Search results for: local politics

Authors: Peninah Agaba, Monica Magadi, Bev Orton

Abstract:

Uganda is one of the countries with high maternal mortality (336/100,000) where adolescents account for 24 percent of the total maternal deaths. Research shows that use of maternal health services may prevent some of these deaths and good provider attitudes attract adolescents to use the services. However, poor health provider’s attitudes discourage adolescents from seeking the services during the maternity period. This study explores the experiences of unmarried female adolescents at the health facilities during the maternity period. The study population is unmarried adolescent girls aged 10-19 years who were pregnant or had given birth within three years before the interview. This is a special interest group that requires attention throughout this period. Most of the pregnancies among unmarried adolescents are unwanted; as a result, many of them have been abused and neglected by parents and close family members including partners who deny fatherhood of the pregnancy/child. These adolescents hope to find comfort from health providers like being listened to during counseling, not abused and judged; unfortunately this is not the case always. The research was approved by the University of Hull, School of Education and Social Sciences ethics review committee, Mildmay Uganda Research Ethics Committee and Uganda National Council of Science and Technology. The study was carried out in Bushenyi and Kibale districts in Western Uganda. Fourteen in-depth interviews and seven focus group discussions were completed in the local languages and later transcribed to English language. Thematic analysis to identify the themes was done. Adolescents were aged 16-19 years, two had become pregnant before 15 years. Most had not completed secondary education; none had tertiary education and three of the 14 IDI adolescent participants wanted to get pregnant. Analysis shows varied experiences; most adolescents were abused verbally and physically by the health providers due to their young age of pregnancy, lack of essential items during this period (maternity dresses, children clothes, delivery kit) and fear of labour pains. Another cause for abuse was these adolescents coming for antenatal care with no partners yet the implementation of a policy on increasing male involvement in reproductive health in Uganda requires them to attend antenatal care with their partners and most of these unmarried adolescents have no partners to accompany them. Despite the above challenges, the study also identified the care some of these unmarried adolescents received during the maternity visits for example they were not abused, were provided with appropriate information and supported with child care. The study identified abuse and support the unmarried adolescents received during the maternity period. Efforts to provide adolescents with adequate information including what to expect during labour by providers and provision of basic needs are essential. Health providers should have trainings on client care especially how to embrace unmarried adolescents when they come to access maternity services. More so, the policy on improving male involvement in RH issues need to be considerate of unmarried adolescents who in most cases do not have the partners to go with to access maternity care.

Keywords: abuse, maternity care, Uganda, unmarried, adolescents

Procedia PDF Downloads 130

Authors: Nikeshala Weerasekara, Roshan Ajward

Abstract:

Contemporary business environment, given the circumstance of stringent scrutiny toward corporate behavior, organizations are under pressure to develop and implement solid overarching Corporate Social Responsibility (CSR) strategies. In that milieu, in order to differentiate themselves from competitors and maintain stakeholder confidence banks spend millions of dollars on CSR programmes. However, knowledge on how non-western bank employees perceive such activities is inconclusive. At the same time recently only researchers have shifted their focus on positive effects of compassion at work or the organizational conditions under which it arises. Nevertheless, mediation mechanisms between CSR and compassion at work have not been adequately examined leaving a vacuum to be explored. Despite finding a purpose in work that is greater than extrinsic outcomes of the work is important to employees, meaningful work has not been examined adequately. Thus, in addition to examining the direct relationship between CSR and compassion at work, this study examined the mediating capability of meaningful work between these variables. Specifically, the researcher explored how CSR enables employees to sense work as meaningful which in turn would enhance their level of compassion at work. Hypotheses were developed to examine the direct relationship between CSR and compassion at work and the mediating effect of meaningful work on the relationship between CSR and compassion at work. Both Social Identity Theory (SIT) and Social Exchange Theory (SET) were used to theoretically support the relationships. The sample comprised of 450 respondents covering different levels of the bank. A convenience sampling strategy was used to secure responses from 13 local licensed commercial banks in Sri Lanka. Data was collected using a structured questionnaire which was developed based on a comprehensive review of literature and refined using both expert opinions and a pilot survey. Structural equation modeling using Smart Partial Least Square (PLS) was utilized for data analysis. Findings indicate a positive and significant (p < .05) relationship between CSR and compassion at work. Also, it was found that meaningful work partially mediates the relationship between CSR and compassion at work. As per the findings it is concluded that bank employees’ perception of CSR engagement not only directly influence compassion at work but also impact such through meaningful work as well. This implies that employees consider working for a socially responsible bank since it creates greater meaningfulness of work to retain with the organization, which in turn trigger higher level of compassion at work. By utilizing both SIT and SET in explaining relationships between CSR and compassion at work it amounts to theoretical significance of the study. Enhance existing literature on CSR and compassion at work. Also, adds insights on mediating capability of psychologically related variables such as meaningful work. This study is expected to have significant policy implications in terms of increasing compassion at work where managers must understand the importance of including CSR activities into their strategy in order to thrive. Finally, it provides evidence of suitability of using Smart PLS to test models with mediating relationships involving non normal data.

Keywords: compassion at work, corporate social responsibility, employee commitment, meaningful work, positive affect

Procedia PDF Downloads 126

Authors: Ruijia Hu, Susanna T.Y. Tong

Abstract:

Light detection and ranging (LiDAR) and four-channel red, green, blue, and near-infrared (RGBI) remote sensed imageries allow an accurate quantification and contiguous measurement of vegetation characteristics and forest structures. This information facilitates the generation of habitat structure variables for forest species distribution modelling. However, applications of remote sensing data, especially the combination of structural and spectral information, to support evidence-based decisions in forest managements and conservation practices at local scale are not widely adopted. In this study, we examined the habitat requirements of pileated woodpecker (Dryocopus pileatus) (PW) in Hamilton County, Ohio, using ecologically relevant forest structural and vegetation characteristics derived from LiDAR and RGBI data. We hypothesized that the habitat of PW is shaped by vegetation characteristics that are directly associated with the availability of food, hiding and nesting resources, the spatial arrangement of habitat patches within home range, as well as proximity to water sources. We used 186 PW presence or absence locations to model their presence and absence in generalized additive model (GAM) at two scales, representing foraging and home range size, respectively. The results confirm PW’s preference for tall and large mature stands with structural complexity, typical of late-successional or old-growth forests. Besides, the crown size of dead trees shows a positive relationship with PW occurrence, therefore indicating the importance of declining living trees or early-stage dead trees within PW home range. These locations are preferred by PW for nest cavity excavation as it attempts to balance the ease of excavation and tree security. In addition, we found that PW can adjust its travel distance to the nearest water resource, suggesting that habitat fragmentation can have certain impacts on PW. Based on our findings, we recommend that forest managers should use different priorities to manage nesting, roosting, and feeding habitats. Particularly, when devising forest management and hazard tree removal plans, one needs to consider retaining enough cavity trees within high-quality PW habitat. By mapping PW habitat suitability for the study area, we highlight the importance of riparian corridor in facilitating PW to adjust to the fragmented urban landscape. Indeed, habitat improvement for PW in the study area could be achieved by conserving riparian corridors and promoting riparian forest succession along major rivers in Hamilton County.

Keywords: deadwood detection, generalized additive model, individual tree crown delineation, LiDAR, pileated woodpecker, RGBI aerial imagery, species distribution models

Procedia PDF Downloads 51

Authors: Benjamin Glasner, Carlos Henriquez, Fernando Alfaro, Nicole Trefault, Santiago Andrade, Rodrigo De La Iglesia

Abstract:

A central question in ecology refers to the relative importance that local-scale variables have over community composition, when compared with regional-scale variables. In coastal environments, strong seasonal abiotic influence dominates these systems, weakening the impact of other parameters like micronutrients. After the industrial revolution, micronutrients like trace metals have increased in ocean as pollutants, with strong effects upon biotic entities and biological processes in coastal regions. Coastal picoplankton communities had been characterized as a cyanobacterial dominated fraction, but in recent years the eukaryotic component of this size fraction has gained relevance due to their high influence in carbon cycle, although, diversity patterns and responses to disturbances are poorly understood. South Pacific upwelling coastal environments represent an excellent model to study seasonal changes due to a strong influence in the availability of macro- and micronutrients between seasons. In addition, some well constrained coastal bays of this region have been subjected to strong disturbances due to trace metal inputs. In this study, we aim to compare the influence of seasonality and trace metals concentrations, on the community structure of planktonic picoeukaryotes. To describe seasonal patterns in the study area, satellite data in a 6 years time series and in-situ measurements with a traditional oceanographic approach such as CTDO equipment were performed. In addition, trace metal concentrations were analyzed trough ICP-MS analysis, for the same region. For biological data collection, field campaigns were performed in 2011-2012 and the picoplankton community was described by flow cytometry and taxonomical characterization with next-generation sequencing of ribosomal genes. The relation between the abiotic and biotic components was finally determined by multivariate statistical analysis. Our data show strong seasonal fluctuations in abiotic parameters such as photosynthetic active radiation and superficial sea temperature, with a clear differentiation of seasons. However, trace metal analysis allows identifying strong differentiation within the study area, dividing it into two zones based on trace metals concentration. Biological data indicate that there are no major changes in diversity but a significant fluctuation in evenness and community structure. These changes are related mainly with regional parameters, like temperature, but by analyzing the metal influence in picoplankton community structure, we identify a differential response of some plankton taxa to metal pollution. We propose that some picoeukaryotic plankton groups respond differentially to metal inputs, by changing their nutritional status and/or requirements under disturbances as a derived outcome of toxic effects and tolerance.

