Search results for: the optional protocol to the convention on the rights of the child on the sale of children
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6141

Search results for: the optional protocol to the convention on the rights of the child on the sale of children

291 Comparison of Cardiomyogenic Potential of Amniotic Fluid Mesenchymal Stromal Cells Derived from Normal and Isolated Congenital Heart Defective Fetuses

Authors: Manali Jain, Neeta Singh, Raunaq Fatima, Soniya Nityanand, Mandakini Pradhan, Chandra Prakash Chaturvedi

Abstract:

Isolated Congenital Heart Defect (ICHD) is the major cause of neonatal death worldwide among all forms of CHDs. A significant proportion of fetuses with ICHD die in the neonatal period if no treatment is provided. Recently, stem cell therapies have emerged as a potential approach to ameliorate ICHD in children. ICHD is characterized by cardiac structural abnormalities during embryogenesis due to alterations in the cardiomyogenic properties of a pool of cardiac progenitors/ stem cells associated with fetal heart development. The stem cells present in the amniotic fluid (AF) are of fetal origin and may reflect the physiological and pathological changes in the fetus during embryogenesis. Therefore, in the present study, the cardiomyogenic potential of AF-MSCs derived from fetuses with ICHD (ICHD AF-MSCs) has been evaluated and compared with that of AF-MSCs of structurally normal fetuses (normal AF-MSCs). Normal and ICHD AF-MSC were analyzed for the expression of cardiac progenitor markers viz., stage-specific embryonic antigen-1 (SSEA-1), vascular endothelial growth factor 2 (VEGFR-2) and platelet-derived growth factor receptor-alpha (PDGFR-α) by flow cytometry. The immunophenotypic characterization revealed that ICHD AF-MSCs have significantly lower expression of cardiac progenitor markers VEGFR-2 (0.14% ± 0.6 vs.48.80% ± 0.9; p <0.01), SSEA-1 (70.86% ± 2.4 vs. 88.36% ±2.7; p <0.01), and PDGFR-α (3.92% ± 1.8 vs. 47.59% ± 3.09; p <0.01) in comparison to normal AF-MSCs. Upon induction with 5’-azacytidine for 21 days, ICHD AF-MSCs showed a significantly down-regulated expression of cardiac transcription factors such as GATA-4 (0.4 ± 0.1 vs. 6.8 ± 1.2; p<0.01), ISL-1 (2.3± 0.6 vs. 14.3 ± 1.12; p<0.01), NK-x 2-5 (1.1 ± 0.3 vs. 14.1 ±2.8; p<0.01), TBX-5 (0.4 ± 0.07 vs. 4.4 ± 0.3; p<0.001), and TBX-18 (1.3 ± 0.2 vs. 4.19 ± 0.3; p<0.01) when compared with the normal AF-MSCs. Furthermore, immunocytochemical staining revealed that both types of AF-MSCs could differentiate into cardiovascular lineages and express cardiomyogenic, endothelial, and smooth muscle actin markers, viz., cardiac troponin (cTNT), CD31, and alpha-smooth muscle actin (α-SMA). However, normal AF-MSCs showed an enhanced expression of cTNT (p<0.001), CD31 (p<0.01), and α-SMA (p<0.05), compared to ICHD AF-MSCs. Overall, these results suggest that the ICHD-AF-MSCs have a defective cardiomyogenic differentiation potential and that the defects in these stem cells may have a role in the pathogenesis of ICHD.

Keywords: amniotic fluid, cardiomyogenic potential, isolated congenital heart defect, mesenchymal stem cells

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290 The Effectiveness of an Injury Prevention Workshop in Increasing Knowledge and Understanding in Grass-Root Youth Coaches

Authors: Mark De Ste Croix, Jonathan Hughes, Francisco Ayala, Michal Lehnert

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There are well-known challenges to implementing injury prevention training for youth players but no data are available on the knowledge and understanding of deliverers of such programmes at grass root level. To increase adoption and adherence to such programmes coach knowledge and understanding of injury risk and prevention is essential. Therefore, the purpose of this study was to examine grass-root coaches knowledge and understanding of injury risk and prevention in youth players. 68 grass root coaches (18 females and 50 males) who were attending a one-day injury prevention workshop completed a modified validated questionnaire exploring knowledge and understanding of injury risk and prevention in youth players. Only 59% of coaches agreed that youth players are at a high risk of suffering an injury. There were high levels of agreement that injuries can have negative impacts on team performance (75%) and can cause physical problems in later life (85%), however only around half of coaches felt that injuries affect youth players current quality of life (59%). There was strong agreement that it is possible to prevent injuries in youth players (84%), but coaches were generally unaware of programs to help prevent injuries (84%), and only 9% used some form of injury prevention program. Despite this, nearly all coaches felt that their coaching could benefit from a greater understanding of growth and maturation (91%), injury prevention programmes (91%) and specific exercises (93%) for youth athletes. 17% of coaches rated their knowledge of injury prevention as good/very good at the start of the workshop and this increased to 94% at the end of the workshop. 62% of coaches identified their attitude towards injury prevention as indifferent at the start of the workshop compared with only 1% at the end. Only 14% of coaches at the start of the workshop were confident to deliver an injury prevention session but 83% stated they were confident by the end of the workshop. Finally, 98% of coaches felt that the workshop provided them with the confidence and the knowledge to deliver an injury prevention session and 98% suggested that they would implement injury prevention into their coaching. These data suggest that there is a lack of understanding of grass root coaches that children are a high-risk group for injuries, and that such injuries impact on current quality of life. Despite understanding that injuries can be prevented most grass root coaches do not have the knowledge to implement injury prevention into their coaching and very few do. There is a common consensus amongst these coaches that a greater understanding of such programmes will enhance their coaching. The injury prevention workshop appears to have increased the knowledge and changed the attitude of coaches towards injury prevention. All coaches felt that the workshop provided them with the tools to adopt, implement and deliver injury prevention in their coaching. These data highlight that there is a clear need for education regarding injury risk and prevention to be embedded within the coach education pathway, especially at grass root level.

Keywords: coach education, injury prevention, knowledge, and understanding, youth

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289 Management of Urinary Tract Infections by Nurse Practitioners in a Canadian Pediatric Emergency Department: A Rretrospective Cohort Study

Authors: T. Mcgraw, F. N. Morin, N. Desai

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Background: Antimicrobial resistance is a critical issue in global health care and a significant contributor to increased patient morbidity and mortality. Suspected urinary tract infection (UTI) is a key area of inappropriate antibiotic prescription in pediatrics. Management patterns of infectious diseases have been shown to vary by provider type within a single setting. The aim of this study was to assess compliance with national UTI management guidelines by nurse practitioners in a pediatric emergency department (ED). Methods: This was a post-hoc analysis of a retrospective cohort study to review and evaluate visits to a tertiary care freestanding pediatric emergency department. Patients were included if they were 60 days to 36 months old and discharged with a diagnosis of UTI or ‘rule-out UTI’ between July 2015 and July 2020. Primary outcome measure was proportion of visits seen by Nurse Practitioners (NP) which were associated with national guideline compliance in the diagnosis and treatment of suspected UTI. We performed descriptive statistics and comparative analyses to determine differences in practice patterns between NPs, and physicians. Results: A total of 636 charts were reviewed, of which 402 patients met inclusion criteria. 17 patients were treated by NPs, 385 were treated by either Pediatric Emergency Medicine physicians (PEM) or non-PEM physicians. Overall, the proportion of infants receiving guideline-compliant care was 25.9% (21.8-30.4%). Of those who were prescribed antibiotics, 79.6% (74.7-83.8%) received first line guideline recommended therapy and 58.9% (53.8-63.8%) received fully compliant therapy with respect to age, dose, duration, and frequency. In patients treated by NPs, 16/17 (94%(95% CI:73.0-99.0)) required antibiotics, 15/16 (93%(95% CI: 71.7-98.9)) were treated with first line agent (cephalexin), 8/16 (50%(95% CI:28-72)) were guideline compliant of dose and duration. 5/8 (63%(95% CI:30.6-86.3)) were noncompliant for dose being too high. There was no difference in receiving guideline compliant empiric antibiotic therapy between physicians and nurse practitioners (OR: 0.837 CI: 0.302-2.69). Conclusion: In this post-hoc analysis, guideline noncompliance by nurse practitioners is common in children tested and treated for UTIs in a pediatric emergency department. Care by a Nurse Practitioner was not associated with greater rate of noncompliance than care by a Pediatric Emergency Medicine physician. Future appropriately powered studies may focus on confirming these results.

