatch hypothesis (SMH). Its harmful impact on employment has been subject to numerous theoretical propositions. However, all the theoretical models proposed so far are patterned around the American context, which is particular as it is marked by racial discrimination against blacks in the housing and the labour markets. Therefore, it is only natural that most of these models are developed in order to reproduce a steady state characterized by agents carrying out their economic activities in a mono-centric city in which most unskilled jobs being created in the suburbs, far from the Blacks who dwell in the city-centre, generating a high unemployment rates for blacks, while the White population resides in the suburbs and has a low unemployment rate. Our model doesn't rely on any racial discrimination and doesn't aim at reproducing a steady state in which these stylized facts are replicated; it takes the main principle of the SMH -the spatial disconnection between homes and workplaces- as a starting point. One of the innovative aspects of the model consists in dealing with a SMH related issue at an aggregate level. We link the parameters of the passengers transport system to employment in the whole area of a city. We consider here a city that consists of four areas: two of them are residential areas with unemployed workers, the other two host firms looking for labour force. The workers compare the indirect utility of working in each area with the utility of unemployment and choose between submitting an application for the job that generate the highest indirect utility or not submitting. This arbitration takes account of the monetary and the time expenditures generated by the trips between the residency areas and the working areas. Each of these expenditures is clearly and explicitly formulated so that the impact of each of them can be studied separately than the impact of the other. The first findings show that the unemployed workers living in an area benefiting from good transport infrastructures and services have a better chance to prefer activity to unemployment and are more likely to supply a higher 'quantity' of labour than those who live in an area where the transport infrastructures and services are poorer. We also show that the firms located in the most accessible area receive much more applications and are more likely to hire the workers who provide the highest quantity of labour than the firms located in the less accessible area. Currently, we are working on the matching process between firms and job seekers and on how the equilibrium between the labour demand and supply occurs.

Keywords: labour market, passenger transport infrastructure, spatial mismatch hypothesis, urban economics

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404 An in silico Approach for Exploring the Intercellular Communication in Cancer Cells

Authors: M. Cardenas-Garcia, P. P. Gonzalez-Perez

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Intercellular communication is a necessary condition for cellular functions and it allows a group of cells to survive as a population. Throughout this interaction, the cells work in a coordinated and collaborative way which facilitates their survival. In the case of cancerous cells, these take advantage of intercellular communication to preserve their malignancy, since through these physical unions they can send signs of malignancy. The Wnt/β-catenin signaling pathway plays an important role in the formation of intercellular communications, being also involved in a large number of cellular processes such as proliferation, differentiation, adhesion, cell survival, and cell death. The modeling and simulation of cellular signaling systems have found valuable support in a wide range of modeling approaches, which cover a wide spectrum ranging from mathematical models; e.g., ordinary differential equations, statistical methods, and numerical methods– to computational models; e.g., process algebra for modeling behavior and variation in molecular systems. Based on these models, different simulation tools have been developed from mathematical ones to computational ones. Regarding cellular and molecular processes in cancer, its study has also found a valuable support in different simulation tools that, covering a spectrum as mentioned above, have allowed the in silico experimentation of this phenomenon at the cellular and molecular level. In this work, we simulate and explore the complex interaction patterns of intercellular communication in cancer cells using the Cellulat bioinformatics tool, a computational simulation tool developed by us and motivated by two key elements: 1) a biochemically inspired model of self-organizing coordination in tuple spaces, and 2) the Gillespie’s algorithm, a stochastic simulation algorithm typically used to mimic systems of chemical/biochemical reactions in an efficient and accurate way. The main idea behind the Cellulat simulation tool is to provide an in silico experimentation environment that complements and guides in vitro experimentation in intra and intercellular signaling networks. Unlike most of the cell signaling simulation tools, such as E-Cell, BetaWB and Cell Illustrator which provides abstractions to model only intracellular behavior, Cellulat is appropriate for modeling both intracellular signaling and intercellular communication, providing the abstractions required to model –and as a result, simulate– the interaction mechanisms that involve two or more cells, that is essential in the scenario discussed in this work. During the development of this work we made evident the application of our computational simulation tool (Cellulat) for the modeling and simulation of intercellular communication between normal and cancerous cells, and in this way, propose key molecules that may prevent the arrival of malignant signals to the cells that surround the tumor cells. In this manner, we could identify the significant role that has the Wnt/β-catenin signaling pathway in cellular communication, and therefore, in the dissemination of cancer cells. We verified, using in silico experiments, how the inhibition of this signaling pathway prevents that the cells that surround a cancerous cell are transformed.

Keywords: cancer cells, in silico approach, intercellular communication, key molecules, modeling and simulation

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403 Marginalisation of an Age Old Culture. The Case of Female Cultural Initiation in Some South African Cultural Groups

Authors: Lesibana Rafapa

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Accounts exist of circumcision-anchored cultural initiation in central Africa, East Africa, Southern Africa, North Africa, and West Africa -straddling states like Botswana, Kenya, Lesotho, Malawi, Senegal, South Africa, Zambia, and Zimbabwe. This attests to the continent-wide spread of this cultural practice. In this paper, the writer relates the cultural aspect of circumcision-subsuming initiation among black African cultural groups across the continent to the notion that African cultures are varied yet subscribe to a common central concept. The premise of the paper is that the common practice of initiation for both male and female children that have to be initiated by adults to the tradition and customs of a people coincides with such a central concept. The practice of traditional initiation is as broad as to encompass aspects of spirituality, morality, and social organisation, in the nature of the central concept of which it is a trans-sectional part. Cultural initiation, sometimes referred to as traditional circumcision, constitutes culture-determined rites of passage for the initiates. The study’s aim, the findings of which are presented in this paper, was to probe gender equality in the development and promotion of the cultural practice of initiation. The researcher intended to demonstrate how in South Africa, female circumcision is treated equally or marginalised in efforts of the democratic government to regulate and strengthen the practice of circumcision as part of its broader liberation programme meant to reverse politico-cultural bondage experienced during apartheid rule that the present black regime helped bring to an end. It is argued that the failure to regard female circumcision as equal to its male counterpart is a travesty of the black government’s legislation and policies espousing equality and the protection and empowerment of vulnerable and previously marginalised population groups that include black women. The writer did a desk-top study of the history and characteristics of female circumcision among the black Northern Sotho, VaTsonga, and VhaVenda cultural groups of the Limpopo Province, stretching north to the border of South Africa with Zimbabwe, as well as literature on how political and other authorities exert efforts to preserve and empower the practice. The findings were that male initiation is foregrounded and totalised to represent the practice of initiation as a whole, at the expense of its female counterpart facing marginalisation and unequal regard. It is outlined in this paper how such impoverishment of an otherwise woman-empowering cultural practice deprives hitherto black cultures that suffered brutal repression during apartheid of a fuller recovery much needed in the democratic era. The writer applies some aspects of postcolonial theory and some tropes of feminism in the discussion of an uneven status of cultural circumcision at the hands of present day powers that be.