Keywords: Picoeukaryotes, plankton communities, trace metals, seasonal patterns

Procedia PDF Downloads 172

Authors: Miranda Lin

Abstract:

This project examined the impact of a globally focused service-learning project implemented in a multicultural education course in a Midwestern university. This project facilitated critical self-reflection and build cross-cultural competence while nurturing a partnership with two schools that serve students with disabilities in Vietnam. Through a service-learning project, pre-service teachers connected via Skype with the principals/teachers at schools in Vietnam to identify and subsequently develop needed instructional materials for students with mild, moderate, and severe disabilities. Qualitative data sources include students’ intercultural competence self-reflection survey (pre-test and post-test), reflections, discussions, service project, and lesson plans. Literature Review- Global service-learning is a teaching strategy that encompasses service experiences both in the local community and abroad. Drawing on elements of global learning and international service-learning, global service-learning experiences are guided by a framework that is designed to support global learning outcomes and involve direct engagement with difference. By engaging in real-world challenges, global service-learning experiences can support the achievement of learning outcomes such as civic. Knowledge and intercultural knowledge and competence. Intercultural competence development is considered essential for cooperative and reciprocal engagement with community partners.Method- Participants (n=27*) were mostly elementary and early childhood pre-service teachers who were enrolled in a multicultural education course. All but one was female. Among the pre-service teachers, one Asian American, two Latinas, and the rest were White. Two pre-service teachers identified themselves as from the low socioeconomic families and the rest were from the middle to upper middle class.The global service-learning project was implemented in the spring of 2018. Two Vietnamese schools that served students with disabilities agreed to be the global service-learning sites. Both schools were located in an urban city.Systematic collection of data coincided with the course schedule as follows: an initial intercultural competence self-reflection survey completed in week one, guided reflections submitted in week 1, 9, and 16, written lesson plans and supporting materials for the service project submitted in week 16, and a final intercultural competence self-reflection survey completed in week 16. Significance-This global service-learning project has helped participants meet Merryfield’s goals in various degrees. They 1) learned knowledge and skills in the basics of instructional planning, 2) used a variety of instructional methods that encourage active learning, meet the different learning styles of students, and are congruent with content and educational goals, 3) gained the awareness and support of their students as individuals and as learners, 4) developed questioning techniques that build higher-level thinking skills, and 5) made progress in critically reflecting on and improving their own teaching and learning as a professional educator as a result of this project.

Keywords: global service-learning, teacher education, intercultural competence, diversity

Procedia PDF Downloads 115

Authors: Maxwell Henderson, Tristan Cook, Justin Chan Jin Le, Mark Hodson, YoungJung Chang, John Novak, Daniel Padilha, Nishan Kulatilaka, Ansu Bagchi, Sanjoy Ray, John Kelly

Abstract:

We present a method of using adiabatic quantum optimization (AQO) to solve a mixed integer nonlinear programming (MINLP) problem instance. The MINLP problem is a general form of a set of NP-hard optimization problems that are critical to many business applications. It requires optimizing a set of discrete and continuous variables with nonlinear and potentially nonconvex constraints. Obtaining an exact, optimal solution for MINLP problem instances of non-trivial size using classical computation methods is currently intractable. Current leading algorithms leverage heuristic and divide-and-conquer methods to determine approximate solutions. Creating more accurate and efficient algorithms is an active area of research. Quantum computing (QC) has several theoretical benefits compared to classical computing, through which QC algorithms could obtain MINLP solutions that are superior to current algorithms. AQO is a particular form of QC that could offer more near-term benefits compared to other forms of QC, as hardware development is in a more mature state and devices are currently commercially available from D-Wave Systems Inc. It is also designed for optimization problems: it uses an effect called quantum tunneling to explore all lowest points of an energy landscape where classical approaches could become stuck in local minima. Our work used a novel algorithm formulated for AQO to solve a special type of MINLP problem. The research focused on determining: 1) if the problem is possible to solve using AQO, 2) if it can be solved by current hardware, 3) what the currently achievable performance is, 4) what the performance will be on projected future hardware, and 5) when AQO is likely to provide a benefit over classical computing methods. Two different methods, integer range and 1-hot encoding, were investigated for transforming the MINLP problem instance constraints into a mathematical structure that can be embedded directly onto the current D-Wave architecture. For testing and validation a D-Wave 2X device was used, as well as QxBranch’s QxLib software library, which includes a QC simulator based on simulated annealing. Our results indicate that it is mathematically possible to formulate the MINLP problem for AQO, but that currently available hardware is unable to solve problems of useful size. Classical general-purpose simulated annealing is currently able to solve larger problem sizes, but does not scale well and such methods would likely be outperformed in the future by improved AQO hardware with higher qubit connectivity and lower temperatures. If larger AQO devices are able to show improvements that trend in this direction, commercially viable solutions to the MINLP for particular applications could be implemented on hardware projected to be available in 5-10 years. Continued investigation into optimal AQO hardware architectures and novel methods for embedding MINLP problem constraints on to those architectures is needed to realize those commercial benefits.

Keywords: adiabatic quantum optimization, mixed integer nonlinear programming, quantum computing, NP-hard

Procedia PDF Downloads 524

Authors: L. Bidyalakshmi, R. Ananthan, T. Longvah

Abstract:

Antioxidants are substances that can prevent or delay oxidative damage of lipids, proteins and nucleic acids by reactive oxygen species. These help in lowering incidence of degenerative diseases such as cancer, arthritis, atherosclerosis, heart disease, inflammation, brain dysfunction and acceleration of the ageing process. The north eastern part of India falls among the global hotspots of biodiversity. Over the years, the local communities in the region have developed ingenious uses of many wild plants within their environment as food sources. Many of these less familiar foods form an integral part of the diet of these communities, and some are traditionally valued for its therapeutic effects. So the study was carried to estimate the antioxidant activity of some of these indigenous foods. Twenty-eight indigenous plant foods were studied for their antioxidant activity. Antioxidant activities were determined by using DPPH (2, 2-diphenyl-1-picrylhydrazyl) assay, FRAP (Ferric Reducing Antioxidant Power) assay and SOSA (Super Oxide Scavenging Assay). Out of the twenty-eight plant foods, there were thirteen leafy vegetables, four fruits, five roots and tubers, four spices and two mushrooms. Water extract and methanol extract of the samples were used for the analysis. The leafy vegetable samples exhibited antioxidant capacity with IC50 ranging from 8-1414 mg/ml for lipid extract and 34-37878 mg/ml for aqueous extract in DPPH assay. Total FRAP value ranging from 58-1005 mmol FeSO4 Eq/100g of the sample, which is comparatively higher than the antioxidant capacity of some commonly consumed leafy vegetables. In SOSA, water extract of leafy vegetables show a range of 0.05-193.68 µmol ascorbic acid equivalent/g of the samples. While the methanol extract of the samples show 0.20-21.94 µmol Trolox equivalent/g of the samples. Polygonum barbatum, Wendlandia glabrata and Polygonum posumbu have higher antioxidant activity among the leafy vegetables analysed. Among the fruits, Rhus hookerii showed the highest antioxidant activities in both FRAP and SOSA methods while Spondias magnifera exhibited higher antioxidant activity in DPPH method. Alocasia cucullata exhibited higher antioxidant activity in DPPH and FRAP assays while Alpinia galanga showed higher antioxidant activity in SOSA assay when compared to the other samples of roots and tubers. Elsholtzia communis showed high antioxidant activity in all the three parameters among the spices. For the mushrooms, Pleurotus ostreatus exhibited higher antioxidant activity than Auricularia delicate in DPPH and SOSA. The samples analysed exhibited antioxidant activity at varying levels and some exhibited higher antioxidant activity than the commonly consumed foods. So consumption of these less familiar foods may play a role in preventing human disease in which free radicals are involved. Further studies on these food samples on phytonutrients and its contribution to the antioxidant activities are required.

Keywords: antioxidant activity, DPPH, FRAP, SOSA

Procedia PDF Downloads 276

Authors: Mohamed Naser Zainol, P. P. Angeline Song

Abstract:

Over the years, the profile of end-stage renal patients placed under The National Kidney Foundation Singapore (NKFS) dialysis program has evolved, with a gradual incline in the number of patients with behavior-related issues. With these challenging profiles, social workers and counsellors are often expected to oversee behavior management, through referrals from its partnering colleagues. Due to the segregation of tasks usually found in many hospital-based multi-disciplinary settings, social workers’ and counsellors’ interventions are often seen as an endpoint, limiting other stakeholders’ involvement that could otherwise be potentially crucial in managing such patients. While patients’ contact in local hospitals often leads to eventual discharge, NKFS patients are mostly long term. It is interesting to note that these patients are regularly seen by a team of professionals that includes doctors, nurses, dietitians, exercise specialists in NKFS. The dynamism of relationships presents an opportunity for any of these professionals to take ownership of their potentials in leading interventions that can be helpful to patients. As such, it is important to have a framework that incorporates the strength of these professionals and also channels empowerment across the multi-disciplinary team in working towards wholistic patient care. This paper would like to suggest a new framework for NKFS’s multi-disciplinary team, where the group synergy and dynamics are used to encourage ownership and promote empowerment. The social worker and counsellor use group work skills and his/her knowledge of its members’ strengths, to generate constructive solutions that are centered towards patient’s growth. Using key ideas from Karl’s Tomm Interpersonal Communications, the Communication Management of Meaning and Motivational Interviewing, the social worker and counsellor through a series of guided meeting with other colleagues, facilitates the transmission of understanding, responsibility sharing and tapping on team resources for patient care. As a result, the patient can experience personal and concerted approach and begins to flow in a direction that is helpful for him. Using seven case studies of identified patients with behavioral issues, the social worker and counsellor apply this framework for a period of six months. Patient’s overall improvement through interventions as a result of this framework are recorded using the AB single case design, with baseline measured three months before referral. Interviews with patients and their families, as well as other colleagues that are not part of the multi-disciplinary team are solicited at mid and end points to gather their experiences about patient’s progress as a by-product of this framework. Expert interviews will be conducted on each member of the multi-disciplinary team to study their observations and experience in using this new framework. Hence, this exploratory framework hopes to identify the inherent usefulness in managing patients with behavior related issues. Moreover, it would provide indicators in improving aspects of the framework when applied to a larger population.

