Search results for: increased densities
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8782

Search results for: increased densities

2842 Using Problem-Based Learning on Teaching Early Intervention for College Students

Authors: Chen-Ya Juan

Abstract:

In recent years, the increasing number of children with special needs has brought a lot of attention by many scholars and experts in education, which enforced the preschool teachers face the harsh challenge in the classroom. To protect the right of equal education for all children, enhance the quality of children learning, and take care of the needs of children with special needs, the special education paraprofessional becomes one of the future employment trends for students of the department of the early childhood care and education. Problem-based learning is a problem-oriented instruction, which is different from traditional instruction. The instructor first designed an ambiguous problem direction, following the basic knowledge of early intervention, students had to find clues to solve the problem defined by themselves. In the class, the total instruction included 20 hours, two hours per week. The primary purpose of this paper is to investigate the relationship of student academic scores, self-awareness, learning motivation, learning attitudes, and early intervention knowledge. A total of 105 college students participated in this study and 97 questionnaires were effective. The effective response rate was 90%. The student participants included 95 females and two males. The average age of the participants was 19 years old. The questionnaires included 125 questions divided into four major dimensions: (1) Self-awareness, (2) learning motivation, (3) learning attitudes, and (4) early intervention knowledge. The results indicated (1) the scores of self-awareness were 58%; the scores of the learning motivations was 64.9%; the scores of the learning attitudes was 55.3%. (2) After the instruction, the early intervention knowledge has been increased to 64.2% from 38.4%. (3) Student’s academic performance has positive relationship with self-awareness (p < 0.05; R = 0.506), learning motivation (p < 0.05; R = 0.487), learning attitudes (p < 0.05; R = 0.527). The results implied that although students had gained early intervention knowledge by using PBL instruction, students had medium scores on self-awareness and learning attitudes, medium high in learning motivations.

Keywords: college students, children with special needs, problem-based learning, learning motivation

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2841 Use of the Budyko Framework to Estimate the Virtual Water Content in Shijiazhuang Plain, North China

Authors: Enze Zhang

Abstract:

One of the most challenging steps in implementing virtual water content (VWC) analysis of crops is to get properly the total volume of consumptive water use (CWU) and, therefore, the choice of a reliable crop CWU estimation method. In practice, lots of previous researches obtaining CWU of crops follow a classical procedure for calculating crop evapotranspiration which is determined by multiplying reference evapotranspiration by appropriate coefficient, such as crop coefficient and water stress coefficients. However, this manner of calculation requires lots of field experimental data at point scale and more seriously, when current growing conditions differ from the standard conditions, may easily produce deviation between the calculated CWU and the actual CWU. Since evapotranspiration caused by crop planting always plays a vital role in surface water-energy balance in an agricultural region, this study decided to alternatively estimates crop evapotranspiration by Budyko framework. After brief introduce the development process of Budyko framework. We choose a modified Budyko framework under unsteady-state to better evaluated the actual CWU and apply it in an agricultural irrigation area in North China Plain which rely on underground water for irrigation. With the agricultural statistic data, this calculated CWU was further converted into VWC and its subdivision of crops at the annual scale. Results show that all the average values of VWC, VWC_blue and VWC_green show a downward trend with increased agricultural production and improved acreage. By comparison with the previous research, VWC calculated by Budyko framework agree well with part of the previous research and for some other research the value is greater. Our research also suggests that this methodology and findings may be reliable and convenient for investigation of virtual water throughout various agriculture regions of the world.

Keywords: virtual water content, Budyko framework, consumptive water use, crop evapotranspiration

Procedia PDF Downloads 332
2840 Vocational Rehabilitation for People with Disabilities: Employment Rates, Job Persistence and Wages

Authors: Hester Fass, Ofir Pinto

Abstract:

Research indicates gaps in education, employment rates and wages between people with disabilities and those without disabilities. One of the main tools available to reduce these gaps is vocational rehabilitation. In order to examine the effects of vocational rehabilitation, a follow-up study, based on comprehensive administrative data, was conducted. The study included 88,286 people with disabilities who participated in vocational rehabilitation of the National Insurance Institute of Israel (NII), and completed the process between 1999 and 2012. Research variables included: employment rates, job persistence and wage levels. This research, the first of its kind in Israel, has several unique aspects: a)a long-range follow-up study on people who completed vocational rehabilitation; b) examination of a broad population spectrum, including also people that are not eligible to disability pensions ; c) a comparison among those with work-related injuries, those injured in hostile acts and those injured in other circumstances; and finally d) the identification of the characteristics of those who are entitled to vocational rehabilitation but who do not participate in any vocational rehabilitation plan. The most notable results include: 1. Vocational rehabilitation contributed to employment, job persistence and wage levels. Participation in vocational rehabilitation resulted in an employment rate of 65% within two years after completing the program, and 73% eventually. Participation in a vocational rehabilitation plan also contributed to job persistence and wage levels. 2. Vocational rehabilitation plans aimed at integration in universal frameworks increased the chances of being employed, persisting at the job and receiving a higher wage than did the vocational rehabilitation aimed at selective frameworks (such as sheltered workshops). 3. The type of disability affected the chances of integration in a vocational rehabilitation plan and in the labor market. People with a disability from birth had greater chances of integration in a vocational rehabilitation plan, while the type of disability and its severity affected the chances of the person with disabilities to find employment.

Keywords: vocational rehabilitation, employment, job persistence, wages

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2839 Planning for Enviromental and Social Sustainability in Coastal Areas: A Case of Alappad

Authors: K. Vrinda

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Coastal ecosystems across the world are facing a lot of challenges due to natural phenomena as well as from uncontrolled human interventions. Here, Alappad, a coastal island situated in Kerala, India is undergoing significant damage and is gradually losing its environmental and social sustainability. The area is blessed with very rare and precious black mineral sand deposits. Sand mining for these minerals started in 1911 and is still continuing. But, unfortunately all the problems that Alappad faces now, have its root on mining of this mineral sand. The land area is continuously diminishing due to sea erosion. The mining has also caused displacement of people and environmental degradation. Marine life also is getting affected by mining on beach and pollution. The inhabitants are fishermen who are largely dependent on the eco-system for a living. So loss of environmental sustainability subsequently affects social sustainability too. Now the damage has reached a point beyond which our actions may not be able to make any impact. This was one of the most affected areas of the 2004 tsunami and the environmental degradation has further increased the vulnerability. So this study focuses on understanding the concerns related to the resource utilization, environment and the indigenous community staying there, and on formulating suitable strategies to restore the sustainability of the area. An extensive study was conducted on site, to find out the physical, social, and economical characteristics of the area. A focus group discussion with the inhabitants shed light on different issues they face in their day-to-day life. The analysis of all these data, led to the formation of a new development vision for the area which focuses on environmental restoration and socio-economic development while allowing controlled exploitation of resources. A participatory approach is formulated which enables these three aspects through community based programs.