Keywords: African cultures, female circumcision, gender equality, women empowerment

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402 Law, Resistance, and Development in Georgia: A Case of Namakhvani HPP

Authors: Konstantine Eristavi

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The paper will contribute to the discussion on the pitfalls, limits, and possibilities of legal and rights discourse in opposing large infrastructural projects in the context of neoliberal globalisation. To this end, the paper will analyse the struggle against the Namakhvani HPP project in Georgia. The latter has been hailed by the government as one of the largest energy projects in the history of the country, with an enormous potential impact on energy security, energy independence, economic growth, and development. This takes place against the backdrop of decades of market-led -or neoliberal- model of development in Georgia, characterised by structural adjustments, deregulation, privatisation, and Laissez-Fair approach to foreign investment. In this context, the Georgian state vies with other low and middle-income countries for foreign capital by offering to potential investors, on the one hand, exemptions from social and environmental regulations and, on the other hand, huge legal concessions and safeguards, thereby participating in what is often called a “race to the bottom.” The Namakhvani project is a good example of this. At every stage, the project has been marred with violations of laws and regulations concerning transparency, participation, social and environmental regulations, and so on. Moreover, the leaked contract between the state and the developer reveals the contractual safeguards which effectively insulate the investment throughout the duration of the contract from the changes in the national law that might adversely affect investors’ rights and returns. These clauses, aimed at preserving investors' economic position, place the contract above national law in many respects and even conflict with fundamental constitutional rights. In response to the perceived deficiencies of the project, one of the largest and most diverse social movements in the history of post-soviet Georgia has been assembled, consisting of the local population, conservative and leftist groups, human rights and environmental NGOs, etc. Crucially, the resistance movement is actively using legal tools. In order to analyse both the limitations and possibilities of legal discourse, the paper will distinguish between internal and immanent critiques. Law as internal critique, in the context of the struggles around the Namakhvani project, while potentially fruitful in hindering the project, risks neglecting and reproducing those factors -e.g., the particular model of development- that made such contractual concessions and safeguards and concomitant rights violations possible in the first place. On the other hand, the use of rights and law as part of immanent critique articulates a certain incapacity on the part of the addressee government to uphold existing laws and rights due to structural factors, hence, pointing to a need for a fundamental change. This 'ruptural' form of legal discourse that the movement employs makes it possible to go beyond the discussion around the breaches of law and enables a critical deliberation on the development model within which these violations and extraordinary contractual safeguards become necessary. It will be argued that it is this form of immanent critique that expresses the emancipatory potential of legal discourse.

Keywords: law, resistance, development, rights

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401 Closing the Loop between Building Sustainability and Stakeholder Engagement: Case Study of an Australian University

Authors: Karishma Kashyap, Subha D. Parida

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Rapid population growth and urbanization is creating pressure throughout the world. This has a dramatic effect on a lot of elements which include water, food, transportation, energy, infrastructure etc. as few of the key services. Built environment sector is growing concurrently to meet the needs of urbanization. Due to such large scale development of buildings, there is a need for them to be monitored and managed efficiently. Along with appropriate management, climate adaptation is highly crucial as well because buildings are one of the major sources of greenhouse gas emission in their operation phase. Buildings to be adaptive need to provide a triple bottom approach to sustainability i.e., being socially, environmentally and economically sustainable. Hence, in order to deliver these sustainability outcomes, there is a growing understanding and thrive towards switching to green buildings or renovating new ones as per green standards wherever possible. Academic institutions in particular have been following this trend globally. This is highly significant as universities usually have high occupancy rates because they manage a large building portfolio. Also, as universities accommodate the future generation of architects, policy makers etc., they have the potential of setting themselves as a best industry practice model for research and innovation for the rest to follow. Hence their climate adaptation, sustainable growth and performance management becomes highly crucial in order to provide the best services to users. With the objective of evaluating appropriate management mechanisms within academic institutions, a feasibility study was carried out in a recent 5-Star Green Star rated university building (housing the School of Construction) in Victoria (south-eastern state of Australia). The key aim was to understand the behavioral and social aspect of the building users, management and the impact of their relationship on overall building sustainability. A survey was used to understand the building occupant’s response and reactions in terms of their work environment and management. A report was generated based on the survey results complemented with utility and performance data which were then used to evaluate the management structure of the university. Followed by the report, interviews were scheduled with the facility and asset managers in order to understand the approach they use to manage the different buildings in their university campuses (old, new, refurbished), respective building and parameters incorporated in maintaining the Green Star performance. The results aimed at closing the communication and feedback loop within the respective institutions and assist the facility managers to deliver appropriate stakeholder engagement. For the wider design community, analysis of the data highlights the applicability and significance of prioritizing key stakeholders, integrating desired engagement policies within an institution’s management structures and frameworks and their effect on building performance

Keywords: building optimization, green building, post occupancy evaluation, stakeholder engagement

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400 Developing Geriatric Oral Health Network is a Public Health Necessity for Older Adults

Authors: Maryam Tabrizi, Shahrzad Aarup

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Objectives- Understanding the close association between oral health and overall health for older adults at the right time and right place, a person, focus treatment through Project ECHO telementoring. Methodology- Data from monthly ECHO telementoring sessions were provided for three years. Sessions including case presentations, overall health conditions, considering medications, organ functions limitations, including the level of cognition. Contributions- Providing the specialist level of providing care to all elderly regardless of their location and other health conditions and decreasing oral health inequity by increasing workforce via Project ECHO telementoring program worldwide. By 2030, the number of adults in the USA over the age of 65 will increase more than 60% (approx.46 million) and over 22 million (30%) of 74 million older Americans will need specialized geriatrician care. In 2025, a national shortage of medical geriatricians will be close to 27,000. Most individuals 65 and older do not receive oral health care due to lack of access, availability, or affordability. One of the main reasons is a significant shortage of Oral Health (OH) education and resources for the elderly, particularly in rural areas. Poor OH is a social stigma, a thread to quality and safety of overall health of the elderly with physical and cognitive decline. Poor OH conditions may be costly and sometimes life-threatening. Non-traumatic dental-related emergency department use in Texas alone was over $250 M in 2016. Most elderly over the age of 65 present with at least one or multiple chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) are at higher risk to develop gum (periodontal) disease, yet they are less likely to get dental care. In addition, most older adults take both prescription and over-the-counter drugs; according to scientific studies, many of these medications cause dry mouth. Reduced saliva flow due to aging and medications may increase the risk of cavities and other oral conditions. Most dental schools have already increased geriatrics OH in their educational curriculums, but the aging population growth worldwide is faster than growing geriatrics dentists. However, without the use of advanced technology and creating a network between specialists and primary care providers, it is impossible to increase the workforce, provide equitable oral health to the elderly. Project ECHO is a guided practice model that revolutionizes health education and increases the workforce to provide best-practice specialty care and reduce health disparities. Training oral health providers for utilizing the Project ECHO model is a logical response to the shortage and increases oral health access to the elderly. Project ECHO trains general dentists & hygienists to provide specialty care services. This means more elderly can get the care they need, in the right place, at the right time, with better treatment outcomes and reduces costs.