Keywords: behavior management, end-stage renal failure, satellite dialysis, multi-disciplinary team

Procedia PDF Downloads 145

Authors: Emine Umran Topcu

Abstract:

In both urban design and architecture, the primary goal is considered to be looking for ways in which people feel and think about space and place. Humans, in general, see a place as security and space as freedom and feel attached to place and long for space. Contemporary urban design manifests itself by addressing basic physical and psychological human needs. Not much attention is paid to transcendence. There seems to be a gap in the hierarchy of human needs. Usually, social aspects of public space are addressed through urban design. More personal and intimately scaled needs of an individual are neglected. How does built form contribute to an individual’s growth, contemplation, and exploration? In other words, a greater meaning in the immediate environment. Architects love to talk about meaning, poetics, attachment and other ethereal aspects of space that are not visible attributes of places. This paper aims at describing spirituality through built form with a personal experience of Kamppi Chapel of Helsinki. Experience covers various modes through which a person unfolds or constructs reality. Perception, sensation, emotion, and thought can be counted as for these modes. To experience is to get to know. What can be known is a construct of experience. Feelings and thoughts about space and place are very complex in human beings. They grow out of life experiences. The author had the chance of visiting Kamppi Chapel in April 2017, out of which the experience grew. The Kamppi Chapel is located on the South side of the busy Narinnka Square in central Helsinki. It offers a place to quiet down and compose oneself in a most lively urban space. With its curved wooden facade, the small building looks more like a museum than a chapel. It can be called a museum for contemplation. With its gently shaped interior, it embraces visitors and shields them from the hustle bustle of the city outside. Places of worship in all faiths signify sacred power. The author, having origins in a part of the world where domes and minarets dominate the cityscape, was impressed by the size and the architectural visibility of the Chapel. Anyone born and trained in such a tradition shares the inherent values and psychological mechanisms of spirituality, sacredness and the modest realities of their environment. Spirituality in all cultural traditions has not been analyzed and reinterpreted in new conceptual frameworks. Fundamentalists may reject this positivist attitude, but Kamppi Chapel as it stands does not look like it has a say like “I’m a model to be followed”. It just faces the task of representing a religious facility in an urban setting largely shaped by modern urban planning, which seems to the author as looking for a new definition of individual status. The quest between the established and the new is the demand for modern efficiency versus dogmatic rigidity. The architecture here has played a very promising and rewarding role for spirituality. The designers have been the translators for human desire for better life and aesthetic environment for an optimal satisfaction of local citizens and the visitors alike.

Keywords: architecture, Kamppi Chapel, spirituality, urban

Procedia PDF Downloads 182

Authors: Petrus Louis Nolte

Abstract:

University sport in South Africa is not isolated from the complexity of globalization and professionalization of sport, as it forms an integral part of the sport development environment in South Africa. In order to align their sport programmes with global and professional requirements, several universities opted to develop elite sport programmes; recruit specialized personnel such as coaches, administrators and athletes; provide expert coaching; scientific and medical services; sports testing; fitness, technical and tactical expertise; sport psychological and rehabilitation support; academic guidance and career assistance; and student-athlete accommodation. In addition, universities provide administrative support and high-quality physical resources (training facilities) for the benefit of the overall South African sport system. Although it is not compulsory for universities to develop elite sport programmes to prepare their teams for competitions, elite competitions such as the annual Varsity Sport, University Sport South Africa (USSA) and local club competitions and leagues within university international competitions where universities not only compete but also deliver players for representative national netball teams. The aim of this study is therefore to describe the perceptions of players of the university elite netball programmes they were participating in. This study adopted a descriptive design with a quantitative approach, utilizing a self-structured questionnaire as research technique. As this research formed part of a national research project for NSA with a population of 172 national and provincial netball players, a sample of 92 university netball players from the population was selected. Content validity of the self-structured questionnaire was secured through a test-retest process, with construct validity through a member of the Statistical Consultation Services (STATCON) of the University of Johannesburg that provided feedback on the structural format of the questionnaire. Reliability was measured utilising Cronbach Alpha on p<0.005 level of significance. A reliability score of 0.87 was measured. The research was approved by the Board of Netball South Africa and ethical conduct implemented according to the processes and procedures approved by the Ethics Committees of the Faculty of Health Sciences, University of Johannesburg with clearance number REC-01-30-2019. From the results it is evident that university elite netball programmes are professional, especially with regards to the employment of knowledgeable and competent coaches and technical officials such as team managers and sport sciences staff. These professionals have access to elite training facilities, support staff, and relatively large groups of elite players, all elements of an elite programme that could enhance the national federation’s (Netball South Africa) system. Universities could serve the dual purpose of serving as university netball clubs, as well as providing elite training services and facilities as performance hubs for national players.

Keywords: elite sport programmes, university netball, player experiences, Varsity Sport netball

Procedia PDF Downloads 146

Authors: V. Schmidt, L. Janovák, N. Wiegand, B. Patczai, K. Turzó

Abstract:

Large bone defects are not able to heal spontaneously. Bioactive glasses seem to be appropriate (bio)materials for bone reconstruction. Bioactive glasses are osteoconductive and osteoinductive, therefore, play a useful role in bony regeneration and repair. Because of their not optimal mechanical properties (e.g., brittleness, low bending strength, and fracture toughness), their applications are limited. Bioactive glass can be used as a coating material applied on metal surfaces. In this way -when using them as implants- the excellent mechanical properties of metals and the biocompatibility and bioactivity of glasses will be utilized. Furthermore, ion release effects of bioactive glasses regarding osteogenic and angiogenic responses have been shown. Silicate bioactive glasses (45S5 Bioglass) induce the release and exchange of soluble Si, Ca, P, and Na ions on the material surface. This will lead to special cellular responses inducing bone formation, which is favorable in the biointegration of the orthopedic prosthesis. The incorporation of other additional elements in the silicate network such as fluorine, magnesium, iron, silver, potassium, or zinc has been shown, as the local delivery of these ions is able to enhance specific cell functions. Although hip and knee prostheses present a high success rate, bacterial infections -mainly implant associated- are serious and frequent complications. Infection can also develop after implantation of hip prostheses, the elimination of which means more surgeries for the patient and additional costs for the clinic. Prosthesis-related infection is a severe complication of orthopedic surgery, which often causes prolonged illness, pain, and functional loss. While international efforts are made to reduce the risk of these infections, orthopedic surgical infections (SSIs) continue to occur in high numbers. It is currently estimated that up to 2.5% of primary hip and knee surgeries and up to 20% of revision arthroplasties are complicated by periprosthetic joint infection (PJIs). According to some authors, these numbers are underestimated, and they are also increasing. Staphylococcus aureus is the leading cause of both SSIs and PJIs, and the prevalence of methicillin-resistant S. aureus (MRSA) is on the rise, particularly in the United States. These deep infections lead to implant removal and consequently increase morbidity and mortality. The study targets this clinical problem using our experience so far with the Ag-doped polymer coatings on Titanium implants. Non-modified or modified (e.g., doped with antibacterial agents, like Ag) bioactive glasses could play a role in the prevention of infections or the therapy of infected tissues. Bioactive glasses have excellent biocompatibility, proved by in vitro cell culture studies of human osteoblast-like MG-63 cells. Ag-doped bioactive glass-scaffold has a good antibacterial ability against Escherichia coli and other bacteria. It may be concluded that these scaffolds have great potential in the prevention and therapy of implant-associated bone infection.

Keywords: antibacterial agents, bioactive glass, hip and knee prosthesis, medical implants

Procedia PDF Downloads 191

Authors: Kai Warsoenke, Maik Mackiewicz

Abstract:

To achieve a high quality of assembled car body structures, tolerancing is used to ensure a geometric accuracy of the single car body parts. There are two main techniques to determine the required tolerances. The first is tolerance analysis which describes the influence of individually tolerated input values on a required target value. Second is tolerance synthesis to determine the location of individual tolerances to achieve a target value. Both techniques are based on classical statistical methods, which assume certain probability distributions. To ensure competitiveness in both saturated and dynamic markets, production processes in vehicle manufacturing must be flexible and efficient. The dimensional specifications selected for the individual body components and the resulting assemblies have a major influence of the quality of the process. For example, in the manufacturing of forming tools as operating equipment or in the higher level of car body assembly. As part of the metrological process monitoring, manufactured individual parts and assemblies are recorded and the measurement results are stored in databases. They serve as information for the temporary adjustment of the production processes and are interpreted by experts in order to derive suitable adjustments measures. In the production of forming tools, this means that time-consuming and costly changes of the tool surface have to be made, while in the body shop, uncertainties that are difficult to control result in cost-intensive rework. The stored measurement results are not used to intelligently design tolerances in future processes or to support temporary decisions based on real-world geometric data. They offer potential to extend the tolerancing methods through data analysis and machine learning models. The purpose of this paper is to examine real-world measurement data from individual car body components, as well as assemblies, in order to develop an approach for using the data in short-term actions and future projects. For this reason, the measurement data will be analyzed descriptively in the first step in order to characterize their behavior and to determine possible correlations. In the following, a database is created that is suitable for developing machine learning models. The objective is to create an intelligent way to determine the position and number of measurement points as well as the local tolerance range. For this a number of different model types are compared and evaluated. The models with the best result are used to optimize equally distributed measuring points on unknown car body part geometries and to assign tolerance ranges to them. The current results of this investigation are still in progress. However, there are areas of the car body parts which behave more sensitively compared to the overall part and indicate that intelligent tolerancing is useful here in order to design and control preceding and succeeding processes more efficiently.