Keywords: Community development, Disaster resilience, Ecological restoration, Environmental sustainability, Social-environmental planning, Social Sustainability

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2838 Necessary Condition to Utilize Adaptive Control in Wind Turbine Systems to Improve Power System Stability

Authors: Javad Taherahmadi, Mohammad Jafarian, Mohammad Naser Asefi

Abstract:

The global capacity of wind power has dramatically increased in recent years. Therefore, improving the technology of wind turbines to take different advantages of this enormous potential in the power grid, could be interesting subject for scientists. The doubly-fed induction generator (DFIG) wind turbine is a popular system due to its many advantages such as the improved power quality, high energy efficiency and controllability, etc. With an increase in wind power penetration in the network and with regard to the flexible control of wind turbines, the use of wind turbine systems to improve the dynamic stability of power systems has been of significance importance for researchers. Subsynchronous oscillations are one of the important issues in the stability of power systems. Damping subsynchronous oscillations by using wind turbines has been studied in various research efforts, mainly by adding an auxiliary control loop to the control structure of the wind turbine. In most of the studies, this control loop is composed of linear blocks. In this paper, simple adaptive control is used for this purpose. In order to use an adaptive controller, the convergence of the controller should be verified. Since adaptive control parameters tend to optimum values in order to obtain optimum control performance, using this controller will help the wind turbines to have positive contribution in damping the network subsynchronous oscillations at different wind speeds and system operating points. In this paper, the application of simple adaptive control in DFIG wind turbine systems to improve the dynamic stability of power systems is studied and the essential condition for using this controller is considered. It is also shown that this controller has an insignificant effect on the dynamic stability of the wind turbine, itself.

Keywords: almost strictly positive real (ASPR), doubly-fed induction generator (DIFG), simple adaptive control (SAC), subsynchronous oscillations, wind turbine

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2837 Brain Stem Posterior Reversible Encephalopathy Syndrome in Nephrotic Syndrome

Authors: S. H. Jang

Abstract:

Posterior reversible encephalopathy syndrome (PRES) is characterized by acute neurologic symptoms (visual loss, headache, altered mentality and seizures) and by typical imaging findings (bilateral subcortical and cortical edema with predominatly posterior distribution). Nephrotic syndrome is a syndrome comprising signs of proteinuria, hypoalbuminemia, and edema. It is well known that hypertension predispose patient with nephrotic syndrome to PRES. A 45-year old male was referred for suddenly developed vertigo, disequilibrium. He had previous history of nephrotic syndrome. His medical history included diabetes controlled with medication. He was hospitalized because of generalized edema a few days ago. His vital signs were stable. On neurologic examination, his mental state was alert. Horizontal nystagmus to right side on return to primary position was observed. He showed good grade motor weakness and ataxia in right upper and lower limbs without other sensory abnormality. Brain MRI showed increased signal intensity in FLAIR image, decreased signal intensity in T1 image and focal enhanced lesion in T1 contrast image at whole midbrain, pons and cerebellar peduncle symmetrically, which was compatible with vasogenic edema. Laboratory findings showed severe proteinuria and hypoalbuminemia. He was given intravenous dexamethasone and diuretics to reduce vasogenic edema and raise the intra-vascular osmotic pressure. Nystagmus, motor weakness and limb ataxia improved gradually over 2 weeks; He recovered without any neurologic symptom and sign. Follow-up MRI showed decreased vasogenic edema fairly. We report a case of brain stem PRES in normotensive, nephrotic syndrome patient.

Keywords: posterior reversible encephalopathy syndrome, MRI, nephrotic syndrome, vasogenic brain edema

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2836 The Impact of E-Commerce on the Physical Space of Traditional Retail System

Authors: Sumayya S.

Abstract:

Making cities adaptive and inclusive is one among the inherent goal and challenge for contemporary cities. This is a serious concern when the urban transformations occur in varying magnitude due to visible and invisible factors. One type of visibly invisible factor is ecommerce and its expanding operation that is understood to cause changes to the conventional spatial structure positively and negatively. With the continued growth in e-commerce activities and its future potential, market analysts, media, and even retailers have questioned the importance of a future presence of traditional Brick-and-mortar stores in cities as a critical element, with some even referring to the repeated announcement of the closure of some store chains as the end of the online shopping era. Essentially this raises the question of how adaptive and inclusive the cities are to the dynamics of transformative changes that are often unseen. People have become more comfortable with seating inside and door delivery systems, and this increased change in usage of public spaces, especially the commercial corridors. Through this research helped in presetting a new approach for planning and designing commercial activities centers and also presents the impact of ecommerce on the urban fabric, such as division and fragmentation of space, showroom syndrome, reconceptualization of space, etc., in a critical way. The changes are understood by analyzing the e-commerce logistic process. Based on the inferences reach at the conclusion for the need of an integrated approach in the field of planning and designing of public spaces for the sustainable omnichannel retailing. This study was carried out with the following objectives Monitoring the impact of e commerce on the traditional shopping space. Explore the new challenges and opportunities faced by the urban form. Explore how adaptive and inclusive our cities are to the dynamics of transformative changes caused by ecommerce.

Keywords: E-commerce, shopping streets, online environment, offline environment, shopping factors

Procedia PDF Downloads 88
2835 Study Properties of Bamboo Composite after Treatment Surface by Chemical Method

Authors: Kiatnarong Supapanmanee, Ekkarin Phongphinittana, Pongsak Nimdum

Abstract:

Natural fibers are readily available raw materials that are widely used as composite materials. The most common problem facing many researchers with composites made from this fiber is the adhesion between the natural fiber contact surface and the matrix material. Part of the problem is due to the hydrophilic properties of natural fibers and the hydrophobic properties of the matrix material. Based on the aforementioned problems, this research selected bamboo fiber, which is a strong natural fiber in the research study. The first step was to study the effect of the mechanical properties of the pure bamboo strip by testing the tensile strength of different measurement lengths. The bamboo strip was modified surface with sodium hydroxide (NaOH) at 6wt% concentrations for different soaking periods. After surface modification, the physical and mechanical properties of the pure bamboo strip fibers were studied. The modified and unmodified bamboo strips were molded into a composite material using epoxy as a matrix to compare the mechanical properties and adhesion between the fiber surface and the material with tensile and bending tests. In addition, the results of these tests were compared with the finite element method (FEM). The results showed that the length of the bamboo strip affects the strength of the fibers, with shorter fibers causing higher tensile stress. Effects of surface modification of bamboo strip with NaOH, this chemical eliminates lignin and hemicellulose, resulting in the smaller dimension of the bamboo strip and increased density. From the pretreatment results above, it was found that the treated bamboo strip and composite material had better Ultimate tensile stress and Young's modulus. Moreover, that results in better adhesion between bamboo fiber and matrix material.