Keywords: geriatric, oral health, project echo, chronic disease, oral health

Procedia PDF Downloads 175
399 Leadership Education for Law Enforcement Mid-Level Managers: The Mediating Role of Effectiveness of Training on Transformational and Authentic Leadership Traits

Authors: Kevin Baxter, Ron Grove, James Pitney, John Harrison, Ozlem Gumus

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The purpose of this research is to determine the mediating effect of effectiveness of the training provided by Northwestern University’s School of Police Staff and Command (SPSC), on the ability of law enforcement mid-level managers to learn transformational and authentic leadership traits. This study will also evaluate the leadership styles, of course, graduates compared to non-attendees using a static group comparison design. The Louisiana State Police pay approximately $40,000 in salary, tuition, housing, and meals for each state police lieutenant attending the 10-week program of the SPSC. This school lists the development of transformational leaders as an increasing element. Additionally, the SPSC curriculum addresses all four components of authentic leadership - self-awareness, transparency, ethical/moral, and balanced processing. Upon return to law enforcement in roles of mid-level management, there are questions as to whether or not students revert to an “autocratic” leadership style. Insufficient evidence exists to support claims for the effectiveness of management training or leadership development. Though it is widely recognized that transformational styles are beneficial to law enforcement, there is little evidence that suggests police leadership styles are changing. Police organizations continue to hold to a more transactional style (i.e., most senior police leaders remain autocrats). Additionally, research in the application of transformational, transactional, and laissez-faire leadership related to police organizations is minimal. The population of the study is law enforcement mid-level managers from various states within the United States who completed leadership training presented by the SPSC. The sample will be composed of 66 active law enforcement mid-level managers (lieutenants and captains) who have graduated from SPSC and 65 active law enforcement mid-level managers (lieutenants and captains) who have not attended SPSC. Participants will answer demographics questions, Multifactor Leadership Questionnaire, Authentic Leadership Questionnaire, and the Kirkpatrick Hybrid Evaluation Survey. Analysis from descriptive statistics, group comparison, one-way MANCOVA, and the Kirkpatrick Evaluation Model survey will be used to determine training effectiveness in the four levels of reaction, learning, behavior, and results. Independent variables are SPSC graduates (two groups: upper and lower) and no-SPSC attendees, and dependent variables are transformational and authentic leadership scores. SPSC graduates are expected to have higher MLQ scores for transformational leadership traits and higher ALQ scores for authentic leadership traits than SPSC non-attendees. We also expect the graduates to rate the efficacy of SPSC leadership training as high. This study will validate (or invalidate) the benefits, costs, and resources required for leadership development from a nationally recognized police leadership program, and it will also help fill the gap in the literature that exists between law enforcement professional development and transformational and authentic leadership styles.

Keywords: training effectiveness, transformational leadership, authentic leadership, law enforcement mid-level manager

Procedia PDF Downloads 107
398 Risk Assessment Tools Applied to Deep Vein Thrombosis Patients Treated with Warfarin

Authors: Kylie Mueller, Nijole Bernaitis, Shailendra Anoopkumar-Dukie

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Background: Vitamin K antagonists particularly warfarin is the most frequently used oral medication for deep vein thrombosis (DVT) treatment and prophylaxis. Time in therapeutic range (TITR) of the international normalised ratio (INR) is widely accepted as a measure to assess the quality of warfarin therapy. Multiple factors can affect warfarin control and the subsequent adverse outcomes including thromboembolic and bleeding events. Predictor models have been developed to assess potential contributing factors and measure the individual risk of these adverse events. These predictive models have been validated in atrial fibrillation (AF) patients, however, there is a lack of literature on whether these can be successfully applied to other warfarin users including DVT patients. Therefore, the aim of the study was to assess the ability of these risk models (HAS BLED and CHADS2) to predict haemorrhagic and ischaemic incidences in DVT patients treated with warfarin. Methods: A retrospective analysis of DVT patients receiving warfarin management by a private pathology clinic was conducted. Data was collected from November 2007 to September 2014 and included demographics, medical and drug history, INR targets and test results. Patients receiving continuous warfarin therapy with an INR reference range between 2.0 and 3.0 were included in the study with mean TITR calculated using the Rosendaal method. Bleeding and thromboembolic events were recorded and reported as incidences per patient. The haemorrhagic risk model HAS BLED and ischaemic risk model CHADS2 were applied to the data. Patients were then stratified into either the low, moderate, or high-risk categories. The analysis was conducted to determine if a correlation existed between risk assessment tool and patient outcomes. Data was analysed using GraphPad Instat Version 3 with a p value of <0.05 considered to be statistically significant. Patient characteristics were reported as mean and standard deviation for continuous data and categorical data reported as number and percentage. Results: Of the 533 patients included in the study, there were 268 (50.2%) female and 265 (49.8%) male patients with a mean age of 62.5 years (±16.4). The overall mean TITR was 78.3% (±12.7) with an overall haemorrhagic incidence of 0.41 events per patient. For the HAS BLED model, there was a haemorrhagic incidence of 0.08, 0.53, and 0.54 per patient in the low, moderate and high-risk categories respectively showing a statistically significant increase in incidence with increasing risk category. The CHADS2 model showed an increase in ischaemic events according to risk category with no ischaemic events in the low category, and an ischaemic incidence of 0.03 in the moderate category and 0.47 high-risk categories. Conclusion: An increasing haemorrhagic incidence correlated to an increase in the HAS BLED risk score in DVT patients treated with warfarin. Furthermore, a greater incidence of ischaemic events occurred in patients with an increase in CHADS2 category. In an Australian population of DVT patients, the HAS BLED and CHADS2 accurately predicts incidences of haemorrhage and ischaemic events respectively.

Keywords: anticoagulant agent, deep vein thrombosis, risk assessment, warfarin

Procedia PDF Downloads 264
397 A Study on Green Building Certification Systems within the Context of Anticipatory Systems

Authors: Taner Izzet Acarer, Ece Ceylan Baba

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This paper examines green building certification systems and their current processes in comparison with anticipatory systems. Rapid growth of human population and depletion of natural resources are causing irreparable damage to urban and natural environment. In this context, the concept of ‘sustainable architecture’ has emerged in the 20th century so as to establish and maintain standards for livable urban spaces, to improve quality of urban life, and to preserve natural resources for future generations. The construction industry is responsible for a large part of the resource consumption and it is believed that the ‘green building’ designs that emerge in construction industry can reduce environmental problems and contribute to sustainable development around the world. A building must meet a specific set of criteria, set forth through various certification systems, in order to be eligible for designation as a green building. It is disputable whether methods used by green building certification systems today truly serve the purposes of creating a sustainable world. Accordingly, this study will investigate the sets of rating systems used by the most popular green building certification programs, including LEED (Leadership in Energy and Environmental Design), BREEAM (Building Research Establishment's Environmental Assessment Methods), DGNB (Deutsche Gesellschaft für Nachhaltiges Bauen System), in terms of ‘Anticipatory Systems’ in accordance with the certification processes and their goals, while discussing their contribution to architecture. The basic methodology of the study is as follows. Firstly analyzes of brief historical and literature review of green buildings and certificate systems will be stated. Secondly, processes of green building certificate systems will be disputed by the help of anticipatory systems. Anticipatory Systems is a set of systems designed to generate action-oriented projections and to forecast potential side effects using the most current data. Anticipatory Systems pull the future into the present and take action based on future predictions. Although they do not have a claim to see into the future, they can provide foresight data. When shaping the foresight data, Anticipatory Systems use feedforward instead of feedback, enabling them to forecast the system’s behavior and potential side effects by establishing a correlation between the system’s present/past behavior and projected results. This study indicates the goals and current status of LEED, BREEAM and DGNB rating systems that created by using the feedback technique will be examined and presented in a chart. In addition, by examining these rating systems with the anticipatory system that using the feedforward method, the negative influences of the potential side effects on the purpose and current status of the rating systems will be shown in another chart. By comparing the two obtained data, the findings will be shown that rating systems are used for different goals than the purposes they are aiming for. In conclusion, the side effects of green building certification systems will be stated by using anticipatory system models.