Keywords: automotive production, machine learning, process optimization, smart tolerancing

Procedia PDF Downloads 114

Authors: Archana Sharma, Vijayashree Nayak, Ashok Kumar

Abstract:

Three-dimensional matrices were fabricated from blend of natural-natural polymers like carrageenan-gelatin and synthetic -natural polymers such as PEG- gelatin (PEG of different molecular weights (2,000 and 6,000) using two different crosslinkers; glutaraldehyde and EDC-NHS by cryogelation technique. Blends represented a feasible approach to design 3-D scaffolds with controllable mechanical, physical and biochemical properties without compromising biocompatibility and biodegradability. These matrices possessed interconnected porous structure, good mechanical strength, biodegradable nature, constant swelling kinetics, ability to withstand high temperature and visco-elastic behavior. Hemocompatibility of cryogel matrices was determined by coagulation assays and hemolytic activity assay which demonstrated that these cryogels have negligible effects on coagulation time and have excellent blood compatibility. In vitro biocompatibility (cell-matrix interaction) inferred good cell adhesion, proliferation, and secretion of ECM on matrices. These matrices provide a microenvironment for the growth, proliferation, differentiation and secretion of ECM of different cell types such as IMR-32, C2C12, Cos-7, rat bone marrow derived MSCs and human bone marrow MSCs. Hoechst 33342 and PI staining also confirmed that the cells were uniformly distributed, adhered and proliferated properly on the cryogel matrix. An ideal scaffold used for tissue engineering application should allow the cells to adhere, proliferate and maintain their functionality. Neurotransmitter analysis has been done which indicated that IMR-32 cells adhered, proliferated and secreted neurotransmitters when they interacted with these matrices which showed restoration of their functionality. The cell-matrix interaction up to molecular level was also evaluated so to check genotoxicity and protein expression profile which indicated that these cryogel matrices are non-genotoxic and maintained biofunctionality of cells growing on these matrices. All these cryogels, when implanted subcutaneously in balb/c mice, showed no adverse systemic or local toxicity effects at implantation site. There was no significant increase in inflammatory cell count has otherwise been observed after scaffold implantation. These cryogels are supermacroporous and this porous structure allows cell infiltration and proliferation of host cells. This showed the integration and presence of infiltrated cells into the cryogel implants. Histological analysis confirmed that the implanted cryogels do not have any adverse effect in spite of host immune system recognition at the site of implantation, on its surrounding tissues and other vital host organs. In vivo biocompatibility study after in vitro biocompatibility analysis has also concluded that these synthesized cryogels act as important biological substitutes, more adaptable and appropriate for transplantation. Thus, these cryogels showed their potential for soft tissue engineering applications.

Keywords: cryogelation, hemocompatibility, in vitro biocompatibility, in vivo biocompatibility, soft tissue engineering applications

Procedia PDF Downloads 222

Authors: Kunyaporn Pipithsangchan, Alongkorn Korntong, Assanee Songserm, Phatchara Piriyavinit, Saowanee Dechakampoo

Abstract:

The Kingdom of Thailand is one of the South East Asian countries. From its area of 514,000 square kilometers (51 million ha), at least 18,000 plant species (8% of the world total) have been estimated to be found in the country. As a result, the conservation of plant genetic diversity, particularly food crops, is becoming important and is an assurance for the national food security. Department of Agriculture Genebank or DOA Genebank, Thailand is responsible for the conservation of plant germplasm by participating and accomplishing several collaborative projects both at national and international levels. Integrated Management System of Plant Genetic Resources or IMPGR is one of the most outstandingly successful cooperation. It is a multilateral project under the Asian Food and Agriculture Cooperation Initiative (AFACI) supported by the Rural Development Administration (RDA) of South Korea. The member countries under the project consist of 11 nations namely Bangladesh, Cambodia, Indonesia, Laos PDR, Mongolia, Nepal, Philippines, Sri Lanka, Thailand, Vietnam and South Korea. The project enabled the members to jointly address the global issues in plant genetic resource (PGR) conservation and strengthen their network in this aspect. The 1st phase of IMPGR project, entitled 'Collection, Conservation, Regeneration and Characterization of Cucurbitaceae and Solanaceae 2012-2014', comprises three main objectives that are: 1) To improve management in storage facilities, collection, and regeneration, 2) To improve linkage between Genebank and material sources (for regeneration), and 3) To improve linkage between Genebank and other field crop or/and horticultural research centers. The project was done for three years from 2012 to 2014. The activities of the project can be described as following details: In the 1st year, there were 9 target provinces for completing plant genetic resource survey and collection. 108 accessions of PGR were collected. In the 2nd year, PGR were continuously surveyed and collected from 9 provinces. The total number of collection was 140 accessions. In addition, the process of regeneration of 237 accessions collected from 1st and 2nd year was started at several sites namely Biotechnology Research and Development Office, Sukothai Horticultural Research Center, Tak Research, and Development Center and Nakhon Ratchasima Research and Development Center. In the 3rd year, besides survey and collection of 115 accessions from 9 target provinces, PGR characterization and evaluation were done for 206 accessions. Moreover, safety duplication of 253 PGR at the World Seed Vault, RDA, was also done according to Standard Agreement on Germplasm Safety Duplication between Department of Agriculture, Ministry of Agriculture and Cooperatives, the Kingdom of Thailand and the National Agrobiodiversity Center, Rural Development Administration of the Republic of Korea. The success of the 1st phase project led to the second phase which entitled 'Collection and Characterization for Effective Conservation of Local Capsicum spp., Solanum spp. and Lycopersicon spp. in Thailand 2015-2017'.

Keywords: characterization, conservation, DOA genebank, plant genetic resources

Procedia PDF Downloads 173

Authors: Aliya K. Salahova

Abstract:

Scientific thinking, characterized by purposeful knowledge-seeking and the harmonization of theory and facts, holds a crucial role in preparing young minds for an increasingly complex and technologically advanced world. This abstract presents a research study aimed at fostering scientific thinking in early childhood, focusing on children aged 5 to 9 years, through experiential learning in Kids Science Labs (STEM). The study utilized a longitudinal exploration design, spanning 240 weeks from September 2018 to April 2023, to evaluate the effectiveness of the Kids Science Labs program in developing scientific thinking skills. Participants in the research comprised 72 children drawn from local schools and community organizations. Through a formative psychology-pedagogical experiment, the experimental group engaged in weekly STEM activities carefully designed to stimulate scientific thinking, while the control group participated in daily art classes for comparison. To assess the scientific thinking abilities of the participants, a registration table with evaluation criteria was developed. This table included indicators such as depth of questioning, resource utilization in research, logical reasoning in hypotheses, procedural accuracy in experiments, and reflection on research processes. The data analysis revealed dynamic fluctuations in the number of children at different levels of scientific thinking proficiency. While the development was not uniform across all participants, a main leading factor emerged, indicating that the Kids Science Labs program and formative experiment exerted a positive impact on enhancing scientific thinking skills in children within this age range. The study's findings support the hypothesis that systematic implementation of STEM activities effectively promotes and nurtures scientific thinking in children aged 5-9 years. Enriching education with a specially planned STEM program, tailoring scientific activities to children's psychological development, and implementing well-planned diagnostic and corrective measures emerged as essential pedagogical conditions for enhancing scientific thinking abilities in this age group. The results highlight the significant and positive impact of the systematic-activity approach in developing scientific thinking, leading to notable progress and growth in children's scientific thinking abilities over time. These findings have promising implications for educators and researchers, emphasizing the importance of incorporating STEM activities into educational curricula to foster scientific thinking from an early age. This study contributes valuable insights to the field of science education and underscores the potential of STEM-based interventions in shaping the future scientific minds of young children.

Keywords: Scientific thinking, education, STEM, intervention, Psychology, Pedagogy, collaborative learning, longitudinal study

Procedia PDF Downloads 61

Authors: Faith O. Olanrewaju

Abstract:

Internal displacement and the vulnerability of women are two critical aspects of forced migration that have dominated both global and local discourses. Statistics show that in November 2021, there were over 2.1 million internally displaced persons (IDPs) in Nigeria. Literature also states that displaced women and girls are more vulnerable than displaced men. They are susceptible to adversative experiences, including various forms of sexual violence and rape. As a result, the displaced women and girls are faced with psychological and physical traumas, including HIV/AIDS as well as unexpected or poorly spaced pregnancies. In addition, the poor condition of living of internally displaced women in IDP camps affects their reproductive health, pregnancy outcomes, and maternal mortality levels. Incontrovertibly, internally displaced women constitute an imperative contributor to the ills of Nigeria's maternal health status, which is the second worse globally and the worst in Africa. World Health Organisation statistics showed that approximately 536,000 girls and women die from pregnancy-related causes globally, and Nigeria accounts for 14% of the global maternal deaths. Undeniably, this supports the claims that maternal mortality remains a challenge in Nigeria and can be exacerbated by internal displacement crises. Therefore, maternal mortality remains a critical impediment to the actualisation of the 3.1 SDG target. Owing to this, concerns arise about the quality of the policy in Nigeria’s health sector. More specifically, this study is concerned with the maternal health care services displaced women receive in IDP camps in the three states affected by internal displacement in north-central Nigeria, an understudied area. The novelty of the study also lies in its comparative investigation of maternal healthcare service delivery in three different camp structures (faith-based, government, and informal IDP camps), a pattern that is absent in literature. Therefore, this study will investigate how the camp structures affect access to maternal health services in the study areas; analyse the successes and challenges in the delivery of maternal health care services to displaced women in the various camps; and recommendation and strategies for reducing maternal healthcare disparities/gaps across IDP camps in Nigeria (should they exist). It will adopt a mixed-method approach and multi-stage sampling technique. A total of 1,152 copies of the study questionnaire will be distributed to displaced pregnant and nursing mothers (PNM); nine focus group discussions will also be held with the displaced PNM; in-depth interviews will be conducted with humanitarian actors, policymakers, and health professionals. The quantitative and qualitative data will be analysed using Statistical Package for Social Science (SPSS) 21.0 and thematic analysis, respectively. The findings of the study will be used to develop a model of care that will address the fragmentations in Nigeria's healthcare system. The findings will also inform the development of best policies and practices in the maternal health of displaced women.