Keywords: antibiotic stewardship, infectious disease, nurse practitioner, urinary tract infection

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288 Corrosion Study of Magnetically Driven Components in Spinal Implants by Immersion Testing in Simulated Body Fluids

Authors: Benjawan Saengwichian, Alasdair E. Charles, Philip J. Hyde

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Magnetically controlled growing rods (MCGRs) have been used to stabilise and correct spinal curvature in children to support non-invasive scoliosis adjustment. Although the encapsulated driving components are intended to be isolated from body fluid contact, in vivo corrosion was observed on these components due to sealing mechanism damage. Consequently, a corrosion circuit is created with the body fluids, resulting in malfunction of the lengthening mechanism. Particularly, the chloride ions in blood plasma or cerebrospinal fluid (CSF) may corrode the MCGR alloys, possibly resulting in metal ion release in long-term use. However, there is no data available on the corrosion resistance of spinal implant alloys in CSF. In this study, an in vitro immersion configuration was designed to simulate in vivo corrosion of 440C SS-Ti6Al4V couples. The 440C stainless steel (SS) was heat-treated to investigate the effect of tempering temperature on intergranular corrosion (IGC), while crevice and galvanic corrosion were studied by limiting the clearance of dissimilar couples. Tests were carried out in a neutral artificial cerebrospinal fluid (ACSF) and phosphate-buffered saline (PBS) under aeration and deaeration for 2 months. The composition of the passive films and metal ion release were analysed. The effect of galvanic coupling, pH, dissolved oxygen and anion species on corrosion rates and corrosion mechanisms are discussed based on quantitative and qualitative measurements. The results suggest that ACSF is more aggressive than PBS due to the combination of aggressive chlorides and sulphate anions, while phosphate in PBS acts as an inhibitor to delay corrosion. The presence of Vivianite on the SS surface in PBS lowered the corrosion rate (CR) more than 5 times for aeration and nearly 2 times for deaeration, compared with ACSF. The CR of 440C is dependent on passive film properties varied by tempering temperature and anion species. Although the CR of Ti6Al4V is insignificant, it tends to release more Ti ions in deaerated ACSF than under aeration, about 6 µg/L. It seems the crevice-like design has more effect on macroscopic corrosion than combining the dissimilar couple, whereas IGC is dominantly observed on sensitized microstructure.

Keywords: cerebrospinal fluid, crevice corrosion, intergranular corrosion, magnetically controlled growing rods

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287 Statistical Models and Time Series Forecasting on Crime Data in Nepal

Authors: Dila Ram Bhandari

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Throughout the 20th century, new governments were created where identities such as ethnic, religious, linguistic, caste, communal, tribal, and others played a part in the development of constitutions and the legal system of victim and criminal justice. Acute issues with extremism, poverty, environmental degradation, cybercrimes, human rights violations, crime against, and victimization of both individuals and groups have recently plagued South Asian nations. Everyday massive number of crimes are steadfast, these frequent crimes have made the lives of common citizens restless. Crimes are one of the major threats to society and also for civilization. Crime is a bone of contention that can create a societal disturbance. The old-style crime solving practices are unable to live up to the requirement of existing crime situations. Crime analysis is one of the most important activities of the majority of intelligent and law enforcement organizations all over the world. The South Asia region lacks such a regional coordination mechanism, unlike central Asia of Asia Pacific regions, to facilitate criminal intelligence sharing and operational coordination related to organized crime, including illicit drug trafficking and money laundering. There have been numerous conversations in recent years about using data mining technology to combat crime and terrorism. The Data Detective program from Sentient as a software company, uses data mining techniques to support the police (Sentient, 2017). The goals of this internship are to test out several predictive model solutions and choose the most effective and promising one. First, extensive literature reviews on data mining, crime analysis, and crime data mining were conducted. Sentient offered a 7-year archive of crime statistics that were daily aggregated to produce a univariate dataset. Moreover, a daily incidence type aggregation was performed to produce a multivariate dataset. Each solution's forecast period lasted seven days. Statistical models and neural network models were the two main groups into which the experiments were split. For the crime data, neural networks fared better than statistical models. This study gives a general review of the applied statistics and neural network models. A detailed image of each model's performance on the available data and generalizability is provided by a comparative analysis of all the models on a comparable dataset. Obviously, the studies demonstrated that, in comparison to other models, Gated Recurrent Units (GRU) produced greater prediction. The crime records of 2005-2019 which was collected from Nepal Police headquarter and analysed by R programming. In conclusion, gated recurrent unit implementation could give benefit to police in predicting crime. Hence, time series analysis using GRU could be a prospective additional feature in Data Detective.

Keywords: time series analysis, forecasting, ARIMA, machine learning

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286 Biofuels from Hybrid Poplar: Using Biochemicals and Wastewater Treatment as Opportunities for Early Adoption

Authors: Kevin W. Zobrist, Patricia A. Townsend, Nora M. Haider

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Advanced Hardwood Biofuels Northwest (AHB) is a consortium funded by the United States Department of Agriculture (USDA) to research the potential for a system to produce advanced biofuels (jet fuel, diesel, and gasoline) from hybrid poplar in the Pacific Northwest region of the U.S. An Extension team was established as part of the project to examine community readiness and willingness to adopt hybrid as a purpose-grown bioenergy crop. The Extension team surveyed key stakeholder groups, including growers, Extension professionals, policy makers, and environmental groups, to examine attitudes and concerns about growing hybrid poplar for biofuels. The surveys found broad skepticism about the viability of such a system. The top concern for most stakeholder groups was economic viability and the availability of predictable markets. Growers had additional concerns stemming from negative past experience with hybrid poplar as an unprofitable endeavor for pulp and paper production. Additional barriers identified included overall land availability and the availability of water and water rights for irrigation in dry areas of the region. Since the beginning of the project, oil and natural gas prices have plummeted due to rapid increases in domestic production. This has exacerbated the problem with economic viability by making biofuels even less competitive than fossil fuels. However, the AHB project has identified intermediate market opportunities to use poplar as a renewable source for other biochemicals produced by petroleum refineries, such as acetic acid, ethyl acetate, ethanol, and ethylene. These chemicals can be produced at a lower cost with higher yields and higher, more-stable prices. Despite these promising market opportunities, the survey results suggest that it will still be challenging to induce growers to adopt hybrid poplar. Early adopters will be needed to establish an initial feedstock supply for a budding industry. Through demonstration sites and outreach events to various stakeholder groups, the project attracted interest from wastewater treatment facilities, since these facilities are already growing hybrid poplar plantations for applying biosolids and treated wastewater for further purification, clarification, and nutrient control through hybrid poplar’s phytoremediation capabilities. Since these facilities are already using hybrid poplar, selling the wood as feedstock for a biorefinery would be an added bonus rather than something requiring a high rate of return to compete with other crops and land uses. By holding regional workshops and conferences with wastewater professionals, AHB Extension has found strong interest from wastewater treatment operators. In conclusion, there are several significant barriers to developing a successful system for producing biofuels from hybrid poplar, with the largest barrier being economic viability. However, there is potential for wastewater treatment facilities to serve as early adopters for hybrid poplar production for intermediate biochemicals and eventually biofuels.

Keywords: hybrid poplar, biofuels, biochemicals, wastewater treatment

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285 Making Sense of C. G. Jung’s Red Book and Black Books: Masonic Rites and Trauma

Authors: Lynn Brunet

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In 2019 the author published a book-length study examining Jung’s Red Book. This study consisted of a close reading of each of the chapters in Liber Novus, focussing on the fantasies themselves and Jung’s accompanying paintings. It found that the plots, settings, characters and symbolism in each of these fantasies are not entirely original but remarkably similar to those found in some of the higher degrees of Continental Freemasonry. Jung was the grandson of his namesake, C.G. Jung (1794–1864), who was a Freemason and one-time Grand Master of the Swiss Masonic Lodge. The study found that the majority of Jung’s fantasies are very similar to those of the Ancient and Accepted Scottish Rite, practiced in Switzerland during the time of Jung’s childhood. It argues that the fantasies appear to be memories of a series of terrifying initiatory ordeals conducted using spurious versions of the Masonic rites. Spurious Freemasonry is a term that Masons use for the ‘irregular’ or illegitimate use of the rituals and are not sanctioned by the Order. Since the 1980s there have been multiple reports of ritual trauma amongst a wide variety of organizations, cults and religious groups that psychologists, counsellors, social workers, and forensic scientists have confirmed. The abusive use of Masonic rites features frequently in these reports. This initial study allows a reading of The Red Book that makes sense of the obscure references, bizarre scenarios and intense emotional trauma described by Jung throughout Liber Novus. It suggests that Jung appears to have undergone a cruel initiatory process as a child. The author is currently examining the extra material found in Jung’s Black Books and the results are confirming the original discoveries and demonstrating a number of aspects not covered in the first publication. These include the complex layering of ancient gods and belief systems in answer to Jung’s question, ‘In which underworld am I?’ It demonstrates that the majority of these ancient systems and their gods are discussed in a handbook for the Scottish Rite, Morals and Dogma by Albert Pike, but that the way they are presented by Philemon and his soul is intended to confuse him rather than clarify their purpose. This new study also examines Jung’s soul’s question ‘I am not a human being. What am I then?’ While further themes that emerge from the Black Books include his struggle with vanity and whether he should continue creating his ‘holy book’; and a comparison between Jung’s ‘mystery plays’ and examples from the Theatre of the Absurd. Overall, it demonstrates that Jung’s experience, while inexplicable in his own time, is now known to be the secret and abusive practice of initiation of the young found in a range of cults and religious groups in many first world countries. This paper will present a brief outline of the original study and then examine the themes that have emerged from the extra material found in the Black Books.