Keywords: anticipatory systems, BREEAM, certificate systems, DGNB, green buildings, LEED

Procedia PDF Downloads 221
396 Liquid Waste Management in Cluster Development

Authors: Abheyjit Singh, Kulwant Singh

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There is a gradual depletion of the water table in the earth's crust, and it is required to converse and reduce the scarcity of water. This is only done by rainwater harvesting, recycling of water and by judicially consumption/utilization of water and adopting unique treatment measures. Domestic waste is generated in residential areas, commercial settings, and institutions. Waste, in general, is unwanted, undesirable, and nevertheless an inevitable and inherent product of social, economic, and cultural life. In a cluster, a need-based system is formed where the project is designed for systematic analysis, collection of sewage from the cluster, treating it and then recycling it for multifarious work. The liquid waste may consist of Sanitary sewage/ Domestic waste, Industrial waste, Storm waste, or Mixed Waste. The sewage contains both suspended and dissolved particles, and the total amount of organic material is related to the strength of the sewage. The untreated domestic sanitary sewage has a BOD (Biochemical Oxygen Demand) of 200 mg/l. TSS (Total Suspended Solids) about 240 mg/l. Industrial Waste may have BOD and TSS values much higher than those of sanitary sewage. Another type of impurities of wastewater is plant nutrients, especially when there are compounds of nitrogen N phosphorus P in the sewage; raw sanitary contains approx. 35 mg/l Nitrogen and 10 mg/l of Phosphorus. Finally, the pathogen in the waste is expected to be proportional to the concentration of facial coliform bacteria. The coliform concentration in raw sanitary sewage is roughly 1 billion per liter. The system of sewage disposal technique has been universally applied to all conditions, which are the nature of soil formation, Availability of land, Quantity of Sewage to be disposed of, The degree of treatment and the relative cost of disposal technique. The adopted Thappar Model (India) has the following designed parameters consisting of a Screen Chamber, a Digestion Tank, a Skimming Tank, a Stabilization Tank, an Oxidation Pond and a Water Storage Pond. The screening Chamber is used to remove plastic and other solids, The Digestion Tank is designed as an anaerobic tank having a retention period of 8 hours, The Skimming Tank has an outlet that is kept 1 meter below the surface anaerobic condition at the bottom and also help in organic solid remover, Stabilization Tank is designed as primary settling tank, Oxidation Pond is a facultative pond having a depth of 1.5 meter, Storage Pond is designed as per the requirement. The cost of the Thappar model is Rs. 185 Lakh per 3,000 to 4,000 population, and the Area required is 1.5 Acre. The complete structure will linning as per the requirement. The annual maintenance will be Rs. 5 lakh per year. The project is useful for water conservation, silage water for irrigation, decrease of BOD and there will be no longer damage to community assets and economic loss to the farmer community by inundation. There will be a healthy and clean environment in the community.

Keywords: collection, treatment, utilization, economic

Procedia PDF Downloads 80
395 Wadjda, a Film That Quietly Sets the Stage for a Cultural Revolution in Saudi Arabia

Authors: Anouar El Younssi

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This study seeks to shed some light on the political and social ramifications and implications of Haifaa al-Mansour’s 2012 film Wadjda. The film made international headlines following its release, and was touted as the first film ever to be shot in its entirety inside the Kingdom of Saudi Arabia, and also the first to be directed by a female (Haifaa al-Mansour). Wadjda revolves around a simple storyline: A teenage Saudi girl living in the capital city Riyadh—named Wadjda—wants to have a bicycle just like her male teenage neighbor and friend Abdullah, but her ultra-conservative Saudi society places so many constraints on its female population—including not allowing girls and women to ride bicycles. Wadjda, who displays a rebellious spirit, takes concrete steps to save money in order to realize her dream of buying a bicycle. For example, she starts making and selling sports bracelets to her school mates, and she decides to participate in a Qur’an competition in hopes of winning a sum of money that comes with the first prize. In the end, Wadjda could not beat the system on her own, but the film reverses course, and the audience gets a happy ending: Wadjda’s mother, whose husband has decided to take a second wife, defies the system and buys her daughter the very bicycle Wadjda has been dreaming of. It is quite significant that the mother takes her daughter’s side on the subject of the bicycle at the end of the film, for this shows that she finally came to the realization that she and her daughter are both oppressed by the cultural norms prevalent in Saudi society. It is no coincidence that this change of heart and action on the part of the mother takes place immediately after the wedding night celebrating her husband’s second marriage. Gender inequality is thus placed front and center in the film. Nevertheless, a major finding of this study is that the film carries out its social critique in a soft and almost covert manner. The female actors in the film never issue a direct criticism of Saudi society or government; the criticism is consistently implied and subtle throughout. It is a criticism that relies more on showing than telling. The film shows us—rather than tells us directly—what is wrong, and lets us, the audience, decide and make a judgment. In fact, showing could arguably be more powerful and impactful than telling. Regarding methodology, this study will focus on and analyze the visuals and a number of key utterances by the main actor Wadjda in order to corroborate the study’s argument about the film’s bent on critiquing patriarchy. This research will attempt to establish a link between the film as an art object and as a social text. Ultimately, Wadjda sends a message of hope, that change is possible and that it is already happening slowly inside the Kingdom. It also sends the message that an insurrectional approach regarding women’s rights in Saudi Arabia is perhaps not the right one, at least at this historical juncture.

Keywords: bicycle, gender inequality, social critique, Wadjda, women’s rights

Procedia PDF Downloads 131
394 Platform Virtual for Joint Amplitude Measurement Based in MEMS

Authors: Mauro Callejas-Cuervo, Andrea C. Alarcon-Aldana, Andres F. Ruiz-Olaya, Juan C. Alvarez

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Motion capture (MC) is the construction of a precise and accurate digital representation of a real motion. Systems have been used in the last years in a wide range of applications, from films special effects and animation, interactive entertainment, medicine, to high competitive sport where a maximum performance and low injury risk during training and competition is seeking. This paper presents an inertial and magnetic sensor based technological platform, intended for particular amplitude monitoring and telerehabilitation processes considering an efficient cost/technical considerations compromise. Our platform particularities offer high social impact possibilities by making telerehabilitation accessible to large population sectors in marginal socio-economic sector, especially in underdeveloped countries that in opposition to developed countries specialist are scarce, and high technology is not available or inexistent. This platform integrates high-resolution low-cost inertial and magnetic sensors with adequate user interfaces and communication protocols to perform a web or other communication networks available diagnosis service. The amplitude information is generated by sensors then transferred to a computing device with adequate interfaces to make it accessible to inexperienced personnel, providing a high social value. Amplitude measurements of the platform virtual system presented a good fit to its respective reference system. Analyzing the robotic arm results (estimation error RMSE 1=2.12° and estimation error RMSE 2=2.28°), it can be observed that during arm motion in any sense, the estimation error is negligible; in fact, error appears only during sense inversion what can easily be explained by the nature of inertial sensors and its relation to acceleration. Inertial sensors present a time constant delay which acts as a first order filter attenuating signals at large acceleration values as is the case for a change of sense in motion. It can be seen a damped response of platform virtual in other images where error analysis show that at maximum amplitude an underestimation of amplitude is present whereas at minimum amplitude estimations an overestimation of amplitude is observed. This work presents and describes the platform virtual as a motion capture system suitable for telerehabilitation with the cost - quality and precision - accessibility relations optimized. These particular characteristics achieved by efficiently using the state of the art of accessible generic technology in sensors and hardware, and adequate software for capture, transmission analysis and visualization, provides the capacity to offer good telerehabilitation services, reaching large more or less marginal populations where technologies and specialists are not available but accessible with basic communication networks.