Keywords: bamboo fiber, bamboo strip, composite material, bamboo composite, pure bamboo, surface modification, mechanical properties of bamboo, bamboo finite element method

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2834 An Experiment Research on the Effect of Brain-Break in the Classroom on Elementary School Students’ Selective Attention

Authors: Hui Liu, Xiaozan Wang, Jiarong Zhong, Ziming Shao

Abstract:

Introduction: Related research shows that students don’t concentrate on teacher’s speaking in the classroom. The d2 attention test is a time-limited test about selective attention. The d2 attention test can be used to evaluate individual selective attention. Purpose: To use the d2 attention test tool to measure the difference between the attention level of the experimental class and the control class before and after Brain-Break and to explore the effect of Brain-Break in the classroom on students' selective attention. Methods: According to the principle of no difference in pre-test data, two classes in the fourth- grade of Shenzhen Longhua Central Primary School were selected. After 20 minutes of class in the third class in the morning and the third class in the afternoon, about 3-minute Brain-Break intervention was performed in the experimental class for 10 weeks. The normal class in the control class did not intervene. Before and after the experiment, the d2 attention test tool was used to test the attention level of the two-class students. The paired sample t-test and independent sample t-test in SPSS 23.0 was used to test the change in the attention level of the two-class classes around 10 weeks. This article only presents results with significant differences. Results: The independent sample t-test results showed that after ten-week of Brain-Break, the missed errors (E1 t = -2.165 p = 0.042), concentration performance (CP t = 1.866 p = 0.05), and the degree of omissions (Epercent t = -2.375 p = 0.029) in experimental class showed significant differences compared with control class. The students’ error level decreased and the concentration increased. Conclusions: Adding Brain-Break interventions in the classroom can effectively improve the attention level of fourth-grade primary school students to a certain extent, especially can improve the concentration of attention and decrease the error rate in the tasks. The new sport's learning model is worth promoting

Keywords: cultural class, micromotor, attention, D2 test

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2833 Change Management as a Critical Success Factor In E-Government initiatives

Authors: Mohammed Alassim

Abstract:

In 2014, a UN survey stated that: "The greatest challenge to the adoption of whole-of government, which fundamentally rests on increased collaboration, is resistance to change among government actors". Change management has experienced both theoretically and practically many transformation over the years. When organizations have to implement radical changes, they have to encounter a plethora of issues which leads to ineffective or inefficient implementation of change in most cases. 70% of change projects fail because of human issues. It has been cited that” most studies still show a 60-70% failure rate for organizational change projects — a statistic that has stayed constant from the 1970’s to the present.”. E-government involves not just technical change but cultural, policy, social and organizational evolution. Managing change and overcoming resistance to change is seen as crucial in the success of E-government projects. Resistance can be from different levels in the organization (top management, middle management or employees at operational levels). There can be many reasons for resistance including fear of change and insecurity, lack of knowledge and absence of commitment from management to implement the change. The purpose of this study is to conduct in-depth research to understand the process of change and to identify the critical factors that have led to resistance from employees at different levels (top management, Middle management and operational employees) during e-government initiatives in the public sector in Saudi Arabia. The study is based on qualitative and empirical research methods conducted in the public sector in the Kingdom of Saudi Arabia. This research will use triangulation in data method (interview, group discussion and document review). This research will contribute significantly to knowledge in this field and will identify the measures that can be taken to reduce resistance to change, Upon analysis recommendations or model will be offered which can enable decision makers in public sector in Saudi Arabia how to plan, implement and evaluate change in e-government initiatives via change management strategy.

Keywords: change management, e-government, managing change, resistance to change

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2832 Impact of Heat Moisture Treatment on the Yield of Resistant Starch and Evaluation of Functional Properties of Modified Mung Bean (Vigna radiate) Starch

Authors: Sreejani Barua, P. P. Srivastav

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Formulation of new functional food products for diabetes patients and obsessed people is a challenge for food industries till date. Starch is a certainly happening, ecological, reasonable and profusely obtainable polysaccharide in plant material. In the present scenario, there is a great interest in modifying starch functional properties without destroying its granular structure using different modification techniques. Resistant starch (RS) contains almost zero calories and can control blood glucose level to prevent diabetes. The current study focused on modification of mung bean starch which is a good source of legumes carbohydrate for the production of functional food. Heat moisture treatment (HMT) of mung starch was conducted at moisture content of 10-30%, temperature of 80-120 °C and time of 8-24 h.The content of resistant starch after modification was significantly increased from native starches containing RS 7.6%. The design combinations of HMT had been completed through Central Composite Rotatable Design (CCRD). The effects of HMT process variables on the yield of resistant starch was studied through Rapid Surface Methodology (RSM). The highest increase of resistant starch was found up to 34.39% when treated the native starch with 30% m.c at 120 °C temperature for 24 h.The functional properties of both native and modified mung bean starches showed that there was a reduction in the swelling power and swelling volume of HMT starches. However, the solubility of the HMT starches was higher than that of untreated native starch and also observed change in structural (scanning electron microscopy), X-Ray diffraction (XRD) pattern, blue value and thermal (differential scanning calorimetry) properties. Therefore, replacing native mung bean starch with heat-moisture treated mung bean starch leads to the development of new products with higher resistant starch levels and functional properties.

Keywords: Mung bean starch, heat moisture treatment, functional properties, resistant starch

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2831 Factors Associated with Acute Kidney Injury in Multiple Trauma Patients with Rhabdomyolysis

Authors: Yong Hwang, Kang Yeol Suh, Yundeok Jang, Tae Hoon Kim

Abstract:

Introduction: Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. Acute kidney injury is a potential complication of severe rhabdomyolysis and the prognosis is substantially worse if renal failure develops. We try to identify the factors that were predictive of AKI in severe trauma patients with rhabdomyolysis. Methods: This retrospective study was conducted at the emergency department of a level Ⅰ trauma center. Patients enrolled that initial creatine phosphokinase (CPK) levels were higher than 1000 IU with acute multiple trauma, and more than 18 years older from Oct. 2012 to June 2016. We collected demographic data (age, gender, length of hospital day, and patients’ outcome), laboratory data (ABGA, lactate, hemoglobin. hematocrit, platelet, LDH, myoglobin, liver enzyme, and BUN/Cr), and clinical data (Injury Mechanism, RTS, ISS, AIS, and TRISS). The data were compared and analyzed between AKI and Non-AKI group. Statistical analyses were performed using IMB SPSS 20.0 statistics for Window. Results: Three hundred sixty-four patients were enrolled that AKI group were ninety-six and non-AKI group were two hundred sixty-eight. The base excess (HCO3), AST/ALT, LDH, and myoglobin in AKI group were significantly higher than non-AKI group from laboratory data (p ≤ 0.05). The injury severity score (ISS), revised Trauma Score (RTS), Abbreviated Injury Scale 3 and 4 (AIS 3 and 4) were showed significant results in clinical data. The patterns of CPK level were increased from first and second day, but slightly decreased from third day in both group. Seven patients had received hemodialysis treatment despite the bleeding risk and were survived in AKI group. Conclusion: We recommend that HCO3, CPK, LDH, and myoglobin should be checked and be concerned about ISS, RTS, AIS with injury mechanism at the early stage of treatment in the emergency department.