Keywords: C. G. Jung, the red book, the black books, masonic themes, trauma and dissociation, initiation rites, secret societies

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284 Public-Private Partnership for Better Protection of Trafficked Victims in Thailand: Case Study on Public Protection and Welfare Center in Cooperation with Jim Thompson Foundation in Occupational Development on Silk Sewing and Tailoring

Authors: Aungkana Kmonpetch

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Protection of trafficked victims and partnership among stakeholders are established as core principles in 5P’ strategies in international and national anti-human trafficking policies. In this article, it is of interest to discuss how the role of public-private partnerships in promoting the occupation development for employment in wage will enhance the better protection for victims of trafficking who affirmatively decide they want a criminal justice intervention, using Thailand as a case. Most of the victims who have accepted to be witness in the criminal justice system have lost income during their absence from work. The analysis of Thailand case is based on two methodological approaches: 1) interview with victims of trafficking, protection authorities, service providers, trainers and teachers, social workers, NGOs, police, prosecutors, business owners and enterprises, ILO, UNDP etc.; 2) create collaborative effort through workshops/consultation meetings in participation of all stakeholders – governmental agencies, private organizations, UN and international agencies. The linking of protection and partnership is anchored in international conventions and human trafficking directives. While this is actually framed as a responsive advantage for 5P strategies of anti-human trafficking – prevention, protection, persecution, punishment, and partnership, in reality, there might have more practical requirements of care and support. The article addresses how the partnership between governmental agencies and private organizations provide opportunities for trafficked victims to engage in high-skilled occupational development such as Silk-Sewing and Tailoring. The discussion is also focused how this approach of capacity building of the trainer for trainee, be enable the trafficked victims to cultivate the practices of high-skilled training to engage them into the business of social enterprise with employment in wage. The partnership coordination draws specifically to two aspects: firstly, to formulate appropriate assistance for promotion and protection of human rights of the trafficked victims in response to the 5P’ strategies of anti-human trafficking policy; secondly, to empower them to settle some economic stability for livelihood opportunity in the country of origin on their return and reintegration. Therefore, they can define how they want to move forward to prevent them at risk of vulnerable situations where they might being trafficked again or going on to work in exploitative conditions. It strengthens proper access to protection and assistance, depending on how the incentive of protection for cooperation is perceived to be and how useful the capacity building in occupation development for employment in wage will be implemented practically both in the host country and in the country of origin. This also brings into question how the victim of trafficking are able to access to the trade of market and are supported the employment opportunity according to the concept of decent work as they are constituted as witnesses. We discuss these issues in the area of a broader literature on social protection, economic security, gender, law, and victimhood.

Keywords: employment opportunity, occupation development, protection for victim of trafficking, public-private partnership

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283 School Belongingness and Coping with Bullying: Greek Adolescent Students' Experiences

Authors: E. Didaskalou, C. Roussi-Vergou, E. Andreou, G. Skrzypiec, P. Slee

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There has been growing interest lately, in the study of victimization among adolescent students in Greece and elsewhere with a view to improve school policies concerning anti-bullying practices. Researchers have recently focused on investigating the relationships between the extent of students’ victimization and the distinct mechanisms that they employ for coping with this particular problem. In particular, the emphasis has been placed on exploring the relationship between the coping strategies students use to counteract bullying, their sense of belonging at school, and extent of their victimization. Methods: Within the research framework outlined above, we set out to: a) examine the frequency of self-reported victimization among secondary school students, b) investigate the coping strategies employed by students when confronted with school bullying and c) explore any differences between bullied and non-bullied students with regard to coping strategies and school belongingness. The sample consisted of 860 from fifteen secondary public schools in central Greece. The schools were typical Greek secondary schools and the principals volunteered to participate in this study. Participants’ age ranged from 12 to 16 years. Measures: a) Exposure to Victimization: The frequency of victimization was directly located by asking students the question: ‘Over the last term, how often have you been bullied or harassed by a student or students at this high school?’ b) Coping Strategies: The ‘Living and Learning at School: Bullying at School’ was administered to students, c) School belongingness was assessed by the Psychological Sense of School Membership Scale, that students completed. Results: Regarding the frequency of self-reported victimization, 1.5% of the students reported being victimized every day, 2.8% most days of the week, 2.1% one or more days a week, 2.9% about once a week, 22.6% less than once a week and 68.1% never. The coping strategies that the participants employed for terminating their victimization included: a) adult support seeking, b) emotional coping/keep away from school, c) keeping healthy and fit, d) demonstrating a positive attitude towards the bully, d) peer support seeking, e) emotional out bursting, f) wishful thinking and self-blaming, g) pretending as if it is not happening, h) displaying assertive behaviors and i) getting away from the bullies. Bullied from non-bullied children did not differ as much in coping, as in feelings of being rejected in school. Discussion: The findings are in accordance with accumulated research evidence which points to a strong relationship between student perceptions of school belongingness and their involvement in bullying behaviors. We agree with the view that a positive school climate is likely to serve as a buffer that mitigates wider adverse societal influences and institutional attitudes which favor violence and harassment among peers.

Keywords: school bullying, school belonging, student coping strategies, victimization

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282 Demographic Determinants of Spatial Patterns of Urban Crime

Authors: Natalia Sypion-Dutkowska

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Abstract — The main research objective of the paper is to discover the relationship between the age groups of residents and crime in particular districts of a large city. The basic analytical tool is specific crime rates, calculated not in relation to the total population, but for age groups in a different social situation - property, housing, work, and representing different generations with different behavior patterns. They are the communities from which criminals and victims of crimes come. The analysis of literature and national police reports gives rise to hypotheses about the ability of a given age group to generate crime as a source of offenders and as a group of victims. These specific indicators are spatially differentiated, which makes it possible to detect socio-demographic determinants of spatial patterns of urban crime. A multi-feature classification of districts was also carried out, in which specific crime rates are the diagnostic features. In this way, areas with a similar structure of socio-demographic determinants of spatial patterns on urban crime were designated. The case study is the city of Szczecin in Poland. It has about 400,000 inhabitants and its area is about 300 sq km. Szczecin is located in the immediate vicinity of Germany and is the economic, academic and cultural capital of the region. It also has a seaport and an airport. Moreover, according to ESPON 2007, Szczecin is the Transnational and National Functional Urban Area. Szczecin is divided into 37 districts - auxiliary administrative units of the municipal government. The population of each of them in 2015-17 was divided into 8 age groups: babes (0-2 yrs.), children (3-11 yrs.), teens (12-17 yrs.), younger adults (18-30 yrs.), middle-age adults (31-45 yrs.), older adults (46-65 yrs.), early older (66-80) and late older (from 81 yrs.). The crimes reported in 2015-17 in each of the districts were divided into 10 groups: fights and beatings, other theft, car theft, robbery offenses, burglary into an apartment, break-in into a commercial facility, car break-in, break-in into other facilities, drug offenses, property damage. In total, 80 specific crime rates have been calculated for each of the districts. The analysis was carried out on an intra-city scale, this is a novel approach as this type of analysis is usually carried out at the national or regional level. Another innovative research approach is the use of specific crime rates in relation to age groups instead of standard crime rates. Acknowledgments: This research was funded by the National Science Centre, Poland, registration number 2019/35/D/HS4/02942.

Keywords: age groups, determinants of crime, spatial crime pattern, urban crime

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281 Spatial Analysis of the Socio-Environmental Vulnerability in Medium-Sized Cities: Case Study of Municipality of Caraguatatuba SP-Brazil

Authors: Katia C. Bortoletto, Maria Isabel C. de Freitas, Rodrigo B. N. de Oliveira

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The environmental vulnerability studies are essential for priority actions to the reduction of disasters risk. The aim of this study is to analyze the socio-environmental vulnerability obtained through a Census survey, followed by both a statistical analysis (PCA/SPSS/IBM) and a spatial analysis by GIS (ArcGis/ESRI), taking as a case study the Municipality of Caraguatatuba-SP, Brazil. In the municipal development plan analysis the emphasis was given to the Special Zone of Social Interest (ZEIS), the Urban Expansion Zone (ZEU) and the Environmental Protection Zone (ZPA). For the mapping of the social and environmental vulnerabilities of the study area the exposure of people (criticality) and of the place (support capacity) facing disaster risk were obtained from the 2010 Census from the Brazilian Institute of Geography and Statistics (IBGE). Considering the criticality, the variables of greater influence were related to literate persons responsible for the household and literate persons with 5 or more years of age; persons with 60 years or more of age and income of the person responsible for the household. In the Support Capacity analysis, the predominant influence was on the good household infrastructure in districts with low population density and also the presence of neighborhoods with little urban infrastructure and inadequate housing. The results of the comparative analysis show that the areas with high and very high vulnerability classes cover the classes of the ZEIS and the ZPA, whose zoning includes: Areas occupied by low-income population, presence of children and young people, irregular occupations and land suitable to urbanization but underutilized. The presence of zones of urban sprawl (ZEU) in areas of high to very high socio-environmental vulnerability reflects the inadequate use of the urban land in relation to the spatial distribution of the population and the territorial infrastructure, which favors the increase of disaster risk. It can be concluded that the study allowed observing the convergence between the vulnerability analysis and the classified areas in urban zoning. The occupation of areas unsuitable for housing due to its characteristics of risk was confirmed, thus concluding that the methodologies applied are agile instruments to subsidize actions to the reduction disasters risk.