Keywords: inertial sensors, joint amplitude measurement, MEMS, telerehabilitation

Procedia PDF Downloads 260
393 The Influence of Age and Education on Patients' Attitudes Towards Contraceptives in Rural California

Authors: Shivani Thakur, Jasmin Dominguez Cervantes, Ahmed Zabiba, Fatima Zabiba, Sandhini Agarwal, Kamalpreet Kaur, Hussein Maatouk, Shae Chand, Omar Madriz, Tiffany Huang, Saloni Bansal

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Contraceptives are an effective public health achievement, allowing for family planning and reducing the risk of sexually transmitted diseases (STDs). California’s rural Central Valley has high rates of teenage pregnancy and STDs. Factors affecting contraceptive usage here may include religious concerns, financial issues, and regional variations in the accessibility and availability of contraceptives. The increasing population and diversity of the Central Valley make the understanding of the determinants of unintended pregnancy and STDs increasingly nuanced. Patients in California’s Central Valley were surveyed at 6 surgical clinics to assess attitudes toward contraceptives. The questionnaire consisted of demographics and 14 Likert-scale statements investigating patients’ feelings regarding contraceptives. Parametric and non-parametric analysis was performed on the Likert statements. A correlation matrix for the Likert-scale statements was used to evaluate the strength of the relationship between each question. 76 patients aged 18-75 years completed the questionnaire. 90% of the participants were female, 76% Hispanic, 36% married, 44% with an income range between 30-60K, and 83% were between childbearing ages. 60% of participants stated they are currently using or had used some type of contraceptive. 25% of participants had at least one unplanned pregnancy. The most common type of contraceptives used were oral contraceptives(28%) and condoms(38%). The top reasons for patients’ contraceptive usage were: prevention of pregnancy (72%), safe sex/prevention of STDs (32%), and regulation of menstrual cycle (19%). Further analysis of Likert responses revealed that contraception usage increased due to approval of contraceptives (x̄=3.98, σ =1.02); partner approval of contraceptives (x̄=3.875, σ =1.16); and reduced anxiety about pregnancy (x̄=3.875, σ =1.23). Younger females (18-34 years old) agreed more with the statement that the cost of contraceptive supplies is too expensive than older females (35-75 years old), (x̄=3.2, σ = 1.4 vs x̄=2.8, σ =1.3, p<0.05). Younger females (44%) were also more likely to use short-acting contraceptive methods (oral and male condoms) compared to older females (64%) who use long-acting methods (implants/ intrauterine devices). 51% of Hispanic females were using some type of contraceptive. Of those Hispanic females who do not use contraceptives, 33% stated having no children, and all plan to have at least one child in the future. 35% of participants had a bachelor's degree. Those with bachelor’s degrees were more likely to use contraceptives, 58% vs 51%, p<0.05, and less likely to have unplanned pregnancy, 50% vs. 12%, p<0.01. There is increasing use and awareness among patients in rural settings concerning contraceptives. Our finding shows that younger women and women with higher educational attainment tend to have more positive attitudes towards the use of contraceptives. This work gives physicians an understanding of patients’ concerns about contraceptive methods and offers insight into culturally competent intervention programs that respect individual values.

Keywords: contraceptives, public health, rural california, women of child baring age

Procedia PDF Downloads 60
392 Halloysite Based Adsorbents for Removing Pollutants from Water Reservoirs

Authors: Agata Chelminska, Joanna Goscianska

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The rapid growth of the world’s population and the resulting economic development have had an enormous influence on the environment. Multiple industrial processes generate huge amounts of wastewater containing dangerous substances, most of which are discharged into water bodies. These contaminants include pharmaceuticals and synthetic dyes. Regardless of the presence of wastewater treatment plants, a lot of pollutants cannot be easily eliminated by well-known technologies. Hence, more effective methods of removing resistant chemicals are being developed. Due to cost-effectiveness as well as the availability of a wide range of adsorbents, a large interest in the adsorption process as an alternative way of water purification has been observed. Clay minerals, e.g., halloysite, are one of the most researched natural adsorbents because of their availability, non-toxicity, high specific surface area, porosity, layered structure, and low cost. The negatively charged surface makes them ideal for binding cations and organic compounds. Halloysite can be subjected to modifications which enhance its adsorptive properties. The aim of the presented research was to apply pure and modified halloysite in removing particular pollutants (tetracycline, tartrazine, and phosphates) from aqueous solutions. Halloysite was modified with alcoholic and aqueous solutions of hexadecyltrimethylammonium bromide (CTAB) and urea in different concentrations and subsequently impregnated with lanthanum(III) chloride. Acidic and basic oxygen groups located on the surface of all materials were determined. Moreover, the adsorbents obtained were characterized by X-ray diffraction, low-temperature nitrogen adsorption, scanning, and transmission electron microscopy. The effectiveness of samples in tetracycline, tartrazine, and phosphates adsorption from the liquid phase was then studied in order to determine their potential application in eliminating contaminants from water reservoirs. Modifiers’ employment enabled obtaining materials that possess better adsorption properties, which makes them useful for removing various pollutants from water. Modifying the pure halloysite with CTAB and urea solutions and impregnating LaCl₃ led to the formation of acidic and basic oxygen functional groups on the surface. Their amount increases with an increasing percentage of lanthanum content. The acid-base properties of materials, as well as the type of functional groups that appear on their surface, have a significant influence on their sorption capacities towards antibiotics, dyes, and phosphate(V) anions. The selected contaminants adsorb onto the halloysite studied following the Langmuir type isotherm. The thermodynamic study indicated that the adsorption was a spontaneous and exothermic process. The adsorption equilibrium was rapidly attained after 120 min of contact time. Research showed that synthesized materials based on halloysite may be applied as adsorbents for antibiotics, organic dyes, and PO₄³- ions which are difficult to eliminate.

Keywords: adsorption processes, halloysite, minerals, water reservoirs pollutants

Procedia PDF Downloads 182
391 Intended Use of Genetically Modified Organisms, Advantages and Disadvantages

Authors: Pakize Ozlem Kurt Polat

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GMO (genetically modified organism) is the result of a laboratory process where genes from the DNA of one species are extracted and artificially forced into the genes of an unrelated plant or animal. This technology includes; nucleic acid hybridization, recombinant DNA, RNA, PCR, cell culture and gene cloning techniques. The studies are divided into three groups of properties transferred to the transgenic plant. Up to 59% herbicide resistance characteristic of the transfer, 28% resistance to insects and the virus seems to be related to quality characteristics of 13%. Transgenic crops are not included in the commercial production of each product; mostly commercial plant is soybean, maize, canola, and cotton. Day by day increasing GMO interest can be listed as follows; Use in the health area (Organ transplantation, gene therapy, vaccines and drug), Use in the industrial area (vitamins, monoclonal antibodies, vaccines, anti-cancer compounds, anti -oxidants, plastics, fibers, polyethers, human blood proteins, and are used to produce carotenoids, emulsifiers, sweeteners, enzymes , food preservatives structure is used as a flavor enhancer or color changer),Use in agriculture (Herbicide resistance, Resistance to insects, Viruses, bacteria, fungi resistance to disease, Extend shelf life, Improving quality, Drought , salinity, resistance to extreme conditions such as frost, Improve the nutritional value and quality), we explain all this methods step by step in this research. GMO has advantages and disadvantages, which we explain all of them clearly in full text, because of this topic, worldwide researchers have divided into two. Some researchers thought that the GMO has lots of disadvantages and not to be in use, some of the researchers has opposite thought. If we look the countries law about GMO, we should know Biosafety law for each country and union. For this Biosecurity reasons, the problems caused by the transgenic plants, including Turkey, to minimize 130 countries on 24 May 2000, ‘the United Nations Biosafety Protocol’ signed nudes. This protocol has been prepared in addition to Cartagena Biosafety Protocol entered into force on September 11, 2003. This protocol GMOs in general use by addressing the risks to human health, biodiversity and sustainable transboundary movement of all GMOs that may affect the prevention, transit covers were dealt and used. Under this protocol we have to know the, ‘US Regulations GMO’, ‘European Union Regulations GMO’, ‘Turkey Regulations GMO’. These three different protocols have different applications and rules. World population increasing day by day and agricultural fields getting smaller for this reason feeding human and animal we should improve agricultural product yield and quality. Scientists trying to solve this problem and one solution way is molecular biotechnology which is including the methods of GMO too. Before decide to support or against the GMO, should know the GMO protocols and it effects.