Keywords: forced displacement, internally displaced women, maternal healthcare, maternal mortality

Procedia PDF Downloads 170

Authors: Lia Marchi, Ernesto Antonini

Abstract:

The impact of industrial sites on people’s living environment both involves detrimental effects on the ecosystem and perceptual-aesthetic interferences with the scenery. These, in turn, affect the economic and social value of the landscape, as well as the wellbeing of workers and local communities. Given the diffusion of the phenomenon and the relevance of its effects, it emerges the need for a joint approach to assess and thus mitigate the impact of factories on the landscape –being this latest assumed as the result of the action and interaction of natural and human factors. However, the impact assessment tools suitable for the purpose are quite heterogeneous and mostly monodisciplinary. On the one hand, green building rating systems (GBRSs) are increasingly used to evaluate the performance of manufacturing sites, mainly by quantitative indicators focused on environmental issues. On the other hand, methods to detect the visual and social impact of factories on the landscape are gradually emerging in the literature, but they generally adopt only qualitative gauges. The research addresses the integration of the environmental impact assessment and the perceptual-aesthetic interferences of factories on the landscape. The GBRSs model is assumed as a reference since it is adequate to simultaneously investigate different topics which affect sustainability, returning a global score. A critical analysis of GBRSs relevant to industrial facilities has led to select the U.S. GBC LEED protocol as the most suitable to the scope. A revision of LEED v4 Building Design+Construction has then been provided by including specific indicators to measure the interferences of manufacturing sites with the perceptual-aesthetic and social aspects of the territory. To this end, a new impact category was defined, namely ‘PA - Perceptual-aesthetic aspects’, comprising eight new credits which are specifically designed to assess how much the buildings are in harmony with their surroundings: these investigate, for example the morphological and chromatic harmonization of the facility with the scenery or the site receptiveness and attractiveness. The credits weighting table was consequently revised, according to the LEED points allocation system. As all LEED credits, each new PA credit is thoroughly described in a sheet setting its aim, requirements, and the available options to gauge the interference and get a score. Lastly, each credit is related to mitigation tactics, which are drawn from a catalogue of exemplary case studies, it also developed by the research. The result is a modified LEED scheme which includes compatibility with the landscape within the sustainability assessment of the industrial sites. The whole system consists of 10 evaluation categories, which contain in total 62 credits. Lastly, a test of the tool on an Italian factory was performed, allowing the comparison of three mitigation scenarios with increasing compatibility level. The study proposes a holistic and viable approach to the environmental impact assessment of factories by a tool which integrates the multiple involved aspects within a worldwide recognized rating protocol.

Keywords: environmental impact, GBRS, landscape, LEED, sustainable factory

Procedia PDF Downloads 111

Authors: Adriana Postal, Silvio C. Sampaio, Marcio A. Villas Boas, Josué P. Castro

Abstract:

This study deals with the estimation of reference evapotranspiration (ET₀) in an agricultural context, focusing on efficient irrigation management to meet the growing interest in the sustainable management of water resources. Given the importance of water in agriculture and its scarcity in many regions, efficient use of this resource is essential to ensure food security and environmental sustainability. The methodology used involved the application of artificial intelligence techniques, specifically Multilayer Perceptron (MLP) Artificial Neural Networks (ANNs), to predict ET₀ in the state of Paraná, Brazil. The models were trained and validated with meteorological data from the Brazilian National Institute of Meteorology (INMET), together with data obtained from a producer's weather station in the western region of Paraná. Two optimizers (SGD and Adam) and different meteorological variables, such as temperature, humidity, solar radiation, and wind speed, were explored as inputs to the models. Nineteen configurations with different input variables were tested; amidst them, configuration 9, with 8 input variables, was identified as the most efficient of all. Configuration 10, with 4 input variables, was considered the most effective, considering the smallest number of variables. The main conclusions of this study show that MLP ANNs are capable of accurately estimating ET₀, providing a valuable tool for irrigation management in agriculture. Both configurations (9 and 10) showed promising performance in predicting ET₀. The validation of the models with cultivator data underlined the practical relevance of these tools and confirmed their generalization ability for different field conditions. The results of the statistical metrics, including Mean Absolute Error (MAE), Mean Squared Error (MSE), Root Mean Squared Error (RMSE), and Coefficient of Determination (R²), showed excellent agreement between the model predictions and the observed data, with MAE as low as 0.01 mm/day and 0.03 mm/day, respectively. In addition, the models achieved an R² between 0.99 and 1, indicating a satisfactory fit to the real data. This agreement was also confirmed by the Kolmogorov-Smirnov test, which evaluates the agreement of the predictions with the statistical behavior of the real data and yields values between 0.02 and 0.04 for the producer data. In addition, the results of this study suggest that the developed technique can be applied to other locations by using specific data from these sites to further improve ET₀ predictions and thus contribute to sustainable irrigation management in different agricultural regions. The study has some limitations, such as the use of a single ANN architecture and two optimizers, the validation with data from only one producer, and the possible underestimation of the influence of seasonality and local climate variability. An irrigation management application using the most efficient models from this study is already under development. Future research can explore different ANN architectures and optimization techniques, validate models with data from multiple producers and regions, and investigate the model's response to different seasonal and climatic conditions.

Keywords: agricultural technology, neural networks in agriculture, water efficiency, water use optimization

Procedia PDF Downloads 45

Authors: Richele P. Severino, Maria M. F. Alchaar, Lorena R. F. De Sousa, Patrik S. Vital, Ana G. Silva, Rosy I. M. A. Ribeiro

Abstract:

Recognized as a global biodiversity hotspot, the Cerrado (Brazil) presents an extreme abundance of endemic species and it is considered to be one of the biologically richest tropical savanna regions in the world. Erythroxylum genus is found in Cerrado and chemically is characterized by the presence of tropane alkaloids, among them cocaine, a natural alkaloid produced by Erythroxylum coca Lam., which was used as a local anesthetic in small surgeries. However, cocaine gained notoriety due to its psychoactive activity in the Central Nervous System (CNS), becoming one of the major problems of public health today. Some species of Erythroxylum are referred to in the literature as having pharmacological potential, which provide alkaloids, terpenoids, and flavonoids. E. vacciniifolium Mart., commonly known as 'catuaba', is used as a central nervous system stimulant and has aphrodisiac properties and E. pelleterianum A. St.-Hil. in the treatment of stomach pains. Already E. myrsinites Mart. and E. suberosum A. St.-Hil. are used in the tannery industry. Species of Erythroxylum are also used in folk medicine for various diseases, against diabetes, antiviral, fungicidal, cytotoxicity, among others. The Cerrado is recognized as the richer savannah in the world in biodiversity but little explored from the chemical view. In our on-going study of the chemistry of Erythroxylum genus, we have investigated four specimens collected in central Cerrado of Brazil: E. campestre (EC), E. deciduum (ED), E. suberosum (ES) and E. tortuosum (ET). The cytotoxic activity of extracts was evaluated using HeLa cells, in vitro assays. The chemical investigation was performed preparing the extracts using n-hexane (H), dichloromethane (D), ethyl acetate (E) and methanol (M). The cells were treated with increasing concentrations of extracts (50, 75 and 100 μg/mL) diluted in DMSO (1%) and DMEM (0.5% FBS and 1% P/S). The IC₅₀ values were determined measured spectrophotometrically at 570 nm, after incubation of HeLa cell line for 48 hours using the MTT (SIGMA M5655), and calculated by nonlinear regression analysis using GraphPad Prism software. All the assays were done in triplicate and repeated at least two times. The cytotoxic assays showed some promising results with IC₅₀ values less than 100 μg/mL (ETD = 38.5 μg/mL; ETM = 92.3 μg/mL; ESM = 67.8 μg/mL; ECD = 24.0 μg/mL; ECM = 32.9; EDA = 44.2 μg/mL). The chemical profile study of ethyl acetate (E) and methanolic (M) extracts of E. tortuosum leaves was performed by LC-MS, and the structures of the compounds were determined by analysis of ¹H, HSQC and HMBC spectra, and confirmed by comparison with the literature data. The investigation led to six substances: α-amyrin, β-amyrin, campesterol, stigmastan-3,5-diene, β-sitosterol and 7,4’-di-O-methylquercetin-3-O-β-rutinoside, with flavonoid the major compound of extracts. By alkaline extraction of the methanolic extract, it was possible to identify three alkaloids: tropacocaine, cocaine and 6-methoxy-8-methyl-8-azabicyclo[3.2.1]octan-3-ol. The results obtained are important for the chemical knowledge of the Cerrado biodiversity and brought a contribution to the chemistry of Erythroxylum genus.