Keywords: socio-environmental vulnerability, urban zoning, reduction disasters risk, methodologies

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280 Effect of Lifestyle Modification for Two Years on Obesity and Metabolic Syndrome Components in Elementary Students: A Community-Based Trial

Authors: Bita Rabbani, Hossein Chiti, Faranak Sharifi, Saeedeh Mazloomzadeh

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Background: Lifestyle modifications, especially improving nutritional patterns and increasing physical activity, are the most important factors in preventing obesity and metabolic syndrome in children and adolescents. For this purpose, the following interventional study was designed to investigate the effects of educational programs for students, as well as changes in diet and physical activity, on obesity and components of the metabolic syndrome. Methods: This study is part of an interventional research project (elementary school) conducted on all students of Sama schools in Zanjan and Abhar in three levels of elementary, middle, and high school, including 1000 individuals in Zanjan (intervention group) and 1000 individuals (control group) in Abhar in 2011. Interventions were based on educating students, teachers, and parents, changes in food services, and physical activity. We primarily measured anthropometric indices, fasting blood sugar, lipid profiles, and blood pressure and completed standard nutrition and physical activity questionnaires. Also, blood insulin levels were randomly measured in a number of students. Data analysis was done by SPSS software version 16.0. Results: Overall, 589 individuals (252 male, 337 female) entered the case group, and 803 individuals (344 male, 459 female) entered the control group. After two years of intervention, mean waist circumference (63.8 ± 10.9) and diastolic BP (63.8 ± 10.4) were significantly lower; however, mean systolic BP (10.1.0 ± 12.5), food score (25.0 ± 5.0) and drinking score (12.1 ± 2.3) were higher in the intervention group (p<0.001). Comparing components of metabolic syndrome between the second year and at time of recruitment within the intervention group showed that although number of overweight/obese individuals, individuals with hypertriglyceridemia and high LDL increased, abdominal obesity, high BP, hyperglycemia, and insulin resistance decreased (p<0.001). On the other hand, in the control group, number of individuals with high BP increased significantly. Conclusion: The prevalence of abdominal obesity and hypertension, which are two major components of metabolic syndrome, are much higher in our study than in other regions of country. However, interventions for modification of diet and increase in physical activity are effective in lowering their prevalence.

Keywords: metabolic syndrome, obesity, life style, nutrition, hypertension

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279 Numerical Prediction of Width Crack of Concrete Dapped-End Beams

Authors: Jatziri Y. Moreno-Martinez, Arturo Galvan, Xavier Chavez Cardenas, Hiram Arroyo

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Several methods have been utilized to study the prediction of cracking of concrete structural under loading. The finite element analysis is an alternative that shows good results. The aim of this work was the numerical study of the width crack in reinforced concrete beams with dapped ends, these are frequently found in bridge girders and precast concrete construction. Properly restricting cracking is an important aspect of the design in dapped ends, it has been observed that the cracks that exceed the allowable widths are unacceptable in an aggressive environment for reinforcing steel. For simulating the crack width, the discrete crack approach was considered by means of a Cohesive Zone (CZM) Model using a function to represent the crack opening. Two cases of dapped-end were constructed and tested in the laboratory of Structures and Materials of Engineering Institute of UNAM. The first case considers a reinforcement based on hangers as well as on vertical and horizontal ring, the second case considers 50% of the vertical stirrups in the dapped end to the main part of the beam were replaced by an equivalent area (vertically projected) of diagonal bars under. The loading protocol consisted on applying symmetrical loading to reach the service load. The models were performed using the software package ANSYS v. 16.2. The concrete structure was modeled using three-dimensional solid elements SOLID65 capable of cracking in tension and crushing in compression. Drucker-Prager yield surface was used to include the plastic deformations. The reinforcement was introduced with smeared approach. Interface delamination was modeled by traditional fracture mechanics methods such as the nodal release technique adopting softening relationships between tractions and the separations, which in turn introduce a critical fracture energy that is also the energy required to break apart the interface surfaces. This technique is called CZM. The interface surfaces of the materials are represented by a contact elements Surface-to-Surface (CONTA173) with bonded (initial contact). The Mode I dominated bilinear CZM model assumes that the separation of the material interface is dominated by the displacement jump normal to the interface. Furthermore, the opening crack was taken into consideration according to the maximum normal contact stress, the contact gap at the completion of debonding, and the maximum equivalent tangential contact stress. The contact elements were placed in the crack re-entrant corner. To validate the proposed approach, the results obtained with the previous procedure are compared with experimental test. A good correlation between the experimental and numerical Load-Displacement curves was presented, the numerical models also allowed to obtain the load-crack width curves. In these two cases, the proposed model confirms the capability of predicting the maximum crack width, with an error of ± 30 %. Finally, the orientation of the crack is a fundamental for the prediction of crack width. The results regarding the crack width can be considered as good from the practical point view. Load-Displacement curve of the test and the location of the crack were able to obtain favorable results.

Keywords: cohesive zone model, dapped-end beams, discrete crack approach, finite element analysis

Procedia PDF Downloads 148
278 Psycho-Social Associates of Deliberate Self-Harm in Rural Sri Lanka

Authors: P. H. G. J. Pushpakumara, A. M. P. Adikari, S. U. B. Tennakoon, Ranil Abeysinghe, Andrew Dawson

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Introduction: Deliberate Self-harm (DSH) is a global public health problem. Since 1950, suicide rates in Sri Lanka are among the highest national rates in the world. It has become an increasingly common response to emotional distress in young adults. However, it remains unclear the reason for this occurrence. Objectives: The descriptive component of this study was conducted to identify of epidemiological pattern of DSH and suicide in Kurunegala District (KD). Assessment of association between DSH socio-cultural, economical and psychological factors were the objectives of the case control component. Methods: Prospective data collection of DSH and suicide was conducted at all (46) hospitals and all (28) police stations in the KD for thirty six months, from 1st January 2011, as the descriptive component. Case control component was conducted at T.H. Kurunegala (THK) for eighteen months duration, from 1st July 2011. Cases (n=439) were randomly selected from a block of 7 consecutively admitted consenting DSP patients using a computer program. Age, sex and residential divisional secretariat division one to one matched, individuals were randomly selected as controls from patients presented to Out Patient Department. Structured Clinical Interview for DSM-IV-TR Axis I and II Disorders was used to diagnose psychiatric disorders. Validated tools were used to measure other constructs. Results: Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011- 2013 (Male:female ratio 5.7, 4.4 and 6.4). 60% of suicides were due to poisoning. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population in 2011- 2013. Highest age standardized male DSP incidence reported in 20-24 years (769.6/100,000) and female in 15-19 years (1304.0/100,000). Bing married (age >25 years), monthly family income less than Rs.30,000, not achieving G.C.E (O/L) qualifications, a school drop-out, not in a permanent position in occupation, being a manual and an own account worker, were significantly associated with DSP. Perceiving the quality of relationship as bad or very bad with parents, spouse/ girlfriend/ boyfriend and sibling as associated with 8, 40 and 10.5 times higher risk respectively. Feeling and experiences of neglect, other emotional abuses, feeling of insecurity with the family, in child hood, and having a contact history carried an excess risk for DSP. Cases were less likely to seek help. Further, they had significantly lower scores for life skills and life skills application ability. 25.6% DSH patients had DSM TR axis-I and/or TR axis-II disorder. The presence of psychiatric disorder carried 7.7 (95% CI 4.3 – 13.8) times higher risk for DSP. Conclusion: In general, pattern of DSH and suicide is, unique, different from developed, upper and middle income and lower and middle income countries. It is a learned way of expressing emotions in difficult situations of vulnerable people.

Keywords: deliberate self-harm, help-seeking, life-skills, mental- health, psychological, social, suicide

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277 Effect of Cerebellar High Frequency rTMS on the Balance of Multiple Sclerosis Patients with Ataxia

Authors: Shereen Ismail Fawaz, Shin-Ichi Izumi, Nouran Mohamed Salah, Heba G. Saber, Ibrahim Mohamed Roushdi

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Background: Multiple sclerosis (MS) is a chronic, inflammatory, mainly demyelinating disease of the central nervous system, more common in young adults. Cerebellar involvement is one of the most disabling lesions in MS and is usually a sign of disease progression. It plays a major role in the planning, initiation, and organization of movement via its influence on the motor cortex and corticospinal outputs. Therefore, it contributes to controlling movement, motor adaptation, and motor learning, in addition to its vast connections with other major pathways controlling balance, such as the cerebellopropriospinal pathways and cerebellovestibular pathways. Hence, trying to stimulate the cerebellum by facilitatory protocols will add to our motor control and balance function. Non-invasive brain stimulation, both repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), has recently emerged as effective neuromodulators to influence motor and nonmotor functions of the brain. Anodal tDCS has been shown to improve motor skill learning and motor performance beyond the training period. Similarly, rTMS, when used at high frequency (>5 Hz), has a facilitatory effect on the motor cortex. Objective: Our aim was to determine the effect of high-frequency rTMS over the cerebellum in improving balance and functional ambulation of multiple sclerosis patients with Ataxia. Patients and methods: This was a randomized single-blinded placebo-controlled prospective trial on 40 patients. The active group (N=20) received real rTMS sessions, and the control group (N=20) received Sham rTMS using a placebo program designed for this treatment. Both groups received 12 sessions of high-frequency rTMS over the cerebellum, followed by an intensive exercise training program. Sessions were given three times per week for four weeks. The active group protocol had a frequency of 10 Hz rTMS over the cerebellar vermis, work period 5S, number of trains 25, and intertrain interval 25s. The total number of pulses was 1250 pulses per session. The control group received Sham rTMS using a placebo program designed for this treatment. Both groups of patients received an intensive exercise program, which included generalized strengthening exercises, endurance and aerobic training, trunk abdominal exercises, generalized balance training exercises, and task-oriented training such as Boxing. As a primary outcome measure the Modified ICARS was used. Static Posturography was done with: Patients were tested both with open and closed eyes. Secondary outcome measures included the expanded Disability Status Scale (EDSS) and 8 Meter walk test (8MWT). Results: The active group showed significant improvements in all the functional scales, modified ICARS, EDSS, and 8-meter walk test, in addition to significant differences in static Posturography with open eyes, while the control group did not show such differences. Conclusion: Cerebellar high-frequency rTMS could be effective in the functional improvement of balance in MS patients with ataxia.