Keywords: acute kidney injury, emergencies, multiple trauma, rhabdomyolysis

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2830 Curcumin Reduces the Expression of Main Fibrogenic Genes and Phosphorylation of Smad3C Signaling Pathway in TGFB-Activated Human HSCs. A New Remedy for Liver Fibrosis

Authors: Elham Shakerian, Reza Afarin

Abstract:

The hepatic disease causes approximately 2 million deaths/year worldwide. Liver fibrosis is the last stage of numerous chronic liver diseases, and until now there is no definite cure or drug for it. Activation of hepatic stellate cells (HSCs) is the main reason for fibrosis. Transforming growth factor (TGF-β), as a main profibrogenic cytokine, if increased in these cells, leads to liver fibrosis through smad3 signaling pathways and increasing the expressions of Collagen type I and III, and actin-alpha smooth muscle (αSMA) genes. Curcumin (CUR) is a polyphenolic compound and an active ingredient derived from the rhizome of the turmeric plant that exerts effective antioxidant, anti-inflammatory, and antimicrobial activity. It has been shown that daily consumption of curcumin may have a protective effect on the liver against oxidative stress associated with alcohol consumption. In this study, we investigate the role of Curcumin in decreasing HSC activation and treating liver fibrosis. First, the human HSCs were treated with 2 ng/ml of (TGF-β) for 24 hours to become activated, then with Silibinin for 24 hours. Total RNAs were extracted, reversely transcribed into cDNA, Quantitative Real-time PCR, and western blot were performed. The mRNA expression levels of Collagen type I and III, αSMA genes, and the level of smad3 phosphorylation in TGF-β activated human HSCs treated with Curcumin were significantly reduced compared to human HSCs untreated with Curcumin. Curcumin is effective in reducing the expression of fibrogenic genes in the activated human HSCs treated with TGFB through downregulation of the TGF-β/smad3 signaling pathway. Therefore, Curcumin possesses significant antifibrotic properties in hepatic fibrosis

Keywords: hepatic fibrosis, human HSCs, curcumin, fibrogenic genes

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2829 Effect of Temperature on Investigation of Index Properties of Red Clay Soil

Authors: Birhanu Kassa

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The knowledge of temperature effect on index properties and, thus, the understanding of its behavior may be essential for a complete understanding of the various cases of Geotechnical Engineering problems and for conducting meaningful practical research, analysis, and design in tropical regions, such as the Ethiopian environment. The scarcity of the proper geotechnical information on the subsoil makes foundation and engineering works risk able, difficult, and sometimes hazardous. Seasonal variations, environmental effects, terrain challenges, and temperature effects all affect the quality of soil. Simada is a city which is found in south Gondar and it is developing rapidly both in horizontal and vertical construction. Rapid urbanization in the city area has led to an increased interest in the basic properties of soils that are present within the city area. There has been no previous research that looks into the effect of temperature on the investigation of clay soil index qualities in Simada. This work focuses mainly on investigating the Index and some other properties of soil in Simada Town with varying temperatures. To explore the influence of temperature change, samples were collected from various regions of the city, and routine laboratory tests were performed on the collected samples at various temperatures. Disturbed samples were taken at intervals where an average depth of 1.5-2m depths below natural ground level. The standard laboratory tests performed on all twenty-four soil samples were the water content, gradation analysis, Atterberg limits, specific gravity, and compaction test. All specimens were tested at different temperatures (25°C, 35 °C, 45 °C, 65 °C,75 and 105 °C). The variation of the plasticity characteristics of the soils has been determined based on the temperature variation. From the test result, we can conclude that temperature has a significant effect on the index properties of clay soil, in our case, red clay soil.

Keywords: airdried, oven dried, soils index properties, compaction test

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2828 A 0-1 Goal Programming Approach to Optimize the Layout of Hospital Units: A Case Study in an Emergency Department in Seoul

Authors: Farhood Rismanchian, Seong Hyeon Park, Young Hoon Lee

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This paper proposes a method to optimize the layout of an emergency department (ED) based on real executions of care processes by considering several planning objectives simultaneously. Recently, demand for healthcare services has been dramatically increased. As the demand for healthcare services increases, so do the need for new healthcare buildings as well as the need for redesign and renovating existing ones. The importance of implementation of a standard set of engineering facilities planning and design techniques has been already proved in both manufacturing and service industry with many significant functional efficiencies. However, high complexity of care processes remains a major challenge to apply these methods in healthcare environments. Process mining techniques applied in this study to tackle the problem of complexity and to enhance care process analysis. Process related information such as clinical pathways extracted from the information system of an ED. A 0-1 goal programming approach is then proposed to find a single layout that simultaneously satisfies several goals. The proposed model solved by optimization software CPLEX 12. The solution reached using the proposed method has 42.2% improvement in terms of walking distance of normal patients and 47.6% improvement in walking distance of critical patients at minimum cost of relocation. It has been observed that lots of patients must unnecessarily walk long distances during their visit to the emergency department because of an inefficient design. A carefully designed layout can significantly decrease patient walking distance and related complications.

Keywords: healthcare operation management, goal programming, facility layout problem, process mining, clinical processes

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2827 Improving Digital Data Security Awareness among Teacher Candidates with Digital Storytelling Technique

Authors: Veysel Çelik, Aynur Aker, Ebru Güç

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Developments in information and communication technologies have increased both the speed of producing information and the speed of accessing new information. Accordingly, the daily lives of individuals have started to change. New concepts such as e-mail, e-government, e-school, e-signature have emerged. For this reason, prospective teachers who will be future teachers or school administrators are expected to have a high awareness of digital data security. The aim of this study is to reveal the effect of the digital storytelling technique on the data security awareness of pre-service teachers of computer and instructional technology education departments. For this purpose, participants were selected based on the principle of volunteering among third-grade students studying at the Computer and Instructional Technologies Department of the Faculty of Education at Siirt University. In the research, the pretest/posttest half experimental research model, one of the experimental research models, was used. In this framework, a 6-week lesson plan on digital data security awareness was prepared in accordance with the digital narration technique. Students in the experimental group formed groups of 3-6 people among themselves. The groups were asked to prepare short videos or animations for digital data security awareness. The completed videos were watched and evaluated together with prospective teachers during the evaluation process, which lasted approximately 2 hours. In the research, both quantitative and qualitative data collection tools were used by using the digital data security awareness scale and the semi-structured interview form consisting of open-ended questions developed by the researchers. According to the data obtained, it was seen that the digital storytelling technique was effective in creating data security awareness and creating permanent behavior changes for computer and instructional technology students.