Keywords: cytotoxicity, Erythroxylum, chemical profile, secondary metabolites

Procedia PDF Downloads 144

Authors: Muhammad Umer Mehmood, Muhammad Luqman, Muhammad Yaseen, Imtiaz Hussain

Abstract:

Climate change is an arduous fact, which could not be unheeded easily. It is a phenomenon which has brought a collection of challenges for the mankind. Scientists have found many of its negative impacts on the life of human being and the resources on which the life of humanity is dependent. There are many issues which are associated with the factor of prime importance in this study, 'climate change'. Whenever changes happen in nature, they strike the whole globe. Effects of these changes vary from region to region. Climate of every region of this globe is different from the other. Even within a state, country or the province has different climatic conditions. So it is mandatory that the response in that specific region and the coping strategy of this specific region should be according to the prevailing risk. In the present study, the objective was to assess the coping strategies and vulnerability of small landholders. So that a professional suggestion could be made to cope with the vulnerability factor of small farmers. The cross-sectional research design was used with the intervention of quantitative approach. The study was conducted in the Khanewal district, of Punjab, Pakistan. 120 small farmers were interviewed after randomized sampling from the population of respective area. All respondents were above the age of 15 years. A questionnaire was developed after keen observation of facts in the respective area. Content and face validity of the instrument was assessed with SPSS and experts in the field. Data were analyzed through SPSS using descriptive statistics. From the sample of 120, 81.67% of the respondents claimed that the environment is getting warmer and not fit for their present agricultural practices. 84.17% of the sample expressed serious concern that they are disturbed due to change in rainfall pattern and vulnerability towards the climatic effects. On the other hand, they expressed that they are not good at tackling the effects of climate change. Adaptation of coping strategies like change in cropping pattern, use of resistant varieties, varieties with minimum water requirement, intercropping and tree planting was low by more than half of the sample. From the sample 63.33% small farmers said that the coping strategies they adopt are not effective enough. The present study showed that subsistence farming, lack of marketing and overall infrastructure, lack of access to social security networks, limited access to agriculture extension services, inappropriate access to agrometeorological system, unawareness and access to scientific development and low crop yield are the prominent factors which are responsible for the vulnerability of small farmers. A comprehensive study should be conducted at national level so that a national policy could be formulated to cope with the dilemma in future with relevance to climate change. Mainstreaming and collaboration among the researchers and academicians could prove beneficiary in this regard the interest of national leaders’ does matter. Proper policies to avoid the vulnerability factors should be the top priority. The world is taking up this issue with full responsibility as should we, keeping in view the local situation.

Keywords: adaptation, coping strategies, climate change, Pakistan, small farmers, vulnerability

Procedia PDF Downloads 141

Authors: Beverly Black

Abstract:

Background: Adolescent dating abuse (ADA) is widespread throughout the world and negatively impacts many adolescents. ADA is associated with lower self-esteem, poorer school performance, lower employment opportunities, higher rates of depression, absenteeism from school, substance abuse, bullying, smoking, suicide, pregnancy, eating disorders, and risky sexual behaviors, and experiencing domestic violence later in life. ADA prevention is sometimes addressed through school programming; yet, parental responses to ADA can also be an important vehicle for its prevention. In this exploratory study, the author examined how mothers, including abused mothers, responded to scenarios of ADA involving their children. Methods: Six focus groups were conducted between December, 2013 and June, 2014 with mothers (n=31) in the southern part of the United States. Three of the focus groups were comprised of mothers (n=17) who had been abused by their partners. Mothers were recruited from local community family agencies. Participants were provided a series of four scenarios about ADA and they were asked to explain how they would respond. Focus groups lasted approximately 45 minutes. All participants were given a gift card to a major retailer as a ‘thank you’. Using QSR-N10, two researchers’ analyzed the focus group data first using open and axial coding techniques to find overarching themes. Researchers triangulated the coded data to ensure accurate interpretations of the participants’ messages and used the scenario questions to structure the coded results. Results: Almost 30% of 699 comments coded as mothers’ recommendations for responding to ADA focused on the importance of providing advice to their children. Advice included breaking up, going to police, ignoring or avoiding the abusive partner, and setting boundaries in relationships. About 22% of comments focused on the need for educating teens about healthy and unhealthy relationships and seeking additional information. About 13% of the comments reflected the view that parents should confront abuser and/or abusers’ parents, and less than 2% noted the need to take their child to counseling. Mothers who had been abused offered similar responses as parents who had not experienced abuse. However, their responses were more likely to focus on sharing their own experience exercising caution in their responses, as they knew from their own experiences that authoritarian responses were ineffective. Over half of the comments indicated that parents would react stronger, quicker, and angrier if a girl was being abused by a boy than vice versa; parents expressed greater fear for their daughters than their sons involved in ADA. Conclusions. Results suggest that mothers have ideas about how to respond to ADA. Mothers who have been abused draw from their experiences and are aware that responding in an authoritarian manner may not be helpful. Because parental influence on teens is critical in their development, it is important for all parents to respond to ADA in a helpful manner to break the cycle of violence. Understanding responses to ADA can inform prevention programming to work with parents in responding to ADA.

Keywords: abused mothers' responses to dating abuse, adolescent dating abuse, mothers' responses to dating abuse, teen dating violence

Procedia PDF Downloads 217

Authors: A. Rahim Baharudin, Nor Arinee binti Mat Saaud, Muhammad Afiq Azman, Farah Adiba A. Sani

Abstract:

Objectives: This paper shares the case study on the engineering analysis, data analysis, and real-time data comparison for qualifying the stand wires' minimum breaking load and safe working load upon loadout operation for a new project and, at the same time, eliminate the risk due to discrepancies and unalignment of COMPANY Technical Standards to Industry Standards and Practices. This paper demonstrates “Lean Construction” for COMPANY’s Project by sustaining fit-for-purpose Technical Requirements of Loadout Strand Wire Factor of Safety (F.S). The case study utilizes historical engineering data from a few loadout operations by skidding methods from different projects. It is also demonstrating and qualifying the skidding wires' minimum breaking load and safe working load used for loadout operation for substructure and other facilities for the future. Methods: Engineering analysis and comparison of data were taken as referred to the international standard and internal COMPANY standard requirements. Data was taken from nine (9) previous projects for both topsides and jacket facilities executed at the several local fabrication yards where load out was conducted by three (3) different service providers with emphasis on four (4) basic elements: i) Industry Standards for Loadout Engineering and Operation Reference: COMPANY internal standard was referred to superseded documents of DNV-OS-H201 and DNV/GL 0013/ND. DNV/GL 0013/ND and DNVGL-ST-N001 do not mention any requirements of Strand Wire F.S of 4.0 for Skidding / Pulling Operations. ii) Reference to past Loadout Engineering and Execution Package: Reference was made to projects delivered by three (3) major offshore facilities operators. Strand Wire F.S observed ranges from 2.0 MBL (Min) to 2.5 MBL (Max). No Loadout Operation using the requirements of 4.0 MBL was sighted from the reference. iii) Strand Jack Equipment Manufacturer Datasheet Reference: Referring to Strand Jack Equipment Manufactured Datasheet by different loadout service providers, it is shown that the Designed F.S for the equipment is also ranging between 2.0 ~ 2.5. Eight (8) Strand Jack Datasheet Model was referred to, ranging from 15 Mt to 850 Mt Capacity; however, there are NO observations of designed F.S 4.0 sighted. iv) Site Monitoring on Actual Loadout Data and Parameter: Max Load on Strand Wire was captured during 2nd Breakout, which is during Static Condition of 12.9 MT / Strand Wire (67.9% Utilization). Max Load on Strand Wire for Dynamic Conditions during Step 8 and Step 12 is 9.4 Mt / Strand Wire (49.5% Utilization). Conclusion: This analysis and study demonstrated the adequacy of strand wires supplied by the service provider were technically sufficient in terms of strength, and via engineering analysis conducted, the minimum breaking load and safe working load utilized and calculated for the projects were satisfied and operated safely for the projects. It is recommended from this study that COMPANY’s technical requirements are to be revised for future projects’ utilization.

Keywords: construction, load out, minimum breaking load, safe working load, strand jacking, skidding

Procedia PDF Downloads 111

Authors: Wim Hollander, Petrus Louis Nolte

Abstract:

University sport in South Africa is not isolated from the complexity of globalization and professionalization of sport, as it forms an integral part of the sports development environment in South Africa. In order to align their sports programs with global and professional requirements, several universities opted to develop elite sports programs; recruit specialized personnel such as coaches, administrators, and athletes; provide expert coaching; scientific and medical services; sports testing; fitness, technical and tactical expertise; sport psychological and rehabilitation support; academic guidance and career assistance; and student-athlete accommodation. In addition, universities provide administrative support and high-quality physical resources (training facilities) for the benefit of the overall South African sport system. Although it is not compulsory for universities to develop elite sports programs to prepare their teams for competitions, elite competitions such as the annual Varsity Sport, University Sport South Africa (USSA) and local club competitions and leagues within international university competitions where universities not only compete but also deliver players for representative national netball teams. The aim of this study is, therefore, to describe the perceptions of players of the university elite netball programs they were participating in. This study adopted a descriptive design with a quantitative approach, utilizing a self-structured questionnaire as a research technique. As this research formed part of a national research project for NSA with a population of 172 national and provincial netball players, a sample of 92 university netball players from the population was selected. Content validity of the self-structured questionnaire was secured through a test-retest process, with construct validity through a member of the Statistical Consultation Services (STATCON) of the University of Johannesburg that provided feedback on the structural format of the questionnaire. Reliability was measured utilizing Cronbach Alpha on p < 0.005 level of significance. A reliability score of 0.87 was measured. The research was approved by the Board of Netball South Africa and ethical conduct implemented according to the processes and procedures approved by the Ethics Committees of the Faculty of Health Sciences, the University of Johannesburg with clearance number REC-01-30-2019. From the results, it is evident that university elite netball programs are professional, especially with regards to the employment of knowledgeable and competent coaches and technical officials such as team managers and sport sciences staff. These professionals have access to elite training facilities, support staff, and relatively large groups of elite players, all elements of an elite program that could enhance the national federation’s (Netball South Africa) system. Universities could serve the dual purpose of serving as university netball clubs, as well as providing elite training services and facilities as performance hubs for national players.