Keywords: brain neuromodulation, high frequency rTMS, cerebellar stimulation, multiple sclerosis, balance rehabilitation

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276 Effect of Lullabies on Babies Stress and Relaxation Symptoms in the Neonatal Intensive Care Units

Authors: Meltem Kürtüncü, Işın Alkan

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Objective: This study was carried out with an experimental design in order to determine whether the lullaby, which was listened from mother’s voice and a stranger’s voice to the babies born at term and hospitalized in neonatal intensive care unit, had an effect on stress and relaxation symptoms of the infants. Method: Data from the study were obtained from 90 newborn babies who were hospitalized in Neonatal Intensive Care Unit of Zonguldak Maternity And Children Hospital between September 2015-January 2016 and who met the eligibility criteria. Lullaby concert was performed by choosing one of the suitable care hours. Stress and relaxation symptoms were recorded by the researcher on “Newborn response follow-up form” at pre-care and post-care. Results: After lullaby concert when stress symptoms compared to infants in the experimental and control groups before the care was not detected statistically significant difference between crying, contraction, facial grimacing, flushing, cyanosis and the rates of increase in temperature. After care, crying, contractions, facial grimacing, flushing, and restlessness revealed a statistically significant difference between the groups, but as the cyanosis and temperature increased stress responses did not result in a significant difference between the groups. In the control group babies the crying, contraction, facial grimacing, flushing, and restlessness behaviors rates were found to be significantly higher than experimental group babies. After lullaby concert when relaxation symptoms compared to infants in the experimental and control groups before the care, eye contact rates who listen to lullaby from mother’s voice was found to be significantly higher than infants who listen to lullaby from stranger’s voice and infants in the control group. After care as eye contact, smiling, sucking/searching, yawning, non-crying and sleep behaviors relaxation symptoms revealed statistically significant results. In the control group, these behaviors were found statistically lower degree than the experimental groups. Conclusion: Lullaby concerts as masking the ambient noise, reducing the stress symptoms and increasing the relaxation symptoms, and also for soothing and stimulant affects, due to ease the transition to the sleep state should be preferred in the neonatal intensive care units.

Keywords: lullaby, mother voice, relaxation, stress

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275 Re-Creating Women of the Past in Historical Series on Mexican Television: The Work of Patricia Arriaga Jordan

Authors: Maria De Los Angeles Rodriguez Cadena

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This paper discusses how the fictional versions of women of the past contribute to advance today’s ideas of social justice, personal freedom and emancipation as well as to highlight the creative challenge of constructing people and events on fictional narratives on television that incorporate multiple and simultaneous layers of meaning and complexity. This project builds on existing scholarship on audiovisual texts by exploring an influential but under-studied director. In two Mexican television series, Patricia Arriaga Jordan, an award-winning television producer, scriptwriter and director, constructs the life of two outstanding women that have played an influential role in national history and captured Mexican’s popular imagination for generations: Sor Juana Inés de la Cruz, and Malinche. Malinche (2018) tells the story of an extraordinary indigenous woman, Malintzin, during the Spanish Conquest (1511-1550) that is considered to have played a key role in the fall of the Aztec empire by acting as translator, negotiator and cultural mediator for the Spanish conquerors. Juana Ines (2016) portrays Sor Juana, a poet, essayist, playwright, theologian, philosopher, nun, of XVII century colonial Mexico, one of the brightest minds of her time, and now recognized as the first feminist of the Americas who wrote on the rights of women to an education, religious authority and feminist advocacy. Both series, as fictional narratives that recreate defining historical periods, specific events and relevant characters in the History of Mexico can be read as an example of what is called texts of cultural memory. A cultural memory text is a narrative that bonds the concepts of history, identity and belonging, and that is realized and disseminated through symbolic systems such as written documents, visual images, and dramatic representation. Cultural memory, through its narratives of historical fiction, emphasizes memory processes (historiography) and its implications and artifacts (cultural memory) mainly through the medial frameworks of remembering, which are the medial process by which memories (narratives, documents) participate in public knowledge and become collective memory. Historical fiction on television not only creates a portrayal of the past related to the real lives of protagonists, but it also significantly contributes to understand the past as an ever-evolving entity that highlights both, the necessary connection with the present as part of a developing sense of collective identity and belonging, as well as the relevance of the medium in which the past is represented and that ultimately supports the process of historical awareness. Through the emblematic recreation of national heroines and historical events in the unique context of historical drama on television, those texts constitute a venue where concepts of the past and the traditionally established ideas about history and heroines are highlighted, questioned and transformed.

Keywords: cultural memory, historical fiction, Mexico, television, women directors

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274 Design and Validation of the 'Teachers' Resilience Scale' for Assessing Protective Factors

Authors: Athena Daniilidou, Maria Platsidou

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Resilience is considered to greatly affect the personal and occupational wellbeing and efficacy of individuals; therefore, it has been widely studied in the social and behavioral sciences. Given its significance, several scales have been created to assess resilience of children and adults. However, most of these scales focus on examining only the internal protective or risk factors that affect the levels of resilience. The aim of the present study is to create a reliable scale that assesses both the internal and the external protective factors that affect Greek teachers’ levels of resilience. Participants were 136 secondary school teachers (89 females, 47 males) from urban areas of Greece. Connor-Davidson Resilience Scale (CD-Risc) and Resilience Scale for Adults (RSA) were used to collect the data. First, exploratory factor analysis was employed to investigate the inner structure of each scale. For both scales, the analyses revealed a differentiated factor solution compared to the ones proposed by the creators. That prompt us to create a scale that would combine the best fitting subscales of the CD-Risc and the RSA. To this end, the items of the four factors with the best fit and highest reliability were used to create the ‘Teachers' resilience scale’. Exploratory factor analysis revealed that the scale assesses the following protective/risk factors: Personal Competence and Strength (9 items, α=.83), Family Cohesion Spiritual Influences (7 items, α=.80), Social Competence and Peers Support (7 items, α=.78) and Spiritual Influence (3 items, α=.58). This four-factor model explained 49,50% of the total variance. In the next step, a confirmatory factor analysis was performed on the 26 items of the derived scale to test the above factor solution. The fit of the model to the data was good (χ2/292 = 1.245, CFI = .921, GFI = .829, SRMR = .074, CI90% = .026-,056, RMSEA = 0.43), indicating that the proposed scale can validly measure the aforementioned four aspects of teachers' resilience and thus confirmed its factorial validity. Finally, analyses of variance were performed to check for individual differences in the levels of teachers' resilience in relation to their gender, age, marital status, level of studies, and teaching specialty. Results were consistent to previous findings, thus providing an indication of discriminant validity for the instrument. This scale has the advantage of assessing both the internal and the external protective factors of resilience in a brief yet comprehensive way, since it consists 26 items instead of the total of 58 of the CD-Risc and RSA scales. Its factorial inner structure is supported by the relevant literature on resilience, as it captures the major protective factors of resilience identified in previous studies.

Keywords: protective factors, resilience, scale development, teachers

Procedia PDF Downloads 285
273 Insectivorous Medicinal Plant Drosera Ecologyand its Biodiversity Conservation through Tissue Culture and Sustainable Biotechnology

Authors: Sushil Pradhan

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Biotechnology contributes to sustainable development in several ways such as biofertilizer production, biopesticide production and management of environmental pollution, tissue culture and biodiversity conservation in vitro, in vivo and in situ, Insectivorous medicinal plant Drosera burmannii Vahl belongs to the Family-Droseraceae under Order-Caryophyllales, Dicotyledoneae, Angiospermeae which has 31 (thirty one) living genera and 194 species besides 7 (seven) extinct (fossil) genera. Locally it is known as “Patkanduri” in Odia. Its Hindi name is “Mukhajali” and its English name is “Sundew”. The earliest species of Drosera was first reported in 1753 by Carolous Linnaeus called Drosera indica L (Indian Sundew). The latest species of Drosera reported by Fleisch A, Robinson, AS, McPherson S, Heinrich V, Gironella E and Madulida D.A. (2011) is Drosera ultramafica from Malaysia. More than 50 % species of Drosera have been reported from Australia and next to Australia is South Africa. India harbours only 3 species such as D. indica L, Drosera burmannii Vahl and D. peltata L. From our Odisha only D. burmannii Vahl is being reported for the first time from the district of Subarnapur near Sonepur (Arjunpur Reserve Forest Area). Drosera plant is autotrophic but to supplement its Nitrogen (N2) requirement it adopts heterotrophic mode of nutrition (insectivorous/carnivorous) as well. The colour of plant in mostly red and about 20-30cm in height with beautiful pink or white pentamerous flowers. Plants grow luxuriantly during November to February in shady and moist places near small water bodies of running water stream. Medicinally it is a popular herb in the locality for the treatment of cold and cough in children in rainy season by the local Doctors (Kabiraj and Baidya). In the present field investigation an attempt has been made to understand the unique reproductive phase and life cycle of the plant thereby planning for its conservation and propagation through various techniques of tissue culture and biotechnology. More importantly besides morphological and anatomical studies, cytological investigation is being carried out to find out the number of chromosomes in the cell and its genomics as there is no such report as yet for Drosera burmannii Vahl. The ecological significance and biodiversity conservation of Drosera with special reference to energy, environmental and chemical engineering has been discussed in the research paper presentation.