Keywords: digital storytelling, self-regulation, digital data security, teacher candidates, self-efficacy

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2826 Aging and Falls Profile from Hospital Databases

Authors: Nino Chikhladze, Tamar Dochviri, Nato Pitskhelauri, Maia Bitskhinashvili

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Population aging is a key social and demographic trend of the 21st century. Falls represent a prevalent geriatric syndrome that poses significant risks to the health and independence of older adults. The World Health Organization notes a lack of comprehensive data on falls in low- and middle-income countries, complicating the creation of effective prevention programs. To the authors’ best knowledge, no such studies have been conducted in Georgia. The aim of the study is to explore the epidemiology of falls in the elderly population. The hospitalization database of the National Center for Disease Control and Public Health of Georgia was used for the retrospective study. Falls-related injuries were identified using ICD-10 classifications using the class XIX (S and T codes) and class XX for the type of injury (V-Y codes). Statistical data analyses were done using SPSS software version 23.0. The total number of fall-related hospitalizations for individuals aged 65 and older from 2015 to 2021 was 29,697. The study revealed that falls accounted for an average of 63% (ranging from 59% to 66%) of all hospitalizations and 68% (ranging from 65% to 70%) of injury-related hospitalizations during this period. The 69% of all patients were women and 31%-men (Chi2=4482.1, p<0.001). The highest rate of hospitalization was in the age groups 80-84 and 75-79. The probability of fall-related hospitalization was significantly higher in women (p<0.001) compared to men in all age groups except 65-69 years. In the target age group of 65 years and older, the probability of hospitalization increased significantly with an increase in age (p<0.001). The study's results can be leveraged to create evidence-based awareness programs, design targeted multi-domain interventions addressing specific risk factors, and enhance the quality of geriatric healthcare services in Georgia.

Keywords: elderly population, falls, geriatric patients, hospitalization, injuries

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2825 Effect of Concentration Level and Moisture Content on the Detection and Quantification of Nickel in Clay Agricultural Soil in Lebanon

Authors: Layan Moussa, Darine Salam, Samir Mustapha

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Heavy metal contamination in agricultural soils in Lebanon poses serious environmental and health problems. Intensive efforts are employed to improve existing quantification methods of heavy metals in contaminated environments since conventional detection techniques have shown to be time-consuming, tedious, and costly. The implication of hyperspectral remote sensing in this field is possible and promising. However, factors impacting the efficiency of hyperspectral imaging in detecting and quantifying heavy metals in agricultural soils were not thoroughly studied. This study proposes to assess the use of hyperspectral imaging for the detection of Ni in agricultural clay soil collected from the Bekaa Valley, a major agricultural area in Lebanon, under different contamination levels and soil moisture content. Soil samples were contaminated with Ni, with concentrations ranging from 150 mg/kg to 4000 mg/kg. On the other hand, soil with background contamination was subjected to increased moisture levels varying from 5 to 75%. Hyperspectral imaging was used to detect and quantify Ni contamination in the soil at different contamination levels and moisture content. IBM SPSS statistical software was used to develop models that predict the concentration of Ni and moisture content in agricultural soil. The models were constructed using linear regression algorithms. The spectral curves obtained reflected an inverse correlation between both Ni concentration and moisture content with respect to reflectance. On the other hand, the models developed resulted in high values of predicted R2 of 0.763 for Ni concentration and 0.854 for moisture content. Those predictions stated that Ni presence was well expressed near 2200 nm and that of moisture was at 1900 nm. The results from this study would allow us to define the potential of using the hyperspectral imaging (HSI) technique as a reliable and cost-effective alternative for heavy metal pollution detection in contaminated soils and soil moisture prediction.

Keywords: heavy metals, hyperspectral imaging, moisture content, soil contamination

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2824 Bone Mineral Density of the Lumbar Spine, Femur in Elite Egyptian Male Swimmers

Authors: Magdy Abouzeid

Abstract:

Introduction: Physical activity has been shown to have a positive effect on bone mineral density (BMD) and bone mineral content (BMC) among children, adolescents, and adults. Sports characterized by little or moderate weight bearing or impact have a low osteogenic effect. However, the action of such sports on bone turnover remains unclear. Swimming, as a non-weight-bearing sport, has been considered to be insignificant in the maintenance of bone mass. Purpose: To examine this issue we measured (BMD) and(BMC) of the lumbar spine, proximal femur via dual energy x-ray absorptiometry in the group of elite male swimmers, and determine the effect of swimming training on bone health and compared the results with matched controls group in age, body weight and height. Materials and Methods: Twenty-five male swimmers (age 20.7+/-0.8 years) training for 12-15 hours/week; and the controls group consisted of 25 non-active male (age 21.3 +/-1.3 years) were studied BMD and BMC of lumbar spine, femur were assessed via (DXA) absorptiometry. Results: There was significant difference between swimmers and control group in BMD and BMC, BMD of Swimmers was significantly greater than controls at all sites. The lumbar spine (1, 08 +/-0.202 vs., 0717+0.57 gxcm (-2), right proximal femur (1, 02 +/-, 044 vs., 771+/-, 027 gxcm (-2), and left proximal femur (1.374+/-0.212 vs. 1.01 +/-0.141 gxcm (-2). Swimmers were significantly taller, and had greater BMC and BMD compared to the controls group (P<0.001). Conclusions: These results suggest that swimming training may be beneficial in the prevention or therapy of OSTEOPENIA, and may lead to increased (BMD) and (BMC) for male swimmers. Swimming may be an effective non-pharmacological intervention for the adults and adolescent. Further research with younger athletes of another type of aquatics sport is warranted to better identify the periods of BMD development during which Aquatics sport has the greatest impact on bone health.