Keywords: elite sport programmes, university netball, player experiences, varsity sport netball

Procedia PDF Downloads 165

Authors: Elizabeth M. Annoni, Elena G. Tolkacheva

Abstract:

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia that is a known prognostic marker for stroke, heart failure and death. Reentrant mechanisms of rotor formation, which are stable electrical sources of cardiac excitation, are believed to cause AF. No existing commercial mapping systems have been demonstrated to consistently and accurately predict rotor locations outside of the pulmonary veins in patients with persistent AF. There is a clear need for robust spatio-temporal techniques that can consistently identify rotors using unique characteristics of the electrical recordings at the pivot point that can be applied to clinical intracardiac mapping. Recently, we have developed four new signal analysis approaches – Shannon entropy (SE), Kurtosis (Kt), multi-scale frequency (MSF), and multi-scale entropy (MSE) – to identify the pivot points of rotors. These proposed techniques utilize different cardiac signal characteristics (other than local activation) to uncover the intrinsic complexity of the electrical activity in the rotors, which are not taken into account in current mapping methods. We validated these techniques using high-resolution optical mapping experiments in which direct visualization and identification of rotors in ex-vivo Langendorff-perfused hearts were possible. Episodes of ventricular tachycardia (VT) were induced using burst pacing, and two examples of rotors were used showing 3-sec episodes of a single stationary rotor and figure-8 reentry with one rotor being stationary and one meandering. Movies were captured at a rate of 600 frames per second for 3 sec. with 64x64 pixel resolution. These optical mapping movies were used to evaluate the performance and robustness of SE, Kt, MSF and MSE techniques with respect to the following clinical limitations: different time of recordings, different spatial resolution, and the presence of meandering rotors. To quantitatively compare the results, SE, Kt, MSF and MSE techniques were compared to the “true” rotor(s) identified using the phase map. Accuracy was calculated for each approach as the duration of the time series and spatial resolution were reduced. The time series duration was decreased from its original length of 3 sec, down to 2, 1, and 0.5 sec. The spatial resolution of the original VT episodes was decreased from 64x64 pixels to 32x32, 16x16, and 8x8 pixels by uniformly removing pixels from the optical mapping video.. Our results demonstrate that Kt, MSF and MSE were able to accurately identify the pivot point of the rotor under all three clinical limitations. The MSE approach demonstrated the best overall performance, but Kt was the best in identifying the pivot point of the meandering rotor. Artifacts mildly affect the performance of Kt, MSF and MSE techniques, but had a strong negative impact of the performance of SE. The results of our study motivate further validation of SE, Kt, MSF and MSE techniques using intra-atrial electrograms from paroxysmal and persistent AF patients to see if these approaches can identify pivot points in a clinical setting. More accurate rotor localization could significantly increase the efficacy of catheter ablation to treat AF, resulting in a higher success rate for single procedures.

Keywords: Atrial Fibrillation, Optical Mapping, Signal Processing, Rotors

Procedia PDF Downloads 322

Authors: Stephanie Wall, Guido Wimmers

Abstract:

The construction and operation of buildings greatly contribute to environmental degradation through resource and energy consumption and greenhouse gas emissions. The design of the envelope system affects the environmental impact of a building in two major ways; 1) high thermal performance and air tightness can significantly reduce the operational energy of the building and 2) the material selection for the envelope largely impacts the embodied energy of the building. Life cycle assessment (LCA) is a scientific methodology that is used to systematically analyze the environmental load of processes or products, such as buildings, over their life. The paper will discuss the results of a comparative LCA of different envelope designs and the long-term monitoring of the Wood Innovation Research Lab (WIRL); a Passive House (PH), industrial building under construction in Prince George, Canada. The WIRL has a footprint of 30m x 30m on a concrete raft slab foundation and consists of shop space as well as a portion of the building that includes a two-story office/classroom space. The lab building goes beyond what was previously thought possible in regards to energy efficiency of industrial buildings in cold climates due to their large volume to surface ratio, small floor area, and high air change rate, and will be the first PH certified industrial building in Canada. These challenges were mitigated through the envelope design which utilizes solar gains while minimizing overheating, reduces thermal bridges with thick (570mm) prefabricated truss walls filled with blown in mineral wool insulation and a concrete slab and roof insulated with EPS rigid insulation. The envelope design results in lower operational and embodied energy when compared to buildings built to local codes or with steel. The LCA conducted using Athena Impact Estimator for Buildings identifies project specific hot spots as well illustrates that for high-efficiency buildings where the operational energy is relatively low; the embodied energy of the material selection becomes a significant design decision as it greatly impacts the overall environmental footprint of the building. The results of the LCA will be reinforced by long-term monitoring of the buildings envelope performance through the installation of temperature and humidity sensors throughout the floor slab, wall and roof panels and through detailed metering of the energy consumption. The data collected from the sensors will also be used to reinforce the results of hygrothermal analysis using WUFI®, a program used to verify the durability of the wall and roof panels. The WIRL provides an opportunity to showcase the use of wood in a high performance envelope of an industrial building and to emphasize the importance of considering the embodied energy of a material in the early stages of design. The results of the LCA will be of interest to leading researchers and scientists committed to finding sustainable solutions for new construction and high-performance buildings.

Keywords: high performance envelope, life cycle assessment, long term monitoring, passive house, prefabricated panels

Procedia PDF Downloads 161

Authors: Catherine Constantinidis (Nee Tsacalos)

Abstract:

This paper presents one aspect of the larger Masters qualitative study exploring the roles of married Greek Orthodox clergy, the Priest and Presbytera, under the wing of the Greek Orthodox Archdiocese of Australia. This ground breaking research necessitated the creation of primary data within a phenomenological paradigm drawing from lived experiences of the Priests and Presbyteres in contemporary society. As a Social Worker, a bilingual (Greek/English) Mental Health practitioner and a Presbytera, the questions constantly raised and pondered are: Who do the Priest and Presbytera turn to when they experience difficulties or problems? Where do they go for support? What is in place for their emotional and psychological health and well-being? Who cares for the spiritual carer? Who is there to catch our falling clergy and their wives? What is their 'safety net'? Identified phenomena of angst, stress, frustration and confusion experienced by the Priest and (by extension) the Presbytera, within their position, coupled with basic assumptions, perceptions and expectations about their roles, the role of the organisation (the Church), and their role as spouse often caused confusion and in some cases conflict. Unpacking this complex and multi-dimensional relationship highlighted not only the roller coaster of emotions, potentially affecting their physical and mental health, but also the impact on the interwoven relationships of marriage and ministry. The author considers these phenomena in the light of bilingual cultural and religious organisational practice frameworks, specifically the Greek Orthodox Church, whilst filtering these findings through a mental health lens. One could argue that it is an expectation that clergy (and by default their wives) take on the responsibility to be kind, nurturing and supportive to others. However, when it comes to taking care of self, they are not nearly as kind. This research looks at a recurrent theme throughout the interviews where all participants talked about limited support systems and poor self care strategies and the impact this has on their ministry, mental, emotional, and physical health and ultimately on their relationships with self and others. The struggle all participants encountered at some point in their ministry was physical, spiritual and psychological burn out. The overall aim of the researcher is to provide a voice for the Priest and the Presbytera painting a clearer picture of these roles and facilitating an awareness of struggles and dilemmas faced in their ministry. It is hoped these identified gaps in self care strategies and support systems will provide solid foundations for building a culturally sensitive, empathetic and effective support system framework, incorporating the spiritual and psychological well-being of the Priest and Presbytera, a ‘safety net’. A supplementary aim is to inform and guide ministry practice frameworks for clergy, spouses, the church hierarchy and religious organisations on a local and global platform incorporating some sort of self-care system.

Keywords: care for the carer, mental health, Priest, Presbytera, religion, support system

Procedia PDF Downloads 392

Authors: Patrícia Pires, Renata Vaz, Bárbara Teles, Marco Pato, Pedro Beckert

Abstract:

Introduction: The management of lateral third clavicle fractures can be challenging due to difficulty in distinguishing subtle variations in the fracture pattern, which may be suggestive of potential fracture instability. They occur most often in men between 30 and 50 years of age, and in individuals over 70 years of age, its distribution is equal between both men and women. These fractures account for 10%–30% of all clavicle fractures and roughly 30%–45% of all clavicle nonunion fractures. Lateral third clavicle fractures may be treated conservatively or surgically, and there is no gold standard, although the risk of nonunion or pseudoarthrosis impacts the recommendation of surgical treatment when these fractures are unstable. There are many strategies for surgical treatment, including locking plates, hook plates fixation, coracoclavicular fixation using suture anchors, devices or screws, tension band fixation with suture or wire, transacromial Kirschner wire fixation and arthroscopically assisted techniques. Whenever taking the hardware into consideration, we must not disregard that obtaining adequate lateral fixation of small fragments is a difficult task, and plates are more associated to local irritation. The aim of the appropriate treatment is to ensure fracture healing and a rapid return to preinjury activities of daily living but, as explained, definitive treatment strategies have not been established and the variety of techniques avalilable add up to the discussion of this topic. Methods and Results: We present a clinical case of a 43-year-old man with the diagnosis of a lateral third clavicle fracture (Neer IIC) in the sequence of a fall on his right shoulder after a bicycle fall. He was operated three days after the injury, and through K-wire temporary fixation and indirect reduction using a ZipTight, he underwent osteosynthesis with an interfragmentary figure-of-eight tension band with polydioxanone suture (PDS). Two weeks later, there was a good aligment. He kept the sling until 6 weeks pos-op, avoiding efforts. At 7-weeks pos-op, there was still a good aligment, starting the physiotherapy exercises. After 10 months, he had no limitation in mobility or pain and returned to work with complete recovery in strength. Conclusion: Some distal clavicle fractures may be conservatively treated, but it is widely accepted that unstable fractures require surgical treatment to obtain superior clinical outcomes. In the clinical case presented, the authors chose an osteosuture technique due to the fracture pattern, its location. Since there isn´t a consensus on the prefered fixation method, it is important for surgeons to be skilled in various techniques and decide with their patient which approach is most appropriate for them, weighting the risk-benefit of each method. For instance, with the suture technique used, there is no wire migration or breakage, and it doesn´t require a reoperation for hardware removal; there is also less tissue exposure since it requires a smaller approach in comparison to the plate fixation and avoids cuff tears like the hook plate. The good clinical outcome on this case report serves the purpose of expanding the consideration of this method has a therapeutic option.