Keywords: insectivorous, medicinal, drosera, biotechnology, chromosome, genome

Procedia PDF Downloads 367
272 Barriers and Facilitators of Implementing Digital Mental Health Resources in Underserved Regions of Ontario during the COVID-19 Pandemic

Authors: Samaneh Abedini, Diana Urajnik, Nicole Naccarato

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A high prevalence of mental health problems was observed in marginalized youth living in underserved regions of Ontario during the COVID-19 pandemic. To address this issue, a growing number of community-based traditional mental health services are offering digital mental health resources due to their accessibility, affordability, and scalability. The feasibility of providing these resources in underserved regions has been examined by researchers rather than by representatives of effective services within a mental health system. Indeed, digitalized mental health contents are not routinely embedded within local mental health organizations' services in Northern Ontario, where they can make a substantial impact. To date, many technology-based mental health initiatives have not been effectively implemented in this region. The obstacles associated with implementing digitalized mental health resources in Northern Ontario may be unique to that region. Thus, specific context-based considerations might need to be applied for developing and implementing digital resources by regional mental health organizations in Northern Ontario. The target population was child-serving organizations situated in northeastern Ontario, specifically within Greater Sudbury and the Sudbury District. A sample of six organizations were selected with representation from the mental health, social, and healthcare sectors. The project supervisor was in a unique position to access the organizations by virtue of existing relationships with the practice and lay communities at large. Thus, recruitment was conducted through professional outreach in partnership with the Center for Rural and Northern Health Research (CRaNHR). Semi-structured interviews were conducted with 1-2 key personnel (e.g., administrator, clinician) from participating organizations. Audio recordings from the semi-structured interviews were transcribed verbatim and thematically analyzed supported by NVivo. Thematic analysis of the data resulted in a total of 13 excerpts which were categorized into two major themes including 1) digital mental health services as a valuable resource for organizations both during and after the pandemic, and 2) barriers and facilitators to a successful implementation of digital mental health resources in northern Ontario. Four secondary themes were identified: 1) perceived barriers to implementation of digital mental health resources to the offered services by mental health agencies; 2) acceptability and feasibility of digital health sources for people living in northern Ontario; 3) data security, safety, and risk; and 4) connecting with clients. The employees of mental health organizations in northern Ontario considered digital mental health resources as generally acceptable to youth. However, they raised several concerns that may affect their implementation into routine practice and service delivery. The implementation of digital systems should be simple and straightforward and should enhance rather than hinder clinical workflows for staff. A clear plan for implementing technological services is also required for the successful adoption of digital systems. For successful adoption and implementation of digital systems, staff views must be considered.

Keywords: COVID-19 pandemic, digital mental health resources, Ontario, underserved

Procedia PDF Downloads 90
271 Developing a Sustainable System to Deliver Early Intervention for Emotional Health through Australian Schools

Authors: Rebecca-Lee Kuhnert, Ron Rapee

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Up to 15% of Australian youth will experience an emotional disorder, yet relatively few get the help they need. Schools provide an ideal environment through which we can identify young people who are struggling and provide them with appropriate help. Universal mental health screening is a method by which all young people in school can be quickly assessed for emotional disorders, after which identified youth can be linked to appropriate health services. Despite the obvious logic of this process, universal mental health screening has received little scientific evaluation and even less application in Australian schools. This study will develop methods for Australian education systems to help identify young people (aged 9-17 years old) who are struggling with existing and emerging emotional disorders. Prior to testing, a series of focus groups will be run to get feedback and input from young people, parents, teachers, and mental health professionals. They will be asked about their thoughts on school-based screening methods and and how to best help students at risk of emotional distress. Schools (n=91) across New South Wales, Australia will be randomised to do either immediate screening (in May 2021) or delayed screening (in February 2022). Students in immediate screening schools will complete a long online mental health screener consisting of standard emotional health questionnaires. Ultimately, this large set of items will be reduced to a small number of items to form the final brief screener. Students who score in the “at-risk” range on any measure of emotional health problems will be identified to schools and offered pathways to relevant help according to the most accepted and approved processes identified by the focus groups. Nine months later, the same process will occur among delayed screening schools. At this same time, students in the immediate screening schools will complete screening for a second time. This will allow a direct comparison of the emotional health and help-seeking between youth whose schools had engaged in the screening and pathways to care process (immediate) and those whose schools had not engaged in the process (delayed). It is hypothesised that there will be a significant increase in students who receive help from mental health support services after screening, compared with baseline. It is also predicted that all students will show significantly less emotional distress after screening and access to pathways of care. This study will be an important contribution to Australian youth mental health prevention and early intervention by determining whether school screening leads to a greater number of young people with emotional disorders getting the help that they need and improving their mental health outcomes.

Keywords: children and young people, early intervention, mental health, mental health screening, prevention, school-based mental health

Procedia PDF Downloads 80
270 Just a Heads Up: Approach to Head Shape Abnormalities

Authors: Noreen Pulte

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Prior to the 'Back to Sleep' Campaign in 1992, 1 of every 300 infants seen by Advanced Practice Providers had plagiocephaly. Insufficient attention is given to plagiocephaly and brachycephaly diagnoses in practice and pediatric education. In this talk, Nurse Practitioners and Pediatric Providers will be able to: (1) identify red flags associated with head shape abnormalities, (2) learn techniques they can teach parents to prevent head shape abnormalities, and (3) differentiate between plagiocephaly, brachycephaly, and craniosynostosis. The presenter is a Primary Care Pediatric Nurse Practitioner at Ann & Robert H. Lurie Children's Hospital of Chicago and the primary provider for its head shape abnormality clinics. She will help participants translate key information obtained from birth history, review of systems, and developmental history to understand risk factors for head shape abnormalities and progression of deformities. Synostotic and non-synostotic head shapes will be explained to help participants differentiate plagiocephaly and brachycephaly from synostotic head shapes. This knowledge is critical for the prompt referral of infants with craniosynostosis for surgical evaluation and correction. Rapid referral for craniosynostosis can possibly direct the patient to a minimally invasive surgical procedure versus a craniectomy. As for plagiocephaly and brachycephaly, this timely referral can also aid in a physical therapy referral if necessitated, which treats torticollis and aids in improving head shape. A well-timed referral to a head shape clinic can possibly eliminate the need for a helmet and/or minimize the time in a helmet. Practitioners will learn the importance of obtaining head measurements using calipers. The presenter will explain head calculations and how the calculations are interpreted to determine the severity of the head shape abnormalities. Severity defines the treatment plan. Participants will learn when to refer patients to a head shape abnormality clinic and techniques they should teach parents to perform while waiting for the referral appointment. The purpose, mechanics, and logistics of helmet therapy, including optimal time to initiate helmet therapy, recommended helmet wear-time, and tips for helmet therapy compliance, will be described. Case scenarios will be incorporated into the presenter's presentation to support learning. The salient points of the case studies will be explained and discussed. Practitioners will be able to immediately translate the knowledge and skills gained in this presentation into their clinical practice.

Keywords: plagiocephaly, brachycephaly, craniosynostosis, red flags

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269 “laws Drifting Off While Artificial Intelligence Thriving” – A Comparative Study with Special Reference to Computer Science and Information Technology

Authors: Amarendar Reddy Addula

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Definition of Artificial Intelligence: Artificial intelligence is the simulation of mortal intelligence processes by machines, especially computer systems. Explicit operations of AI comprise expert systems, natural language processing, and speech recognition, and machine vision. Artificial Intelligence (AI) is an original medium for digital business, according to a new report by Gartner. The last 10 times represent an advance period in AI’s development, prodded by the confluence of factors, including the rise of big data, advancements in cipher structure, new machine literacy ways, the materialization of pall computing, and the vibrant open- source ecosystem. Influence of AI to a broader set of use cases and druggies and its gaining fashionability because it improves AI’s versatility, effectiveness, and rigidity. Edge AI will enable digital moments by employing AI for real- time analytics closer to data sources. Gartner predicts that by 2025, further than 50 of all data analysis by deep neural networks will do at the edge, over from lower than 10 in 2021. Responsible AI is a marquee term for making suitable business and ethical choices when espousing AI. It requires considering business and societal value, threat, trust, translucency, fairness, bias mitigation, explainability, responsibility, safety, sequestration, and nonsupervisory compliance. Responsible AI is ever more significant amidst growing nonsupervisory oversight, consumer prospects, and rising sustainability pretensions. Generative AI is the use of AI to induce new vestiges and produce innovative products. To date, generative AI sweats have concentrated on creating media content similar as photorealistic images of people and effects, but it can also be used for law generation, creating synthetic irregular data, and designing medicinals and accoutrements with specific parcels. AI is the subject of a wide- ranging debate in which there's a growing concern about its ethical and legal aspects. Constantly, the two are varied and nonplussed despite being different issues and areas of knowledge. The ethical debate raises two main problems the first, abstract, relates to the idea and content of ethics; the alternate, functional, and concerns its relationship with the law. Both set up models of social geste, but they're different in compass and nature. The juridical analysis is grounded on anon-formalistic scientific methodology. This means that it's essential to consider the nature and characteristics of the AI as a primary step to the description of its legal paradigm. In this regard, there are two main issues the relationship between artificial and mortal intelligence and the question of the unitary or different nature of the AI. From that theoretical and practical base, the study of the legal system is carried out by examining its foundations, the governance model, and the nonsupervisory bases. According to this analysis, throughout the work and in the conclusions, International Law is linked as the top legal frame for the regulation of AI.