Keywords: bone mineral density, lumbar spine, femur, swimming, DXA absorptiometry

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2823 Effects of Forest Bathing on Cardiovascular and Metabolic Parameters in Middle-Aged Males

Authors: Qing Li, Maiko Kobayashi, Shigeyoshi Kumeda, Hiroko Ochiai, Toshiya Ochiai, Takashi Miura, Takahide Kagawa, Michiko Imai, Toshiaki Otsuka, Tomoyuki Kawada

Abstract:

In the present study, we investigated the effects of a forest bathing program on cardiovascular and metabolic parameters. Nineteen healthy male subjects (mean age: 51.3 ± 8.8 years) were selected after obtaining informed consent. These subjects took day trips to a forest park named Akasawa Shizen Kyuyourin, Agematsu, Nagano Prefecture (situated in central Japan), and to an urban area of Nagano Prefecture as a control in August 2015. On both trips, they walked 2.6 km for 80 min each in the morning and afternoon on Saturdays. Blood and urine were sampled in the morning before and after each trip. Cardiovascular and metabolic parameters were measured. Blood pressure and pulse rate were measured by an ambulatory automatic blood pressure monitor. The Japanese version of the profile of mood states (POMS) test was conducted before, during and after the trips. Ambient temperature and humidity were monitoring during the trips. The forest bathing program significantly reduced pulse rate, and significantly increased the score for vigor and decreased the scores for depression, fatigue, and confusion in the POMS test. The levels of urinary noradrenaline and dopamine after forest bathing were significantly lower than those after urban area walking, suggesting the relaxing effect of the forest bathing program. The level of adiponectin in serum after the forest bathing program was significantly greater than that after urban area walking. There was no significant difference in blood pressure between forest and urban area trips during the trips.

Keywords: ambient temperature, blood pressure, forest bathing, forest therapy, human health, POMS, pulse rate

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2822 Breeding Cotton for Annual Growth Habit: Remobilizing End-of-season Perennial Reserves for Increased Yield

Authors: Salman Naveed, Nitant Gandhi, Grant Billings, Zachary Jones, B. Todd Campbell, Michael Jones, Sachin Rustgi

Abstract:

Cotton (Gossypium spp.) is the primary source of natural fiber in the U.S. and a major crop in the Southeastern U.S. Despite constant efforts to increase the cotton fiber yield, the yield gain has stagnated. Therefore, we undertook a novel approach to improve the cotton fiber yield by altering its growth habit from perennial to annual. In this effort, we identified genotypes with high-expression alleles of five floral induction and meristem identity genes (FT, SOC1, FUL, LFY, and AP1) from an upland cotton mini-core collection and crossed them in various combinations to develop cotton lines with annual growth habit, optimal flowering time and enhanced productivity. To facilitate the characterization of genotypes with the desired combinations of stacked alleles, we identified markers associated with the gene expression traits via genome-wide association analysis using a 63K SNP Array (Hulse-Kemp et al. 2015 G3 5:1187). Over 14,500 SNPs showed polymorphism and were used for association analysis. A total of 396 markers showed association with expression traits. Out of these 396 markers, 159 mapped to genes, 50 to untranslated regions, and 187 to random genomic regions. Biased genomic distribution of associated markers was observed where more trait-associated markers mapped to the cotton D sub-genome. Many quantitative trait loci coincided at specific genomic regions. This observation has implications as these traits could be bred together. The analysis also allowed the identification of candidate regulators of the expression patterns of these floral induction and meristem identity genes whose functions will be validated via virus-induced gene silencing.

Keywords: cotton, GWAS, QTL, expression traits

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2821 Interorganizational Relationships in the Brazilian Milk Production Chain

Authors: Marcelo T. Okano, Oduvaldo Vendrametto, Osmildo S. Santos, Marcelo E. Fernandes, Heide Landi

Abstract:

The literature on the interorganizational relationship between companies and organizations has increased in recent years, but there are still doubts about the various settings. The interorganizational networks are important in economic life, the fact facilitate the complex interdependence between transactional and cooperative organizations. A need identified in the literature is the lack of indicators to measure and identify the types of existing networks. The objective of this research is to examine the interorganizational relationships of two milk chains through indicators proposed by the theories of the four authors, characterizing them as network or not and what the benefits obtained by the chain organization. To achieve the objective of this work was carried out a survey of milk producers in two regions of the state of São Paulo. To collect the information needed for the analysis, exploratory research, qualitative nature was used. The research instrument of this work consists of a roadmap of semistructured interviews with open questions. Some of the answers were directed by the interviewer in the form of performance notes aimed at detecting the degree of importance, according to the perception of intensity to that regard. The results showed that interorganizational relationships are small and largely limited to the sale of milk or dairy cooperatives. These relationships relate only to trade relations between the owner and purchaser of milk. But when the producers are organized in associations or networks, interorganizational relationships and increase benefits for all participants in the network. The various visits and interviews in several dairy farms in the regions of São Pau-lo (indicated that the inter-relationships are small and largely limited to the sale of milk to cooperatives or dairy. These relationships refer only to trade relations between the owner and the purchaser of milk. But when the producers are organized in associations or networks, interorganizational relationships increase and bring benefits to all participants in the network.

Keywords: interorganizational networks, dairy chain, interorganizational system, São Pau-lo

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2820 Narrative Therapy as a Way of Terrorist Rehabilitation at Mohammad Bin Naif Counselling and Care Center: A Case Study

Authors: Yasser Almazrua

Abstract:

Terrorism is a multidimensional phenomenon that has increased recently. Many countries started combating terrorism through security forces; however, there has been relatively little attention given to rehabilitation programs for people involved in such terrorism acts. In Saudi Arabia, after facing so many terrorist attacks, they started understanding and countering terrorism differently by establishing Mohammad bin Naif Counselling and Care Center in 2006. The center now is considered one of the top experience centers in the world for terrorist rehabilitation and ideology correction. The center offers different programs such as training, educational, social, art and psychological programs. One of the approaches that have been used by psychological experts at the center is Narrative Therapy. It is a therapeutic approach that focuses on the ability of the client to identify their personal life story. The client during therapy works as a storyteller where he or she gets insight, meaning and better understanding of their own lives. Because each client at the center had a story, it can be better fit method for rehabilitation towards healing and personal development. The case describes a 34-years-old man who was involved in some terrorism activities locally by technically and financially supporting a terrorist group related to Al-Qaida. The beneficiary joined Mohammad bin Naif Counseling and Care Center after serving his sentence. Informed of consent has been given to the beneficiary before starting the therapeutic program. Both qualitative and quantitative data on the beneficiary are collected by self-reporting during the initial session, and by using a psychological measurement. The result found that the beneficiary was not insightful about himself, and he had a high level of repression which relatedly moved him to be targeted for recruitment in the terrorist group. With rehabilitation and by using the therapeutic approach, the beneficiary improved on the level of insight, specifically about himself and also about the experience. This case illustrates the importance of considering the effect of Narrative Therapy in terrorist rehabilitation programs.