Keywords: lateral third, clavicle, suture, fixation

Procedia PDF Downloads 75

Authors: G. A. Asciak, C. Camilleri, A. Rizzo

Abstract:

The waste management in Malta is a national challenge. Coupled with Malta’s recent economic boom, which has seen massive growth in several sectors, especially the construction industry, drastic actions need to be taken. Wood waste, currently being dumped in landfills, is one type of waste which has increased astronomically. This research study aims to carry out a thorough examination on the possibility of using this waste as a biomass resource and adopting a waste-to-energy technology in order to generate electrical energy. This study is composed of three distinct yet interdependent phases, namely, data collection from the local SMEs, thermal analysis using the bomb calorimeter, and generation of energy from wood waste using a micro biomass plant. Data collection from SMEs specializing in wood works was carried out to obtain information regarding the available types of wood waste, the annual weight of imported wood, and to analyse the manner in which wood shavings are used after wood is manufactured. From this analysis, it resulted that five most common types of wood available in Malta which would suitable for generating energy are Oak (hardwood), Beech (hardwood), Red Beech (softwood), African Walnut (softwood) and Iroko (hardwood). Subsequently, based on the information collected, a thermal analysis using a 6200 Isoperibol calorimeter on the five most common types of wood was performed. This analysis was done so as to give a clear indication with regards to the burning potential, which will be valuable when testing the wood in the biomass plant. The experiments carried out in this phase provided a clear indication that the African Walnut generated the highest gross calorific value. This means that this type of wood released the highest amount of heat during the combustion in the calorimeter. This is due to the high presence of extractives and lignin, which accounts for a slightly higher gross calorific value. This is followed by Red Beech and Oak. Moreover, based on the findings of the first phase, both the African Walnut and Red Beech are highly imported in the Maltese Islands for use in various purposes. Oak, which has the third highest gross calorific value is the most imported and common wood used. From the five types of wood, three were chosen for use in the power plant on the basis of their popularity and their heating values. The PP20 biomass plant was used to burn the three types of shavings in order to compare results related to the estimated feedstock consumed by the plant, the high temperatures generated, the time taken by the plant to produce gasification temperatures, and the projected electrical power attributed to each wood type. From the experiments, it emerged that whilst all three types reached the required gasification temperature and thus, are feasible for electrical energy generation. African Walnut was deemed to be the most suitable fast-burning fuel. This is followed by Red-beech and Oak, which required a longer period of time to reach the required gasification temperatures. The results obtained provide a clear indication that wood waste can not only be treated instead of being dumped in dumped in landfill but coupled.

Keywords: biomass, isoperibol calorimeter, waste-to-energy technology, wood

Procedia PDF Downloads 241

Authors: Jitka Rychtarikova

Abstract:

Regional differences in mortality in the Czech Republic (CR) may be moderate from a broader European perspective, but important discrepancies in life expectancy can be found between smaller territorial units. In this study territorial units are based on Administrative Districts of Municipalities with Extended Powers (MEP). This definition came into force January 1, 2003. There are 205 units and the city of Prague. MEP represents the smallest unit for which mortality patterns based on life tables can be investigated and the Czech Statistical Office has been calculating such life tables (every five-years) since 2004. MEP life tables from 2009-2013 for males and females allowed the investigation of three main life cycles with the use of temporary life expectancies between the exact ages of 0 and 35; 35 and 65; and the life expectancy at exact age 65. The results showed regional survival inequalities primarily in adult and older ages. Consequently, only mortality indicators for adult and elderly population were related to census 2011 unlinked data for the same age groups. The most relevant socio-economic factors taken from the census are: having a partner, educational level and unemployment rate. The unemployment rate was measured for adults aged 35-64 completed years. Exploratory spatial data analysis methods were used to detect regional patterns in spatially contiguous units of MEP. The presence of spatial non-stationarity (spatial autocorrelation) of mortality levels for male and female adults (35-64), and elderly males and females (65+) was tested using global Moran’s I. Spatial autocorrelation of mortality patterns was mapped using local Moran’s I with the intention to depict clusters of low or high mortality and spatial outliers for two age groups (35-64 and 65+). The highest Moran’s I was observed for male temporary life expectancy between exact ages 35 and 65 (0.52) and the lowest was among women with life expectancy of 65 (0.26). Generally, men showed stronger spatial autocorrelation compared to women. The relationship between mortality indicators such as life expectancies and socio-economic factors like the percentage of males/females having a partner; percentage of males/females with at least higher secondary education; and percentage of unemployed males/females from economically active population aged 35-64 years, was evaluated using multiple regression (OLS). The results were then compared to outputs from geographically weighted regression (GWR). In the Czech Republic, there are two broader territories North-West Bohemia (NWB) and North Moravia (NM), in which excess mortality is well established. Results of the t-test of spatial regression showed that for males aged 30-64 the association between mortality and unemployment (when adjusted for education and partnership) was stronger in NM compared to NWB, while educational level impacted the length of survival more in NWB. Geographic variation and relationships in mortality of the CR MEP will also be tested using the spatial Durbin approach. The calculations were conducted by means of ArcGIS 10.6 and SAS 9.4.

Keywords: Czech Republic, mortality, municipality, socio-economic factors, spatial analysis

Procedia PDF Downloads 117

Authors: Omar Nouri, Wafa Mnejja, Fatma Dhouib, Syrine Zouari, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Leila Farhat, Nejla Fourati, Jamel Daoud

Abstract:

Purpose and Objective: Intensity modulated radiation (IMRT) technique, associated with induction chemotherapy (IC) and/or concomitant chemotherapy (CC), is actually the recommended treatment modality for nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the therapeutic results and the patterns of relapse with this treatment protocol. Material and methods: A retrospective monocentric study of 145 patients with NPC treated between June 2016 and July 2021. All patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. The high-risk volume dose was 66.5 Gy in children. Survival analysis was performed according to the Kaplan-Meier method, and the Log-rank test was used to compare factors that may influence survival. Results: Median age was 48 years (11-80) with a sex ratio of 2.9. One hundred-twenty tumors (82.7%) were classified as stages III-IV according to the 2017 UICC TNM classification. Ten patients (6.9%) were metastatic at diagnosis. One hundred-thirty-five patient (93.1%) received IC, 104 of which (77%) were TPF-based (taxanes, cisplatin and 5 fluoro-uracil). One hundred-thirty-eight patient (95.2%) received CC, mostly cisplatin in 134 cases (97%). After a median follow-up of 50 months [22-82], 46 patients (31.7%) had a relapse: 12 (8.2%) experienced local and/or regional relapse after a median of 18 months [6-43], 29 (20%) experienced distant relapse after a median of 9 months [2-24] and 5 patients (3.4%) had both. Thirty-five patients (24.1%) died, including 5 (3.4%) from a cause other than their cancer. Three-year overall survival (OS), cancer specific survival, disease free survival, metastasis free survival and loco-regional free survival were respectively 78.1%, 81.3%, 67.8%, 74.5% and 88.1%. Anatomo-clinic factors predicting OS were age > 50 years (88.7 vs. 70.5%; p=0.004), diabetes history (81.2 vs. 66.7%; p=0.027), UICC N classification (100 vs. 95 vs. 77.5 vs. 68.8% respectively for N0, N1, N2 and N3; p=0.008), the practice of a lymph node biopsy (84.2 vs. 57%; p=0.05), and UICC TNM stages III-IV (93.8 vs. 73.6% respectively for stage I-II vs. III-IV; p=0.044). Therapeutic factors predicting OS were a number of CC courses (less than 4 courses: 65.8 vs. 86%; p=0.03, less than 5 courses: 71.5 vs. 89%; p=0.041), a weight loss > 10% during treatment (84.1 vs. 60.9%; p=0.021) and a total cumulative cisplatin dose, including IC and CC, < 380 mg/m² (64.4 vs. 87.6%; p=0.003). Radiotherapy delay and total duration did not significantly affect OS. No grade 3-4 late side effects were noted in the evaluable 127 patients (87.6%). The most common toxicity was dry mouth which was grade 2 in 47 cases (37%) and grade 1 in 55 cases (43.3%).Conclusion: IMRT for nasopharyngeal carcinoma granted a high loco-regional control rate for patients during the last five years. However, distant relapses remain frequent and conditionate the prognosis. We identified many anatomo-clinic and therapeutic prognosis factors. Therefore, high-risk patients require a more aggressive therapeutic approach, such as radiotherapy dose escalation or adding adjuvant chemotherapy.

Keywords: therapeutic results, prognostic factors, intensity-modulated radiotherapy, nasopharyngeal carcinoma

Procedia PDF Downloads 62