Keywords: artificial intelligence, ethics & human rights issues, laws, international laws

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268 Innovation Outputs from Higher Education Institutions: A Case Study of the University of Waterloo, Canada

Authors: Wendy De Gomez

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The University of Waterloo is situated in central Canada in the Province of Ontario- one hour from the metropolitan city of Toronto. For over 30 years, it has held Canada’s top spot as the most innovative university; and has been consistently ranked in the top 25 computer science and top 50 engineering schools in the world. Waterloo benefits from the federal government’s over 100 domestic innovation policies which have assisted in the country’s 15th place global ranking in the World Intellectual Property Organization’s (WIPO) 2022 Global Innovation Index. Yet undoubtedly, the University of Waterloo’s unique characteristics are what propels its innovative creativeness forward. This paper will provide a contextual definition of innovation in higher education and then demonstrate the five operational attributes that contribute to the University of Waterloo’s innovative reputation. The methodology is based on statistical analyses obtained from ranking bodies such as the QS World University Rankings, a secondary literature review related to higher education innovation in Canada, and case studies that exhibit the operationalization of the attributes outlined below. The first attribute is geography. Specifically, the paper investigates the network structure effect of the Toronto-Waterloo high-tech corridor and the resultant industrial relationships built there. The second attribute is University Policy 73-Intellectal Property Rights. This creator-owned policy grants all ownership to the creator/inventor regardless of the use of the University of Waterloo property or funding. Essentially, through the incentivization of IP ownership by all researchers, further commercialization and entrepreneurship are formed. Third, this IP policy works hand in hand with world-renowned business incubators such as the Accelerator Centre in the dedicated research and technology park and velocity, a 14-year-old facility that equips and guides founders to build and scale companies. Communitech, a 25-year-old provincially backed facility in the region, also works closely with the University of Waterloo to build strong teams, access capital, and commercialize products. Fourth, Waterloo’s co-operative education program contributes 31% of all co-op participants to the Canadian economy. Home to the world’s largest co-operative education program, data shows that over 7,000 from around the world recruit Waterloo students for short- and long-term placements- directly contributing to the student’s ability to learn and optimize essential employment skills when they graduate. Finally, the students themselves at Waterloo are exceptional. The entrance average ranges from the low 80s to the mid-90s depending on the program. In computer, electrical, mechanical, mechatronics, and systems design engineering, to have a 66% chance of acceptance, the applicant’s average must be 95% or above. Singularly, none of these five attributes could lead to the university’s outstanding track record of innovative creativity, but when bundled up into a 1000 acre- 100 building main campus with 6 academic faculties, 40,000+ students, and over 1300 world-class faculty, the recipe for success becomes quite evident.

Keywords: IP policy, higher education, economy, innovation

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267 A Rare Case Report of Non-Langerhans Cell Cutaneous Histiocytosis in a 6-Month Old Infant

Authors: Apoorva D. R.

Abstract:

INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a severe, potentially fatal syndrome in which there is excessive immune activation. The disease is seen in children and people of all ages, but infants from birth to 18 months are most frequently affected. HLH is a sporadic or familial condition that can be triggered by various events that disturb immunological homeostasis. In cases with a genetic predisposition and sporadic occurrences, infection is a frequent trigger. Because of the rarity of this disease, the diverse clinical presentation, and the lack of specificity in the clinical and laboratory results, prompt treatment is essential, but the biggest obstacle to a favorable outcome is frequently a delay in identification. CASE REPORT: Here we report a case of a 6-month-old male infant who presented to the dermatology outpatient with disseminated skin lesions present over the face, abdomen, scalp, and bilateral upper and lower limbs for the past month. The lesions were insidious in onset, initially started over the abdomen, and gradually progressed to involve other body parts. The patient also had a history of fever which was moderate in grade, on and off in nature for 1 month. There were no significant complaints in the past, family, or drug history. There was no history of feeding difficulties in the baby. Parents gave a history of developmental milestones appropriate for age. Examination findings include multiple well-defined monomorphic erythematous papules with a central crater present over bilateral cheeks. Few lichenoid shiny papules present over bilateral arms, legs, and abdomen. Ultrasound of the abdomen and pelvis showed mild degree hepatosplenomegaly, intraabdominal lymphadenopathy, and bilateral inguinal lymphadenopathy. Routine blood investigations showed anemia and lymphopenia. Multiple X-rays of the skull, chest, and bilateral upper and lower limbs were done and were normal. Histopathology features were suggestive of non-Langerhans cell cutaneous histiocytosis. CONCLUSION: HLH is a fatal and rare disease. A high level of suspicion and an interdisciplinary approach among experienced clinicians, pathologists, and microbiologists to define the diagnosis and causative disease are key to diagnosing this case. Early detection and treatment can reduce patient morbidity and mortality.

Keywords: histiocytosis, non langerhans cell, case report, fatal, rare

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266 Differences in Parental Acceptance, Rejection, and Attachment and Associations with Adolescent Emotional Intelligence and Life Satisfaction

Authors: Diana Coyl-Shepherd, Lisa Newland

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Research and theory suggest that parenting and parent-child attachment influence emotional development and well-being. Studies indicate that adolescents often describe differences in relationships with each parent and may form different types of attachment to mothers and fathers. During adolescence and young adulthood, romantic partners may also become attachment figures, influencing well being, and providing a relational context for emotion skill development. Mothers, however, tend to be remain the primary attachment figure; fathers and romantic partners are more likely to be secondary attachment figures. The following hypotheses were tested: 1) participants would rate mothers as more accepting and less rejecting than fathers, 2) participants would rate secure attachment to mothers higher and insecure attachment lower compared to father and romantic partner, 3) parental rejection and insecure attachment would be negatively related to life satisfaction and emotional intelligence, and 4) secure attachment and parental acceptance would be positively related life satisfaction and emotional intelligence. After IRB and informed consent, one hundred fifty adolescents and young adults (ages 11-28, M = 19.64; 71% female) completed an online survey. Measures included parental acceptance, rejection, attachment (i.e., secure, dismissing, and preoccupied), emotional intelligence (i.e., seeking and providing comfort, use, and understanding of self emotions, expressing warmth, understanding and responding to others’ emotional needs), and well-being (i.e., self-confidence and life satisfaction). As hypothesized, compared to fathers’, mothers’ acceptance was significantly higher t (190) = 3.98, p = .000 and rejection significantly lower t (190) = - 4.40, p = .000. Group differences in secure attachment were significant, f (2, 389) = 40.24, p = .000; post-hoc analyses revealed significant differences between mothers and fathers and between mothers and romantic partners; mothers had the highest mean score. Group differences in preoccupied attachment were significant, f (2, 388) = 13.37, p = .000; post-hoc analyses revealed significant differences between mothers and romantic partners, and between fathers and romantic partners; mothers have the lowest mean score. However, group differences in dismissing attachment were not significant, f (2, 389) = 1.21, p = .30; scores for mothers and romantic partners were similar; father means score was highest. For hypotheses 3 and 4 significant negative correlations were found between life satisfaction and dismissing parent, and romantic attachment, preoccupied father and romantic attachment, and mother and father rejection variables; secure attachment variables and parental acceptance were positively correlated with life satisfaction. Self-confidence was correlated only with mother acceptance. For emotional intelligence, seeking and providing comfort were negatively correlated with parent dismissing and mother rejection; secure mother and romantic attachment and mother acceptance were positively correlated with these variables. Use and understanding of self-emotions were negatively correlated with parent and partner dismissing attachment, and parent rejection; romantic secure attachment and parent acceptance were positively correlated. Expressing warmth was negatively correlated with dismissing attachment variables, romantic preoccupied attachment, and parent rejection; whereas attachment secure variables were positively associated. Understanding and responding to others’ emotional needs were correlated with parent dismissing and preoccupied attachment variables and mother rejection; only secure father attachment was positively correlated.

Keywords: adolescent emotional intelligence, life satisfaction, parent and romantic attachment, parental rejection and acceptance

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265 Cognitive Decline in People Living with HIV in India and Correlation with Neurometabolites Using 3T Magnetic Resonance Spectroscopy (MRS): A Cross-Sectional Study

Authors: Kartik Gupta, Virendra Kumar, Sanjeev Sinha, N. Jagannathan

Abstract:

Introduction: A significant number of patients having human immunodeficiency virus (HIV) infection show a neurocognitive decline (NCD) ranging from minor cognitive impairment to severe dementia. The possible causes of NCD in HIV-infected patients include brain injury by HIV before cART, neurotoxic viral proteins and metabolic abnormalities. In the present study, we compared the level of NCD in asymptomatic HIV-infected patients with changes in brain metabolites measured by using magnetic resonance spectroscopy (MRS). Methods: 43 HIV-positive patients (30 males and 13 females) coming to ART center of the hospital and HIV-seronegative healthy subjects were recruited for the study. All the participants completed MRI and MRS examination, detailed clinical assessments and a battery of neuropsychological tests. All the MR investigations were carried out at 3.0T MRI scanner (Ingenia/Achieva, Philips, Netherlands). MRI examination protocol included the acquisition of T2-weighted imaging in axial, coronal and sagittal planes, T1-weighted, FLAIR, and DWI images in the axial plane. Patients who showed any apparent lesion on MRI were excluded from the study. T2-weighted images in three orthogonal planes were used to localize the voxel in left frontal lobe white matter (FWM) and left basal ganglia (BG) for single voxel MRS. Single voxel MRS spectra were acquired with a point resolved spectroscopy (PRESS) localization pulse sequence at an echo time (TE) of 35 ms and a repetition time (TR) of 2000 ms with 64 or 128 scans. Automated preprocessing and determination of absolute concentrations of metabolites were estimated using LCModel by water scaling method and the Cramer-Rao lower bounds for all metabolites analyzed in the study were below 15\%. Levels of total N-acetyl aspartate (tNAA), total choline (tCho), glutamate + glutamine (Glx), total creatine (tCr), were measured. Cognition was tested using a battery of tests validated for Indian population. The cognitive domains tested were the memory, attention-information processing, abstraction-executive, simple and complex perceptual motor skills. Z-scores normalized according to age, sex and education standard were used to calculate dysfunction in these individual domains. The NCD was defined as dysfunction with Z-score ≤ 2 in at least two domains. One-way ANOVA was used to compare the difference in brain metabolites between the patients and healthy subjects. Results: NCD was found in 23 (53%) patients. There was no significant difference in age, CD4 count and viral load between the two groups. Maximum impairment was found in the domains of memory and simple motor skills i.e., 19/43 (44%). The prevalence of deficit in attention-information processing, complex perceptual motor skills and abstraction-executive function was 37%, 35%, 33% respectively. Subjects with NCD had a higher level of Glutamate in the Frontal region (8.03 ± 2.30 v/s. 10.26 ± 5.24, p-value 0.001). Conclusion: Among newly diagnosed, ART-naïve retroviral disease patients from India, cognitive decline was found in 53\% patients using tests validated for this population. Those with neurocognitive decline had a significantly higher level of Glutamate in the left frontal region. There was no significant difference in age, CD4 count and viral load at initiation of ART between the two groups.