Keywords: narrative therapy, rehabilitation, Saudi Arabia, terrorism

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2819 Changing Subjective Well-Being and Social Trust in China: 2010-2020

Authors: Mengdie Ruan

Abstract:

The authors investigate how subjective well-being (SWB) and social trust changed in China over the period 2010–2020 by relying on data from six rounds of the China Family Panel Studies (CFPS), then re-examine Easterlin’s hypothesis for China, with a more focus on the role of social trust and estimate income-compensating differentials for social trust. They find that the evolution of well-being is not sensitive to the measures of well-being one uses. Specifically, self-reported life satisfaction scores and hedonic happiness scores experienced a significant increase across all income groups from 2010 to 2020. Social trust seems to have increased based on CFPS in China for all socioeconomic classes in recent years, and male, urban resident individuals with higher income have a higher social trust at a given point in time and over time. However, when we use an alternative measure of social trust, out-group trust, which is a more valid measure of generalized trust and represents “most people”, social trust in China literally declines, and the level is extremely low. In addition, this paper also suggests that in the typical query on social trust, the term "most people" mostly denotes in-groups in China, which contrasts sharply with most Western countries where it predominantly connotes out-groups. Individual fixed effects analysis of well-being that controls for time-invariant variables reveals social trust and relative social status are important correlates of life satisfaction and happiness, whereas absolute income plays a limited role in boosting an individual’s well-being. The income-equivalent value for social capital is approximately tripling of income. It has been found that women, urban and coastal residents, and people with higher income, young people, those with high education care more about social trust in China, irrespective of measures on SWB. Policy aiming at preserving and enhancing SWB should focus on social capital besides economic growth.

Keywords: subjective well-being, life satisfaction, happiness, social trust, China

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2818 Mechanical and Physical Properties of Various Types of Dental Floss

Authors: Supanitayanon Lalita, Dechkunakorn Surachai, Anuwongnukroh Niwat, Srikhirin Toemsak, Roongrujimek Pitchaya, Tua-Ngam Peerapong

Abstract:

Objective: To compare maximum load, percentage of elongation, physical characteristics of 4 types of dental floss: (1) Thai Silk Floss (silk, waxed), (2) Oral B® Essential Floss (nylon, waxed), (3) Experimental Floss Xu (nylon, unwaxed), (4) Experimental Floss Xw (nylon, waxed). Materials & method: Four types of floss were tested (n=30) with a Universal Testing Machine (Instron®). Each sample (30 cm long, 5 cm segment) was fixed, and pulled apart with load cell of 100 N and a test speed of 100 mm/min. Physical characteristics were investigated by digital microscope under 2.5×10 magnification, and scanning electron microscope under 1×100 and 5×100 magnification. The size of the filaments was measured in micron (μm) and the fineness were measured in Denier. Statistical analysis: For mechanical properties, the maximum load and the percentage of elongation were presented as mean ± SD. The distribution of the data was calculated by the Kolmogorov-Smirnov test. One-way ANOVA and multiple comparison (Tukey HSD) were used to analyze the differences among the groups with the level of a statistical difference at p < 0.05. Results: The maximum load of Floss Xu, Floss Xw, Oral B and Thai Silk were 47.39, 46.46, 25.38, and 23.70 N, respectively. The percentage of elongation of Oral B, Floss Xw, Floss Xu and Thai Silk were 72.43, 44.62, 31.25, and 16.44%, respectively. All 4 types of dental floss showed statistically differences in both the maximum load and percentage of elongation at p < 0.05, except for maximum load between Floss Xw and Floss Xu that showed no statistically significant difference. Physical characteristics of Thai silk revealed the most disintegrated, the smallest, and the least fine filaments. Conclusion: Floss Xu had the highest maximum load. Oral B had the highest percentage of elongation. Wax coating on Floss X increased the elongation but had no significant effect on the maximum load. The physical characteristics of Thai Silk resulted in the lowest mechanical properties values.

Keywords: dental floss, maximum load, mechanical property, percentage of elongation, physical property

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2817 Molecular Design and Synthesis of Heterocycles Based Anticancer Agents

Authors: Amna J. Ghith, Khaled Abu Zid, Khairia Youssef, Nasser Saad

Abstract:

Backgrounds: The multikinase and vascular endothelial growth factor (VEGF) receptor inhibitors interrupt the pathway by which angiogenesis becomes established and promulgated, resulting in the inadequate nourishment of metastatic disease. VEGFR-2 has been the principal target of anti-angiogenic therapies. We disclose the new thieno pyrimidines as inhibitors of VEGFR-2 designed by a molecular modeling approach with increased synergistic activity and decreased side effects. Purpose: 2-substituted thieno pyrimidines are designed and synthesized with anticipated anticancer activity based on its in silico molecular docking study that supports the initial pharmacophoric hypothesis with a same binding mode of interaction at the ATP-binding site of VEGFR-2 (PDB 2QU5) with high docking score. Methods: A series of compounds were designed using discovery studio 4.1/CDOCKER with a rational that mimic the pharmacophoric features present in the reported active compounds that targeted VEGFR-2. An in silico ADMET study was also performed to validate the bioavailability of the newly designed compounds. Results: The Compounds to be synthesized showed interaction energy comparable to or within the range of the benzimidazole inhibitor ligand when docked with VEGFR-2. ADMET study showed comparable results most of the compounds showed absorption within (95-99) zone varying according to different substitutions attached to thieno pyrimidine ring system. Conclusions: A series of 2-subsituted thienopyrimidines are to be synthesized with anticipated anticancer activity and according to docking study structure requirement for the design of VEGFR-2 inhibitors which can act as powerful anticancer agents.

Keywords: docking, discovery studio 4.1/CDOCKER, heterocycles based anticancer agents, 2-subsituted thienopyrimidines

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2816 The Meaning and Roles of Leisure among Elderly People

Authors: Jureerat Kilsomporn, Chularat Howharn

Abstract:

The aim of this qualitative study was to describe the meaning of leisure and the role of leisure among elderly people aged more than 80. Participants were purposive selected. Inclusion criteria were age more than 80 year, has no disease, and independent for daily life activities. Data were collected by in-depth interview. Each participant was interviewed two times and 45-60 minutes in each time of interview. Content analyses were conducted to describe the findings. The findings were as followed. Ten active aging participated in this study. All of them are Buddhist with age between 83-89 years old. Most of them completed the primary school. All of them were active members of community club such as elderly club, women club, and funeral association. Active aging described leisure as activities that connected them with their communities. Leisure could be categorized into three groups which were religious activities, entertainment activities, and hobbies. Examples of religious activities were ordination, house-blessing ceremony, and wedding ceremony. Examples of entertainment activities were Thai dance, beat a drum, and sang local songs. Participants described more that they joined and did in leisure for a sake of pleasure. These leisure played significant roles; significantly affect were their minds and their spiritual. Religious activities play a significant role in spiritual well-being while entertainment activities play a significant role in maintaining good status of mental health. Effect of hobby activities which most of these were payable activities were increased their self-valued. Although it was not high incomes but they can use their own money as they designed. Moreover, participants describe that they have a feeling of use their time wisely since they can earn the money, they can have an exercise, and they can share the time with their neighborhood with these activities. Suggestions from this study were that authorized personnel should promote leisure for aging regularly and continuously. Any facilities that meet with their need and their desired should be promoted since these can facilitate aging to maintain their good health status.