Keywords: biotechnology, GMO (genetically modified organism), molecular marker

Procedia PDF Downloads 234
390 Persuading ICT Consumers to Disconnect from Work: An Experimental Study on the Influence of Message Frame, Regulatory Focus, Ad Believability and Attitude toward the Ad on Message Effectiveness

Authors: Katharina Ninaus, Ralf Terlutter, Sandra Diehl

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Information and communication technologies (ICT) have become pervasive in all areas of modern life, both in work and leisure. Technological developments and particularly the ubiquity of smartphones have made it possible for ICT consumers to be constantly connected to work, fostering an always-on mentality and increasing the pressure to be accessible at all times. However, performing work tasks outside of working hours using ICT results in a lack of mental detachment and recovery from work. It is, therefore, necessary to develop effective behavioral interventions to increase risk awareness of a constant connection to the workplace in the employed population. Drawing on regulatory focus theory, this study aims to investigate the persuasiveness of tailoring messages to individuals’ chronic regulatory focus in order to encourage ICT consumers to set boundaries by defining fixed times for professional accessibility outside of working hours in order to contribute to the well-being of ICT consumers with high ICT involvement in their work life. The experimental study examines the interaction effect between consumers’ chronic regulatory focus (i.e. promotion focus versus prevention focus) and positive or negative message framing (i.e. gain frame versus loss frame) on consumers’ intention to perform the advocated behavior. Based on the assumption that congruent messages create regulatory fit and increase message effectiveness, it is hypothesized that behavioral intention will be higher in the condition of regulatory fit compared to regulatory non-fit. It is further hypothesized that ad believability and attitude toward the ad will mediate the effect of regulatory fit on behavioral intention given that ad believability and ad attitude both determine consumer behavioral responses. Results confirm that the interaction between regulatory focus and message frame emerged as a predictor of behavioral intention such as that consumers’ intentions to set boundaries by defining fixed times for professional accessibility outside of working hours increased as congruency with their regulatory focus increased. The loss-framed ad was more effective for consumers with a predominant prevention focus, while the gain-framed ad was more effective for consumers with a predominant promotion focus. Ad believability and attitude toward the ad both emerged as predictors of behavioral intention. Mediation analysis revealed that the direct effect of the interaction between regulatory focus and message frame on behavioral intention was no longer significant when including ad believability and ad attitude as mediators in the model, indicating full mediation. However, while the indirect effect through ad believability was significant, the indirect effect through attitude toward the ad was not significant. Hence, regulatory fit increased ad believability, which then increased behavioral intention. Ad believability appears to have a superior effect indicating that behavioral intention does not depend on attitude toward the ad, but it depends on whether or not the ad is perceived as believable. The study shows that the principle of regulatory fit holds true in the context of ICT consumption and responds to calls for more research on mediators of health message framing effects.

Keywords: always-on mentality, Information and communication technologies (ICT) consumption, message framing, regulatory focus

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389 Association between Obstetric Factors with Affected Areas of Health-Related Quality of Life of Pregnant Women

Authors: Cinthia G. P. Calou, Franz J. Antezana, Ana I. O. Nicolau, Eveliny S. Martins, Paula R. A. L. Soares, Glauberto S. Quirino, Dayanne R. Oliveira, Priscila S. Aquino, Régia C. M. B. Castro, Ana K. B. Pinheiro

Abstract:

Introduction: As an integral part of the health-disease process, gestation is a period in which the social insertion of women can influence, in a positive or negative way, the course of the pregnancy-puerperal cycle. Thus, evaluating the quality of life of this population can redirect the implementation of innovative practices in the quest to make them more effective and real for the promotion of a more humanized care. This study explores the associations between the obstetric factors with affected areas of health-related quality of life of pregnant women with habitual risk. Methods: This is a cross-sectional, quantitative study conducted in three public facilities and a private service that provides prenatal care in the city of Fortaleza, Ceara, Brazil. The sample consisted of 261 pregnant women who underwent low-risk prenatal care and were interviewed from September to November 2014. The collection instruments were a questionnaire containing socio-demographic and obstetric variables, in addition to the Brazilian version of the Mother scale Generated Index (MGI) characterized by being a specific and objective instrument, consisting of a single sheet and subdivided into three stages. It allows identifying the areas of life of the pregnant woman that are most affected, which could go unnoticed by the pre-formulated measurement instruments. The obstetric data, as well as the data concerning the application of the MGI scale, were compiled and analyzed through the statistical program Statistical Package for the Social Sciences (SPSS), version 20.0. After the compilation, a descriptive analysis was carried out. Then, associations were made between some variables. The tests applied were the Pearson Chi-Square and the Fisher's exact test. The odds ratio was also calculated. These associations were considered statistically significant when the p (probability) value was less than or equal to a level of 5% (α = 0.05) in the tests performed. Results: The variables that negatively reflected the quality of life of the pregnant women and presented a significant association with the polaciuria were: gestational age (p = 0.022) and parity (p = 0.048). Episodes of nausea and vomiting also showed significant with gestational age correlation (p = 0.0001). Evaluating the crossing of stress, we observed a significant association with parity (p = 0.0001). In turn, emotional lability revealed dependence on the variable type of delivery (p = 0.009). Conclusion: The health professionals involved in the assistance to the pregnant woman can understand how the process of gestation is experienced, considering all its peculiar transformations; to meet their individual needs, stimulating their autonomy and their power of choice, envisaging the achievement of a better quality of life related to health in the perspective of health promotion.