Keywords: HIV, neurocognitive decline, neurometabolites, magnetic resonance spectroscopy

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264 Strengthening Adult Literacy Programs in Order to End Female Genital Mutilation to Achieve Sustainable Development Goals

Authors: Odenigbo Veronica Ngozi, Lorreta Chika Ukwuaba

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This study focuses on how the strengthening adult literacy program can help accelerate transformative strategies to end female genital mutilation (FGM) in Nigeria, specifically in Nsukka Local Government Area. The research delves into the definition of FGM, adult literacy programs, and how to achieve ending FGM to attain Sustainable Development Goals (SDGs) in 2030. It further discusses the practice of FGM in Nigeria and emphasizes the statement of the problem. The main aim of the study is to investigate how strengthening adult literacy programs can help accelerate transformative strategies to end FGM in Nigeria and achieve SDGs in 2030. The researchers utilized a survey research design to conduct the study in Nsukka L.G.A. The population was composed of 26 facilitators and adult learners in five adult learning centers in the area. The entire population was used as a sample, and structured questionnaires were employed to elicit information. The items on the questionnaire were face-validated by three experts, and the reliability of the instrument was verified using Cronbach Alpha Reliability Technique. The research questions were analyzed using means and standard deviation while the hypothesis was tested at 0.05 level of degree of significance using a t-test. The findings show that through adult literacy program acceleration of transformative strategies, the practices of FGM can be ended. Strengthening adult literacy programs is a good channel to end or stop FGM through the knowledge and skill acquired from the learning centers. The theoretical importance of the study lies in the fact that it highlights the role of adult literacy programs in accelerating transformative strategies to combat harmful cultural practices such as FGM. It further supports the importance of education and knowledge in achieving sustainable development goals by 2030. Structured questionnaires were distributed to an entire population of 26 facilitators and adult learners in five adult learning centers in Nsukka L.G.A. The questionnaire items were face–validated by three experts, and the reliability of the instrument was verified using Cronbach Alpha Reliability Technique. The research questions were analyzed using means and standard deviation, while the hypothesis was tested using a t-test at 0.05 level of degree of significance. The study addressed the question of how strengthening adult literacy programs can help accelerate transformative strategies to end FGM in Nigeria and achieve SDGs by 2030. In conclusion, the study found that adult literacy is a good tool to end FGM in Nigeria. The recommendations were that government, non-governmental organizations (NGOs), Community-based organizations (CBOs), and individuals should support the funding and establishment of adult literacy centers in communities so as to reach every illiterate parent or individual and acquire the knowledge and skill needed to understand the negative effect of FGM in the life of a girl child.

Keywords: adult literacy, female genital mutilation, learning centers, SDGs, strengthening

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263 Aquaporin-1 as a Differential Marker in Toxicant-Induced Lung Injury

Authors: Ekta Yadav, Sukanta Bhattacharya, Brijesh Yadav, Ariel Hus, Jagjit Yadav

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Background and Significance: Respiratory exposure to toxicants (chemicals or particulates) causes disruption of lung homeostasis leading to lung toxicity/injury manifested as pulmonary inflammation, edema, and/or other effects depending on the type and extent of exposure. This emphasizes the need for investigating toxicant type-specific mechanisms to understand therapeutic targets. Aquaporins, aka water channels, are known to play a role in lung homeostasis. Particularly, the two major lung aquaporins AQP5 and AQP1 expressed in alveolar epithelial and vasculature endothelia respectively allow for movement of the fluid between the alveolar air space and the associated vasculature. In view of this, the current study is focused on understanding the regulation of lung aquaporins and other targets during inhalation exposure to toxic chemicals (Cigarette smoke chemicals) versus toxic particles (Carbon nanoparticles) or co-exposures to understand their relevance as markers of injury and intervention. Methodologies: C57BL/6 mice (5-7 weeks old) were used in this study following an approved protocol by the University of Cincinnati Institutional Animal Care and Use Committee (IACUC). The mice were exposed via oropharyngeal aspiration to multiwall carbon nanotube (MWCNT) particles suspension once (33 ugs/mouse) followed by housing for four weeks or to Cigarette smoke Extract (CSE) using a daily dose of 30µl/mouse for four weeks, or to co-exposure using the combined regime. Control groups received vehicles following the same dosing schedule. Lung toxicity/injury was assessed in terms of homeostasis changes in the lung tissue and lumen. Exposed lungs were analyzed for transcriptional expression of specific targets (AQPs, surfactant protein A, Mucin 5b) in relation to tissue homeostasis. Total RNA from lungs extracted using TRIreagent kit was analyzed using qRT-PCR based on gene-specific primers. Total protein in bronchoalveolar lavage (BAL) fluid was determined by the DC protein estimation kit (BioRad). GraphPad Prism 5.0 (La Jolla, CA, USA) was used for all analyses. Major findings: CNT exposure alone or as co-exposure with CSE increased the total protein content in the BAL fluid (lung lumen rinse), implying compromised membrane integrity and cellular infiltration in the lung alveoli. In contrast, CSE showed no significant effect. AQP1, required for water transport across membranes of endothelial cells in lungs, was significantly upregulated in CNT exposure but downregulated in CSE exposure and showed an intermediate level of expression for the co-exposure group. Both CNT and CSE exposures had significant downregulating effects on Muc5b, and SP-A expression and the co-exposure showed either no significant effect (Muc5b) or significant downregulating effect (SP-A), suggesting an increased propensity for infection in the exposed lungs. Conclusions: The current study based on the lung toxicity mouse model showed that both toxicant types, particles (CNT) versus chemicals (CSE), cause similar downregulation of lung innate defense targets (SP-A, Muc5b) and mostly a summative effect when presented as co-exposure. However, the two toxicant types show differential induction of aquaporin-1 coinciding with the corresponding differential damage to alveolar integrity (vascular permeability). Interestingly, this implies the potential of AQP1 as a differential marker of toxicant type-specific lung injury.

Keywords: aquaporin, gene expression, lung injury, toxicant exposure

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262 Menstruating Bodies and Social Control – Insights From Dignity Without Danger: Collaboratively Analysing Menstrual Stigma and Taboos in Nepal

Authors: Sara Parker, Kay Standing

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This paper will share insights into how menstruators bodies in Nepal are viewed and controlled in Nepal due to the deeply held stigmas and taboos that exist that frame menstrual blood as impure and polluting. It draws on a British Academy Global Challenges Research (BA/GCRF) funded project, ‘Dignity Without Danger,’ that ran from December 2019 to 2022. In Nepal, beliefs and myths around menstrual related practices prevail and vary in accordance to time, generation, caste and class. Physical seclusion and/or restrictions include the consumption of certain foods, the ability to touch certain people and objects, and restricted access to water sources. These restrictions not only put women at risk of poor health outcomes, but they also promote discrimination and challenge fundamental human rights. Despite the pandemic, a wealth of field research and creative outputs have been generated to help break the silence that surrounds menstruation and also highlights the complexity of addressing the harms associated with the exclusion from sacred and profane spaces that menstruators face. Working with locally recruited female research assistants, NGOS and brining together academics from the UK and Nepal, we explore the intersecting factors that impact on menstrual experiences and how they vary throughout Nepal. WE concur with Tamang that there is no such thing as a ‘Nepali Woman’, and there is no one narrative that captures the experiences of menstruators in Nepal. These deeply held beliefs and practices mean that menstruators are denied their right to a dignified menstruation. By being excluded from public and private spaces, such as temples and religious sites, as well as from kitchens and your own bedroom in your own home, these beliefs impact on individuals in complex and interesting ways. Existing research in Nepal by academics and activists demonstrates current programmes and initiatives do not fully address the misconceptions that underpin the exclusionary practices impacting on sexual and reproductive health, a sense of well being and highlight more work is needed in this area. Research has been conducted in all 7 provinces and through exploring and connecting disparate stories, artefacts and narratives, we will deepen understanding of the complexity of menstrual practices enabling local stakeholders to challenge exclusionary practices. By using creative methods to engage with stakeholders and share our research findings as well as highlighting the wealth of activism in Nepal. We highlight the importance of working with local communities, leaders and cutting across disciplines and agencies to promote menstrual justice and dignity. Our research findings and creative outputs that we share on social media channels such as Dignity Without Danger Facebook, Instagram and you tube stress the value of employing a collaborative action research approach to generate material which helps local people take control of their own narrative and change social relations that lead to harmful practices.

Keywords: menstruation, Nepal, stigma, social norms

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