Keywords: active aging, activities, elderly, leisure

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2815 The Feasibility of Glycerol Steam Reforming in an Industrial Sized Fixed Bed Reactor Using Computational Fluid Dynamic (CFD) Simulations

Authors: Mahendra Singh, Narasimhareddy Ravuru

Abstract:

For the past decade, the production of biodiesel has significantly increased along with its by-product, glycerol. Biodiesel-derived glycerol massive entry into the glycerol market has caused its value to plummet. Newer ways to utilize the glycerol by-product must be implemented or the biodiesel industry will face serious economic problems. The biodiesel industry should consider steam reforming glycerol to produce hydrogen gas. Steam reforming is the most efficient way of producing hydrogen and there is a lot of demand for it in the petroleum and chemical industries. This study investigates the feasibility of glycerol steam reforming in an industrial sized fixed bed reactor. In this paper, using computational fluid dynamic (CFD) simulations, the extent of the transport resistances that would occur in an industrial sized reactor can be visualized. An important parameter in reactor design is the size of the catalyst particle. The size of the catalyst cannot be too large where transport resistances are too high, but also not too small where an extraordinary amount of pressure drop occurs. The goal of this paper is to find the best catalyst size under various flow rates that will result in the highest conversion. Computational fluid dynamics simulated the transport resistances and a pseudo-homogenous reactor model was used to evaluate the pressure drop and conversion. CFD simulations showed that glycerol steam reforming has strong internal diffusion resistances resulting in extremely low effectiveness factors. In the pseudo-homogenous reactor model, the highest conversion obtained with a Reynolds number of 100 (29.5 kg/h) was 9.14% using a 1/6 inch catalyst diameter. Due to the low effectiveness factors and high carbon deposition rates, a fluidized bed is recommended as the appropriate reactor to carry out glycerol steam reforming.

Keywords: computational fluid dynamic, fixed bed reactor, glycerol, steam reforming, biodiesel

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2814 A Theory of Aftercare for Human Trafficking Survivors: A Grounded Theory Analysis of Survivors and Aftercare Providers in South Africa

Authors: Robyn L. Curran, Joanne R. Naidoo, Gugu Mchunu

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Along with the increasing awareness of human trafficking, is the acknowledgement that it is no longer just a social problem but also a significant public health problem that requires both increased knowledge and the specialist equipping of aftercare providers such as nurses who care for human trafficking survivors. Current discourse regarding aftercare of human trafficking survivors, is that approaches do not clearly explain the function or content of aftercare and what aftercare entails. Although psychological and medical aftercare are emphasized as important components, little practical attention is devoted to what these components actually involve and the effectiveness of current practice in aftercare. Review of the literature on the processes that take place from aftercare to empowerment, revealed the need for emphasis to be placed on the voices of survivors concerning their liberation from oppression. The aim of the study was to develop a theory for aftercare of human trafficking survivors, through analyzing the experiences of survivors and aftercare providers in shelters in three provinces in South Africa. Through using a Straussian grounded theory approach, the researcher developed a theory to inform care of human trafficking survivors in low resource settings using the voice of the survivors and those experienced in direct care of human trafficking survivors. Four human trafficking survivors and three aftercare providers from three shelters in three provinces in South Africa were individually interviewed in order for the theory to emerge. The findings of the study elicited a theoretical model of the renewed self, and the conditions that facilitate this process in care of human trafficking survivors. The process that human trafficking survivors navigate to empowerment require mutual collaboration of the aftercare provider and survivor as the survivor awakens vision, confronts reality, re-salvages autonomy and liberates self. Psychological resilience of the survivor facilitates the transition to renewed self. The recommendations of this study may improve the nursing care provided to human trafficking survivors and equip professionals with knowledge and skills to promote the process of renewing self for survivors.

Keywords: aftercare, aftercare providers, grounded theory, human trafficking survivors

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2813 Assessment of HIV/Hepatitis B Virus Co-Infection among Patients Living with HIV in Northern and Southern Region of Nigeria

Authors: Folajinmi Oluwasina, Greg Abiaziem, Moses Luke, Mobolaji Kolawole, Nancy Yibowei, Anne Taiwo

Abstract:

Background: Occurrence of HIV infection has an adverse effect on the natural causes of Hepatitis B Viral (HBV) infection, faster progression of hepatic fibrosis demonstrated in patients with co-infection. This study was carried out to determine the incidence of HBV infection among HIV-positive patients, and to retrospectively evaluate laboratory characteristics of patients with HIV/HBV co-infection. Methods: A retrospective analysis of patient files for all HIV-infected cases followed-up and treated at 52 health facilities. Among HIV-infected cases, those with HBsAg positivity and HIV/Hepatitis B co-infection were determined. Socio demographic, alcohol or substance use, ART, CD4, Viral Load levels and treatment durations were retrospectively evaluated. Results: Of the 125 HIV-infected patients evaluated retrospectively, 17 (13.6%) had HBsAg positivity. Of these 17 cases were 11(64.7%) male and 6 (35.3%) female, with a mean age of 48.7 years. No patients had a history of alcohol or substance use. The mean duration of follow up was 28 months. 9 (52.9%) patients had negative HBV DNA at presentation while 8(47%) had positive HBV DNA, with normal ALT levels in all subjects. Among the 9 cases with negative HBV DNA who had no indication for the treatment of chronic hepatitis B. In five cases, treatment was commenced since HBV DNA was elevated in conjunction with low CD4. One patient in whom treatment was not indicated based on HBV DNA and CD4 levels in conjunction with the absence of AIDS defining clinical picture was currently being followed-up without treatment. Of the patients receiving HAART therapy, the average CD4 count at presentation was 278 cells/mm3 vs. 466 cells/mm3 at the end of 12 months. In three subjects with positive HBV DNA, a decrease in HBV DNA was noted after initiation of treatment. In four patients with negative DNA who received treatment, the HBV DNA negative status was found to remain, while one patient who did not receive treatment had elevated HBV DNA and decreased CD4 levels. Conclusion: It was shown that this group of patients with HIV/HBV co-infection, HAART was found to be associated with a decrease in HBV DNA in HBV DNA positive cases, absence of transition to positivity among those with negative HBV DNA, and with increased CD4 in all subjects.

Keywords: Hepatitis B, DNA, anti retroviral therapy, co-infection

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