Keywords: health-related quality of life, obstetric nursing, pregnant women, prenatal care

Procedia PDF Downloads 295
388 Examination of Indoor Air Quality of Naturally Ventilated Dwellings During Winters in Mega-City Kolkata

Authors: Tanya Kaur Bedi, Shankha Pratim Bhattacharya

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The US Environmental Protection Agency defines indoor air quality as “The air quality within and around buildings, especially as it relates to the health and comfort of building occupants”. According to the 2021 report by the Energy Policy Institute at Chicago, Indian residents, a country which is home to the highest levels of air pollution in the world, lose about 5.9 years from life expectancy due to poor air quality and yet has numerous dwellings dependent on natural ventilation. Currently the urban population spends 90% of the time indoors, this scenario raises a concern for occupant health and well-being. The built environment can affect health directly and indirectly through immediate or long-term exposure to indoor air pollutants. Health effects associated with indoor air pollutants include eye/nose/throat irritation, respiratory diseases, heart disease, and even cancer. This study attempts to demonstrate the causal relationship between the indoor air quality and its determining aspects. Detailed indoor air quality audits were conducted in residential buildings located in Kolkata, India in the months of December and January 2021. According to the air pollution knowledge assessment city program in India, Kolkata is also the second most polluted mega-city after Delhi. Although the air pollution levels are alarming year-long, the winter months are most crucial due to the unfavorable environmental conditions. While emissions remain typically constant throughout the year, cold air is denser and moves slower than warm air, trapping the pollution in place for much longer and consequently is breathed in at a higher rate than the summers. The air pollution monitoring period was selected considering environmental factors and major pollution contributors like traffic and road dust. This study focuses on the relationship between the built environment and the spatial-temporal distribution of air pollutants in and around it. The measured parameters include, temperature, relative humidity, air velocity, particulate matter, volatile organic compounds, formaldehyde, and benzene. A total of 56 rooms were audited, selectively targeting the most dominant middle-income group. The data-collection was conducted using a set of instruments positioned in the human breathing-zone. The study assesses indoor air quality based on factors determining natural ventilation and air pollution dispersion such as surrounding environment, dominant wind, openable window to floor area ratio, windward or leeward side openings, and natural ventilation type in the room: single side or cross-ventilation, floor height, residents cleaning habits, etc.

Keywords: indoor air quality, occupant health, urban housing, air pollution, natural ventilation, architecture, urban issues

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387 Soil Matric Potential Based Irrigation in Rice: A Solution to Water Scarcity

Authors: S. N. C. M. Dias, Niels Schuetze, Franz Lennartz

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The current focus in irrigated agriculture will move from maximizing crop production per unit area towards maximizing the crop production per unit amount of water (water productivity) used. At the same time, inadequate water supply or deficit irrigation will be the only solution to cope with water scarcity in the near future. Soil matric potential based irrigation plays an important role in such deficit irrigated agriculture to grow any crop including rice. Rice as the staple food for more than half of the world population, grows mainly under flooded conditions. It requires more water compared to other upland cereals. A major amount of this water is used in the land preparation and is lost at field level due to evaporation, deep percolation, and seepage. A field experimental study was conducted in the experimental premises of rice research and development institute of Sri Lanka in Kurunegala district to estimate the water productivity of rice under deficit irrigation. This paper presents the feasibility of improving current irrigation management in rice cultivation under water scarce conditions. The experiment was laid out in a randomized complete block design with four different irrigation treatments with three replicates. Irrigation treatments were based on soil matric potential threshold values. Treatment W0 was maintained between 60-80mbars. W1 was maintained between 80-100mbars. Other two dry treatments W2 and W3 were maintained at 100-120 mbar and 120 -140 mbar respectively. The sprinkler system was used to irrigate each plot individually upon reaching the maximum threshold value in respective treatment. Treatments were imposed two weeks after seed establishment and continued until two weeks before physiological maturity. Fertilizer applications, weed management, and other management practices were carried out per the local recommendations. Weekly plant growth measurements, daily climate parameters, soil parameters, soil tension values, and water content were measured throughout the growing period. Highest plant growth and grain yield (5.61t/ha) were observed in treatment W2 followed by W0, W1, and W3 in comparison to the reference yield (5.23t/ha) of flooded rice grown in the study area. Water productivity was highest in W3. Concerning the irrigation water savings, grain yield, and water productivity together, W2 showed the better performance. Rice grown under unsaturated conditions (W2) shows better performance compared to the continuously saturated conditions(W0). In conclusion, soil matric potential based irrigation is a promising practice in irrigation management in rice. Higher irrigation water savings can be achieved in this method. This strategy can be applied to a wide range of locations under different climates and soils. In future studies, higher soil matric potential values can be applied to evaluate the maximum possible values for rice to get higher water savings at minimum yield losses.

Keywords: irrigation, matric potential, rice, water scarcity

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386 Impact of Lined and Unlined Water Bodies on the Distribution and Abundance of Fresh Water Snails in Certain Governorates in Egypt

Authors: Nahed Mohamed Ismail, Bayomy Mostafa, Ahmed Abdel Kader, Ahmed Mohamed Azzam

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Effect of lining watercourses on the distribution and abundance of fresh water snails at two Egyptian governorates, Baheria (new reclaimed area) and Giza was studied. Seasonal survey in lined and unlined sites during two successive years was carried out. Samples of snails and water were collected from each examined site and the ecological conditions were recorded. The collected snails from each site were placed in plastic aquaria and transferred to the laboratory, where they were sorted out, identified, counted and examined for natural infection. The size frequency distribution was calculated for each snail species. Results revealed that snails were represented in all examined watercourses (lined and unlined) at the two tested habitats by 14 species. (Biomphalaria alexandrina, B. glabrata, Bulinus truncatus, Physa acuta. Helisoma duryi, Lymnaea natalensis, Planorbis planorbis, Cleopatra bulimoids, Lanistes carinatus, Bellamya unicolor, Melanoides tuberculata, Theodoxus nilotica, Succinia cleopatra and Gabbiella senaarensis). During spring, the percentage of live (45%) and dead (55%) snail species was extremely highly significant lower (p>0.001) in lined water bodies compared to the unlined ones (93.5% and 6.5%, respectively) in the examined sites at Baheria. At Giza, the percentage values of live snail species from all lined watercourses (82.6% and 60.2%, during winter and spring, respectively) was significantly lower (p>0.05 & p>0.01) than those in unlined ones (91.1% and 79%, respectively). Size frequency distribution of snails collected from the lined and unlined water bodies at Baheria and Giza governorates during all seasons revealed that during survey, snail populations were stable and the recruitment of young to adult was continuing for some species, where the recruits were observed with adults. However, there was no sign of small snails occurrence in case of B. glabrata and B. alexandrina during autumn, winter and spring and disappear during summer at Giza. Meanwhile they completely absent during all seasons at Baheria Governorate. Chemical analysis of some heavy metals of water samples collected from lined and unlined sites from Baheria and Giza governorates during autumn, winter and spring were approximately as the same in both lined and unlined water bodies. However, Zn and Fe were higher in lined sites (0.78±0.37and 17.4 ± 4.3, respectively) than that of unlined ones (0.4±0.1 and 10.95 ± 1.93, respectively) and Cu was absent in both lined and unlined sites during summer at Baheria governorate. At Giza, Cu and Pb were absent and Fe were higher in lined sites (4.7± 4.2) than that of unlined ones (2.5 ± 1.4) during summer. Statistical analysis showed that no significant difference in all physico-chemical parameters of water in lined and unlined water bodies at the two tested habitats during all seasons. However, it was found that the water conductivity and TDS showed a lower mean values in lined sites than those of unlined ones. Thus, the present obtained data support the concept of utilizing environmental modification such as lining of water courses to help in minimizing the population density of certain vector snails and consequently reduce the transmission of snails born diseases.

Keywords: lining, fresh water, snails, watercourses

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385 Integrated Care on Chronic Diseases in Asia-Pacific Countries

Authors: Chang Liu, Hanwen Zhang, Vikash Sharma, Don Eliseo Lucerno-Prisno III, Emmanuel Yujuico, Maulik Chokshi, Prashanthi Krishnakumar, Bach Xuan Tran, Giang Thu Vu, Kamilla Anna Pinter, Shenglan Tang

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Background and Aims: Globally, many health systems focus on hospital-based healthcare models targeting acute care and disease treatment, which are not effective in addressing the challenges of ageing populations, chronic conditions, multi-morbidities, and increasingly unhealthy lifestyles. Recently, integrated care programs on chronic diseases have been developed, piloted, and implemented to meet such challenges. However, integrated care programs in the Asia-Pacific region vary in the levels of integration from linkage to coordination to full integration. This study aims to identify and analyze existing cases of integrated care in the Asia-Pacific region and identify the facilitators and barriers in order to improve existing cases and inform future cases. Methods: The study is a comparative study, with a combination approach of desk-based research and key informant interviews. The selected countries included in this study represent a good mix of lower-middle income countries (the Philippines, India, Vietnam, and Fiji), upper-middle income country (China), and high-income country (Singapore) in the Asia-Pacific region. Existing integrated care programs were identified through the scoping review approach. Trigger, history, general design, beneficiaries, and objectors were summarized with barriers and facilitators of integrated care based on key informant interviews. Representative case(s) in each country were selected and comprehensively analyzed through deep-dive case studies. Results: A total of 87 existing integrated care programs on chronic diseases were found in all countries, with 44 in China, 21 in Singapore, 12 in India, 5 in Vietnam, 4 in the Philippines, and 1 in Fiji. 9 representative cases of integrated care were selected for in-depth description and analysis, with 2 in China, the Philippines, and Vietnam, and 1 in Singapore, India, and Fiji. Population aging and the rising chronic disease burden have been identified as key drivers for almost all the six countries. Among the six countries, Singapore has the longest history of integrated care, followed by Fiji, the Philippines, and China, while India and Vietnam have a shorter history of integrated care. Incentives, technologies, education, and performance evaluation would be crucial for developing strategies for implementing future programs and improve already existing programs. Conclusion: Integrated care is important for addressing challenges surrounding the delivery of long-term care. To date, there is an increasing trend of integrated care programs on chronic diseases in the Asia-Pacific region, and all six countries in our study set integrated care as a direction for their health systems transformation.

Keywords: integrated healthcare, integrated care delivery, chronic diseases, Asia-Pacific region

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384 'You’re Not Alone': Peer Feedback Practices for Cross-Cultural Writing Classrooms and Centers

Authors: Cassandra Branham, Danielle Farrar

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As writing instructors and writing center administrators at a large research university with a significant population of English language learners (ELLs), we are interested in how peer feedback pedagogy can be effectively translated for writing center purposes, as well as how various modes of peer feedback can enrich the learning experiences of L1 and L2 writers in these spaces. Although peer feedback is widely used in classrooms and centers, instructor, student, and researcher opinions vary in respect to its effectiveness. We argue that peer feedback - traditional and digital, synchronous and asynchronous - is an indispensable element for both classrooms and centers and emphasize that it should occur with both L1 and L2 students to further develop an array of reading and writing skills. We also believe that further understanding of the best practices of peer feedback in such cross-cultural spaces, like the classroom and center, can optimize the benefits of peer feedback. After a critical review of the literature, we implemented an embedded tutoring program in our university’s writing center in collaboration with its First-Year Composition (FYC) program and Language Institute. The embedded tutoring program matches a graduate writing consultant with L1 and L2 writers enrolled in controlled-matriculation composition courses where ELLs make up at least 50% of each class. Furthermore, this program is informed by what we argue to be some best practices of peer feedback for both classroom and center purposes, including expectation-based training through rubrics, modeling effective feedback, hybridizing traditional and digital modes of feedback, recognizing the significance the body in composition (what we call writer embodiment), and maximizing digital technologies to exploit extended cognition. After conducting surveys and follow-up interviews with students, instructors, and writing consultants in the embedded tutoring program, we found that not only did students see an increased value in peer feedback, but also instructors saw an improvement in both writing style and critical thinking skills. Our L2 participants noted improvements in language acquisition while our L1 students recognized a broadening of their worldviews. We believe that both L1 and L2 students developed self-efficacy and agency in their identities as writers because they gained confidence in their abilities to offer feedback, as well as in the legitimacy of feedback they received from peers. We also argue that these best practices situate novice writers as experts, as writers become a valued and integral part of the revision process with their own and their peers’ papers. Finally, the use of iPads in embedded tutoring recovered the importance of the body and its senses in writing; the highly sensory feedback from these multi-modal sessions that offer audio and visual input underscores the significant role both the body and mind play in compositional practices. After beginning with a brief review of the literature that sparked this research, this paper will discuss the embedded tutoring program in detail, report on the results of the pilot program, and will conclude with a discussion of the pedagogical implications that arise from this research for both classroom and center.

Keywords: English language learners, peer feedback, writing center, writing classroom

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383 Lived Experiences and Perspectives of Adult Survivors of Incest-Related Childhood Sexual Abuse

Authors: Varsha Puri, Sharon Hudson, Ian Kim

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Background: Incest-related childhood sexual abuse (IRCSA) is challenging to study due to the shame and secrecy experienced by its survivors. Ramifications of IRCSA worsen when it is unidentified, and interventions are not made. IRCSA perspectives are essential for future prevention and intervention strategies. However, there is limited understanding of this population’s experiences, perspectives, and long-term struggles. To date, research for IRCSA has utilized data from treatment programs and qualitative research with cohorts of 10-20 people, much of the data is from 10-40 years prior. Methods. In June 2018, an anonymous online survey was posted to multiple social media sites (e.g., Facebook IRCSA groups) and sexual abuse resource sites. Survey responses were collected for a year. The survey collected non-identifying demographics, IRCSA experiences, and outcomes data. Results: We obtained 1310 completed surveys. Demographics of all ages, racial backgrounds, financial backgrounds, and genders were obtained; the majority identified as white (81%) and female (76%). Childhood sexual abuse (CSA) started before the age of 6 in 49% and was endured for more than one year in 84% of respondents, and 39% reported ten or more years of abuse. CSA by multiple perpetrators occurred in 58%, while 8% had ten or more perpetrators. CSA by perpetrators under 21 years old was reported by 46%. Female perpetrators were reported by 28% of respondents. Fathers were the highest reported sexual abusers at 60%, and mothers were reported at 17%. Only 16% reported that at least one of their perpetrators was prosecuted for sexual abuse of a minor. Respondents confirmed that 54% of the time, they informed an adult of the abuse; only 2% agreed that “an intervention was made by the family that protected me.” A majority reported that IRCSA has negatively impacted their intimate/sexual relationships (96%) and mental health (96%). A majority reported negative impacts on biological family relationships (88%), physical health (73%), finances (59%), educational achievement (57%), and employment (56%). When asked about suffering from addiction, 85% of respondents answered yes. Prevention strategies selected most by respondents include early school education around CSA prevention (67%), removing the statute of limitations for reporting CSA (69%), and improved laws protecting IRCSA survivors (63%). Conclusion: The data document that IRCSA can be pervasive, and the dearth of intervention and support for survivors have major lasting impacts. Survivors have a unique and valuable perspective on what interventions are needed to prevent IRCSA and support survivors; their voice has long been unheard in crafting prevention and intervention policies and services. These results thus provide an important call to action from these critical stakeholders. Pediatricians should recognize that perpetrators can be pediatric patients, women, and parents. Pediatricians can advocate for more early CSA prevention education and policy changes that remove the statute of limitations for reporting CSA.

Keywords: incest, childhood sexual abuse, incest-related childhood sexual abuse, incest survivor

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